Overcoming Binge Eating: Seeking Help Beyond Medication

Doctor, it's still me... (referring to binge eating disorder)

Hello Doctor,
Actually, I couldn't wait for a reply, so I went to Cheng Kung University Hospital on my own.
I thought I would just take a chance and see which doctor I would encounter, and it turned out to be the doctor you recommended, Dr.
Yang Yan-Guang.
He was really great and asked me detailed questions about my condition and why I was experiencing it.
When he asked if my binge eating would affect my menstrual cycle, I said no, but I shared that I had a period of over five months without menstruation while preparing for entrance exams.
After discussing a bit more, he told me that even though I was relying on willpower, the part of my brain that controls emotions, eating, and my menstrual cycle might be more sensitive (he showed me a diagram).
Therefore, relying solely on willpower would be very difficult and might not yield good results.
He suggested that I could try medication to assist me, combining both approaches for better control.

He noticed my hesitation about taking medication because I kept asking him about potential side effects.
He first asked if I was ready to use medication, and since I didn't say no, he prescribed a small amount for me to try (it was Sertraline).
He scheduled a follow-up appointment for a week later to see if the medication was suitable.
However, after taking the medication on the first day, I felt very uncomfortable, dizzy, and nauseous.
Although he had warned me about these possible symptoms, I still didn't want to continue taking it because I have always been somewhat resistant to Western medicine (I hope this doesn't come off as criticism of Western medicine).
This might be related to my frequent visits to traditional Chinese medicine practitioners and my reading of some natural therapy books.
Therefore, I haven't taken the medication for the past few days, and I probably won't go back for a follow-up.
However, my condition worsened last night; I cried a lot and even thought about using the sleeping pills the doctor prescribed to commit suicide.
It was only because a friend called and chatted with me that I started to feel better.
I shared my situation with that friend, who had also experienced severe depression for a while and attended a course by a teacher named Xiao Zhang at school, so he was able to provide timely support.

I apologize for sharing so much, but I just wanted to ask you one question: Is it possible for these symptoms to improve without medication? I feel that if I resist medication, then it wouldn't be effective for me.
On the day I took the medication, I even told myself I would try it to see if it could really help me, but then I went and binge ate again! It feels absurd! I bought a book yesterday titled "Group Therapy for Eating Disorders," and after skimming through it, I felt that the situations described in it were similar to mine, and it articulated the psychological aspects of my episodes.

Are there currently any treatment groups like this in Taiwan? Thank you for your response.

yij, 20~29 year old female. Ask Date: 2004/01/09

Dr. Chen Guangpeng reply Psychiatry

Dear netizens,
I regret to hear that the medication has caused you discomfort.
However, there should be a significant buffer zone between the discomfort from medication and the decision not to seek medical advice; it does not necessarily lead to such mutually exclusive outcomes.
For instance, there is room for adjusting dosages, changing medications, or discussing non-pharmacological therapies.
Traditional Chinese medicine (TCM) and other alternative therapies do have their value, but many lack scientific validation.
If they are ineffective, they may simply waste time and money, or even delay treatment and undermine morale.
The concern is that some adverse reactions may go unnoticed, potentially harming the body.
This has been evidenced by recent serious issues arising from natural substances like Aristolochic acid and yam.
I have a background in pharmacy and have studied traditional Chinese medicine and pharmacognosy.
The evolution of human history began with natural remedies, but among the myriad materials and methods, the effective and successful ones are limited.
Through scientific scrutiny, we have gradually refined and advanced modern medicine.
You should be aware of the existence of "scientific TCM." It is a well-established fact that Western medicine has side effects, but these are results obtained through experimentation, and Western medicine honestly confronts and diligently addresses them.
In contrast, the myth that TCM is milder and free of side effects, or that many therapies have never been systematically screened for adverse reactions, often leads to patients paying the price for their health only after the fact, or to embellishing mistakes and disappearing altogether.
As intellectuals, should we not engage in more comprehensive scientific thinking rather than relying on hearsay?
Today's alternative therapies may one day become mainstream, but the only path forward is through scientific validation, not through aggressive marketing or empty promises.
Many scientists, like you, hope for more treatment options and are continuously researching newly proposed therapies to understand their efficacy and side effects.
Until definitive results are available, wise individuals should pragmatically assess the pros and cons of existing therapies rather than blindly becoming someone else's guinea pig.
Furthermore, we must be more cautious in verifying the sources and credibility of the knowledge we acquire.
We often criticize various Western medical therapies easily because they are transparently presented before us.
Did you know that a new drug must undergo nearly ten years of research and submit a substantial amount of experimental data to the U.S.
Food and Drug Administration to obtain approval for market release? However, which alternative therapy you prefer has truly existed (let alone been tested) for over ten years? Which has been certified by a reputable international authority? TCM has been proven effective in many areas, but this does not include psychiatry.
The efficacy of TCM is assessed through modern scientific examination of past therapies, and it is well-known that the past Chinese communities did not prioritize or address psychological or mental issues (and still do not to a significant extent).
The more unfortunate cases were viewed as superstitions, relegated to the realm of the divine, leaving TCM out of the equation.
The more astute individuals transformed their complaints into various physical ailments, avoiding discussions about environmental or psychological pain, leading to a focus on symptomatic treatment without addressing the root causes.
Consequently, no effective therapies could be passed down, leaving you to wonder what help you could gain from them.
Dr.
Yang is correct; human emotions, desires, and behaviors are determined by our brains, much like a computer's calculations depend on its hardware and software.
If a computer malfunctions and is not compared with a human counterpart, you may not realize an error has occurred.
Your current feelings, thoughts, and actions, especially reflexive ones, are entirely controlled by a diseased brain.
The underlying therapeutic approach must address the brain.
You have many entrenched ideas, akin to a program with bugs, which not only affect your condition but also influence your attitude toward treatment and its effectiveness.
I hope that this lengthy discourse can awaken your insight, while the various aspects of group psychotherapy may be secondary.

