Binge Eating Disorder

DSM Diagnostic Criteria Recurrent episodes of binge eating, which is characterized by eating, in a discrete period of time, an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances, and a sense of lack of control over eating during the episode The binge-eating episodes are associated with three or more of the following Eating much more rapidly than normal Eating until feeling uncomfortably full Eating large amounts of food when not feeling physically hungry Eating alone because of feeling embarrassed by how much one is eating Feeling disgusted with oneself, depressed, or very guilty afterwards Binge eating disorder (BED) has a reported prevalence of 6.6%, with equal proportions in women and men. The prevalence of BED increases to between 9% and 19% in obesity clinic populations and between 9% and 47% among bariatric surgery patients. Obese patients who have BED appear to be significantly older than non-obese patients who have BED. Additionally, as the degree of obesity increases, the prevalence of BED also seems to increase. This suggests that binge eating may be a risk factor for weight gain and/or obesity. It is important to note that obesity itself is not a criterion of BED, and the disorder is clinically significant and distinct from typical obesity. In comparison to obese patients without BED, obese patients with the disorder have lower self-esteem and greater depressive symptoms. Obese patients with BED also have more comorbid psychiatric disorders such as mood, anxiety, and substance use disorders. When comparing individuals diagnosed with BED, obesity, and bulimia nervosa, studies show that...

Exercise Addiction

Considering its benefits, both mentally and physically, regular exercise can be viewed as beneficial and even therapeutic. However, when practiced obsessively, rewarding behaviors such as exercise can trigger severe negative consequences. Exercise addiction has been associated with eating disorder traits such as concern for weight and perfectionism. In fact, eating disorders are the most common disorder to co-occur with exercise addiction, although exercise addiction can also be comorbid with other addiction disorders such as substance and alcohol abuse. While the DSM-V lists only gambling under behavioral addictions, researchers have modified the DSM-IV TR criteria for substance dependence to identify exercise addiction. Tolerance: in order to feel the desired effect (a “buzz” or sense of accomplishment), the amount of exercise increases Withdrawal: negative effects such as anxiety, irritability, restlessness, and sleep problems occur in the absence of exercise Lack of control: attempts to cease exercising for a period of time or to reduce exercise level are unsuccessful Intention effects: consistently exercising beyond the intended amount or exceeding the intended routine Time: a great deal of time is spent recovering from, preparing for, and/or engaging in exercise Reduction in other activities: occupational, recreational, and/or social activities occur less often or stop altogether as a direct result of exercise Continuance: continuing to exercise despite the behavior creating or exacerbating psychological, interpersonal and/or physical problems To understand how exercise can become an addiction, clinicians can refer to the “Four Phase” model. In the first phase, exercise is recreational and occurs primarily because it is rewarding and pleasurable. In the second phase, the exercise has become an at-risk behavior, with the exercise becoming more...

Nutritional Counseling Services

Center for Hope offers nutritional counseling as part of our multidisciplinary approach to mental health. Our registered and certified dietitian, Amanda Atkinson, MA, RD, CD, provides outpatient and intensive outpatient care for our practice. To achieve optimal health for clients, Amanda collaborates with primary care physicians, psychiatrists, mental health therapists, and other medical providers. Nutritional Services Nutrition Education Meal Planning Sports Nutrition Counseling Personalized Nutritional Health Counseling Amanda is experienced in treating clients with eating disorders, exercise addiction, and maladaptive relationships with food. She strives to help those struggling with eating issues to gain a healthy relationship with food through Intuitive Eating, a philosophy that focuses on mindfulness and where all foods can fit. Environments like the grocery store or a restaurant can trigger dysfunctional thoughts and behaviors for those struggling with disordered eating. Amanda provides assistance navigating those environments to prepare clients for life outside of treatment. Additionally, Amanda provides sports nutrition counseling through the high school level. To sustain peak performance, Amanda ensures athletes have the proper nutrition to complement their physical activity. Non-athletes and those without eating disorder symptoms benefit from one-on-one support regarding nutrition education and meal planning as well. With abounding diets and conflicting theories, it can be a challenge to know what’s true when it comes to food. Amanda helps all clients decipher between nutrition myths and facts so they are able to make informed choices from the grocery store to the dining...