Binge Eating Disorder and Fatphobia: Social Stigma, Exclusion, and the Need for a New Perspective on Health

Abstract

Binge eating disorder (BED) has long been an overlooked mental health condition, making its recognition and treatment more challenging. This study examines the impacts of social stigma and fatphobia on individuals with BED, exploring how these factors influence their well-being and perpetuate cycles of exclusion and discrimination. Using a psychosocial approach, this research analyzes how societal misperceptions about BED foster harmful stereotypes, such as the belief that being overweight results from a lack of willpower or personal negligence. This study is based on a qualitative discourse analysis of 12 participants diagnosed with BED. The findings highlight the presence of compensatory behaviors, including fasting, excessive exercise, and laxative use, which challenge the conventional understanding of BED. The results reveal that BED affects not only individuals at a personal level, but also deeply impacts their social and family lives, reinforcing shame, guilt, and self-hatred. Diet culture and weight stigma contribute to social exclusion, further hindering access to proper treatment. This study provides a critical perspective on the need for a cultural shift in how society perceives weight and eating behaviors, advocating for a more inclusive health model that prioritizes mental well-being and body diversity over arbitrary aesthetic standards. These findings underscore the need for greater societal understanding, inclusive health narratives, and further qualitative research into the lived experiences of individuals with BED.

1. Introduction

Eating disorders (EDs) are complex mental health conditions characterized by persistent disturbances in eating behaviors and related thoughts and emotions. They often involve an excessive preoccupation with body weight, shape, and food, leading to significant physical, emotional, and social impairments (American Psychiatric Association, APA, 2022) [1]. EDs encompass a range of diagnoses, including anorexia nervosa, bulimia nervosa, and binge eating disorder (BED), each with distinct behavioral patterns and diagnostic criteria. While BED is the most prevalent of these disorders, it remains comparatively under-researched and frequently misunderstood.

In recent years, there has been a significant increase in the prevalence of eating disorders (EDs), particularly among adolescents [2]. The American Psychiatric Association [1] defines these disorders as behavioral disturbances related to food intake, primarily driven by attempts to control body weight and shape. Numerous studies have highlighted the roles of the media, social networks, and cultural constructs related to body image in the development and persistence of these disorders [3,4,5].

Binge eating disorder (BED) is characterized by the recurrent consumption of large amounts of food in a short period of time, accompanied by a perceived loss of control over eating. Unlike bulimia nervosa or anorexia nervosa, BED is diagnosed in the absence of compensatory behaviors such as self-induced vomiting, fasting, or excessive exercise. Individuals with BED frequently report high levels of psychological distress, including shame, guilt, and anxiety, which can significantly impair their quality of life. In addition, research has shown that people with BED face substantial social stigma, experience higher rates of depression and low self-esteem, and are more likely to suffer from poor physical health outcomes, such as metabolic syndrome and cardiovascular issues [6,7,8,9].

Although the public is generally aware of binge eating disorder (BED), many misconceptions about the condition persist. These misconceptions often lead to stigma and negative perceptions toward individuals with BED. A common belief is that BED is simply a matter of lack of self-control or willpower, which oversimplifies the complexity of the disorder. It is important to address these misconceptions, as they affect public understanding and contribute to the stigma faced by individuals with BED [8].

Nevertheless, BED was not formally conceptualized until later decades. Spitzer played a key role in naming the disorder after studying a group of overweight individuals who were trapped in a recurring “binge–diet–binge” cycle. According to various authors [7,10,11,12], BED is characterized by the consumption of large amounts of food in a short period, coupled with a significant loss of control over eating behaviors. This condition is also associated with persistent emotional distress, and unlike other EDs such as bulimia nervosa or anorexia, it is generally not accompanied by compensatory behaviors like self-induced vomiting [13]—a point that will be further examined in this study.

