Beyond The Binge

Medication & Binge Eating: Does It Work?

January 07, 2021 Mo Rezk, RD Season 1 Episode 8
Beyond The Binge
Medication & Binge Eating: Does It Work?
Show Notes Transcript

In this episode we dive into the 3 different types of meditation commonly prescribed for binge eating. We also discuss how it works, what it does, what to expect and why some people relapse even while medicating. Is it worth it to go on medications if you're struggling with binge eating? Listen to find out. 

Mo Rezk:

Hello and welcome to another episode of beyond the binge. My name is Mo and I'm a dietitian and binge eating recovery coach. In every episode, I do my best to bring you closer to a life free of binge eating so you can live your best life physically, emotionally, mentally and spiritually, and not worry about binge eating and all the problems that brings in your life anymore. And today we're going to talk about medications and binge eating specifically certain medications that are commonly prescribed to help people overcome binge eating, what to expect from them, how they make you feel, how they actually work, so you can understand what you're putting in your body and what to expect from it. So many people frustrated with binge eating end up going to their doctor despite desperate for help. So doctors aren't really trained in working with binge eating, which is why when confronted with it, there are only two solutions is either to refer to other professionals or to prescribe medications. Many decide to prescribe medications. And so if you're considering taking medication or have been on some for a while, and this podcast is for you. Just a reminder that my signature eight week program beyond the binge is currently 25% off during the pandemic you can apply for it at WWW dot m or is that k.com. This might not be what you want to hear. But the truth is many people prescribe medication for binge eating don't actually recover or get cured from binge eating because there actually is no medication that is specifically targeted for binge eating. In fact, 80% of my clients who come to me for guidance are already on some of these medications that we're about to discuss. And they're still struggling with binge eating. All the medication we're about to dive into are primarily developed for a specific problem. But doctors have somehow found that useful for some binge eating patients. So they use it as an off label blindly with their patients who struggle with benching. And one of my previous podcasts titled The six root causes of binge eating, I discussed one one root cause of binge eating as the end being the imbalances in brain chemicals. But there are five other root causes. Unfortunately, most people have three, four, or sometimes even six out of six root causes for binge eating. So if that's the case, the medication might be helpful short term, but not the long run. And we're gonna understand today how. So let's dive into these different types of commonly prescribed medications and help you understand what they do short term long term so that there's no surprises and you're better prepared for them. I've split the different medication types into three categories that we're going to go through the first category is stimulant medication and stimulant medication Examples are vyvanse, Ritalin and Adderall and vyvanse is actually heavily marketed nowadays and prescribed for binge eating. These medications work by increasing dopamine production in the brain. Dopamine is a neurotransmitter, which is also a signaling chemical that signals the prefrontal cortex, which is our logical center to work more so allows us to feel more motivated, focused, and able to think think more logically. When the brain is low and dopamine we tend to think not think as logical and become depressed and feel down and feel a bit hopeless and helpless. Often, the urge to binge is your body's way of trying to increase dopamine because the body can make dopamine from certain foods, mainly carbohydrates and proteins. And when we're restricting during the day, then that could lower our dopamine. So the urge to binge is sometimes the body's way of trying to increase dopamine. Initially, these medications were actually prescribed for those who have ADHD, and can improve their quality of life without side effects in the long run. with ADHD people are specifically have internally their brain cannot actually produce enough dopamine and that is why they suffer from attention deficit hyperactivity disorder. So this like even while doing everything they can, they still are unable to produce enough dopamine as opposed to people who have normal dopamine production in their brain. So doctors discovered that it can also help with binge eating disorder, although they're unsure how. So then they started prescribing it as an off label for BD. Unfortunately, if you don't have ADHD, the side effects can be quite high taking these stimulant medications because they're actually quite strong. And they can include feeling sick, nauseated constipated, you can develop irregular sleeping patterns become a bit more Insomniac decreases sexual desire and function increases anxiety, irritability, and causes you to be a bit more rigid. I find that the biggest problem is that this class of medication has a very high risk of addiction and dependency. And so if you have a family or personal history of addiction, then it could be a problem in the long run. A lot of people abuse this type of medication to get a high or achieve a certain feeling. So dependency to me, for me is the worst side effect or outcome on this medication. Because what happens is your body adapts to these stimulants. And it's inevitable that when you get a certain amount from this