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A Clinician's Guide to Differential Diagnosis and the First Steps in Treating Binge Eating Disorder

Stanley Efrem

Jan 5, 2026

Binge Eating Disorder affects approximately 2-5% of the general population, yet remains one of the most misdiagnosed and undertreated eating disorders in clinical practice. Your patient describes episodes of eating large quantities of food with complete loss of control. The differential diagnosis pathway becomes murky. BED symptoms often hide behind shame, compensatory behaviors, and comorbid conditions that complicate accurate assessment—making it far less visible than anorexia or bulimia presentations.

Establishing an effective treatment plan requires more than identifying the disorder. You must craft interventions that address both behavioral symptoms and underlying emotional triggers. Setting appropriate treatment goals means understanding how neurobiological dysregulation interacts with emotional distress and maladaptive coping mechanisms. Successful recovery depends on developing goals that extend beyond symptom reduction to include emotional regulation and self-compassion.

This guide provides clinical tools for accurate BED diagnosis within F50.8 classification limitations. You'll learn to distinguish BED from similar presentations and implement evidence-based interventions during critical first sessions. We'll cover practical strategies for addressing shame, building emotional awareness, and creating personalized pause plans that help patients regain control over their eating behaviors.

Understanding ICD-10 Code F50.8 in Clinical Context

The ICD-10 classification system provides the foundation for diagnostic coding worldwide. Understanding F50.8 nuances becomes essential for accurate diagnosis, proper documentation, and effective treatment planning when working with eating disorders.

Defining F50.8: Other Specified Eating Disorders

F50.8 represents "Other eating disorders" within the World Health Organization's ICD-10 system under Mental, Behavioral and Neurodevelopmental disorders [18]. This umbrella category captures eating disorders that don't fit standard classifications like anorexia nervosa or bulimia nervosa.

F50.8 includes these specific subtypes:

F50.81: Binge eating disorder
F50.82: Avoidant/restrictive food intake disorder
F50.83: Pica in adults
F50.84: Rumination disorder in adults
F50.89: Other specified eating disorder [18]

The code enables documentation of eating disorders with atypical presentations or those not meeting full criteria for commonly recognized conditions. Research shows eating disorders collectively affect lifetime prevalence of approximately 7% in women and 3% in men in the United States [18].

Why Binge Eating Disorder Falls Under F50.8

Binge eating disorder sits within subcategory F50.81 of the F50.8 classification. The 2025 expansion recognized varying severity levels:

F50.810: Binge eating disorder, mild (1-3 episodes weekly)
F50.811: Binge eating disorder, moderate
F50.812: Binge eating disorder, severe
F50.813: Binge eating disorder, extreme
F50.814: Binge eating disorder, in remission
F50.819: Binge eating disorder, unspecified [18]

This classification recognizes binge eating involves consuming large food quantities with complete loss of control. The loss of control distinguishes BED from occasional holiday overeating. Patients cannot control what or how much they consume during episodes. Weekly episodes over several months may lead to health complications, including obesity, diabetes, high cholesterol, and hypertension [5].

Limitations of the Code in Capturing Clinical Complexity

F50.8 presents limitations despite recent improvements. The code struggles to capture full clinical complexity and individual variations in binge eating disorders.

The system focuses on behavioral symptoms rather than underlying psychological mechanisms. The 2025 severity specifiers represent progress, yet they address binge frequency rather than psychological distress or functional impairment.

Eating disorders often present with mixed features or subthreshold symptoms that resist discrete categorization. Research shows individuals with eating disorders not otherwise specified (EDNOS) fall into three groups: those with subthreshold anorexia or bulimia symptoms, those with mixed features of both disorders, or those with atypical eating behaviors not fitting established disorders [3].

These classification challenges affect research, policy, and clinical practice. Developing capacity to evaluate clinically relevant eating disorder burden remains critical, especially given mortality evidence, poor data availability, and subsequent overlooking by healthcare professionals and policy makers [3].

Differential Diagnosis: What's Hiding Behind the Binge?

Accurate diagnosis forms the foundation for effective BED treatment. Patients seeking help often present with overlapping symptoms that could indicate various conditions. True Binge Eating Disorder requires careful differentiation from other presentations with similar features.