Fairburn [14] observed that, initially, binge episodes might produce temporary pleasurable sensations, such as relief or calmness. However, once the episode ends, individuals often experience frustration, anxiety, guilt, and intense self-disappointment. Furthermore, these episodes are commonly carried out in isolation or secrecy due to the shame they provoke [15]. Recent findings using ecological momentary assessment (EMA) support this affective trajectory. Mason [16] reported that self-discrepancy and negative affect predicted binge eating episodes in everyday life. Additionally, Smith [17] highlighted the role of rumination as a key transdiagnostic factor associated with eating disorder psychopathology. These real-time data provide empirical support for the emotional mechanisms described by participants in the present study.

There is no consensus among researchers regarding the exact frequency and duration of binge episodes. However, several studies suggest that the severity of binge eating disorder is best determined by the extent to which it negatively impacts an individual’s quality of life, rather than solely by binge frequency. Research has shown that individuals with BED often experience significant psychological distress and impaired functioning in daily life, supporting the inclusion of quality-of-life impairment as a clinical indicator of severity [18].

Regarding the types of foods consumed during binge episodes, research suggests that individuals often compulsively eat the very foods they usually restrict or avoid in their daily diets [19]. Another relevant aspect of BED is the altered state of consciousness frequently reported by individuals, who describe their binge episodes as trance-like or dissociative experiences in which nothing exists except themselves, the food, and their compulsion to eat.

This study is grounded in a qualitative approach informed by discourse analysis and the principles of grounded theory. Discourse analysis enables the examination of how language reflects and constructs participants’ experiences, identities, and sociocultural meanings related to BED. Grounded theory provides a systematic yet flexible framework for identifying emergent themes within participants’ narratives, allowing the research to remain closely tied to the data. This combination allows for a nuanced understanding of how individuals diagnosed with BED interpret their condition and navigate a weight-centric society.

Building on this approach, this research sets out to achieve three main objectives: first, to analyze how individuals with binge eating disorder perceive their condition; second, to examine the impact of BED on their daily lives; and third, to explore the extent to which limited societal understanding of the disorder affects those who suffer from it.

2. Design and Method

This study is framed within the qualitative research paradigm, which enables an in-depth exploration of the subjective experiences of individuals diagnosed with binge eating disorder (BED). This research focuses on three main analytical dimensions: (1) the construction of disorder perception, (2) the implications of BED in daily life, and (3) the impact of societal misperceptions on individuals with BED.

• Participant Recruitment and Sample

Participants were recruited through online platforms and communities focused on BED awareness and support. These platforms, such as social media groups and informational forums, provided access to individuals who were engaged with the topic and familiar with BED-related content. The primary inclusion criterion was a formal diagnosis of BED by a qualified mental health professional. All participants were over 18 years of age and provided informed consent prior to participation. Recruitment efforts emphasized confidentiality and ethical transparency [1]. The final sample included 12 participants, whose sociodemographic characteristics are presented in

Table 1. Sociodemographic characteristics of participants.

Participant (P)	Age	Sex	Year of Diagnosis	Approximate Age of BED Onset
1	26	M	2022	12
2	27	M	2023	14
3	29	M	2023	16
4	31	M	2023	10
5	32	M	2022	13
6	32	M	2022	20
7	34	M	2023	25
8	35	M	2023	10
9	37	M	2023	12
10	42	H	2022	35
11	45	M	2023	13
12	47	H	2022	7

Note: H = Man; M = Woman.

.

2.

Data Collection

Data were collected through two focus groups conducted using Google Meet, a secure video-conferencing platform. To protect the participants’ anonymity and encourage openness, only audio was recorded—video functions were disabled during sessions. Each session lasted for approximately 90 min and was moderated by trained researchers following a semi-structured guide. The focus group methodology was chosen for its effectiveness in promoting dynamic interactions and co-construction of meaning among participants [20].

3.

Data Analysis

All audio recordings were transcribed verbatim. The analysis was conducted using thematic analysis guided by grounded theory principles. Two researchers independently coded the data and identified emergent themes through constant comparison and iterative reading. Both researchers had advanced training in qualitative methods, particularly in discourse analysis and grounded theory. Discrepancies were resolved through discussion and consensus. This approach allowed for an inductive construction of meaning grounded in participants’ language and experience.

