Dialectical Behavioral Therapy
Binge Eating Disorder & Bulimia
Can DBT help treat Binge Eating Disorder and Bulimia?
DBT has also been adapted to treat clients with symptoms of Binge Eating Disorder (BED) and Bulimia (BN). The adapted version has been created to help those whose primary treatment focus in BED and BN. This adapted version combines elements of the functions of two distinct modalities in standard DBT: individual psychotherapy (enhancement of motivation) and group skills training (acquisition/strengthening of new skills). These are delivered in 20 weekly sessions, a 2-hour group format for clients with BED or 1 hour individual format for clients with BN symptoms. In addition this adapted version of DBT includes three of the four skills training modules of standard program DBT ( Mindfulness, Emotion Regulation, Distress Tolerance).
What type of clients might most benefit from receiving this treatment?
The most conservative recommendation at this time DBT as adapted for binge eating and bulimic behavior may be most appropriate for clients who have undergone the standard, evidence-based eating-disorder treatments ( cognitive behavioral therapy and interpersonal psychotherapy) and failed to improve or received minimal benefit. For a client struggling with emotional eating who describes binge-eating episodes clearly triggered by negative emotions ( anger, sadness ) this treatment may be particularly suitable.
Clients we recommend not receive this adapted DBT treatment?
It is not unusual for clients seeking treatment for BED or BN to suffer from comorbid conditions such as mood disorders and Axis II disorders. With clients with multiple symptoms, it is always advisable to prioritize treatment targets. Accordingly, if other serious behaviors, such as current substance abuse or dependance or suicidal behaviors, are present, we recommend postponing the use of DBT for BED and BN treatment until eating-disorder symptoms are the appropriate primary treatment target. That is say, we would not recommend this adapted DBT approach for clients with severely chronic multiple symptoms who are also actively suicidal or who have borderline personality disorder (BPD) or combined BPD with substance dependence.