DSM-5 Criteria for Binge Eating Disorder

DSM-5 recognizes BED as a distinct eating disorder with specific diagnostic criteria. Your patient must experience:

Recurrent binge eating episodes (consuming objectively large food amounts in discrete periods)
Marked distress about binging behavior
Absence of compensatory behaviors (distinguishing it from bulimia)
Episodes occurring at least weekly for three months
Three or more episode characteristics: rapid eating, eating until uncomfortably full, eating large amounts without hunger, eating alone from embarrassment, or experiencing disgust/depression/guilt afterward

Marked distress separates clinical BED from occasional overeating. Patients describe feeling "out of control" during binges, often saying they're "on autopilot" or "unable to stop once started."

Emotional Overeating vs. True BED

Both conditions use food as emotional coping, but key differences exist. Emotional overeating correlates directly with specific triggers and typically stops when emotions subside. BED episodes often occur without clear precipitants and involve dissociative experiences.

Emotional eaters maintain awareness during eating episodes. BED patients report trance-like states and memory gaps during binges. Emotional eaters rarely experience the intense shame and self-loathing characteristic of BED.

Ask: "Do you remember the actual eating process?" This simple question helps differentiate conditions, as BED patients frequently report memory gaps during episodes.

ADHD-Related Impulsive Eating (F90.0)

ADHD presents significant comorbidity risk with BED. Patients with ADHD may exhibit binge-like eating patterns stemming from executive functioning deficits rather than emotional regulation problems. ADHD-related eating features:

Forgetting previous meals
Continuous grazing rather than discrete binges
Impulsive food choices based on environment
Minimal meal planning or preparation
Little behavioral distress until weight consequences emerge

Screen for ADHD when assessing suspected BED. Stimulant medications can reduce binge eating in comorbid patients, suggesting distinct neurobiological mechanisms.

Post-Dietary Restriction Rebound

Many patients present with binges following dietary restriction periods. These episodes reflect physiological responses to food deprivation rather than true BED. Post-restriction rebounds typically:

Follow specific dietary rules or "clean eating" attempts
Resolve when regular eating patterns resume
Lack persistent loss of control characteristic of BED
Don't occur with consistent, adequate nutrition

Detailed dietary history becomes essential for accurate diagnosis. Ask specifically about fasting, elimination diets, or calorie counting preceding binge episodes.

Using a Food-Emotion Log for Diagnostic Clarity

Structured food-emotion logs provide diagnostic insights beyond patient self-reporting. Have patients document:

Food consumed and approximate quantities
Time and context (location, social setting)
Emotions before, during, and after eating
Hunger/fullness levels (1-10 scale)
Control sense (1-10 scale)

This tool reveals patterns invisible to patients. True BED shows binges across various emotional states, while emotional eating correlates with specific emotions. Logs often reveal dietary restriction patterns preceding binges, clarifying whether the issue represents post-restriction rebound rather than BED.

Session 1: Establishing Safety and Ending the Shame Cycle

The first session with a binge eating client requires establishing safety before any behavioral work begins. Create an atmosphere where clients feel secure exploring their behaviors without judgment. This foundation makes sustainable recovery possible.

Introducing the No-Diet Contract

Start your first session by establishing a no-diet contract. Dieting attempts often trigger more binge eating, creating a cycle that becomes increasingly difficult to break [6]. This paradox between restriction and binging provides the rationale for this essential agreement.

A no-diet contract includes:

Client agreement to stop all dietary restriction
Commitment to eating regularly (every 2-3 hours) regardless of hunger
Permission to eat previously "forbidden" foods
Support person involvement in meal planning when needed
Focus on consistency over "perfect" eating

Many clients resist this approach initially. They fear weight gain or losing control. This resistance offers valuable therapeutic material—it reflects the restrictive mindset fueling the binge-restriction cycle [7]. The contract serves both as intervention and education.

Reframing Binging as a Survival Strategy

Help clients understand binging as biological response rather than character weakness. Binge eating represents a natural survival mechanism. Our brains haven't evolved much since food scarcity was common [7]. When we restrict certain foods through willpower, it triggers primitive deprivation fears.

Clinical experience shows that many people address physical restriction but ignore mental restriction. Labeling foods as "good" and "bad," avoiding "unhealthy" options, and similar mental restrictions increase binge urges [7]. Explain both physiological and psychological mechanisms. Clients need to see binging not as personal failure but as their body protecting against perceived starvation.

