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Binge Eating Disorder, B.E.D., is the most common eating disorder affecting 1% to 5% of adults in the America. According to the National Eating Disorders Association about 50% of those with B.E.D. are either overweight or obese, however being diagnosed with B.E.D. involves more than just overeating. Only a trained and qualified health care professional can make the appropriate diagnosis and then develop the correct treatment plan that will be successful.

Cause of Binge Eating Disorder

With research and recent medical advances the exact cause of B.E.D. remains uncertain. There is some evidence that Binge Eating Disorder may be hereditary with the disorder linked to family genetics. There are some hypotheses that B.E.D. is caused by certain brain chemicals, or even certain life experiences such as life-threatening accidents or natural disasters.

Diagnosis of Binge Eating Disorder

The diagnosis of B.E.D. is very specific and all of the following symptoms must be present for a true and accurate diagnosis:

• Regularly eating far more amounts of food than an average person would be able to eat in a similar time period
• Feeling that the amount of food eaten is out of control during a binge
• Becoming very upset by the episode(s) of binge eating
• Binge eating typically occurs at least 1x/week over a 3-month period
• Those with Binge Eating Disorder do not try to correct their excessive eating habits by throwing up or by over-exercising; B.E.D. is not part of another type of eating disorder.

In addition to meeting all of the criteria above, at least three or more of the following symptoms must also be present for an appropriate diagnosis:

• Eating extremely fast
• Eating beyond the feeling of being full
• Eating large amounts of food when not hungry
• Eating alone to hide how much is being eaten
• Feeling bad about oneself after a binge has occurred

Degree of Binge Eating Disorder Exhibited

Along with an accurate diagnosis is the determination of the severity of the B.E.D. which your doctor will utilize in the development of an effective treatment program.  There are four levels of this disorder:

• Mild degree with 1 to 3 binge eating episodes exhibited a week
• Moderate degree with from 4 to 7 binge eating episodes a week
• Severe degree where 8 to 13 episodes are reported each week
• Extreme degree with 14 or more binge eating episodes every week

Treatment for B.E.D.

Vyvanse is the first and only medication approved to treat moderate to severe adult Binge Eating Disorder. Vyvanse (lisdexametamine dimesylate) is a prescription medication that your psychiatrist may choose to utilize in the treatment of your eating disorder. Following a comprehensive evaluation, an individualized treatment plan will be developed that may include Vyvanse, cognitive behavioral therapy, adjunct therapy, or support groups.

Binge Eating Disorder Psychiatrist

For qualified experienced care in the diagnosis and treatment of B.E.D., call the office of Dr. Hege to get your eating under control. It is time to enjoy life without the hidden struggle of binge eating.

A study published in the June 2015 Journal of Psychopharmacology reports widespread cognitive decline of menopausal women.  The areas of cognitive decline affect executive functions, most notably difficulties with time management, organization, memory, attention and problem solving. With approximately 90 million post-menopausal women in the U.S. with an average age of 52 at onset, these women live in a post-menopausal state for almost 1/3 of their lives.

Prior to this study, I hadn’t seen objective studies of ADHD like syndrome emerging during menopause, but I had seen numerous women presenting with suspected ADHD during menopause. My history taking with these women almost always reveals a history of pre-existing ADHD or sub-threshould multiple ADHD like symptoms. Regardless of the origin of the ADHD like symptoms, Vyvanse and other psychostimulants typically are quite helpful.

ADHD Vyvanse Dual Use

The medication Vyvanse primarily used in the treatment of adult ADHD, has also successfully treated cognitive issues of menopausal women promoting healthy cognitive aging as a major public health goal.  ADHD Vyvanse research data shows a 41% overall improvement in executive function deficits compared to those receiving a placebo medication.

Benefits of Vyvanse Treatment

Vyvanse, also known as lisdexamfetamine or LDX, not only improves executive function in menopausal women, the medication has also been proven to show significant improvements in rating four out of the five subscales used in mental health evaluation and diagnosis which include:

• Organization and motivation for work
• Attention and concentration
• Alertness, effort, and processing speed
• Working memory and accessing recall

Comprehensive Evaluation Critical for Correct Diagnosis

Study results show that ADHD Vyvanse, LXD or lisdexamfetamine, show significant positive results. It is crucial however to confirm that the complaints of cognitive changes including loss of memory, or issues with executive function abilities are tied to the transition to menopause and do not point to another pathological cognitive impairment. Working with a psychiatrist experienced in this field is mandatory for a correct diagnosis or diagnoses to build the proper medication and treatment plan upon.

