The Two Binge Eating Pathways and How To Address Them

There are two common binge eating pathways. Most of our patients identify with both patterns but some find one may be more relevant than the other.

Binge Eating Pathway #1: under-eating, deprivation, dieting

Chronic dieting: you name the diet, you’ve tried it

Restriction: trying to “be good”  

Over-control of food or constant restraint: “I shouldn’t” 

Guilt after eating: “I shouldn’t have”

Maybe these behaviors leave you so ravenous that you can’t help but over-eat. Or alternatively, they just leave you frustrated, conflicted, deprived. Either way, the result is over-eating or bingeing, feeling lousy, and then trying to “get back on track” by jumping right back into a restrictive pattern. Are there any elements of this pattern that ring true for you?

Binge Eating Pathway #2: in reaction to emotion

Anxiety, stress, boredom, loneliness — feelings. We all have them but don’t always manage them effectively. Food is a means of escape, numbing, relaxing, pleasure, and relief. Unfortunately, these are short-term “benefits,” but long-term, using food to cope leads to all sorts of problems. This is why treatment must incorporate alternative skills for coping. How are you supposed to stop using food if there is no other immediately effective tool to manage?

The Solution: CBT-E

The research is clear: Enhanced Cognitive Behavioral Therapy (CBT-E) is the most effective treatment for binge eating.  CBT-E is a time-limited therapy (20 weeks – not open ended like most “talk therapies”) that is present-focused, addressing the factors day-to-day that keep the eating problem going.

CBT-E is going to give you strategies to establish a stable, pattern of flexible eating. You will identify the emotions that get you in trouble and learn alternative skills for coping. You will be given strategies for increasing your awareness of what’s happening with your food and skills for simply doing something else when tempted to eat when you’re not actually hungry!

We have nothing against “talk therapy;” open-ended “exploratory,” “insight-oriented” therapy is great… but it won’t help your eating problem. CBT-E – a behavioral therapy, proven through research to be the first line treatment for binge eating – is absolutely the way to go. If you’ve been struggling and have not tried CBT-E, you owe it to yourself to do it!


At Columbus Park, we formally track how our patients respond to CBT-E, and the results are excellent. Read more about our outcomes.

Additionally, please see my blog about how to find the right CBT-E therapist.