The chapter describes the Binge Eating module of the intensive CBT-E for eating disorders. Binge eating is defined as the consumption of food accompanied by a loss of control and can be objective (large quantity) or subjective (perceived excess). It is maintained not by lack of willpower, as many patients believe, but by specific mechanisms: caloric dietary restriction/low weight, breaking rigid dietary rules, adverse events and emotions, compensatory behaviours, and disinhibition (e.g., alcohol). In rehabilitative inpatient CBT-E, binge eating often stops initially due to structured eating, absence of environmental triggers, and a healthy lifestyle. However, during the transition to day-hospital or outpatient settings, re-exposure to triggers can cause recurrence. The chapter emphasizes a non-judgmental, collaborative approach, real-time self-monitoring, and incorporation of binge eating into the patient’s individual formulation. Core strategies include adopting a healthy lifestyle, reducing food cues, establishing regular eating patterns, managing urges through the “things to say and do” procedure, addressing adverse events and emotions with the proactive problem-solving procedure, and using the Events, Moods, and Eating module when needed. If a binge occurs, patients are taught to view it as a lapse rather than a relapse, to avoid the abstinence violation effect, and to return promptly to normal eating without compensation. Each episode should be analysed using the binge analysis sheet to identify maintaining mechanisms and create targeted action plans. This structured, skill-based approach reduces guilt, prevents escalation, and strengthens long-term binge control, supporting sustainable recovery.

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Binge Eating Module

  • Riccardo Dalle Grave

摘要

The chapter describes the Binge Eating module of the intensive CBT-E for eating disorders. Binge eating is defined as the consumption of food accompanied by a loss of control and can be objective (large quantity) or subjective (perceived excess). It is maintained not by lack of willpower, as many patients believe, but by specific mechanisms: caloric dietary restriction/low weight, breaking rigid dietary rules, adverse events and emotions, compensatory behaviours, and disinhibition (e.g., alcohol). In rehabilitative inpatient CBT-E, binge eating often stops initially due to structured eating, absence of environmental triggers, and a healthy lifestyle. However, during the transition to day-hospital or outpatient settings, re-exposure to triggers can cause recurrence. The chapter emphasizes a non-judgmental, collaborative approach, real-time self-monitoring, and incorporation of binge eating into the patient’s individual formulation. Core strategies include adopting a healthy lifestyle, reducing food cues, establishing regular eating patterns, managing urges through the “things to say and do” procedure, addressing adverse events and emotions with the proactive problem-solving procedure, and using the Events, Moods, and Eating module when needed. If a binge occurs, patients are taught to view it as a lapse rather than a relapse, to avoid the abstinence violation effect, and to return promptly to normal eating without compensation. Each episode should be analysed using the binge analysis sheet to identify maintaining mechanisms and create targeted action plans. This structured, skill-based approach reduces guilt, prevents escalation, and strengthens long-term binge control, supporting sustainable recovery.