Binge Eating Disorder

This article provides a comprehensive overview of binge eating disorder, including the main symptoms, causes, risk factors, treatment and management options, and other pertinent information.

Key Takeaways:

• Binge eating disorder involves consuming very large amounts of food within a distinct time period. Many individuals with this disorder also find it hard to stop or feel that they lack control over their behaviors.
• Physical and mental comorbidities are very common in binge eating disorder. It increases the risk for obesity and is associated with depression, anxiety, and other psychiatric disorders.
• Psychotherapy is an often effective treatment, while medication can be used successfully too. Social support and self-management strategies can also improve outcomes and reduce binge eating episodes.

Understanding Binge Eating Disorder

Binge eating disorder is a mental health condition characterized by uncontrollable eating of excessive amounts of food during a short period of time, typically within two hours. According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), individuals with this disorder eat amounts of food that are much larger than what would be considered normal, and they also feel that they lack control over their eating behaviors. ^{[1] [2]}

While some people experience binge eating occasionally, people with this disorder experience these episodes at least once per week for several months. Thus, it’s much different from a one-off binge eating episode, and has a persistent course. ^[3]

Binge eating disorder not only leads to physical issues, such as uncomfortable fullness or weight gain, many people with this disorder also experience shame, guilt, and other negative emotions. Together, these can cause significant distress and may disrupt overall well-being and daily functioning.

How Common is It?

The overall prevalence of binge eating disorder ranges from 1.9 to 2.6%, which makes it relatively common. It is more common in women than men at a rate of roughly 3:2, and affects teenagers more than adults, at a rate of roughly 4:3. ^{[1] [2] [4]}

Binge eating disorder is also more common in individuals with a body mass index (BMI) of 25 or higher compared to those with a BMI lower than 25. In addition, nearly 30% of obese individuals who are seeking weight loss treatment have comorbid binge eating disorder. ^{[1] [2]}

How Does it Differ from Bulimia Nervosa?

Binge eating disorder and bulimia nervosa are both types of eating disorders involving the consumption of excessive amounts of food. However, bulimia nervosa also involves specific compensatory behaviors after this occurs, such as self-induced puking, excessive exercise, or use of laxatives. These behaviors do not occur in binge eating disorder. ^{[1] [2]}

Symptoms

Binge eating disorder has several symptoms, some of which are always present, and some of which may vary from person to person. The main symptoms of binge eating disorder are: ^{[1] [3] [5]}

• Eating much larger amounts of food at one time than what is considered normal
• Especially within a short time frame (2 hours or less)
• A feeling that you are unable to control your eating behaviors
• Eating to a period of discomfort or excessive fullness
• Eating much more quickly than normal
• Eating a lot of food, even when you’re not hungry
• Negative emotions after eating, such as embarrassment, depression, shame, or disgust
• Eating by yourself or in secret
• Eating in response to stress
• Obsessive thoughts about food
• Strong, specific food cravings
• Hiding food in secret/hidden places to access later

Some individuals with binge eating disorder also engage in chronic dieting. They may diet before, after, or otherwise surrounding their binge eating episodes to try to lose weight or negate the effects of their binges. However, as mentioned, this doesn’t involve vomiting or other compensatory behaviors. ^{[3] [4]}

In addition, many people with binge eating disorder keep their habits a secret. Close family or others who live with them may not even know about their binge eating behaviors. ^{[4] [6]}

When Does Binge Eating Start?

Binge eating disorder can start at any age, but it typically begins in adolescence or early adulthood. The average age of onset is at 25 years old. ^{[2] [4]}

Other Conditions Linked to Binge Eating Disorder

Binge eating disorder is linked to several other conditions. Nearly 50% of individuals with binge eating disorder experience 3 or more comorbid conditions, and over 90% have at least one comorbid psychiatric condition. ^{[1] [2]}

Rates for common comorbid psychiatric conditions are as follows: ^{[1] [2]}

• 56.1% have an anxiety disorder
• 46.1% have a mood disorder
• 25.4% have a disruptive behavior disorder
• 23.7% have a substance use disorder
• 32% have post-traumatic stress disorder (PTSD)

Some studies show even higher rates for these, such as up to 60 and 70% for anxiety and mood disorders, respectively. ^[6]

Binge eating disorder is also associated with physical health conditions, such as obesity, joint and muscle pain, and digestive issues. For example: ^[2]

• 31% have hypertension
• 24% have arthritis
• 27% have elevated cholesterol
• 14% have diabetes mellitus
• 29% have sleep problems
• 40% are smokers

Causes

There are likely several causes of binge eating disorder that affect and interact with each other. This includes biological, psychological, social, and cultural factors.

