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Treatment plans for binge eating disorder (BED)—or other eating disorders and mental health conditions—are generally created by a care provider and patient together, once a patient is admitted to a care facility or enters into treatment.
To find the best binge eating disorder treatment plan for you, you should speak with your doctor, therapist, or another medical professional. Your health insurance company may also be able to point you in the direction of a specialist or program that will help you develop a personalized binge eating treatment plan.
Still, there are some clinically-tested ideas about BED and eating disorder treatment that can work to build a broad outline for optimal care. For information sharing purposes, here are some considerations to keep in mind.
The best strategy for treating binge eating disorder depends on several factors.
One of the biggest influences on recommended treatment is the severity of symptoms. Different types or intensities of therapy may be more helpful at different points in the recovery journey.
Several levels of care have been developed to address these varying needs, each with their own treatment goals for binge eating disorder.
Sometimes it may be necessary for a person with BED to be admitted for inpatient treatment, particularly if they are psychologically or medically compromised.
A person may need inpatient treatment if:1
They have severe depression and/or anxiety, or have suicidal thoughts
BED has caused serious medical problems, such as an unstable heart rate
Lab tests indicate an acute health risk
The eating disorder is severe with worsening BED behaviors
Other forms of treatment have been unsuccessful
Care and monitoring is provided around the clock, usually in a hospital setting or a unit specialized in the treatment of eating disorders. Medical intervention may be required, such as IV fluids and medications to improve mood.
Inpatient stays are generally short, with the goal of helping a patient reach medical stabilization. After that point, patients are usually admitted to a residential treatment facility or another care program.
Round-the-clock care is also available in residential treatment, but these facilities are generally more home-like than hospital. Patients can stay in a residential program anywhere from several weeks to several months, depending on the severity of their symptoms and the pace of their recovery.
Multidisciplinary treatment is provided, including different types of binge eating disorder therapy, nutritional counseling, medical check-ins, medication consultations, and monitoring at mealtimes to prevent harmful eating behaviors and rituals.2
Residential treatment is generally recommended for someone with severe binge eating disorder, or someone still struggling with intrusive thoughts and behaviors. The structured environment is usually considered helpful for breaking these negative patterns and reinforcing new coping mechanisms and skills.
Partial hospitalization programs (PHPs) are the middle ground of binge eating disorder interventions, with patients living and sleeping at home while commuting to treatment. This allows them to continue receiving support and structure for recovery, while having the space to start practicing new coping strategies and eating habits outside of a facility setting.
Schedules are generally intensive, but usually adjusted as someone progresses with their recovery. Patients may go to a facility up to 5 days a week, for up to 8 hours per day, and receive many of the same types of care as residential facilities, including individual and group therapy, nutritional counseling, and meal monitoring.11
If a patient is transitioning from a residential facility, they may even keep the same treatment team, depending on the program.
Intensive outpatient programs (IOPs) are a step down from PHPs. They include more frequent or intensive binge eating disorder therapy than standard outpatient care, but more freedom than a partial hospitalization program. This makes them a great option for someone who is ready to start incorporating more social responsibilities, like school or work, back into their daily lives.
Generally, a patient in IOP treatment has been able to successfully reduce binge eating, but they may still want or need more structure or support for ongoing recovery. Programs can last between 6 to 30 hours per week, over the course of 3 to 5 days.12
People with binge eating disorder may attend additional therapy sessions to help work on self-esteem, address other related mental health conditions, and/or monitor for triggers of binge eating episodes.
As the least-intensive level of care for BED, outpatient treatment requires patients to be mostly in control of their unhelpful thoughts and behaviors. The goal of this type of care is to help patients stay accountable to themselves and their ongoing recovery, while continuing to provide an outlet for concerns, anxieties, or other issues.
Care schedules vary widely, depending on a patient's needs, but it's common for someone to attend weekly or twice monthly sessions with a therapist, dietician, or other treatment team member. If a patient was prescribed medication to help with their BED, outpatient treatment could also include regular medical check-ins and medication evaluations.
By some estimates, BED is the most common eating disorder in the United States.13 As such, how to treat binge eating disorder has become a much-studied topic, with several therapeutic methods found to be particularly helpful.
This type of psychotherapy focuses on the relationship between negative thoughts, emotions, and behaviors. Specifically, it posits unhelpful thoughts as the source of unhelpful behaviors, and argues that, since these behaviors are "learned," they can be "unlearned."4
Patients are taught how to recognize unhelpful patterns and are given strategies for redirecting negative thoughts. The goal is to eventually have troubled thoughts redirect automatically, and eventually stop all together.
To help reinforce these new learnings, patients are sometimes given "homework" assignments. CBT for binge eating disorder may include tasks like food journaling and monitoring emotions, or working on brain teasers or puzzles to encourage different types of thinking.
