The Binge–Purge Cycle in Bulimia and Why It Feels So Hard to Stop

Posted on April 15, 2026April 14, 2026 by Alison Pelz, LD, RD, CDE, LCSW

You may not think of it as bulimia.

More often, it sounds like a quiet, ongoing negotiation with yourself: I just need to get my eating under control. Or, I won’t do this again.

And yet, it keeps happening.

If you’re reading this, you may be struggling with your relationship with food, or you may be worried about someone you love. Either way, you’re not alone, and help is available.

In my work with clients, I help you understand the factors that contributed to the development and what keeps you feeling stuck in the cycle of binge-purge, while compassionately guiding you toward a path forward grounded in hope and recovery.

The binge-purge cycle you may feel trapped in

For many, bulimia isn’t just about behavior but it’s about a painful cycle that can feel impossible to escape.

It might look something like this:

“I’m not going to do this again. Tomorrow will be different.”
“I’ll be more disciplined. I’ll eat perfectly.”

And for a while, maybe things feel under control. But then something happens: an increase in stress, loneliness, boredom, overwhelm, or even just hunger and the urge builds.

“I’ve already messed up. I might as well keep going.”
“I’ll just start over tomorrow.”

The binge happens. Then comes the guilt, the discomfort, the shame.

“I can’t believe I did that again.”
“I need to fix this.”

Purging follows, bringing a brief sense of relief both physically and emotionally.

And then the cycle resets:
“I swear this is the last time.”

What is bulimia nervosa?

Bulimia nervosa is a serious eating disorder characterized by a cycle of:

Binge eating, or consuming large amounts of food in a short period, often with a sense of loss of control, followed by
Compensatory behaviors such as vomiting, excessive exercise, fasting, or misuse of laxatives to “undo” the binge

One of the hallmarks of binge eating is that feeling of “I can’t stop.” It’s often followed by intense shame, guilt, and distress.

This isn’t a failure of willpower. It’s a learned cycle in which your brain and body try to cope with distress and emotions.

Why does bulimia nervosa develop?

There isn’t a single cause of bulimia. It’s a complex condition influenced by emotional, psychological, and biological factors.

Some known risk factors include:

Chronic dieting or food restriction
Body image distress
ADHD, anxiety, depression, or chronic stress
Low self-worth
Family history of eating disorders

Bulimia often begins in late adolescence (around age 18), and while it is more commonly diagnosed in women, it affects people of all genders, body sizes, and backgrounds, including those in marginalized communities.

Without support, it can become chronic. Unfortunately, only about 50–60% of people ever seek treatment.

Why bingeing and purging “work” (in the short term)

Binge eating often serves a purpose. It can temporarily soothe intense emotions like anxiety, loneliness, exhaustion, or overwhelm. In those moments, food can feel like relief. But that relief is short-lived, and over time, it often increases distress.

Purging behaviors tend to follow intense emotional or physical discomfort including shame, panic, or sensory overload. Purging can create a rapid shift in the body, leading to a temporary sense of release.

Your brain learns: this reduces distress.
And so the cycle repeats.

Even if it feels “manageable,” the toll adds up physically, mentally, and emotionally.

The impact on physical and mental health

Physically, bulimia can lead to:

Electrolyte imbalances (which can be life-threatening)
Gastrointestinal distress
Dental problems
Hormonal disruptions

Emotionally, the cycle often deepens distress over time.

Thoughts like:
“Why do I keep doing this?”
“What is wrong with me?”
“I’ll stop tomorrow.”

…can reinforce shame, guilt, and self-criticism.

Many people begin to isolate themselves to hide the behavior. Relationships can suffer. You may find yourself avoiding socializing. You may not find joy in activities that you normally would. Going to school or work may feel harder.

Thoughts of what to eat and not eat and worries about your body may take over much of your thoughts.

You may feel more easily annoyed and frustrated.

The eating disorder takes up more and more space in your life.