3. Sample and Participant Selection

This study involved 12 participants, all of whom had been formally diagnosed with binge eating disorder by a mental health specialist. The only selection criterion was the requirement of an official BED diagnosis. All participants were over the age of 18 and provided informed consent prior to participating in the study. Table 1 presents the sociodemographic characteristics of the participants.

For data collection, participants were divided into two focus groups. The focus group methodology has been widely recognized as an effective tool in mental health and eating disorder research, as it facilitates interaction among participants and enables a collective construction of meaning and experiences [20].

One of the main methodological challenges of this study was participant recruitment, which, paradoxically, became one of its strengths. The selection process required consistent engagement through social media, particularly within online spaces dedicated to raising awareness and educating about BED. These digital communities are highly active and serve as supportive networks, which allowed for a natural and respectful approach to potential participants. Through these interactions, invitations to participate in this study were extended while strictly adhering to ethical principles of confidentiality and informed consent (American Psychological Association [1]).

This research was conducted by recruiting participants through platforms focused on raising awareness of binge eating disorder (BED). The participants were diagnosed with BED, which was the primary criterion for inclusion in this study. The location of participants was not a key factor in our study; instead, our focus was on reaching individuals diagnosed with BED, as this was a challenging group to identify. While the participants were predominantly from Spain, their geographic location was not considered critical to the research, as our goal was to explore their experiences with the disorder rather than focusing on the territory. Our representativeness is based on the participants’ discourse, not a territorial sample, which allowed us to capture a variety of experiences that enrich our understanding of the disorder.

4. Data Collection Method

As the participants resided in different geographical locations, the focus groups were conducted online. The use of digital platforms has been recognized as a valid and effective strategy in qualitative research, as it enhances accessibility and facilitates participation for individuals who might otherwise face challenges attending in-person sessions [21]. Additionally, this format provided greater comfort and anonymity, which may have encouraged more openness in discussing sensitive personal experiences.

5. Gender Bias in the Sample

It is important to acknowledge that the sample was not proportionally selected based on gender. While examining potential differences between men and women with binge eating disorder would be valuable, two key factors influenced the gender composition of the sample:

• Higher representation of women in BED-related support and awareness spaces, making them more accessible as participants;
• Greater willingness among women to participate in research on eating disorders and mental health, a trend previously identified in the literature;
• Despite this limitation, the findings offer valuable insights into the lived experiences of individuals with BED, contributing to future research that could expand the sample’s gender diversity.

6. Fieldwork and Data Analysis

Two focus groups were conducted, one at the end of November 2023 and the other in the first week of December 2023, with each session lasting approximately 60 min. As previously mentioned, the interactions took place online, specifically via Google Meet, which facilitated communication among participants from different geographical locations. Only audio was used during the sessions; video was not required nor enabled. This decision was made to preserve participants’ anonymity and to emphasize the analysis of their verbal discourse, which was the primary focus of this study. To guide the discussions, a structured question guide was developed based on the research objectives.

Table 2. Sample questions from the focus group guide.

Questions
Since when have you had binge eating disorder (BED)?
At what point did you become aware that you had BED?
Does BED have implications in your daily life?
Does the lack of social awareness about BED affect your personal experiences?

presents some of the key questions designed to gather insights into this study’s focus areas.

The sessions were audio-recorded (excluding video) with the informed consent of all participants, obtained both verbally and in writing, ensuring adherence to ethical research guidelines [22].

For data analysis, the Atlas. Ti6 software was employed to manage coding and categorize data using the constant comparison method. This method involves identifying similarities and differences through the systematic analysis of recurring patterns within the data.

