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Compulsive overeating: causes, symptoms, diagnosis, treatment
Last reviewed: 04.07.2025
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Binge eating disorder is characterized by episodes of binge eating that do not involve inappropriate compensatory behaviors such as self-induced vomiting or laxative use. The diagnosis is clinical. There is growing evidence that the most effective treatment is a standard behavioral weight loss program.
Binge eating disorder affects 2-4% of the general population and becomes more common with increasing body weight, reaching 30% among obese patients in some weight loss programs.
Unlike bulimia nervosa, binge eating disorder is typically seen in obese individuals and promotes obesity through excessive calorie consumption. Patients with binge eating disorder are usually older than those with anorexia nervosa and bulimia nervosa and are more often (approximately 50%) men.
Patients with binge eating disorder typically experience distress, especially if they are trying to lose weight. About 50% of obese patients with binge eating disorder are depressed, compared with less than 5% of obese patients without binge eating disorder.
Most patients are treated in traditional weight-loss programs that pay little attention to binge eating disorder. Patients agree to such interventions because they are usually more concerned about their weight than about binge eating disorder. The presence of binge eating disorder does not limit weight loss in these programs.
Treatment evaluation is complicated by the variability of binge eating disorder. Without treatment, improvement may occur, and the placebo effect is very high. Cognitive behavioral therapy is effective in controlling binge eating disorder but has little effect on weight, possibly due to compensatory (non-compulsive) overeating. Drug therapy with SSRIs helps control both binge eating disorder and weight, but withdrawal is often followed by relapse. Paradoxically, the most effective treatment for binge eating disorder is a standard behavioral weight loss program that not only promotes weight loss but also control of binge eating disorder.
Self-help groups that follow the principles of Alcoholics Anonymous, such as Overeaters Anonymous or Food Addicts Anonymous, help some patients with compulsive overeating.
The presence of compulsive overeating does not preclude the use of surgical treatment methods in patients with severe obesity.
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