Work

Binge eating and purging behaviors in the general population of Flanders: prevalence rates and help-seeking behaviors

Year: 2026

Type: article

Abstract: This study aimed to estimate the prevalence of binge eating and purging behaviors (BPB), help-seeking, the use of professional treatment or counselling and of prescribed medication for emotional or substance use problems, and barriers to treatment in a representative sample of the general adult population of Flanders, Belgium. We also compared study outcomes in different population subgroups, including BPB groups (binge-only, purge-only, combined BPB) and respondents with other mental health problems. Self-report web surveys were obtained from 6,401 respondents across the Flemish and Bruxelles regions of Belgium. As part of the World Mental Health initiative of the World Health Organization, the survey screened lifetime and 12-month BPB, mental health disorders, treatment access, and barriers to treatment. One in seven (15.0%) respondents reported 12-months BPB, and 17.9% lifetime BPB. Lifetime and 12-months access to any treatment was received by 36.9% and 19%, respectively. The most common barriers to treatment were preference to handle problems alone, subjectively high costs of treatment, and uncertainty regarding where to find help. Barriers to treatment were different across BPB groups, with a positive, dose-response association between number of BPB symptoms and barriers to treatment’s scores. BPB prevalence is high among the general population of Flanders, Belgium, and there is an unmet mental health treatment need in this population. Clinicians and researchers need to identify effective ways to overcome treatment barriers in this population. Binge eating and purging behaviors are more widespread than commonly assumed: nearly 1 in 5 adults in Belgium reports to have experienced them at some point in their life. This number rises to 1 in 3 among young adults under 25 years. Despite being common and related to a wide range of mental health problems, most people never access help for any emotional or substance use problems. Two out of three respondents reporting them had never received any mental health treatment. Respondents reporting binge eating and purging behaviors experienced higher levels of subjective barriers to treatment. This might require specific strategies for policy makers to overcome the treatment gap in this part of the population. This is one of the first studies of its kind based on a large, representative sample of the general public, not only focusing on people who are already in treatment. Binge eating (eating very large amounts of food in a short time, feeling out of control) and purging (making yourself vomit, or using laxatives or else to avoid gaining weight) are more common than many people realise. In this study, we asked over 6,000 adults in Belgium about these experiences and whether they had ever sought help for them. We found that nearly one in five adults reports to have experienced binge eating or purging at some point in their life. Among people under 25, the figure was closer to one in three. Despite this, two out of three people who experienced these behaviours had never received any kind of mental health support. The most common reasons for not seeking help were wanting to deal with the problem on their own, concern about the cost of treatment, and not knowing where to find help. People with binge eating and purging behaviours also reported feeling more embarrassed and more worried about what others would think compared to people with other mental health difficulties. These findings highlight the urgent need for better awareness, reduced stigma, and clearer pathways to support for people experiencing these behaviours.

Source: Journal of Eating Disorders

DOI: 10.1186/s40337-026-01801-9