Understanding Binge Eating Disorder After Bariatric Surgery

Binge eating disorder (BED) is more than just overeating—it’s a serious condition that can affect both physical health and emotional well-being. For those who have undergone bariatric surgery, maintaining healthy eating habits is essential for long-term success, but BED can make that journey more challenging. It’s not just about eating too much; it’s about feeling a loss of control around food, which can stall progress and lead to other health concerns.

Recognizing the signs, understanding the underlying causes, and finding the right support can make a big difference in managing BED and maintaining the benefits of bariatric surgery.

Why Does BED Matter After Bariatric Surgery?

After bariatric surgery, your stomach is significantly smaller, making it difficult to consume large quantities of food. However, binge eating can still occur as a loss of control in different ways, such as frequent grazing or repeatedly consuming small portions of calorie-dense foods, leading to excessive intake over time. This can result in weight gain, slow weight loss, and poor long-term weight loss.¹ Additionally, binge eating can cause discomfort, including dumping syndrome, acid reflux, bloating, and abdominal pain.²

BED is also associated with several comorbid health conditions, including diabetes, hypertension, stroke, and heart disease, as well as psychiatric illnesses such as anxiety and depression.³ To meet the diagnostic criteria, binge episodes must occur at least once per week on average over a three-month period.²

Signs You Might be Struggling With BED⁴

• Eating despite feeling full or not being physically hungry
• Feeling a loss of control over eating habits
• Experiencing guilt, shame, or distress after eating
• Frequently eating alone due to embarrassment about food intake

Why Does BED Happen?

Binge eating isn’t just about willpower—it often has deeper emotional and physiological roots. Common triggers include:^4,5

• Emotional factors: Stress, anxiety, depression, or past trauma
• Habitual behaviors: Long-standing patterns of using food for comfort
• Physical factors: Hormonal changes, disrupted hunger signals, and brain chemistry

What Can You Do?

Overcoming BED is possible with the right strategies and support:

• Seek professional help: Therapy, support groups, and working with a registered dietitian can make a big difference
• Practice mindful eating: Focus on hunger cues, eat slowly, and eliminate distractions
• Identify triggers: Keeping a food journal can help pinpoint emotional or situational triggers
• Use healthy coping mechanisms: Replace emotional eating with activities like walking, journaling, or deep breathing exercises
• Stay connected: Engage with support groups or trusted friends and family for accountability and encouragement

Final Thoughts

If you suspect you’re struggling with BED, know that you are not alone. Many bariatric patients face similar challenges, and support is available. Recognizing the signs and seeking help can empower you to take control and build a healthy, balanced relationship with food.

References

1. Sato Y et al. Clin J Gastroenterol. 2015;8(5):255-263.
2. Brode CS et al. Psychiatr Clin North Am. 2019;42(2):287-297.
3. McCuen-Wurst C et al. Ann N Y Acad Sci. 2018;1411(1):96-105.
4. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 2021. https://www.niddk.nih.gov/health-information/weight-management/binge-eating-disorder/symptoms-causes. Accessed March 11, 2025.
5. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 2021. https://www.niddk.nih.gov/health-information/weight-management/binge-eating-disorder/definition-facts. Accessed March 11, 2025.