TL;DR
If you have bulimia nervosa, being at a weight lower than your body’s natural high point ( known as weight suppression) may actually be fueling your binge eating. When the body is pushed below its natural weight, hormones like leptin drop, metabolism slows, and appetite increases, making bingeing the body’s way of fighting back against starvation. Research shows that people with bulimia nervosa often start at a higher-than-average weight before their illness, lose significant weight as the disorder progresses, and end up well below their personal highest weight, even if they appear to be in a “normal” weight range. On average, that gap is around 30 pounds.
Greater weight suppression is linked to more severe symptoms, longer illness duration, and a stronger drive to binge and purge. The takeaway: if you’re still bingeing despite eating regularly, your body may be signaling that it needs to weigh more. Recovery may mean accepting a higher weight than you currently prefer. One that is genetically appropriate for you specifically. While that can be a difficult psychological shift, weight gain may reduce food preoccupation, ease bulimic symptoms, and significantly improve quality of life. If this resonates, consider seeking therapy for binge eating disorder and bulimia to guide your recovery.
Weight Suppression and Binge Eating: What You Should Know
If you have bulimia nervosa, did you know that being at a weight that is too low for your body could be a problem? And that it could be driving your binge eating and other behaviors.
Many people are aware that patients with anorexia nervosa need to gain weight in order to recover, but few people are aware that this may also apply to people with bulimia nervosa. This article will review research on the role of previous and current weight on the development and maintenance of bulimia nervosa.
What is Weight Suppression and Why Is It a Problem?
Weight suppression is the difference between one’s highest adult body weight and one’s current weight. It can also be thought of as the amount of weight one has lost from a previous high weight, most commonly in response to dieting.
Human bodies exist in a variety of shapes and sizes. When a person of any size tries to reduce their size to smaller than that intended by their genetics, binge eating may be the body’s natural defense to avoid death by starvation and return the body to a healthier, higher weight.
Weight loss decreases metabolism and the amount of energy the body burns. It also seems to increase appetite. The hormone leptin, which sends satiety signals to the brain, is believed to play a role in this process. Studies indicate that individuals with high weight suppression—that is, who have lost a lot of weight—appear to have lower levels of leptin. For these reasons, there is a strong biological predisposition to regain lost weight.
Early Research on Weight Suppression in Bulimia Nervosa
In 1979, Gerald Russell published a seminal paper that first described bulimia nervosa as a variant of anorexia nervosa. In this paper, he noted that weight suppression seemed to play a role in the development of bulimia nervosa. He described these patients as trying to drive their weight below a healthy body weight and, as a result, starting to binge and purge.
In Russell’s initial study of 30 patients with bulimia nervosa, 17 had previously met full criteria for anorexia nervosa, including low weight. Another 7 patients had also lost weight, but not enough to qualify for anorexia nervosa. Every patient but one had experienced at least some weight loss prior to the onset of bulimia nervosa
Despite this early account, prior to the last 15 years, there was not much research on weight suppression. More recently, several researchers have begun to study the impact of current and past weights on eating disorders. Although still in its early stages, this research is helping us to better understand the dangers of weight suppression.
Recent Research on Weight Suppression’s Role in Bulimia Nervosa
Research indicates that prior to the start of their illness, people with bulimia nervosa often start out at a higher-than-average body weight. As the eating disorder progresses, people with bulimia nervosa seem to lose a significant amount of weight. By the time they present for treatment, they are generally within what is usually considered a “healthy” weight range. But crucially, they tend to be well below their highest adult weights. One study measuring the average degree of weight suppression in people with bulimia found the average amount of weight suppressed was approximately 30 pounds.
These findings indicate that individuals may use bulimic behaviors such as restricting and purging to avoid returning to higher body weights. Not surprisingly, greater weight suppression appears to be associated with more bulimic symptoms and a longer length of illness. Greater weight suppression also predicts weight gain in patients with bulimia nervosa, both during and after treatment. The role of weight suppression is important because it illustrates that bulimia nervosa is not merely caused by psychological factors—complex biological factors are also at play.
