Frequently Asked Questions
How do I know if I have BED?
BED has a number of symptoms, but the bottom line is feeling out of control in your relationship with food. A person with BED may try to change their eating behavior (typically many times), but will ultimately return to old patterns unless they seek treatment.
People with BED come in all shapes and sizes. You cannot tell by looking if someone has BED. Eating patterns vary as well. Some people binge eat, but others may “graze”, never really finishing eating, or they may eat a relatively small amount of food, but feel tremendous guilt and shame regardless of the amount consumed. Most with BED also have periods of significant food restriction or dieting. For most people, BED involves both bingeing and restriction, often occurring in an endless cycle.
Why can’t I stop this behavior? Isn’t it just a question of willpower?
BED is often as much about restriction as it is about binge eating. It takes extraordinary willpower to keep trying to go on diets or make changes to eating patterns. If willpower were the only issue, this problem would have been solved long ago.
The reasons behind binge eating are always complex, and are about both past and present stressors, biochemistry, and genetics. Often, people have a long history of using food to meet needs other than hunger, including distraction from life, soothing big emotions, and dealing with depression or anxiety. To change eating habits permanently, these needs must be met in new ways. Otherwise, the person will revert back to binge eating as soon as a stressor occurs.
Should I use weight loss drugs (GLP-1s) if I have BED?
GLP-1 drugs, including Ozempic, Wegovy, Trulicity and others, have grown in popularity, promising quick weight loss. However, these medications do not address the issues that drive binge eating. For many people, the frequency of binge eating lessens temporarily with these medications but almost always returns. Additionally, these drugs and procedures have significant side effects. For long-term change, it is critical to understand your relationship with food, and learn new ways to meet underlying needs. If you are using any of these medications and have BED, our program can help you navigate the best path for sustainable recovery. Click here for more detailed information about these medications.
Should I consider weight loss surgery if I have BED?
Seventy percent of people seeking weight loss surgeries have an eating disorder, most commonly BED. These surgeries, including bariatric interventions (bypass or sleeve) and intragastric balloons, do not address the underlying causes of binge eating. Weight loss surgeries also tend to have significant health risks and complications. Additionally, people with BED are highly likely to continue binge eating after the surgeries, increasing the likelihood of additional risks and side effects. The best treatment for long-term change must address the underlying reasons for binge eating. If you have had weight loss surgery and still struggle with BED, our program can help you work with the issues that these procedures cannot address.
What does "recovered" mean?
Recovered means eating and moving in response to body needs most of the time. Your body’s needs will vary day to day.
It means eating to check out will become rarer and rarer, with less and less food, for shorter and shorter episodes.
It means one episode will not, by default, lead to another.
It means an episode will get your attention right away; you will have better skills to address the binge, and be able to learn from the experience.
Recovery is a journey, not a destination. You will recover at the rate that is just right for you!
Who is at risk for developing binge eating or BED?
Many factors are at play in the development of BED, and the combination is unique to each person. A list of common causes includes:
Family history of eating disorders, depression, alcoholism, or OCD
Intense family or personal concern with weight and appearance
Difficulty identifying and/or expressing feelings
Family atmosphere that limited emotional expression in significant ways
Significant emotional trauma or loss
Tendency to be a “people pleaser,” too often putting others’ needs before one’s own
Difficulty setting limits with others
High degree of perfectionism or “black and white” thinking
Genetic predisposition to experiencing feelings particularly intensely
Strong tendency toward self-soothing and dissociation (“checking out”) behaviors
Mood disorders, including anxiety disorders, depression and bipolar disorders
Significantly negative or distorted body image
A diagnosis of ADHD (thirty percent of people with BED also have characteristics of ADHD)
What do people with BED use food to do?
There are many uses for bingeing, and everyone uses food to meet needs other than hunger sometimes. But if this becomes a pattern such that your peace of mind is compromised, there may well be an underlying eating disorder. Some common uses of food for people with BED include:
Distraction (from feelings, from others, from feared situations or stressors)
Reward
Escape
Rebellion (from dieting, from other’s needs, from the “rules”)
Slowing time/Avoiding a scary/stressful issue or problem
Cherishing yourself by allowing yourself any food you crave
Setting a my “space” boundary or alone time
Soothing loneliness
Soothing anxiety, fear, shame, grief
Express anger and pain