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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
Control binge eating and get on the path to recovery Overcoming Binge Eating for Dummies provides trusted information, resources, tools, and activities to help you and your loved ones understand your binge eating -- and gain control over it. Written with compassion and authority, it uses stories and examples from the authors' work with clients they've helped to overcome this complicated disorder. In Overcoming Binge Eating For Dummies, you'll find information and insight on identifying the symptoms of binge eating disorder, overcoming eating as an addiction, ways to overcome the urge to binge, how to institute a healthy eating pattern, ways to deal with anxiety and emotional eating, and much more. * Provides professional resources for seeking additional help for binge eating * Includes advice on talking with loved ones about binge eating * Offers tips and guidance to establish a safe and healthy recovery plan Overcoming Binge Eating For Dummies is for those currently suffering or recovering from BED, as well as families and friends looking for a comprehensive and expert resource to this widespread but largely misunderstood disorder.
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Seitenzahl: 633
Veröffentlichungsjahr: 2013
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Overcoming Binge Eating For Dummies®
Published by: John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774, www.wiley.com
Copyright © 2013 by John Wiley & Sons, Inc., Hoboken, New Jersey
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Library of Congress Control Number: 2013942772
ISBN 978-1-118-55087-8 (pbk); ISBN 978-1-118-55090-8 (ebk); ISBN 978-1-118-55092-2 (ebk); ISBN 978-1-118-55093-9 (ebk)
Manufactured in the United States of America
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Overcoming Binge Eating For Dummies®
To access the cheat sheet specifically for this book, go to www.dummies.com/cheatsheet/overcomingbingeeating.
Table of Contents
Introduction
About This Book
Foolish Assumptions
Icons Used in This Book
Beyond the Book
Where to Go from Here
Part I: Binge Eating Disorder: What It Is and What It Isn’t
Chapter 1: The World of Binge Eating Disorder
Examining Binge Eating Disorder: What it Is and What it Isn’t
Defining binge eating
Dealing with the consequences of binge eating
Accepting the Reality of an Eating Disorder
Seeing the signs
Deciding to make a change
Seeking treatment and support
Taking Steps to Get Better
To be or not to be an addiction — that’s the question
Considering professional treatment
Relapsing as a necessary part of the process
Looking across the Population
Understanding that men binge too
Shifting hormones in mid-life
Offering a Helping Hand
Supporting the recovery process of another
Understanding the role of family
Chapter 2: Defining Binge Eating Disorder
Understanding the Clinical Definition of Binge Eating
Breaking down the DSM-V definition
Recognizing BED as an eating disorder
Drawing a Line between Bingeing and Overeating
Looking at the Anatomy of a Binge
Before a binge
During a binge
After a binge
All or Nothing: Bingeing as a Way of Life
Deciding whether You Have Binge Eating Disorder — A Quiz
Chapter 3: Who Binges and Why
Debating Nature versus Nurture
Comparing Bingeing and Associated Disorders
Finding common ground
Developing more than one disorder
Diagnosing a Rising — and Varied — Tide
Bingeing across genders
Recognizing men who binge
Focusing on older women
Growing numbers
Understanding Physical Triggers
Wash, rinse, spin, repeat: The cycle of bingeing, obesity, and dieting
Drinking alcohol and bingeing
Feeling hungry
Sensing Psychological Triggers
Seeing the body for what it isn’t
Comparing yourself to others
Feeling blue
Fighting the big B — Boredom
Losing track of routine
Experiencing Environmental Triggers
Chapter 4: Physical and Psychological Effects
Harming the Body
Stretching the stomach
Eating to obesity and all of its risk factors
Confusing your metabolism
Clouding the Mind
Shifting personality and mood
Impacting relationships
Chapter 5: Distinguishing Binge Eating Disorder from Other Eating Disorders
Traveling Along the Eating Disorder Continuum
Exploring Anorexia Nervosa
Understanding what it means to be anorexic
Recognizing the signs and symptoms
Facing the consequences of anorexia (and yes, this pertains to binge eaters)
Understanding Bulimia Nervosa
Understanding what it means to be bulimic
Recognizing the signs and symptoms of bulimia
Facing the long-term consequences of bulimia
Including the Other Specified Feeding or Eating Disorder (OSFED) Category
Understanding what it means to be diagnosed with OSFED
Linking the Various Disorders
Part II: Do You Have Binge Eating Disorder?
Chapter 6: Understanding the Symptoms of Binge Eating
Listing Common Signs of Binge Eating
Realizing that if it feels like bingeing, it’s a binge
Identifying a binge regardless of what you eat
Recognizing your eating patterns
Looking at Moderate-Weight Bingers and the Binge/Diet Cycle
Dieting as a trigger
Swinging from binge to diet and back again
Considering Overweight and Obese Bingers
Seeing through the illusion of control
Dealing with extended binges: What are you really hungry for?
Getting Back to Normal
Chapter 7: Becoming Motivated for Change
Finding Your Personal Reasons for Change
Getting ready
Rating your reasons
Setting SMART goals
Using multiple motivators for success
Feeling Better About Yourself
Emphasizing the positive
Finding ways to reward yourself
Improving Your Physical Health
Removing the Stigma from Binge Eating Disorder
Motivational Tools to Start the Process of Change
Chapter 8: Deciding to Seek Treatment
Taking the First Step
Seeing your doctor
Scheduling time with specialists
Seeking Psychological Support
Figuring out where to start
Understanding why psychotherapy matters
Recovering with the help of a therapist
Enlisting Nutritional Support
Working with Your Insurance Provider
Finding Free Resources
Investigating Other Treatments
Investigating bariatric surgery
Considering another alternative: Gastric band hypnosis or virtual gastric band
Considering a residential or inpatient setting
Part III: Getting Well: The Team Approach to Recovery
Chapter 9: Is Binge Eating an Addiction? (Well, if it Walks Like a Duck . . . )
Understanding Addictive Behaviors
Showing signs of addiction
Treating addictions across the spectrum
Looking at What the Research Says
Decoding the studies
Mapping the body’s response to binge eating
Overlapping Addictions
Chapter 10: Seeking Out Professionals and Support Groups
Understanding the Most Effective Treatment Options
Talk therapy
Cognitive behavioral therapy
Dialectical behavior training
Mindfulness training
Alternate coping skills
Finding a Therapist who Specializes in Eating Disorders
Making a Match with the Right Dietitian
Finding a dietitian
Making a personal connection
Working with a team player
Paying for nutrition counseling
Finding Community in Support Groups
Which group is right for you?
