Bipolar Disorder Cyclothymia and Binge Eating Disorder, What to do

The understanding of binge eating and overeating has come into its own these days. I just finished some new training on binge eating and would like to pass on a few ideas and some resources.

First, I see it as the number one eating problem of bipolar disorder patients:

1. unconscious eating, heavy grazing of food
2. overeating, large amounts
3. eating when full or not hungry

Unlike Bulimia, there may not necessarily be planned binge eating with Binge Eating Disorder (which is a new term and evolving). However, there is overeating when not needing food. The triggers for this could be both genetic and inherited as well as primarily stress.

Unlike the rampant hunger given by Zyprexa and some other medications, the binge eat does not have a severe appetite problem. They feel full. While there are many ways to look at the triggers, it seems too much depth analysis of that may not help: insight into the triggers helps as does behavioral therapy, or actions to intervene. The number one aid for this is charting or monitoring.

There is a problem with BED for patients even treated well. I do see more BED with lamictal use as well as Abilify. But, for those on good regiments, say lithium, BED can come about because

1. mood and stress problems are reduced and to leave that chaotic lifestyle can actually be a stressor of itself: what do I do with my time and mind now it’s calmer
2. there is an expectation that the good mood medication alleviates all life woes and you are impervious to life stress and struggle. Change, shift, stress, work problems and so on will still come into your life.
3. there are problems in life like biting your nails and overeating that are pretty hard to overcome.

If you are an overeater, and you binge half the time in a month, putting 5 to 10 lbs a month is easy. And, most patients then blame their medication. While there are those that clearly cause weight gain, there are those that do not……hmmmm, the problem might be you and your eating? Ya think?

And, if it is you and binge eating, there is no mood medication that greatly impacts this. The diet medications should be used with extreme caution if you are bipolar. They could help and they could open mania. Its a big gamble.

I would like to recommend books and materials that are current to the last 8 years so that they include new information on overeating and different types of binging.

If you have a website or book like this you’d like to recommend, please put that in the comments section below. Thanks, Dr. Bunch

Here are a couple of recommendations for information: