DBT vs. CBT in Binge Eating Disorder Treatment

DBT vs. CBT in Binge Eating Disorder Treatment by Samantha Bothwell, LMFT Freelance Writer for Eating Disorder Hope

Binge eating disorder (BED) is one type of eating disorder. While BED is characterized by bingeing, BED is more than just over-eating sometimes. Everyone over-eats occasionally.

Professionals look for certain symptoms to diagnose binge eating disorder. Individuals with BED have emotionally upsetting and continual instances of binge eating that feel out of their control [1]. Bingeing is when someone eats an amount of food that seems larger than normal within a short amount of time.

While it is hard to determine what normal eating is, it can be helpful to think of abnormal eating as eating more than what is physically satisfying. Other signs of BED are:

  • Eating faster than normal
  • Eating until uncomfortably full
  • Eating large amounts of food even if you’re not hungry
  • Eating alone because the amount of food feels embarrassing
  • Feeling emotionally upset after a binge [1]

This behavior can cause emotional and physical discomfort. Fortunately, there are several types of treatment for binge eating disorder. Professionals often use two evidenced-based methods.

These two methods are Dialectical Behavioral Therapy (DBT) and Cognitive Behavioral Therapy (CBT). A recent research study reviewed the effectiveness of these treatment methods [2]. While DBT is essentially an offshoot of CBT, they are different.

Both approaches can help people make positive changes. However, CBT and DBT approach BED treatment differently. There is one key difference between the two.

CBT and DBT therapists aim to help someone stop BED behaviors. Both approaches agree that binge behaviors stem from someone’s attempt to cope with uncomfortable feelings.

However, CBT helps people make positive changes by changing their thoughts. The idea is that the way someone thinks impacts the way they feel and act. For example, if someone thinks no one likes them, they are likely to feel lonely or sad. These feelings can lead to a binge.

African American Black Woman in binge eating disorder treatmentTo change behavior, you can change one’s thoughts. Cognitive Behavioral Therapy could help someone with binge eating disorder learn to shift their thinking patterns. This shift involves replacing negative thoughts with reality-based thoughts. The hope is this shift in thinking will stop binge behaviors.

While CBT focuses on changing thoughts, DBT helps someone learn to cope with difficult emotions [2]. There are four main components to Dialectical Behavioral Therapy. These are:

  • Mindfulness
  • Distress tolerance
  • Interpersonal effectiveness
  • Emotion regulation

These four core areas give people the opportunity to learn a variety of coping skills. Each core area teaches a type of coping skill. For example, mindfulness skills help someone learn to stay in the present moment. This can help prevent impulsive behavior.

Through the use of coping skills, individuals can learn how to cope with difficult feelings without binging. CBT and DBT both have something helpful to offer those who are seeking binge eating disorder treatment. However, it’s helpful to understand what both approaches offer when seeking treatment. Either way, both can be an ally in eating disorder recovery.


[1] American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Publishing; 2013.[2] Lammers, M.W., Vroling, M.S, Crosby, R.D., Van Strien, T. (2020). Dialectical behavior therapy adapted for binge eating compared to cognitive behavior therapy in obese adults with binge eating disorder: A controlled study. Journal of Eating Disorders, 8(27), 1-11. https://doi.org/10.1186/s40337-020-00299-z

About the Author:

Samantha Bothwell PhotoSamantha Bothwell, LMFT, is a licensed Marriage and Family Therapist, writer, explorer, and lipstick aficionado. She became a therapist after doing her own healing work so she could become whole after spending many years living with her mind and body disconnected. She has focused her clinical work to support the healing process of survivors of sexual violence and eating disorders. She is passionate about guiding people in their return to their truest Self so they can live their most authentic, peaceful life.