Some clients use binge eating for emotion regulation. Others employ it for grounding or to cope with painful memories [7]. Acknowledge these adaptive functions while introducing more effective alternatives.

Normalizing the Client's Experience

Address the isolation that intensifies shame. BED affects almost 3% of the U.S. population, making it the most common eating disorder [8]. This information often provides immediate relief.

Shame reduction isn't optional—it's clinically necessary. "One of the foundations for recovering from BED is working through shame," evidence suggests. "If you experience shame, know that society has placed it on you and it's not yours to carry" [7].

Acceptance-based behavioral treatment (ABBT) approaches show promise by combining behavioral elements with techniques that directly address shame [9]. These help clients develop distress tolerance skills needed for engaging with treatment recommendations.

Your initial session should accomplish three goals: establish the no-diet agreement, reframe binging as survival response rather than moral failure, and normalize the experience through education and compassion. Safety and shame reduction create the foundation for structured interventions that follow.

Session 2: Building Emotional Vocabulary and Awareness

Your first session established safety. Now focus on developing emotional awareness—a skill many BED patients lack entirely. Research shows individuals with binge eating disorder struggle significantly with emotional awareness (alexithymia), interoceptive awareness, and emotional clarity compared to both normal-weight and obese individuals without eating disorders [10].

Using Emotion Wheels and Feeling Charts

Emotion wheels organize feelings into primary categories, then branch into nuanced emotional states. These visual tools help clients move beyond "good" or "bad" feeling descriptions. Start with core emotions—happiness, sadness, anger, fear, surprise—then expand into complex feelings like contentment, jealousy, or shame [11].

Effective Implementation Steps:

Introduce the wheel as a way to "decode" internal experiences
Demonstrate with your own examples ("When a client cancels, I might feel...")
Guide clients from central emotions outward
Assign homework using the wheel throughout the week

Many people with binge eating struggle to identify what they're feeling. This wheel provides language to describe internal experiences. Research shows participants in emotion-focused interventions report increased understanding of emotions (M = 4.29, SD = 0.66) and benefit significantly from these skills (M = 4.18, SD = 0.55) [12].

Identifying Pre-Binge Emotional States

Negative affects directly precede overeating episodes in BED patients [13]. Help clients identify their specific triggers through systematic examination. Studies show varying emotional distributions before binges:

Anger/frustration (42%)
Anxiety/excitement (37%)
Sadness/depression (16%)
Grief (5%) [13]

Patterns vary between individuals. Structured emotion-monitoring helps clients recognize personal triggers. BED patients experience more negative stressors across work/school, family, friendships, environment, and practical considerations compared to controls [10].

Rumination proves particularly problematic—especially brooding rumination involving passive comparison of current situation to desired standards. This repetitive thinking intensifies negative mood and correlates strongly with eating disorder severity [10].

Ask clients to maintain detailed emotion-eating logs. Review these collaboratively, identifying repeated patterns preceding binges. These logs track emotional states and their relationship to eating behaviors—not just food consumption.

Distinguishing Between Stress and Specific Emotions

Clients often describe negative experiences as "stress"—a vague term that hinders intervention. Specific emotions trigger different eating responses and require distinct coping strategies.

Differentiation Approach:

Validate their stress experience ("It makes sense you feel overwhelmed")
Guide toward specificity ("What feelings make up that stress?")
Teach "emotional radar"—feelings signal needs [14]
Practice the "ABCD of Emotional Regulation":
- Awareness of the emotion (name it specifically)
- Be with and breathe (locate in body, breathe into that area)
- Check the facts (assess if emotion matches reality)
- Decide how to respond [14]

Research using the Salzburg Emotional Eating Scale shows different emotions produce distinct patterns—sadness leads to overeating, anxiety causes undereating, anger creates various responses [15]. Precision in emotional identification matters clinically.

Developing emotional vocabulary establishes foundational skills for the interoceptive awareness work ahead. Emotional literacy opens the gateway to recognizing body signals beyond food cravings.

Session 3: Reconnecting with Bodily Signals

Your third session focuses on rebuilding the mind-body connection that binge eating disorder disrupts. Research shows individuals with eating disorders frequently experience dysfunctional interoception—the ability to sense and understand internal body sensations [16]. This disconnection creates a fundamental recovery obstacle. Patients struggle to distinguish genuine physical hunger from emotional cravings that trigger binges.