Call Dr. Hege for a confidential and comprehensive evaluation to determine the best course of treatment to meet your needs.

Can chronic use of therapeutic doses of Adderall, Vyvanse, or Dexedrine (amphetamines) cause brain damage?

The bottom line is we don't know. However there is a body of research that raises some concerns but gives no strong conclusive evidence either way. A comprehensive review article was published in February of 2009 "Literature Review: Update on Amphetamine Neurotoxicity and Its Relevance to the Treatment of ADHD" and is available free (1).

A worrisome study in monkeys in 2005 by Ricaurte found some evidence suggesting dopamine nerve damage in areas of the brain involved in ADHD dysregulation and amphetamine therapeutic effects (2). Some of the monkeys were given doses that are normally given to humans. However, multiple similar studies in rodents did not find evidence of this damage in usual dosage ranges that are given to humans. In contrast to amphetamines, high dose methylphenidate (Ritalin, Concerta, Focalin, Daytrana) studies appeared to have lower risk for brain toxic effects (3, 4).

Stimulant treatment of ADHD during childhood appears to reduce the risk of substance abuse that is otherwise associated with ADHD.(5, 6) Also children with ADHD who had not been treated with stimulants have smaller brain white matter volume than children with ADHD who had been medicated or children without ADHD. Stimulant treatment in children may actually increase brain growth and development.(7) However, older rodents, when given methamphetamine in doses that are known to be toxic to younger rodents and humans, had more toxic brain reactions than younger rodents. They also had brain levels of amphetamine that was twice as high as the levels in younger rodents when given the same dose. Natural aging processes reduce dopamine production greatly. Older humans may be at greater risk of toxic effects of amphetamine 

No controlled studies have examined the adverse behavioral, cognitive, neurophysiological effects of years, much less decades, of chronic amphetamine treatment. Neuroimaging with PET and MRI techniques are becoming increasingly useful in measuring brain anatomy and function in living human beings to explore for brain damage in humans treated with amphetamine. We look forward to the coming evidence to make more informed treatment recommendations to our patients with ADHD.

1.(Free) Literature Review: Update on Amphetamine Neurotoxicity and Its Relevance to the Treatment of ADH

Dramatic savings can be achieved with this strategy if you're willing to accept some inconvenience and a period of adjustment. Vyvanse, Adderall XR, Concerta, Focalin XR, and Dexedrine Spansules cost at least $125 per month if you are on one pill a day because they cost about four dollars per pill. If you need 2 or 3 pills per day, that costs $250 or $375 per month. Generic Adderall costs $.35 per pill at Costco. If you take 2 or 3 Adderalls per day, that's $.70 to $1 per day or about $20 to $30 per month. Here's how I implement this strategy for the most consistent focusing all day.
I have my patients set a daily alert in their cell phone to go off at a time in the morning soon after they arise each day. They promptly take their first dose of generic Adderall, Ritalin, Dexedrine, or Focalin for the day. Then they note how long it is until the benefit of the first dose starts to decline. The next day they set their second daily alert for each day at a time that is 30 minutes before their focus begins to decline. This way they take the next dose to be replacing the falling brain concentrations of the previous dose. This prevents a dip in focus between doses. Alerts are then set for the third and fourth doses of the day, as necessary, with the same interval between alerts as between the first and second alerts. My patients are reporting significant improvement in their work and school performance, more consistent and improved mood, and avoiding daytime crashes between doses. Crashes are the periods of tiredness, sleepiness, irritability, or easy crying from a rapid drop-off in ADHD medication brain concentrations.
When switching my patients from a more expensive, longer acting ADHD medication to the cheap, shorter acting, generic substitute, we start out on very low doses and then move up the doses gradually. This way we avoid side effects, find the most effective dose, adjust the period between doses, and adjust the size and time of the last dose of the day to prevent difficulty falling asleep.
For more information on how to save money on psychiatric medications, see my blog about affordable psychiatric medications http://www.eveningpsychiatrist.blogspot.com To make an appointment with Dr. Hege for evaluation and treatment for adult ADHD,
Call 770-458-0007.