Toss Cravings, Lose Weight
Of 190 million obese Americans, approximately 10-15 percent engage in harmful binge eating. During single sittings, these over-eaters consume large servings of high-caloric foods. Sufferers contend with weight gain and depression including heart disease and diabetes. A new clinical trial, called Regulation of Food Cues, at UC San Diego Health System, aims to treat binge eating by helping participants to identify real hunger and to practice resistance if the stomach is full.
“Most weight-loss treatments for obese adults focus very little on the reduction of binge eating,” said Kerri Boutelle, PhD, principal investigator and associate professor in the department of psychiatry at UC San Diego School of Medicine. “With this study we use a variety of techniques to train the brain to identify and respond to hunger and cravings and to learn resistance to highly craved foods.”
The one-year study will recruit 30 participants who will undergo weekly 60–90 minute sessions held over 12 weeks. Participants will learn how food cravings originate, how to detect and monitor true hunger, how emotional factors influence eating habits, and how to manage cravings and impulses to eat.
“Binge eaters often consume food in response to their environment, even when they are not hungry. This could be a response to watching TV, long commutes, sitting on the couch, time of day, even loneliness,” said Boutelle, who is also a licensed clinical psychologist. “The goal is to reduce cravings to overeat by up to 50 percent.”
Teaching obese people to recognize hunger signals is based upon the principles of behavioral psychology, which has proven effective in treating conditions such as anxiety and bulimia. Boutelle and her team have developed a treatment model that shows that binge eating often results from response to environmental food cues. Exposure-based treatments help eaters improve their sensitivity to hunger and fullness and reduce their sensitivity to the sight and smell of food.
Chronic dieting can result in a numbing of hunger signals and an inability to recognize fullness. If you don’t respond to hunger knocking on that internal door, eventually it will stop knocking! Eating then occurs in response to stimuli other than true hunger and that’s when the troubles begin – oftentimes resulting in emotional eating and rebound binges.
However, with a little attention to the task, you can re-train yourself to recognize and respond appropriately to hunger and fullness signals. Hunger should be embraced and treated as a valued communication with your body – not something to be feared. Listening to your body and taking the time to care for its needs are critical steps in learning to love and care for yourself.
The first step in recognizing hunger signals and, thus, eating intuitively, is to be “present in the moment”. This is difficult to do in our current society where we are constantly looking to the next task even before finishing the prior one. However, taking the time to slow down and “check in” with yourself will provide you with a multitude of health benefits. Realize that it is normal for hunger to occur 3 to 5 hours after eating. Start familiarizing yourself with the different levels of hunger and the individual signals that your body relays to you at various stages. Initiate this process by listening! Check in with your body throughout the day and “rate” your hunger. A common way to rate hunger is on a scale of one to ten with one equivalent to a state of starving and ten being equivalent to a state of extreme fullness or being overstuffed.
Similar programs aimed at overweight youths have yielded promising results and an ability to maintain reductions in binge eating at six and 12 months after treatment.
Binge eating disorder (BED) is characterized by recurrent, persistent episodes of binge eating that occur without regular compensatory behaviors intended to prevent weight gain. Thus, BED is classified in the Diagnostic and Statistical Manual of Mental Disorders IV as an eating disorder not otherwise specified and listed in an appendix as a diagnosis requiring additional study.
The prevalence of BED among the general population is approximately 1% to 2%; however, the rate of BED among individuals seeking treatment for obesity is considerably higher: It is estimated that as many as a third of individuals who present for treatment in university-based weight-control clinics report significant binge eating. Thus, BED is the one of the most common forms of disordered eating, and the search for efficacious treatments is an ongoing goal.
Not surprisingly, treatments designed for individuals with BED have been adapted from those that have effectively reduced binge eating among individuals with bulimia nervosa (BN). Current treatments include psychotherapy, drug therapy, and combinations of the two. This article provides an update on psychological treatments for BED and reviews the rationale and support for these treatments.
Participants who join the study will be asked to complete interviews and surveys before and after treatment groups. In addition, they will complete food logs in which they will be asked to monitor levels of hunger and fullness as well as cravings.
To learn more about this clinical trial, please call 858-405-0263.
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Source: University of California, San Diego Health Sciences