Understanding the science, emotions, and hope behind healing from binge eating.
Binge Eating Disorder (BED) is more common than many realize—and far more complex than stereotypes suggest. While it’s sometimes mistaken for simply “overeating,” BED is a serious mental health condition that affects how the brain, body, and emotions work together.
If you’ve ever felt trapped in cycles of eating large amounts of food in a short period—feeling full to the point of discomfort, struggling to stop eating, or feeling embarrassed afterward—you’re not alone. Binge Eating Disorder is now recognized as the most common eating disorder in the United States, affecting millions of adults and teens across all backgrounds. In fact, almost half of women with binge eating disorder may develop or experience symptoms during pregnancy, making this period a potential trigger for the disorder.
At the Center for Healthy Eating and Activity Research (CHEAR) at UC San Diego, our team—led by clinical psychologist Dr. Kerri Boutelle—has dedicated decades to understanding what really causes binge eating and, most importantly, how to help people heal.
Understanding Binge Eating Disorder
The American Psychiatric Association defines Binge Eating Disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as recurrent episodes of eating unusually large amounts of food within a short period (typically within two hours), accompanied by a feeling of loss of control. During these binge episodes, the amount of food eaten is much larger than what most people would eat in a similar period, and the eating pattern is marked by rapid consumption and a sense of loss of control.
These episodes occur regularly, often at least once a week for three months or more. Unlike bulimia nervosa, BED episodes aren’t followed by purging behaviors such as vomiting or extreme exercise.
People living with BED often describe:
- Eating beyond physical hunger—feeling unable to stop even when full
- Consuming large quantities of certain foods they try to avoid
- Feeling distress, guilt, or shame after eating binges
- Trying to “make up for it” later by skipping meals or dieting
- Feeling that eating behaviors interfere with daily life and emotional well-being
Though it can occur in anyone, binge eating disorder often develops in middle-aged women but also affects men and adolescents. It can co-occur with other mental health conditions, including anxiety, depression, and substance use disorders.
Why Does Binge Eating Disorder Develop?
Binge Eating Disorder doesn’t have one single cause—it develops through a combination of biological, psychological, and environmental factors. Binge eating behaviors are influenced by a complex interplay of genetic, neurobiological, and environmental triggers, and individuals may binge eat in response to stress, emotional distress, or neurochemical imbalances. Dr. Boutelle’s research helps us better understand this complex picture.
Biological Factors: The Brain, Hormones, and Hunger Cues
Science shows that BED involves differences in how the brain responds to food and hunger signals.
In a 2024 systematic review published in the Current Psychiatry Reports, Dr. Boutelle and her colleagues summarized findings showing that people with BED often have heightened sensitivity in the brain’s reward system—particularly in areas involving dopamine, the chemical linked to motivation and pleasure.
This means food, especially high-calorie foods, may trigger stronger reward responses in the brain. These “food cues” make it harder to resist eating even when you’re not physically hungry. Bingeing on palatable foods can activate the same dopamine and opioid pathways involved in addiction, reinforcing the cycle of compulsive overeating.
At the same time, the parts of the brain responsible for inhibitory control—the ability to pause and make conscious choices—may be less active during binge episodes. Together, these factors can make eating feel automatic, driven by brain chemistry rather than willpower.
Dr. Boutelle’s 2025 study in JAMA Network Open took this understanding further. In a randomized controlled trial (RCT) of veterans with BED or subthreshold binge eating, her team compared traditional Cognitive Behavioral Therapy (CBT) with a newer approach called Regulation of Cues (ROC) combined with Behavioral Weight Loss (BWL).
The results were clear: participants who learned to tune back into their natural hunger and fullness cues through ROC showed greater reductions in binge eating than those who received CBT.
This research confirms that biological psychiatry and behavioral science can work hand in hand—helping people retrain how their brains and bodies interpret food signals.
Psychological Factors: Emotions, Stress, and Self-Esteem
Many people with BED use food as a way to cope with emotional pain. Stress, loneliness, anxiety, or sadness can all trigger binge episodes, which momentarily soothe discomfort—but the relief is often followed by guilt or shame.
Dr. Boutelle’s 2024 study in the journal Eating Behaviors found that negative emotions such as depression and anxiety are strongly tied to binge eating behavior. The research also revealed that appetitive traits (how a person responds to food cues and satiety) and emotional distress interact. In other words, people may be biologically more sensitive to food rewards and psychologically more vulnerable to stress—two forces that combine to fuel binge eating.
