DBT for Binge Eating: How It Works

Dialectical behavior therapy (DBT), a form of treatment that has been researched and tested for 30+ years, targets emotion regulation. For someone with binge eating— particularly for those who try to cope with emotional distress by bingeing—DBT offers a way to better manage and regulate emotions.

Dialectical refers to deriving clarity from two seemingly opposing forces—in this case, accepting you for who you are but empowering you to change. DBT does this by teaching specific skills. These skills are grouped into four modules:

1. Mindfulness skills

Mindfulness is about being present and aware—able to recognize and describe your feelings, thoughts, and urges to act, with non-judgmental acceptance.  For someone with binge eating, this might mean recognizing when you are actually hungry (vs. eating for other reasons), or when you are distressed.

2. Emotion regulation skills

This is about understanding your emotions, “riding them out” and learning how insulate yourself from distress.  For someone with binge eating, this might mean eating on a regular schedule to prevent feeling overly-hungry.

3. Distress tolerance skills

This is about learning how to deal with the inevitable stresses and pains of life…  and getting through difficult situations without making things worse!  For a binge eater, this means developing alternatives to bingeing when stressed or accessing strategies to soothe yourself when you’re upset.

4. Interpersonal skills

This is about learning how to be more assertive in interpersonal situations that otherwise might trigger distress.  So, for example, it might include learning to ask for what you want or how to say “no.”

For many patients with binge eating, DBT skills are very helpful. Feel free to reach out to us to see if DBT is right for you!