Here’s What To Know About Binge-Grazing And Binge Eating After WLS
May 19, 2025Did you struggle with binge eating disorder (BED) before bariatric surgery? Can it be an issue now? How is BED related to binge grazing? And what does that really mean anyway? I had the opportunity to interview psychologist and certified eating disorder specialist Kelly Broadwater, along with registered dietitian Chaundra Evans, who specializes in bariatrics and eating disorders, to get clarity for you.
Kelly said it’s estimated that over 40% of bariatric patients struggle with binge eating disorder. The main issue they see with BED is the tie to a loss of control. Feeling like you can't eat enough, can't stop eating. You're consuming a large amount in a short period of time, eating rapidly, eating until you're uncomfortably full, or maybe even sick, which is pretty common with bariatric surgery because the pouch or the sleeve really lets you know. Also, eating when you’re not hungry. Often this is happening in secret. Eating alone because you’re embarrassed by the amount you’re eating or what you’re eating.
And then there's a whole host of things that happen afterwards. You may feel disgust, guilt, shame, or depression, which can start the cycle of eating even more because you feel bad about what you’ve done.
There is no one absolute eating behavior. Some people really follow the bariatric guidelines all day. And then, there's a reactive release, and they'll engage in binge eating more at nighttime. And then, for some people, it's more inconsistent eating, a little bit here, a little bit there, throughout the day. It really depends on the person, what their pattern is, what their triggers are, and what their environmental setup is day to day.
Did You Know?
Bariatric surgery is not a cure for an eating disorder. Be aware of that if you're dealing with one.
Chaundra shared that the binge eating disorder is themost prevalent eating disorder, and it's also the most commonly recognized eating disorder in bariatric candidates. When Chandra and Kelly meet someone for a bariatric evaluation, it's the eating disorder they’re most likely to see. For those that are struggling with bingeing disorder preoperatively, it may actually start to reoccur again about two years after surgery when the honeymoon phase is over and the newness of the surgery is gone. Weight loss may be maximized at this point, and it’s easy to get back into old behaviors. If you’re being impacted by this, it's really valuable to be proactive in developing a relapse prevention plan with your support team. Chaundra, Kelly, and I are all big advocates of getting support, being honest with yourself, talking about what your struggles are, and getting help.
Many of you have heard the term binge grazing, and you might be thinking, I don't know exactly what that is. I asked Chandra and Kelly about the difference between binge grazing and BED. Binge grazing is consuming a small amount of food over a long period of time. So because of the smaller stomach with bariatric surgery, you’re unable to consume a large amount of food in one sitting, but cumulatively can consume enough food throughout the day to actually constitute a binge.
It can be hard to diagnose when you're trying to identify what is considered a large amount of food, so consider that there is uncontrolled eating, loss of control eating, continuous eating, and even picking and nibbling. How common is binge grazing? These behaviors are recognized in 20-60% of bariatric patients.
To clarify, binge grazing is the combination of eating a large volume of food but in smaller amounts over time because you're a bariatric patient. It is loss-of-control grazing. And it’s often on things that are soft calories and liquid calories.
Did you know?
Binge grazing is actually one of the most prominent behaviors that contributes to weight regain.
What about triggers? Kelly shared that some research suggests binge eating disorder should really be called reactive eating disorder instead because you're reacting to something emotionally or environmentally. In treating her patients, Kelly sees mental health issues such as depression or anxiety tied to binge eating. She suggests this is because binging puts you in an autopilot, numb, dissociative kind of state. You're not thinking about anything else. Food is used to comfort emotions, and if you keep a food record, you may start to recognize these emotional patterns or triggers. As a dietitian, Chaundra often sees slider foods, those highly palatable foods, as the foods that tend to be most triggering. Soft-textured or crunchy processed snacks, things like chips, crackers, and pretzels. Also liquid calories, such as sweet tea and sugary coffee drinks that can be consumed in large volumes and easily slide through the pouch virtually pain-free unless you have dumping syndrome from these foods.
If you recognize yourself here with the slider foods, it’s time to be really intentional with three planned meals and one or two snacks a day. Sometimes they can be really simple, like a protein shake or a low-fat frozen meal. But do prioritize meal planning because eating every three to four hours helps honor the body's needs and prevents impulsivity of food choices that are often accompanied with under-eating.
Don’t miss this. Binge grazing is actually one of the most prominent behaviors that contributes to weight regain. You may find yourself turning to food for comfort, for procrastination, for distraction, to make your soul feel better, or to have less pain because eating feels good a lot of the time. So, it's not about the food, which is a hard concept to comprehend because that's where the obsession is. If you see yourself binge grazing, early mental health intervention is key. But even if you don't recognize these triggers and behaviors, ask for help in identifying where these emotions are coming from so you have different coping mechanisms and can set your environment up for more success. Recovery is really about coping and healing emotional wounds.
Bariatric dietitian Dr. Susan Mitchell is host of the podcast Bariatric Surgery Success.
 | ABOUT THE AUTHOR Bariatric dietitian Dr. Susan Mitchell is host of the podcast Bariatric Surgery Success. Selected as one of the Best 35 Dietitian Podcasts, Bariatric Surgery Success was chosen from thousands of podcasts on the web ranked by traffic, social media followers, domain authority, and freshness. With a focus on nutrition before and after bariatric surgery, I help you eat for success while you conquer cravings, emotional eating, and weight regain. Read more articles by Susan! |
