Binge kudya chirwere (BED) ndiyo inowanzovhiringidza kudya muUnited States. Maererano neNational Eating Disorders Association, inofungidzirwa kuti inokonzera 3.5 muzana yevakadzi, 2 muzana yevarume, uye kusvika pa6 muzana yevechiri kuyaruka. Iyo inoratidzirwa zvikamu zvakadzokorora zvekudya zvakadzama pasina maitiro ekubhadhara anowanikwa mu bulimia nervosa.
Binge kudya chirwere chakanga chachangobva kuitika (muna 2013 pamwe nekudhindwa kweChirangariro uye Statistical Manual yeMental Disorders, 5th Edition; DSM-5 ) inorondedzerwa sechirwere chekuongorora. Sezvo zvakadaro, ruzivo pamusoro paro runovhara shure kwee anorexia nervosa uye bulimia nervosa.
Kunyange zvazvo inowanzofungidzirwa kuva "shoma" kudya chirwere, kubata chirwere chekudya kunogona kukonzera kushungurudzika mupfungwa uye mumuviri kunetseka uye kunobatanidza nematambudziko makuru ezvokurapa uye kuwedzera kwekufa kwehuwandu .
CBT yeBinge Eating Disorder
Kutanga-mutsara mushonga wekubata chirwere chekudya zvakanyanya kune vanhu vakuru nderimwe rupiro rwepfungwa. Gwaro-based cognitive behavioral therapy (CBT) ndiyo inonyanya kuongororwa nezvepfungwa yeBED, uye panguva ino, inotsigirwa zvakanakisisa pakati pezvose zvinoshandiswa pakushandisa. Bhuku rinonzi CBT rakanyatsodzidza nezvekusadya dambudziko chirwere ndechebhuku rakabudiswa muna 1993 na Fairburn, Marcus, naWilson pamwe nekuvandudzwa kwehutano uhwu, CBT-E, yakabudiswa muna 2008 na Fairburn.
Maererano naBerkman uye pamwe chete nevamwe vanoongorora zvakanyanya mabhuku (2015) panewo zvidzidzo zvishomanana kuti zvive nemagumisiro pamusoro pekuti zvipi zveBBCT zvingashanda zvakanyanya.
Mune maitiro ekudzivirira maitiro, CBT inogara ichiratidza kuti mune iyo inogona kubatsira varwere vakawanda kuti varege kuzvidya nekutengesa kudya.
Mune zviitiko zvakawanda apo kusazvidzora kubva pakuzvinyima hazviwaniki, zvinogona kubatsira kuderedza kushandiswa kwemajairo uye kufanana-kupindirana kwepfungwa dzepfungwa (zvakadai sekufungisisa nezvemaitiro uye kuyerwa ). Kuvandudza kukuru kwakaratidzwa muBBCT-inotungamirirwa nemapurisa pane mune zvekurapa uye kusabatanidzwa kwevashoma kudaro sekuzvibatanidza kubatsira .
CBT inzira inogadzirisa nguva iyo inotarisana nekubatana pakati pemafungiro, manzwiro, uye maitiro. Zvikamu zvinokosha zvekurapa zvinosanganisira psychoeducation, kuzvitarisira kwezviito zvinokosha, nekugadzirisa tsika dzese dzekudya. CBT yeBED inotarisana nemiganhu yekudya uye kuiswa kwezvokudya zvinotya. Inobatanidzawo pfungwa pamusoro pemaumbirwo uye uremu uye inopa humwe unyanzvi hwokugadzirisa nekurega kushungurudzika. Pakupedzisira, CBT inodzidzisa vatengi nzira dzekudzivirira kudzoka zvakare. Zvakakosha kucherechedza kuti chinangwa cheBBC ndechekuchinja kwehutano, kwete kuora kwekurema - CBT yekudhakwa kwekudya zvakanyanya haisi kutungamirira kukurasikirwa kwepamusoro kunyange pakati pevarwere vane miviri mikuru.
Dzimwe Psychotherapies
Zvimwe zvezvepfungwa zvekudya zvakashata zvekudya zvakadzidzwa uye zvakaratidza chivimbiso, kunyange zviripo iye zvino zvidzidzo zvishomanana kuti zvigadzirise zvachose kana zvichishanda.
Interpersonal therapy (IPT), kurapwa kwenguva pfupi inotarisa panyaya dzevanhu, uye chirwere chinonzi dialectical therapy (DBT), chimiro chitsva cheBBCT chakagadzirirwa kugadzirisa mafungiro asina kufanira, ndiwo maitiro maviri anopa rubatsiro rwekutsvakurudza kubata chirwere chekudya. Kungwarira kunobva pakudya kudzidzisa kudzidzisa (MB-EAT), iyo inobatanidza kudya kwepfungwa nemaitiro ekufunga, yakaratidzawo chivimbiso.
