The Psychological Architecture of Binge Eating Disorder: A Psychobehavioral Analysis of Core Symptoms, Comorbidities, and Underlying Mechanisms

Abstract

Binge Eating Disorder (BED), formally recognized in the DSM-5, is the most prevalent eating disorder, characterized by recurrent episodes of consuming large quantities of food while experiencing a profound sense of loss of control. While its behavioral manifestations are well-documented, the underlying psychological architecture is complex and multifaceted. This article provides a comprehensive psychobehavioral analysis of the core psychological symptoms of BED, moving beyond a mere description to explore their interconnections and neurocognitive underpinnings. We delineate the cognitive-affective landscape, marked by obsessive food-related cognitions, dietary restraint and disinhibition, and profound feelings of shame and guilt. The role of body image disturbance, often overshadowed in BED literature, is examined as a critical maintaining factor. Furthermore, we explore the central role of emotion dysregulation as a core mechanism driving binge episodes, often within the context of high negative affect and stress. The high comorbidity with mood, anxiety, and impulse-control disorders is discussed, highlighting shared transdiagnostic vulnerabilities. Supported by a synthesis of current literature and illustrative models, this review argues that effective intervention for BED must target these deep-seated psychological mechanisms-specifically, emotion dysregulation, cognitive distortions, and maladaptive coping strategies-rather than focusing solely on eating behavior itself. The integration of cognitive-behavioral, dialectical, and mindfulness-based approaches is presented as the most promising therapeutic pathway. Additionally, this expanded review incorporates a deeper exploration of neurobiological correlates, sociocultural influences, and nuanced treatment adaptations to provide a more holistic understanding of BED.