Binge Eating: What Is Causing It and How Can You Overcome It

Authors

Dr Jake Linardon, PhD https://breakbingeeating.com/

Amanda Rizo, MS, APCC

Background

Binge eating is defined as the consumption of an unusually large amount of food in a short period of time accompanied by a sense of lost control [1]. It is a behaviour that is becoming more and more prevalent in both men and women globally, is a core symptom featured in most of the eating disorder subtypes, and is associated with a significant degree of impairment and psychological distress [2]. Evidence also suggests that binge eating is more frequent and severe in competitive athletes (e.g., bodybuilders) than in the general population [3].

In this article, we cover evidence-based strategies that are designed to overcome binge eating. We break this article up into parts: The first part discusses the factors that maintain binge eating. The second part introduces evidence-based strategies to overcome binge eating.

Part A: What Is Maintaining Your Binge Eating?

Understanding the factors that maintain binge eating is an essential first step before addressing binge eating. This is because the techniques that are used to overcome binge eating are designed to target these maintaining factors. The idea is that eliminating these maintaining factors will eliminate binge eating.

There are three main binge eating maintaining factors.

1. Inflexible dietary restraint

Inflexible dietary restraint refers to the multiple specific, demanding, and rigid diet rules that dictate when, what, and how much someone should eat [4]. It is usually expressed through three related but distinct forms.

• Dietary restriction: where someone eats much less than their body needs
• Delayed eating: where someone goes for very long periods of waking hours (6+ hours) without eating
• Food avoidance: where someone avoids certain foods or food groups in fear of weight gain

Each form of inflexible dietary restraint is a problem because it directly maintains binge eating behaviour. The reason for this is that these diet rules are usually too difficult to keep on top of, and the inevitable “breaking” of these rules is interpreted as a failure in self-control, which is then assumed to promote bouts of binge eating. For this reason, addressing inflexible dietary restraint is very important.

2. Shape and weight overvaluation

Shape/weight overvaluation refers to judgements of self-worth that are largely based on one’s shape and weight and their control [5]. This factor is considered to be the “core psychopathology” that underpins all features of eating disorders. The most direct expression of this core psychopathology is inflexible dietary restraint. That is, people who are highly concerned about their body usually adopt strict dietary restraint methods to try and control their weight and shape. Therefore, if we are able to eliminate shape/weight overvaluation, then people would not feel the need to diet, which means that they would be less likely to binge eat.

3. Mood fluctuations

Changes in mood states (e.g., sadness, loneliness, frustration) also directly affect binge eating [6]. The reason for this is that eating highly palatable foods makes us feel better during that brief moment and it also serves as a temporary distraction from negative emotions. However, negative mood states can cause people to overindulge in these palatable foods, particularly for those who hold such rigid diet rules. Therefore, teaching more effective coping strategies is important for not letting negative mood states influence binge eating.

Part B: Evidence-based Strategies to Overcome Binge Eating

Let’s now take a look at some of the more established techniques used to target each of the maintaining factors discussed above.

Techniques to target rigid restraint

• Eating regularly and flexibly: Aiming to adopt a pattern of regular and flexible eating is the most important technique used to target rigid dietary restraint (and thus, target binge eating). People should aim to eat at least 3 meals and 1-3 snacks a day, no more than 3-4 hours apart. Eating regularly like this will eliminate two crucial components of dietary restraint that are known to cause binge eating – delayed eating and dietary restriction. There is a wealth of evidence showing that adopting a regular eating approach is associated with reductions in binge eating behaviour [7]. Implementing this strategy requires you to plan, each night, what will be eaten and what times these meals/snacks will be eaten.
• Food exposure: Many people who binge eat have a list of forbidden foods. These foods are “trigger foods” in that their consumption can cause considerable anxiety and can prompt binge eating. These forbidden foods need to be slowly reintroduced through graded exposure back into your diet. Once they are re-introduced, they’ll no longer trigger you to binge.

