Implementing a Binge Eating Intervention


Morelife piloted a new Binge Eating Intervention in September 2021 to support a cohort of clients displaying severe binge eating behaviours. The aim of this pilot was to provide the binge eating intervention prior to starting the main weight management intervention to see if this improves client outcomes. The Binge Eating intervention is 12-weeks in duration and consists of individuals working through a manual alongside seven telephone support sessions from their trained guide. Once clients complete the Binge Eating Intervention, they then enter our standard 1-year weight management intervention.

This pilot is still ongoing as some of the clients are still on programme, however, we include the quantitative and qualitative findings and results we have gathered so far.


To identify those clients who are most suitable for this pilot, we introduced the Binge Eating Scale (BES) questionnaire into our initial triage. This is not a diagnostic tool and screens for binge eating rather than binge eating disorder. The BES is a 16-item questionnaire assessing the presence of certain binge eating behaviours. Once complete, it is scored and results are between number between 0 and 46. Clients are classified as having no binge eating (score ≤ 17), mild to moderate binge eating (score of 18 – 26) and severe binge eating (score ≥ 27). Those clients who scored 27 or above were offered the binge eating intervention prior to starting our standard weight management intervention (see Appendix I for details).

During the triage phase we identified that 33% of clients scored 27 or above for the BES questionnaire and were eligible for this pilot.

Case Study from a client who participated in the Binge Eating Intervention

“I had tried weight loss journeys in the past but couldn’t find the right support network to help guide her in the right direction. Then she found Morelife, who helped her feel less lost.”

Before I started the binge eating course through Morelife, I was struggling with my mental and physical health. I felt like my body was a barrier that was getting in the way of me living my life how I wanted to.

I was in pain and always felt exhausted. I worried about the way I looked and what other people would think of me. I felt like I was letting my kids down because I couldn’t do all of the things that I wanted to do with them. I felt so anxious and avoided going outside because I felt so much safer in my own home.

I realised I couldn’t sustain this way of life any longer. I wanted to start making changes. I had gotten engaged and wanted to look back at my wedding photos with pride. I wanted to go on family holidays. I wanted to live a long, healthy life and be able to meet my great-grandchildren. I had never felt so committed and motivated in my life.

The weight loss programmes I had tried in the past were so restrictive. They would focus on cutting out entire food groups or having a strict exercise routine. Everything felt so negative, and I never had the right kind of support. I always felt like I was doing it alone.

Morelife was so different. I completed the binge eating course. I’m currently on the weight management programme, where I am learning about healthier approaches to food.

I have learnt about calorie counting and portion sizes, but most importantly I have learnt about balance. I have learned to look at changes as a lifestyle and not a “diet.” For once in my life, I’m eating a balanced diet and not eliminating any food groups.

I also learnt that a healthy lifestyle isn’t always about food, diet and exercise. My mental health plays a big part too.

My practitioner – Lucy – who helped me through the binge eating course was wonderful. She helped me to gain a lot of faith in myself. I learned to look at things differently; how to be more mindful and present in the moment. This helped me during mealtime because if I’m more present, I am less likely to overeat.

I also have support through my group. At first, I was so scared to be on Zoom calls with strangers, but they quickly became good friends. We offer each other tips, recipes, and advice. We encourage each other every day.

My journey with Morelife started with the binge eating course. However, losing weight has only begun since starting the weight management course.

I am almost at my 5% weight loss goal after five sessions. I’m planning and preparing meals. I have my support group, as well as my family. I no longer feel alone.

When I started Morelife I doubted myself all the time. I still have a long way to go, but I’ve already come so far. I’m confident Morelife will help me keep the weight off because I have been provided with the tools and information that I need to live a better, healthier life. I’m so grateful I was given this amazing opportunity.

This programme has been so much more than eating habits and weight loss. I have learned a whole new way of life which I love. I have become a much better person through Morelife. I cannot thank the team enough.

“This client is continuing their weight management programme with Morelife and is confident in continuing to build the healthy habits that will last her a lifetime.”

Quantitative Results

Number of eligible clients contacted and offered programme – 33 clients

Number of clients not interested/could not contact – 11 out of 33 clients (33%)

Number of clients started (Attended 1 or more sessions) – 22 out of 33 clients (67%)

Number of clients dropped out during programme – 7 out of 33 clients (21%)

Number of clients completed Binge Eating Programme – 10 out of 22 clients (45%)

Number of clients currently on Binge Eating Programme – 5 out of 22 clients (23%)

Total number of completers including potential completers – 15 clients out of 22 (68%)

Binge Eating Scale (BES) Results

Once clients complete the 12-week binge eating programme we resent the Binge Eating Scale (BES) questionnaire sent previously within the initial triage phase. We compared the results to find out if there were improvements in clients binge eating behaviours after the 12-week intervention. The average scores from the pre-intervention and post-intervention have significantly reduced after the 12 weeks which can be seen below indicating that binge eating behaviours have reduced after clients engaged in the binge eating programme.

