What first-line treatment options are recommended for adults with binge eating disorder in primary care?

Offer a binge-eating-disorder-focused guided self-help programme to adults with binge eating disorder, which uses cognitive behavioural self-help materials and focuses on adherence to the programme, supplemented with brief supportive sessions (for example, 4 to 9 sessions lasting 20 minutes each over 16 weeks, running weekly at first) ¹.

If guided self-help is unacceptable, contraindicated, or ineffective after 4 weeks, consider group cognitive behavioural therapy (CBT‑ED), typically consisting of 16 weekly 90-minute group sessions over 4 months, focusing on psychoeducation, self-monitoring, and identifying binge triggers ¹.

If group CBT‑ED is not available or declined, individual CBT‑ED should be offered, usually comprising 16 to 20 sessions, focusing on developing a formulation of psychological issues, addressing emotional triggers, and encouraging regular eating, with monitoring of binge episodes and dietary intake ¹.