Mishonga
Anodzvinyirira, kunyanya kusarudza serotonin reuptake inhibitors (SSRIs), akaratidza kuti anobatsira mumakiriniki emakiriniki mukuderedza kuwandisa kwebinges pamwe nekudya zvakabatana zvakasangana.
Anodzvinyirirawo (hazvishamisi) akadzikisa zviratidzo zvekuvhiringidzika. Vyvanse, mishonga yeDHD iyo yakangobva yava mishonga yokutanga kugamuchirwa neU.S. Food and Drug Administration (FDA) pakurapa BED, yakadzidzwa mumatatu matatu uye yakabatanidzwa nekuderedza mabheji episodes pavhiki, yakaderedza kudya-yakabatana kuora mwoyo uye kumanikidzwa, uye kuderedza kuderedza uremu. Anticonvulsant mishonga, kunyanya kufuratira, yakanyatsodzidza uye pane humwe uchapupu huripo hunoratidza kuti hunobatsira. Kunyange zvazvo kutsvakurudza kweVivvanse uye ikozvino kweDAA kugamuchirwa kwekurapa BED iri kuvimbisa, mishonga yose inotakura mungozi yemigumisiro yakaipa isingawaniki neyepfungwa.
Kuzvibatsira-uye Kutungamirirwa Kuzvibatsira
Berkman nevamwe vashandi vanocherechedza kuti "Nhamba yevanachiremba vane ruzivo muBBCT yeBED yakagadzikana." Zvichipa nhamba huru yevanhu vanotambura, kuyerwa uku kunokonzera dambudziko. Imwe nzira yekugadzirisa chirwere chekurapa kwave kuri kukurudzirwa kwekuzvibatsira uye kutungamirirwa mishonga yekuzvibatsira-kubata chirwere chekudya, chinoratidza chivimbiso.
Kunetseka Nezvekurasikirwa Kwemafupa Okurasikirwa
Nemhaka yokuti chikamu chikuru chevarwere veBED vanorema, vanhu vane BED vakagara vachitsvaga kurapwa uye vakabata kurasikirwa nekurema. Kunyange zvazvo zvimwe zvidzidzo zvepakutanga zvakaratidzika kuratidzira kuti kurasikirwa kwemaitiro kunogona kushanda mukurapa BED, zvidzidzo izvi zvakanga zviduku uye zvisina kunaka zvakagadzirirwa. Wilson uye vashandi pamwe chete navo (2010) vakaona kuti kurasika kwehutachiona kwakaderera kune CBT mukuderedza kusadya zvakanyanya uyewo hazvina kukonzera kurasikirwa kukuru kwekukura; vakagumisa vachiti, "nzira dzinobatsira dzekutora nguva yakareba-kurasikirwa kwemahombekombe dzinoramba dzisingabviri." Nenguva yakawanda, vazhinji vanodya zvirwere zvepfungwa zvino vanoziva kuti kuedza kurerutsa kurapwa pakati pevarwere vane BED kunogona kungowedzera kukonzera dambudziko uye kuwedzera kuwedzera chirwere ichi, zvichikonzera kunyadziswa kukuru uye zvakaguma mu kuwedzera pfuma. Nokudaro, kurasikirwa kwehutachiona hakubatsiri.
Nzira Yokuwana Kurapa
Binge Eating Disorder Association (BEDA) inochengetedza bhuku reInternet rinowanikwa kune vashandi. Uyezve, vamwe vanodya dambudziko rehutano vane ruzivo mukurapa BED. Kana iwe usingakwanisi kuwana nyanzvi yemunharaunda, ungada kuongorora kuzvibatsira-kana kutungamirirwa iwe-rubatsiro.
Sources:
Berkman, ND, Brownley, KA, Peat, CM, Lohr, KN, Cullen, KE, Morgan,. . . Bulik, CM (2015). Kutungamira uye Kubudirira kweBinge-Eating Disorder [Mukurumbira Mukuru].
Fairburn, CG (2008). Cognitive Behavior Therapy and Eating Disorders . New York, NY: Guilford.
Fairburn, CG, Marcus, MD, & Wilson, GT (1993). Kuchengetedza-Kuita Maitiro Okudya Binge uye Bulimia Nervosa: A Comprehensive Treatment Manual. Mu: CG Fairburn & GT Wilson (Eds.). Kudya Zvokudya: Zvisikwa, Kuongorora uye Kurapa (pp. 361-404) . New York, NY: Guilford.
Fichter, M., & Quadflieg, N. (2016). Kufa mukutambudzika kwekudya - Zvigumisiro zveChikuru Chichida Chipatara Longitudinal Study. International Journal of Eating Disorders .
Kristeller, J., Wolever, RQ, & Sheets, V. (2014). Kufungisisa-Kubva Kudya Kudzidzisa Kudzidzisa (MB-EAT) yeBinge Yokudya: A Randomized Clinical Trial. Kufungisisa , 5 (3), 282-297.