Binge Eating Disorder & Alcohol Use: The Neuroscience Behind the Overlap
by San Diego, California binge eating therapist, Dr. Marianne Miller
Binge eating disorder (BED) and alcohol use often intersect in ways that are both behavioral and neurological. Both conditions involve patterns of impulsivity, emotional regulation, and coping mechanisms, with similar effects on the brain’s reward system. For many, the two can become intertwined, creating a cycle of bingeing that involves both food and alcohol. Understanding the neuroscience behind this connection can shed light on why these behaviors co-occur and how they can be treated effectively.
Binge Eating Disorder and Alcohol: The Neurobiology of Reward
At the heart of both binge eating and alcohol use is the brain’s reward system. The brain responds to both food and alcohol by releasing dopamine, a neurotransmitter that reinforces pleasurable behaviors. When we eat food that brings us pleasure, the brain experiences a surge of dopamine, which creates a feeling of satisfaction. Along a similar vein, alcohol consumption also triggers dopamine release, offering a brief “high” or sense of relief.
Here are where things differ between food and alcohol: overly relying on alcohol for pleasure can cause the brain’s reward system to become less sensitive to dopamine. As a result, individuals may need to consume more alcohol to achieve the same level of satisfaction.
Food does NOT have similar properties as alcohol in that the more you binge eat, the less satisfaction you experience. People with binge eating disorder actually get more pleasure out of eating than individuals who don’t have an eating disorder.
What can increase binge eating behavior is the numbing or avoidance of uncomfortable emotions. Plus, when you binge eat, you feel a rush of shame and guilt, which often lead to restricting food. Such restriction creates a psychological deprivation (obsessing about food) and physiological deprivation (extreme hunger/glucose deficit) that makes it near impossible not to binge. It’s a destructive cycle.
Impulse Control and Decision-Making: The Role of the Prefrontal Cortex
Another key area of overlap between BED and alcohol use is the prefrontal cortex, which is responsible for impulse control, decision-making, and planning. When functioning optimally, the prefrontal cortex helps us weigh the consequences of our actions and resist impulsive behaviors.
In both BED and alcohol misuse, however, the prefrontal cortex often shows reduced activity, leading to a diminished ability to regulate behavior. When someone is under the influence of alcohol, this reduced activity becomes even more pronounced, making it harder to control urges to overeat or drink. The combination of impaired impulse control and a hyperactive reward system can make binge eating more likely, especially in social or emotionally charged settings.
Emotional Regulation and Coping: The Amygdala’s Involvement
The emotional component of both BED and alcohol use stems largely from the brain’s amygdala, which processes emotions like fear, stress, and anxiety. For many individuals, binge eating and drinking serve as coping mechanisms to manage overwhelming emotions. When someone feels anxious or stressed, the amygdala signals the brain to seek relief, whether through food or alcohol.
Alcohol can initially help numb emotional pain, much like binge eating, but over time, both behaviors contribute to emotional dysregulation. Rather than resolving the underlying emotional distress, they reinforce the use of food or alcohol as a way to avoid dealing with difficult feelings. This emotional avoidance becomes a cyclical process, where both behaviors feed into one another, especially when stress or negative emotions are high.
How Drinking Alcohol Makes People More Susceptible to Binge Eating
Alcohol’s effects on decision-making and impulse control make individuals more susceptible to binge eating in a number of ways:
Lowered Inhibitions: Alcohol impairs the prefrontal cortex, which is responsible for self-control and rational decision-making. When this part of the brain is underactive, it becomes much easier to give in to cravings or impulsive behaviors, including overeating. Even for individuals who typically manage their food intake well, alcohol can make it difficult to stick to these intentions.
Increased Cravings: Alcohol can also directly increase hunger signals. Drinking alcohol, especially in large amounts, lowers blood sugar levels, leading to feelings of hunger. This drop in blood sugar can trigger cravings for high-calorie, carbohydrate-rich foods, which the brain associates with quick energy and pleasure.
