Binge Eating and the Science Behind Bertie
What is binge eating?
While each person’s experience is unique, key features of binge eating are:
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Eating an excessive amount, and
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Feeling out of control
During a binge, people typically eat and drink at a rapid pace. Many people describe feeling as though they are in a trance-like state, and are unable to stop or control their consumption. Binge eating can be very distressing, with associated feelings of self-disgust, guilt, and shame. Binge eating is therefore typically done in secret and hidden from others (Fairburn, 2013).
When episodes of binge eating are recurrent and severe they may be symptomatic of an eating disorder such as binge eating disorder, or bulimia nervosa if compensatory behaviours (e.g., purging) are also present (American Psychiatric Association, 2022).
Who is impacted?
Around 5% of Australians report a history of binge eating (Australian Bureau of Statistics, 2022). The prevalence of binge eating disorder in Australia is around 1%, with almost twice as many women impacted than men (Deloitte Access Economics, 2024). A recent systematic review estimated that approximately 1.5% of people globally will experience binge eating disorder in their lifetime (Qian et al., 2021). Binge eating is particularly common in women from western countries (Qian et al., 2021). Although people of all ages can be impacted, binge eating issues usually emerge during adolescence or early adulthood (Kessler et al., 2013).
What causes binge eating?
There is no one ‘cause’ of binge eating, however strict dieting and negative emotions are two key factors in the cycle of binge eating.
Dieting and compensatory behaviours
Western society places significant value on thin bodies, particularly for women. As such, many people attempt to achieve the ‘thin ideal’ via weight loss strategies and dieting. Strict dieting, perpetuates and triggers the onset of binge eating: dieting and the associated restriction results in preoccupation with thoughts of food and eating and a sense of deprivation (Jones & Rogers, 2003). In addition to this psychological pressure, restricting food mimics food scarcity (aka starvation) which results in an increase in physiological cravings, particular for calorie-dense foods (Gilhooly et al., 2007; Polivy et al., 2005). With mounting biological hunger and psychological deprivation, subsequent eating consequently feels out of control, and binge eating becomes a natural response to the restriction.
In addition to dieting, other forms of restriction contribute to the cycle of binge eating. Compensatory behaviours aim to control one’s weight/avoid weight gain associated with food intake or binging. Examples of compensatory behaviours include self-induced vomiting, using laxatives, over-exercising, and fasting. While compensatory behaviours may bring short-term relief, they are ineffective at controlling calories absorbed after a binge, may further strengthen the restraint/binge cycle, and are associated with a variety of serious physical health impacts (Kay et al,. 1993; Roerig et al., 2010).
Unpleasant emotions
Many individuals engage in binge eating as a way to cope with difficult emotions, such as stress, sadness, anxiety, shame, or loneliness (Haedt-Matt et al., 2011). For many people binge eating may help people to temporarily numb or soothe their emotions, providing a sense of escape or distraction. Eating may even provide a momentary sense of pleasure as neurobiological reward systems are activated in the brain (Leenaerts et al., 2022). While the act of bingeing provides temporary relief, this is generally short-term, and quickly replaced by negative emotions of guilt, shame, or disgust for binging. Over time, binge eating in response to negative emotions ultimately reinforces a cycle of emotional distress, making future binges more likely and potentially leaving people feeling stuck in this cycle (Schaefe et al., 2020).
How does Bertie help?
Improving access to treatment
Despite being associated with high levels of distress and impairment, only approximately one quarter of those with an eating disorder receive treatment (Hart et al., 2011; Weissman et al., 2017). Although there are a variety of factors that contribute to this treatment gap, common barriers include limited access to appropriate treatments (including barriers to entry, challenges navigating health systems, delays in treatment), cost of treatment, and stigma associated with help-seeking (Hamilton et al., 2022; Kazdinet al., 2017; Penwell et al., 2024). Digital interventions, such as mobile apps, accordingly provide a unique opportunity to overcome such barriers and improve access to treatment for many unserviced people with binge eating issues (Graham, 2024): mobile apps are widely utilised and a low-cost treatment option. Additionally, mobile apps enable access to evidence-based interventions anytime anywhere, extending what is possible within the realms of traditional clinician-led therapeutic treatment. People with binge eating issues are willing to use apps to support their mental health (Anderson et al., 2024), further supporting their utilisation as a low-intensity, self-guided treatment modality.
Evidence-based treatment interventions
Various evidence-based treatments are highly effective for people struggling with binge eating. Of note, self-guided digital interventions (such as mobile apps like Bertie) were recently endorsed as a front-line treatment of binge eating disorder, with the highest level of empirical evidence supporting their use (Australian Psychological Society, 2024). This endorsement stems from the effectiveness of self-guided digital interventions amongst people with binge-eating disorder as well as those with subthreshold experiences (Moghimi et al., 2021).