Teaching Hunger vs. Emotional Craving

Clients must understand the distinct differences between physical hunger and emotional cravings. Physical hunger develops gradually, results in longer satisfaction periods, and various foods can satisfy it. Emotional hunger has sudden onset, produces short-lived satisfaction, and targets specific comfort foods [17].

Create a simple comparison chart for clients:

Physical Hunger: Develops gradually, can be postponed, satisfied with any food, leads to feeling full, results in satisfaction after eating [5]
Emotional Hunger: Comes suddenly based on triggers (stress, boredom), feels urgent, driven by specific cravings, may lead to uncomfortable fullness, often followed by guilt or shame [5]

Physical hunger involves clear physiological signals. Stomach growling, energy depletion, difficulty focusing, irritability, or lightheadedness [5]. These cues represent genuine fuel needs versus psychological drives to eat for comfort.

Mindful Eating Exercises for Interoceptive Awareness

Structured mindful eating practices rebuild interoceptive awareness. These exercises help clients reconnect with sensations they've learned to ignore or misinterpret. Start with a simple mindful eating exercise:

"Choose a small food item and observe its colors, textures, and smells before eating. Take small bites, chew slowly, and notice the flavors and textures in your mouth. Pay attention to your body's hunger signals before, during, and after eating" [16].

Enhance this practice by instructing clients to:

Take three deep belly breaths before eating to activate the parasympathetic "rest and digest" response [18]
Sit comfortably with feet grounded and good posture to allow space for digestion [18]
Appreciate all aspects of the food—its origins, preparation, and sensory qualities [18]

These practices help clients slow down and observe internal sensations. They gradually rebuild capacity to recognize genuine hunger and fullness cues.

Tracking Physical vs. Emotional Cues

Structured tracking tools help clients systematically differentiate between physical and emotional eating triggers. The Hunger-Fullness Scale proves particularly valuable—a 1-10 system that encourages clients to check in with their bodies throughout the day [5].

Scale 1 represents "starving/ravenous" with weakness, dizziness, and irritability. Scale 5 indicates "neutral/balanced"—neither hungry nor full. Scale 10 represents "stuffed/painfully full" with physical pain, lethargy, and intense negative emotions [19].

Combine this scale with emotion journaling for maximum effectiveness: "Set aside a few minutes each day to describe physical sensations you're experiencing. Write about emotions you're feeling and consider how these might connect to the sensations. Reflect on patterns over time" [16].

This dual-tracking approach helps clients recognize connections between emotional states and eating behaviors while rebuilding awareness of genuine physical cues. Patterns emerge that illuminate when eating serves emotional regulation versus physical nourishment.

Session 4: Installing the Pause with the Parking Technique

Your fourth session shifts focus to behavioral interventions that interrupt the binge cycle. The "parking technique" creates a crucial pause between urge and action. Instead of automatic responses, clients gain space for conscious choice.

Creating a Personalized Pause Plan

Effective pause plans require customization. Each client needs strategies that address their specific binge pathways. You'll develop a concrete, step-by-step protocol clients can implement when urges hit.

Start by identifying each client's "point of no return"—when binge urges become overwhelming. Some clients reach this point while purchasing trigger foods. Others experience it when alone with food already at home.

A personalized pause plan includes:

Early warning signs (emotional states, situations, thoughts)
Written protocol with specific actions
Environmental modifications that support pausing
Accountability measures with support persons

Explain that the goal isn't eliminating urges but creating space between impulse and action. Urges typically peak and then naturally subside if not acted upon, usually within 20-30 minutes. This biological reality provides both hope and scientific rationale for the technique.

Examples of Disruptive Micro-Actions

Disruptive micro-actions function as pattern interrupts. These brief activities shift attention away from food obsession temporarily, allowing urge intensity to diminish naturally.

Effective micro-actions include:

Physical redirection: Taking a short walk, stretching exercises, or changing location
Sensory grounding: Holding ice cubes, smelling essential oils, or listening to specific music
Cognitive engagement: Puzzles, word games, or counting backward from 100
Creative expression: Journaling, drawing, or playing an instrument
Social connection: Calling a supportive friend or joining an online support group

Match techniques to client needs and preferences. Boredom-triggered binges benefit from engaging activities. Anxiety-triggered binges typically respond better to calming sensory interventions.

The mechanism creates enough distance from urges to engage the prefrontal cortex rather than responding from the primitive limbic system. Effectiveness increases when clients practice these techniques regularly, not just during crisis moments.

