What it is
Binge Eating Disorder (BED) involves recurrent binge eating (large amounts with a sense of loss of control) without regular compensatory behaviors like purging. Binges often occur rapidly, to the point of discomfort, and are followed by guilt or shame. BED is common and highly treatable.
BED can occur at any body size; medical monitoring is important.
Common signs and symptoms
- Recurrent binges: eating much more than usual in a short time, feeling out of control
- Patterns: eating rapidly, eating when not physically hungry, eating alone due to embarrassment, feeling disgusted/depressed/guilty after
- Triggers: restriction, stress, boredom, loneliness, perfectionism, long gaps between meals
- Impact: emotional distress, weight cycling, metabolic issues, sleep problems
BED is not a lack of willpower; it’s a treatable pattern with biological and psychological drivers.
Why it happens
- Biology: genetics; differences in reward and satiety signaling; sleep and circadian disruption
- Psychology: emotion regulation difficulties, rigid food rules, negative body image, shame
- Environment: weight stigma, diet culture, ultra-restrictive plans
- Restriction–binge cycle: restricting increases drive to binge; shame maintains the cycle
What helps
- Evidence-based therapies
- CBT-E: normalizes eating (3 meals + 2–3 snacks), challenges all-or-nothing thinking, reduces binges
- DBT skills: tolerate distress, regulate emotions, reduce impulsive eating
- Interpersonal therapy (IPT): improves relationships and mood, reducing binge triggers
- Nutrition
- Flexible, regular eating; include satisfying foods; avoid extreme restriction
- Identify trigger times/places; plan alternatives (calls, walks, crafts)
- Medications
- Lisdexamfetamine (Vyvanse) FDA-approved for BED; SSRIs can help some
- Discuss benefits, side effects, heart/blood pressure, sleep/appetite effects
- Lifestyle supports
- Sleep routine, stress management, movement that feels good (not punishment)
- Self-compassion and body-neutral practices reduce shame, a key driver of binges
When to seek help now
- Binges multiple times per week with significant distress
- Medical concerns (diabetes, blood pressure, sleep apnea) worsened by patterns
- Thoughts of self-harm or not wanting to live (seek urgent help)
How to talk to a clinician
- “I have recurring episodes of eating a lot of food quickly with a sense of loss of control. I’d like CBT-E or IPT and to discuss medication options like lisdexamfetamine.”
Outlook
With regular eating, skills, and support, binge episodes usually decrease within weeks. Recovery focuses on freedom from cycles, improved energy, and better relationship with food and body.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline (call/text 988); Crisis Text Line (text HOME to 741741)
- Eating disorder care: National Alliance for Eating Disorders; NEDA; F.E.A.S.T. (family)
- Find care: Psychology Today (filter for eating disorders/CBT-E/IPT); FindTreatment.gov; NAMI HelpLine
- Low-cost/community: Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Confirm in-network therapy, nutrition, medication coverage; prior authorization where required; parity appeals; copay/coinsurance, deductible, out-of-pocket max
- Work/school supports: EAP; ADA accommodations (breaks, flexible scheduling); campus counseling
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.