To do this, you need to create a list of your forbidden foods. Rank them from “least forbidden” to “most forbidden”. The task is to begin re-introducing some of these foods, starting from the “least forbidden” side, until they no longer cause you angst. For example, if cereal is your “least forbidden” food, you may decide to include 20 grams of cereal in your usual breakfast smoothie. Although at first it may be uncomfortable, over time it will be normal and it won’t prompt you to binge. Once you feel comfortable with that particular food, your task is to then start on the next food down the list.

Techniques to Target Shape/Weight Overvaluation

• Activity scheduling: In order to reduce the importance placed on shape and weight, you will need to increase the number of life domains in which you evaluate your self-worth. If you’re able to effectively broaden your scheme of self-worth by increasing the importance placed on other life domains, then you won’t feel the desire to diet and you won’t binge eat.

To do this, you need to generate a list of activities that you think can bring you some meaning in life. Some examples could include: joining a sporting club, taking up art classes, meeting new friends, learning to powerlift, or dancing.

You will need to commit to trying one of these. Test a few ideas and see what you really enjoy and can commit to. The purpose of participating in these activities is to give your life much more meaning and fulfilment that is independent of weight/shape. Eventually, if you devote enough energy to these activities, then over time you’ll realize what the more important things are in life, and your craving to control your weight and shape will subside.

Techniques to Target Emotion Dysregulation

• Learn effective problem solving: Recall that binge eating is usually a maladaptive coping strategy used to deal with negative mood states. Meaning, you’ve developed a pattern of coping with stress that provides short-term relief, but actually adds to your stress in the long run. To prevent this from happening, you need to learn how to engage in more adaptive emotion regulation strategies. Problem solving is an excellent example.

There are four important steps to effective problem solving.

1. Identify the problem: You really need to identify what the actual problem is and where, when, and why the problem occurs, and why it causes your mood to fluctuate. This may seem obvious, but most of the time people don’t really think about these important details.
2. Think about many different solutions: You then need to come up with as many potential ways as you can to deal with the problem. Come up with both adaptive and maladaptive solutions the problem. This will help with step 3.
3. Think through each solution’s implications: After you’ve thought about all of these different solutions, think about what will happen if you implemented each solution. Carefully thinking about this allows you to weigh up all possible pros and cons of each generated solution and you will therefore have a better grasp on what your chosen solution will be.
4. Pick the most adaptive solution and act on it. You’ve probably realised that having a scoop of ice-cream after you’re feeling lonely is a bad idea. This usually leads to a binge, leaving you to feel worse than you felt before. Alternatively, you might realise that calling your best friend for a phone chat may be the better solution because it will distract you for an hour. In the past, talking to a friend may have cheered you up, so you’re urge to binge may eventually subside.

Conclusion

These techniques, based on cognitive-behavioural interventions, have proven to be effective for binge eating problems. Notwithstanding this, implementing these techniques takes considerable practice, patience, and perseverance, and it is important to be mindful that change may take a little bit of time.

References

1. Fairburn, C.G., Overcoming binge eating. 2013, London, UK: Guilford Press
2. Wilson, G.T., C.M. Grilo, and K.M. Vitousek, Psychological treatment of eating disorders. American Psychologist, 2007. 62: p. 199-216.
3. Sundgot-Borgen, J. and M.K. Torstveit, Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical journal of sport medicine, 2004. 14(1): p. 25-32.
4. Fairburn, C.G., Z. Cooper, and R. Shafran, Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behavior Research and Therapy, 2003. 41: p. 509-528.
5. Fairburn, C.G., Cognitive behavior therapy and eating disorders. 2008, New York, NY: Guilford Press.
6. Lavender, J.M., et al., Dimensions of emotion dysregulation in anorexia nervosa and bulimia nervosa: A conceptual review of the empirical literature. Clinical Psychology Review, 2015. 40: p. 111-122.
7. Linardon, J., et al., The efficacy of cognitive-behavioral therapy for eating disorders: A systematic review and meta-analysis Journal of Consulting and Clinical Psychology, 2017. 85: p. 1080–1094.