stimulus, the body is going to want more for you to start to maintain that level of of kind of high that you get and function that you get from it. And so as you require more to get the same effect from it, the doctors can increase your dosage until you hit the maximum limit per day and then they can do no more The first few days on this medication can actually feel pretty good and people will report feeling fixed Finally, and cured. But I promise you this feeling wears off. And this is why some development addiction because they try to get creative in achieving that initial feeling again, with the medication, I never recommend you do this. So a lot of people will resort to ways such as like, taking more than they're allowed or even like crushing the pills and stored and snorting them which that is typical addictive behavior so they can attain that high feeling they got in the beginning when they were on this medication and they felt great all the sudden, that initial feeling almost always goes away. And the reason why again, is because your body adapts to it and it kind of feels like a new normal. So you're not really going to feel that as much as when you're when you go through when you've been on it for a while. So the doctors, we said the doctors don't necessarily know how this type of medication works. But the theory is by increasing dopamine in your brain, it can stop benching, if you're benching is caused by any of the following causes that we're going to discuss the first is a lack of dopamine in the brain, where you're unable to make logical choices because your prefrontal cortex is under active and again, that causes you to make decisions that are not really logical OR on par with the goals that you set for yourself. The second is depression, which depletes dopamine in the brain and can leave you feeling hopeless and helpless. And a lot of people when they're depressed, they stress eat or emotionally eat is their way of coping. So again, that depression is mainly caused by low dopamine in the brain. And finally, if you actually have ADHD, and use eating as a form of distraction, that can be a cause as well. So when you have ADHD, let's say they're sitting down to study or sitting down to do something for work, their minds automatically starts looking for distraction, whether it's social media or go to the washroom or getting food and sometimes food is a strong source of distraction. So the downside of these medications is that the body adapts to them, the dependency can be quite difficult. Initially, they might have a strong effect on your bingeing urges, because their strong appetite suppressant. So this is why a lot of people in the beginning say oh, I'm finally cured is because these stimulant medications really suppress your appetite in the short term. But eventually the body adapts to them and your urges can come back again. If you're diagnosed with ADHD, they can certainly help you with your benching in the long run. But that is only if you don't have other factors contributing to revenge eating. So again, I discussed six specific routes, root causes that contribute to binge eating in my program, and actually in a podcast episode that I will link somewhere below. And one of these causes is low dopamine and low brain, other brain chemicals that we're going to get into. But there are five other causes as well. And so if you are struggling with any of the other five causes, then the medication can can help live in the short term, but these other causes will start to cause you to want to binge again in the future. And then what will happen is that you will potentially be given to the urge in the future. And again, this is not to discourage you as much as it is prepare you for what might happen if you're on medication and to also make you understand that it is not your fault that if you're on medication and it does not it is not helping long term. Again, it's not your fault, because there are other causes root causes that need to be addressed addressed for you to be able to overcome benching. What these medications won't solve is binge eating caused by negative thinking, food restriction, poor eating habits and not meeting your energy needs. And basically just kind of like your lifestyle overall, it won't help with that. So this medication, what it will do is it will just kind of give you a bit more focus, and a bit more motivation. But it won't help you know what to do and what's what you know what's right from wrong and what certain thought patterns need to be changed and to rewire reframe your brain, as a lot of people need to win overcoming binge eating. So the first few weeks again, can feel good on his medication. But as your body adapts you find yourself back potentially at point zero if you have other root causes and drug dependency to go along with it. Because to get off to get off stimulant medications is actually pretty difficult. And it takes probably like two weeks or more of going through withdrawal. So that you can adapt again to a new normal and come down from a new high. So this is why you should be very very careful before going on estimate medication and assess if it is if it is something that is worth giving it a go or not. Again, always listen to your doctor. Primarily if you have ADHD, it can help but if you don't, then potentially there are other root causes that can cause you to continue to binge eat while still having this medication. The second category of medications are antidepressants and underneath them there's two two different classes we're going to go to the first one is antidepressants such as bupropion, and examples of that brands like that, that may Group A prion or a plantain for fever and Wellbutrin. Wellbutrin is the most