05 Jul When You Can’t Stop Eating
Do you, or does someone you care about, struggle with binge eating?
Perhaps you can identify with a fictional woman, I’ll call her Lynne, who has been a binge-eater for many years. Sometimes, when the stress of her job and her difficult marriage got to be overwhelming for her, Lynne would stop at Dunkin Donuts after work. There she would order an iced latte, along with two dozen donuts – sometimes saying, “For the kids” or “For my meeting tonight”, when she worried the other customers were judging her for ordering donuts while being overweight.
When she got home, still feeling depressed, as well as hungry, she’d start to eat them. The sweet taste and soft texture of the donuts were like heaven – pleasure in every bite! But soon, she was unable to feel how full her stomach was becoming; in fact, it seemed she was unable to feel at all. Part of her was dimly aware that this “numb” feeling was the only way she could cope with her emotional pain. She would stuff the empty boxes under a trash bag in the outdoor trash bin, hoping her husband wouldn’t notice them.
By then she felt sick, and very disgusted with herself. Unable to even think about making or eating a healthy dinner, she’d spend the rest of the evening miserably in front of the TV, waiting for her husband to come home after his evening shift. Lynne hadn’t admitted this pattern to her doctor, though she’d already been diagnosed as pre-diabetic and the doctor kept admonishing her to lose the excess weight. Lynne kept telling herself that this binge would be the last.
Binge eating disorder (BED) is newly recognized as an “official” psychiatric diagnosis but has long been the most common eating disorder, affecting about 3.5% of women and 2% of men nationwide according to the Binge Eating Disorder Association.
Most of us overeat at times, but the problem becomes a diagnosable disorder when someone binge eats at least once a week for at least 3 months. The person may or may not be overweight. If they “undo” the binge by fasting, over-exercising, or purging (making themselves vomit or using laxatives), then the diagnosis is bulimia, rather than BED.
An eating “binge” is characterized by a feeling of loss of control and inability to stop eating even when the person is uncomfortably full. Almost always the binge brings with it feelings of intense guilt and shame, often leading to eating in secret and destroying the “evidence”. In fact, we know that shame is one of the underlying causes of binge eating in the first place. Ironically, shame about one’s body or eating behavior can result in self-soothing by using food as a drug to “numb out” the feelings of shame.
And shame originates in the family’s or society’s pressure to be thin, at all costs. People with BED tend to be blamed and even ridiculed, far more than people with any other psychological disorder. In one study it was found that women who believed the stereotypes about “fat”, and who blamed themselves for the stigma of being overweight, actually engaged in more frequent eating binges (Puhl, 2007).
Binge Eating Disorder brings with it the health risks associated with excess body weight including diabetes, high blood pressure, heart disease, gallbladder disease, and musculoskeletal disorders. In addition, BED is almost always accompanied by depression and low self-esteem. People with BED often have other psychological problems or stressors that contribute to the binge eating such as mood disorders (bipolar disorder), anxiety, and a history of sexual trauma or other abuse.
What kind of help is available? Most often, binge eating disorder can be treated on an outpatient basis. Individual psychotherapy is an important part of treatment. Therapy may help change the way you think, act, and experience your life. In therapy, you may learn skills such as mindfulness meditation and relaxation strategies. You may also develop helpful insight into the origins of your eating disorder, and learn ways to think differently about food and your body.
While she made significant progress in therapy, Lynne also began to consult a psychiatrist, who prescribed a medication to help her depression. She came to realize that she had been using food as “self-medication” for her low mood. Some medications also may target food cravings. Because it’s believed that the disorder may have in part a biological basis, medications may be used to help regulate neurotransmitters and the “reward center” of the brain (see review of biological theories on the website www.bingeeating disorder.com).
In therapy and in her support group, Lynne began to question the self-hatred she’d grown up with because of her lifelong struggle with weight. She learned to value her body and herself, and to take better care of her health out of a feeling of self-worth, rather than self-punishment. As a writer on the BEDA website tells us, “Our bodies are not billboards. They do not exist to attain approval, or to prove worth and value. Our body is the place where we each will spend our entire lives. It is doing its very best, every moment of every day. We must work to develop compassion for the incredible journey through which our body has come.”
Please also try the website of the National Eating Disorders Association, which has some excellent educational materials and handouts. Take an online screening test for eating disorders at http://www.mybodyscreening.org/. Learn more about coping with binge eating by following the WebMD series on binge eating disorder; for example, this article on “How to Stop a Binge Before it Happens.”
Eating disorder resources local to the Delaware Valley include:
and many therapists and psychiatrists, including some of those at Psych Choices of the Delaware Valley.