Binge eating: How it starts, why it keeps happening, and how to stop
Written byAmy Pershing, LMSW, ACSW, CCTP-II
Last updated: 10/11/2022
“A freight train couldn’t have stopped me from bingeing.”
“When I decide to binge, I’m free. There is nothing like it. I can feel my body relax and then kind of disappear. Just me, the TV, the food, then then sleep. I’m just numb. I won’t think about all the things I’m going to screw up tomorrow, or who doesn’t like me, or who is going to leave me.”
“I hate that I do this, but I just can’t stop. I even look forward to it sometimes! What is wrong with me?”
“I stick to my diet so well, and then everything just falls apart. I keep repeating the cycle over and over.”
These are just a few of many quotes from my clients, reflecting on their long and complicated relationship with food. As a psychotherapist specializing in treating binge eating disorder (BED), I have seen some incredible people come through my office doors in the last thirty years, each in a desperate search for help to stop binge eating. My clients, like most with BED, are resilient, capable, and strong—although they do not see themselves this way. They come from all walks of life, all ages, colors, beliefs, physical abilities, genders, socioeconomic groups, and sexual orientations. They are every shape and size. Many have survived extraordinary hardships, or have significant histories of trauma. They usually feel a terrible shame about their eating, but know it has somehow provided a safe hiding place that belongs to them, and them alone.
I first sought my own treatment for binge eating—very reluctantly and with much embarrassment—almost forty years ago. Back in the early eighties, there was no label for my behavior patterns with food. I ate uncontrollably, despite using every ounce of willpower I possessed to make it stop. Even the thought of stopping during a binge filled me with anxiety, dread, and sadness. I could not deal with how badly I would feel if I stopped to notice. So, once it started, I had to see it through to the end.
My binge episodes were frequent and frantic, but also trance-like and disconnected from the world around me. I sometimes planned a binge, looking forward to it all day until I could eat. It felt like a huge relief, finally letting go of something heavy, a weight lifted. Other times, my binges were impulsive, seeming to come out of nowhere. Regardless, they were always followed by intense self-recrimination and judgment for succumbing yet again. I swore each time I would never do this again. I would commit to my diet, and stick to it, no matter what. This, of course, never worked. Thankfully, I finally figured out what to do.
The Most Common of All
Three to five million people struggle with binge eating disorder. BED is three times more common than anorexia and bulimia combined, and more common than breast cancer, HIV, and schizophrenia. BED is not only for young privileged white women, as eating disorders are often misunderstood to be.
Those of us who know binge eating disorder have a relationship with food fraught with confusion, contradiction, and shame. Food is an enemy in certain ways—something that triggers guilt-ridden thoughts, worry about sticking to a food plan, “cheating” on a diet, and gaining (or regaining) weight. But food is also a safe haven, a brief disconnection and respite from the toughest parts of life, both past and present.
BED Is Not About “Pathology”—It’s About Coping
Despite what we may have been told, BED is never about personal weakness, or lack of willpower. Treating BED successfully requires understanding the way a person’s relationship with food has protected and served them when other options were not available or safe.
For many people, binge eating behaviors develop in childhood. Eating releases neurochemicals that create a sensation of soothing and wellbeing. Going to food is thus a powerful coping strategy when the world feels unsafe, and often the only option available for a child.
Changing this relationship with food can happen, but it requires self-compassion, and learning to access our innate ability to heal. In other words, we must be able to care for ourselves in ways even more powerful than food.
Is Body Size an Indication of BED?
In short, no. People with BED come in every shape and size. People in bigger bodies do not necessarily have BED (or any eating disorder). Just as people with BED come in all sizes, so do people without BED. In other words, you can’t tell anything by simply looking at body size.
In the course of BED, some people gain weight, some do not, some have periods of restriction and weight loss.
The Weight of Body Shame
As with most eating disorders, significant body shame is typically part of BED, regardless of actual body size. As for most women (and increasing numbers of men) in our culture, with or without BED, disliking our body feels normal. Many with BED have lived through weight-related bullying, and judgments from family, partners, doctors, other health professionals, and society at large.
Internalized negative attitudes about weight, known as weight stigma, can play a big role in the development of BED and eating disorders in general. For those with BED, body shame—a direct result of weight stigma—is a powerful factor in driving the desire to use food to escape and to numb. Since binges intensify this shame, people are thus faced with an inescapable cycle.
To change this cycle, we need to challenge cultural attitudes about body size. In fact, studies show that weight stigma increases the risk of high blood pressure, metabolic syndrome, diabetes, high cholesterol, and eating disorders. This means that using weight loss as an indicator of recovery is actually physically harmful, and has the opposite of the intended effect on health.
Why Can’t I Just Stick to a Food Plan or Diet Program?
BED is very often an eating disorder with significant restriction behaviors. It takes extraordinary willpower to keep trying to go on diets or make changes to eating patterns; as such, if willpower were the only issue, the problem would have been solved long ago. The reasons behind binge eating are always complex, and are typically about both past and present stressors, biochemistry, and genetics.
Additionally, dieting actually makes BED worse. A significant body of research tells us that behavioral weight loss efforts very rarely result in long-term weight loss. Put simply, diets don’t work.