commonly prescribed antidepressant for binge eating disorder. It works by inhibiting the uptake of dopamine from the brain. So again, it functions on dopamine when the brain naturally releases neurotransmitters so like like dopamine, the dopamine will trigger certain nerve cells And then eventually when it's done as job, it will get cleared up again from the brain. And then the brain will release again, depending on what happens. So just kind of ongoing cycle. What happens with this medication is that this class of antidepressants will inhibit the re uptake of the of dopamine. So when dopamine is released, it doesn't get cleared up, it stays there longer. So that means dopamine gets to last longer in your brain. And almost similar to the same as medication except not as strong, because it doesn't actually help you produce more dopamine, it just helps you not clear up the ones that your brain has already released, it helps it last longer in your brain. So this can, this can help you curb your appetite suppress your appetite a little bit again in the short term. As you adjust and allows you it can allow you to make more logical decisions as it helps you stimulate your prefrontal cortex, which is again your logical center of the brain. The downside to these medications is that they don't actually increase dopamine production, they only inhibit the re uptake of it. So if your lifestyle is one that depletes your dopamine, then this might not really be helpful. So the typical lifestyle that depletes dopamine is one where pleasure seeking habits are high, and self care habits are low. So examples of pleasure seeking habits is a lot of junk food, a lot of heavy social media use a lot of pornography, watching, you're playing a lot of video games, watching too much TV things that basically bring a lot of pleasure tend to actually deplete our dopamine and leave us leave us in something called a dopamine deficit state, which I'm sure I'll be making a podcast about because it is a huge thing to discuss. But a dopamine depths estate basically is a period of time where your dopamine is so low, because you spiked it up so high during a certain activity that brings an intense amount of pleasure. And so after that, there's a huge massive load after that we go through. Common side effects of some antidepressants include dependency, headaches, irregular seating patterns, irritability, decreased or increased sexual desire. It affects people differently, nausea, blurred vision, fatigue, anxiety, constipation, and sometimes even increased appetite. These are just some examples and people respond to differently depending on their lifestyle and a lot of internal things. I also found through working with people that because this class of medication can increase your focus, they also tend to keep you stuck on some thoughts or ideas that don't serve you and you can almost say can cause you to be a bit more rigid. Although this is not true for everyone. worth noting that some antidepressants can cause seizures and people who suffer from binge eating and bulimia at the same time. So if if you if you have the habit of a few bulimia in your life right now you struggle bulimia and you purge, then if you are an antidepressant such as bupropion, it can cause seizures if you're doing that. So be very careful and discuss openly with your doctor because again, many people are not are not really ready to tell their doctors they're also started struggling with bulimia or purging. They just mentioned binge eating and then if they get prescribed antidepressants, the doctor doesn't really know that you're also purging and I give you a risk of seizures. So make sure you discuss all that you're experiencing openly before you go on any medication. Like stimulants, these medications can help with negative thoughts or benching as a result of not meeting your energy needs or poor eating habits. So your body will also eventually adapt to them and they will feel like the new normal for you this is again really key is to understand that with all types of medication, the body naturally adapts to it and that becomes a new normal for us. And so if there are other causes or root causes of bingeing in our life, it could still bring it up and allow it to exist. If you suffer from clinical depression, antidepressants can improve the quality of your life. If you're binge if you're binge eating is out of depression, and this could potentially help you but if there are other reasons or factors contributing to a binge eating, then it won't in the long run and benching quit again, find this way back in your life as you get used to this medication and continue to take it because it was also a little bit difficult to to get off antidepressants. Although not as difficult as to me with medication, but you do also still go through a period of withdrawal. I also want to note that with antidepressants, it takes time for for it to work in your in your brain, as opposed to stimulant medication that you can feel almost instantly an effect on your life with antidepressants. It takes a little bit of time as a drug builds up in your system and has its full effect on your brain. The second class of antidepressants we're going to discuss are called selective serotonin, serotonin reuptake inhibitors or SSRIs. And examples of that is Prozac. sertraline, or Zoloft and other anti anxiety medication so this specific type of medication is primarily used as an antidepressant but also anti anxiety so they function both as antidepressants anti anxiety, and this one is a bit de this class is a bit different because it doesn't really work on dopamine as much as it works on the the inhibiting the re uptake of serotonin in the brain. serotonin is another is another