Overeaters Anonymous: An Overlooked Intervention for Binge Eating Disorder

Abstract

The purpose of this communication is to provide an overview as well as the strengths and weaknesses of Overeaters Anonymous (OA) as an intervention for binge eating disorder treatment. Binge eating disorder is associated with low remission rates, high relapse rates, treatment dissatisfaction, and high rates of failure to receive treatment attributed to stigma, misconceptions, lack of diagnosis, access to care, and inadequate insurance coverage. New interventions are needed that can overcome these barriers. OA is a twelve-step program and established fellowship for individuals who self-identify as having problematic relationships with food or eating. OA can be referred clinically or sought out by an individual confidentially, without a diagnosis, and free of charge. OA’s Nine Tools, Twelve Steps, and Twelve Traditions can provide structure, social support, and open, anonymous sharing that fosters a sense of connection and belonging. This may provide benefit to individuals who value structure and social support in their recovery. The tradition of anonymity may also create some challenges for conducting research and may explain the shortage of empirical support. This commentary reviews existing research findings on the effectiveness of twelve-step interventions and OA. Common misunderstandings about and within OA are also addressed and OA’s limitations are discussed. Overall, OA provides a promising option for binge eating disorder treatment that warrants clinical research on its feasibility and efficacy in a way that respects and protects its tradition of anonymity.

Clinical aspects of binge eating disorder: A cross-sectional mixed-methods study of binge eating disorder experts' perspectives

“…Thus, our findings also underscore the importance of equal and adequate screening for binge eating disorder across race, ethnicity, sexual and gender orientation, body weight/shape/size, and socioeconomic status. It is also important to identify ways to include marginalized individuals who do not have access to adequate information, screening, or treatment in binge eating research and help find treatment interventions accessible to them [see ( 18 , 79 )].…”

Features of Addiction in Binge-Eating Disorder: Considerations for Screening and Treatment

“… 93 Twelve-step programs of food addiction and Overeaters Anonymous encourage abstinence from foods and use food plans that encourage members to eliminate certain foods. 94 These programs are common, but these interventions have not been tested among individuals with BED. Further research should determine whether all patients with BED should be treated with nonrestrictive strategies or whether a subgroup of individuals might benefit from abstinence-based approaches, and if there were such a subgroup, how to identify them.…”

Clinical Considerations of Ultra-processed Food Addiction Across Weight Classes: an Eating Disorder Treatment and Care Perspective

“…If the latter is present, nutrition interventions aimed at reduced exposure to ultra-processed foods while simultaneously pursuing weight restoration may be clinically appropriate. It may also be useful to discuss the pros and cons of engaging in a 12-Step program for compulsive eating, as these groups can be attractive to those feeling misunderstood by clinicians but can reinforce restrictive ED symptoms in some cases [ 125 ]. It is important to assess for DR and other compensatory behaviors (e.g., excessive exercise) in the absence of clinically significant ED that may be driving weight loss.…”

“…Targeting positive social connections is beneficial for other forms of addiction recovery and should not be overlooked in disorders of eating [ 45 ]. 12-Step programs such as Overeaters Anonymous is one well-established example [ 125 ]. The addiction framework may reduce perceptions of personal failure [ 138 •] which may be ameliorated through engagement with a like-minded community.…”