Reward System Overlap: Alcohol enhances the brain’s reward system, which makes the consumption of food more rewarding. After drinking, the brain may experience heightened pleasure from eating, especially foods that are already seen as “taboo” or “indulgent,” such as sweets, fried foods, or overall calorically dense foods. Drinking alcohol makes it easier to eat without feeling as much guilt or self-regulation in the moment.
Emotional Eating: Alcohol is often used to cope with emotions like stress, loneliness, or sadness. In these situations, the combination of emotional vulnerability and reduced impulse control can lead to binge eating as a way to further soothe emotional distress. Many people find themselves turning to food after drinking because their emotional defenses are already down, and food offers another source of comfort.
Environmental Triggers: Social environments where alcohol is consumed, such as parties or gatherings, often involve the availability of large quantities of food. Alcohol can make individuals more likely to mindlessly eat in these settings, consuming more than they intend simply because the food is there and their inhibitions are lowered.
Neurotransmitter Imbalances: Dopamine, Serotonin, and GABA
Beyond the effects on the reward system, alcohol and binge eating affect several neurotransmitters that regulate mood and behavior:
Dopamine: Alcohol consumption and binge eating affects how much the brain is able to capture dopamine, reinforcing these behaviors as ways to seek pleasure or relief. With alcohol, it leads to tolerance, where more alcohol is needed to achieve the same level of satisfaction. With food, individuals with BED receive more pleasure from eating than folks without BED. It’s therefore easier to turn to food for comfort.
Serotonin: Low levels of serotonin are linked to mood disorders and can contribute to both binge eating and alcohol misuse. People with low serotonin levels may use food or alcohol as a way to self-medicate feelings of depression or anxiety.
GABA (gamma-aminobutyric acid): Alcohol increases GABA activity, which reduces feelings of anxiety and creates a sense of calm. In the context of BED, however, GABA imbalances can lead to higher levels of anxiety, which may drive binge eating episodes.
Stress and the HPA Axis: The Role of Cortisol
Stress is another key factor that links binge eating and alcohol use. Both behaviors activate the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the body’s stress response. Chronic stress leads to elevated levels of cortisol, the stress hormone, which can increase cravings for both high-calorie foods and alcohol.
When someone is under constant stress, their brain becomes primed to seek out comfort in the form of food or alcohol, creating a cycle where stress fuels both behaviors. Alcohol can temporarily reduce cortisol levels, but once the effects wear off, cortisol spikes again, leading to renewed cravings for food or alcohol.
Neuroplasticity and the Potential for Recovery
The brain’s capacity for neuroplasticity offers hope for recovery from both BED and alcohol use. While both conditions involve deeply ingrained neural pathways, the brain can rewire itself with the right treatment and support.
Cognitive-behavioral therapy (CBT): Helps individuals identify and change harmful thought patterns that contribute to binge eating or alcohol misuse.
Mindfulness-based interventions: Train the brain to become more aware of triggers and help build healthier emotional regulation skills.
Medication: For some, medications that target neurotransmitter imbalances, such as SSRIs or SSNRIs for serotonin, can support recovery by improving mood and reducing urges to binge eat or drink.
Treating BED and Alcohol Use: A Comprehensive Approach
Effective treatment for individuals struggling with both BED and alcohol misuse requires an integrative approach that addresses both behaviors simultaneously. This might include therapy, medical support, and peer groups that offer a non-judgmental space to explore these issues and develop healthier coping mechanisms.
Moving Toward Lasting Change
Understanding the neuroscience behind the connection between binge eating and alcohol use can help individuals navigate their path to recovery. The brain’s reward system, emotional centers, and impulse control mechanisms play significant roles in both disorders, but with the right interventions, the brain can heal.
Recovery is a journey that involves unlearning old habits and creating new, healthier neural pathways. With time, support, and self-compassion, individuals can break free from the cycle of binge eating and alcohol use, finding healthier ways to cope with life’s challenges.
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