Ask The Expert: Week 4

Each Friday, I will post a question answered by Dr. Kathryn J. Zerbe. The questions are part of an on-going coversation with Dr. Zerbe from the New York Times.

NY Times Bio
Dr. Zerbe is the author of “The Body Betrayed: A Deeper Understanding of Women, Eating Disorders, and Treatment” (Gurze Books, 1993) and “Integrated Treatment of Eating Disorders: Beyond the Body Betrayed” (Norton, 2008). She has had 25 years of experience working with individuals with eating disorders and directed the Eating Disorder Unit at the Menninger Clinic for five years. She also served on the American Psychiatric Association’s Work Group on Eating Disorders in 2000 and 2006.


Week Four
(Edited to correct typos/spelling in original question)

There is so little focus in our society given to binge-eating. General sentiment seems to be, “go on a diet.” Yet there are some people who’s eating disorders actually manifest themselves via binging and not purging.

Do you think this is changing/will change? Also, are there treatment programs for this? I’ve looked at a couple of web sites, but binge eating seems to be regarded as sort of an “also ran” alongside anorexia and bulimia.

Thanks for your input.

Dr. Zerbe responds:
You are certainly correct that binge eating disorder gets less attention than anorexia or bulimia, but we are learning much more about it because research is starting to focus on it a lot. Doctors are using some medications for it, such as fluoxetine (Prozac), but cognitive-behavioral therapy also can help people who suffer learn coping skills that help them avoid binging.

I certainly agree with you that “going on a diet” is not the answer. One needs to learn what might be causing the person to binge in certain circumstances and to find ways to deal with food that is “all around us” in the modern world. Many people turn to food in times of stress because in our modern society it is so readily available (think of the fast food restaurant down the street or the multitude of snacks and candies in your local grocery store) and how relatively inexpensive food is compared to 50 years ago.

We also tend to eat alone a lot more than in the past (snacking by the computer; having lunch at our desks), so we learn to eat faster and without thinking or talking to anybody. Family mealtimes slow our eating down, and we get psychological nurturance when talking with our loved ones, but so many times nowadays this just doesn’t seem to happen as often as it might.

One concrete suggestion I have for the binge eater is to never get too hungry. Try to eat protein at every meal and always have some low calorie snacks available, especially in the car or at times when you might be tempted to binge. Then, begin to look at the triggers that might cause you to binge. Journal about them, and if at all possible, seek out a professional with experience in eating disorders to discuss them with. You might also consider looking for a helpful book about binge eating that fits your needs by going to the Gurze Books Web site on Eating Disorders at http://www.gurze.com.