neurotransmitter produced in the brain responsible for communicating with parts of the brain involved in habit formation and shifting from thought to thought. I actually want to correct what I just said and say that actually tonin is producing their brain Yes, but actually 90% of your serotonin is produced in the gut. And that is the gut brain connection by the bacteria in your gut. And that is why we stress so much about gut health, and that if your gut is healthy and you're nourishing good, then you're likely to increased produce more serotonin. But on the other hand, if you're not eating foods that are nourishing to your gut bacteria, then you could you will be producing way way less serotonin because again, 90% of the serotonin in your brain is produced by the gut bacteria. So to low serotonin can leave you feeling anxious and fixated on negative thoughts, you find might find it difficult to change from thought to thought. And so it allows you to just stay fixated on certain negative scenarios that can cause you to also binge. This class of medication helps people feel more calm and can be specifically helpful for those prone to obsessive compulsive disorder. And we're going to go into this for a little bit because binge eating can actually fall under the obsessive compulsive disorder spectrum. Not people not all people who struggle with binge eating, also struggle with OCD, but there is a strong correlation between binge eating and OCD. So this is the case for you then selective serotonin reuptake inhibitors can help like antidepressants again, they take two to three weeks to kick in. So let's talk a little bit OCD. OCD is a mental disorder. Unlike what we see nowadays, in social media, such as like Oh, you like things done a certain way are so OCD and that is that is not what OCD is truly is OCD, or obsessive compulsive disorder is compromised of two parts. The first is an obsessive thought. And the second is a compulsion. The obsessive thought is always uninvited and persistent as in the person doesn't really want to think about it. And it brings about massive amounts of anxiety as we fixate on it. So imagine this huge screen in your brain that just you can't seem to turn off. With thoughts. We have multiple different tabs in our in our brain, always we have different tabs like imagine like a web browser open and there's multiple tabs open. At the same time. This is how the brain function, there's multiple things that it thinks off of this. And we can shift from thought to thought to thought to thought with OCD, that intrusive thought is like a huge screen that is there the entire time and you can't seem to minimize and it's just there despite whatever you whatever you do, and it can't seem to go away. This is what the obsessive thought looks like. And it also brings a massive amount of anxiety. Now the compulsion, which is the other half of it, is the person's attempt to making the anxiety go away. Making the thought go away, except it follows no logic whatsoever. And the person knows that but they're unable to stop anyways. So an exam example of that is an obsessive thought that somebody close to you might die and the compulsion is you holding your breath for one minute, there's no there's no logic whatsoever to say that you're you holding your breath for one minute is going to prevent the scenario that that person might die, but you can't help it and you do it anyways. And you know that it is not logical. Or with food specifically, you might start having irrational thoughts that you won't have access to food again. And the compulsion is to binge eat to store that food within you. And that makes the thought go away. Again, no logical no logic and you note as well but you're unable to stop it. OCD can range of severity from mild to very severe depending on how much time and energy it takes from your day there actually tests online tests you can type for free out there, they ask you a few questions and tells you how severe OCD is. Selective Serotonin Reuptake Inhibitors help because the ease the anxiety that comes with resisting carrying out the compulsion. So you have the obsessive thought that's creating anxiety and that anxiety is causing you to act out this irrational compulsion with with SSRIs. They just ease the anxiety by numbing the anxiety completely so you no longer feel the anxiety and you can resist the compulsion and this is what brings breaks the OCD cycle is by resisting that thought compulsion. Connection SSRIs can help decrease benching if it exists in your life as part of an obsessive compulsive disorder. So some SSRIs also work like antidepressants by stimulating the prefrontal cortex, which is the brain's logical center. But primarily they increase serotonin, which helps you ease the anxiety. The downside of SSRIs is that they have their own host of side effects and the most common being emotional blunting long term. So you basically just kind of feel like you're emotionally disconnected and don't care about a lot of things that you used to care about in the law in your life. And that's because it numbs a lot of your emotions, especially your anxiety. If incorrectly prescribed for someone who has low dopamine in the brain, it can cause them to engage in behaviors they might later regret. And this one is huge. A lot of doctors prescribe anti anxiety medication to people who actually have also low dopamine in the brain. And that can cause them to engage in behaviors that they later regret. And that is because anxiety can actually be sometimes good for us. It could contribute to our intuition by preventing us from doing things that go against our values, morals or goals. So imagine, imagine there's a moral of yours and you have you know, US stick to