Binge Eating Disorder: Symptoms, Causes, and Treatment

Binge eating disorder is a diagnosable eating disorder in which a person regularly eats an unusually large amount of food in a short period while feeling unable to control the behavior.¹ It's the most common eating disorder in the United States, with a lifetime prevalence of 2.8% among adults.² But binge eating disorder is treatable, and many people see meaningful, lasting improvement with the right combination of care.

What Is Binge Eating Disorder?

Binge eating disorder (BED) involves recurrent episodes of eating significantly more food than most people would eat in a similar period of time, along with a sense of losing control over the eating itself.² Unlike bulimia nervosa, binge eating disorder doesn't involve self-induced vomiting, laxative misuse, fasting, exercising excessively, or other recurrent compensatory behaviors to prevent weight gain after a binge.¹

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), a diagnosis of binge eating disorder requires recurrent episodes of binge eating, marked distress about the binge eating, and three or more of the following features occurring during those episodes:³

• Eating much more rapidly than normal.
• Eating until feeling uncomfortably full.
• Eating large amounts of food when not physically hungry.
• Eating alone due to embarrassment about the amount of food being eaten.
• Feeling disgusted with oneself, depressed, or very guilty afterward.

Losing control is a central feature of binge eating disorder. Researchers sometimes use the broader concept of “loss of control eating” to describe the feeling that you can't stop eating or control what or how much you're eating, regardless of the amount of food actually involved.¹ For BED, however, binge eating episodes involve both this sense of lost control and eating an unusually large amount of food. When this happens at least once a week for three months or longer, it may point to BED specifically.¹

To meet full diagnostic criteria, these episodes also can't occur alongside the regular use of behaviors like vomiting or laxative use to prevent weight gain.¹ Occasional overeating, like eating too much at a holiday meal, isn't the same as binge eating disorder. What sets BED apart is the frequency, the ongoing loss of control, and the distress that comes with it.

Signs and Symptoms of Binge Eating Disorder

Recognizing what binge eating is often starts with noticing patterns around food, not just how much someone eats in a single sitting. The behavioral, emotional, and physical signs and symptoms of binge eating disorder can include:^4,5

• Eating unusually large amounts of food within about two hours.
• Eating much more quickly than usual during a binge.
• Eating until feeling uncomfortably full.
• Eating large amounts of food even when not hungry.
• Eating alone or in secret out of embarrassment about the amount being eaten.
• Feeling disgusted, depressed, or guilty after a binge.
• Frequent dieting, often without significant weight loss.

Emotionally, binge eating disorder often comes with a strong sense of shame, and many people go to great lengths to hide their eating habits, even from close friends and family.¹ Binge episodes may also be accompanied by acute GI symptoms and physical discomfort, including bloating and other gastrointestinal symptoms.⁴

Causes and Risk Factors

Binge eating disorder likely develops from a mix of genetic, psychological, and social factors rather than any single cause.⁵ Genetics play a role, and binge eating disorder tends to run in families.¹ A person's thoughts and feelings about their weight and body shape, along with unhealthy dieting patterns like skipping meals, may also contribute.⁵

Painful early experiences, such as family conflict or critical comments about weight, shape, or eating habits, have also been linked to a higher risk of developing binge eating disorder.¹ Cultural and social pressure around body size and dieting adds another layer, shaping how people relate to food and their bodies and potentially contributing to BED risk.⁵

Co-Occurring Mental Health and Substance Use Conditions

Binge eating disorder frequently occurs alongside other mental health conditions, most often depression, anxiety disorders, and substance use disorders.⁴ These conditions can complicate a person’s symptoms and treatment, and binge eating may sometimes develop as a way of coping with difficult emotions.⁵ Because co-occurring conditions are an important part of the overall clinical picture, many people benefit from depression treatment or other mental health care delivered alongside eating disorder care, rather than separate interventions for each condition.⁴

Binge Eating Disorder vs. Other Eating Disorders

Binge eating disorder shares some features with other eating disorders, but a few key differences set it apart.⁴ Getting the right diagnosis matters, since treatment approaches can differ depending on which eating disorder someone has.

Binge Eating Disorder vs. Bulimia Nervosa

People with bulimia nervosa binge eat and then use compensatory behaviors, such as self-induced vomiting, laxatives, diuretics, fasting, or excessive exercise, to prevent weight gain.¹ People with binge eating disorder may occasionally try one of these strategies, but it isn't a regular part of the pattern.¹ Because of this, binge eating disorder is more often associated with weight gain and related health problems, while bulimia nervosa doesn't always affect a person's weight in a noticeable way.¹

OSFED and ARFID

Not every eating disorder fits neatly into a single category. Other specified feeding or eating disorder (OSFED) describes eating disorder symptoms that cause real distress and impairment but don't meet the full criteria for another specific eating disorder, such as anorexia nervosa, bulimia nervosa, or binge eating disorder. An example would be binge eating episodes that happen less than once a week or for fewer than three months.⁶ Despite sometimes being treated as a less serious diagnosis, OSFED is associated with health risks and levels of impairment similar to other eating disorders.⁶

