Case Study


Case Study

From Weight to Well-Being: The Challenges of Treating Binge Eating Disorder

January/February 2018


As a therapist who specializes in working with eating disorders, I often see people in my office who struggle with issues around restricting their food intake, overexercising, or engaging in purging behaviors. Although binge eating disorder (BED) is the most common type of eating disorder—with a 3.5 percent prevalence rate in the United States, compared to 0.9 for anorexia and 1.5 for bulimia—many people suffering with it don’t get the help they need because of their embarrassment about their bodies and eating habits. They often have long histories of disordered eating, multiple unsuccessful diets, and shameful interactions with medical professionals. Many of them avoid seeing therapists for fear of more shame and more useless advice to just stop eating.

Because people with BED have higher rates of depression, anxiety, and addictive behavior, many therapists overlook the symptoms of BED, which include recurrent episodes of overeating, even when not physically hungry, a sense of lack of control during these episodes, eating more rapidly than normal, feeling uncomfortably full, and feeling guilt after overeating. Research suggests that 30 to 40 percent of individuals seeking weight-loss treatment could be diagnosed with BED; however, not all larger-sized individuals have BED, nor do all of those who have BED necessarily have larger body sizes.

Despite its prevalence, BED didn’t get its own category in the DSM until 2013, meaning that it’s no longer grouped into…

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