Why go to a support group?
Chapter 11: Using CBT to Replace Damaging Behaviors with Healthy Ones
Breaking Down the Basics of CBT
Explaining the CBT method
Changing the way you think
Introducing the ABC’s of CBT
Using CBT to Treat Binge Eating Disorder
Filling in CBT worksheets
Establishing regular eating patterns
Challenging your thinking and replacing irrational thoughts with rational ones
Developing alternatives to binge eating
Building problem-solving strategies and taking stock
Addressing Food Issues with CBT
Focusing on specific foods
Setting attainable goals for nutrition
Tracking your thoughts about food
Chapter 12: Nourishing Your Bodywith Proper Nutrition
Seeing Food in a Whole New Light
What is emotional eating?
Figuring out whether your hunger is physical or emotional
Meal planning to stop binge eating
Keeping track of what you eat
Eating with a group
Chapter 13: Considering Medication and Dietary Supplements
Considering Medication for Underlying Conditions
Attention Deficit Hyperactivity Disorder (ADHD)
Anxiety
Depression
Talking with Your Team about Dietary Supplements
Taking supplements safely
Explaining dietary supplements
Looking at supplements for everybody
Recognizing the false promise of weight-loss supplements
Supporting a healthy mind with supplements
Chapter 14: Enlisting Family and Friends
Asking for Help from Friends and Family
Looking to your inner circle
Finding new friends and supporters
Knowing Who to Tell and Who Not to Tell
Finding the right support for the right time
Neutralizing your detractors
Dealing with overeating friends
Being realistic about what others can and cannot do for you
Dining Do’s and Don’ts
Chapter 15: Relapsing and Reassessing: It’s a New Day
Preparing for the Possibility of Relapse
Being realistic about relapse
Defining a relapse
Rebooting after a Relapse
Putting the binge in perspective
Understanding the reasons for the binge
Ending the blame game
Getting Back on Track
Keeping Triggers at Bay
Saying goodbye to dieting
Managing day-to-day stress and anxiety
Being scared of your own success
Sleeping better and feeling better
Part IV: How BED Affects Special Populations and Biological Systems
Chapter 16: Men Who Binge
The Rising Tide of Men Who Binge
Comparing Men and Women Who Binge
Understanding the Reasons Men Binge
Getting Help That’s the Right Fit
Finding the right psychological support
Establishing appropriate nutritional support
Chapter 17: Children and Bingeing
A Rising Tide: Kids and Binge Eating
Looking at communities at risk
Examining the role of dieting
Uncovering Genetic Risk Factors
Looking for signs of binge eating
Bingeing by Example
The family that binges together
Breaking the cycle
Facing Adolescence and the Teenage Years
Dealing with shifting hormones
Coping with changing expectations and societal triggers
Helping Kids Deal with Binge Eating and Emotional Eating
Chapter 18: The Endocrine System and Binge Eating
Understanding the Endocrine System
Connecting Hypothyroidism and Binge Eating
Explaining hypothyroidism
Symptoms and diagnosis
Linking thyroid irregularities and bingeing or overeating
Dealing with the whole picture
Coping with Polycystic Ovary Syndrome
Defining polycystic ovary syndrome
Managing PCOS through nutrition
Chapter 19: Menopause and Bingeing
Shifting Hormonal Seas of Menopause
Understanding perimenopause
Detecting menopausal hormone shifts
Completing the cycle
Seeking Treatment and Finding Balance
Accepting change and yourself
Treating the symptoms of menopause
Chapter 20: Obesity and Bingeing
Explaining What It Means to Be Obese
Explaining obesity medically
Assessing your health risks
Facing the social and emotional costs of obesity
Looking at the societal implications
Analyzing the economic costs
Understanding the Connection between Binge Eating and Obesity
Seeking the Right Kind of Treatment
Assessing psychological versus physical concerns
Balancing necessary nutrition needs with the delicate treatment of BED
Part V: Providing Help: Advice for Family and Friends
Chapter 21: Helping Someone with Binge Eating Disorder
Telling the Truth and Making Progress Together
Being aware of a binge eater’s world
Keeping the basics of helping in mind
Leaving all blame at the door
Helping Someone Who Asks for Help
Making the First Move
Coping with Someone who Doesn’t Want Help
Approaching a binge eater who’s keeping a secret
Taking a step back
Chapter 22: Finding Help with Family
Looking at Various Types of Family
Understanding the Need for Family Therapy
Breaking Down the Different Types of Family Therapy
Getting started with genograms
Seeing the family as a system
Dedicating time to family nutrition
Reconnecting as a couple
Chapter 23: Changing Family Habits and Routines
Recovering Step by Step
Controlling the Need to Control
Defining controlling behavior
Identifying controlling behaviors specific to binge eating
Living Life as a Family
Finding Ground Rules that Work
Looking toward the Future
Chapter 24: Taking Care of Yourself
Going for Individual Therapy
Understanding the benefits of therapy
Seeking therapy for yourself
Treating the Family
Using Support Groups
Caring for Yourself in Other Ways
Maintaining relationships
Making nutrition a priority
Sleeping well night after night
Exercising as a regular habit
Part VI: The Part of Tens
Chapter 25: Ten Do’s for Binge Eaters
Do Consult with a Medical Doctor
Do Seek Treatment
Do Keep a Food-and-Emotions Journal
Do Allow Yourself to Eat
Do Focus on Your Inner Qualities
Do Be Patient with Yourself
Do Expect Your Recovery to Have Ups and Downs
Do Find People who Support Your Recovery
Do Distance Yourself from Relationships that Bring You Down
Do Remind Yourself that You Are Not Alone
Chapter 26: Top Ten Myths about Binge Eating Disorder
All Binge Eaters Are Obese
People with BED Have No Willpower
Binge Eating Is not a Real Eating Disorder
Binge Eaters Just Need to Exercise Some Will Power and Go on a Diet
Weight Loss Surgery Can Cure Binge Eating Disorder
Only Women Binge
Binge Eaters Are always Hungry
Only Adults Are Binge Eaters
Medical Doctors Are the Go-To Experts for Binge Eating
After You’re Diagnosed with BED, You’ll always Have BED
Chapter 27: Ten Best Ways to Help Someone who Binges
Educate Yourself about Binge Eating
Let Your Loved One Take the Lead
Listen without Judgment
Know Your Limits
Practice Patience
Remember that Recovery is Day to Day
Do Not Suggest Your Loved One Go on a Diet!
