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Binge eating disorder (BED) affects about two percent of the overall population, making it easily the most common eating disorder in the United States.Unlike some other eating disorders like anorexia nervosa or ARFID, people with binge eating disorder don’t usually lose weight, but instead, tend to be overweight. Nonetheless, binge eating disorder is often related to a person’s experiences with dieting and concerns over their body size and shape. While dieting itself is not a primary cause of binge eating disorder, the stresses that normally result in extreme dieting are very commonly associated with the disorder itself.

How Does Binge Eating Disorder Develop?

The experts at binge eating treatment centers can’t point to a single cause of binge eating disorder, but they agree that a combination of factors is almost always present. These include:

1.Biological factors

Although they are not present in every case, certain glandular and hormonal diseases can trigger the beginnings of binge eating disorder, by removing a person’s ability to feel “full” or satiated. Another biological factor seems to be genetic, as people whose parents have binge eating are more likely to develop the disorder themselves. Unlike many other eating disorders, there is not a pronounced split between men and women in the incidence of binge eating disorder.

2.Psychological factors

Binge eating disorder is much more present in people with other mental health disorders, especially anxiety disorders and depression. This ties into dieting as these disorders often cause people to feel their body is fat or otherwise unattractive, which can cause them to experiment with extreme or fad dieting. Binge eating episodes also release dopamine in the bloodstream. Dopamine is a neurotransmitter that causes feelings of pleasure that also alleviates negative emotions, including those caused by depression, anxiety, or PTSD.

3.Environmental factors

This is the factor that most closely aligns with dieting as a cause of binge eating disorder. People who are criticized for their weight or appearance as children, or are forced into dieting, often develop feelings of guilt or shame surrounding food intake, which can lead to a disordered relationship with food. Even inadvertent signals from parents or family members can influence a disordered relationship with food. For example, having a parent who is constantly counting calories or trying to lose weight can indicate to an impressionable child that eating intuitively is something to avoid. In later life, sneaking food or eating in private while dieting in public are clear signs there may be a problem.

Self-Image and Body Image

Binge eating disorder is inextricably tied to body image, as are most cases of extreme dieting. Almost every form of eating disordered is centered at least in part in a negative self-image, which in its simplest definition means the person doesn’t like what they see when they look in the mirror. As it pertains to eating disorders, it’s most commonly associated with  In all eating disorders, including anorexia nervosa, orthorexia nervosa, bulimia nervosa, and binge eating disorder, a distorted or negative self-image is a causative factor.

The average age for onset of BED is usually in late adolescence or early adulthood (although it’s not unusual for adults in middle age to experience the disorder), but a poor self-image often has roots in childhood. Children who experience criticism or mockery for their weight or body shape can internalize the negative feelings resulting from these criticisms, feeling ashamed about their body or guilt over their eating habits. If a parent or a medical team forces the individual into a diet or makes them feel that their body is somehow “bad” it can set the seeds for future binge eating disorder.

Diet Culture and the Diet Industry

It would be remiss in any discussion of dieting and binge eating disorder not to mention diet culture and its sometimes detrimental effects. The United States has been dealing for decades with what’s known as “the obesity epidemic.” While many people, adults and children both, are considered overweight by medical standards, there is considerable evidence that basing a person’s health on their BMI is an outdated practice. There has been a trend in recent years among the eating disorder recovery community to promote HAES-informed treatment (Healthy At Every Size), but the idea that weight loss is necessary for everyone is still pervasive.

So pervasive, in fact, that an entire billion-dollar industry has grown centering on promoting weight loss. Well-known diet companies certainly help people without eating disorders lose weight but several aspects of their business model put people with body image problems and eating disorders at risk. There is generally a strict limit on calories, encouraging obsessive calorie counting. This is detrimental to people with binge eating disorder, who often restrict food publicly until urges to eat result in binge eating episodes. These companies also exploit negative body image by showing advertising that portrays heavier people as unattractive and unhappy, which also drives feelings of shame about body size and dissatisfaction with body image.

