Binge eating disorder treatment can include psychotherapy and lifestyle changes and may include medication. If it is at all possible, it is recommended a person living with an eating disorder seek help from a specialist in eating disorders, given their complexity.
Treatment for binge eating disorder typically involves a form of psychotherapy and prescription medication, such as antidepressants. Around 43.6% of people with binge eating disorder will get treatment at some point in their lives.
What Is Binge Eating?
Binge eating disorder involves episodes of eating large amounts of food in a short time without doing behaviors to counteract binge eating (such as inducing vomiting or excessively exercising). People with binge eating disorder feel out of control when eating and feel guilt or disgust after these episodes.
This article will cover the current treatment options for binge eating disorder, from medication to therapy.
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Psychotherapy for Binge Eating Disorder
Psychotherapy is the most common treatment for binge eating disorder. Several types of therapy are available for treating binge eating disorder, but cognitive behavioral therapy (CBT) is generally the first one tried.
Cognitive Behavioral Therapy
Cognitive behavioral therapy is a type of psychotherapy that focuses on disordered or negative thinking patterns and works on changing them into positive, productive ones.
CBT helps people with:
Identifying faulty or unhelpful ways of thinkingRecognizing learned patterns of unhelpful behaviorDeveloping better ways to cope with psychological challenges in their lives
A form of CBT called Enhanced CBT (CBT-E) has been developed specifically to help people with eating disorders. In CBT-E, people with binge eating disorder have a feeling of control because they are actively involved in all areas of treatment and have the final say on all decisions.
CBT-E emphasizes addressing the underlying disordered thinking that causes eating disorders, rather than the symptoms. A therapist can tailor the treatment to the specific eating disorder that a person has as well as the unique factors in a person’s life that are contributing to the disorder.
In one study, CBT-E had a success rate of about 66% in treating multiple eating disorders. A 2014 study showed that participants with binge eating disorder showed improvement during short-term CBT treatment and continued to improve or were stable during the four years after treatment.
While designed for adults, CBT-E can be adapted to be used with younger people.
Support Groups for Eating Disorders
Support groups for binge eating disorder include:
Guided Self-Help
Guided self-help (CBTgsh) is based on the principles and practices of CBT. CBTgsh can be easier to access than CBT-E because mental health professionals can provide it even if they do not specialize in eating disorders.
That said, researchers are still unsure about the effectiveness of CBTgsh. Older studies suggested that participants with binge eating disorder had positive results from treatment with CBTgsh and that it may be beneficial for some people.
Importance of Weight-Inclusive Treatment
Stigma, fatphobia, and equating body size with value are all barriers to treatment for binge eating disorder. Healthcare providers should use language and practices that are weight-inclusive and consider “fat” a neutral descriptor.
Interpersonal Psychotherapy for Eating Disorders
A 2018 study showed that people with binge eating disorder have more interpersonal problems than those without binge eating disorder, regardless of their weight. Interpersonal problems may begin before binge eating disorder starts or develop as a result of binge eating disorder.
Interpersonal psychotherapy (IPT) for binge eating disorder helps people work on problems they’re having in their relationships, such as poor communication and arguments with their family, friends, and coworkers. It can take place in a group or individual format. IPT is done in three phases over 20 weekly sessions.
A 2015 study comparing CBT-E with IPT showed improvement for people with binge eating disorder in both treatment categories, but CBT-E was more effective than IPT. At the end of treatment, 65.5% of the CBT-E participants reached remission, compared to 33.3% of the IPT participants. In the follow-up period, the CBT-E remission rate was 69.4%, while for IPT it was 49%.
It takes longer to see results with IPT for binge eating disorder and the success rate is lower than it is with CBT-E. However, it is an option for people who are unable to participate in CBT-E, have not responded to other treatments, or would benefit from an interpersonal focus in therapy.