• The discourse analysis of the participants’ responses followed a structured multi-phase process [23];
• Transcription of the focus groups was carried out;
• The research team conducted multiple readings of the transcriptions to extract the most significant meaning units from the discourse;
• The extracted meaning units were then grouped into thematic dimensions and categories, ensuring coherence between responses. The coding process was conducted by two researchers with advanced training in qualitative research methods, particularly in discourse analysis and grounded theory. Both independently coded the transcripts and then met to compare and discuss their coding. Discrepancies were resolved through discussion and consensus;
• Finally, a thematic interpretation of the findings was performed to generate insights.

7. Ethical Considerations

This study adhered to the bioethical principles of the Helsinki Declaration, ensuring that confidentiality and anonymity were maintained throughout the research process. Additionally, participants were verbally and in writing informed about the study’s objectives and the potential publication of findings. In compliance with data protection regulations, all transcribed interventions were securely stored, ensuring absolute anonymity for participants (World Medical Association [24]. Additionally, this study was approved by the Bioethics Committee of the University of Almería (Ref: 2024/022).

8. Results

The sample consisted of 12 participants, with an average age of 34 years. Table 2 presents the key sociodemographic characteristics of the participants, which were considered relevant to this specific phase of the research.

9. Emerging Themes from the Analysis

Through discourse analysis, three key thematic dimensions emerged, each subdivided into two subdimensions. These thematic dimensions align with the broader experience and impact of binge eating disorder on individuals’ lives.

The first dimension focuses on how participants become aware of their disorder and how they navigate their coping mechanisms. The second dimension examines the impact of BED on multiple levels, ranging from personal well-being to social and familial dynamics. Finally, the third dimension explores how societal ignorance and stigmatization of BED contribute to participants’ experiences, often reinforcing negative self-perceptions and barriers to seeking help [25].

10. Awareness of Binge Eating Disorder

(a)

Discovery

An important issue to highlight is the significant difference between the moment individuals realize they have a disorder—or, as one interviewee described it, “when it is given a name”—and the early memories of engaging in behaviors related to binge eating disorder (BED).

As shown in

Table 3. Subjective experiences: dimensions and subdimensions.

Dimensions	Subdimensions
Awareness of having BED	Discovery
	Coping
Consequences of BED (on individuals’ lives)	Individual impact
	Family impact
	Social impact
Implications of limited societal understanding of BED	Stereotypes
	Stigmatization

, most participants received their official diagnosis in 2022 or 2023. However, both their narratives and the data indicate that they had been living with the disorder for many years prior to being formally diagnosed. This finding aligns with previous research indicating that individuals with BED often experience prolonged undiagnosed symptoms, as binge eating behaviors are frequently normalized, overlooked, or attributed to a lack of willpower, rather than a clinical disorder [1].

“I remember compulsively eating chocolate when I was around 12. We didn’t have it at home, so I would buy it myself and eat it in secret. I could eat two whole chocolate bars by myself, and I remember feeling really, really small. I knew something was wrong, but I didn’t know what to call it. I knew eating in secret was bad and meant lying, but it was my secret.”

(P1)

“I think I was around seven years old when I first remember it happening. It was during a family meal. I remember it so clearly because my mom scolded me for taking food from everyone’s plates and eating too fast. My mom, poor thing, was just trying to correct me, but from that moment on, I understood that I couldn’t eat like that. And since then—imagine, since then—I feel ashamed and hide when I eat around people who are not my family.”

(P12)

• (b) Coping Mechanisms

Participants reported significant difficulties in coping with BED for two main reasons.

• Lack of Information

A major barrier to seeking help was the absence of knowledge about BED as a recognized eating disorder. Several participants assumed that their experiences did not fit within the stereotypical image of eating disorders commonly depicted in the media and public discourse [5].

“I felt like I couldn’t control my eating, but of course, I didn’t vomit, so it wasn’t bulimia. And that reassured me because I didn’t have the ‘popular’ problem that my classmates talked about. I was healthy—just fat (laughs). But I didn’t have what they discussed in class, what my friends or the TV talked about. No anorexia, no bulimia.”

(P2)

“I was always the glutton, the big eater in my family, nothing more. And actually, they still see me that way. They have all these funny memories about me and my eating, and when they talk about it, they laugh. But they have no idea about the hell behind it…”

(P10)

2.