Beyond the weight-loss culture, there is also a widespread diet culture that can adversely affect people with binge eating and other disorders. There are countless websites devoted to dieting and other weight loss techniques, which people suffering from body dysmorphic disorder may spend hours looking for tips and furthering their negative body image. Social media accounts are even more intrusive and addictive – as the recent Congressional interview with Instagram executives highlighted. All of these aspects of diet culture combine to promote an obsession about losing weight that has harmful effects on a person with binge eating disorder.

Treatment for Binge Eating Disorder and Compulsive Dieting

It’s completely possible to recover from binge eating disorder and establish healthy eating habits with the help of an eating disorder specialist or therapist. People with binge eating disorder experience a cycle of negative self-image, which leads to dieting, which leads to binge eating episodes, returning to the feelings of guilt or shame that brought on the negative self-image in the first place. Unfortunately, this cycle becomes entrenched if left untreated over time, making it worse and worse.

Although there are certain medical treatments for binge eating disorder, they are generally not considered to be the primary option. Eating disorder treatment programs that focus on the psychological and emotional underpinnings of the disorder are more successful in the long run. A fully recovered lifestyle is only possible if the root causes and emotions are addressed through experienced and compassionate therapy.

Binge eating disorder can cause physical ailments as well as psychological distress, such as diabetes type 2, heart disease, high cholesterol, and gastrointestinal issues. These do require medical attention, which can be managed and continued after specialized treatment is completed. The priority beforehand, however, is always to modify disordered eating behaviors. This requires specialized staff trained in treating psychiatric illness in general and eating disorders in particular. In these situations, having a recovered staff who has gone through the same process helps ease the process.

Evidence-Based Treatments

It’s hard to break the cycle of disordered eating without professional help – that’s why eating disorder treatment centers have prioritized personalized, evidence-based treatment methods to help their charges.

Techniques like cognitive behavioral therapy (CBT) are a perfect example. Through several sessions, clients engaging in CBT will identify disordered thoughts and feelings surrounding food and self-perception, and then make a concentrated effort to understand them. They can then begin to replace these distorted and negative thoughts with more realistic, and self-accepting thought patterns. One of these positive attitudes is a “healthy” relationship with food.

As mentioned, many of the feelings of shame surrounding a person’s body, acquired from parental influence, media, or elsewhere have been so internalized that a person with BED may even feel that food is an enemy of sorts. Breaking this cycle is possible by accepting themselves and their body – not ignoring a medically appropriate weight and nutritional balance but not putting undue pressure on oneself to meet an unrealistic goal of attractiveness.

Binge Eating Disorder Treatment – The Sooner It’s Addressed, the Better

Binge eating disorder tends to begin slightly later than other eating disorders. As compared to anorexia nervosa or bulimia nervosa, which often start around age 15 (or earlier), binge eating disorder is more likely to start in later adolescence. However, the underpinnings (like dieting and body image distortions) often first rear their heads even earlier. If treatment is required, it’s usually better to start earlier rather than later. Adolescent-focused treatment centers, on both a residential and a day treatment basis, are prepared to work on self-esteem, body image, and compulsive behaviors in teenagers with eating disorders.

Even more importantly, treatment at this age can instill a healthier relationship with food and eating at a young age. Eating intuitively and to satiety is important for people with binge eating disorder – a regular schedule can help avoid cravings to diet and subsequently binge eat. They can also act as preventative care for the detrimental health effects of unchecked binge eating. If you or your child is showing the signs of binge eating disorder, consider reaching out as soon as you can.


Melissa Spann, PhD, LMHC, CEDS-S

Melissa Orshan Spann, PhD, LMHC, RTY 200, is Chief Clinical Officer at Monte Nido & Affiliates, overseeing the clinical operations and programming for over 50 programs across the U.S. Dr. Spann is a Certified Eating Disorder Specialist and clinical supervisor as well as an accomplished presenter and passionate clinician who has spent her career working in the eating disorder field in higher levels of care. She is a member of the Academy for Eating Disorders and the International Association of Eating Disorder Professionals where she serves on the national certification committee, supervision faculty, and is on the board of her local chapter. She received her doctoral degree from Drexel University, master’s degree from the University of Miami, and bachelor’s degree from the University of Florida.