Avoidant/restrictive food intake disorder (ARFID) is a different type of eating disorder altogether. Rather than involving binge eating or body image concerns, ARFID involves avoiding or restricting food for reasons such as lack of interest in eating, sensitivity to a food’s taste and texture, or a fear of choking or vomiting. Over time, this can lead to significant weight loss, nutritional deficiencies, and other health issues.⁴ OSFED and other eating disorder diagnoses show that eating disorders don't always fit neatly into a single category, which is part of why getting an accurate diagnosis from a mental health professional matters.

Health Effects of Binge Eating Disorder

Binge eating disorder can affect both physical and mental health over time. Physically, it's associated with an increased risk of type 2 diabetes, heart disease, high blood pressure, high cholesterol, sleep problems, and digestive issues like bloating.^1,4 Because binge eating disorder often leads to weight gain, many of its physical health risks overlap with those linked to obesity more broadly.¹

Binge eating disorder may also be relevant to fertility and reproductive health. Eating disorders, including binge eating disorder, are estimated to be about six times more common in women receiving fertility treatment than among pregnant women in the general population.⁷

Mentally, binge eating disorder frequently coexists with depression, anxiety, and low self-esteem, and more than half of people with binge eating disorder say it interferes with their social lives.¹ Based on national survey data, about 62.6% of people with binge eating disorder experience some degree of impairment from it, and 18.5% experience severe impairment.² The good news is that treatment can meaningfully improve these effects, and early intervention is linked to better treatment outcomes.⁶

Treatment for Binge Eating Disorder

Binge eating disorder is treatable, and care may involve a combination of approaches depending on a person’s individual needs.⁸ Effective eating disorder treatment may include psychotherapy, medical and nutritional support, and sometimes medication.⁴

Cognitive Behavioral Therapy (CBT) for Binge Eating Disorder

Cognitive behavioral therapy (CBT) and interpersonal psychotherapy are among the best-supported psychotherapeutic treatments for binge eating disorder.⁹ Cognitive behavioral therapy helps people identify and change the thoughts and behaviors that contribute to binge eating and develop healthier coping strategies.⁸ CBT for eating disorders can also be adapted to focus specifically on the thoughts and body image concerns that drive binge episodes.⁹ Interpersonal psychotherapy takes a different approach, focusing on relationship difficulties and communication patterns that may contribute to binge eating, rather than directly targeting thoughts about food.⁹ Treatment usually takes place over several months and can be delivered individually, in a group, or sometimes through guided self-help materials.⁸

Other approaches focus more on emotional regulation. Dialectical behavior therapy (DBT) for eating disorders teaches skills for managing difficult emotions and changing behaviors that may contribute to binge eating.8 A mental health professional can help you figure out which approach fits your needs best.

Nutrition Support and Working With a Registered Dietitian

A registered dietitian trained in disordered eating can play a central role in binge eating disorder treatment.⁸ Rather than focusing on restrictive dieting or weight loss, this kind of nutrition support can help someone build structured, regular eating patterns and repair their relationship with food.⁸ Later in recovery, some people also explore intuitive eating for binge eating, which shifts the focus toward tuning into hunger and fullness cues rather than following external food rules.

Medication and Support Groups

Lisdexamfetamine (Vyvanse) is currently the only medication specifically approved by the U.S. Food and Drug Administration (FDA) for binge eating disorder in adults, and it's been shown to reduce both binge eating episodes and body weight.¹⁰ It isn't approved or recommended for weight loss on its own, so it's prescribed specifically to treat binge eating disorder itself.¹⁰

Other medications are sometimes used off-label, meaning they're prescribed for binge eating disorder even though the FDA hasn't specifically approved them for it. The anticonvulsant topiramate has shown benefit for both binge eating frequency and weight in clinical trials, though it can come with side effects like sedation, memory or word-finding difficulties, and kidney stones, which sometimes leads people to stop taking it.⁹ Selective serotonin reuptake inhibitors (SSRIs) have also been studied for binge eating disorder. They can help reduce how often binge eating episodes happen, but they haven't been shown to lead to meaningful weight loss when used to treat BED.¹¹

Alongside medication and other professional treatment, connecting with others who understand the experience or through other outlets of peer support can help. If you're ready to find a support group, options range from condition-specific peer groups to broader mental health communities, and many are free to join.

Finding Treatment for Binge Eating Disorder

If any of this sounds familiar, talking with a mental health professional is a good first step.⁵ A doctor or eating disorder specialist can assess your symptoms, rule out other causes, and help you find the right level of care.⁸

You don't have to figure this out on your own. You can search for eating disorder treatment centers near you to find providers who specialize in binge eating disorder and connect with support that fits your needs.