What recovery looks like

Recovery from bulimia is both behavioral and insight-oriented.

That means we work on:

Gradually reducing eating disorder behaviors
Building more consistent, nourishing eating patterns
Developing healthier ways to cope with emotions
Understanding and addressing underlying factors like anxiety, depression, or low self-worth
Challenging unhelpful thoughts about food and body image
Building self-compassion and resilience

In my work, I use a combination of cognitive behavioral therapy, mindfulness, parts work, and radical acceptance to help guide recovery.

Recovery is not linear. It often feels like a few steps forward and a few steps back. It can feel messy at times and that’s okay. That’s part of the process.

You don’t have to do this alone

Many people with bulimia feel stuck in secrecy and shame. Reaching out can feel scary but it can also be the beginning of something different or perhaps feel a bit of relief.

If you are struggling with your eating, it doesn’t mean something is wrong with you. It means you’ve been trying to cope in the best way you knew how.

Recovery is possible. Healing is possible. Whether this has been going on for a short time or for years, it is not too early or too late to get help.

If you’re ready to take the next step, I invite you to reach out. Even a single conversation can begin to shift things. Sign up for a free consultation to learn more about how I can help you.

Nourish to Heal: How Eating Enough Supports Binge Eating Recovery

Posted on July 16, 2025March 24, 2026 by Alison Pelz, LD, RD, CDE, LCSW

Eating more will likely help you reduce binge eating.

This feels counterintuitive and is certainly not what the weight loss industry or the medical community typically advises, so I know this recommendation can feel very scary.

The weight loss industry provides “tricks” to reduce binge eating, usually focusing on how to limit consumption of certain foods. However, rather than helping navigate binge eating, it often fuels and perpetuates binge eating. Science has taught us that dietary restriction is a risk factor for developing an eating disorder, including binge eating. Dietary restriction also maintains the eating disorder–in other words, a restrictive diet keeps the disorder going.

Binge eating can cause significant distress to those who are experiencing it, so understandably, you would do almost anything to stop it.

First, we need to normalize binge eating. Most humans experience eating episodes related to emotions, as eating can be a common way we cope with and regulate emotions. If you have sensory and neurological differences, including anxiety or ADHD, eating can be a useful tool to help you feel more comfortable.

We hear harmful messages in our culture about binge eating: that it means something negative about us, or that we “have no will power or we are not disciplined enough”. Of course, we then internalize these messages, meaning we believe these untrue messages about ourselves, further disconnecting us from self.

Let’s take a closer look at why eating more helps to reduce binge eating.

Our brain’s primary job is to keep us alive. We need food to survive. Most of us experience pleasure from eating (That’s our brain’s way to ensure that we eat!).

If your meal gets delayed for some reason, you feel really hungry, often leading to feeling “hangry” (hungry & angry–that grumpy feeling we get when we’ve gone too long without food)-our body’s cue to eat. Consequently, you might eat quickly and possibly more than usual. This is our body’s nifty mechanism to keep us alive.

Many people who experience binge eating try to limit their food intake or the types of food they typically binge on. This makes perfect sense given the messages about food in our culture. But dietary restriction is eating less food than your body needs. An example of dietary restriction may be “I am going to eat out for lunch, so I’ll skip or have a ‘light’ breakfast”. This simple act, which our culture often rewards, sets our body’s drive up to alert us to eat.

Dietary restriction is a key feature in what initiates and sustains eating disorders.

Herman and Polivy coined the term dietary restraint in the 1970s. It suggests that when human eating behavior is under cognitive control, it reduces the ability to read internal satiety cues.

In other words, simply thinking about restricting food types and amounts can lead us to eat past fullness. Dietary restraint is the key feature of EVERY DIET. And dietary restraint is a significant risk factor for developing an eating disorder.

What can be done?

Many clients who experience binge eating also experience dietary restriction and restraint–the natural reaction is often to focus on eliminating binge eating by using more dietary restriction and restraint. Again, this makes sense given diet culture and our medical system. However, it often maintains the eating disorder.

