Binge eating (psychogenic binge eating): diagnosis and treatment
In order to diagnose binge eating, a doctor needs to take a careful medical history . At the same time, he can ask about the eating habits, physical and mental condition, lifestyle and social environment of the disabled person. In addition, it is necessary to clarify the circumstances under which the potential patient takes food, how frequent the bouts of overeating are, and the type and amount of food taken. In addition, the doctor will perform a thorough physical examination and may request some other tests.
A diagnosis of binge eating disorder
The diagnosis is established on the basis of an anamnestic interview and after clarification of physical and mental problems or problems.
- Body weight and physical diseases . Those affected may be overweight or obese . Depending on how disturbed eating habits are manifested, as well as on the current body weight, the doctor may indicate various examinations (e.g. in case of suspicion of type 2 diabetes mellitus , high blood pressure , etc.). With a long-lasting disease and high body weight, people affected by binge eating have the same health problems as obese patients. In connection with weight gain, other diseases can also develop, e.g. disorders of the thyroid gland .
- Mental status, medication use , substance abuse . The doctor asks the patient if he is taking any medications. Some drugs , such as glucocorticoids , estrogens , insulin or psychotropic drugs , can be involved in changing eating habits and thus lead to weight gain. It is also important to clarify possible mental illnesses (e.g. depression , anxiety disorders , personality disorders ). Other forms of eating disorders must also be considered . The doctor will also take into account the possible abuse of addictive substances (e.g. alcohol ).
- Laboratory examination . The diagnosis also includesthe determination of various laboratory values, such as blood count , lipid metabolism ( triacylglycerols and cholesterol ), glycemia , kidney function tests( creatinine and urea ), urine tests , total protein and albumin , amylase and transaminase. In addition, the doctor can have the level of certain hormones (such as thyroid hormones ) or other laboratory values determined.
- Another examination. The doctor may also indicate some other examinations, such as an EKG , or examinations in connection with orthopedic problems (e.g. with the spine or knees).
Treatment of binge eating
In the treatment of binge eating, different approaches are used, which depend on the individual needs and health problems of the patient. The goal of therapy is not only to prevent overeating and treat physical and mental illnesses, but also to lose weight.
The doctor decides on the most suitable form of treatment. Not only the patient, but also his/her relatives are informed about the disease itself, its consequences and its treatment. In many cases, the disabled seek out a doctor themselves – due to their high body weight – and come to him for advice on the best way to lose weight .
Psychotherapy and eating habits
Treatment usually takes the form of psychotherapy , either on an outpatient basis or during hospitalization . Hospitalization is necessary, for example, if the mental or physical condition of the affected person requires it. Therapy sessions can take place individually or in a group.
Weight loss can be achieved in various ways, e.g. gradual lifestyle changes, healthy eating and a diet that is less rich in calories (see the category Reduction diets ). Information about nutrition and the consequences of excessive food intake can also contribute to the normalization of eating habits (e.g. as part of nutritional counseling ). The doctor may recommend modification of the movement regime or prescribe certain medications, and in extreme cases may even indicate surgical intervention.
In some cases, for example, if the sufferer is diagnosed with depression at the same time as the eating disorder, the doctor may prescribe medication (e.g. antidepressants ). However, it is the doctor, not the patient, who decides on the use of medication.
In the course of therapy, relapses may occur , or even (repeated) interruption of treatment.
Family environment
An important role in the treatment is played by the family of the affected person, or someone else close to him/her. The contribution of parents or legal guardians in all phases of the diagnostic-treatment process can be decisive for the success of the treatment: from the recognition of symptoms to the diagnosis to intensive cooperation with the therapeutic team.
Not only for children, but also for adolescents, important decisions and tasks rest on the shoulders of their parents or legal representatives. The support of relatives plays an important role even in case of relapses, if they occur.
For more information on this topic, see the article Eating disorders: what can relatives do?
Who can I contact?
Adults should first contact their GP , while children and adolescents should first contact their GP . If necessary, the general practitioner will provide further examination and treatment. Doctors of various specializations, possibly even psychotherapists, participate in the treatment itself.
