Sitka is one of the most beautiful and most isolated communities in the country — a fishing town on Baranof Island, reachable only by plane or the Alaska Marine Highway ferry, tucked between the Tongass National Forest and the open Pacific. That isolation shapes daily life in a lot of ways, and it also shapes mental health care access. Specialized psychiatric care, including treatment for eating disorders, is essentially unavailable locally, which means a common — and treatable — condition like binge eating disorder often goes unaddressed for years.
What Is Binge Eating Disorder?
Binge eating disorder (BED) is a recognized diagnosis in the DSM-5 and is actually the most common eating disorder in the United States — more common than anorexia and bulimia combined. It involves recurrent episodes of eating unusually large amounts of food while feeling a genuine loss of control, at least once a week for three months or more, without the regular use of purging, fasting, or excessive exercise to compensate afterward. BED affects people of every gender, age, and body size, and it is not the same thing as simply overeating occasionally.
Symptoms to Watch For
- Eating unusually large amounts of food in a short period of time
- Feeling unable to stop or control eating once a binge starts
- Eating rapidly, even when not physically hungry
- Eating alone or in secret out of embarrassment about the amount of food
- Intense guilt, shame, or disgust after eating
- Fluctuating weight or gradual weight gain over time
- Using food to cope with stress, loneliness, boredom, or isolation
That last symptom is worth sitting with if you live somewhere like Sitka. Long winters, limited daylight, and genuine physical isolation from friends and family can all feed a cycle where food becomes one of the only accessible coping tools — which can make BED both more likely to develop and easier to overlook as “just how things are up here.”
Why Sitka Residents Face Unique Barriers
Sitka’s healthcare system, anchored by the Southeast Alaska Regional Health Consortium and the local hospital, covers a lot of ground for a remote community, but specialized behavioral health care — particularly for eating disorders — is not something most residents can access without flying to Anchorage, Seattle, or further. For a condition that thrives on secrecy and shame, that kind of travel barrier often means people simply don’t seek help at all.
Treatment: Medication, Therapy, or Both
Binge eating disorder responds well to treatment, and there’s more than one path to recovery. Cognitive Behavioral Therapy (CBT) is the most well-researched approach and helps identify the triggers and thought patterns behind binge episodes. For some patients, medication management is also appropriate — certain medications are specifically studied for reducing binge frequency, and treating co-occurring anxiety or depression can reduce the urge to binge as well. Many people do best with a combination of both, tailored to their own history and needs.
Randy Goleman, PMHNP, works with each patient individually — there’s no single protocol applied to everyone. Some people need therapy first, some need medication support to stabilize before therapy can be effective, and some need both from the start.
Getting Care Without Leaving Sitka — No Long Waits
Valiant Mental Health provides secure telepsychiatry across Alaska, which means Sitka residents can get evaluated and treated without a ferry schedule or a flight to Anchorage. There are no long waiting lists — many patients are seen the next day, and same-day appointments are often available when insurance verification isn’t required. Everything happens over a secure, HIPAA-compliant video visit from wherever you are on the island.
Frequently Asked Questions
Q: Is binge eating disorder just overeating?
A: No. BED is a recognized psychiatric condition involving a genuine loss of control during eating episodes, along with significant emotional distress — it’s not a matter of willpower.
Q: Can BED be treated with medication alone?
A: For some patients, medication can meaningfully reduce binge frequency, but most people see the best results when medication is combined with therapy that addresses the underlying triggers.
Q: How is BED different from bulimia?
A: Unlike bulimia, binge eating disorder does not involve regular purging, fasting, or excessive exercise to compensate for binge episodes.
Q: How soon can I be seen from Sitka?
A: Many patients are seen the next day, and same-day telehealth appointments are often available when insurance verification isn’t needed — no travel required.
If food has started to feel like something you can’t control, you don’t have to figure it out alone or wait for a trip off the island. Request an appointment with Valiant Mental Health and get started from home.