Binge-eating disorder (BED) is characterized by recurrent binge-eating episodes not followed by the regular use of compensatory behaviors. Research indicates a lifetime prevalence of 0.42 percent in men and 1.25 percent in women, with an overall rate of 0.85 percent. Although BED can affect individuals of normal weight, it is more commonly found in those with higher weight.

In this post, I present a new cognitive-behavioral theory of BED, which integrates well-established cognitive-behavioral mechanisms that sustain binge-eating episodes with additional cognitive and behavioral factors that contribute to the maintenance of higher weight (Figure 1). While not all these maintenance factors are present in every case of BED, each case involves a combination of these elements.

Life events and associated mood changes frequently trigger and sustain binge-eating episodes in individuals with BED. This link between life events, emotional changes, and binge-eating can be understood through several key observations:

However, despite the initial relief from negative emotions, binge-eating episodes often result in feelings of guilt, anxiety, and depression. These negative feelings can then trigger subsequent binge-eating episodes, creating a vicious cycle.

A person is described as having an overvaluation of shape and weight when they predominantly, and sometimes exclusively, judge their self-worth based on their body shape, weight, and their ability to control them. This characteristic is present in approximately 50 percent of individuals with BED.

In BED, overvaluation of shape and weight is often accompanied by intermittent........

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