Binge Eating Disorder and Anxiety: A Few Tips for Co-Occurring Treatment

When binge eating disorder and anxiety co-occur, as they often do, they can make it difficult for patients to move toward recovery with purpose. The symptoms caused by these conditions can complicate binge eating recovery by impeding the use of healthy coping skills. Therefore, people who are going through binge eating disorder treatment need to address their anxiety using effective management techniques. By taking this approach, it is possible to manage the symptoms of both anxiety and binge eating disorder to become fully recovered.

Co-occurring disorders are the norm for mental health treatment – eating disorder treatment included. Various forms of anxiety, depression and less generalized psychiatric disorders like OCD and borderline personality disorder occur at a much higher rate among people with eating disorders than they do in the general population. These disorders can trigger disordered eating behaviors or be triggered by them – it often turns into a vicious cycle.

Feelings of anxiety, for example, can trigger a binge eating episode, which causes the release of powerful brain chemicals like serotonin. This chemical raises the mood and alleviates negative emotions, which helps the person manage negative emotions in the short term. Unfortunately, the behavior and subsequent “reward” can easily become a compulsion. As a single binge eating episode becomes a repeated occurrence, the individual becomes subject to the physical, emotional, and psychosocial risks the disorder causes.

Disordered eating behaviors are also a source of guilt, shame, and embarrassment for many sufferers of binge eating disorder. They tend to eat in private and make efforts to hide evidence of their binge eating episodes. Often, binge eating sessions are triggered by hunger because the person is publicly “on a diet” or trying to lose weight. All these factors combine to increase anxiety about their body, about being discovered, or about having their secrets exposed. Even if a person didn’t display signs of anxiety before developing binge eating disorder, these factors can cause great feelings of worry and distress.

What Are the Symptoms of Binge Eating Disorder?

As the most common form of eating disorder in the United States, millions of people suffer from binge eating disorder. Two-thirds of people with this diagnosis are considered clinically obese, and the health risks from the disorder are in line with clinical obesity. As defined by the National Eating Disorder Association (NEDA), binge eating disorder consists of:

  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
  • Eating, in a discrete period (e.g., within any 2-hour period), an amount of food that is larger than what most people would eat in a similar period under similar circumstances.
  • A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating).
  • The binge eating episodes are associated with three (or more) of the following:
    • Eating much more rapidly than normal.
    • Eating until feeling uncomfortably full.
    • Eating large amounts of food when not feeling physically hungry.
    • Eating alone because of feeling embarrassed by how much one is eating.
    • Feeling disgusted with oneself, depressed, or very guilty afterward.

These episodes need to occur at least once a week on average for at least three months for a diagnosis of binge eating disorder to be made. Also, if there are compensatory purges to offset the number of calories taken in during binge eating episodes, the diagnosis will be bulimia nervosa instead of binge eating disorder. As with most eating disorders, people with binge eating disorder often struggle with poor or distorted body image and weight fluctuations.

What Are the Symptoms of Anxiety?

There are several different kinds of anxiety disorders. The most common form, generalized anxiety disorder is defined by the National Institute of Mental Health (NIMH) as:

  • Feeling restless, wound-up, or on-edge
  • Being easily fatigued
  • Having difficulty concentrating; mind going blank
  • Being irritable
  • Having muscle tension
  • Difficulty controlling feelings of worry
  • Having sleep problems, such as difficulty falling or staying asleep, restlessness, or unsatisfying sleep

While everyone experiences fear and worry from time to time, it’s usually passing or temporary. For people with anxiety disorders, it’s constant or near-constant for 6 months or more. It can become debilitating, affecting a person’s ability to relate to others, engage in social situations, and even professional and school performance.

Other kinds of common anxiety disorders include:

  • Phobias – This form of irrational, all-consuming fear can be of virtually anything. AS related to eating disorders, certain kinds of food can be the source of a phobia or fear of gaining weight or being “fat.”
  • Panic disorder – In this disorder, people experience disorienting and terrifying panic attacks, in which they may tremble, collapse, become short of breath, and experience feelings of impending doom. Sufferers might also feel anxious about when the next panic attack will occur, worsening the effect.
  • Social anxiety – A disorder in which people feel extremely uncomfortable in social situations, with great anxiety about being judged or disliked by others. People with both binge eating disorder and social anxiety often feel they are being judged about their body or what they eat in social situations, which can worsen the urge t binge eat in private.
  • PTSD – Although Post-Traumatic Stress Disorder isn’t an anxiety disorder per se, it causes great anxiety in its sufferers. PTSD is one of the most common triggers for disordered eating behaviors of all kinds.

