Binge eating: treatment for overcoming compulsive eating

Written by: Dr Beverley Marais
Edited by: Robert Smith

Throughout the lockdown many of our habits have changed and, for some of us, it’s been our eating habits. Sometimes we can turn to food for comfort, but it can get out of hand.

We spoke to leading consultant psychologist, Dr Beverley Marais about binge eating and treatment available for overcoming binge eating disorder.


What treatment for binge eating is available?

The National Institute for Health and Care Excellence (NICE, 2017) guidelines recommend the following evidence-based treatment for binge eating disorder:

1. Guided self-help

This initial approach to treating binge eating disorder involves engaging with materials more independently, for example, using a recommended workbook or online course whilst also engaging with a therapist for additional support. Sessions with a therapist are generally brief, lasting approximately 20 minutes and used to facilitate and guide the patient through the workbook or online course effectively.


2. Cognitive Behavioural Therapy (CBT)

Should the patient require a different approach, CBT is recommended, ideally within a group setting. Treatment would involve

  • psychoeducation about food and food choices,
  • identifying triggers to binge eating,
  • introducing regular eating patterns,
  • addressing concerns about body, weight and shape,
  • developing skills and alternative coping strategies for dealing with triggers to bingeing and
  • learning how to reduce and recover from lapses.


How is treatment personalised to each patient?

In order to personalise treatment to the patient, the initial assessment involves an in-depth clinical assessment, taking into account the person’s current eating patterns, how these changed over time, their attitudes to food, their weight and body image, and a review of any interventions they might have tried in the past.

The patient is encouraged to engage in self-monitoring in order to help understand and identify triggers and situations eliciting a binge. Therapist and patient use this information to collaboratively formulate an understanding of their binge eating. This formulation then informs an individualised treatment package meeting the specific needs of the individual.


How do patients’ relationships with food and body image change during treatment?

During treatment, patients become more conscious of the reasons behind their eating patterns. Part of the function of binge eating is to block out or numb uncomfortable thoughts and feelings. Over time, eating then becomes a learned coping strategy for dealing with difficulties, however, this coping strategy (bingeing), then becomes the problem focus.

Treatment helps to identify some of the punitive rules and negative attitudes associated with food and body image as well as the patient’s behaviours which would reinforce them. The focus of treatment is largely on behaviour change through the application of regular tasks designed to challenge unhelpful thoughts and assumption about food. As patients are provided with alternative strategies to manage binge eating whilst learning to tolerate and process uncomfortable thoughts and feelings, their relationship to food and their body changes.


What guidance is given to patients to cope with emotional binge eating triggers?

Patients are guided to begin identifying their emotions, understand them, and learn how to communicate these in order to meet their needs. Instead of habitually blocking these out, initial strategies are provided to help tolerate overwhelming emotions. Some of these might involve delaying a binge response by engaging in an alternative behaviour or task such as going for a walk, making a call, spending time with others or changing the environment.


When is it determined that someone has overcome their binge eating disorder?

Patients will feel more in control of their eating and a less preoccupied with food, weight and body image. They would have established a regular pattern of eating and learned how to make use of lapses. Eating no longer serves as the sole strategy for coping with difficulties and they are able to value their emotions, even uncomfortable ones as necessary and important features maintaining recovery.


For more support on combating eating disorders, feel free to book an appointment with Dr Beverley Marais. Visit her profile today for more information on treatment and appointment availability.

By Dr Beverley Marais

Dr Beverley Marais is a consultant psychologist in FarnhamMidhurst and Old Woking who specialises in eating disorders and addiction. In addition to this, she works with anxiety, depression, obsessive-compulsive disorder, self-harm and relationship issues.

Dr Marais completed her undergraduate psychology training in South Africa. This then followed with more specialist postgraduate psychology and psychotherapy in the UK, totalling 9 years of training in her field. Dr Marais has worked with the large team of counselling and clinical psychologists in the field of addictions at the world-renowned South London and Maudsley NHS Trust. She then worked in partnership with leading experts in eating disorders at the Maudsley Hospital.

She has developed and delivered group-based psychological teaching and training programmes and trained practitioners in advanced skills. Dr Marais is the founder and CEO of The Wellbeing Lounge, which is an online eating disorders programme for women living and experiencing eating, body image and weight concerns.

In 2014 she also published her book A Step-by-Step Guide for Beating Anorexia and Bulimia where she uses evidence-based research and her experience as a psychologist to help parents, carers and sufferers learn and understand about the eating disorders.

PLC number: ​PYL18582

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