Start with a GP, because that is the only route to treatment. NICE says adults with binge eating disorder should be offered a binge-eating-disorder-focused guided self-help programme, and the NHS names guided self-help and cognitive behavioural therapy as the two main treatments. Beat is for support alongside that, not instead of it. And before joining any food fellowship, ask one specific question, which is at the bottom of this page.
Three routes, and they are not interchangeable. Here is what each one actually is.
The NHS route
**The door is a GP.** The NHS instruction is to see a GP as soon as you can if you think you may have an eating disorder. They will ask about your eating habits and how you are feeling, and may refer you to an eating disorder specialist or team.
**What treatment looks like.** NICE puts guided self-help first for adults: "Offer a binge-eating-disorder-focused guided self-help programme to adults with binge eating disorder." Cognitive behavioural therapy, in a group or one to one, is the other main route. Medication is not a standalone answer, and NG69 says so: "Do not offer medication as the sole treatment for binge eating disorder."
**What treatment is not aimed at.** This is the part to know before you walk in, because it is the opposite of what most people expect. NG69 recommendation 1.4.1 tells clinicians to explain that psychological treatments for binge eating "have a limited effect on body weight and that weight loss is not a therapy target in itself", and 1.4.7 tells them to "advise the person not to try to lose weight (for example, by dieting) during treatment, because this is likely to trigger binge eating."
**What cannot be used to turn you away.** NG69 is explicit: "Do not use single measures such as BMI or duration of illness to determine whether to offer treatment for an eating disorder", and screening tools such as SCOFF must not be used on their own to decide whether someone has one. If you have been telling yourself you are the wrong size or have not been unwell long enough, the guideline disagrees with you.
**Waits are real.** They vary by area and they can be long. That is an argument for getting on the list today and using Beat in the meantime, not for skipping the referral. The words for the appointment are in [telling someone about binge eating](/guides/food/telling-someone-about-binge-eating).
Beat
Beat is the UK eating disorder charity, and its helpline is the most useful thing available to you between deciding something is wrong and being seen.
| Nation | Number | |---|---| | England | 0808 801 0677 | | Scotland | 0808 801 0432 | | Wales | 0808 801 0433 | | Northern Ireland | 0808 801 0434 |
Open 3pm to 8pm, Monday to Friday. Calls are free from UK landlines and mobiles and do not appear on itemised bills.
**What it is.** Trained advisers who have this conversation every day. "You don't need a formal diagnosis to use our Helpline." Support for people affected, and for families.
**What it is not.** Beat is clear on both limits: it does "not operate a crisis service" and its staff are "not medically trained". So it is not the number for a medical question and not the number at three in the morning.
**Two things worth knowing about the hours.** They are weekday evenings only, so it does not cover the nights and weekends when a lot of people need it. And if you are in danger, Samaritans is 116 123, any hour.
The fellowships, and the question to ask
Peer fellowships for eating exist, they are free, and for some people the meetings are the thing that makes the difference. They are also the one route in this stream where you need to check something before you commit.
**The conflict, stated plainly.** Some food fellowships ask members to follow a weighed and measured food plan, with a list of ingredients that are not permitted, agreed with a sponsor. In NICE's terms that is dieting during treatment, which the guideline expects to trigger binge eating. It is not a small difference of philosophy. It is the specific thing the national guideline tells clinicians to advise against.
**So ask this before your first meeting.** *"Does this group expect me to follow a food plan, weigh or measure my food, or cut out particular foods?"*
If the answer is yes, and you are being treated for binge eating, take that answer to whoever is treating you before you start. You are allowed to find the peer support useful and decline the food plan.
**The fellowships differ from each other.** Eating Disorders Anonymous, for example, states that "the only requirement for membership is a desire to recover from an eating disorder", with no food conditions attached to that. Overeaters Anonymous has the widest UK coverage and a Great Britain helpline on 07000 784 985. Practice varies between groups within the same fellowship, which is exactly why the question above is worth asking of the specific meeting rather than of the organisation.
**What fellowships are good at.** Being free, being available in the evenings, being other people who have done this, and not requiring a diagnosis or a referral.
**What they are not.** Treatment. None of them is a substitute for the NHS route, and none of them is regulated.
What to do this week
- Book the GP appointment. It is the only step that leads to treatment.
- Write down the times of episodes over the last fortnight to take with you. Not the amounts.
- Ring Beat if you want to say it out loud first. Weekday afternoons and evenings.
- If you are looking at a fellowship, ask the food plan question before your first meeting.
- Keep eating regularly while you wait, because it is the part with guidance behind it that you can start today. See [eating enough is the intervention](/guides/food/eating-enough-is-the-intervention).
Renovyn keeps the times logged quietly in the background if you would rather not carry a notebook into a waiting room. It sits alongside treatment rather than in place of it.
Common questions
**How do I get NHS treatment for binge eating?** Through a GP. Say what happens, how often and for how long, and ask to be referred. NICE puts binge-eating-disorder-focused guided self-help first for adults, with CBT as the other main route.
**Can I be refused treatment for being the wrong weight?** NG69 says single measures such as BMI or duration of illness must not be used to decide whether to offer treatment, and that screening tools must not be used alone to decide whether someone has an eating disorder. If you are told otherwise, that is worth questioning or seeking a second appointment about.
**Is Overeaters Anonymous a good idea?** It depends on the group and on what it asks of you. Peer support is genuinely useful and costs nothing. A weighed and measured food plan with banned foods is dieting in NICE's terms, so ask what the meeting expects before you commit, and tell whoever is treating you.
**Can Beat refer me?** No. Beat is support and information rather than a clinical service, it does not operate a crisis service, and its staff are not medically trained. The referral comes from a GP.
**What if I cannot face the GP yet?** Ring Beat first, or write it down and hand it over at the appointment rather than saying it. If you are not sure which pattern you are describing, [is this binge eating or something else](/guides/food/is-this-binge-eating-or-something-else) sorts the words out first.
Sources
- [NICE guideline NG69, Recommendations](https://www.nice.org.uk/guidance/ng69/chapter/Recommendations). Guided self-help first, medication not as sole treatment, no dieting during treatment, and the limits of BMI, duration and screening tools.
- [NHS, Binge eating disorder overview](https://www.nhs.uk/mental-health/conditions/binge-eating/overview/). The two main treatments and what a GP appointment involves.
- [Beat, Helplines](https://www.beateatingdisorders.org.uk/get-information-and-support/get-help-for-myself/i-need-support-now/helplines/). The four national numbers, opening hours, no diagnosis needed, and the limits of the service.
- [Eating Disorders Anonymous](https://eatingdisordersanonymous.org/). The single membership requirement, with no food conditions attached.