Minimization of the Problem

Even when participants began encountering information about BED, they often downplayed its significance and struggled to recognize their eating behaviors as part of a clinical disorder.

“I started reading about this online, but not long ago—maybe three or four years ago. I thought, ‘Could I have this?’ But then I would stop looking and just try more diets. I’ve tried a thousand diets, convinced that I just needed willpower. Until I realized that this shit doesn’t work like that—it’s not about me being weak or lacking willpower. That’s when I knew I needed to see a psychologist.”

(P4)

3.

Consequences of BED on Individuals’ Lives

The consequences of BED extend beyond individual distress and have profound effects on personal, familial, and social relationships. The disorder mediates and shapes participants’ romantic relationships, family dynamics, friendships, and overall social interactions.

(a)

Personal Consequences

The most commonly reported personal impact of BED was a preoccupation with food, weight, and body image, which participants described as a constant mental burden [26]. Many expressed years of obsessive thoughts about dieting, binge episodes, and self-worth tied to weight and eating behaviors.

“From the moment I wake up, I think about food: ‘Today I’m going to do it right.’ I think that’s the sentence I repeat the most. But as the day goes on, if I slip up—if I eat something I wasn’t supposed to—I spiral. And then I start berating myself. Hating myself. Hating myself and punishing myself.”

(P9)

This preoccupation with body weight also led to self-perception distortions and negative body image, reinforcing low self-esteem and feelings of inadequacy.

“Since I was little, I’ve thought things like, ‘I’ll be happy when I lose weight,’ ‘I’ll be desirable when I weigh less,’ or ‘They don’t like me because I’m fat.’ Over time, I realized that all my worth depended on my weight—or at least, that’s what I believed. So, I’ve always felt like I was worth nothing because I could never be thin. I felt incapable.”

(P11)

In response to uncontrollable binge episodes, participants described attempting compensatory behaviors such as restrictive dieting, excessive exercise, or laxative use—which paradoxically reinforced the binge–restrict cycle [27,28].

“For a while, I just accepted binge eating as normal. So, I had to do things to avoid gaining weight. Why do you think I became so good at my sport? Because I trained like an animal. If I couldn’t control my eating, at least I could control my sacrifices in other areas. And that’s how I’ve managed my weight all this time.”

(P10)

“I’ve done extreme diets, gone days without eating. But I think that only led to more binge eating. I’ve done crazy things—even taken laxatives after stuffing myself. But over time, I realized that none of it worked. Extreme diets, fasting—nothing stopped the binges.”

(P6)

• (b) Family Consequences

BED also impacted family relationships, especially regarding romantic partnerships. Some participants longed to start families but feared rejection due to their physical appearance.

For those already in relationships, BED imposed limitations on shared experiences. Participants often canceled plans due to body image distress or avoided eating in public settings, affecting their partners.

“I know it must be exhausting to be with me. Especially when I cancel plans because I feel bad, ugly, fat—or when I get scared of eating in front of people who might judge me. And my partner stays with me. Sometimes they get frustrated, and they’re losing patience. It’s normal. I don’t know…”

(P7)

Moreover, negative body image led some participants to avoid intimacy in their relationships.

“I have never let my partner see me naked. We’ve been together for seven years. And it weighs on both of us—I know it does—even if we never talk about it.”

(P8)

• (c) Social Consequences

All participants reported significant social limitations due to BED. Many avoided social gatherings or public activities where food and body image were involved.

“A bad body image day can make me stay home instead of going out with my friends. And eventually, they get tired of me. So, when I finally feel like going out, no one invites me anymore.”

(P3)

“I don’t go to pools in the summer. I feel too fat, too heavy, too disgusting. I haven’t set foot on a beach in years, even though I used to love it. I don’t even wear short sleeves or shorts. I just wear black…”

(P6)

4.