Binge eating disorder has an estimated heritability rate of 41 to 57%, which is highly significant. Therefore, genetic factors likely play a role, although the exact genes aren’t fully known. ^[1]

Individuals with binge eating disorder sometimes show dysfunctions or abnormalities in key brain regions linked with behavioral control and reward processing, such as the prefrontal cortex. Other possible biological factors/causes include a disrupted gut microbiome and altered neurotransmitter levels and functioning. ^{[1] [2]}

Who is at Risk of Developing Binge Eating Disorder?

There are several risk factors associated with the development of binge eating disorder, such as: ^{[1] [3] [5] [6]}

• Having a family member who has or had binge eating disorder or another eating disorder
• Psychological factors, such as perfectionism and tendency towards negativity
• Childhood obesity
• Conduct problems
• Family/interpersonal conflict
• Physical or sexual abuse
• Loss of control of eating as a child
• Family history of weight issues
• Substance use problems
• Having a mental health condition

Risks and Complications

Many people with binge eating disorder are overweight or obese, which itself is associated with an increased risk of high blood pressure, diabetes, cardiovascular disease, and other important concerns. The binge eating episodes themselves may also cause heartburn, acid reflux, and other digestive issues, which could lead to greater problems over time. ^{[1] [2]}

Worsening mental health is also a potential complication with binge eating disorder. Many individuals experience shame, guilt, anger, self-criticism, and other negative reactions which can worsen mental health. They may also isolate themselves and find it difficult to enjoy life. If left untreated, this can lead to significant mental health issues and may increase the risk of suicidality or self-harm behaviors. ^{[3] [4] [5]}

Diagnosing Binge Eating Disorder

Diagnosing binge eating disorder requires several steps, including personal history overview, detailed interview/assessment of symptoms, physical examination, and comprehensive mental health screening. Additional tests may be used if there are possible comorbid physical or medical conditions.

You can be diagnosed by a primary care physician or a mental health professional. They compare your symptoms to those found in the DSM-5. A diagnosis of binge eating disorder is met by the following criteria:

• Recurrent episodes of binge eating, characterized by both of the following:
• Eating a significantly larger amount of food than most people would eat, within a discrete time period (e.g. within two hours),
• A sense of lack of control over eating, such as being unable to stop
• Binge-eating episodes are associated with three or more of the following:
• Eating much faster than normal
• Eating until discomfort
• Eating large amounts of food when not physically hungry
• Eating alone due to embarrassment about the amount of food eaten
• Feelings of disgust, depression, or guilt after the eating episodes
• Significant distress surrounding the binge eating
• Binge eating occurs at least once a week for three months (on average)
• Binge eating is not associated with compensatory behaviors and does not occur exclusively within bulimia nervosa or anorexia nervosa

When to See a Doctor

Many individuals may experience binge eating from time to time. But if you have frequent binge eating episodes that are significantly disrupting your well-being and ability to function, you should see your doctor for further evaluation.

Tests and Assessments

A variety of tests and assessments are used when diagnosing binge eating disorder. This includes assessment of binge eating behaviors specifically, along with other tests to identify any comorbid medical conditions and/or consequences related to binge eating.

A variety of self-report measures are used to get an initial idea of binge eating behaviors, including: ^{[1] [2]}

• Binge Eating Disorder Screener 7 (BDS-7): This is a 7-item measure that assesses specific binge eating disorder symptoms as they relate to DSM-5 criteria.
• Binge Eating Scale: This 16-item scale measures the overall severity of binge eating symptoms.
• Eating Disorder Examination Questionnaire (EDE-Q): This is a 28-item scale with four subscales that measure restraint, eating concern, shape concern, and weight concern.

These assessments provide valuable initial information. However, a comprehensive expert clinical interview is needed for official diagnosis. This is mainly done through the Structured Clinical Interview for DSM-5 Disorders, which is conducted by a mental health expert. ^{[1] [2]}

Given the potential complications with binge eating disorder, various physical tests may be used too, including tests for: ^{[1] [2]}

• Triglycerides
• Low-density lipoprotein (LDL) cholesterol
• Fasting blood glucose
• Weight and height (to give BMI)
• Waist circumference
• Blood pressure
• Thyroid function

Treatment Approaches

Treatment for binge eating disorder focuses not only on resolving binge eating symptoms, but also treating any comorbidities or other consequences that have developed from binge eating behaviors. Psychotherapy and medication are the most common treatments. Treatment may also include behavior modification and, in some cases, alternative treatments such as transcranial magnetic stimulation.

