BINGE

EATING
DISORDER

Pasian, Jessie Jr.

Parel, Benjamin
Gaddang, Sazzy
 What exactly is binge eating
disorder?
The hallmark symptom of binge eating
disorder is recurring episodes of bingeing,
or eating excessive amounts of food at one
time, without associated purging behaviors
like vomiting, exercising, or medication
abuse
Cont…
Binge eating disorder was only recently (in 2013
with the publication of the 
Diagnostic and Statistical Manual of Mental Disor
ders, 5th Edition; DSM-5
) classified as an official diagnosis. As such,
knowledge about it lags behind that of anorexia
nervosa and bulimia nervosa.
Some facts:
both males and females, however females are
1.5x more likely to engage in such behavior
Tends to be adolescence through young
childhood
Long history of on-again, and off-again dieting
Can happen to anyone and not realizing it
Studies: -International Journal of Eating Disorder

Young girls who were told by their parents

they were “overweight” ended up
developing a higher BMI, and often binged
more as adults than those who didn’t have
much parental pressure.
Studies: -International Journal of Eating
Disorder

Yale University tracked the hunger and

emotional status of women to see when
binge eating occurred. The loss of control
occurred when the participant had felt
depressed, stressed, loneliness, and overall
a negative mood
Cause:
The causes of binge-eating disorder are
unknown. But genetics, biological factors,
long-term dieting and psychological
issues increase your risk.
Risk factors:
 Family history. You're much more likely to have an eating disorder
if your parents or siblings have (or had) an eating disorder. This
may indicate that inherited genes increase the risk of developing an
eating disorder.
 Dieting. Many people with binge-eating disorder have a history of
dieting. Dieting or restricting calories during the day may trigger an
urge to binge eat, especially if you have symptoms of depression.
 Psychological issues. Many people who have binge-eating disorder
feel negatively about themselves and their skills and
accomplishments. Triggers for bingeing can include stress, poor
body self-image and the availability of preferred binge foods.
People who binge eat: S&S
 EMOTIONAL AND BEHAVIORAL:
 Evidence of binge eating, including disappearance of large amounts
of food in short periods of time or lots of empty wrappers and
containers indicating consumption of large amounts of food.
 Appears uncomfortable eating around others 
 Any new practice with food or fad diets, including cutting out
entire food groups (no sugar, no carbs, no dairy,
vegetarianism/veganism)
 Fear of eating in public or with others
 Steals or hoards food in strange places  
 Creates lifestyle schedules or rituals to make time for binge
sessions  
 Withdraws from usual friends and activities
Cont…
 Frequently diets  
 Eating alone out of embarrassment at the quantity of food being
eaten
 Feelings of disgust, depression, or guilt after overeating
 Shows extreme concern with body weight and shape  
 Frequent checking in the mirror for perceived flaws in appearance
 PHYSICAL:
 Noticeable fluctuations in weight, both up and down 
 Stomach cramps, other non-specific gastrointestinal complaints
(constipation, acid reflux, etc.) 
 Difficulties concentrating
Complications:
 Poor quality of life
 Problems functioning at work, with your personal life or in social
situations
 Social isolation
 Obesity
 Medical conditions related to obesity, such as joint problems, heart
disease, type 2 diabetes, gastroesophageal reflux disease (GERD)
and some sleep-related breathing disorders
 Depression
 Bipolar disorder
 Anxiety
 Substance use disorders
Nursing care management:
 Note weight, waist circumference, and calculate body mass
index (BMI).
 Obtain a thorough history.
 Evaluate patient’s physiological status in relation to weight
control.
 Be mindful of the patient’s distorted thinking ability.
 Allow the patient to draw a picture of self.
 Assess dietary intake through 24-hour recall or questions
regarding usual intake of food groups.
 Help patient formulate goals for self (not related to eating)
and create a manageable plan to reach those goals, one at a
time, progressing from simple to more complex.
Cont…
 Listen to or avoid challenging irrational, illogical thinking.
Present reality concisely and briefly
 Review electrolyte and renal function tests.
 Encourage patient to take charge of own life in a more
healthful way by making own decisions and accepting self as
she or he is at this moment (including inadequacies and
strengths).
 Assist patient to learn strategies other than eating for dealing
with feelings. Have the patient keep a diary of feelings,
particularly when thinking about food.
 Teach stress reduction methods as alternatives to eating.
Cont…
Ask client to practice self monitoring in the following tasks:
Limit food intake to one site in the home
Plan food intake for each day
Rearrange schedule to avoid inappropriate eating
Avoid boredom; keep a list of activities on the refrigerator
Decide beforehand what to order in a restaurant Slow down
eating
Drink a glass of water before each meal; take sips of water
between bites of food
Chart your progress
Do not reward yourself with food
Practice relaxation techniques
Best therapy appropriate:
COGNITIVE BEHAVIORAL THERAPY (CBT):

 is the most researched psychotherapy for BED, and at

present, is the best-supported among all treatment
options.
 CBT is a time-limited approach that focuses on the
interaction between thoughts, feelings, and behaviors.
CBT key components:
 psychoeducation
 mindfulness
 self-monitoring of key behaviors
 cognitive restructuring
 establishing regular patterns of eating
 CBT for BED addresses dietary restriction and the
incorporation of feared foods.
 It also tackles thoughts about shape and weight and
offers alternative skills for coping with and tolerating
distress.
Cont…
 CBT for BED addresses dietary restriction and the
incorporation of feared foods.
 It also tackles thoughts about shape and weight and
offers alternative skills for coping with and tolerating
distress.
  It is important to note that the goal of CBT is behavior
change, not weight loss.
 When used for treating binge eating disorder, CBT
doesn't necessarily lead to weight loss.
 Pharmacotherapeutics:
DRUG ACTION INDICATION AND SIDE EFFECTS AND NURSING
CONTRAINDICATIO ADVERSE EFFECTS CONSIDERSTIONS
N