Many anxiety disorders can be treated with medication, which is not the case for binge eating disorder. Although the prescriptions are not prescribed for binge eating disorder, managing the anxiety disorder helps people avoid their disordered eating behaviors. Treatment for both of these types of disorder is normally a wide variety of behavioral therapy methods and traditional talk therapy combined with nutritional education and mindful movement exercises.

How Are Co-Occurring Anxiety and Binge Eating Disorder Treated?

Effective binge eating treatment centers offer many different levels of care. Through these levels, clients can receive targeted treatments for their eating disorders and all co-occurring conditions. Each person coming into a recovery center receives a personalized treatment plan that takes their symptom types and severity into account.

Depending on their unique treatment needs, people with binge eating disorder may enter residential or outpatient (day treatment) programs to work toward binge eating disorder recovery. In many cases, a person who has just completed a residential program will attend day treatment sessions several times a week as a step-down, helping them reacclimate to life outside residential treatment. These programs are centered around helping clients learn life skills and build their coping abilities. Usually, these skills are taught and developed through daily exercises and counseling sessions.

When treating anxiety and binge eating disorder, clients will attend regular therapy sessions one on one with their counselors and as a group with their peers. Family counseling sessions can also help patients start to manage their symptoms and become recovered. Through these counseling sessions and other supportive activities, patients can start to work on managing their eating disorder and anxiety symptoms.

Tips for Coping with Anxiety While in Binge Eating Disorder Treatment

Anxiety symptoms can worsen or cause relapses for people in binge eating disorder treatment, so their management is imperative. At an eating disorder treatment center, clients will learn how to use the following tips to cope with anxiety. They are also quite useful for managing binge eating disorder after official treatment as come to its conclusion; relapses are common, and should not be considered failures, but they do need to be addressed. Thankfully, these tips can be used in or out of treatment.

Deep Breathing

Anxiety and panic can make it feel like it is too hard to take a breath, which only serves to make the symptoms worse. With deep breathing, it is possible to overcome these anxious feelings and achieve a calm state of mind. This practice teaches people to properly inhale, hold and exhale each breath to quickly resolve anxious thoughts and feelings. With this approach, they can mitigate the anxiety before it has a chance to cause disordered thoughts patterns and behaviors to return.

Mindful Meditation

Through mindful meditation, people can acknowledge and release anxious thoughts and feelings without dwelling on them or feeling compelled to act. This practice helps promote emotional regulation by clearing the mind, slowing breathing, and reducing stress. Using mindful mediation, it’s possible for people to simply observe their thought patterns without judgment to let the stress and anxiety slip away naturally. With time, they can learn to quickly release the underlying causes of the anxiety to let their body and mind calm down.


Refocusing one’s attention is another way to relieve the negative emotions and fixations caused by anxiety. By diverting their attention to a hobby, people redirect their energy to another activity and let the anxious feelings pass by. Hobbies are a great way to remain distracted while waiting for relief from anxiety. Hobbies can include artwork, solving puzzles, playing board games, learning a new language, or any other activity that interests them enough to block out the anxiety.


Excellent self-care practices can relieve stress and help people in treatment to feel less anxious. This helps to prevent anxiety, but it can also be used to find relief. Taking a long bath or spending time in nature, for example, can help reduce anxious thoughts from circling through the brain. Even spending time with loved ones can be an act of self-care for those who are charged with social activities. Each individual must reflect on their unique preferences to find the self-care routines that work best to relieve anxiety.

Getting Treatment for Binge Eating Disorder and Anxiety Symptoms

With a combined approach to binge eating disorder treatment, individuals can work on relieving the symptoms of their eating disorder as well as their anxiety. The treatment of all co-occurring conditions makes it easier for patients to purposefully work toward becoming recovered. The coping skills and other techniques learned in binge eating treatment can continue to support patients after they graduate from the program and transition back home. If you or a loved one is struggling with an eating disorder and/or anxiety, reach out for help sooner rather than later. Early intervention is a key factor in long-term, successful recovery.


With 20 years of behavioral health business development experience, Carrie combines world-class marketing, media, public relations, outreach and business development with a deep understanding of client care and treatment. Her contributions to the world of behavioral health business development – and particularly eating disorder treatment – go beyond simple marketing; she has actively developed leaders for her organizations and for the industry at large.