One of the first steps in my work with clients is to gradually reduce dietary restraint and restriction. I can understand that this can feel very scary.

In sessions, we explore your personal story and understand where you learned about dietary restriction and restraint. We then consider if it makes sense to approach things differently.

We do work on reducing binges, but that typically comes later in treatment. First, dismantling the restriction and restraint is needed to reduce binge eating.

If you want to learn more about binge eating, I highly recommend this book. Additionally, Decolonizing Wellness is an excellent resource. If you would like to learn more about how I work with clients struggling with binge eating, the first step is to schedule an initial consultation. I would love to hear from you.

Book Review: Binge Eating Disorder: The Journey to Recovery and Beyond is a Must Read

Posted on January 8, 2025June 3, 2025 by Alison Pelz, LD, RD, CDE, LCSW

Binge Eating Disorder: The Journey to Recovery and Beyond by Amy Pershing with Chevese Turner, seamlessly blends clinical knowledge with the lived experiences of those affected by BED. It is an invaluable guide for individuals experiencing BED and their families. It is divided into three parts: understanding BED, addressing its root causes, and finding sustainable recovery strategies. This book is a must-read for anyone looking for an insightful and compassionate resource on binge eating disorder (BED).

Understanding Binge Eating Disorder

Binge eating disorder (BED) is the most common eating disorder. It can develop at any age, often in childhood, and can impact people across diverse identities and backgrounds. It is characterized by recurrent episodes of eating unusually large amounts of food in a short period, accompanied by feelings of loss of control.

BED affects an estimated 2.8 million individuals, making it the most prevalent eating disorder in the United States. Despite its high prevalence, BED often goes undiagnosed or misunderstood, in part due to societal weight bias and outdated treatment paradigms.

Understanding Binge Eating Disorder Symptoms

BED is not a one-size-fits-all diagnosis. And can often affect people in unique ways, but some hallmark symptoms are commonly observed. Which include:

Frequent Episodes of Binge Eating:
- Consuming more food than most people would in a similar time frame and situation.
- Feeling unable to stop eating during a binge episode.
Emotional Distress Around Eating:
- Intense feelings of shame, guilt, or embarrassment during or after binge episodes.
- Experiencing disgust or self-loathing related to eating habits.
Behavioral Indicators:
- Eating rapidly or at an unusually fast pace.
- Eating until uncomfortably full.
- Consuming large amounts of food even when not physically hungry.
- Preferring to eat alone to hide the behavior from others.
Physical Symptoms:
- Fluctuating weight due to consistent overeating and undereating.
- Gastrointestinal discomfort or other health issues linked to excessive eating.

If these symptoms occur at least once a week for three months, it could indicate BED, and you should talk to a trusted care provider.

Who experiences Binge Eating Disorder?

BED doesn’t discriminate—it can affect people of any age, gender, race, or socioeconomic background. Please note that people of all body sizes can experience binge eating disorders.

Why is Binge Eating Disorder: The Journey to Recovery and Beyond by Amy Pershing with Chevese such a powerful resource?

