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You’ve finally decided to get professional help for binge eating disorder (BED). However, you may feel anxious and uncertain about what you’ll experience during treatment.
You’re not alone in what you’re feeling, and it’s normal to be apprehensive about what comes next. This article will go through what you can expect from treatment for binge eating disorder, the kind of therapies that may be used in your treatment plan, and how you can support your recovery at home.
The primary goals for the treatment of binge eating disorder are to reduce binge eating episodes, address restrictive thoughts and behaviors that can lead to a binge-restrict cycle, and identify alternative strategies to cope with trauma and painful emotions. As shame, guilt, poor self-image, and other negative emotions often go hand-in-hand with binge eating, treatment may also address these feelings and any other co-occurring mental health issues, such as depression or anxiety.1
While there may be exceptions, treatment for eating disorders, including binge eating disorder, typically includes the following:2
Address and treat life-threatening psychiatric and medical symptoms. In some cases, it is necessary to start treatment at an inpatient level of care to monitor symptoms until an individual is physically and medically stable to attend other levels of eating disorder care safely.
Interrupt disordered eating behaviors (i.e., eating until stuffed or in physical pain, inconsistent nutrition intake, secretive eating, etc.) if they occur, as well as restriction, which may play a role in driving bingeing episodes.
Nutritional rehabilitation and the establishment of consistent and adequate eating to help a person enjoy food without feeling shame or anxiety.
Challenge unhelpful and negative binge eating-related thoughts and behaviors, such as hiding food, eating in secret, and feeling guilty about food.
Continue to address ongoing physical and mental health issues.
Identifying physical and emotional triggers of bingeing episodes, working to address traumas and other mental health challenges that may be contributing to eating disorder behaviors, and practicing alternative responses to known eating disorder triggers.
Create a plan to help prevent relapse and what to do should a relapse occur.
Treatment options for binge eating disorder
Your treatment plan for your binge eating disorder will depend on the underlying causes and the severity of your disordered behaviors. Typically, a multidisciplinary team—including a physician, psychotherapist, psychiatrist, and dietitian—will handle your care to address all aspects of an eating disorder.
Psychotherapies for binge eating disorder
The first line of treatment is psychological therapy, which may be carried out on a one-to-one basis, in a group setting, or even in a self-guided format. For some people, one type of therapy may be required, although typically, a combination of therapies is used for the best possible treatment outcomes.
While your treatment team will help determine which forms of therapy will be suitable for you, the most common include:
Cognitive behavioral therapy (CBT) focuses on the interaction between thoughts, feelings, and behaviors. Through CBT, you will address the disordered and/or negative thinking patterns and emotions that trigger binge eating episodes.3 Once the underlying causes of harmful thoughts and feelings have been identified, strategies to help change them into something more positive can be formed.
CBT for binge eating will also address any dietary restrictions and help someone incorporate fear foods to help establish regular eating patterns. It also challenges negative thoughts about shape, weight, and body and offers alternative coping skills.
Therapist-led CBT is believed to be the most effective treatment for binge eating, but guided self-help CBT is another option.4 In this form of therapy, a manual to work through at home is provided, and progress and setting goals are discussed in regular meetings with a therapist.
Dialectical behavior therapy (DBT)
Dialectical behavioral therapy (DBT) can be helpful to people who binge eat as an emotional reaction to experiences and feelings that are difficult to cope with.4 Through DBT, one learns how to regulate emotional responses through the use of multiple skills to cope with negative situations instead of using eating disorder symptoms.
There are four main areas of treatment in DBT: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness (improving relationships). These elements will help you identify your triggers as well as implement alternate responses when they occur.5
Interpersonal psychotherapy (IPT)
Interpersonal psychotherapy (IPT) may be helpful for individuals who engage in binge eating as a coping mechanism for unresolved personal problems, such as relationship conflicts, life changes, and grief.6
IPT aims to improve interpersonal skills—i.e., how you relate to and communicate with others—which may help address binging triggered by problematic relationships and poor communication skills.