Implications of Societal Unawareness of Binge Eating Disorder

Binge eating disorder (BED) has only recently begun to gain public and clinical recognition, making it difficult for individuals to identify their condition and seek treatment. This lack of awareness not only affects those with BED, but also extends to their social environment, which often has limited or inaccurate information about the disorder.

When asked whether societal unawareness of BED impacts their lives, all participants responded affirmatively. They highlighted two main issues: stereotypes and stigmatization. Previous research has shown that limited public understanding of BED reinforces social discrimination, prevents access to treatment, and contributes to internalized shame and guilt [8,25,29].

(a)

Stereotypes

1.

The Myth of the “Carefree and Happy Overweight Person”

Several participants mentioned encountering the stereotype that overweight individuals are indifferent about their health and body image. This misconception assumes that people with BED lack concern for social norms, when in reality, many struggle profoundly with their relationship with food and body perception [30].

“My brother—my own brother!—once told me that I didn’t care about anything, that I would eat whatever I wanted, and that he admired me for not caring about being fat. That really broke me.”

(P12)

2.

The Myth That People with BED Are Overweight by Choice

One of the most common misconceptions is the belief that people with BED should just eat less and exercise more. This oversimplified view ignores the psychological, biological, and emotional factors that drive binge eating behaviors [27].

“The most common thing I hear is, ‘You just need to stop eating so much and have more willpower.’ I don’t blame them because I used to think the same thing before therapy. But it’s exhausting and frustrating to hear it over and over from people who don’t understand this disorder.”

(P2)

• (b) Stigmatization

Of the 12 participants, 8 identified as obese, 2 as overweight, and 2 as within the recommended weight range. However, the latter two explicitly stated that they maintain their weight through restrictive dieting and excessive exercise to avoid societal stigma. One participant who identified as overweight shared the following experience:

“I was so embarrassed when I started a new gym and everyone clapped for me after I did an exercise I find easy. They assumed that, because I’m fat, I wouldn’t be able to do it. I won’t go back. Going to the gym was already a challenge for me, and this just made it worse.”

(P7)

11. Discussion and Conclusions

The findings of this study highlight several key aspects of binge eating disorder (BED) and its impact on individuals’ lives. One of the most significant challenges participants reported was the lack of awareness surrounding BED and the prevalence of misconceptions that minimized their condition. Many were unaware that their behaviors constituted a diagnosable disorder and attributed their experiences to personal weakness or a lack of willpower. As some participants put it: “I felt like I couldn’t control my eating, but of course, I didn’t vomit, so it wasn’t bulimia” (P2), and “I’ve tried a thousand diets, convinced that I just needed willpower” (P4). This perception aligns with previous research showing that BED is frequently normalized or overlooked [1,5], often resulting in delayed diagnosis and treatment. Moreover, contrary to traditional definitions of BED, which exclude compensatory behaviors, our findings show that participants frequently engaged in extreme dietary restriction, fasting, excessive exercise, and laxative use. One participant stated: “I can follow a strict diet for months, eat the bare minimum, and lose weight. But as soon as I crave something and break my routine, I can’t stop. It lasts for days, weeks, even months—binge after binge after binge. The more I restrict myself, the harder it is to stop later. It’s a never-ending cycle” (P7). These findings challenge the clear-cut distinctions between BED and other eating disorders like bulimia, echoing claims made in prior studies [12,27,28,31,32,33,34].

The relationship between binge eating and dietary restraint was a recurring theme in participants’ narratives and aligns with recent empirical findings. Several participants described cycles of extreme restriction followed by loss of control, suggesting that dietary restraint may play a significant role in maintaining binge behaviors. This supports existing literature indicating that individuals with binge-spectrum eating disorders often engage in patterns of restraint that are linked to greater symptom severity [35]. Moreover, studies using ecological momentary assessment have demonstrated bidirectional associations between binge episodes and restrictive behaviors, highlighting the dynamic and reciprocal nature of these processes [36]. More recently, Bartholomay [37] found that dietary restriction may function as a maintaining factor in BED, reinforcing the idea that restrictive patterns can increase vulnerability to future binges. These findings suggest that the binge–restrict cycle is not only common, but may be central to the chronicity of BED, and should be addressed more explicitly in both clinical settings and awareness campaigns.