Practicing the Pause in Real-Time Scenarios

Clients need guided practice implementing the pause technique in progressively challenging scenarios. Role-play exercises within sessions provide safe opportunities to rehearse responses to triggering situations.

Start with straightforward scenarios. Gradually progress to situations clients identify as high-risk. Assign homework that deliberately exposes clients to mild triggers with their pause plan in place. This graduated exposure builds confidence while installing the pause response as an automatic habit.

Technology enhances real-time practice. Smartphone apps with timed reminders help clients check in throughout the day, particularly during vulnerable periods. Voice recordings of pause instructions in the client's own words provide immediate guidance during difficult moments.

Clients often feel discouraged when struggling to implement the pause technique consistently. Normalize this experience. Reinforce that each attempt—even unsuccessful ones—strengthens neural pathways supporting the new behavior. Recovery rarely follows a linear path. It involves gradual increases in successful pause implementation over time.

Consistent practice in increasingly challenging scenarios makes the pause technique an internalized skill—a habitual response that interrupts the automatic progression from urge to binge.

Addressing Shame and Body Image in Treatment

Body image disturbance accompanies binge eating disorder in many patients. Even clients without weight concerns may experience significant body dissatisfaction that maintains their disorder. Targeted interventions beyond behavioral approaches become necessary.

CBT-E for Cognitive Restructuring

Enhanced cognitive behavioral therapy (CBT-E) provides a structured approach to body image disturbance in BED treatment. This "transdiagnostic" treatment works across various eating disorders, including binge eating [20]. CBT-E adapts to each person's specific eating challenges rather than following a standard protocol.

Treatment typically addresses body image concerns in Stage Three:

Identifying and modifying dysfunctional weight and shape-related attitudes
Critically reflecting on Western culture's slenderness ideals
Gradually confronting body-related avoidance behaviors

Research shows CBT-E's effectiveness. 65.5% of participants met remission criteria post-treatment compared to 33.3% with alternative approaches [21]. The cognitive-affective component—how clients think and feel about their bodies—improves significantly with appropriate intervention [22].

ACT and CFT for Shame Reduction

Acceptance and Commitment Therapy (ACT) alongside Compassion-Focused Therapy (CFT) target the shame driving many binge behaviors. Traditional approaches attempt to change negative body thoughts. Acceptance-based approaches help patients change their relationship with those thoughts [23].

CFT was developed for individuals struggling with shame and self-criticism—both prevalent in BED [1]. The model proposes binge eating serves as a functional mechanism to regulate negative emotions within the "threat system" [24]. CFT-E (the eating disorder adaptation) teaches clients:

The biological impacts of disordered eating patterns
How their "tricky brain" evolved for survival in food-scarce environments
Alternative methods for managing emotional threats besides binge eating

Studies show CFT-E produces substantial improvements in well-being. 73% of bulimia patients met recovery criteria post-treatment [1].

Building Self-Compassion as a Protective Factor

Self-compassion—treating oneself with kindness, recognizing shared humanity, and maintaining mindful awareness—serves as a powerful protective factor against eating pathology [25]. Clients with greater self-compassion report higher life satisfaction and lower levels of shame, depression, and anxiety [26].

Self-compassion operates through four pathways:

Directly decreasing eating disorder outcomes
Preventing initial occurrence of risk factors like thin-ideal internalization
Buffering against existing risk factors
Disrupting the mediational chain through which risks operate [25]

Early gains in self-compassion predict faster decreases in shame over treatment [27]. The strong connection between perfectionism and eating disorders makes building self-compassion skills essential for long-term recovery [28].

When and How to Refer: The Interdisciplinary Triad

Effective BED treatment often requires expertise beyond what a single provider can offer. Recognizing when specialized care becomes necessary represents a critical clinical skill that directly impacts patient outcomes.

Referral to a Multidisciplinary Team

Eating disorder symptoms demand immediate action. Noticeable symptoms typically indicate the disorder has persisted for some time and may already pose significant risks [29]. Early detection and intervention—not a wait-and-see approach—leads to better recovery outcomes [29].

The interdisciplinary triad forms the cornerstone of specialized eating disorder care:

Medical Provider (physician, psychiatrist, or advanced practice provider) – Manages medical complications, prescribes medications when appropriate, and monitors physical health parameters throughout treatment [4].