Patients with weight suppression and bulimia nervosa who are preoccupied with achieving a lower weight appear to be stuck in a bio-behavioral bind. Their weight suppression makes them more prone to weight gain. But the preoccupation with maintaining a lower weight makes this weight gain highly threatening.
We Need More Research
Researchers do not yet fully understand whether as little as 5 pounds of weight suppression is problematic, or whether only larger amounts of weight suppression are an issue. They also do not know whether the effects of weight suppression are greater if someone was at a higher weight for a longer period of time or whether their weight has been suppressed for a longer time. These are among the answers that researchers studying weight suppression hope to be able to answer.
What Does This Mean for People With Bulimia Nervosa?
Juarascio and colleagues (2017) suggest that some patients who do not recover with a course of Cognitive Behavioral Therapy (CBT) for bulimia nervosa might improve their recovery by gaining weight. It appears that weight gain could reduce the urge to binge and purge. They recommend that clinicians routinely and thoroughly assess for relevant weight history. Juarascio and colleagues also recommend that patients with significant weight suppression and those who gain weight during the initiation of regular eating should receive additional education about the impact of weight suppression on symptoms of bulimia nervosa. They also recommend that clinicians educate patients about the fact that, over time, dieting often backfires and leads to weight gain.
Thus, even if you are eating enough and not restricting intake, continuing to binge may indicate that you need to gain weight. Successful treatment may include accepting that genetics contributes to variations in body size and shape. It also may require you to accept that your appropriate weight may be higher than you now prefer. You are not destined to inhabit the same body as someone else.
Self-acceptance can be hard psychological work, but this is one place where we can help support you. Keep in mind that the alternative to acceptance may be a continuation of bingeing and purging.
How Do I Know If My Weight Is Suppressed?
At EDTLA, these are some of the questions we ask clients to consider:
- Is your current weight lower than your highest adult weight?
- Are you preoccupied with thoughts about food?
- Do you experience episodes of eating in which you eat unusually large amounts of food in a short period of time and feel out of control while doing so?
- Do you eat impulsively–when you haven’t planned to–or engage in emotional eating?
If more than one of the above is true, consider seeking help from an experienced eating disorder therapist and gaining some weight. Getting to a weight that is biologically determined healthy for you, regardless of where that number is on population norms, is usually the healthiest. We do not yet have enough research to know whether you would need to go back to your highest weight, or whether regaining some of the suppressed weight may be sufficient. You may find that weight gain will relieve some preoccupation with food, reduce some symptoms of bulimia nervosa, and generally improve the quality of your life. You may also discover that the negative consequences of weight gain that you fear do not come true.
When weight is not suppressed, you can more fully enjoy eating a variety of foods without obsessive worry and live life more fully. You can go out for dinner and enjoy a drink, indulge in a cupcake for a coworker’s birthday, and travel to a different region and experience the local cuisine, all without accompanying anxiety.
In a Huffpost blog post, one woman discussed accepting a higher body weight and living more fully.
Your Body Has Been Trying to Tell You Something. Binge Eating Therapy in Los Angeles Can Help You Listen
If the research on weight suppression has you seeing your binge eating in a new light, therapy can help you take that understanding and turn it into a genuine path forward. One rooted in compassion rather than control. Working with a specialized binge eating disorder therapist means finally addressing what your body has been responding to all along, and building a relationship with food that works with your biology instead of against it.
The cycle of weight suppression and bingeing isn’t a personal failure. It’s a physiological response that deserves real, evidence-based clinical support. Binge eating disorder therapy can help you understand your body’s hunger and fullness signals, work through the emotional weight of years spent fighting your natural set point, and develop sustainable habits that no longer hinge on restriction.
