Binge Eating: A Way Forward

What is Binge Eating?

Binge eating is a common food consumption behaviour which affects over 3% of the population in the USA (Cleveland Clinic, 2023). While everyone overeats from time to time, binge eating is a unique behavioural pattern of food overconsumption that involves…

• Eating more food than most others would within a small amount of time (one to two hours)

• Feeling like you have no control or a sense of compulsion when eating

• Experiencing self-loathing and stress about binge eating

If you have struggled with any of the above at least once a week for several months, you may have Binge Eating Disorder (BED; American Psychiatric Association, 2013). BED is unlike other eating disorders because it stops with eating – it does not involve purging via overexercising, forcing vomiting, or using laxatives (American Psychiatric Association, 2013). Telltale signs of BED are…

• Eating past the point of fullness

• Eating so quickly you do not recognize when you are full or how it feels

• Emotional eating, where someone eats in response to emotional distress

• Food addiction, where someone obsesses about specific food cravings

• Eating big amounts of food even when not hungry or after finishing a meal

• Secretly eating or not eating in the presence of others

• Stashing, saving, or hoarding food

• Scheduling binge eating sessions

• Frequent dieting, which may also cause constant fluctuations in weight

• Feelings of guilt or shame associated with binge eating patterns (American Psychiatric Association, 2013; Cleveland Clinic, 2023).

BED affects women more than men, and is more prevalent in teenage populations than in adult ones (Cleveland Clinic, 2023). There are many risk factors for BED – things that make you more likely to develop it – like familial patterns of eating disorders or poor emotional coping, trauma, a history of food insecurity, mood disorders, attention deficit/hyperactivity disorder, body dysmorphic disorder, or substance use disorder (Cleveland Clinic, 2023). Health complications involve diabetes, cardiovascular disease, arthritis, and obesity (Cleveland Clinic, 2023). There are also several mental health risks associated with BED, like increasingly antisocial and erratic behaviours, body dysmorphia, anxiety, depression, self-loathing, and risk of self-harm (American Psychiatric Association, 2013).

When to Seek Treatment

Many people seek out professional help for BED because they would like to lose weight. For example, they may have found that traditional weight-loss programs fail to change their eating behaviours, or that using willpower to control food intake is not working. They may have found themselves on a binge-diet rollercoaster, where, despite all attempts to control food intake, they end up binging at one point or another. However, change begins with the realization that mental health matters. Eventually, many who struggle with binge eating or BED start to recognize that life has become too chaotic to support a healthy mind. This is a great time to seek therapy and counselling.

You may be thinking that this sounds like you, or someone close to you in your life. If that is the case, it may be beneficial to start therapy and request to get screened for BED. BED is screened for and diagnosed by medical doctors, psychologists, and psychiatrists. Diagnosis may help those struggling to access certain types of treatment programs like specialized in-patient and out-patient services. However, no diagnosis is needed to access counselling online or in-person for the treatment of BED.

Counselling for Binge Eating and BED

Many think that counselling for binge eating and BED involves meal planning, exercise routines, and other “health” behaviours. However, a focus on weight maintenance or weight loss may not be the best approach. Sometimes, focusing on weight is actually contrary to emotional and physical health. With the help of a therapist, clients may instead understand how food behaviours are affected by their mental health, and so by focusing on mental health, they might change their mood and their food behaviours. Formal treatments for binge eating and BED include…

Cognitive Behavioural Therapy (CBT): A therapist might use CBT to help you better understand the thoughts and feelings that lay underneath food behaviours. Using structured activities and homework, your therapist will help you to find better coping strategies than binging when you experience the same thoughts and feelings (Cleveland Clinic, 2023; Flett et al., 2017).

Family Therapy: Considering that family food behaviours and emotional coping patterns are risk factors for developing BED, family therapy has been proven to be an effective treatment for clients with BED (Flett et al., 2017). By involving family members in recovery, a therapist may help to positively influence the social and emotional environment that a client finds themselves in when engaging in binge eating, in order to help reduce it.

Solution Focused / Interpersonal Therapy: This short-term brief therapy addresses present-day problems instead of past trauma, emotional, or familial issues. Using this treatment method, a therapist may help you to explore solutions that can be implemented in a short time frame (Cleveland Clinic, 2023).

Dialectical Behaviour Therapy (DBT): Finally, using DBT, a therapist may help you to explore two contradicting themes when addressing binge eating behaviours: acceptance and change. By first coming to terms with one’s binge eating behaviours, history, and emotional experiences, and accepting them and the self, change then becomes possible (Cleveland Clinic, 2023).

A Way Forward: Intuitive Eating

Regardless of which treatment modality is used, many therapists find it useful to introduce intuitive eating as a replacement for chaotic binge eating patterns. Intuitive eating (IE) is a way of eating that is positively correlated to positive body image and negatively correlated to obesity (Ayyıldız et al., 2023). Unlike other substances, food is something that must be consumed everyday, and so complete abstinence is impossible. The answer is instead eating according to someone’s hunger and satiety cues, rather than being emotionally sensitive before and during food intake (Heart Matters, n.d.).

There are several principles to intuitive eating (Heart Matters, n.d.):

1. Reject the Diet Mentality. (Dieting isn’t working anyways!)

2. Recognize Your Hunger. (Eat when your body tells you it’s time).

3. Make Peace with Food. (Ditch food rules. No foods are off-limits).

4. Challenge the “Food Police.” (Aka. The voices inside and outside of you who tell you falsely to re-implement old food rules).

5. Feel your Fullness. (Tune into feelings of fullness.)

6. Discover satisfaction. (Enjoy eating again. When you eat, do nothing else. Savour foods you like mindfully and appreciate the experience).

7. Manage Your Emotions without Using Food. (For example, use techniques learned in therapy instead).

8. Respect your body. (Respect for and acceptance of what the body looks like are the first steps to making lifestyle choices that are rational rather than emotion-based).

9. Exercise for How it Feels. (Move to feel good, rather than to erase calories or achieve a certain shape).

10. Honour your health. (Select foods that are nutritious, healthy, and tasty).

By exploring these principles with the help of your therapist, you may find you are able to take a step away from binge eating and move forward into the life you want to live.