BES results table

Average Pre-intervention binge eating scale (BES) Average Post-intervention binge eating scale (BES)
33 16

Results – Client/Progress

Results - Client/Progress

Client Progress/Status Benefits client has noticed since attending the binge Eating Intervention Pre-intervention Binge Eating Scale (BES) score Post-intervention Binge Eating Scale (BES) score
1 Completed 12-week binge eating intervention – currently on the standard weight management programme at week 6 Feels very happy with their progress, eating more regularly since attending, feels very supported and feels that this programme has helped control binges. Has noticed they have experienced less negative/unhelpful thoughts and have better control over these thoughts. 40 11
2 Completed the 12-week Binge Eating Intervention – booked onto weight management programme starting 9th March 2022 This client explained that they find change challenging due to their autism, mental health and also being a carer for their son, so having a routine is really important to them. Since starting the programme this client has started to make changes in their self-care routine, by being kinder to themselves, especially after having a difficult day with their mental health, this is enabling this client to recover quicker. They have also started to feel more comfortable eating in front of their partner during the programme which was a huge step for this client. They have also recognised that restricting food or eating too much triggers binge eating which has increased this client's awareness to make change. 31 16
3 Completed the 12-week Binge Eating Intervention Client has noticed that they are starting to question their thoughts and habits around food more, they are also trying not to restrict themselves around food which has triggered off binge eating in the past and has increased their anxiety levels. This client is also focusing on changing their all or nothing thinking and is improving their self-care by taking 1 day off during the week, which is improving their overall wellbeing. 42 Awaiting for their questionnaire to be returned
4 Completed the 12-week Binge Eating Intervention - currently on a weight management programme at week 3 The client has become much more aware of their relationship with food and has now felt more confident to eat out which is something they have found difficult in the past and have noticed they have reduced overeating. Another outcome from participating in the binge eating programme, this client recognised that they needed some support with their mental health, this came up during one of their sessions with the practitioner. We understand that due to the topics discussed within the content of the sessions and the rapport built between the client and the practitioner, this helped the client to recognise their struggles and to feel comfortable in approaching their practitioner regarding some support with their mental health. We have since made connections with the local mental health team and they are helping provide this client with further support. 31 31
5 Completed the 12-week Binge Eating Intervention - currently on a weight management programme at week 3 Client wanted to improve the relationship with their body image, they now feel confident to go out for meal, which they found particularly difficult to do in the past. This client also experienced mental health and personal problems during the programme, this client felt extremely happy with their progress on the programme considering the challenges and is focused on tackling negative thoughts around body image. 37 Awaiting for their questionnaire to be returned
6 Completed the 12-week Binge Eating Intervention - currently on a weight management programme on week 6 Client has explained that they have learnt a lot about their relationship with food particularly how this is related to mood. The client spoke about how they are saving money by reducing their takeaways which is enabling them to pay off debt repayments. 30 9
7 Completed the 12-week Binge Eating Intervention - currently on a weight management programme on week 6 This client provided us with a case study on their journey please see pages 2 and 3 of this report. 27 15
8 Completed the 12-week Binge Eating Intervention - currently on a weight management programme on week 6 This client has focused a lot on self-care, and habits around eating with stress and has particularly focused on their past relationships which have been a trigger, they became aware of this whilst doing the programme that binging is linked to their emotions and past relationships. 28 29
9 Still on Binge Eating programme up to session 4 The client has been completing a food diary and eating more regularly since starting the programme. This client is focusing on their negative/unhelpful thoughts and feelings around eating and has also started walking regularly which the client reported is helping. 33 Not finished the programme
10 Still on Binge Eating programme up to session 4 This client is a carer for her parents who have dementia so eating full and regular meals throughout the day is an important goal whilst on this programme. This binge eating programme has also enabled this client to focus more time on themselves to help support their wellbeing. 29 Not finished the programme
11 Completed Binge eating Intervention – Booked onto weight management programme due to start (30/3/22) This client has been focusing on mindfulness and challenging unhelpful thoughts around food and has decided not to weigh themselves for the time being as this can be a trigger. This client is now regularly eating 3 meals a day and has started to introduce snacks in between meals to reduce feeling too hungry in between meals which can lead onto binging. There have been times when this client feels they have lost control, however, they reported that they did feel less guilty afterwards which they regarded as a positive, as this enabled them to recover more quickly from this emotion and to get back on track. 42 Awaiting for their questionnaire to be returned
12 Completed the 12-week Binge Eating Intervention - currently on a weight management programme on week 6 The client is now maintaining a new behaviour of eating 3 meals per day, on days they were unable to eat 3 meals the client reported that they now have the awareness to remind themselves in that moment to eat a meal instead. During session 4 this client reported 0 binges over a two-week period and reported that eating 3 regular meals a day has helped with this. This client also mentioned that they are sleeping better and have more energy. This client reported that they experienced 1 binge between sessions 5 and 6, however still maintained 3 meals a day, they explained that when they did binge instead of beating themselves up, they changed this and put it down to a bad day and moved on the following day, therefore recovery time was a lot quicker. Client reported that they feel really happy with their progress and have felt motivated to set a goal to book a personal trainer for January to help increase physical activity. This client reported that they now feel more ready to start the weight management programme moving forward. 41 4
13 Still on Binge Eating Invention – session 2 complete Client is housebound, so is currently focusing on physical activity by walking around their garden several times a day. The client felt comfortable to open up with their challenges around binge eating which was triggered due to loneliness. We are currently supporting this client with external services. 41 Not finished the programme
14 Still on Binge Eating Intervention – session 4 complete From attending this intervention, this client has felt comfortable expressing their challenges around their mental health, we are currently exploring mental health services with this client. 29 Not finished the programme
15 Still on Binge Eating Intervention – session 4 complete This client has expressed triggers and influences around being bullied as a child, this programme has enabled them to learn about how this has impacted their thoughts and feelings. This client has made progress with regular eating and understanding their triggers over binge eating and has felt more mindful which has helped their portion control. 27 Not finished the programme