At our Los Angeles eating disorder therapy practice, our experienced therapists specialize in weight-inclusive, evidence-based care for binge eating disorder in both teens and adults. Meeting you where you are without judgment. Starting is straightforward:
- Contact Eating Disorder Therapy LA directly to begin the conversation
- Complete our brief Google form, and we’ll match you with a binge eating disorder therapist in Los Angeles, CA
- Take the first step toward understanding your body, breaking the binge cycle, and reclaiming a more peaceful life with food
Other Services EDTLA Provides in Los Anageles, California
When weight suppression has been quietly fueling your binge eating, having a therapist who understands the science behind your body’s responses can be truly transformative. With specialized, weight-inclusive therapeutic support, you can expect to stop fighting your biology, reduce the frequency and intensity of binge episodes, and develop a more trusting and sustainable relationship with your body and food.
At Eating Disorder Therapy LA, we provide personalized, evidence-based care rooted in weight-inclusive principles to clients across the lifespan, including adults, college students, children, teens, and caregivers. Our therapists treat the full range of eating disorders and related concerns, including Binge Eating Disorder, Anorexia Nervosa, Atypical Anorexia, Bulimia Nervosa, Avoidant/Restrictive Food Intake Disorder (ARFID), and Family-Based Treatment (FBT). We also offer specialized support for Excessive Exercise, Body Image challenges, and Phobias Related to Swallowing, Choking, and Vomiting.
Recognizing that flexible, accessible care is essential to recovery, our Los Angeles therapy practice offers both online counseling and group therapy for eating disorders. Additional services include small group FBT and ARFID consultations, eating disorder education, speaking and training, school programs, and clinical supervision for eating disorder therapists.
For those looking to deepen their understanding of eating disorder recovery, we encourage you to explore our Eating Disorder Blog and Dr. Mulheim’s published books: When Your Teen Has an Eating Disorder and The Weight-Inclusive CBT Workbook for Eating Disorders (available in 2026). To connect with our team, call (323) 743-1122 or email Hello@EDTLA.com. We’re here to help you work with your body, not against it, on the road to lasting recovery.
About the Author
As a clinician deeply versed in the research connecting weight suppression and binge eating, Dr. Lauren Muhlheim brings both scientific rigor and genuine compassion to her work with clients whose bodies have been caught in this difficult cycle. The founder of Eating Disorder Therapy LA, Dr. Muhlheim, holds the credentials Psy.D., FAED, and CEDS-C, and has built her practice around weight-inclusive, evidence-based care that honors the biology behind disordered eating rather than pathologizing it.
Across her career, Dr. Muhlheim has developed deep expertise in treating binge eating disorder, anorexia, bulimia, ARFID, and related concerns in clients of all ages — from children and teens to adults and the caregivers who support them. Her weight-inclusive philosophy, which runs counter to the diet-culture thinking that so often worsens binge eating, is woven throughout her clinical work and her two published books: When Your Teen Has an Eating Disorder and The Weight-Inclusive CBT Workbook for Eating Disorders (available in 2026). She has also developed one of the only FBT training courses for dietitians in the field — a widely respected resource in eating disorder treatment.
One of a select few FBT-certified therapists in Los Angeles, Dr. Muhlheim is a recognized advocate for family-centered, weight-inclusive approaches to eating disorder recovery. She is licensed in California, Indiana, New York, and Oregon, with a telehealth license in Florida, making her specialized expertise in binge eating disorder and weight suppression accessible to clients well beyond Los Angeles.
Sources
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Juarascio, Adrienne, Elin L. Lantz, Alexandra Muratore, and Michael Lowe. 2017. “Addressing Weight Suppression to Improve Treatment Outcome for Bulimia Nervosa.” Cognitive and Behavioral Practice, October. https://doi.org/10.1016/j.cbpra.2017.09.004.
Keel, Pamela K., Lindsay P. Bodell, Alissa A. Haedt-Matt, Diana L. Williams, and Jonathan Appelbaum. 2017. “Weight Suppression and Bulimic Syndrome Maintenance: Preliminary Findings for the Mediating Role of Leptin.” The International Journal of Eating Disorders 50 (12):1432–36. https://doi.org/10.1002/eat.22788.
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