Help Tackle Some of the Day-to-Day Stressors for Your Loved One
Don’t Talk about How Other People Look
Allow Yourself to be a Distraction
Make Positive Comments Only
Plan Fun, Food-Free Activities
Don’t Become Overly Involved
About the Authors
Cheat Sheet
Connect with Dummies
Introduction
Do you eat when you feel stressed, sad, or angry? Do you sometimes follow strict diets only to find yourself out of control with food when you return to “normal” eating patterns? Do certain foods or situations inevitably set off an unstoppable urge to eat? Has the quantity of food you eat had a negative impact on your health? Do you feel desperate and hopeless after an eating binge? Have you ever wondered whether you have a problem with binge eating?
If you answered “yes” to any or all of these questions, you’re reading the right book. Whether you’re just starting to realize that there’s a problem or have known it for a while, the information, ideas, and strategies we provide can help get you started on the road to healing and sustainable recovery from binge eating or any other type of overeating. This book is your road map to systematically but gently identify and change the feelings and behaviors that drive your binge eating.
If you identify yourself as a binge eater, you may be ready to take action today. But even if you don’t feel that your habits completely fit with what’s described as binge eating disorder, you can still benefit from these strategies as you address why you eat for reasons other than physical hunger. No matter where you are in your journey, this book can help you improve your health and well-being.
Depending on the severity of your struggles with food and eating, you may frequently recognize yourself (or someone you love) and your behaviors during the course of reading this book. Perhaps you’ve been formally diagnosed with binge eating disorder or self-diagnosed as an emotional eater. Left unchecked and untreated, disordered eating of any kind worsens over time, and the habits and behaviors become that much more entrenched. The sooner you seek support, the better.
Hopefully, it’s heartening to know that you don’t have to go it alone — we’ll be with you every step of the way as you begin to understand binge eating and exactly what to do about it. We hope that this book is just what you need to finally make a difference in your physical and emotional well-being. You may use it as a jumping-off point for seeking professional help in a more informed way. With compassion towards yourself and a deeper understanding of the fact that binge eating didn’t develop overnight and will take some time to change, you can achieve sustainable results.
About This Book
Although binge eating disorder (BED) has been understood and treated by professionals for some time now, the publication of this book coincides with the first formal inclusion of the diagnosis BED in the DSM-V (fifth edition of the Diagnostic and Statistical Manual of Mental Disorders), which is used for all psychiatric diagnoses. Recognizing binge eating disorder as a diagnosable condition alongside other eating disorders such as anorexia nervosa and bulimia nervosa represents an important shift in the understanding and treatment of binge eating.
To get the most out of this book, you don’t need to start at the beginning and read straight through, although reading the entire book, in whatever order you choose, will certainly benefit you in the long run. Put another way, like a good meal, take what you want and leave the rest. In fact, you often see us use food metaphors in discussing various aspects of the disorder because attitudes about food and eating extend to most other areas of life including money and relationships. That may sound strange, but as you read through, you’ll undoubtedly make the connections.
Also feel free to skip sidebars and anything marked with a Technical Stuff icon. We’ve written them to enhance and deepen the material in each chapter, but they’re not essential to understanding what you need to know.
It’s useful to note that each chapter and section stand alone, so if you prefer, you can begin wherever you like, picking and choosing what’s most helpful to you in learning about and reframing your long-held views and reflexive responses to food and emotions. You may even want to revisit certain sections repeatedly in order to more fully grasp new concepts, strategies, and practical ideas in a way that works for you.
Within this book, you may note that some web addresses break across two lines of text. If you’re reading this book in print and want to visit one of these web pages, simply key in the web address exactly as it’s noted in the text, as if the line break doesn’t exist. If you’re reading this as an e-book, you’ve got it made — just click the web address to be taken directly to the recommended web page.
Foolish Assumptions
If you picked up this book, we assume that you fit into at least one of the following categories:
You’re a binge eater, or you suspect you may be. Healing and recovering from an eating disorder of any kind doesn’t happen overnight even if you’d like that to be the case. Whether you’re at the beginning of the journey and just realizing that you may have a problem or a bit farther down the path and looking for further motivation and resources, you’ll find what you need in this book.
You love someone who’s a binge eater. Watching someone you love struggle with binge eating in its various forms can be extremely difficult. We wrote this book not only for people struggling with binge eating, compulsive overeating, or emotional eating but also for loved ones affected by someone else’s disordered eating.
You’re a professional who treats people who suffer from disordered eating or related issues and conditions. Perhaps you treat people with all kinds of eating disorders, related psychological conditions, and/or the physical consequences that may result. Of course you know your stuff, but this book offers a quick, practical, and layman-friendly reference guide that you and your patients can use together.
Icons Used in This Book
Throughout the book, we use icons in the margins to call special attention to certain paragraphs. Keep an eye out for the following symbols.
