Binge eating disorder compulsive eating Diagnosis: - DSM5: Binge Eating Disorder - ICD10: "Eating disorder, unspecified" (F50.9) or "Binge eating associated with other psychological disturbances" (F50.4)

Symptoms of BINGE EATING COMPULSIVE EATING:

• Binge eating episodes or eating binges.
• The compulsive eating occurs in phases. Periodic episodes of ravenous hunger. Recurrent eating binges accompanied by a feeling of loss of control. Loss of control.
• Frequency of eating binges: at least once weekly over three months.
• Distress due to the eating binges.
• Large quantities of food are consumed. Eating a lot without being hungry. Eating large amounts of food without physical hunger.
• Mostly high-fat and sweet foods.
• Uncomfortable feeling of fullness. Eating until an uncomfortable feeling of fullness sets in.
• Eating faster than usual, hasty eating ("gulping").
• Eating alone because of shame.
• Following an eating binge: shame, disgust, depression, loss of self-worth, feelings of guilt, dejection.

DD Differential diagnostics for BINGE EATING DISORDER COMPULSIVE EATING:

• The eating binges are not regularly followed by inappropriate compensatory measures.
• Eating binges do not occur exclusively in the context of BN Bulimia or Anorexia Nervosa (AN).
• Eating binges are exclusively psychologically caused and triggered predominantly by negative feelings, stress, boredom.

Risk factors for the development of BINGE EATING COMPULSIVE EATING:

• Restrained eating behavior.
• Overweight.
• Negative body image.

Functional analysis of Binge Eating compulsive eating: Where from = What for this disorder? Maintaining factors (= current causes) for BINGE EATING DISORDER BED COMPULSIVE EATING:

• BED patients cope with the negative cognitions and emotions that normally accompany binge eating by reinforcing a dysfunctional diet-binge cycle.
• An eating binge is followed by a reduction in tension, leading to negative reinforcement.
• The typical BED solution attempts to control the compulsion to eat through restrictions (e.g., abstinence, resistance to food cravings, restrictive eating). However, instead of increasing control over the compulsion to eat, these restrictions tend to increase the desire for food, cause loss of control, and give in to the pleasure of binging.
• Dysfunctional maladaptive emotion regulation.
• Suppressing unpleasant sensations.
• Improving mood.
• Reducing tension.
• Avoidance behavior.
• Frequent rumination about food.
• Frequent dieting.
• Restrictive eating behavior.
• Low self-esteem.
• Self-worth problems.
• Negative emotions.

Psychotherapeutic procedures, goals & approaches for Binge Eating Disorder compulsive eating:

• Cognitive Behavioral Therapy.
• Incremental three-stage BED treatment approach by Fairburn, Marcus, Wilson.
• BST Binge Eating Therapy four-stage treatment approach by Nardone & Salvini.
• Treatment of BED symptoms (binge eating = compulsive eating) such as: eating binges. Binge eating episodes.
• Normalize eating behavior: regular, healthy eating behavior. Change eating habits.
• Too strong a focus on weight reduction can hinder the reduction of eating binges (primary treatment goal for BED Binge Eating compulsive eating).
• Treatment of other psychological complaints such as:
• Recognizing and changing dysfunctional thoughts.
• Tension reduction.
• Appropriate stress management.
• Self-worth regulation. Strengthening self-esteem.
• Affect regulation. Strengthening emotion regulation strategies. Allowing and reevaluating feelings.

Treatment of comorbid mental disorders such as:

• Depression.
• Obesity.
• Self-doubt.

Approaches in the treatment of BED Binge Eating Disorder compulsive eating:

• The therapeutic language is applied strategically restructuring and reframing, logical, rational, demonstratively explanatory, convincing and inviting, suggestive, metaphorically-analogically inducing.
• Assessment, explanation of the cognitive framework for understanding the development and maintenance of BED Binge Eating Disorder:
• The dysfunctionality of controlling binging perception through food reduction should be corrected.
• It should be understood that food-delaying compensation intensifies binging vulnerability, the enjoyment of binging, and worsens the situation.
• It should be understood that the previous disorder was and is maintained by an incorrect and repeated solution attempt.
• It should be understood that such a thinking/perception pattern intensifies the problems.
• It should be understood that only one's own decision to change the meaning of perception and to change one's own reaction can lead to healing.
• It should be understood that weight gain and loss of control overall are the results of food shifting and control attempts.
• Self-observation of eating behavior, binge eating episodes and triggers for binge eating episodes.
• Behavioral goals, contracts & agreements are established and
• Self-instructions = self-verbalizations = self-statements are practiced.
• Increasing self-confidence and self-efficacy:
• Stop dieting behavior.
• Stop fasting behavior.
• Stop restrictive eating behavior.
• Introduction of moderate, flexible, balanced, healthy and regular meals.
• Stimulus control: The situations relevant to a (desired) behavior are changed so that the future probability of this behavior is increased. An automated behavioral chain is interrupted. Through a new arrangement (expanding/reducing) of situational conditions, the probability of the target behavior is increased. The probability of undesired behavior is reduced by restricting situational conditions. For this:
• Identification, reframing and changing dichotomous and distorted cognitions regarding:
• Eating
• Weight
• Body image
• Self-worth
• Self-control beliefs
• Developing and applying problem-solving strategies.
• Intensive practice in creatively developing alternative behaviors.
• Increasing social competence level.
• Increasing stress management, so that eating is no longer used for this.
• Increasing emotion regulation skills.
• Negative emotions are accepted.
• Strategies for coping with interpersonal conflicts are developed and successfully applied.
• Reduction of perfectionism.
• Increasing self-acceptance.
• Self-reinforcement, increasing the sense of self-efficacy and self-image through self-monitoring of one's own successes and change progress. Thereby intensifying the enjoyment of positive self-responsibility.

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