Low self-esteem, poor body image, and a history of disordered eating (such as chronic dieting or skipping meals) also play major roles. When someone constantly battles their body shape or eating habits, food can become both an enemy and a comfort—creating a painful cycle that’s hard to break.
Environmental and Social Factors: The World Around Us
Our surroundings influence how, when, and why we eat. Cultural pressure to maintain a “healthy weight” or idealized body shape can lead to restrictive dieting—one of the most common risk factors for binge eating disorder.
Restriction often backfires: when you don’t eat enough food or skip meals for long periods, your body’s natural hunger hormones increase, making it even harder to stop eating once you finally allow yourself to eat.
Other environmental factors include:
- Growing up in a household where food was used as reward or punishment
- Experiencing trauma, neglect, or criticism about weight or appearance
- Exposure to advertising that glorifies “thinness” and demonizes “certain foods”
Family history also matters. People with relatives who have eating disorders, substance abuse, or other mental disorders may have a higher risk of developing BED due to shared genetic and environmental factors.
Biological and Psychological Interactions: It’s Not One Thing
One of the key takeaways from Dr. Boutelle’s work is that binge eating disorder develops through interacting systems—not a single cause.
Her studies demonstrate that appetitive traits, such as high responsiveness to food cues and difficulty sensing fullness, combine with negative affect (stress, sadness, or anxiety) to maintain binge eating.
This insight helps researchers design treatments that address both biology and emotion, rather than just focusing on willpower or food restriction.
Food Intake and Eating Habits
Binge eating disorder is marked by distinct patterns of food intake and eating habits that set it apart from other eating disorders. People with binge eating disorder often find themselves eating unusually large amounts of food in a short period, sometimes consuming more food than most people would under similar circumstances. These episodes are frequently accompanied by a sense of losing control—feeling unable to stop eating even when not physically hungry or long after feeling full.
Unlike normal eating, binge eating episodes are often characterized by eating rapidly, eating alone due to embarrassment, and choosing certain foods that may be considered “off-limits” or especially tempting. This can lead to eating until uncomfortably full, and afterward, many individuals experience intense feelings of guilt, shame, or distress about their eating behaviors.
These eating habits can have a profound impact on daily life. Binge eating disorder is associated with weight gain and a higher risk of developing health problems such as metabolic syndrome, high blood pressure, and type 2 diabetes. The disorder can also worsen or be complicated by other mental health conditions, including depression, anxiety, and substance use disorders. For many, the cycle of binge eating and emotional distress can interfere with work, relationships, and overall well-being.
The American Psychiatric Association recognizes binge eating disorder as a common eating disorder in the diagnostic and statistical manual (DSM-5), highlighting that it affects people of all ages and backgrounds, including middle-aged women. Research shows that a combination of biological factors (like brain chemicals and genetic predisposition), psychological factors (such as low self-esteem and body image concerns), and environmental factors (including social pressures and stress) all contribute to the development and maintenance of binge eating disorder.
Seeking help from a mental health professional is crucial for anyone struggling with these symptoms. Early diagnosis and intervention can make a significant difference. Treatment often includes talk therapy, such as cognitive behavioral therapy, which helps individuals develop healthier ways to cope with stress and emotions, as well as practical strategies for managing eating habits. Lifestyle changes—like eating regular meals, avoiding known triggers, and engaging in physical activity—can also support recovery.
Raising awareness about binge eating disorder and other eating disorders is essential for promoting early detection and reducing stigma. According to a systematic review published in the International Journal of Eating Disorders, evidence-based treatment can lead to meaningful improvements in symptoms and quality of life for those affected.
In addition to professional support, individuals can take steps to manage their condition by practicing self-care, building a support network, and addressing underlying issues such as self-esteem and body image. With the right help and a better understanding of their eating behaviors, people with binge eating disorder can learn healthier ways to relate to food and improve their overall well-being.
Symptoms and Diagnosis: Recognizing the Signs
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, binge eating disorder is diagnosed when: Clinical assessment is required to have binge eating disorder diagnosed, which typically involves questions about symptoms, eating patterns, and medical history.
- Episodes of eating a large amount of food occur regularly (typically once per week for at least three months).
- The person feels a loss of control during these episodes.
