Brian Pollack, LCSW, CEDS-C
Brian is the Founder and Clinical Director of Hilltop Behavioral Health, a boutique eating disorder specialty practice in Summit, NJ. He is one of the few male master’s-level Certified Eating Disorder Specialists in the country, with expertise in FBT, male clients, athletes, and muscle dysmorphia. He hosts the Minding Men podcast and serves as an adjunct professor at Yeshiva University.
Learn more about Brian →Recently, I had the privilege of joining Austin Cross on AirTalk to discuss something I spend much of my professional life sitting with: the quiet, often hidden struggle of binge eating disorder. The conversation also featured Dr. Alexis Conason, a psychologist and author I deeply respect. What stayed with me most after the show wasn’t the statistics we cited or the clinical language we used. It was the simple fact that an hour of public radio was devoted to a condition that, despite being the most common eating disorder in the United States, still lives largely in shadow.
If you’re reading this and something about binge eating feels personal, maybe for you, maybe for someone you love, I want you to know this blog is for you. Not as a replacement for real clinical support, but as a hand extended from someone who spends his days helping people find their way back to themselves.
Binge Eating Disorder Is More Common Than You Think, and More Misunderstood
Binge eating disorder (BED) is defined by recurrent episodes of eating unusually large amounts of food in a short period, accompanied by a sense of loss of control and, almost always, a profound aftermath of shame. It is not about a second slice of pizza on a Friday night. It is not the bag of chips in front of a movie. It is a pattern that leaves the person feeling physically ill, emotionally crushed, and often terrified that something is wrong with them.
Here is what the research tells us. According to the National Institute of Diabetes and Digestive and Kidney Diseases, binge eating disorder is the most common eating disorder in the United States, affecting roughly 1.25% of adult women and 0.42% of adult men at any given time. Lifetime prevalence data compiled in StatPearls through the National Library of Medicine places the U.S. figure at approximately 2.6%, with about 79% of people with BED carrying at least one additional psychiatric diagnosis, most often an anxiety disorder, mood disorder, or substance use disorder.
That last number is the one I always return to in my clinical work. Binge eating almost never travels alone. It arrives holding hands with anxiety, with depression, with trauma, with the weight of being human in a culture that has taught us our bodies are problems to be solved.
The Hidden Population: Why Men Aren’t Talking About Binge Eating
One of the points I felt most strongly about raising on AirTalk is how dramatically undercounted binge eating is among men and boys. The stereotype, that eating disorders are a “young woman’s issue,” has real clinical consequences. It delays diagnosis. It deepens shame. It keeps men out of treatment for years, sometimes decades.
A 2023 study published in the Journal of Eating Disorders examining a demographically diverse national sample of early adolescents found that adolescent males actually had higher odds of binge-eating behaviors compared to adolescent females, directly challenging the long-standing assumption that eating disorders primarily affect girls. The authors explicitly called for the field to move away from that stereotype.
In my practice at Hilltop Behavioral Health, I have seen this play out hundreds of times. Men come in later, sicker, and more reluctant. They have usually spent years quietly cycling through restrictive diets, gym culture built around body transformation, and private episodes of binge eating they are convinced no one else experiences. The cultural script that men must be in control, strong, and unbothered collides brutally with a disorder whose defining feature is the experience of losing control.
If you are a man reading this, I want to say something plainly: what you are struggling with is not a character flaw. It is not weakness. It is a recognized, treatable clinical condition, and you deserve support that understands the specific shape it takes in your life.
The Restriction-Binge Cycle: What Almost Everyone Gets Wrong
On the show, Dr. Conason made a point that I want to underline in bold: binge eating disorder is not just about binges. It is fundamentally intertwined with restriction.
This is the piece that most people miss, and it is the piece that keeps the cycle spinning.
When we restrict, whether through skipped meals, rigid food rules, labeling foods as “good” or “bad,” or following the latest diet plan, we set the stage biologically and psychologically for the next binge. A study published in the International Journal of Eating Disorders examining 112 individuals with binge eating disorder confirmed this directly: dietary restriction predicted subsequent binge eating episodes. Restriction is not the solution to binge eating. It is, for most people, one of the engines driving it.
Dieting itself is one of the strongest known risk factors for developing an eating disorder. A landmark prospective cohort study published in the BMJ followed adolescents over three years and found that those who dieted at a severe level were 18 times more likely to develop an eating disorder than those who did not diet, and even moderate dieters were five times more likely. Dieting is not a neutral wellness behavior. It is, for a meaningful percentage of people, the doorway in.
This is why well-meaning advice like “just try harder,” “eat less,” or “go on a program” often makes binge eating worse. The body and brain of someone in a restrict-binge cycle have learned to respond to deprivation with urgency. When food becomes scarce, the nervous system mobilizes. When the rules finally break, the binge is not a failure of willpower. It is a predictable biological and psychological response.
Healing requires the opposite of what diet culture preaches. It requires regular, consistent, adequate nourishment. It requires dismantling the internal rulebook. It requires rebuilding trust with a body that has spent years being treated as an adversary.
What Actually Helps
The good news, and I mean this genuinely, is that binge eating disorder is highly treatable when approached through evidence-based care. Cognitive behavioral therapy, interpersonal psychotherapy, and dialectical behavior therapy all have strong support in the literature. Working with a specialized therapist alongside a registered dietitian who understands eating disorders is often the gold standard. Medication can play a supporting role for some people, though it is not a substitute for addressing the underlying patterns.
If you notice yourself in what I am describing, here is what I would invite you to consider:
Begin by noticing your food rules rather than reinforcing them. Ask yourself what foods feel “off limits,” and recognize that the forbiddenness itself is often what gives those foods their power. Commit to regular meals and snacks, even on days you have binged. Skipping the next meal to “make up for” a binge is the fuel that keeps the cycle burning.
Seek out a clinician who specializes in eating disorders, not a general practitioner, not a weight loss program. The specialization matters enormously. And please, do not wait for the problem to feel “bad enough.” Eating disorders do not announce themselves with a clear threshold. If your relationship with food is causing you distress, that is reason enough to reach out.
A Closing Word
What I want you to take from the AirTalk conversation, and from this piece, is that there is nothing shameful about struggling with food. Our culture made this difficult. Our industries profited from it. Our bodies are doing their best to survive in an environment that has been hostile to them for a long time.
Recovery is possible. I have watched it happen, over and over again, in people who were certain they were beyond help. The first step is almost always the hardest: picking up the phone, writing the email, saying the words out loud to one trusted person.