Reply Date: 2004/01/09

More Info

Overcoming binge eating is a complex issue that often requires a multifaceted approach, especially when considering the psychological and physiological aspects involved. It’s commendable that you are seeking help and exploring various avenues for recovery. While medication can be beneficial for some individuals, it’s important to recognize that it is not the only solution, and many people successfully manage their symptoms through therapy, lifestyle changes, and support systems.

Firstly, it’s crucial to understand that binge eating disorder (BED) is often linked to emotional distress, anxiety, and depression. The feelings of discomfort you experienced after taking medication, such as dizziness and nausea, are common side effects, and it’s understandable to feel hesitant about continuing medication if it doesn’t sit well with you. However, it’s also important to communicate these feelings with your healthcare provider, as they may be able to adjust your dosage or suggest alternative medications that might be better tolerated.

In terms of non-medication strategies, cognitive-behavioral therapy (CBT) has been shown to be particularly effective for treating binge eating disorder. CBT focuses on identifying and changing negative thought patterns and behaviors related to eating. It can help you develop healthier coping mechanisms for dealing with stress and emotional triggers that lead to binge eating. You mentioned that you bought a book on group therapy for eating disorders, which is a great step. Group therapy can provide a supportive environment where you can share experiences and learn from others facing similar challenges.

In Taiwan, there are various support groups and therapy options available for individuals struggling with eating disorders. Organizations such as the Taiwan Association for Eating Disorders offer resources and may facilitate group therapy sessions. It would be beneficial to reach out to local mental health professionals or organizations specializing in eating disorders to find a suitable group or therapist.

In addition to therapy, consider incorporating mindfulness practices into your daily routine. Mindfulness can help you become more aware of your eating habits and emotional triggers, allowing you to respond to them in a more constructive manner. Techniques such as meditation, yoga, or even simple breathing exercises can help reduce anxiety and improve your overall emotional well-being.

Nutrition also plays a significant role in managing binge eating. A balanced diet that includes a variety of nutrients can help stabilize your mood and reduce cravings. Focus on whole foods, such as fruits, vegetables, whole grains, lean proteins, and healthy fats. Avoiding highly processed foods and excessive sugar can also help regulate your energy levels and mood.

Lastly, building a strong support network is vital. You mentioned a friend who has been supportive; consider reaching out to more friends or family members who can provide encouragement and understanding. Sometimes, just talking about your feelings can alleviate some of the burdens you carry.

In conclusion, while medication can be a helpful tool in managing binge eating disorder, it’s not the only path to recovery. Therapy, mindfulness practices, nutritional changes, and a supportive community can all contribute to overcoming binge eating. It’s essential to find what works best for you and to remain open to exploring different options. Remember, recovery is a journey, and it’s okay to seek help along the way.

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