Binge eating: how to stop overeating and when to get help

Binge-eating disorder means recurrent episodes of eating a markedly larger amount than usual in a short time with a sense of loss of control, followed by shame and guilt, but without vomiting or other “compensation”. If episodes occur at least once a week for three months, this is an eating disorder, and it is treatable: the main method is psychotherapy (CBT) combined with regular eating without strict diets. The free online DEBQ test helps you understand which type of overeating predominates in your case — it does not make a diagnosis, but shows what to discuss with a specialist.

In brief

• What to do: eat regularly — 3 meals and 2–3 snacks, without skipping breakfast and lunch; write down binge episodes and what preceded them; seek help from a psychotherapist and a dietitian.
• What to avoid: strict diets, fasting days and “forbidden” foods — restriction is what most often triggers the next binge; punishing yourself with exercise or fasting after an episode.
• When to see a specialist: episodes recur once a week or more often; you eat in secret and feel ashamed; overeating comes with anxiety or low mood; you have started vomiting after eating — this is a reason to seek help straight away.

How to tell binge eating from ordinary overeating

Overeating at a celebration is normal. Binge eating differs in the feeling that you cannot stop, and in the fact that it keeps recurring. During an episode, at least three of the following signs are usually present:

• eating much more rapidly than usual;
• eating until uncomfortably full;
• eating large amounts when not physically hungry;
• eating alone because of embarrassment at how much you are eating;
• after the episode — feeling disgusted with yourself, guilty, depressed.

Unlike bulimia, the episode is not followed by regular vomiting, laxatives or exhausting exercise. Body weight in binge-eating disorder can be anything — including normal.

Why it happens

There are usually several causes: strict diets and alternating restriction with binges, stress and the habit of “eating your feelings”, anxiety and depression, as well as hereditary predisposition. The stricter the restriction during the day, the higher the risk of overeating in the evening — which is why the advice to “just eat less” does not work.

What helps

• Regular eating. Three main meals and 2–3 snacks reduce the intense hunger that triggers episodes.
• No bans. Favourite foods stay in the diet in normal portions — banning them increases cravings.
• A diary. What, when and in what state you ate — this is how triggers become visible.
• Psychotherapy. Cognitive behavioural therapy, including guided self-help, is the first-line treatment in the NICE guidelines.
• A doctor. Medication is possible, but only a doctor can prescribe it.

Online overeating test

The Dutch Eating Behaviour Questionnaire (DEBQ) — 33 questions, 5–7 minutes. It shows which eating style predominates: restrained, emotional or external. The result is a reason to discuss it with a doctor, not a diagnosis. Other tests are on the page “Eating behaviour tests”.

More about how we work with eating disorders on the page “Nutrition in eating disorders”.

Sources

1. NICE NG69. Eating disorders: recognition and treatment — National Institute for Health and Care Excellence.
2. Giel KE et al. Binge eating disorder — Nat Rev Dis Primers, 2022.
3. Hilbert A et al. Meta-analysis of the efficacy of psychological and medical treatments for binge-eating disorder — J Consult Clin Psychol, 2019.