Fargo research center studying new treatment for binge eating disorder
FARGO - Binge eating disorder isn't simply "eating too much," nor can it be treated by simply "eating less."
Dr. Stephen Wonderlich, chairman of the Sanford Eating Disorders and Weight Management Center and director of clinical research at the Neuropsychiatric Research Institute in Fargo, was awarded a National Institute of Mental Health grant to study a new treatment for binge eating disorder.
"It's designed to help people have sort of a 'crisis-management plan' in place in case they're at risk," he says.
The goal is to enroll 56 people at NRI and 56 at the University of Minnesota Medical School in Minneapolis in the three-year study, which started this past winter.
Wonderlich's counterpart at the U of M, assistant professor Carol Peterson, says the timing couldn't be better.
Binge eating disorder was added to the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), published in May 2013, thanks in large part to the work of Wonderlich, who was on the DSM-V task force.
The manual defines the disorder as "recurring episodes of eating significantly more food in a short period of time than most people would eat under similar circumstances, with episodes marked by feelings of lack of control.
"Someone with binge eating disorder may eat too quickly, even when he or she is not hungry. The person may have feelings of guilt, embarrassment, or disgust and may binge eat alone to hide the behavior.
"This disorder is associated with marked distress and occurs, on average, at least once a week over three months."
Previously, binge eating fell under the catch-all category of "eating disorders not otherwise specified."
With the new categorization, Peterson says, "We can really try to develop a treatment for a disorder that we think is going to be more widely recognized."
She says binge eating in the overweight and obese was first described in the 1950s but dropped off the radar in the years since.
However, it's similar to bulimia nervosa, a more commonly understood eating disorder; the main difference is there's no purging in binge eating.
"You see the same thing as far as a rapid consumption of food, a sense of loss of control, a lot of shame and negative emotions that both trigger the symptoms and result from the weight gain," Peterson says.
So, it makes sense that it be treated similarly.
The treatment currently being studied by the NIH and the U of M helps patients identify specific patterns that trigger their binge eating episodes and teaches them strategies to change their eating in those high-risk moments.
Wonderlich says part of the problem with eating disorders is triggers become automatic.
"Most people who have eating disorders maybe either never knew or sort of have lost track of what are the cues and triggers which are driving their behaviors," he says.
Called integrative cognitive affective therapy, or I-CAT, the new treatment will be compared to the typical treatment for binge eating disorder, cognitive behavioral therapy.
Participants use "electronic diaries" (their cellphones) to record what they're doing, how they're feeling, and how that relates to their eating.
"Our treatment uses this technology-based information to develop interventions that are very much what we would call 'momentary-focused'; they're focused on trying to change moments of people's lives and choices in people's lives, as opposed to trying to change people, more broadly," Wonderlich says.
In conjunction with the study, he's working on a book that explains I-CAT, with the goal of publishing within a year to a year and a half.
"The eating disorder treatment community, around the U.S. and around the world, is excited to get the book so people can start figuring out how to do this treatment," he says.
If you're interested in participating in the study, call (701) 365-4920.
Readers can reach Forum reporter Meredith Holt at (701) 241-5590