Equip Lead Peer Mentor Makailah (Mak) Dowell describes her relationship with her eating disorder as a “toxic marriage” rooted in a cycle of binging and restriction. “There is no way I could eat and not have a ‘consequence,’” she says. “The consequence was deeply rooted in fatphobia, stigma, and a careless lack of love and respect for myself. The cycle led to binges, then discomfort, and then days of restricting, self-hatred, and isolation.”

Dowell is only able to reflect so eloquently on her struggles because, by confronting her eating disorder head-on, she achieved full recovery. That confrontation included becoming educated on the binge-restrict cycle, an often misunderstood pattern of problematic behaviors that has unfortunately been normalized in today’s society. While bingeing and restricting may seem like complete opposites, they commonly go hand-in-hand (which ties into the often overlooked truth that food restriction is the root of most eating disorders). Read on to learn more about the binge-restrict cycle, what it looks like, and why addressing it is a key part of eating disorder treatment.

What is the binge-restrict cycle?

First, let’s define the terms. Restriction is when a person suppresses or ignores their body’s hunger cues to limit their food intake. Someone who is restricting might eat very little food, or no food at all. Binge eating is when a person eats an objectively large amount of food (more than most people would eat in similar circumstances) in a short amount of time, often past fullness and even to the point of physical discomfort. Someone who is bingeing usually feels like they can’t control what they’re eating, and once the binge is over, they often feel distressing emotions.

When a person restricts their food for any reason, their body responds by producing ghrelin, otherwise known as the “hunger hormone,” to try to communicate that it needs nourishment. The longer restriction goes on, the more ghrelin is produced, and this can ultimately cause the hunger to take over, which can—understandably—result in a binge.

“The binge-restrict cycle refers to a pattern of restriction that is followed by binge eating, which then triggers more restriction,” says Equip Director of Program Development Tana Luo, PhD. “The pattern of restriction and binge eating becomes a self-perpetuating cycle that can be difficult to break.”

Part of that self-perpetuating cycle are the intense feelings of guilt and shame that often come after a binge, which then prompt the urge to restrict, either as punishment for “failing” or to “make up for” the food eaten. “It begins with the binge itself, then a period of self-hatred and body dysmorphia, and then that translates to the act of restricting,” Dowell says.

The four stages of the cycle

While the binge-restrict cycle is composed of two main behaviors—bingeing and restricting—the cycle itself is actually broken down into four stages:

1. Restriction. “This can mean skipping meals or snacks, limiting the amount of food being eaten, or restricting the types of foods eaten,” Luo says.
2. Craving. “Restriction is followed by an increased urge to eat,” Luo says. “This can look like an obsession with food, because food intake has been restricted.”
3. Bingeing. “That increased urge to eat can then trigger the third stage, which is a binge episode,” Luo says.
4. Guilt. “Binge eating is followed by feelings of guilt, shame, or embarrassment,” Luo says. “There is also often a desire to ‘make up’ for the binge or to ‘get back on track.’ This is what then drives restriction following a binge, and then the cycle repeats itself.”

How the binge-restrict cycle shows up in eating disorders

Bingeing and restricting are characteristic of a number of eating disorders, including binge eating disorder (BED), bulimia, some forms of OSFED, and anorexia binge-purge subtype (AN-BP). The binge-restrict cycle may also contribute to other disordered behaviors, like purging. “Restricting can lead to purging and other eating disorder behaviors,” Dowell says. “The cycle itself can include restriction, binge eating, and purging, and it can show up in many kinds of eating disorders. The cycle usually ends with a moment of ‘calm.’ Inevitably, the calm is disrupted by the eating disorder.”

Those who haven’t experienced the binge-restrict cycle themselves or observed it in a loved one may be surprised to know that many eating disorders involve both behaviors. While anorexia is typically characterized by restriction and bulimia is commonly characterized by bingeing and purging, there are many other forms of disordered eating, and even these specific diagnoses can present in a variety of ways.

“The binge-restrict cycle is really common across eating disorders where binge eating is a feature,” Luo says. “While not always the case, restriction often contributes to the maintenance of binge eating behaviors. Assessing for restriction is therefore an important part of understanding the full picture of someone who struggles with binge eating.”

How to break the binge-restrict cycle

Because each phase of the binge-restrict cycle fuels the next, it can be tough—if not impossible—to break on your own. However, with the right professional support, you can stop the continual loop of behaviors and establish a healthier relationship to food and eating. Here are the essential steps to breaking the binge-restrict cycle:

Seek expert help

“If someone is struggling with the binge-restrict cycle, it is important to get an assessment from a professional and to seek treatment,” Luo says. “Usually, treatment then involves getting onto a regular schedule of eating and stopping restriction. This can feel really counterintuitive—people might wonder why they are being encouraged to eat more frequently throughout the day in order to stop binge eating. But because we know that restriction is often the driver of binge eating, it’s important to tackle restriction first.”

Normalize eating habits

This step is easier said than done (and helps illustrate why a multidisciplinary team of experts is so essential), but committing to a schedule of regular meals and snacks can go a long way in breaking the binge-restrict cycle. It’s crucial to keep up this eating pattern even if a binge occurs, because any form of restriction will only perpetuate the cycle. Over time, these eating patterns will help regulate hunger and eliminate the urge to binge.

Work to reframe food rules

Diet culture is everywhere, but actively working to resist the disordered messages that have become normalized in our society will go a long way in breaking the binge-restrict cycle. “Treatment should also focus on breaking free from diet rules and ensuring a wide variety of foods in the diet,” Luo says. “This means steering away from labeling foods as ‘good’ and ‘bad’ or ‘healthy’ and ‘unhealthy.’”

Ensure accountability

“As someone who didn’t have access to treatment and had to learn how to combat my eating disorder solo for some time, I know how important it is to make sure you stay accountable,” Dowell says. “Let others know how you are doing, eat meals at a friend’s house, ensure your loved ones have a ‘window’ to your mental health, and do skills work. Dialectical behavior therapy (DBT) skills are some of the most effective interventions for high distress, emotional regulation, and choosing values that resemble yourself, not the eating disorder.”

While the binge-restrict cycle looks similar from person to person, we know that each patient’s needs and challenges are unique. That’s why our providers pull from the leading evidence-based modalities to tailor treatment to you and work collaboratively with one another to ensure that you get the support you need to break the cycle. Get in touch with our team today for more information or to schedule a free consultation.