- The episodes are associated with at least three of the following:
- Eating much more rapidly than normal
- Eating until uncomfortably full
- Eating large quantities of food when not physically hungry
- Eating alone due to embarrassment
- Feeling disgusted, depressed, or guilty afterward
BED is distinct from other eating disorders like anorexia nervosa or bulimia nervosa, though they can share overlapping emotional roots.
Many people with BED also experience health problems related to weight gain, such as metabolic issues, but it’s important to understand that not everyone with binge eating disorder has a high body weight, and weight loss alone does not cure the disorder.
The Impact on Daily Life and Well-Being
Binge Eating Disorder (BED) affects much more than eating—it can impact mental health, physical health, and quality of life.
People may avoid social situations, experience fatigue, digestive issues, or changes in mood. They may feel isolated, hopeless, or ashamed about their eating behaviors.
But here’s what research and lived experience show: recovery is absolutely possible.
When binge eating is treated as a mental health condition—not a moral failure—people can learn healthier ways to respond to emotions and body signals.
How CHEAR Treats Binge Eating Disorder
At CHEAR, Dr. Boutelle and her team use evidence-based approaches grounded in decades of research, including her landmark ROC (Regulation of Cues) method.
Regulation of Cues (ROC)
ROC teaches individuals to:
- Reconnect with internal hunger and fullness signals
- Reduce reactivity to external food cues (like sights, smells, or emotions)
- Build balanced, normal eating patterns
- Practice self-compassion instead of guilt
In the 2025 JAMA Network Open RCT, ROC combined with Behavioral Weight Loss outperformed CBT in reducing binge frequency, offering a new path forward for people who have struggled for years.
Talk Therapy and Behavioral Techniques
CHEAR’s therapists also use Cognitive Behavioral Therapy (CBT), exposure therapy, and mindfulness-based interventions to help patients notice triggers, manage stress, and build resilience.
Holistic Support for Mental Health
Because BED often co-occurs with depression, anxiety, or substance use, treatment addresses the whole person, not just food intake. This may include coordination with primary care providers, psychiatric evaluation, and referrals when appropriate.
The Role of Research in Healing
Dr. Boutelle’s ongoing studies, such as the SHARE Trial (2025), continue to explore how brain chemicals, social factors, and appetitive traits interact to create or sustain binge eating disorder.
Her research—published in journals like the American Journal of Clinical Nutrition and the International Journal of Eating Disorders—is helping clinicians worldwide gain a better understanding of what drives binge eating and how to develop healthier ways to treat it.
By volunteering for CHEAR’s no-cost studies, participants not only receive specialized support but also contribute to a body of research that’s transforming care for this common eating disorder across the country.
Some of the research conducted at CHEAR or by Dr. Boutelle has been supported by grants from the National Institutes of Health, underscoring the importance of government-funded research in advancing understanding and treatment of binge eating disorder.
Breaking the Stigma
One of the most harmful myths about BED is that it’s about “lack of control” or “lack of discipline.” In reality, it’s a biopsychosocial disorder—meaning biological, psychological, and social elements combine to shape eating patterns.
Understanding this helps replace shame with compassion. Just as no one chooses to have anxiety or high blood pressure, no one chooses to live with binge eating disorder.
By bringing awareness, sharing stories, and connecting with resources, we can help more people seek support and find freedom from dangerous eating behaviors that interfere with well-being.
Finding Hope and Help
If you or someone you love is struggling with binge eating, help is available—and effective.
At CHEAR, we offer no-cost programs and clinical studies for children, adolescents, and adults experiencing challenges with eating, body image, or weight.
Participants work with a compassionate care team that understands both the science and the human side of recovery.
You deserve to feel at peace with food, your body, and yourself. Healing begins with understanding—and understanding begins here.
References to Dr. Boutelle’s Work
- Boutelle K. N. et al. (2025). Regulation of Cues Combined with Behavioral Weight Loss vs Cognitive Behavioral Therapy for Veterans With Binge Eating Disorder or Subthreshold Binge Eating Disorder. JAMA Network Open.
- Pasquale C. A., Boyar K., & Boutelle K. N. (2024). Reward and Inhibitory Control Mechanisms in Binge Eating Disorder: A Systematic Review. Current Psychiatry Reports.
- Boutelle K. N. et al. (2024). Appetitive Traits and Negative Affect Associated With Binge Eating in Adults With Overweight/Obesity. Eating Behaviors.
- Boutelle K. N. et al. (2025). SHARE Trial Design: Regulation of Cues Intervention for Adults With High Food Responsiveness. Contemporary Clinical Trials.