This book is chock full of practical information you can use now and in the future. When we use a tip icon, we’re highlighting a specific idea or technique we’ve found particularly useful for almost everyone we’ve treated over the years.
We cover a lot of ground in this book, but what we know about eating disorders and how to treat them often stems from a few key ideas and philosophies. When you see a remember icon, we’re either reminding you of something we’ve written about before or stressing how important it is to keep one of these central ideas in mind as you read.
Eating disorders can have a long-term impact on your psychological and physical health. When we use a warning icon, we want you to take into account that your well-being is your top priority as well as ours.
Dealing with binge eating encompasses many different subjects: medicine, psychology/behavior, physiology, nutrition, cultural awareness, and more. Sometimes we delve more deeply into these areas, and we label that exploration with a technical stuff icon. You don’t have to read those paragraphs to get the big picture of a section or chapter, but you certainly may want to if you’re seeking more in-depth information.
Beyond the Book
In addition to the material in the print or e-book you're reading right now, this book comes with an eCheat Sheet you can access on the web anywhere, anytime at www.dummies.com/cheatsheet/overcomingbingeeating. The articles there address a range of binge-eating tips:
Don’t know where to start or need a reminder of how to eat a healthy, satisfying diet that will sustain you both mentally and physically? Check out ten ideas for eating healthfully.
Even though it may be uncomfortable to think about, binge eating poses serious short- and long-term risks to your health. For an idea of what you need to be on the lookout for, we include a list of the most significant medical risks.
If you’re reading this book because you have a friend or loved one who suffers from binge eating, we offer tips to help you stay on the right track in your efforts to support someone else’s recovery from disordered eating.
Perhaps you’re struggling with the urge to binge right now. Take this list of alternate activities with you everywhere and turn to them when you need ideas for something you can do to distract yourself that’s meaningful and engaging, not just a time-filler.
Where to Go from Here
You can start wherever you like in Overcoming Binge Eating For Dummies; you don’t have to begin with Chapter 1 and read straight through to get the information you need to understand and begin to recover from binge eating. For example, if you’re interested in sampling a smorgasbord of the treatments out there, skip to Chapter 10 to get a sense of all your options. If you’re looking for motivation, Chapters 7 and 9 are good starting places. If you want to dive right into nutrition, Chapter 12 has lots of tools and tips for meal planning and coping skills for dealing with food. And if you’re the friend or family member of someone who binges, Chapter 21 is the first in a series of chapters about how to help someone you love get better.
Part I
Binge Eating Disorder: What It Is and What It Isn’t
Visit www.dummies.com for great Dummies content online.
In this part . . .
Identify the components of binge eating disorder (BED) and other eating disorders. Distinguish BED from compulsive overeating, emotional overeating, and the nervosas — anorexia and bulimia.
Look into possible reasons for developing an eating disorder. Heredity and environment both play a role in the emergence of many eating disorders.
Realize that BED is an addiction recognized by the American Psychiatric Association with a variety of effective treatment methods.
Understand that BED and other disordered eating habits result in both physical and psychological ailments. In the same vein, existing physical and emotional disorders may contribute to the development of eating disorders.
Chapter 1
The World of Binge Eating Disorder
In This Chapter
Uncovering the realities of binge eating disorder
What binge eating is and what it isn’t
Deciding to get help and finding the right treatment
Supporting others and keeping healthy yourself
For some people, hunger is simply a physical sensation usually satisfied by a moderate amount of food. For others, physical hunger is mistaken for what we call emotional hunger, and eating food becomes a misguided attempt to soothe away the worries and upsets of life.
When you think about it, the fact that many people have eating disorders isn’t really surprising. Eating and nourishment is so primal; suckling is the very first instinct you act upon after you’re born. Throughout your life, eating is a fundamental part of many social, cultural, and family rituals. It therefore makes sense that many people use food as a way to get a different kind of nurturance and to self-soothe during difficult situations. Similar to drugs, alcohol, and other additive substances, food can come to be seen as a great source of temporary comfort.
But when eating becomes a primary contributor to your problems rather than a solution to them, it’s a surefire sign that you need to look at your eating habits. If, for instance, you overeat to the point of physical pain or discomfort, hide your excessive eating from others, and/or feel intense shame and guilt over how much you consume, you may want to consider that you have a problem you may not be able to resolve on your own. That problem is called binge eating disorder.
In this chapter, we explore what binge eating actually means and how to determine whether you suffer from binge eating disorder (BED) or an eating disorder of any kind. We discuss a few of the many available treatments and identify who suffers from binge eating. Finally, we address those of you who may be struggling to support and help a friend or loved one who’s a binge eater.
Examining Binge Eating Disorder: What it Is and What it Isn’t
Binge eating disorder (BED) isn’t simply having an extra piece of cake at a birthday party or overeating during the holidays or on vacation. It’s a serious, progressive condition that affects both the body and mind and may drive you to eat in response to something other than physical hunger. This simple definition of binge eating, and all emotional or compulsive overeating for that matter, is a useful way to think about the whole issue. (We explain the range of eating disorders in Chapter 2.)
Simply put, disordered eating is eating in response to something other than physical hunger. Notice the non-judgmental simplicity with which you can start to think about disordered eating by referring to it this way.
During a binge, you lose control and can consume many thousands of calories in an attempt to numb unwanted negative emotions. Up until May 2013, clinically speaking, binge eating had been classified as EDNOS, or eating disorder not otherwise specified. As of the publication of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), binge eating disorder was officially recognized as a distinct and definable condition, which hopefully allows for more reimbursable treatment options as well as more research into the causes of and most effective treatments available for this complex disorder. (The EDNOS classification itself is now other specified feeding or eating disorder, or OSFED.)
Defining binge eating
What does it mean to binge? The criteria are clearer now than they’ve ever been and yet you may still have picked up this book wondering if how you eat qualifies you as someone suffering from binge eating disorder. The DSM-V sets out the following criteria:
Eating a larger amount of food than normal in a short period of time
Losing control during the binge episode
Bingeing at least once per week for at least three months
Not using any sort of compensatory behaviors like purging or exercising
We discuss these criteria in more depth in Chapter 2, but if this list starts you thinking about some of your own behaviors, you’ve come to the right place. When you’re ready to embrace and tackle the issues, this book can help you not only figure out what to do but why and how to do it.
