What role do psychological therapies play in the management of binge eating disorder, and which should I recommend?

Psychological therapies play a central role in the management of binge eating disorder, focusing on addressing psychological factors rather than weight loss as a primary goal ¹.

For adults, guided self-help programmes using cognitive behavioural self-help materials are recommended initially, with brief supportive sessions to enhance adherence ¹.

If guided self-help is unacceptable, contraindicated, or ineffective after 4 weeks, group cognitive behavioural therapy for eating disorders (CBT‑ED) should be offered, typically consisting of 16 weekly sessions focusing on psychoeducation, self-monitoring, and identifying binge triggers ¹.

Alternatively, individual CBT‑ED can be considered, usually comprising 16 to 20 sessions, which develop a formulation of psychological issues, address emotional triggers, and include monitoring of binge episodes and dietary intake ¹.

It is important to advise patients not to attempt weight loss during treatment, as this can trigger binge episodes, and to focus on stopping binge eating as a primary therapeutic aim ¹.