Helping your clients overcome binge eating

Helping your clients overcome binge eating can be complex and may require additional support from other healthcare providers. However, through proper nutritional care, you can help your clients reduce binging episodes to improve their health and quality of life.

Binge eating is one of the most common eating disorders and needs to be carefully handled to ensure a full recovery. It tends to directly correlate with nutritional intake and diet. For this reason, registered dietitians play an integral role in the treatment and recovery plan to help clients overcome binge eating. You can do this by helping your clients recognize the difference between physical hunger and satiety cues, repair their relationship with food, and practice mindfulness.

Before discussing some recommendations for helping your client reduce binging episodes, let’s understand what binge eating is and what can contribute to it. 

Binge eating vs. overeating

This term can often be mistaken for overeating, so as a nutrition professional it’s important that you understand the difference between the two. 

Overeating is typically characterized as eating more than planned or feeling too full after a meal. As such, it’s not considered to be an eating disorder. 

Conversely, binge eating is one of the most common eating disorders and can develop at any point in life. It can be defined as happening at least once a week over a three-month period, with usually 1,000 to 10,000 calories consumed each time [1]. People affected have similar symptoms as those with bulimia, but do not restrict calories or purge in order to compensate for binges. Common symptoms include:

• Eat large amounts of food rapidly, even if not hungry;
• Feelings of shame, disgust, and guilt when thinking about the behavior;
• No use of purging like excessive exercise, vomiting or laxatives.

Those with this disorder often are overweight or obese, which can increase their risk for heart disease, strokes, and type 2 diabetes.

Tip: Learn more about how you can support clients with eating disorders.

What contributes to binge eating?

Whether it’s psychological, social, or physical, there are many reasons that binge eating may occur. Here are a few types of binge eating to be aware of.

Physical binging

This is often triggered when the body does not meet its physical needs. This includes:

• Consuming too few calories
• Dieting and deprivation
• Limiting carbohydrate intake
• Exercising too much
• Dehydration
• Replacing meals with liquids
• Avoiding a food because it is “bad”
• Being underweight
• Purging or laxative use

Emotional binging

This is often triggered by emotions, such as:

• Anger
• Boredom
• Stress
• Anxiety
• Inadequacy
• Sadness
• Loneliness
• Low self-esteem
• Embarrassment

Overcome binge eating with the right nutritional assessment

When working with clients to overcome binge eating, it’s recommended that you take a dive deep into their relationship with food and lifestyle choices. You should also inquire about coexisting mental health disorders (like depression, anxiety, and OCD) [2]. You can also ask certain questions to further aid in your assessment, such as:

• When you want to eat, what are you hungry for?
• Food or not, what fulfills you and brings you joy?
• When you eat, are you truly hungry?
• How are you feeling right now?
• How can you comfort yourself without food? 
• What are some fun hobbies you can participate in that are not food-related? 
• Do you feel like something is missing in your life?

Dietary and lifestyle recommendations to overcome binge eating

Based on the severity of your client’s condition and the ultimate diagnosis, you may need to refer the client to an inpatient center. However, if the client is stable enough to work with you in an outpatient setting, here are some recommendations to help them overcome binge eating.

Food is your friend

Research shows that deeming food as “bad” or “good” contributes to disordered eating patterns and enhances cravings [5]. Those suffering from an eating disorder typically have many negative thoughts about food. As a dietitian, it’s your job to help your clients start thinking about “food as fuel” rather than “food as an enemy”. and having them understand the difference between physical hunger and satiety cues.

Since many people affected with eating disorders feel guilt or shame around certain foods, you can help your clients overcome this. Guide them to realize that food provides sustenance and pleasure by encouraging the thought that “all food is good food”. As your sessions progress, you can also help your client become more comfortable with food-related activities (such as cooking, grocery shopping, or eating out).

Don’t skip meals

When your client adheres to a regular eating pattern, they can reduce the risk of overeating [8]. Regular meal patterns are also associated with lower levels of ghrelin and fasting blood sugar, both of which play a role in hunger and satiety.

Encourage nutritious foods

While you should encourage your clients to enjoy all foods, you can provide nutritious choices that will promote satiety and fulfill their hunger cues. Studies have shown that diets high in protein, healthy fats, and whole foods can lessen the desire to binge later in the day [4].

Practice mindfulness

You can help your clients learn to listen to their bodies by being mindful of how they feel at any given moment, especially when eating. This can prevent overeating by helping them recognize when they aren’t hungry. As such, mindfulness can improve eating behaviors and reduce the incidence of binge eating [3].

Lifestyle changes

Studies show that sleep, physical activity, and hydration all play a role in reducing binge eating episodes. These can improve your client’s body image and may decrease the feeling of hunger [6]. Additionally, you can encourage your client to find support from a friend, family member, or significant other. Having someone to talk to can help your client overcome binge eating [7].

Work with other healthcare providers

Depending on the severity of your client’s eating disorder, they may require different levels of care and treatment, such as inpatient treatment, residential treatment, partial hospitalization, or outpatient.

As a dietitian, you would collaborate with other healthcare providers to ensure that your client’s needs are being met. These needs can range from constant round-the-clock care, sessions for a few hours every day, or even sessions just once a week.

Summary

Binge eating disorders are complex and can affect everyone differently. Dietitians play an integral role in a client's treatment and recovery plan. They can help them repair their relationship with food, normalize eating habits and patterns and work with other healthcare providers. As such, you play a vital role in helping clients overcome binge eating to improve their health and quality of life.

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References:

1. Iqbal, A., & Rehman, A. (2021). Binge Eating Disorder. In StatPearls. StatPearls Publishing.
   
   
2. Telch, C. F., & Stice, E. (1998). Psychiatric comorbidity in women with binge eating disorder: Prevalence rates from a non-treatment-seeking sample. Journal of Consulting and Clinical Psychology, 66(5), 768–776.
   
   
3. Katterman, S. N., Kleinman, B. M., Hood, M. M., Nackers, L. M., & Corsica, J. A. (2014). Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eating behaviors, 15(2), 197–204.  
   
   
4. Cioffi, I., Ibrugger, S., Bache, J., Thomassen, M. T., Contaldo, F., Pasanisi, F., & Kristensen, M. (2016). Effects on satiation, satiety and food intake of wholegrain and refined grain pasta. Appetite, 107, 152–158.
   
   
5. Hardcastle, S. J., Thøgersen-Ntoumani, C., & Chatzisarantis, N. L. (2015). Food Choice and Nutrition: A Social Psychological Perspective. Nutrients, 7(10), 8712–8715.   
   
   
6. Dashti, H. S., Scheer, F. A., Jacques, P. F., Lamon-Fava, S., & Ordovás, J. M. (2015). Short sleep duration and dietary intake: epidemiologic evidence, mechanisms, and health implications. Advances in nutrition (Bethesda, Md.), 6(6), 648–659.
   
   
7. Cadzow, R. B., & Servoss, T. J. (2009). The association between perceived social support and health among patients at a free urban clinic. Journal of the National Medical Association, 101(3), 243–250.
   
   
8. Zendegui, E., West, J., Zandberg, L. (2014). Binge eating frequency and regular eating adherence: the role of eating pattern in cognitive behavioral guided self-help. National Library of Medicine.