Generic Name: Enhances action of INDICATIONS: SIDE EFFECTS: Assess attention span,
Dopamine, impulse control,
Lisdexamfetamine Indicated for patients • Decreased interaction with others.
norepinephrine by
with ADHD and Question history
  blocking reuptake • appetite.
BED.
from synapses, of cardiomyopathy,
  • Insomnia,
increasing levels in   glaucoma,
Brand Name: extra neuronal space. • Upper abdominal hypertension,
Therapeutic effects:   hyperthyroidism,
Vyvanse pain,
improves attention psychiatric
CONTRAINDICATI
  span in ADHD • headache,
ONS: disorder, renal
• irritability, impairment. Receive
Hypersensitivity to full medication history
Classification: lisdexamfetamine, • vomiting, and screen for
amphetamine
PHARMACOTHER • weight decrease.  interactions.
APEUTIC:
Monitor for CNS
Amphetamine stimulation, increase in
(Schedule II). B/P, weight loss, pulse,
CLINICAL: CNS sleep pattern,
stimulant.
ADVERSE appetite;
EFFECTS: palpitations, cardiac
arrhythmia. Observe
• Abrupt
for signs of hostility,
withdrawal
following aggression,
prolonged depression.
administration of
Patient/family
high dosage may
teaching
produce extreme
• Take early in day.
fatigue (may last for
wks.). Prolonged • May mask extreme
administration to fatigue.
children
• Report pronounced
with ADHD may dizziness, decreased
produce a appetite, dry mouth,
suppression of weight loss, new
weight and/or height
patterns. May or worsened
psychiatric
problems,
palpitations,
dyspnea.
• Suddenly stopping
treatment may cause
extreme fatigue that
can last for wks.
Discontinuance must
be done under the
close supervision of
health care
 DRUG ACTION INDICATION AND SIDE EFFECTS AND NURSING
CONTRAINDICATIO ADVERSE EFFECTS CONSIDERSTIONS
N
Generic Name: - Blocks neuronal INDICATIONS: SIDE EFFECTS: Seizure: Review
sodium history of seizure
Topiramate Indicated for patients  
channels, disorder (intensity,
(Topamax) with Adjunctive
enhances Drowsiness, frequency, duration,
Treatment of Partial-
  GABA activity; dizziness, ataxia,
Onset Seizures, level of
antagonizes nervousness,
Brand Name: Lennox-Gastaut, consciousness). Initiate
glutamate nystagmus,
Syndrome (LGS), seizure precautions.
Qudexy XR receptors and
Tonic-Clonic diplopia, paresthesia, Provide quiet, dark
weakly inhibits
Topamax Seizures, nausea, tremor.
carbonic environment. Question
Monotherapy with Confusion, breast
Topamax Sprinkle anhydrase. for sensitivity to
Partial-Onset, Tonic-
  pain, dysmenorrhea, topiramate, pregnancy,
Trokendi XR Clonic Seizures
dyspepsia, use of other
  CONTRAINDICATI depression, asthenia,
anticonvulsant
ONS: pharyngitis, weight
Classification: medication Migraine:
loss,
Hypersensitivity to Assess pain location,
PHARMACOTHER topiramate. Recent anorexia, rash, duration, intensity.
APEUTIC: Carbonic musculoskeletal pain, Assess renal function.
anhydrase inhibitor. alcohol use (within 6
abdominal pain, Observe frequently for
hrs. prior to or after);
difficulty with recurrence of seizure
pts with metabolic
activity. Assess for
acidosis who are coordination, clinical improvement
sinusitis, agitation, (decrease in
taking metformin (It
flu-like symptoms. intensity/frequency of
is used in patients
with type 2 diabetes)   seizures).
ADVERSE Monitor renal function
EFFECTS: tests, LFT. Assist with
ambulation if dizziness
Psychomotor slowing,
occurs.
impaired
concentration, Patient/family teaching
language problems
• Avoid tasks that
(esp. wordfinding
require alertness,
difficulties), memory
motor skills until
disturbances occur
response to drug is
occasionally.
Metabolic established (may cause
dizziness, drowsiness,
impaired
concentration).
• Drowsiness usually
diminishes with
continued therapy.
• Avoid use of alcohol,
other CNS
depressants.
• Do not abruptly
discontinue drug (may
precipitate seizures).
• Strict maintenance of
drug therapy is
essential for seizure
control.
• Do not chew, crush,
dissolve, or divide
tablets (bitter taste).
• Maintain adequate
fluid intake (decreases
risk of renal stone
formation).
• Report blurred
vision, eye pain.
• Report suicidal
ideation, depression,
unusual behavior.
• Instruct pt. to use
alternative/additional
means of
contraception
(topiramate
END OF PRESENTATION
RESOURCES:

 https://
www.medicinenet.com/binge_eating_disorder_symptoms_and_signs/symptoms.htm
 https://
www.verywellmind.com/treatments-for-binge-eating-disorder-4047408#toc-binge-eating
-disorder-treatment

 https://www.webmd.com/
 https://www.mayoclinic.org/
 https://nurseslabs.com/7-eating-disorders-anorexia-bulimia-nervosa-nursing-care-plans/3
/
 https://nurseslabs.com/imbalanced-nutrition-more-body-requirements/
 https://nurseslabs.com/7-eating-disorders-anorexia-bulimia-nervosa-nursing-care-plans/4
/
 https://www.nationaleatingdisorders.org/learn/by-eating-disorder/bed
 https://
docs.google.com/document/d/1DzWYqGOZBsJl2HvyuuZFtIFkt5tMHoLABqPO10Ecx7s/edit