Treating Co-Occurring Mental Health Conditions
People with eating disorders may also have other mental health disorders that need to be addressed in treatment for treatment of the eating disorder to be effective. A 2022 review noted that for eating disorders in general, 62% also had anxiety, up to 54% had a mood disorder, and 27% were living with a substance use disorder, and 27% had post-traumatic stress disorder.
Mindfulness-Based Eating Awareness Training
Mindfulness-based eating disorder awareness training (MB-EAT) uses mindfulness practices to help a person develop greater awareness of hunger and fullness cues, sensory-specific satiety (feeling satisfied), and emotional and other triggers that lead to binge eating. General mindfulness practices are also included in the treatment.
MB-EAT does not recommend or ban specific foods—it advocates for eating with intention and without distraction. Mindful eating exercises can include:
Being aware of hunger cuesChewing food slowlyTuning in to tasteNoticing fullness
While research suggests that mindfulness-based practices can be helpful for some people with binge eating disorder, there have not been enough high-quality, long-term studies to know for sure. In some studies, the techniques helped in the short term but were not as effective over a longer period.
Multidisciplinary Approach
Treatment for binge eating disorder may involve more than one approach at a time, such as CBT-E and medication. A 2015 review indicated that a multidisciplinary strategy shows promising results and should be studied further.
FDA-Approved Medications
Prescription medications that are used to treat other conditions such as depression, attention deficit hyperactivity disorder (ADHD), and epilepsy are sometimes used to treat binge eating disorder as well.
For example, a 2015 study showed that second-generation antidepressants topiramate (Topamax), and lisdexamfetamine (Vyvanse) may have a positive effect on binge eating disorder.
Second-Generation Antidepressants
Most second-generation antidepressants fall into two main categories: selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).
These medications help treat binge eating by changing the balance of chemicals in the brain that contribute to symptoms of depression and anxiety, as well as helping to regulate emotions.
Common SSRIs include:
Citalopram (Celexa)Escitalopram (Lexapro)Fluoxetine (Prozac)Fluvoxamine (Luvox)Paroxetine (Paxil)Sertraline (Zoloft)
Common SNRIs include:
Venlafaxine (Effexor)Desvenlafaxine (Pristiq)Duloxetine (Cymbalta)Levomilnacipran (Fetzima)
Topamax (Topiramate)
Topiramate (Topamax) is an anticonvulsant that has been used to treat binge eating disorder. This medication can help stabilize mood, control impulses, reduce cravings, and regulate appetite.
Older studies suggested that Topamax can be an effective medication for people with binge eating disorder and may help them have fewer binges. More research is needed to look at the long-term effectiveness and safety of using Topamax for binge eating disorder.
Vyvanse (Lisdexamfetamine)
Lisdexamfetamine (Vyvanse) is a stimulant used to treat ADHD that has been shown to decrease binge eating. In 2015, the Food and Drug Administration (FDA) approved Vyvanse to treat moderate to severe binge eating disorder in adults.
Vyvanse is better known as a treatment for ADHD, but research has shown that people who took Vyvanse had fewer episodes of binge eating per week compared to people who took a placebo. It’s thought that Vyvanse helps with binge eating because it changes chemicals in the brain related to mood and thinking. These changes may help people not feel the urge to binge eat or stop the urge if they do feel it.
A Warning About Lisdexamfetamine
Lisdexamfetamine can be abused or lead to dependence. Follow your healthcare provider’s instructions carefully, and let them know if you experience changes in your behavior or have unusual symptoms while you’re taking the medication.
Lifestyle Approaches for Binge Eating Disorder
Binge eating disorder is best treated under the guidance of a healthcare provider or mental health professional, but there are things you can do on your own to help get the most out of your treatment plan.
Listen to Your Body
Hunger cues are your body’s way of telling you that it needs more nutrition so it can provide you with the energy you need to go about your day. Learning to recognize your body’s hunger cues can help you avoid getting so hungry that it triggers a binge. Once you learn what your hunger cues are, pay attention and honor them.
