Binge Eating Disorder & Co-Occurring Issues

Woman struggling with grief and antidepressant withdrawal

It is common for eating disorders to occur alongside existing mental health diagnoses. When this happens, we refer to the disorders as co-occurring. 79% of individuals diagnosed with Binge Eating Disorder (BED) have been to struggle with a co-occurring disorder [1], in particular, mood disorders, such as major depressive disorder (MDD) or bipolar disorder, and substance use disorders [1].

Binge Eating Disorder & Major Depressive Disorder

39% of individuals with a BED diagnosis are also diagnosed with MDD [1]. Studies indicate that individuals that struggle with BED report experiencing a worse quality of life and higher rates of depression and psychological symptoms than those without [2].

Not only do both disorders increase the risk of the other, but the co-occurrence of both also shows a higher risk of experiencing others. Depression in individuals with BED is associated with a higher prevalence of comorbidities, such as obsessive-compulsive disorder (OCD), anxiety, phobias, and panic disorder [2].

One study looked deeper into this relationship, finding that when MDD and BED co-occur, regardless of which disorder precedes the other, this has an “adverse effect on ED psychopathology and overall psychiatric co-morbidity [3].”

BED & Anxiety Disorders

Anxiety disorders are the most common co-occurring diagnosis experienced by those with BED, with 55 to 65% of individuals struggling with both diagnoses [1]. One study aptly pointed out that, even with the above numbers, the role of anxiety in BED is under-reported.

Many researchers and clinicians believe anxiety to be a key precipitating factor in binge eating behaviors and that binge eating is a common method for individuals to cope with anxiety, as studies indicate that these binge eating behaviors result in the reduction of anxiety symptoms [4]. The Cognitive Avoidance Theory posits that individuals engage in binge eating behaviors to escape the state of anxiety they feel uncomfortable with [4].

BED & Substance Use Disorders

Woman thinking and struggling with Binge Eating DisorderBED and substance use disorders may be associated with one another due to the similar behavioral symptoms, such as experiencing mood disorders, impulse control issues, triggering urges to engage in the behaviors, increased tolerance to food/substances, and similar dopamine and opiate pathways for food and substances [5].

They also both peak in adolescence or late adulthood. However, men with BED are two times more likely to have a substance use disorder than females [5]. Because of these similarities, approximately 25% of individuals with BED reported having a lifetime substance use disorder [5].

A 2015 study found frightening results about the relationship between mood disorders, substance use, and BED, reporting that, “individuals with histories of either mood disorder or substance use disorder have a more severe form of BED [6].


[1] NEDA (2019). Eating disorders and co-occurring conditions. National Eating Disorders Association, retrieved from

[2] Araujo, D. M. et al. (2010). Binge eating disorder and depression: a systematic review. World Journal of Biological Psychiatry, 11:2.

[3] Grilo, C., Becker, D. (2016). Binge eating disorder and major depressive disorder comorbidity: sequence and clinical significance, European Psychiatry.

[4] Rosenbaum, D. L., White, K. S. (2013). The role of anxiety in binge eating behavior: a critical examination of theory and empirical literature. Health Psychology Research.

[5] Schreiber, L. R. N., Odlaug, B., L., Grant, J. E. (2013). The overlap between binge eating disorder and substance use disorders: diagnosis and neurobiology. Journal of Behavioral Addictions, 2:4.

[6] Becker, D. F., Grilo, C. M. (2015). Comorbidity of mood and substance use disorders in patients with binge-eating disorder: associations with personality disorder and eating disorder pathology. Journal of Psychosomatic Research, 79.

About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published February 28, 2020, on
Reviewed & Approved on February 28, 2020, by Jacquelyn Ekern MS, LPC

About Baxter Ekern

Baxter is the Vice President of Ekern Enterprises, Inc. He is responsible for the operations of Eating Disorder Hope and ensuring that the website is functioning smoothly.