Treating Eating Disorders by Addressing Emotions

At the heart of many who struggle with eating disorders is a distorted vision of themselves. Instead of seeing reality, these individuals have an intense dissatisfaction with their physical self when compared to others, and this leads to a distortion of their body image.

It often becomes a pattern in disordered eating behaviors to binge eat as a correction for negative emotions. In order to distract themselves from the intense pain they are feeling, the individual focuses entirely on eating. When an individual is experiencing body image distortion, these negative emotions can occur often and severely.

A new approach is being tested for treatment of patients with binge eating disorders. The patients are being enrolled in dialectical behavior therapy, which addresses the negative emotions that lurk behind the binging through therapy. In the past, dialectical behavior therapy has only been tested against the absence of any therapy. In a new study, DBT is tested against an existing form of treatment.

The study was conducted at Stanford University earlier this year by Debra Safer, Athena Hagler Robinson and Booil Jo and was published in Behavior Therapy. The authors, believing that much of binge eating disorder is related to the suppression of negative feelings, wanted to test DBT in a randomized controlled trial.

DBT focuses on helping patients identify and regulate emotions as an intervention for binge eating disorder. The researchers recruited 101 participants and randomly assigned them to two groups either receiving 20 sessions of DBT or 20 sessions of an active control group treatment.

The DBT group was conducted in only group therapy sessions and did not include any interpersonal effectiveness module. The active control group treatment (ACGT) was designed to imitate therapy for depression and emphasized discussions about personal strengths and focused on raising self-esteem.

The patients were assessed before treatment began, immediately following treatment and at 3, 6, and 12 months after treatment.

The results showed that participants in the DBT group responded to treatment much more quickly than did those in the ACGT group. In fact, 64 percent of the DBT participants reported no binge eating immediately after the end of treatment, compared with a rate of 36 percent in the ACGT group.

However, at subsequent follow-ups, there was no difference recorded between the two groups for binge eating abstinence. Both types of treatment generally were effective. In addition, DBT did not appear to be effective in developing emotion regulation skills among the participants in the group.

The findings of the study reveal that while DBT may be effective as a treatment for binge eating disorder, it may be particularly a good choice for treatment when a person is in need of immediate progress in recovery.

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