Binge eating disorder (BED) is a serious mental illness where people experience a loss of control and eat large quantities of food on a regular basis. It can affect anyone of any age, gender, or background. Read more about BED.
If you’re worried that you or someone you know is suffering from binge eating disorder, it’s important to get treatment as early as possible to ensure the best chance of recovery. The first step is usually to book a GP appointment. It can be difficult to talk about your illness with a doctor, but remember, it is an illness, and it is every bit as serious as any other eating disorder. It’s not your fault, and you deserve help to get better.
Evidence-based guidelines from the National Institute of Health and Care Excellence (NICE) are clear about what is best practice when treating binge eating disorder. Healthcare professionals should consider these guidelines when looking at your needs and deciding on a treatment pathway.
Going to the GP
Going to the doctor can be daunting. If you’re worried, you could consider:
- Booking a double appointment so you don’t feel rushed.
- Bringing along someone you trust who can speak to the GP on your behalf if you’re struggling, or can talk about changes in the way you act or feel that they may have noticed.
- Writing down any concerns, questions, symptoms you’ve experienced, etc., before you go, so that you’re not put on the spot in the appointment.
GPs do not specialise in eating disorders, so may not have a full understandingof binge eating disorder. The guide below should help you use the NICE guidelines to address some of the issues you might come across and get a positive result from your appointment. You can also take a look at our binge eating disorder guide.
What if my GP isn’t familiar with binge eating disorder, or doesn’t feel that it’s as serious as other eating disorders?
Like all other eating disorders, binge eating disorder is a serious mental illness, and should be treated as such. People with binge eating disorder need and deserve treatment and support. Binge eating disorder has a clear, evidence-based treatment pathway recommended by NICE.
The NICE guidance that “People with eating disorders should be assessed and receive treatment at the earliest opportunity” applies in all cases. The earlier you can get treatment for your illness, the better your chance of recovery.
What if my GP expects someone with an eating disorder to be of lower weight than me?
Remember, whether you have an eating disorder does not depend on your weight or any changes to it, but people with binge eating disorder may experience weight gain. The NICE guidelines ask healthcare professionals to take into account several possible signs, including “An unusually low or high BMI or body weight for [the patient’s] age.” Anyone of any weight can have an eating disorder, and weight loss is certainly not a given for people with eating disorders, so please don’t allow this misconception to make you think you don’t deserve help.
The NICE guidelines also warn healthcare professionals: “Do not use single measures such as BMI or duration of illness to determine whether to offer treatment for an eating disorder.” They should consider other psychological and physical signs as well.
What if my GP is focused more on weight loss than on the thoughts and feelings behind the illness?
Binge eating disorder is a mental illness, and the weight gain you might experience is a symptom. While sometimes people mention unrelated weight changes as a factor in them developing an eating disorder, it’s very unlikely that this would be the sole and direct cause. Simply focusing on weight loss doesn’t address the root of the illness.
The NICE guidelines state that weight loss isn’t the intended goal of the therapies recommended to treat binge eating disorder. In fact, NICE recommends that therapy should involve advising against trying to lose weight during treatment through methods such as dieting, because this can make people feel the urge to binge eat. Treatment for any eating disorder should always address the underlying causes and the thoughts and feelings that cause issues around food and eating.
Remember, you have a right to good quality treatment. If you’re struggling to get it, it’s okay to ask if you can see a different GP. You can also look into self-referral in your area.
What treatment should I be given?
The recommended treatments for binge eating disorder are mainly based on cognitive behavioural therapy (CBT), a talking therapy that aims to help you deal positively with the underlying thoughts and feelings that cause the illness by breaking problems down into smaller parts. It shows you how to change negative patterns to improve the way you feel.
- NICE recommends guided self-help focused specifically on binge eating disorder as the first step. This should use self-help materials based on CBT, and should involve supportive sessions over the course of the programme to help ensure its effectiveness. The book that is recommended is Professor Christopher Fairburn's Overcoming Binge Eating: The Proven Program to Learn Why You Binge and How You Can Stop (2nd ed.).
- If guided self-help isn’t appropriate for you, NICE recommends group CBT focused on eating disorders.
- If group CBT isn’t available, or you don’t feel that it is suited to you, then NICE recommends offering individual CBT focused on eating disorders.
These treatments are based on evidence of what is most often effective in treating binge eating disorder, and you can read more about them at nice.org.uk. But remember, no two people are the same. If you don’t find these treatments are helping, let the healthcare professionals managing your care know. This isn’t criticising them, but giving them information they should find helpful as they work with you to find the treatment that will best suit you. You can read more about the different types of therapies and what they involve in our glossary or search for therapists on our Helpfinder.
Most treatment for binge eating disorder will take place in outpatient services. Inpatient treatment is usually only necessary when someone is at risk of suicide or severe self-harm.
Should my treatment involve weight loss?
As above, weight loss should not be the focus of treatment of binge eating disorder. The weight gain that binge eating disorder can cause is a symptom, not the illness itself. As stated in the NICE guidelines, treatments for BED are ‘not designed to help you gain or lose weight.’
Treatment for binge eating disorder should aim to reduce the frequency of binges, tackle thoughts related to bingeing, improve mood and, in patients who are obese and diabetic, improve metabolic health and weight. If you need to reach a healthy weight, this should be a long-term part of your recovery and be discussed with your health practitioner.
While restrictive dieting has the risk of increasing urges to binge, establishing a pattern of regular eating is vital to the treatment of binge eating. Self-help guidance, and CBT-based treatments will focus on planning meals and keeping food diaries.
Self-help and support groups
Self-help and support groups where you’re able to talk to others going through similar experiences can be useful to both sufferers and their families throughout treatment and in sustaining recovery. Please search our Helpfinder database for information about what’s available in your area. Alternatively, Beat runs online support groups for people with eating disorders.
Search for support groups
What support can Beat offer?
Beat’s free, confidential Helplines are open 365 days a year 9am-8pm Monday to Friday and 4-8pm Saturday, Sunday and bank holidays.
You can also join one of our online support groups, which are anonymous and give you the opportunity to speak to people going through similar experiences to you.
If you’d like to find face-to-face support in your area, you can use our HelpFinder service to see what’s available.