that moral no matter what, like no drinking, for example, and then, you know, you go out with your friends and your friends start drinking around you And they you know, they offer you some alcohol and your your because you have that moral in your life and you don't really you don't you don't you don't drink and you haven't drank for a while you you sense that anxiety that prevents you from drinking because you're like, Oh, I shouldn't really do it. Well, we'll selective serotonin reuptake inhibitors and numbs that anxiety so it might be easier for you to engage in that behavior because there's no anxiety preventing you from doing it. So again, it removes it almost like a removes the brakes from our behavior. So we have to be very careful if you struggle with low dopamine, then select anti anxiety medication could actually make you make you do things that you would later regret. So make sure you mentioned to your doctor if you also feel like you have low dopamine by an exam or get examples of local communities when you feel like you're depressed, can't focus not not motivated anything like that. As always, the body adapts to selective serotonin reuptake inhibitors and so if there are other factors or root causes contributing to benching, they find their way back into your life again. So this is the same with all medication is that medication only works on one of the root causes, which is the brain chemicals, imbalances, but there are other five root causes. And if we struggle with that, a lot of people do have multiple multiples of this multiples of the root cause in their life. It can become difficult to to overcome, overcome binge eating and get rid of it and once and for all. The third class of medication are usually prescribed for patients with epilepsy or seizures, but doctors have been using them as an off label for B for binge eating disorder. And examples of these medications are topamax. These medications can cause heavy side effects such as memory problems, hair loss, and much more. They also don't affect mood at all, unlike antidepressants, or stimulants, but doctors have found that they haven't, they can help some people with binge eating disorder. They're not sure how I'm also unsure how to be honest with you. But it besides other says that it can help as well. Again, this is data taken from real, like reports of doctors who say that this is what the patients say in reality is it could be flawed because it patients could could, you know, could say yes, it's helping me but in reality, they could be struggling with it down the road. Or they could still secretly be struggling with it, but just not open to sharing because they feel a little bit of shame that the medication didn't help and they feel like something is wrong with them when in reality, they're just addressing one of the root causes as opposed to addressing the other five root causes. So the bottom line is that there is no one pill that can fix binge eating. Often medication can help in the short term, but it's not the ultimate solution. And eventually the body adapts. And if you have other factors contributing to a binge eating, then it comes back again. So again, I discussed the six root causes of binge eating and a separate podcast which I'll link below and if you haven't listened to it, I highly recommend you listen to it, because it will give you this awareness of why potentially you're benching still existence persistent and that will allow you to focus on developing complan that can help you overcome the different root causes. So you can overcome binge eating once and for all. Once you identify which root causes effect you're bingeing, and you have a plan to overcome them. I promise you binge eating is very simple to overcome. It's not something that is meant to stay in your life for the rest of your life, you're definitely not broken, it is not something that you're stuck with. You just need to work on the right root causes that allow it to exist, overcome these and that will just all of a sudden Benji will disappear from your life and it won't come back again as you keep these root causes out of your life as well. This is the number one thing I focus on with my clients when working in my programs. If you happen to be prescribed medication, then my recommendation is to combine it with therapy geared towards binge eating disorder as well as nutrition education and coaching that can help you build a flexible lifestyle instead of a restrictive diet. In my program beyond the binge, we combined a therapeutic approach with nutrition coaching, and habit designed to help you accomplish all that. So if you're interested in learning more about it, you can schedule a call with me through the link below. And all my programs again are currently 25% off during the pandemic. If you're not a medication but thinking about it then my best advice for you is to try therapy and coaching first particularly useful is cognitive behavioral therapy, or CBT. Because it helps you rewire your brain and change your thought pattern. And this is actually one of the most important ways of overcoming binge eating is changing, reframing your your your thought patterns and rewiring your brain and changing the thoughts that are going on internally. I use CBT or cognitive behavioral therapy in all my programs. It's the bread and butter of building long lasting and sustainable results. A lot of excellent therapists and psychologists out there use it nowadays. If you're still not convinced, then here's how you can make a decision ask yourself is the high worth the lower not assuming you don't struggle with clinical depression and generalized anxiety disorder, epilepsy or ADHD than the lows of being a medication is the huge array of side