Even if you flip through these first chapters and decide that you don’t technically suffer from binge eating disorder, the information you uncover about compulsive or emotional eating may still resonate strongly with you. Whatever form your disordered eating takes, you can surely benefit from the ideas and strategies in these chapters. You may even feel inspired or motivated to take a step beyond the guidance offered here and seek out professional treatment, if needed.
Dealing with the consequences of binge eating
Binge eating, compulsive overeating, and emotional eating take a toll on the mind and body. Although some binge eaters may maintain an average weight, most become overweight or obese and suffer from chronic diseases associated with excess weight. If you’re a binge eater, you probably already know that you’re at increased risk for heart disease, high blood pressure, high cholesterol, metabolic diseases, and diabetes among many other conditions. (Chapter 4 talks about physical and emotional health concerns.)
Perhaps you also experience some of the psychological or emotional causes and effects of binge eating. For example, depression, anxiety, attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), and other disorders can be part of a complicated system that triggers and/or exacerbates binge eating.
In the final analysis, the whole complex of emotions, experiences, and behaviors may leave you feeling desperate, hopeless, and increasingly socially isolated, all of which can make the urge to binge even greater.
Accepting the Reality of an Eating Disorder
Many binge eaters must deal with lives that feel out of control almost all the time. Even if you try to ignore the persistent thoughts, feelings, and urges you have with regard to food, it isn’t enough to overcome your drive to binge eat or overeat. However, as much as you’d like help and a way to heal yourself, it can be difficult to acknowledge that you have a problem.
If you’ve picked up this book, chances are you’re struggling with disordered eating of some kind, and no matter what label you put on it, making changes would benefit you both physically and psychologically in the long run.
Seeing the signs
No matter the exact form your overeating takes, you may still be telling yourself that it’s no big deal or that it’s not a real problem (although you’re reading this book, so you’re at least a bit suspicious). If, in fact, you’ve readily acknowledged that you have a problem, you may be struggling to find some way to keep it from taking over your life. Or perhaps you’re at a more advanced stage and the bingeing has already put your health and/or your relationships in jeopardy.
Whatever stage you’re in, the signs that you may be in trouble from using food to soothe yourself are relatively easy to spot if you know what to look for. When you’re bingeing or overeating in any way:
You feel out of control. The hallmark of binge eating is a sense that you cannot stop regardless of whether you want to or your body hurts from taking in so much food.
You turn to food to deal with negative emotions or situations you feel you can’t cope with in any other way. At the beginning, bingeing may have helped you feel better, at least temporarily. Now, it creates as many or more problems than it resolves, but you don’t know what else to do but eat.
You keep your eating habits a secret. In eating as in the rest of life, if you’re desperate to keep something a secret, it’s probably not a good sign. You try as best you can to make sure that no one knows anything about how, what, when, where, or why you’re eating, and this in and of itself suggests you may have a problem.
You feel utter regret when the binge is over. You may promise yourself every time that you won’t binge again, and when you do binge, you’re overwhelmed by shame, guilt, grief, and desperation. What’s even worse is that these negative emotions simply perpetuate the continuous cycle of feeling bad and then eating for release. Of course, it’s more complicated than that, but over time, the hopelessness that descends upon you is one factor that makes the situation worse.
Deciding to make a change
If you’re a binge eater, compulsive overeater, or emotional eater, you’ve probably already tried every diet under the sun more than once. Maybe some of them work for a while, but eventually you fall back into old routines and end up right back where you started or even worse off than where you began.
Most binge eaters mentally beat themselves up on a regular basis by telling themselves that it was just a matter of not having will power, that even trying to stop bingeing is stupid and hopeless. These conclusions are painfully and needlessly punishing and also just not so.
The reasons that diets don’t work are because
Diets don’t ever work. Diets just create an inevitable pendulum swing of deprivation and cravings, both emotionally and physically.
Binge eating, as with all disordered eating, actually has nothing to do with food. Yes, you read that right. Strange as it may sound, food is just the available weapon, if you will.
You may be scratching your head, wondering what in the world we’re talking about, but as you may have already noticed, focusing only on food when it comes to tackling these issues simply isn’t working. Instead, when you’re ready to make a change, you have to find other reasons that will help finally flip the switch for you.
Everyone’s different, and your personal motivations for slowly putting a stop to binge eating are likely quite different from the reasons that motivate other binge eaters. However, many people who’ve successfully put binge eating behind them have some of these strategies in common:
Take time to get ready. Slowing and eventually ending binge eating or overeating of any kind is a marathon and not a sprint. Even though you may be eager to jump in and make changes immediately, if you can step back for a moment, be clear about your motives, gather any pertinent information, and make an action plan, preferably with strategic support from others, you’ll set yourself up for long-term success.
Focus on possibility. Whether it’s imagining all you’ll be able to do with your life when eating doesn’t dominate your day-to-day thinking or concentrating on the small successes you have along the way, overcoming your disordered eating in large part depends on the idea that if you can see it, you can have it. If you can see it, you can be it. It’s a leap of faith to imagine what until now has seemed to be unimaginable. This is an essential strategy for many areas of life.
Set realistic goals and reward yourself for meeting them. Making major changes in the way you eat and, more importantly, the way you think about eating takes time and determination. By establishing small milestones along the way, bite-size pieces, so to speak, you give yourself time to learn new ways of being in the world and give yourself an opportunity to celebrate incremental success in ways that motivate and inspire you. In other words, portion out change rather than bingeing on it. (Caution: The food metaphors have just begun . . . many more to come!)
Chapter 7 addresses motivation in more depth.
Seeking treatment and support
Successful treatment comes in all shapes and sizes. Although some binge eaters choose to see a team of eating-disorder professionals, others may not be able or willing to tackle every issue simultaneously.
