BED Not Surgically Removed

Hi all: So one year out from VSL, down about 120 lbs, which is really great and all, but I have discovered that I still have Binge Eating Disorder. I can't binge the way I used to, thank god, but I've gotten comfortable with my sleeve and it has gotten comfortable with me. I have not lost all the weight I wish to lose, either, but my head is not well, or at least not in recovery mode. I'm considering going back to OA meetings for the support there. Has anyone dealt with this? I do not want to regain my lost weight, of course! I know it happens to the best of us. I would love to find an online version of BED/VSL support if anyone knows of anything like that. Than you!

I would recommend talking with your PCP about management of BED and getting a recommendation for a psychiatrist, preferably one who deals with eating disorders. In addition, cognitive behavioral therapy has proven especially effective for managing BED.

Thank you. I've been in therapy off and on forever to try to determine what drives my emotional eating, plus many years in OA (and do I need to mention I'm a lifetime WWs member?). This issue has dogged me my whole life. I will continue to seek answers and I am so happy for the support I find here on OH.

Binge eating disorder treatment benefits the most from therapy. I use DBT for it, and augment this with psychodynamic therapy for long-term results. CBT is very effective in the short term, however in the long-term it becomes an insight based process, and CBT does not utilize insight. DBT in particular is pretty big right now as the new treatment modality, and it works very well with eating disorders in general. Many of the treatment centers are shifting to more DBT models.

This is because eating disorders occur as a result of environmental stimuli. That is, we aren't born with an eating disorder - we develop them as a response to trauma or averse environmental events. The eating disorder serves a very important purpose: it helps us survive it. Much like a personality disorder, eating disorders are the brain's way to regulate emotion and to establish control over the environment.

You see, all eating disorders have nothing to do with food. Really they are about control - maintaining it, and reestablishing it when we have previously lost it. The food is a red herring, a distraction.

DBT excels at treating these initially because it focuses on mindfulness, emotion regulation, distress tolerance, and communication skills. Typically, when individuals have developed an eating disorder, many of these domains falter. Binges are often a result of compulsivity and impulsivity, and so these skills directly circumvent it.

Don't get me wrong - CBT works well too, but CBT we are now finding in much literature does not have as good long-term effects in general as psychodynamic therapy or DBT. This is because lasting change comes from being able to tolerate distress, regulate emotions, and insight. Changing cognition is important, too, and DBT evolved out of CBT because the creator (Marsha Linehan) herself has borderline personality disorder (again, PDs develop for the same reason as EDs in many cases) and expanded upon and evolved CBT into DBT specifically to treat this.

The Binge Eating Disorder Association has a lot of good resources that you might find helpful to get the services you need :)

Thanks for this great info about DBT vs. CBT!

Thank you for this beautiful response, Donna. Others have recommended DBT and I will investigate.

No problem:)

And, CBT and other workbooks are actually great to do on your own...studies have given them high efficacy.

One that is very good which I have used myself and given to clients is The Food and Feelings Workbook. I prefer the paper version because it's worth writing in, IMO, but the ebook is sure convenient! At any rate, this draws from many theoretical orientations. It's one of my current favorites.