It Addresses the Root Causes:
Authors Chevese Turner and Amy Pershing provide a thorough explanation of how the diet industry, weight bias, and weight stigma all work together to contribute to the development and persistence of eating disorders. Many individuals with BED have endured significant weight stigma and bullying. Which often begins in childhood. Tragically, these experiences are pervasive in peer groups, families, and healthcare settings. In an attempt to avoid further stigma, many people turn to dieting as a way to change their bodies. Unfortunately, this often worsens their relationship with food and deepens the cycle of disordered eating. It is estimated that up to 70% of those experiencing binge eating pursue weight loss services, often making the eating disorder worse. They also delve into systemic oppression and its role in fostering BED.
The book also makes it clear that effective treatment for BED lies in psychological support and nutritional rehabilitation—not weight loss interventions.
It Makes Sense of Binge Eating:
Within the chapter “How BED Happens and Why It Makes Sense” Pershing and Turner offer a groundbreaking discussion of the nervous system and its stress response. They explain how binge eating functions as a coping mechanism, helping individuals feel safe during times of stress or overwhelm, which helps to make sense of binge eating as an adaptive (though ultimately unhelpful) response, which in turn can foster self-compassion and reduce the shame often associated with this behavior.
It Offers Inspiring Personal Narratives:
Chevese Turner courageously shares her story of binge eating, starting from her childhood experiences with food. Amy Pershing complements this narrative with her years of clinical expertise, sharing lessons from her work with clients in recovery. These interwoven stories remind readers that they are not alone in their struggles. By reducing isolation and shame, the authors create a sense of solidarity and hope.
It Provides A Roadmap to Recovery:
Binge Eating Disorder: The Journey to Recovery and Beyond offers a framework for improving readers’ relationships with both food and their bodies. Rather than prescribing rigid meal plans, it focuses on reclaiming a sense of self. Chevese Turner and Amy Pershing introduce concepts from Internal Family Systems (IFS) therapy, such as “parts work,” to help readers understand their binge eating behaviors and work toward recovery. They also address body shame and body image distress, reframing the body as a home—not an object to be judged, but a vessel for experiencing life, joy, and even pain.

The authors critique diet culture and thin privilege, empowering readers to navigate these societal pressures while staying true to themselves.
It Expands Perspectives:
One of the book’s greatest strengths is its ability to broaden readers’ understanding of binge eating. Binge Eating Disorder: The Journey to Recovery and Beyond explores how societal and systemic factors influence BED. This helps to shift the focus away from individual blame and toward a more compassionate, holistic view.

I wish I had discovered it earlier. So I could recommend it to more clients sooner. Those I’ve shared it with have found it incredibly helpful and affirming. If you are experiencing binge eating please consider reaching out for support.

Whether you’re a generalist clinician seeking to understand better binge eating disorder or an experienced eating disorder specialist, this book deserves a place in your professional library. Once you read it, you’ll feel confident recommending it to clients with BED—and they’ll thank you.

3 Important FAQs about Binge Eating Disorder

Posted on June 17, 2020June 16, 2020 by Alison Pelz, LD, RD, CDE, LCSW

Do you feel out of control with food? Once you start eating, do you feel like you can’t stop? Do you feel shame, guilt, and embarrassment after eating? If so, you may struggle with binge eating disorder—the most common type of eating disorder.

Binge eating disorder is characterized by eating large amounts of food in a discrete amount of time when not feeling hungry or eating at a rapid pace until uncomfortably full. Binge eating usually takes place in solitude, and there is marked emotional distress associated with binges.

Here are some most frequently asked questions about binge eating disorder:

I think I may be addicted to food. Is that the same as binge eating disorder?

There is much debate among healthcare providers about whether food addiction is a bona fide diagnosis. Some believe that food absolutely can be addictive. In fact, science shows that our brains are activated in the same way they are with drugs when we eat highly palatable, good tasting food.

People who describe themselves as food addicts have a compulsive drive to eat, even when they are not hungry, eating, perhaps, to soothe emotions or to “check out.” In the short term, overeating feels good. But in the long term, it can feel pretty uncomfortable. Attempts to stop overeating may be made but with little success.

You may not buy certain foods, fearing that you will eat it all in one sitting or over a day or two. Maybe you plan to buy certain foods just to binge on them. Or you buy certain foods and promise yourself that you will not binge on them as you have in the past. Food is often consumed in solitude.

Guilt and shame are feelings often experienced with having a loss of control with food. Sounds similar to drug or alcohol addiction, right?

Furthermore, our brains may become activated similarly to the way they are with drugs and alcohol when we eat certain foods—as a reward pathway. By design, we get pleasure from eating, so we will seek out more food (to sustain us).