Bertie utilises the evidence-based approaches of Cognitive Behaviour Therapy (CBT), Mindfulness, Self-compassion, and Dialectical Behaviour Therapy (DBT) throughout the app features. Bertie extends beyond other available apps by integrating different evidence-based approaches into one intervention to enhance the effectiveness and user experience. Bertie supports users’ recovery from binge eating through five main mechanisms:
1. Monitoring and identifying patterns
Monitoring food consumption is a key behavioural intervention from CBT (Murphy et al., 2010). Monitoring provides important information about eating habits and supports users to identify patterns in their eating and binging. Unlike diet-based approaches to meal monitoring, which often involve counting calories or macronutrients, this form of monitoring is about gathering information about eating patterns in a non-judgmental manner to enable users to identify patterns and subsequently make changes. Bertie provides customisable reminders to log users meals and snacks. The chart features enable clear visualisation of emotional and binging patterns over time.
2. Restoring regular eating
Restoring a pattern of regular eating is a very effective approach to overcome binge eating (Södersten et al., 2017; Zendegui et al., 2014). CBT for binge eating encourages a pattern of regular eating comprising 3 meals and 3 snacks each day (Fairburn, 2013). Ideally eating should occur regularly and long gaps of time (e.g., >4 hours) between meals/snacks should be avoided as this can contribute to the mounting psychological and physiological pressures that result in binging. CBT additionally encourages avoidance of any compensatory behaviours, due to their further contribution to the binge eating cycle. Bertie users are advised on this regular eating structure and can customise their notification schedule to support integration of regular eating into their daily life.
3. Developing mindfulness and compassion
Mindfulness involves bringing non-judgmental awareness to the present moment (Kabat-Zinn, 1994). Mindfulness interventions are particularly relevant to binge eating treatment as they can support awareness of internal experiences (e.g., emotions, physical sensations), facilitate self-acceptance and improve one's ability to cope adaptively with emotions (Katterman et al., 2014; Kristeller & Wolever, 2014). Accordingly, multiple reviews demonstrate that mindfulness is effective in reducing binge eating (Grohmann & Laws, 2021; Katterman et al., 2014; Liu et al., 2025).
Additionally, people with binge eating issues often experience high levels of shame and self-criticism (O'Loghlen et al., 2022; Williams & Levison, 2021). As such, self-compassion, whereby individual’s turn towards themselves with kindness and acceptance, particularly in times of suffering, presents as another poignant approach for binge eating treatment (Neff, 2003; Steindl et al., 2017). Recent literature demonstrates that self-compassion practices are effective in reducing binge eating (Morgan-Lowes et al., 2022) and it has been suggested that self-compassion interventions be integrated into treatments for eating disorders including binge eating (Burnett & Davis, 2024).
Bertie includes a tailored meditation program that focuses on developing both mindfulness and self-compassion in the context of binge eating.
4. Effectively managing urges to binge
DBT has a key focus on effectively regulating emotions and managing distress (Linehan, 1993). Recent research supports the clinical effectiveness of DBT for binge eating, including via online and app formats (Cerolini et al., 2024; Linardon et al., 2024). Drawing on this emerging evidence base, Bertie incorporates a DBT-informed audio-visual practice for users to utilise in critical moments - de-escalating urges with the aim of preventing binge eating from occurring.
5. Promoting social connection and community
Social support and being part of a community have been identified as some of the most significant facilitators of recovery amongst people with binge eating disorder (Bremer et al., 2023). Online discussion forums provide an opportunity to exchange information, as well as receive validation, connection, and peer support from others with shared experiences of eating-related issues (Jones et al., 2022; Kendal et al., 2017; Lord et al., 2018). Research shows that discussion forums that are moderated and recovery-focused are populated by users predominantly providing encouragement and support for other users (McCormack, 2010). This type of online connection has also been associated with reported sense of user empowerment from exchanging information, sharing experiences, and finding recognition (Aardoom et al., 2014). Given the potential benefits of this type of social connection as an adjunct to other evidence-based treatments, the Bertie app incorporates a moderated online discussion board to promote social connection and community amongst users.
Conclusion
The Bertie app draws on multiple evidence-based interventions to support recovery from binge eating. The app's features are designed to support regular eating, provide insights into eating and binging patterns, develop skills across the domains of mindfulness, emotion regulation, and compassion, and promote social connection. The app format improves accessibility to an under-serviced population and allows user to integrate evidence-based tools into their daily life and access help when they need it most.
Written by Dr Chelsea Arnold (PhD), March 2025
Dr Arnold is a clinical psychologist and board-approved supervisor. She has a PhD in digital mental health and has worked across multiple universities researching and developing digital mental health interventions including mobile apps. She is currently researching predictors of eating-related issues across the lifespan.
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