Psychotherapy

Psychotherapy is considered the first-line treatment for binge eating disorder, due to its effectiveness and limited side effects. The three most well-researched and effective forms of psychotherapy for binge eating disorder are cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), and dialectical behavior therapy (DBT).

CBT focuses on addressing dysfunctional and maladaptive thoughts, behaviors, and emotions that are likely perpetuating binge eating behaviors. For example, it helps address negative beliefs about body image or weight, and helps you recognize and control triggers and cravings. Research shows that CBT is well-tolerated and highly effective for many people. ^{[1] [2] [6] [7]}

IPT focuses on the interpersonal stressors that may contribute to binge eating behaviors, such as one’s relationships and problem-solving behaviors. The goal of IPT is to improve interpersonal functioning, which in turn is meant to improve self-esteem, reduce perfectionism, and ultimately lead to healthier eating behaviors. ^{[1] [2] [3]}

DBT focuses on teaching individuals four core skills, all of which promote healthier eating behaviors. These skills are: ^{[1] [2] [3]}

• Mindfulness
• Distress tolerance
• Emotional regulation
• Interpersonal effectiveness

Medication

Medication can be used if psychotherapy is not successful, or for individuals who don’t want to or can’t access psychotherapy. In general, medications come with a higher risk of side effects, but may be needed for best results in more severe cases.

Common medications used for binge eating disorder are: ^{[1] [2] [7]}

• Central nervous system (CNS) stimulants, such as:
• Lisdexamfetamine (the most common one, which is also FDA-approved for moderate to severe binge eating disorder)
• Armodafinil
• Methylphenidate
• Antidepressants, such as:
• Sertraline
• Fluoxetine
• Escitalopram
• Bupropion
• Anticonvulsants, such as:
• Zonisamide
• Topiramate
• Lamotrigine

Behavioral and Other Strategies

Behavior modification may also be used within treatment. This includes exercise, decreasing caloric intake, and choosing nutrient-dense foods. Individuals with severe obesity and/or significant physical comorbidities may be treated with professional interventions, which may include bariatric surgery. ^{[1] [2]}

Management and Self-Care

In addition to professional treatment, management and self-care strategies can increase the likelihood of positive outcomes, and may help you function better and feel better overall. Some things you can do on your own to help manage binge eating disorder are: ^{[1] [3] [6]}

• Practice mindful eating:
• Consciously slow down and stay present while eating.
• Learn to recognize hunger:
• It can also help to ask yourself if you’re hungry to eat something healthy, which can help recognize true hunger versus mere cravings
• Eat when you’re truly hungry:
• Don’t wait too long or deprive yourself
• Stop eating before you’re full:
• Try to stop at around 80% fullness and then wait to see if you notice true fullness in a little bit
• Keep a journal to track your triggers, behaviors, emotions, and other important elements
• Practice stress management strategies, such as deep breathing and meditation
• Be self-compassionate after binging; try to avoid criticism and negativity
• Communicate and gain support from those you trust, such as close family and friends
• Keep unhealthy/trigger foods out of the house (or at least reduce them)
• Keep a regular meal schedule
• And plan your meals ahead of time
• Limit tracking/analyzing of weight and body shape

Helping Someone with Binge Eating Disorder

If you know someone with a binge eating disorder, there are ways you can help. You can encourage them to seek professional treatment, without sounding pushy or judgmental. Other tips to help someone with binge eating disorder include: ^[6]

• Check in with them on a regular basis
• Help them manage their triggers
• Be supportive and understanding
• Let them know that you care and are here for them
• Avoid talking about diets, weight loss, or weight gain
• Refrain from labeling foods as good or bad
• Cook for or with them
• Eat meals together

Additional Resources

If you or someone you know is struggling with binge eating disorder, the following resources offer additional helpful information and support:

• National Eating Disorders Association
• National Institute of Mental Health
• Academy for Eating Disorders
• Overeaters Anonymous

Author

Jack Cincotta

Jack Cincotta holds a M.S. degree in Psychology. He is also a board-certified holistic health practitioner through AADP and an AFPA-certified holistic health coach and nutritionist.

Activity History - Last updated: March 19, 2026, Published date: March 19, 2026

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Reviewer

Jennifer Brown

Dr. Jennifer Brown is dual board-certified in family medicine and obesity medicine. She currently works for Amwell Medical Group, providing virtual primary care services, including mental health treatment.

Activity History - Medically reviewed on March 28, 2026 and last checked on March 19, 2026