Acceptance and commitment therapy (ACT) incorporates elements of CBT, but takes a different approach to overcoming disordered thoughts and behaviors. Rather than training people to recognize and redirect the way they think, the method asks patients to simply accept their thoughts—even the negative ones—as a natural part of life, and to let them go.3
Mindfulness techniques and skills around acceptance and cognitive distancing are taught to help reinforce these ideas. And the energy that would be spent on redirecting thoughts is instead used to redirect focus: Patients are asked to "commit" to hobbies, habits, or causes that are healthy and align with their values, in order to foster a stronger sense of self-worth and an overall more positive perspective.
When used as psychotherapy for binge eating disorder, these teachings can also help foster a greater sense of cognitive flexibility, which can help someone directly confront the kind of rigid thinking that often drives disordered eating behaviors.3
Guided self-help is a common form of treatment for binge eating disorder, as this therapy treatment plan can generally be easily followed at home. It's usually recommended for people with less severe symptoms, who are willing and able to follow through with the program.
Most forms of self-help are modeled after CBT. Even when worked through with a therapist, cognitive behavioral therapy follows a pre-set course for treatment, and with guided self-help, these modules are explained through workbooks, apps, or other materials.5
Guided self-help aims to teach a person living with binge eating disorder the same kinds of skills and concepts their therapist would, including how to recognize unhelpful thought patterns, avoid potentially triggering episodes, improve body image, and prevent a relapse.5
Patients are sometimes encouraged to pair guided self-help with participation in a support group, or occasional check-ins with a therapist, in order to help them stay on track.
Dialectical behavior therapy (DBT) is a form of talking therapy that’s adapted for those who feel emotions intensely. When used as BED treatment, it can help people learn to regulate their emotional responses—which are often at the heart of binge eating episodes—so they can deal with negative thoughts and situations without resorting to disordered behavior.
"Dialectical" means the combination of opposing ideas, and that's at the heart of the method. During DBT sessions, a therapist uses a balance of techniques to foster acceptance and the desire to change, helping someone learn to both love and accept themselves as they are and feel motivated to change their negative coping behaviors.7
As with other types of therapy for binge eating disorder, mindfulness and distress tolerance skills also play a role in DBT, to help reinforce the ideas of acceptance, patience, and positive change.
Once thought on the extreme end of treatment, exposure therapy is increasingly being looked at as a way to address many mental health conditions, including BED and other eating disorders. The method works by directly addressing one of the biggest drivers of binge eating disorder: anxiety.6
Many people who struggle with BED have irrational fears and ideas around food and eating which cause the kind of distress that may trigger binge eating episodes. Through careful and controlled exposure to these situations, people living with BED can gradually face these feelings head-on, allowing them to better understand—and, eventually, let go of—the ideas and their associated disordered behaviors.6
For example, a person may be exposed to a food they regularly binge on, and be asked to talk through their feelings throughout the exposure. As well as binging on food, exposure therapy can help address other anxiety-driven behaviors such as eating alone or certain food rituals.6
Group therapy has been found to have many benefits for people struggling with binge eating disorder and many other mental health conditions.
In this therapy treatment plan, a group of individuals who are going through similar experiences are led through targeted discussions or exercises by a trained therapist. The method helps create an environment where people can feel safe to share experiences, practice new coping mechanisms, and connect with others who have BED.
For many people, that sense of community and understanding can be incredibly reassuring and healing. And studies have shown that the method is also specifically effective at curbing binge eating behavior.14
Interpersonal psychotherapy (IPT) examines the way personal relationships, changing social dynamics, and unresolved conflict impact someone's mental health. Grief, significant life changes, relationship complications, and struggles with socializing are all common subjects.15
For people struggling with binge eating behaviors, connections are generally drawn between binging episodes and these aspects of someone's life, with the idea that binge eating may develop as a maladaptive coping mechanism in the face of these situations.15
Working together, a patient and therapist will identify the specific life problems linked to binging episodes, acknowledge them, and take the steps to resolve them. IPT is usually administered through group therapy or via one-on-one sessions.
Nutrition counseling and meal support for BED
In many cases, the disordered eating patterns involved with BED can lead to additional health complications. That's why nutrition support, education, and therapy for overeating is common when treating BED.
Nutrition counseling is a multidisciplinary approach incorporating dietitians, therapists, and physicians.9 It often helps individuals learn more about the essential vitamins, minerals, and nutrients the body needs to remain healthy. It can also teach those with BED healthy eating habits that can help them not only avoid binge eating episodes, but some of the physical consequences brought on by that behavior.
Specifically, blood sugar levels can be greatly improved with healthier eating habits. This can have a powerful effect on many other internal systems and functions.9
As many people with BED have an unhelpful history with dieting, nutritional counseling generally avoids the kind of tips aimed at losing or controlling weight. Rather, the emphasis is on building an overall healthier relationship with food and eating.
