A Closer Look: Binge Eating Disorder Intensive Outpatient Program
The Emily Program offers a wide array of treatment options for clients at all levels of care. Today, let's take a closer look at our binge eating disorder (BED) intensive outpatient program (IOP). We sat down with Katelyn Burrows, BED IOP Program Coordinator in Cleveland, to learn more.
Q: We all overeat from time to time. So what are the signs that someone may actually have binge eating disorder?
A: You're right, most people overeat occasionally. Whether it be at a party, a restaurant, or just wanting to finish a really good meal. After overeating, someone without binge eating disorder (BED) may feel full, but will most likely go about their day without too much thought to how much they ate. This is not binge eating.
According to the American Psychiatric Association (APA), BED is characterized as recurrent episodes of binge eating. That can range from 1-3 binge eating episodes per week (mild) to 14 or more binge eating episodes per week (extreme). For a BED diagnosis, a binge needs to occur at least once a week for 3 months. A binge eating episode includes eating considerably more than what most people would eat in a 2 hour time period. So in 2 hours, I might have dinner, seconds, and a big dessert. I might feel uncomfortably full, but this wouldn’t be considerably more than what most people would eat. Another characteristic of BED is a sense of lack of control over eating during the binge eating episode. This means, feeling like you can’t stop eating or control what or how much you’re eating.
Binge eating episodes include a few other characteristics. During a binge eating episode, someone with BED may eat at a much more rapid pace than normal, eat until feeling uncomfortably full, eat large amounts of food when not feeling hungry, eat alone due to embarrassment over the amount eaten, and feel disgusted, depressed, guilty, and ashamed after eating. Compared to overeating, binge eating is more frequent, more intense, and comes with many more emotional effects.
Q: What is The Emily Program's philosophy on treating binge eating disorder?
A: At The Emily Program, we treat BED with Cognitive Behavioral Therapy (CBT). CBT is an evidence-based treatment for adults with BED. In CBT, we look for what is going on behind the scenes of eating disorder behaviors. What were the thoughts you were having and the emotions you were feeling? From the CBT perspective, thoughts, feelings, and behaviors are all connected. There is often a lot of rigidity, blaming, and black and white thinking associated with BED (“If I have one slice of pizza, I will eat all of it”). We use a process called cognitive restructuring to identify and challenge these negative, maladaptive thought patterns.
We also work toward mindful and intuitive eating. When eating intuitively, we are paying attention to hunger and satiety cues to tell us “I’m hungry, I should eat” or “I’m getting full, I can stop now.” We are also paying attention to what sounds good. I have a sweet tooth, so I know that I should incorporate something sweet into a meal or snack if I’m really wanting it, that way I don’t feel deprived. When eating mindfully, we are really slowing down the eating process, paying attention to what our food looks like, smells like, and tastes like. We notice what it feels like to chew something crunchy, or how our mouths may water before taking the first bite of something delicious. By slowing down eating, we let our bodies have time to have a more accurate sense of fullness, and typically we feel satisfied with less. We incorporate mindful and intuitive eating into our treatment program here at The Emily Program.
Q: What does a typical day look like for a BED client at The Emily Program in Cleveland?
A: Every day of the week is similar, but slightly different. In the BED Intensive Outpatient Program (IOP), we meet three days a week. Every day includes a meal or snack, where we practice checking in with hunger and satiety cues and eating mindfully. Every day we spend time reviewing previous meals and snacks, problem solving when needed, and planning ahead to help everyone be successful in vulnerable situations. We focus on successes, and identify what the client did to help him/herself be successful. It’s often much easier to focus on the things we aren’t happy with, or our perceived flaws/failures, so we make sure to highlight all the hard work and progress that can be overlooked. A typical day in IOP will also include a strong focus on CBT skills. That may include cognitive restructuring, relaxation techniques, problem solving, or how to set up the environment to support success. We also have one group a week that focuses on using CBT to target body dissatisfaction. We are always looking for negative or inaccurate thoughts (cognitive distortions) that have an impact on how people think about themselves as a person, their bodies, and their food. Once we are aware of what those cognitive distortions are, we are better able to challenge them and change thought processes, feelings, and what we do.
To schedule an assessment or make a referral, please call 1-888-EMILY-77. There is help. There is hope.