Mental Health Professional (psychologist, licensed clinical social worker) – Addresses cognitive distortions and psychological factors contributing to the disorder through evidence-based modalities like CBT, DBT, or psychodynamic approaches [4].

Registered Dietitian – Facilitates nutrition rehabilitation through education and structured meal planning [4]. Dietitians serve as key team members, yet are sometimes overlooked to the detriment of patient care [30].

The referral process requires sensitivity. Focus on getting patients to complete an initial assessment with a specialist rather than convincing them to commit to full treatment immediately [29]. Maintain transparent communication with both patient and specialist team to ensure continuity of care [31].

Patients typically return to your care with enhanced recovery skills upon completing specialized treatment [31]. Establish collaborative relationships with treatment centers that provide regular updates on patient progress and discharge plans [29].

Recovery from binge eating disorder becomes much easier when patients receive appropriate structure and support [31]. Your role as the referring clinician remains crucial—not just in detection but in facilitating treatment engagement and providing ongoing support throughout the recovery journey.

Key Takeaways

This comprehensive guide provides clinicians with essential tools for accurately diagnosing and treating binge eating disorder, emphasizing the importance of early intervention and evidence-based approaches.

• Establish safety first: Begin treatment with a no-diet contract and reframe binging as a survival strategy rather than moral failure to break the shame cycle that perpetuates the disorder.

• Build emotional literacy: Use emotion wheels and structured tracking to help patients distinguish between physical hunger and emotional cravings, as many BED patients struggle with emotional awareness.

• Install the pause technique: Teach personalized micro-actions that interrupt the automatic progression from urge to binge, creating space for conscious choice rather than impulsive response.

• Address shame directly: Utilize CBT-E, ACT, and CFT approaches to target body image disturbance and build self-compassion as protective factors against relapse.

• Know when to refer: Recognize that effective BED treatment often requires an interdisciplinary team including medical providers, mental health professionals, and registered dietitians for comprehensive care.

The key to successful BED treatment lies in understanding that recovery involves more than symptom reduction—it requires rebuilding the mind-body connection, developing emotional regulation skills, and fostering self-compassion. Early intervention with appropriate specialized care significantly improves long-term outcomes for patients struggling with this complex but treatable disorder.

FAQs

What are the most effective treatments for binge eating disorder?

The most effective treatments for binge eating disorder typically include cognitive behavioral therapy (CBT), interpersonal psychotherapy, and dialectical behavior therapy. CBT is particularly helpful as it focuses on identifying and changing unhelpful thought patterns and behaviors related to binge eating. A combination of psychotherapy, nutritional counseling, and sometimes medication may be recommended depending on the individual's needs.

How is binge eating disorder diagnosed?

Binge eating disorder is diagnosed when an individual experiences recurrent episodes of eating large amounts of food in a short period, at least once a week for three months. These episodes are accompanied by a feeling of loss of control and at least three of the following: eating more rapidly than normal, eating until uncomfortably full, eating large amounts when not physically hungry, eating alone due to embarrassment, or feeling disgusted, depressed, or guilty after overeating.

What should you avoid saying to someone with binge eating disorder?

It's important to avoid commenting on a person's weight or appearance, even if you think it's positive. Statements like "You look healthier" or "You've lost weight" can be triggering. Also, avoid giving unsolicited advice about dieting or exercise. Instead, offer support and encourage them to seek professional help if they haven't already.

How can healthcare providers differentiate between emotional overeating and binge eating disorder?

Healthcare providers can differentiate between emotional overeating and binge eating disorder by assessing the frequency, amount of food consumed, and the level of distress associated with eating episodes. While emotional overeating is often linked to specific triggers and stops when emotions subside, binge eating disorder involves a distinct sense of loss of control, often occurs without clear emotional triggers, and is accompanied by intense feelings of shame and guilt.

What role does shame play in binge eating disorder, and how is it addressed in treatment?

Shame plays a significant role in perpetuating the cycle of binge eating disorder. It often leads to secrecy and isolation, making it harder for individuals to seek help. In treatment, addressing shame is crucial. Therapies like Compassion-Focused Therapy (CFT) and Acceptance and Commitment Therapy (ACT) are particularly effective in reducing shame. These approaches help individuals develop self-compassion, accept their experiences without judgment, and change their relationship with negative thoughts and feelings about their body and eating behaviors.