I am in the passenger seat of my own body: A qualitative interview study of the relationship between binge eating and concurrent problematic alcohol use

Background The association between binge eating and alcohol use disorders (AUDs) has been demonstrated in genetic, population-based, and clinical studies. Individuals with binge eating report more binge drinking and heavier alcohol consumption than those with eating disorders (EDs) without binge eating. Co-occurring EDs and AUDs are linked to higher levels of ED symptoms, depression, anxiety, and more severe psychosocial impairment compared with EDs alone. The aim of this qualitative study was to explore how adults with concurrent binge eating and perceived alcohol problems experience these two conditions and their potential interrelationship. Such insight is needed to improve understanding of functional links and perpetuating processes that may complicate treatment. Methods Twelve adults with concurrent binge eating and problematic alcohol use were recruited from a public specialized ED clinic in Stockholm, Sweden, or through an ED patient-organization website between 2024 and early 2025. All interviews were analyzed using reflexive thematic analysis following the principle of Braun and Clarke. Results Four themes were identified. Binge eating and problematic alcohol use were shown to be closely interconnected, as co-occurring emotion regulation strategies, and alcohol being involved before and as part of binge eating situations. Alcohol use maintained the ED, by increasing vulnerability to binge eating, offering short-term relief from ED-related cognitions on restriction, and self-critical views, and being a safety behavior to reduce e.g. body shame in public contexts. Negative responses from healthcare providers regarding concurrent alcohol problems hindered appropriate treatment seeking for both conditions. Conclusions These findings demonstrate the functional relationship between binge eating, and alcohol use, and the maintenance processes of the two conditions. Integrated treatment for both conditions, as well as preventive efforts through earlier identification of alcohol problems in individuals with binge eating difficulties are warranted. Trial registration : The study has not been publicly registered.