Overcoming Binge Eating
article by Dr. Linda Blakeley
“I fought the binge for a few days but I knew I was going to do it over the weekend. I went to the store, bought my favorite junk food and ate until I thought I would die. I never went out the entire weekend.”
Rachel suffered from guilt and shame over her late night binges. After bingeing she felt confused and remorseful. Although Rachel graduated from college with honors, she was unsure of what she wanted to do.
She quit a number of entry level jobs in a variety of career fields. They all left her feeling dissatisfied. She had few friends and rarely dated.
Her story is all too familiar. Women struggling with a Binge Eating Disorder (BED) are robbed of their self esteem and self confidence often preventing them from having satisfaction in both their professional and personal lives.
From an early age, I struggled with binge eating myself. As a clinical psychologist, eating disorder specialist for over fifteen years and national speaker, my mission is to assist women find inner peace and self love, to help them identify their unique voices so they can create a solid foundation for their lives and for the lives of their children.
Find out if you have a Binge Eating Disorder
Today, specific criteria are used to determine Binge Eating Disorder (BED). According to the Diagnostic and Statistical manual for Mental Disorders (4th edition/text revision (DSM-IV-TR) an episode of binge eating is characterized by 2 key criteria:
- Eating within a discrete period, for example within any 2-hour period, an amount of food that is definitely larger than most people would eat during a similar period of time and under similar circumstances
- A sense of lack of control over how much one is eating and the feeling that one cannot stop eating
Everyone overeats once in awhile but to be classified as BED, episodes of binge eating must occur on an average of at least 2 days per week for at least 6 months. Loss of control is a key ingredient in the diagnosis of BED. At least 3 of the following 5 indicators of loss of control must be present:
- Eating much more rapidly than normal.
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Feeling disgusted with oneself, depressed or very guilty after the episode.
BED is not associated with use of compensatory behaviors, such as purging, fasting or exercising excessively.
Factors Contributing to BED
Jamie, twenty-eight years old, entered treatment for BED. She was bingeing on large quantities of food, unable to stop. Having lost over fifty pounds, she regained it again within a short period of time. Feeling hopeless, unlovable and confused, she decided to seek treatment.
During the course of the initial evaluation, I determined she was suffering from depression. Five years earlier, her fiancée had broken off their engagement. Her father died the day before her senior prom. With the breakup of her engagement the flood gates opened and she reverted to binge eating. Unable to tolerate the strong emotions that the death of her father and the break-up of her engagement brought up in her, she began to numb herself out using food. Jamie was unaware of how the incidents related to her eating. When she was invited to be a bridesmaid at her best friend’s wedding, she made a commitment to take off the weight. The upcoming special occasion set her in motion and she lost the fifty pounds by joining a group dieting program.
By the wedding, she was feeling hopeful and positive about herself. During the ceremony, Jamie “cried hysterically” when she was reminded that her father would never walk her down the aisle at her own wedding. Embarrassed and ashamed at her display of emotion, she told herself she would never cry that way again. Soon after the wedding, she started bingeing again and quickly regained the weight she had worked so hard to lose.
Approximately 60% diagnosed with BED are women while 40% are men. It is found among all ethnic groups and in many countries around the world. A significant number of individuals identified as having BED are overweight. Often there is a genetic, environmental or family predisposition towards obesity. The rate of depressive disorders is often higher in their families. It is not uncommon individuals have one parent who has alcohol or substance abuse problems. Many come from divorced families where conflict over custody disrupted their lives for many years after the divorce.
There tends to be a high degree of negative self-evaluation and perfectionism associated with BED. According to the National Department of Health, there is a ninety-five to ninety-eight percent chance an individual will regain all of the weight they lost plus more within one to three years. Studies show dieting and restricting may trigger binge eating. Super sizing of food, a sedentary lifestyle and the media’s celebration of thinness can also be a factor. Commonly, individuals who develop BED are exposed to negative comments or teasing about their shape and or their weight.
Ending the Cycle of BED
If you or someone you love is suffering from BED, it is important to locate a psychotherapist specializing in the treatment of BED in your area. Many eating disorder specialists work as part of a team that includes a physician, psychiatrist and nutritionist. Referrals to qualified mental health professionals can be found online at National Eating Disorders Association.com.
Consider joining an ongoing Support Group. Participation provides additional comfort and support. The National Association of Anorexia and Associated Disorders
have developed a National Support Group Network that you can tap into by contacting them at ANAD.com.
Researchers and clinicians both agree the greatest hope for overcoming binge eating lies in psychological treatment. Cognitive behavioral treatment (CBT) has proven to be successful. Psychotherapists help patients address concerns about shape and weight, perfectionism, all-or-nothing thinking and low self esteem. Behavioral components focus on tackling disturbed eating patterns. Medication has proven to be effective in reducing underlying depression. See a psychiatrist trained in treating BED.
Stage 1 of Treatment: Patients learn to pay close attention to eating behaviors with the expressed purpose of increasing awareness about overall eating and binge patterns. Developing regular eating patterns often reduces bingeing and the urge to binge. Recognizing factors leading to a binge help individuals identify triggers. Practicing alternative methods to resist these urges to binge aids in helping individuals learn to tolerate strong emotions.
Stage 2 of Treatment: Psychodynamic and Interpersonal Therapy (IPT) focuses on relationship factors contributing to binge eating. Unresolved childhood issues, repetitive negative thoughts and poor stress management skills may cause roadblocks that trigger binges. As these are resolved, bingeing is usually reduced.
Stage 3 of Treatment: When chaotic eating patterns resolve through increased awareness and the use of cognitive behavioral strategies, important questions on how one wants to live surfaces. Discovering ones hidden potential, focusing on a long term vision provides hope for a positive future. Continued use of cognitive strategies to enhance self esteem and self confidence, makes it possible to take steps towards realizing goals.
Stage 4 and 5 of Treatment: Reinforcing positive strategies are ongoing in order to promote positive high self esteem, the number one quality for success in all areas of life. Through practice and awareness healthy eating patterns become new habits. Attention to triggers that may lead to binges is ongoing. As realistic goals and expectations are identified, the use of effective stress management tools, support individuals for taking action and reaching their goals.
Women must unite, joining their voices together to help all women, no matter their size, ethnicity or race to reach their full potential valuing themselves for who they are. The fear of discrimination because of weight and external appearance is a major obstacle, preventing many women from discovering their unique voice. As I help women increase their self esteem, they uncover their personal truths and gain confidence to travel their unique path of life with dignity and self love.
2005 All rights reserved. reserved Linda Blakeley, Ph.D, is a clinical psychologist and national speaker located in Beverly Hills, CA. She can be reached at www.Drlindablakeley.com or by email at Drlindablakeley@aol.com.