No matter how enthusiastic and ready you are to move forward, recovery can be emotionally and physically challenging, and taking an approach that makes the most sense to you and pacing yourself in a way that feels comfortable are two ways of building a foundation upon which you can evolve as you begin to heal.
In this book, we take a three-pronged approach to recovery:
Medical/Physiological: Binge eating can take a serious toll on your health, so as you begin to think about getting better, the first stop is your doctor’s office. You may already be in regular contact with your physician about ongoing health issues, or you may have been avoiding a visit for a long time. Either way, it’s important to discuss the fact that you’ve been struggling with binge eating in addition to addressing any of the chronic conditions that may have developed as a result of overeating such as obesity, high blood pressure, heart disease, and diabetes — to name just a few.
Aside from the medical piece of healing from binge eating, there are broad physiological considerations, particularly with respect to learning how to understand your whole body. For instance, as you recover, you learn or relearn how to assess your hunger and fullness accurately and appropriately by listening to the signals your body sends you before and after meals.
You can also discover how to move your body in a way that feels healthy and positive. Over time, healthy forms of exercise and movement can help establish a better sense of self and improve your body image.
Psychological: Healing from disordered eating of any kind, and bingeing in particular, starts with an understanding of the underlying psychological conditions, thoughts, and feelings that lead you to conclude, consciously or otherwise, that overeating is the best way to cope. Even though it may be difficult or uncomfortable at times, understanding your deepest motives and developing a willingness to address longstanding behavior and thought patterns are essential to the process of ending binge eating.
Nutritional: A dietitian specializing in eating disorders can help you establish new strategies when it comes to food. If you’re a chronic binge eater, you may have forgotten or you may never have known what it means to nourish yourself. A dietitian can give you the nutritional support you need to get started and the pointers you’ll want to make changes that work for you along the way.
Chapter 10 talks about the professional and peer support system you may tap into as you head toward recovery.
Don’t let yourself become overwhelmed by what lies ahead. You don’t have to take it all on at once, and in fact, if you’re trying to stop bingeing, it probably makes sense to tackle your recovery in bite-size pieces with the same moderate, gentle approach you’re planning to take towards food, eating, and yourself now and in the future.
Taking Steps to Get Better
Recovering from binge eating or any kind of compulsive overeating isn’t an overnight process. It’s taken months or years to arrive at this point, and getting better takes time as well as determination. You have to be wiling to gently, but resolutely, look at yourself in the mirror and slowly change the thoughts and behaviors that aren’t good for you at the same time that you learn to accept yourself for who you are. It’s not a straightforward or linear affair, but with patience and hard work, you can make a healthier and happier life for yourself.
To be or not to be an addiction — that’s the question
Addiction is a complicated word and one that may be overused in modern culture, but when it comes to binge eating, it can be helpful to think of it as an addictive behavior.
New research shows that the way the bodies and brains of binge eaters react to food mimics the way other addicts respond to the substances and/or behaviors of their addictions. Images of the brain, particularly PET (positron emission tomography) scans and functional MRIs (magnetic resonance images), taken during a food binge, an alcohol binge, and while using cocaine or heroin are virtually identical and show almost identical stimulation of the pleasure centers in the brain. Whether this means that binge eating is an addiction is still an uncertain, but the physiological similarities are so strong that it’s certainly a useful idea to consider during recovery.
Whereas the goal for most other addictions is to achieve abstinence, this is obviously not the case with binge eating. You have to eat to survive. Coming to terms with the idea that you must establish a lifelong relationship with food is one of the complex realities of facing down binge eating, compulsive overeating, or any form of disordered eating. In fact, among Overeaters Anonymous members, one aphorism is that “when you are addicted to drugs you put the tiger in the cage to recover; when you are addicted to food you put the tiger in the cage, but take it out three times a day for a walk.” To be clear, in no way are we making light of the plight of all those who take the courageous journey to beat any addiction. But those involving food are that much more complex in this way.
Continuing research into the way that eating, and certain foods in particular, activate the pleasure centers in the brains of binge eaters and into how and why binge eaters tend to gain weight more easily may ultimately result in different treatment paradigms. However, here and now, thinking of binge eating as an addiction only matters if it helps you reframe the way you think about your own relationship to food and eating and if it changes how others view your behaviors. If people in your life judge you as being lazy or having no discipline, explaining that BED is a recognized addiction may promote a more helpful attitude.
No matter how you feel about it, being flexible and curious on your journey helps you pick and choose the ideas and strategies that’ll be most useful, meaningful, and motivating for you along the way.
Considering professional treatment
By its very nature, binge eating is a condition that tends to isolate its sufferers. You’ve probably tried your best to keep your eating habits and how you feel about yourself and food a secret from most people you know, even those closest to you. You also may have tried to get better on your own without long-lasting success. Hopefully, something in this book will help propel you into meaningful and sustainable change.
Perhaps now is the time to embrace the idea that you don’t have to go it alone. It’s a lot to ask of yourself to try to make significant changes in your life without the proper support and guidance from people who have more experience in this area than you do. Although you may be reluctant to reach out to professionals for a variety of reasons, asking for help from physicians, psychotherapists, dietitians, and other eating disorder specialists is truly a sign of strength and readiness. In fact, it’s also a way to set yourself on the path of being kinder to yourself and more realistic about your abilities and your challenges.
The wide variety of eating disorder treatment possibilities means that there’s something out there for everyone. You need to determine which makes the most sense to you and what you feel will be most effective, but whatever you decide to do, consider that you need to take care of your body, your brain, and your behavior. These are a few of the many treatment options we discuss later in the book
Cognitive behavioral therapy (CBT): One of the most common and effective approaches to treating binge eating disorder, CBT begins with the premise that thoughts and perceptions lead to feelings (or avoidance of them),which then leads to desirable and undesirable behaviors. Ultimately the idea is to understand and intervene in the way you think and feel in order to affect your behaviors. A specific focus in treating binge eating and all forms of disordered eating is to learn new reflexes and new coping skills that do not hurt you in the end. Chapter 11 explains CBT methods.
