Binge eating disorder is a serious condition requiring treatment. But with the right approach, recovery is possible.
If you have binge eating disorder (BED), you go through regular episodes of extreme overeating, and as a result, often experience feelings of severe shame and distress.
Though more common than anorexia nervosa and bulimia nervosa combined, BED is one of the most misunderstood eating disorders.
Some mistakenly believe it’s a character flaw or caused by a lack of willpower. These myths can drive individuals with BED to seek help at weight loss clinics, which usually makes the condition worse.
BED is a very real and challenging disorder — but the good news is that with the right approach, recovery is possible.
What doesn’t work
Weight loss or weight management programs are the wrong approach when it comes to binge eating disorder — even though many resources, including websites and even medical professionals and treatment guidelines, recommend them.
The very methods used to achieve weight loss — restricting food intake, counting calories, weighing yourself, limiting certain food groups — may trigger binge eating, along with feelings of shame and self-loathing.
BED was recognized as a psychiatric diagnosis in the 2013
The first-line treatment for BED is psychotherapy, also known as talk therapy. Medication also may be helpful, but rarely on its own.
Many people with BED also have other disorders that may require treatment. For instance, about
If you have binge eating disorder, having a multidisciplinary team on your side can be highly valuable. This may include:
- a weight-neutral doctor
- a therapist
- a psychiatrist (particularly if there are also concerns about other co-occurring disorders like depression)
- a registered dietitian who specializes in disordered eating, intuitive eating, or both
Talk therapy is often recommended as the first-line treatment for binge eating disorder. Several types of therapy may be beneficial. We recommend you talk with your treatment team about which approach may be the best for you.
Enhanced CBT (CBT-E)
Cognitive behavioral therapy (CBT) is often considered the treatment of choice for people with BED. A specific form called enhanced CBT (CBT-E) has been shown to be particularly effective.
With this approach, you and your therapist focus on understanding BED, reducing bingeing, and reducing concerns about weight and shape. You’ll also focus on reducing or eliminating the factors that maintain BED, such as dieting.
CBT-E generally consists of 20 sessions over 20 weeks. In the last few sessions, you’ll delve into how to deal with setbacks and maintain positive changes.
Interpersonal psychotherapy (IPT)
Another effective BED treatment is interpersonal psychotherapy (IPT). The theory behind this therapy is that interpersonal problems cause low self-esteem, anxiety, and distress, which may trigger binge eating.
In IPT, a therapist helps you explore the link between your relationships and symptoms. They pick oneout of four problem areas to focus on:
- interpersonal role disputes
- role transitions
- interpersonal deficits
For instance, a therapist may help one client navigate the new transition of motherhood and help another client resolve a conflict with their spouse. IPT typically consists of 6 to 20 sessions.
Dialectical behavior therapy (DBT)
Dialectical behavior therapy (DBT) was created to treat people with borderline personality disorder and those who chronically experience suicidal thoughts or attempts. Still, it can be helpful for other mental health conditions, including BED, as well.
If you have BED, a DBT therapist can help you identify what triggers your binge eating episodes, learn to tolerate these emotions without bingeing, and build a fulfilling, meaningful life.
Research using randomized controlled trials in kids and teens is limited. But preliminary studies show that CBT, IPT, and DBT may be effective in younger people as well.
While medication alone is generally not enough to treat binge eating disorder, some medications may be helpful.
Lisdexamfetamine (Vyvanse) is a stimulant usually prescribed for attention deficit hyperactivity disorder (ADHD). However, the Food and Drug Administration (FDA) approved the medication to treat moderate to severe binge eating disorder in 2015.
However, the researches noted that certain populations — like people with a history of substance use disorder, attempted suicide, manic episodes, or heart disease — were excluded from the studies.
This means that results from the review cannot be generalized for people with binge eating disorder who also have one of these conditions.
Also, the studies in the review did not do any long-term follow-ups, which means it may be unclear how effective lisdexamfetamine is in the long run, or how it affects people long term.
Because it’s a stimulant, taking lisdexamfetamine carries a risk of misuse and dependence. It’s a good idea to discuss any concerns you may have with your treatment team.
Common side effects of lisdexamfetamine include:
Antidepressants also are used to treat BED. For instance, your doctor may prescribe fluoxetine (Prozac), a selective serotonin reuptake inhibitor (SSRI) that’s been approved by the FDA to treat bulimia, an eating disorder that involves purging after bingeing.
