If you have ever felt out of control around food — eating far more than you meant to, quickly, often alone, and then feeling ashamed afterward — you are far from alone. Binge eating disorder (BED) is the most common eating disorder in the United States, and it is also one of the most misunderstood.
This guide explains what BED is, why it is not a matter of willpower, which treatments research supports, and what caring, respectful treatment looks like.
What binge eating disorder is
BED became a formal diagnosis in 2013, when the American Psychiatric Association added it to the DSM-5. Before that, many people with BED had no name for what they were experiencing. In broad terms, the diagnosis describes:
- Recurring episodes of binge eating — eating, within a limited period, an amount of food clearly larger than most people would eat in similar circumstances, with a sense of losing control.
- Features that often come with them, such as eating much faster than usual, eating until uncomfortably full, eating when not physically hungry, eating alone out of embarrassment, or feeling disgusted, low, or guilty afterward.
- Marked distress about the binge eating.
- Frequency of at least once a week, on average, for three months.
- No regular compensatory behaviors such as purging, fasting, or excessive exercise, which helps distinguish BED from bulimia nervosa.
Only a qualified clinician can make a diagnosis, but recognizing yourself in this description is a good reason to reach out.
A nationally representative US survey published in 2007 (Hudson and colleagues, using the National Comorbidity Survey Replication) found that about 2.8% of adults experience BED at some point in their lives — about 3.5% of women and 2% of men — making it more common than anorexia nervosa and bulimia nervosa combined.
The same study found that people with eating disorders often also live with mood, anxiety, or substance use conditions, and that fewer than half had ever sought treatment specifically for their eating disorder.
It is not a willpower problem
BED is a recognized mental health condition, not a character flaw. Binges are often tied to emotions, stress, and cycles of restriction: strict dieting and long gaps without eating can increase the pull toward a binge, and the shame that follows can set up the next round. Understanding that cycle is often the first relief people feel in treatment.
BED also occurs in people of every body size. You cannot tell whether someone is struggling by looking at them, and every person who is struggling deserves care.
Treatments with research support
The American Psychiatric Association’s 2023 eating disorder practice guideline and the UK’s National Institute for Health and Care Excellence (NICE) both point to psychotherapy as the foundation of treatment for BED.
Cognitive-behavioral therapy for eating disorders
Eating disorder–focused CBT (often called CBT-E or CBT-ED) has the strongest evidence. It helps you establish regular eating, understand what triggers binges, and work with the thoughts about food, weight, and shape that keep the cycle going. NICE recommends starting with a CBT-based guided self-help program and moving to group CBT if more support is needed.
Interpersonal psychotherapy (IPT)
IPT focuses on relationships, life changes, and the emotions connected to them. The APA guideline names IPT, alongside CBT, as an effective psychotherapy for BED.
DBT-informed approaches
Dialectical behavior therapy has been adapted for binge eating, with a focus on mindfulness, emotion regulation, and tolerating distress without turning to food. Early randomized research found it reduced binge eating compared with a waitlist.
Medication, when indicated
In January 2015 the FDA approved lisdexamfetamine (Vyvanse) for moderate to severe BED in adults — the first medication approved for the condition. It is a controlled stimulant and is not approved for weight loss. Some antidepressants are also used. Medication decisions belong with a prescribing clinician and are usually paired with therapy.
What does that look like in practice? NICE’s patient guidance describes guided self-help as working through a book about binge eating with brief check-ins with a practitioner — usually four to nine sessions of about 20 minutes. Group CBT typically runs as 16 weekly sessions of about 90 minutes. Individual therapy is another option, and a specialist can help you decide which format fits your needs.
A weight-inclusive, team-based approach
The psychotherapies that work for BED are designed to reduce binge eating and the distress around it, not to change body weight. NICE’s patient guidance notes that weight is unlikely to change during therapy because the treatment is not aimed at weight. Clinicians trained in eating disorders generally avoid dieting as part of BED treatment, since restriction can feed the binge cycle, and they speak about bodies with respect and without judgment.
Care often involves a team: a therapist, a medical provider who can check physical health, and, for many people, a registered dietitian experienced with eating disorders. Coordinated care means you are not left to piece the plan together on your own.
What to look for in a provider
Look for a licensed mental health provider with specific eating disorder training, experience with BED in adults, and a respectful, weight-inclusive way of talking about bodies. If you also live with depression, anxiety, or substance use, ask how they address those alongside eating.
Questions worth asking a provider
- “What training do you have in treating binge eating disorder specifically?”
- “Do you use CBT-E, IPT, or another structured approach?”
- “How do you talk about weight and bodies in treatment?”
- “Do you work with a dietitian and a medical provider? How do you coordinate?”
- “How will we track progress?”
- Binge eating disorder is the most common eating disorder in the US and a recognized diagnosis since 2013.
- It is not a willpower problem, and it occurs in people of every body size.
- Eating disorder–focused CBT and interpersonal psychotherapy have the strongest support; medication can help some adults.
- Effective care targets binge eating and its distress, not weight, and is often delivered by a team.
If you are having thoughts of suicide or feel unsafe, call or text 988 at any time. The specialists listed below are mental health providers whose eating disorder training Tandem has reviewed.
References
- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). https://www.psychiatry.org/psychiatrists/practice/dsm
- Hudson, J. I., Hiripi, E., Pope, H. G., Jr., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry, 61, 348–358. https://www.nimh.nih.gov/news/science-updates/2007/study-tracks-prevalence-of-eating-disorders
- Arnold, M. J. (2024). Treating patients with eating disorders: Guidelines from the American Psychiatric Association. American Family Physician, 109(2), 185–187. https://www.aafp.org/afp/2024/0200/practice-guidelines-eating-disorders
- National Institute for Health and Care Excellence. (2017). Eating Disorders: Recognition and Treatment (NG69). https://www.nice.org.uk/guidance/ng69
- Takeda (Shire). (2015). Vyvanse (lisdexamfetamine dimesylate) capsules CII becomes first and only treatment approved by the FDA for adults with moderate to severe binge eating disorder. https://www.takeda.com/newsroom/shire-news-releases/2015/vyvanse-lisdexamfetamine-dimesylate-capsules-cii-becomes-first-and-only-treatment-approved-by/
- National Eating Disorders Association. Recognizing, treating, and coping with binge eating disorder. https://www.nationaleatingdisorders.org/recognizing-treating-and-coping-binge-eating-disorder/