Traditional or process-oriented psychotherapy: Talk therapy is what you may imagine when you think of going to see a therapist. It’s one thing to concentrate on changing behaviors and reactions in the here and now, but it’s also critical to long-term success that you work to gently uncover the driving forces behind your disordered eating. In other words, psychotherapy is a way to uncover what the heck is so strong, so compelling, that an intelligent and successful person like you would continually take part in eating behaviors that you know will not end well. When you can step back with a different lens to view the past and realize that it does not have to predict or determine your future, there is great freedom, insight and thus an ability to steer a different course.
Nutritional counseling: It’s likely that you’ve been bingeing or eating in response to something other than physical hunger for so long that you don’t remember (or perhaps you never knew) how to nourish your body in a healthy and satisfying way. Seeing an experienced dietitian can be a watershed moment for many people because it’s a chance to collaborate on and help create a sustainable plan for eating in a way that supports you, has variety, is not restrictive, fits your lifestyle, and has a certain level of accountability. (Nutrition is the subject of Chapter 12.)
Family/couples therapy: This is most often a critically important component of treatment. It’s educational for those who live with and/or love you, so they can offer constructive and meaningful support, both concretely and emotionally. You all discover vital do’s and don’ts that aren’t so obvious and extremely helpful for the long haul. Family and/or couples therapy can be a path to enhance relationships, especially those that have suffered due to disordered eating.
Support groups: Even if you’re seeing a psychotherapist and dietitian and feel that your treatment plate is full, so to speak, a support group is a great way to find a like-minded community as you move forward. No, it’s not a commiseration session. Ideally, support groups offer a relaxed, non-judgmental, safe environment where you can talk about specific recovery-related issues and get advice and ideas from others in the same situation you’re in. (Chapter 10 offers advice on how to find support groups.)
This is just a tiny taste of the strategies, ideas, and techniques contained in this book. It may take some tweaking to find the perfect combination that works for you, but in time, you will.
Relapsing as a necessary part of the process
Healing from binge eating isn’t a perfectly linear process, and even though it may seem uncomfortable to hear, it’s likely that even if all is generally going well, you will have a relapse. Now that you know, you can stop worrying about it and consider it a part of your evolution. (Chapter 15 explains how to handle and move on after a relapse.)
But not all relapses are alike. The key to success lies in your expectations. If, for instance, you expect that things will change very quickly and that you’ll get better and better and thinner and thinner, never abuse food again, be the perfect weight, and stay there and live happily ever after, you may be quite disappointed. Rather than thinking of the trajectory of your recovery as a perfectly linear process, it’s probably more helpful to imagine it as a road with many with peaks and valleys. Your goal is to even out the ups and downs and make the hills and valleys less pronounced and the distance or time between them greater and greater. With a realistic attitude, you’ll be better prepared for the realities of recovery and better able to keep your commitment to yourself.
A relapse is simply a sign that you need to make adjustments in your recovery plan, not a signal that it (or you) isn’t working. Even though a relapse can be emotionally and physically challenging, it offers a chance to step back and reevaluate your plan. And being able to evaluate what’s working well and identify what’s not, both when it comes to food and when it comes to the rest of your life, is an important skill that you can use in all aspects of your life.
Many binge eaters suffer from an all-or-nothing thinking; try not to let yourself fall into this trap. If you relapse, it doesn’t mean that your recovery is over, that you’re a failure, that it’s hopeless, useless, too late, or that it would be easier just to binge. Nothing could be further from the truth. That thinking is just one of the paths back to what is, in essence, an undesirable but comfortable set of behaviors and habits. A relapse is a setback, yes, but it’s important to think about what may have triggered you to relapse, work out strategies to keep it from happening again, and move forward. Getting better is about finding a moderate, realistic path toward the future, not about being perfect.
Looking across the Population
Traditionally, anorexia nervosa and bulimia nervosa, two very common and long-recognized eating disorders, have been considered conditions that primarily strike young women (even as those statistics continue to change and become broader in scope). Anorexia is characterized by an extremely distorted body image and excessive dieting that leads to severe weight loss with a pathological fear of weight gain and eventually becoming fat. Bulimia is characterized by frequent episodes of binge eating followed by inappropriate behaviors such as self-induced vomiting, laxative abuse, or over-exercising to avoid weight gain. Most bulimics are of normal weight while those with anorexia are underweight.
However, BED is and has always been more of an equal-opportunity condition. Although the numbers aren’t absolutely definitive, more than 3.5 percent of females and 2 percent of males in the United States suffer from binge eating. In Canada, the National Eating Disorder Information Centre reports binge eating disorder affects about 2 percent of all people. And the U.K. Counseling Directory states that it’s thought that binge eating is more common than other eating disorders, with approximately 2 percent of adults being affected. Forty percent (and perhaps more) of sufferers are men, and binge eating affects children and adolescents, younger and older adults, and people of all races. New diagnostic criteria have certainly played a role in giving a realistic picture of who’s suffering from binge eating, but it still remains to be seen why binge eating is on the rise.
Understanding that men binge too
It’s tempting to separate out binge eaters by gender and describe different reasons why women and men binge. But the fact of the matter is that the underlying motivations and root causes aren’t so different. Like women, men suffer from
Body image insecurities and distortions
Perfectionism
Stress, anxiety, depression, and other psychological conditions
Coexisting addictions to drugs or alcohol and/or other addictive tendencies
Self-esteem issues
Past history of abuse or trauma
Some specific tendencies for men who binge or compulsively overeat include
Attitude toward food: Traditionally, men have not been conditioned to feel that certain foods are socially unacceptable or should be forbidden in a diet. Red meats, fried foods, and rich desserts are often perceived as tokens of deserved success. Consuming large quantities of food in a brief period of time is socially acceptable for men who are challenged to engage in eating contests or dared to overeat by restaurant menus and television shows. Consuming four dozen chicken wings in a half-hour may be perceived as a sign of masculinity — certainly not something to feel ashamed about. With a greater tolerance and acceptance of these behaviors, recognition of a disorder beyond one’s control can be difficult.