Recognize hunger cues such as:
Stomach growlingLight-headednessIrritability/crankinessSymptoms of low blood sugar (like dizziness, shakiness, sweating)
Eat when you are hungry, but don’t wait until you are “starving.” Try rating your hunger from 1 (not hungry) to 5 (extremely hungry). Eat when you are at about the 3 mark.
Create a Supportive Environment
If you pay attention to your thoughts and feelings before, during, and after a binge, you’ll quickly pick up on trends. You can use this information to your advantage and take steps to prevent a binge.
Identify your triggers: What situations often lead to binging? How can you avoid them?Get rid of “binge foods:” If you tend to binge on certain foods, don’t keep them in the house. If they aren’t readily available, it is easier to avoid them.Meal-plan: Plan nutritious meals and snacks ahead of time, and stick to your list when grocery shopping. Aim for meals that are nutritious and satisfy you. A dietitian can help you come up with an eating plan.Ditch the scale: If you find that you weigh yourself often and have a difficult time limiting weigh-ins to about once a week, consider getting rid of your scale. Or leave weight checks for when you visit your healthcare provider or dietitian.
Use Your Time Well
Coping with binge eating isn’t only when you’re eating. It’s important to stay in tune with your body at all times, not just when food is around.
Practice mindful eating: Focus on your food and nothing else when you are eating. Avoid being distracted by things like the TV and your phone during meals. This allows you to experience your food. It can make the experience more satisfying and can keep you from absentmindedly overeating.Move your body: Find ways to be physically active that you enjoy and do them regularly.Keep busy: Feeling bored or anxious can make it tempting to eat when you aren’t really hungry. Make a list of activities you find enjoyable and entertaining that you can pull out when you are bored or feel anxiety creeping in.
Where to Find Help
If you or someone you know is struggling with eating disorders or body image issues, you can reach out to the National Alliance for Eating Disorders Helpline at 1-866-662-1235. The helpline is open Monday to Friday, 9 a.m. to 7 p.m. EST and offers emotional support, education, and assistance finding eating disorder treatment and care.
Binge Eating Disorder Treatment Centers
Some people with binge eating disorder attend a treatment program to get help. Your healthcare provider or therapist can talk to you about whether doing so would be beneficial.
Binge eating disorder treatment centers can be inpatient (you live there while you are in treatment) or outpatient/day programs (you have treatment during the day and go home at night).
Some programs are at specific eating disorder clinics, while others are affiliated with (and often located within) hospitals.
One of the most well-known eating disorder treatment centers in the U.S., The Renfrew Centers, takes more than 400 insurance plans. Renfrew also has more than one location.
You may need a referral from your healthcare provider or therapist to enter a treatment program.
If you have health insurance, check with your carrier to find out what coverage they will offer. Some plans will cover certain types of treatment programs or only offer coverage for a limited amount of time. You will also need to check with the eating disorder program you are considering, as some of them do not take insurance.
If you don’t have insurance, your insurance won’t cover treatment, or the program doesn’t take insurance, you’ll need to find out how much treatment will cost. Fees will depend on the type of treatment and how long the program lasts.
If you can’t find a treatment center nearby, you may have to go to another state for treatment. The cost of travel should be factored into the total cost of treatment.
For example, Project HEAL estimates that eating disorder treatment can range from $1,500 to $2,000 a day, depending on whether it’s outpatient or inpatient.
The National Alliance for Eating Disorders can be a helpful starting point to find binge eating disorder treatment centers near you. Eating Disorder Hope is another website that lists eating disorder treatment centers by state.
Summary
Binge eating disorder is different from overeating. While everyone has times they eat until they are uncomfortably full, people who have binge eating disorder feel they are not in control of their eating.
If you feel you may have a problem with eating, book an appointment with your healthcare provider. They can discuss your symptoms with you and help you find a treatment that is right for you.
Different types of therapy, like mindfulness training and CBT, along with prescription medications like antidepressants can also be helpful. For some people, a combination of treatments works best.
