Cycles of overeating, secret meals, late night snacking, or sudden urges to act can feel impossible to manage alone. At Cura Mind and Wellness, patients across the Houston metro receive evidence based treatment for Binge Eating Disorder, BED, and related impulse control issues. We offer in person care in Richmond, TX, with secure telepsychiatry across Houston and Fort Bend County.
Care is led by Vivian Emuobe, MSN, BSN, APRN, PMHNP-BC, a board certified psychiatric mental health nurse practitioner experienced in hospital and outpatient settings, program leadership, and integrated treatment for mood, anxiety, ADHD, and eating related concerns. Plans are respectful, stigma free, and practical.
What we treat, in plain language
- Binge Eating Disorder, BED: Repeated episodes of eating unusually large amounts of food in a short time with a sense of loss of control, often followed by guilt, shame, or emotional numbness. There are no regular compensatory behaviors, such as purging or excessive exercise, which distinguishes BED from bulimia.
- Impulse control issues: Urges that feel hard to resist in the moment, for example, impulsive eating, spending, gaming, hair pulling, skin picking, or risky behaviors linked to stress. Impulsivity often overlaps with ADHD, bipolar spectrum, trauma, or anxiety.
Signs that support could help
Binge eating patterns
- Eating much more rapidly than normal,
- Eating until uncomfortably full,
- Eating large amounts when not physically hungry,
- Eating alone due to embarrassment,
- Feeling disgusted, depressed, or very guilty afterward.
Impulse control patterns
- Urges rise quickly during stress, boredom, or late nights,
- Difficulty pausing once the urge starts,
- Regret and self criticism after the behavior,
- Disrupted focus, finances, skin, or sleep,
- Repeated promises to stop without lasting change.
Why these problems happen
Most patients did not choose this. These patterns are driven by a mix of biology, experience, and environment.
- Brain based factors, reward sensitivity, habit loops, stress response,
- Mood and anxiety, depression, trauma, and generalized anxiety fuel emotional eating and urgency,
- ADHD, distractibility, time blindness, and low dopamine states increase impulsive choices,
- Sleep loss and circadian disruption, late bedtimes and shift work amplify cravings,
- Diet culture and restriction, all or nothing rules make binges more likely,
- Medical contributors, thyroid issues, insulin resistance, PCOS, or medications that affect appetite.
Understanding your pattern lets us choose the right tools.
The Houston context, why local life matters
Patients describe long commutes, heat that drains energy, late work hours, and a rich restaurant culture that makes structure difficult. Hurricanes and severe weather can disrupt routines for weeks. We plan for Houston realities, not idealized schedules.
How we evaluate at Cura Mind and Wellness
- History and pattern mapping, timing of binges or urges, emotional triggers, and daily routines,
- Medical review, weight history without stigma, blood pressure, lipids, glucose, thyroid, and medications,
- Co occurring screening, ADHD, depression, anxiety, PTSD, sleep disorders, substance use,
- Nutrition and activity snapshot, current patterns, restriction, binge triggers, energy needs,
- Values and goals, what better looks like, fewer binges, regular meals, improved energy, clearer skin, steadier mood.
If medical risk is present, we coordinate with primary care. If a higher level of eating disorder care is required, we make a warm referral and remain involved for continuity.
Treatment for Binge Eating Disorder
Therapy at the core
- CBT E, enhanced Cognitive Behavioral Therapy, the leading therapy for BED, focuses on regular eating, trigger awareness, and thought restructuring that breaks the binge restriction cycle.
- DBT skills, emotion regulation and distress tolerance reduce urge driven eating during high stress moments.
- Interpersonal therapy, IPT, improves relationships and life transitions that drive emotional eating.
- Mindful eating and meal structure, three meals and planned snacks, slow pace, hunger and fullness cues, non judgmental awareness.
When helpful, we collaborate with a registered dietitian for meal planning that fits culture, budget, and schedule.
Medication support for BED
Medication never replaces therapy, it can reduce frequency and intensity of binges. Options may include lisdexamfetamine for moderate to severe BED, or antidepressants when depression and anxiety are prominent. Decisions are collaborative and conservative. For patients with side effects or limited benefit in the past, pharmacogenomic gene testing is available at our Richmond office to guide safer choices.
Treatment for impulse control issues
- Habit reversal training, HRT, used for skin picking and hair pulling, builds awareness and replaces the behavior with competing responses,
- Exposure with response prevention, practice tolerating urges without acting,
- Stimulus control, structure and environmental changes that remove common cues,
- ADHD evaluation and treatment when inattention, restlessness, and time blindness fuel impulsivity,
- DBT skills to slow the moment and choose the next best step.
Lifestyle strategies that power the plan
- Sleep consistency, a steady bed and wake time lowers late night urges,
- Protein at breakfast, stabilizes morning energy and reduces mid day binges,
- Movement you enjoy, short walks or strength sets improve mood and executive function,
- Caffeine and alcohol review, both can amplify impulsivity,
- Digital boundaries, plan social media and streaming windows so late nights do not set tomorrow’s cravings.
We write a simple weekly rhythm that you can actually follow in Houston life.
How we measure progress
- Fewer binge episodes per week,
- Reduced urge intensity and faster recovery,
- More days with regular meals and planned snacks,
- Longer gaps between picking or pulling episodes, less skin injury,
- Improved labs and blood pressure when relevant,
- Better sleep, steadier energy, clearer focus,
- Less shame, more self respect, and a kinder inner voice.
Small wins count. We track both data and how you feel.
A 12 week roadmap that adapts
- Weeks 1 to 2, evaluation, safety and medical review, start meal structure, sleep reset, urge tracking,
- Weeks 3 to 6, CBT E modules, DBT skills for urges, create exposure and response practice list, consider medication if indicated,
- Weeks 7 to 10, troubleshoot high risk times, coordinate with dietitian, ADHD or mood treatment if present,
- Weeks 11 to 12, relapse prevention, holiday and travel plan, written maintenance guide, booster schedule.
Pacing is flexible. We pick steps you can complete this week.
FAQs, Binge Eating Disorder and Impulse Control in Houston and Richmond
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No. The focus is health and behavior change. Many patients notice weight trending toward a stable set point as binges decrease and routines improve.
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Not always. Many improve with CBT E, DBT skills, and structured eating. Medication can help when urges remain severe or when ADHD, depression, or anxiety are significant.
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Yes. Skills practice, meal structure coaching, and accountability sessions work well by secure video. In person visits in Richmond are available when you prefer face to face care.
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Restriction increases binge risk. We teach regular eating that stabilizes biology and reduces all or nothing cycles.
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Yes. With your consent, we collaborate to support medical safety, lab monitoring, and sustainable nutrition.
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Many patients feel calmer after the first two to four weeks as structure returns. Durable change builds across months with consistent practice.
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They are not first line for eating disorders. We may consider these for co-occurring treatment resistant depression, not as a primary treatment for BED.
Why patients choose Cura Mind and Wellness
- Board certified leadership with experience across eating and impulse related concerns,
- Integrated care that combines therapy, medication management, gene testing, and medical coordination,
- Stigma free style, respectful care for all bodies and backgrounds,
- Local access, in person appointments in Richmond, telepsychiatry across Houston,
- Practical plans that fit commutes, shift work, family responsibilities, and weather interruptions.
Take a kinder, steadier next step
Binge eating and impulsive urges do not define you. With clear structure, proven skills, and supportive care, you can build a calmer relationship with food, your body, and your choices. Cura Mind and Wellness serves patients across Houston, with in person care in Richmond and telehealth for convenience.