However, unlike drugs and alcohol, we need food to survive. Additionally, most people who feel out of control with food are able to stop eating or ignore foods that are less appealing. Most people who struggle with drug addiction, for example, consume all drugs until they are gone. That is not the case with food.

If you are reading this, whether you think food addiction is a valid term or not, my guess is that you feel out of control with food. Feeling out of control with food is a key feature of binge eating disorder.

I have tried every diet and I can’t get my binge eating under control. Am I ever going to get better?

Yes, you can get better, but not by dieting. Dieting can actually make binge eating worse. In fact, dieting is a risk factor for developing an eating disorder. Cutting out certain types of food and/or under-eating makes your body ripe for binge eating.

It makes sense. Our bodies by design are set up to survive. Obviously we need food to survive, and our bodies send us very strong signals to eat. If we chronically restrict food, our bodies give us signals to eat large amounts at a time.

Although it may seem counterintuitive, eating regularly throughout the day and including all foods in the diet actually helps reduce binge eating. With the help of a registered dietitian, foods that are typically eaten during a binge are slowly reintroduced as part of treatment.

Can I get over binge eating disorder on my own?

Unfortunately, many who struggle with binge eating disorder try to “diet” their way out of binge eating, but this usually makes the binge eating worse.

There is some evidence that self-help programs and books can help reduce binge eating symptoms, but most likely you will need the assistance of a professional.

Asking for professional help can feel daunting. However, relief is often expressed by people with binge eating once they seek treatment because someone understands what they are going through.

Usually, a psychotherapist or counselor, registered dietitian, and a doctor are part of an eating disorder treatment team. Learn more here about how to find an eating disorder professional.

For more resources on eating disorder recovery, intuitive eating, and anti-diet culture, sign up for my newsletter!

Must-Ask Questions When Looking For An Eating Disorder Therapist

Posted on June 12, 2019March 21, 2025 by Alison Pelz, LD, RD, CDE, LCSW

Let’s face it, finding the right eating disorder therapist for your eating disorder can be daunting. It can feel downright overwhelming. You may be ambivalent about getting treatment. Maybe you are worried that your eating disorder isn’t “bad enough” to warrant treatment (trust me, it is). Or perhaps you are feeling hopeless about finding another therapist after being treated in the past.

Whether you are an individual with an eating disorder or a loved one of a person with an eating disorder, looking for a qualified therapist can be tough.

This post will give you tips on what to look for in a treatment provider, and questions to ask to help you determine the right eating disorder therapist for you.

Most therapists are willing to talk with you on the phone before you set an initial appointment. They will help assess goodness of fit in regards to scheduling, payment, and issues you may want to address in therapy.

If the therapist doesn’t offer a phone consultation, then these questions can be asked in the initial face-to-face appointment.

You can use the following questions and talking points when interviewing a potential therapist:

How do you help clients with eating disorders?

If a therapist has a lot of experience treating eating disorders, they should have a concise and clear answer. Many well-meaning therapists indicate on their website, referral site, or insurance websites that eating disorders are their specialty, but really don’t have experience treating eating disorders.

Because of the complex nature of eating disorders, try to get a therapist with extensive experience with eating disorders if possible.

Do you have a network of other professionals who have experience treating an eating disorder to whom you can refer me?

The gold standard of care in eating disorder treatment is to have a multidisciplinary team. An eating disorder treatment team usually consists of a therapist, registered dietitian, medical doctor, psychiatrist, family therapist, and possibly other specialists.

If the therapist has experience treating eating disorders, they should have a relationship with other treatment providers in your community. To learn more about eating disorder treatment teams click here.

What hours do you see clients and what are the payment options?

The course of eating disorder treatment can be long. Having a conversation up front with a potential eating disorder therapist about finances and scheduling is important. Be sure that the scheduling and payment options work for you over the longer -term.

Here are a few resources to help you find a qualified eating disorder therapist in your area:

Finding an eating disorder therapist can take time. Consider breaking down your search into smaller pieces and chip away at it each day.

