Those with binge-eating disorder must learn to eat in response to hunger—a biological signal—rather than in response to emotional needs or external factors (such as the time of day or the simple presence of food). Counselors often direct binge eaters to record their perceptions of physical hunger throughout the day and at the beginning and end of every meal. These people must learn to respond to a prescribed amount of fullness at each meal. They should initially avoid weight-loss diets because feelings of food deprivation can lead to more disruptive emotions and a greater sense of unmet needs. Diets are likely to encourage more intense problems, such as extreme hunger. Many people with binge-eating disorder may experience difficulty in identifying personal emotional needs and expressing emotions. Because this problem is a common predisposing factor in binge eating, communication issues should be addressed during treatment. Binge eaters often must be helped to recognize their own buried emotions in anxiety-producing situations, and then encouraged to share them with their therapist or therapy group. Learning simple but appropriate phrases to say to oneself can help stop bingeing when the desire is strong.
Self-help groups, such as Over eaters Anonymous, aim to help recovery from binge-eating disorder. The treatment philosophy parallels that of Alcoholics Anonymous. Over eaters Anonymous attempts to create an environment of encouragement and accountability to overcome this eating disorder. Dietary advice typically ranges from avoiding restraint in eating to limiting binge foods. Some experts feel that learning to eat all foods—but in moderation—is an effective goal for binge eaters. This practice can prevent the feelings of desperation and deprivation that come from limiting particular foods. Antidepressants, such as fluoxetine (Prozac), and other types of medications also have been found to help reduce binge eating in these individuals by decreasing depression. Overall, people who have this disorder are usually unsuccessful in controlling it on their own. Professional help is advised.