Finally, participants expressed profound psychological distress related to their weight and body image, regardless of clinical classification. Many described persistent feelings of shame, self-hatred, and low self-esteem: “From the moment I wake up, I think about food… I start berating myself. Hating myself. Hating myself and punishing myself” (P9), and “I’ve always felt like I was worth nothing because I could never be thin” (P11). This psychological burden, reinforced by internalized stigma, affected not only their emotional well-being, but also their relationships and quality of life, consistent with existing literature [14,26,30,35].

One of the key strengths of this study lies in its qualitative and discourse-based approach, which offers in-depth insight into the lived experiences of individuals diagnosed with BED. By allowing participants to express themselves in their own words, the research captures the emotional, cognitive, and social dimensions of the disorder that are often overlooked in quantitative studies. Additionally, the focus on internalized stigma and compensatory behaviors contributes novel findings to the literature, particularly in how BED is shaped by sociocultural discourse around weight and health. The use of thematic analysis guided by grounded theory principles further strengthens the validity and interpretive depth of the results, offering a rich and nuanced understanding of the complex dynamics at play.

Despite its contributions, this study has several limitations that should be acknowledged. First, the sample size was relatively small and predominantly composed of women, which limits the generalizability of the findings to more diverse populations, including men and non-binary individuals. While the participants were all formally diagnosed with BED, they were recruited through platforms focused on eating disorder awareness, which may have led to a sample with higher levels of engagement or self-awareness than the general population. Additionally, although participants resided in Spain, geographic location was not a selection criterion, and this study prioritized discourse over territorial representation. This may limit the applicability of findings to specific cultural or regional contexts. Lastly, as with most self-reported data, participants’ narratives may have been influenced by memory bias or social desirability.

12. Conclusions

While individual experiences of BED vary, our findings suggest that we live in a weight-biased society that promotes rigid beauty standards where appearance takes precedence over health. This weight-centric culture not only influences public perceptions of BED, but also affects how individuals with BED perceive themselves, reinforcing internalized fatphobia and self-hatred [38]. Participants expressed feelings of self-rejection and fear of weight gain, often acknowledging that they had internalized societal stigma, even as they themselves were targets of weight discrimination. This self-directed stigma reinforces guilt, shame, and feelings of worthlessness, all of which are significant psychological triggers for binge-eating behaviors [8,25,29]. The dominance of diet culture also emerged as a key contributor to the cycle of restriction and binge eating, highlighting the need to shift away from weight-loss-at-all-costs narratives toward inclusive and health-centered approaches. Rethinking societal definitions of health, body image, and nutrition is essential to improve outcomes for people with BED, focusing instead on body diversity, mental well-being, and sustainable eating practices [39]. Finally, this study proposes weight-centrism—understood as the belief that one’s value is inversely related to their weight—as a concept worth exploring further in future research. This ideology, which equates thinness with worth and weight gain with personal failure, has profound implications for mental health and social exclusion. Ultimately, addressing BED requires not only clinical interventions, but also cultural and policy-level shifts that challenge fatphobia, dismantle diet culture, and redefine health in inclusive and compassionate terms.

This study contributes to the literature by providing a qualitative and discourse-based perspective on the lived experiences of individuals diagnosed with BED, highlighting compensatory behaviors, internalized stigma, and the sociocultural impact of weight-centrism—areas that remain underexplored in existing research.

Based on our findings, we recommend several approaches to address the needs identified. These include the development of health education programs that challenge weight-centric narratives from early schooling, the implementation of training modules for mental health and medical professionals on weight stigma and BED-specific symptomatology, and the integration of body diversity awareness into public health campaigns. For example, structured workshops that combine psychoeducation, media literacy, and lived-experience testimonies could be offered in schools and community centers to promote a more inclusive understanding of health and body image.