Overall, clients in this pilot group felt that the binge eating programme was extremely beneficial and the preferable option to attend before going straight into our standard weight management intervention. Not only did this pilot support clients with changing their behaviours around food, some clients also expressed a need to receive further support with their mental health, as a service we supported these clients by signposting and referring to the local mental health services and informing their GP. We also were able to capture this qualitative feedback below from clients:

My practitioner – Lucy – who helped me through the binge eating course was wonderful. She helped me to gain a lot of faith in myself.’

‘I normally don’t go out for very long because of my anxiety, I usually jump out of the car get what I need and get back in the car, but this time I purposely spent longer out and also spoke to someone which is something I would have not done in the past.’

’I’m now beating myself up less, and taking care of myself.’

‘Reflecting much more on hunger and fullness level, and recognising stress is a trigger for my emotional eating.’

Reasons why clients dropped out

One client was not interested in taking part in the programme because they felt that talking about it would make the binging worse, and they explained that they were not able to complete the programme within the current structure. They decided they wanted to go straight onto a weight management group.

Two clients were interested but dropped out due to covid and health related reasons.

One client qualified and was offered the binge eating programme however they felt that binge eating was rare for them so was not interested and wanted to go straight onto a weight management group.

One client completed session 1 and dropped out afterwards, they reported that they found it awkward and uncomfortable when completing some of the activities within the handbook and wanted to move straight onto a weight management programme.

Three clients reported that they were not interested in the binge eating programme and wanted to move straight onto a weight management programme.

Four clients expressed interest in the programme and was sent the handbook, when the practitioner attempted to make contact for session 1, we were unable to contact the client and unfortunately lost contact.

Another client we lost contact with after they attended session 1, unfortunately we were unable to get in touch with this client to gain any feedback.


During this pilot we experienced some challenges around client attendance due to various factors including illness, unforeseen circumstances and clients not showing up for their session. This created some challenges around the scheduling, and practitioner capacity which was increased to enable additional time to follow up with these clients. We are currently looking into ways to improve attendance, monitoring and accountability. One idea we have is a self-booking system, in which clients can log in and book their own sessions, we have seen this system implemented in other services and have seen good attendance from this.


Overall, the results gathered so far from this pilot show that clients who received the 12-week binge eating intervention reported positive feedback around changes in their eating behaviour, mental health and overall wellbeing. The average results from the Binge Eating Scale (BES) questionnaire sent out pre and post-intervention, show a significant reduction in the binge eating scores after 12 weeks, which indicates a reduction in binge eating behaviours.

Appendix 1

Intervention structure

When Activity
At triage Client completes the BES as part of the triage process. These with a score of 27 or above are identify as suitable for the GSH programme.
Prior to initation into GSH The trainer practitioner has a telephone consultation with the client in order to: • Ensure the client is not engaging in purging behaviour that may indication bulimia nervosa. • Give the client information on the format and aims of the GSH programme • Allow the client to choose whether they would like to be considered for the GSH programme prior to the standard intervention. The client will then need to be taken to our MDT so that the Clinical Lead Psychologist and specialist dietitian can approve their initiation into this pathway.
Week 1 Client receives manual and has a one-hour telephone session with the practitioner.
Week 2-4 Client works through manual and receives weekly telephone sessions with the practitioner.
Weeks 5-8 Client works through manual and receives bi-weekly telephone sessions with the practitioner.
Weeks 9-11 Client works through the manual on their own.
Week 12 Client receives final session with practitioner. They will also once again complete the BES to check whether score has reduced.
Week 13+ Client will enter the intensive phase of the standard weight management programme.