How to Stop Binge Eating: Is a "Dopamine Detox" the Solution?
How to Stop Binge Eating: Is a "Dopamine Detox" the Solution?
Binge eating disorder is characterized by recurring compulsive behaviors called "binge eating episodes." These episodes may be fueled by emotional eating, a coping mechanism for underlying psychological or physical stress.
Individuals with binge eating disorder may also make a habit of skipping meals throughout the day in an effort to compensate for overeating later. In many ways, this creates a reward-driven vicious cycle where starving oneself "pays off" with a massive binge eating episode.
Lately, there's considerable buzz around so-called "dopamine detox" or "dopamine fasting" protocols to alleviate compulsive behaviors (e.g. the urge to binge eat for emotional comfort). This approach is somewhat counterintuitive and remains contentious in the scientific community. So, what exactly is a "dopamine detox" and is it prudent for treating compulsive eating disorders like binge eating disorder?
Medical disclaimer: This article is for informational purposes only and is not intended to replace medical advice/diagnosis from a qualified healthcare practitioner. Eating disorders are serious but treatable. The National Eating Disorders Association provides resources for treatment options and points of contact.
Dopamine and Binge Eating Disorder
Since dopamine is the primary neurotransmitter responsible for driving behaviors that lead to a reward or desired outcome, it's the central target of compulsive eating disorders . When we haven't eaten for some time and hunger is rampant, the brain secretes a generous amount of dopamine once we finally get around to settling in for a nice, home-cooked meal.
Intuitively, the rush of dopamine and feel-good chemicals someone experiences after binge eating can be quite addictive, just like drug users crave the euphoric high brought on by certain substances . But as the brain becomes more tolerant of the acute dopamine response to a reward, dopamine receptors in the mesolimbic region of the brain are desensitized. Consequently, more dopamine is needed to elicit the same desirable feelings as before.
The phenomenon of receptor desensitization and tolerance is readily apparent with the everyday stimulant of choice for most people, caffeine. As you consume more caffeine, the brain develops a tolerance for it. Eventually, you might be able to slam an entire pot of coffee and not feel stimulated at all.
So, what's the solution? Well, taking a break (cold turkey) is one option, as this gives the brain time to resynthesize and upregulate relevant target receptors. Another option is slowly tapering off the drug/behavior in question, which is where cognitive behavioral therapy can help.
And lastly, you could simply keep doing what you're doing; this will likely make it much harder to quit in the long run as the brain becomes dependent on the addictive substance/behavior to maintain baseline function.
Hence, a "dopamine detox" sounds sensible for treating binge eating disorder in theory, but does it actually work?
What Is a Dopamine Detox?
The concept of a "dopamine detox" (sometimes called a "dopamine fast") was created by psychiatrist Dr. Cameron Sepah and, ironically, has little to do with either fasting or dopamine. Even Sepah himself has stated that the catchy term ("dopamine detox") is not to be taken literally.
It's actually impossible to "fast" from dopamine, a naturally occurring brain chemical. No matter how hard we try to deprive ourselves of dopamine, the body will keep producing it because its essential to our survival. After all, dopamine is much more than just a "reward-driven" neurotransmitter; it's also important for cognitive function, arousal, learning, motor activity, motivation, and wakefulness .
Sepah's intention with his dopamine fast protocol was a method, based on cognitive behavioral therapy, to help us become less subjugated by the unhealthy stimuli that come with living in a modern, technology-driven world. We are bombarded with texts, notifications, context-switching social media apps, advertisements, and all sorts of intrigue on a daily basis.
Engaging with these stimuli creates habitual reward-inducing cues that provide us with an instantaneous but short-lived dopamine surge, often followed by moments of emptiness. Notice how this is similar to what happens with binge eating.
In fact, Sepah outlines six compulsive behaviors that his dopamine fasting method can target, one of which is indeed emotional eating. He asserts that we should allow ourselves time to feel the "lows" of loneliness and boredom and stop seeking the thrill of transient highs brought on by compulsive behaviors that may be interfering with our happiness.
But a dopamine detox doesn't mean you should just embrace the misery of withdrawal; instead, the idea is to fill that void with natural, healthier activities and hobbies that bring you joy and pleasure. Exercise, learning an instrument, going for a hike, painting, and reading are some good examples.
Do Dopaminergic Medications Reduce Binge Eating Episodes?
As you can imagine, it's a slippery slope when someone tries to combat compulsive eating habits by self-medicating. Dopaminergic drugs, notably amphetamine, are sometimes prescribed for treating binge eating disorder as they have an appetite-suppressing effect . The problem with this approach is that it's not really addressing any of the root causes of poor eating habits; it's more so masking those causes, like a Band-Aid.
Stimulant medications aren't always practical, either. For example, someone that struggles with binge eating episodes at night wouldn't want to take amphetamine that soon before bed.
Eating Disorders and Mental Health
While there are presumably many health benefits to be had from a "dopamine fast," it's always best to consult with a qualified healthcare pracititioner before trying to treat a mental health condition by yourself. Eating disorders are not intractable, and research has shown that simple lifestyle changes, like mindfulness meditation, intuitive eating, and body image positivity can have profound impacts on peoples' relationship with food [5, 6].
There are also a handful of natural supplements, particularly 5-HTP, that reduce appetite if you need help controlling food intake. You can read more on this topic here.