Topic
Binge Eating Disorder
The binge is not the beginning of the story.
Binge eating is almost always doing work. Heatherton and Baumeister's escape theory named it three decades ago; the ecological-momentary-assessment meta-analytic evidence confirmed it: negative affect rises sharply before a binge and falls after. Treating BED without addressing what is being escaped tends to produce relapse. DBT-BED (Safer, Telch, Chen) is the most strongly evidenced affect-focused option. CBT-E fits when the pattern is body-image driven. This hub is being built out; the EDFE identifies which pattern you are carrying.
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EDFE
The transdiagnostic eating disorder evaluation identifies whether your binge pattern is primarily affect-regulation driven ("Affect-Dysregulation BED") or body-image driven ("Body-Image-Driven BED"). The archetype maps onto different evidence-based treatments.
Take the EDFE → AssessmentPHQ-9
Because binge eating so often co-occurs with depression and because Pathway 2 (negative affect) is often primary, screening mood alongside the EDFE sharpens the clinical picture.
Take the PHQ-9 →Related Articles
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DBT for Binge Eating: What Safer, Telch, and Chen Built for the Affect-Regulation Pattern
How Christy Telch adapted DBT for binge eating, what the Safer, Telch, and Chen manual contains, and when DBT-BED is indicated over Fairburn's CBT-E.
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Why Dieting Causes Binging: Restraint Theory Explained
In 1985, Janet Polivy and C. Peter Herman published the experimental work at the University of Toronto that demolished the willpower model of binge eating. Restraint theory proposes that cognitive dietary restraint, not hunger or lack of discipline, is the proximal cause of the disinhibited eating that follows a breach of a self-imposed rule. Four decades of subsequent research, including Eric Stice's dual-pathway confirmation, have substantiated the basic mechanism and informed why Christopher Fairburn's CBT-E drops dietary restraint early in treatment.
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The Obesity Clinic That Discovered Trauma: Vincent Felitti, the ACE Study, and What Your Binge Is Holding
In the late 1980s, Vincent Felitti ran the obesity clinic at Kaiser Permanente in San Diego. He could not understand why his best-outcomes patients were the ones who quit the program, until he began following them up and discovered what his liquid-diet protocol had been treating without knowing it was treating. The ACE Study grew out of those interviews. What the study found about the relationship between adverse childhood experiences and adult health outcomes, including binge eating and body size, reorganized the epidemiology of trauma in the United States and has not yet reorganized most of the treatment the culture offers.
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The DSM-5 Criteria for Binge Eating Disorder, Read Plainly
The DSM-5-TR criteria for binge eating disorder in plain language, with answers to the three questions patients most often ask when a referral form lists them.
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Escape from Self-Awareness: The Heatherton and Baumeister Theory of Binge Eating
Heatherton and Baumeister's 1991 escape theory: binge eating as relief from aversive self-awareness, and why night-time bingeing rises after days of high demand.
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The Restraint-Binge-Purge Cycle: Why the Loop Closes Itself
Bulimia nervosa is maintained by a mechanistic loop in which dietary restraint, not the binge, is the destabilizer. Understanding why the cycle closes itself explains why willpower fails structurally rather than morally.
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If binge episodes have become unmanageable, or if the affect-regulation pattern has been resistant to self-help strategies, a consultation can help clarify whether DBT-BED, CBT-E, or another approach fits your pattern.
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