Dieting is one of the biggest predictors of the development of eating disorders. In fact, prescribing diets often equates to prescribing disordered eating behaviors. Dieting can lead to severe restrictive eating and malnutrition, cycles of starvation and binge eating, as well as other eating disorder behaviors and their medical complications. Here are a few of the problems with dieting:
- Your body adapts to caloric restriction; the less you eat, the less it uses. Which means to maintain weight loss, you must ALWAYS continue to further restrict.
- Diets create food cravings; we are biologically wired to obsess about food when we are hungry OR when we forbid ourselves certain foods. It is only a matter of time before we satisfy the craving.
- Diets don’t adapt to ongoing changes in your body, and cannot meet your body’s changing needs.
- Dieting makes people less likely to trust their own body. They believe they gained weight back because they “cheated,” not because the diet was impossible to maintain.
- Dieting perpetuates the narrative that being thinner is necessarily better for health. In fact, repeated dieting typically means repeated cycles of weight loss and regain. This is called “weight cycling” and it is associated with a shorter lifespan, and increases the risk of diabetes, high blood pressure, high cholesterol, and heart disease. In fact, weight cycling is more highly correlated with these health risks than being in a larger body.
How Do I Know if I Have BED? What is a “Binge”?
When we think about the term “binge eating,” we typically think of consuming large quantities of food in a short time period. This is common, but being out of control with food may take other forms as well. Some people overeat only at mealtimes, or they “graze eat,” never really finishing a meal.
Additionally, people may hide binge behavior, or binge openly. Types of binge foods can vary as well. Some people binge on highly palatable foods that they otherwise restrict, but others may binge only on “healthy” foods.
Binge behaviors may ebb and flow with time, varying in severity and frequency. In whatever form, binge eating feels frantic, unstoppable, and psychologically distressing. Always, the person feels unable to change their eating patterns permanently.
Who’s at Risk for Developing Binge Eating or BED?
Many factors are at play in the development of BED, and the combination is unique to each person. A list of common causes includes:
- Family history of eating disorders, alcoholism/addiction, or obsessive-compulsive disorder (OCD)
- Intense family or personal concern with weight and appearance
- Difficulty identifying and/or expressing feelings
- History of trauma, especially in childhood
- Difficulty setting limits with others
- High degree of perfectionism or “black and white” thinking
- Predisposition to experiencing feelings particularly intensely
- Strong tendency toward self-soothing and dissociation (“checking out”) behaviors
- Mood disorders, including anxiety disorders, depression and bipolar disorders
How Do People with BED Use Food as a Coping Tool?
When abundant, everyone uses food to meet needs other than hunger sometimes. But when using food becomes a pattern such that your peace of mind is compromised, there may well be an underlying eating disorder.
Some common uses of food for people with BED include:
- Distraction from feelings such as loneliness, anxiety, fear, shame, grief
- Dealing with “flashbacks” and other reactions to triggers of traumatic events
- A reaction to restriction
- A way to avoid a scary/stressful issue or problem
- A way to allow much needed boundaries or time alone
What Does “Recovered” from BED Mean? Is It Possible?
Recovery is possible! How we think about the nature of recovery is actually more complicated and nuanced than simply an end to binge eating. Some things to consider:
- Recovered means eating and moving in response to body needs most of the time. Your body’s needs will vary day to day.
- Recovered does not mean never bingeing again. Bingeing may remain “in the toolbox” for some people.
- Recovered means eating to check out will become rarer and rarer, with less and less food, for shorter and shorter episodes.
- Recovered means one episode will not, by default, lead to another.
- Recovered means an episode will get your attention right away; you will know the real need, let go of any anger at yourself for eating, and meet the real need as best you can.
- Recovery is a journey, not a destination. You will recover at the rate that is just right for you.
How is BED Treated?
For many people, treatment involves highly specialized psychotherapy, such as internal family systems (IFS) or somatic therapy, and nutrition counseling. Sometimes groups, couples therapy, or family therapy can help support the person along the way as well.
Occasionally, more support is needed. In such cases, residential and intensive outpatient programs are available. In any treatment program, it is important to assess if the provider or program uses a strengths-based approach that is trauma informed, and a non-diet framework.
Recovery Is Possible
Remember that recovery takes time and effort, but it will be the best gift you ever give yourself and the people who care about you. For more information about next steps, check out the following resources:
- Book: Binge Eating Disorder
- Book: The Body Positivity Card Deck
- Book: An Internal Family Systems Guide to Recovering from Eating Disorders
- HAES (Health at Every Size) Health Sheets
- The Bodywise Program (offers online quizzes to see if treatment is right for you)
- Food Psych Podcast
About the author
Amy Pershing, LMSW, ACSW, CCTP-II, is the founding director of the Bodywise binge eating disorder (BED) treatment program, vice president of the Center for Eating Disorders, and creator of Hungerwise, an online program for ending chronic dieting and weight cycling. Based on 35 years of clinical experience, she has pioneered a treatment approach for binge eating that incorporates Internal Family Systems theory. She lectures internationally on BED treatment and her own recovery journey, and she offers training for clinicians treating BED. She is the past chair of the Binge Eating Disorder Association and the 2016 winner of its Pioneer in Clinical Advocacy award.
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