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Other types of treatment for binge eating disorder
When building a treatment plan for binge eating disorder, patients may also want to consider a broader range of therapy options, techniques, and other binge eating disorder treatments.
Art therapy
Creative self-expression can help individuals living with BED engage with difficult emotions and gain new perspectives by encouraging them to bypass the more reasoning-based side of the brain and tap into more abstract, subconscious thinking.16
Externalizing these thoughts through a variety of artistic media can also help someone understand their emotional state in a different way, which may lead to further breakthroughs.16
Mindfulness-based eating awareness training (MB-EAT)
Mindfulness-based eating awareness training (MB-EAT), which combines mindful eating with mindfulness strategies, has shown promise in treating BED.10
Using mindfulness techniques, people with BED learn to become more in tune with the needs and rhythms of their body, helping them understand their natural hunger cues. This can help them go on to better recognize and more easily change problematic eating behaviors.
Psychodynamic psychotherapy
The goal of psychodynamic psychotherapy is helping someone cultivate greater understanding and self-awareness around how past experiences work to influence present behavior.17
The therapy revolves around the idea that behaviors associated with a mental health disorder manifest as a result of unresolved conflicts and dysfunctional relationships. Understanding this throughline is presented as a way to help someone better understand and address their disordered thoughts and behaviors.17
Here at Within Health, we understand the importance of treating each patient as an individual. Our personalized treatment plans for clients are designed to help a person to explore their relationship with themselves, their bodies, and food.
Our treatment program for BED has two levels of care—partial hospitalization (PHP), and intensive outpatient (IOP)—and each client is carefully assessed to determine the appropriate treatment.
86%
of those who complete our treatment program report reduced eating disorder symptoms
You’re much more than numbers on a scale, so we don’t use them. There will be no calorie counting, weight measurements, or any other numbers involved. Instead, we focus on an intuitive eating model to counteract the misguided beliefs that come from diet culture, as well as relearning to recognize internal cues of satiety and hunger.
We recognize that it’s hard asking for help for BED and hope you’re reassured that through every step of treatment with Within Health, you’re met with compassion, respect, and empathy. We are proud to offer a safe space and support to any gender identity, ethnicity, sexuality, shape, and size.
Disclaimer about "overeating": Within Health hesitatingly uses the word "overeating" because it is the term currently associated with this condition in society, however, we believe it inherently overlooks the various psychological aspects of this condition which are often interconnected with internalized diet culture, and a restrictive mindset about food. For the remainder of this piece, we will therefore be putting "overeating" in quotations to recognize that the diagnosis itself pathologizes behavior that is potentially hardwired and adaptive to a restrictive mindset.
Disclaimer about weight loss drugs: Within does not endorse the use of any weight loss drug or behavior and seeks to provide education on the insidious nature of diet culture. We understand the complex nature of disordered eating and eating disorders and strongly encourage anyone engaging in these behaviors to reach out for help as soon as possible. No statement should be taken as healthcare advice. All healthcare decisions should be made with your individual healthcare provider.
As with most other eating disorders and mental health conditions, BED is generally considered chronic, meaning there is no permanent cure. The combination of psychological and physiological conditions that result in BED tend to remain in the brain and body, even after successful treatment, leaving open the possibility of relapse.8
Rather than focus on curing binge eating disorder, treatments for BED focus on the idea of ongoing recovery. And happily, with the right kind of management strategies, symptoms often go into long-term remission.
What’s the most effective treatment for binge eating disorder?
How to treat binge eating disorder most effectively depends on a number of personal factors, including someone's health history and severity of symptoms.
In general, cognitive behavioral therapy is widely considered the leading treatment for BED and other disordered eating conditions. Some types of medication may also be helpful, especially when combined with therapy.
But ultimately, the best treatment for binge eating disorder, including the best type of binge eating disorder counseling, should be determined between a patient and their doctor or treatment team.
Can you recover from binge eating disorder on your own?
Yes. It may be possible to reduce binge eating episodes and other symptoms of BED through guided self-help programs.
Still, this type of eating disorder treatment plan is best for people with mild to moderate symptoms, and generally best for those without co-occurring mental health conditions.
If your symptoms continue or get worse while using guided self-help, it may be time to speak with a therapist or other medical professional.
Can you treat binge eating disorder with medication?
Yes. A type of amphetamine called lisdexamfetamine dimesylate (Vyvanse) has been approved by the FDA specifically for the treatment of binge eating disorder. Several other types of medications—especially certain antidepressants—are also sometimes used to help address symptoms of BED.18
These medications are only available through prescription, and should only be used as directed by your doctor or health care provider.
Get access to a streamlined experience with our industry-first treatment app. You can attend individual and group sessions, connect with your care team, submit weights and vitals via a numberless scale provided to you, receive meal support, and access check-ins and recovery-focused tools for use between sessions.