Either in a one-to-one or in a group format, over a 12 to 20-week period, individuals identify the specific issues linked to binge eating symptoms, acknowledge them, and then work with a therapist to make constructive changes.4
Mindful eating
Mindful eating, as the name suggests, uses the principles of mindfulness to provide someone with a better awareness of hunger and fullness cues, as well as emotional triggers that result in binging. Mindful eating exercises include:7
Listening to your body’s hunger cues
Tuning into what you can taste and smell when eating
Chewing food slowly
Recognizing hunger and fullness without fear
Mindful eating encourages eating with intention, enjoying food, and not restricting the type or amount of foods that are eaten.
Paying attention to the sensory experiences of eating instead of eating when distracted, such as while watching TV, helps a person identify the body’s cues and can help establish consistent and adequate eating patterns to decrease the likelihood of falling into a binge-restrict cycle.
Medications for binge eating
Some people with binge eating disorder benefit from incorporating medication as well as therapy and nutrition counseling into their treatment program. This can be especially helpful for individuals who experience other mental health challenges, such as anxiety and depression, in addition to their eating disorders. Some people prefer to try therapeutic treatments for binge eating disorder before adding medication, and different people respond differently to the same medications for a variety of reasons, so this is always a personal decision that should be made after discussing options with your doctor and other treatment providers.
Working with expert eating disorder treatment providers in an outpatient setting or a higher level of care can be very helpful for many people in recovering from binge eating disorder. In addition to your treatment plan, there are some self-care strategies you can consider implementing at home to support your recovery.5
While providers can give you invaluable advice and support, challenging the eating disorder and learning new patterns will ultimately be achieved through your consistent practice over time. When setbacks or challenges occur, be compassionate with yourself and try to view them as learning opportunities, not evidence of failure.
Restricting your food intake by dieting can trigger more binge episodes, resulting in a restrict-binge cycle that’s hard to break. Both restrictive behaviors and thoughts can contribute to this cycle, so practice challenging the idea that some foods are dangerous or off-limits.
Unless you have allergies, intolerances, or other medical reasons that certain foods are not safe for you to eat, all foods you enjoy can be incorporated into your recovery. Work with your team to incorporate all foods into your meals and snacks to prevent feelings of deprivation and scarcity, which can maintain the binge-restrict cycle.
Many people who struggle with eating disorders avoid eating during the day and only eat at night. Regular meals every few hours, starting soon after you wake up, can help prevent extreme feelings of physical and mental restriction from developing.
It’s easy to become isolated when you’re suffering from an eating disorder. Many people who struggle with binge eating feel significant shame about these behaviors and develop secretive patterns. Accept support from friends and family, and reach out to them when you’re struggling.
Find other ways to cope or distract yourself when you’re feeling negative emotions and allow yourself to explore new ways to have fun and add meaning to your life. Even on days when setbacks or recovery feels impossible, treating yourself with compassion and care can help make continuing feel possible. Being kind to yourself will be such an important part of your recovery.
If you are interested in incorporating more movement or learning a new sport or skill, speak to your treatment team about the physical activity you can do that will fit in with your recovery plan. Depending on your physical and mental health needs, different types of movement may or may not be appropriate, and it is always up to you if or when it is something you want to engage in.
Through our supported meals, we help you become reacquainted with your body’s hunger and fullness, and to respond appropriately to those cues.
Help for binge eating disorder is available
Treatment for binge eating disorder can be challenging, but help is available, and it is never too late to reach out for support. Thankfully, there are effective treatments for binge eating disorder and recovery strategies that can help you work towards a life free of your eating disorder.
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.
Resources
Mayo Foundation for Medical Education and Research. (2018, May 5). Binge-eating disorder. Mayo Clinic. Retrieved October 7, 2022.
What to expect from treatment. (n.d.). National Eating Disorders Association. (2018, August 3). Retrieved October 7, 2022.