effects discussed with no promise that you might actually start benching. And the high point is potentially that you could stop mentioning but we don't know that for sure on that until you try it and that is why it is difficult to make a decision but again, at the end of the day, it should be your decision and I'm just simply helping you make a more informed Because bingeing is a complex problem that originates in the mind that can also be affected by hormone imbalances. It can't simply be fixed by changing your brain chemistry. Changing your brain chemistry can only temporarily affect how you feel. But it can change your thoughts thinking process, or what you do or habits and all the other things that accompany binge eating can't help you know which foods to eat or what self care self care habits to focus on. It might make you feel like changing your lifestyle, but it won't change it for you. Ultimately, what you need is a coach or a skilled therapist who can help you sort out what allows Benji to exist in your life and how you can overcome it. And again, everybody is different there. If you are, if you're if you're going on medication soon then then something especially something like stimulants or antidepressants that or even the mood altering ones that take advantage of that short a honeymoon period with these with these mood. stabilizers, medication and build a routine and lifestyle that can stay with you long term. And you can do that again who by working with a coach or, or enrolling in a program that can help you with binge eating disorder. Many of you and this is a word of caution. Many of you out there can be part of binge eating Facebook support groups and you hear stories daily, some stories of what works and what doesn't. In terms of medication, and I'm a part of this group, like to get my advice there every now and then. And I'm so daily, I will see people saying finally I'm prescribed Adderall and I feel cured. I don't feel like benching again. But be very careful that when reading these stories, you're only seeing somebody at a point in time. And usually always they're posting from a high point like the first couple of days the first week. And not because vacation word for someone means it work for you. But what is more important than that is that you don't know what it will what how it's working for them and long term because it's not like you're they're watching their story day by day and taking notes of how they're feeling and what they're actually doing. You only saw a post from them one day that said, Oh, they feel cute from it. And that gave you some hope and all sudden you're like, Okay, now I gotta find this medication too. But you don't know week to three weeks a month, even a year later if you're if they're still going to be struggling with benching or not. And many times they still if they have other root causes to benching in their life, they Benjin finds their way its way back again, and they continue to struggle with it. So keep that in mind. Not every story that you see online or on Facebook apps or success story means that whatever they did is going to work for you. So to recap, medication can help you if you have certain conditions. But mentioning isn't a condition really as much as it's a behavior and a mental disorder that doctors don't really actually understand what is specific cause of it. So with depression, that causes low dopamine with anxiety to causes low serotonin, they can link it to literally like brain brain chemical imbalances with binge eating, everybody's different. So there's no worse Well, that's why there is no one pill that can any that can fix binge eating, because it's different, and they epi and doctors have not been able to find a specific cost to it. So just want you to keep that in mind. So just to recap, medication cannot help if you are struggling with other root causes that are not linked to brain chemical imbalances. So it's easy to get excited that there might be a pill that can just make all this go away. I know this, trust me. And truth is there isn't. Because I know when we're struggling with something for so long. The idea that there's a miracle pill that can make this all go away can make it like, you know, super hopeful and you know, make you super excited to get it. But then once you get get it and you tried for a little bit unconscious, and you realize that it's that they're just not going to work long term, you might come to the conclusion that Oh, you're never gonna find a fix. And that is not true. Because again, you've you've focused on one root cause but not other ones. The truth is the battle is always in the mind, not the balance of chemicals in your brain. You can change the mind by taking a pill but you can change it by engaging in a process that is designed for you to rewire your brain and change your thought process by questioning certain thought processes, certain beliefs within you your habits, again, while you do self care activities and just things that can get your challenge your lifestyle and your life you a little bit to allow you to create the best version of yourself and that best version of yourself will be Ben Shree. So hope you enjoyed this podcast. Just a reminder that my signature program at beyond the bench is currently 25% off during the pandemic you can apply for it at www.morezk.com. In it, we go through the six layers unfixed six root causes of binge eating and how to overcome them by actually taking action and doing all the things that will ensure that major eating doesn't exist in your life. It has a very high success rate and I actually don't give up any of my clients at all. Hope you've enjoyed this podcast and have a lovely lovely day and I will see you in the next one.