Body image: Although times are changing and men are beginning to feel the same sort of societal pressures that women feel to have a perfect or better body, by and large, it’s still considered more acceptable for a man to be overweight or obese than it is for a woman. Unfortunately, that tolerance may ultimately backfire if a man doesn’t realize that his disordered eating puts him at risk for serious health conditions.
Age: Although most women begin bingeing in adolescence, during college, and/or as young adults, the majority of men who binge start somewhat later. The reasons vary from individual to individual but may be related to occupational stressors reflecting early socialization for men to be the primary breadwinners. Age-related hormonal shifts may also be at work as well as a change in lifestyle from typically active to much more sedentary.
Treatment: To put it as candidly and plainly as possible, while admittedly brushing with a broad brush stroke, in general most men prefer processes that are quick and easy, concrete, and very action-oriented while women generally prefer a more measured, progressive, thorough approach. Of course there are many exceptions to this, but it is an important set of ideas to consider when designing treatment plans for both men and women.
Chapter 16 is devoted to issues faced by men who binge.
Shifting hormones in mid-life
You may think of adolescence as a time of great hormonal upheaval, but perimenopause and menopause bring about just as many changes to a woman’s body and signal a new, sometimes challenging, sometimes rewarding, phase of life. It should be noted that men also experience a variety of hormonal changes at various stages that need be considered though they’re often less talked about.
While in the throes of both perimenopause and menopause experiencing the predictably unpredictable estrogen surges and cascades, women suffer from mood and energy swings, anxiety and depression, hot flashes, night sweats, blood pressure and blood sugar fluctuations, muscle and skin changes, unwanted hair growth, and perhaps most frustrating, almost inevitable weight gain even though food intake and/or energy output remain unchanged. What changes is the rate of metabolism, the body’s calorie-burning process.
It’s easy to imagine that in the midst of these physical changes, which may breed feelings of being out of control, compounded by developmental, family, relationship, and professional shifts that often occur at this stage of life, someone who’s vulnerable to bingeing, emotional eating, or who may have been a binge eater earlier in life may turn to overeating as a way to soothe herself, willingly or unwillingly, consciously or unconsciously.
Eventually though, menopause brings about a hormonal calm which may eventually quiet the urge to binge. Until then, treatment, both for the symptoms of menopause and for binge eating itself, can help restore balance to your life.
Bingeing and change-of-life issues are covered in Chapter 19.
Offering a Helping Hand
Few things in life are as upsetting as watching someone you love struggle with addictive behaviors she can’t control. And in fact, if you’re the friend or family member of someone who’s a binge eater, the first step toward being able to truly help that person get better is to step back and see the situation for what it really is.
If you can see binge eating not as a lack of will or discipline, but rather as a set of addictive behaviors and habits that have developed for many different reasons, you have a good chance of being able to play a supportive, non-judgmental role in a loved one’s struggle.
It’s equally important to strike the right balance between supporting another person and considering your own needs, not only for your own physical and psychological but also for that of the binge eater. Later chapters, especially those in Part V, go into much greater depth with specific strategies and suggestions to achieve these ends.
Supporting the recovery process of another
You may have found yourself thinking or saying more than once, “Why can’t you just stop eating?,” or “Don’t you see what you’re doing to yourself,” or some other variation on the theme. It’s perfectly normal to think something along those lines, but those sentiments belie the true complexity of the situation and undoubtedly make it harder or impossible for you to play a meaningful role in your loved one’s recovery. If it were as simple as knowing what to do and doing it, the binge eater in your life would have already found a way to limit the drive to overeat and to stop the binges himself.
No matter where your loved one is along the path of changing her behavior, some general guidelines apply in most, if not all, situations.
Set aside blame. There’s no point in trying to figure who’s at fault when it comes to disordered eating. There is no blame. Focus instead on non-judgmental listening and on efforts to get better.
Wait to be asked for help. Although you can’t always do this, especially if someone you love is in danger, it’s better in the vast majority of cases to wait for someone who suffers from binge eating to come to you. Opening up to others is a sign that someone is ready to make real and lasting changes.
Encourage your loved one to seek professional help. Like all eating disorders, binge eating disorder and its related conditions are progressive. The longer someone waits to seek treatment, the more difficult the recovery. Although it’s not impossible for someone to get better on his own, it’s easier to do so with carefully chosen medical, psychological, and nutritional support.
Accept your own limitations. No matter how desperately you want someone to get better, you can’t do it for them. Your friend or loved one has to drive this process for it to truly be effective.
Take care of yourself. No matter what you do and how good your intentions, you can’t make someone do something they don’t want to or aren’t ready to do. If someone you love is a binge eater and is resistant to change for whatever reasons, the best thing you may be able to do is to accept that for now and continue with your own life.
Understanding the role of family
Families play a unique role in the treatment of any eating disorder. A family is a system, and all families create or exist within certain physical and psychological frameworks, establishing or following patterns and behaviors that make each family system unique. Without a doubt, some of these factors are positive, but others are not, and some family environments may unwittingly contribute to (but not cause) disordered eating or other kinds of negative thoughts or behaviors.
When you’re at your wit’s end, the quick and easy way is to point the finger at someone else rather than doing the hard work of thinking about your own role in how a certain situation has developed. Resist the temptation to blame and focus on what you can do now to make things better. The past is history, and moving forward toward a healthier future is a better way to spend your energy.
Chapter 2
Defining Binge Eating Disorder
In This Chapter
Understanding the clinical definition of binge eating disorder
Distinguishing between binge eating, compulsive overeating, and emotional eating
Exploring what it feels like before, during, and after a binge
Tackling all-or-nothing thinking
Taking a quiz to help determine whether you’re a binge eater
It’s not unusual to hear the word binge