Other SSRIs that have been found to be effective for BED are:
Common side effects of SSRIs include:
- dry mouth
- upset stomach
- sexual dysfunction, such as decreased sexual desire and delayed orgasm
If you’ve been given an SSRI, it’s important to take it as prescribed. If you abruptly stop taking the medication, it can trigger discontinuation syndrome, which is essentially withdrawal. You may experience dizziness, insomnia, and flu-like symptoms.
If you don’t want to take your SSRI anymore, it’s highly recommended to discuss this with your doctor, so you can slowly and gradually decrease the dose. Sometimes, even doing this can still trigger some withdrawal symptoms.
Several treatment guidelines and reviews also recommend topiramate (Topamax), an anticonvulsant, to treat BED.
Like the medications above, topiramate has been shown to decrease binge eating frequency, increase abstinence from binge eating, and reduce eating-related obsessions and compulsions.
Topiramate’s common side effects include:
- numbness in hands or feet
- problems with coordination, speech, and memory
Talking about meds with your doctor
It’s critical to have a thorough discussion about the medication your doctor is prescribing. Things you may want to bring up include:
- any concerns and questions about side effects
- the possibility of interactions (if you’re taking other medications)
- anything else you want to know
The decision to take medication should be a collaborative, thoughtful, and well-informed one.
For most people with binge eating disorder, outpatient treatment is best.
Still, sometimes residential or inpatient treatment at a special facility for eating disorders may be necessary. This may be the case if:
- you also have severe depression or anxiety
- you have thoughts of suicide or have attempted suicide
- you have severe BED
- other treatments have not helped
If medical complications are present, you may need to stay at a hospital to get stabilized.
After you complete inpatient treatment, you may begin attending an outpatient program at an eating disorder facility.
Some people may attend various therapies, such as individual therapy, group therapy, and nutrition counseling, several times a week for several hours.
Others may attend the entire week for up to 10 hours a day and go home to sleep (though this tends to be rare for individuals with BED).
While BED most often requires professional help, research indicates that some self-help strategies can be somewhat beneficial as well — especially when you have guidance and support from a healthcare professional who specializes in disordered eating.
Health At Every Size (HAES)
Instead of focusing on losing weight, the Health At Every Size (HAES) approach emphasizes the importance of helping people cultivate healthy, joyful, genuinely nourishing habits.
HAES focuses on:
- celebrating body diversity
- finding joy in movement
- eating in a flexible and attuned way that values pleasure and honors internal cues of hunger, feelings of fullness, and appetite
You can learn more about HAES at the Association for Size Diversity and Health and in the book “Health At Every Size: The Surprising Truth About Your Weight.”
Intuitive eating is defined as “a self-care eating framework, which integrates instinct, emotion, and rational thought.”
It was created by Evelyn Tribole and Elyse Resch, who are both dietitians, and consists of 10 principles, which include:
- rejecting the diet mentality
- honoring your hunger
- making peace with food
- honoring your feelings without food
Connecting with other people with BED offers you the chance to give and receive support, and most importantly, remember that you’re not alone. Consider joining an online forum or a virtual support group.
Here are some resources to get you started:
- Eating Disorders Resources Center
- National Eating Disorders Association (NEDA) forums
- Eating Disorder Foundation
Processing your emotions
Difficult emotions often trigger binge eating. Learning healthy ways to process emotions can help.
For instance, you can try to gently sit with your emotions by noticing them, validating their presence, and focusing on the present moment. You can also express your emotions through writing.
Effectively processing your emotions is a skill that requires practice and time, but the effort is worth it in the end.
Moving your body
Our bodies are meant to move. The key, however, is to find enjoyable physical activities, which will be different for everyone.
They also may be different for you on different days depending on what you need. Some days, you may want to take a short walk. Other days you may want to dance, try a new yoga class, or ride your bike.
You can find more self-help strategies and information on managing BED in this article, which includes insights from BED experts.
While binge eating disorder is a serious condition that often requires treatment, the good news is that it’s highly treatable and recovery is likely.
There are many treatment options and resources available to those living with BED — but taking the first step is up to you.
It could be as simple as joining an online support group. This small action may help give you the confidence to reach out for counseling next.