Additionally, if you feel overwhelmed trying to find an eating disorder therapist, ask a friend or family member to help you in your search.

Please call for a free 20-minute telehealth consultation to learn how I work with clients with eating disorders.

Don’t live in the Austin Area, but want tips about how to improve your relationship with food and your body? Subscribe to my newsletter here.

5 Ways a Dietitian Can Help Reduce Binge Eating

Posted on February 13, 2018February 7, 2018 by Alison Pelz, LD, RD, CDE, LCSW

Whether you are struggling with binge eating disorder or bulimia nervosa, a dietitian who specializes in eating disorders on your treatment team is a must.

If you have an eating disorder, you probably already know a lot about food. You probably know how many calories, how much fat and how many sugar grams are in different foods. You probably are an expert on the latest diets. You may be asking yourself, “Why do I need to see a dietitian for my recovery if I already know so much about food?”.

Remember, eating disorders are not really about food. Food and eating disorder behaviors are used to cope with stress, relationship struggles, worry, and other uncomfortable feelings.

Therefore, knowledge about food is not the issue, but rather how you relate to food.

5 ways that a dietitian can help in binge eating disorder and bulimia nervosa recovery:

1. Reduce chaotic eating associated with binge eating.

Binge eating can cause chaotic eating patterns in several ways. After a binge, you may find yourself not wanting to eat for several hours or skip the next meal. This turns into a nasty cycle because skipping meals can then lead to more binge eating. If you tend to binge (or binge-purge) at a certain time of the day, let’s say in the evening, then you may tend to restrict food during the day in order to “make-up” for binge eating later on in the evening. Again, restricting calories can exacerbate the binge eating. A registered dietitian will help set-up a meal plan to reduce the food chaos.

2. Ensure that you are eating enough at meals and snacks.

Studies show that food restriction leads to binge eating. Our bodies want to ensure that we get enough food. If we chronically underfeed it at certain times of the day then when we have access to food, we will eat more than we made need at that moment. Along with helping manage your chaotic eating style, a dietitian can help ensure that you are eating enough throughout the day with enough variety to help reduce binge eating.

3. Challenge mistaken beliefs about food.

A dietitian can help you sort out science from fad when it comes to eating, food, weight, and shape. There are a million messages about food on TV and social media and from well-meaning friends, family members, and co-workers. On any given day, it seems like the messages about which foods are “good” and which foods are “bad” to eat are moving targets. During the 90s, fat was the culprit. Now gluten and carbohydrates have a bullet on their head. Not only do we get messages about which foods to eat, but also how to eat them—eat these foods; not these foods; eat 6 small meals a day; don’t eat in between meals. You get the point. There are so many messages out there, it’s no wonder America is plagued with eating problems.

Challenging mistaken beliefs about food can reduce feelings of guilt and increase your confidence about food choices, which ultimately help reduce binge eating and the binge-purge cycle.

4. Learn how to eat “binge foods” without fear.

A dietitian can help you feel more confident around foods that on which historically binged. Once your eating pattern has become less chaotic and you are feeding yourself more regularly throughout the day with foods you enjoy, you will work with your dietitian on “challenge foods.” Challenge foods are foods that you avoid (due to fear of binge or binge-purge), foods that you regularly binge on, and/or foods that cause a lot of anxiety before or after eating them.

A dietitian can work with you several ways to do this, such as doing an in-the-office food challenge (yep, eating your challenge food during the appointment) and practicing eating the foods with others.

5. Intuitive eating.

One of the last steps of nutritional therapy for binge eating and bulimia nervosa is learning how to listen and respond to the internal cues your body provides. In other words, you will learn how to trust your body, not some diet, when it comes to feeding yourself.

Note: Consulting with a registered dietitian who has experience treating eating disorders is a must. While a registered dietitian is one member of the treatment team, a medical doctor, counselor, and a psychiatrist are also needed.