By Eliza Kingsford, MA, LPC Director of Clinical Services, Wellspring at Structure House
Binge Eating Disorder (BED) is categorized by a few defining factors. The first is the consumption of large quantities of food in discrete periods of time. Large quantities can be somewhat subjective, however; think of this as an amount that is considerably more than what most people would eat within a similar amount of time under the same circumstances. Second, BED is characterized by a person feeling a loss of control while eating. They will often report feeling like they are unable to stop even if they wanted to. Many people describe starting to eat and then losing sense of time and place, feeling “zoned out” or disconnected from the experience. Third, people suffering from BED experience an overwhelming sense of shame and/or guilt after the binge. Often, the person will eat in private due to the shame they feel about their behaviors. Depression, guilt, embarrassment and disgust are all common feelings associated with binge eating behaviors.
Other factors are generally present with BED. These are things like eating more rapidly than most people, with an unnecessary sense of urgency; and eating without feeling physically hungry and far beyond the point of feeling comfortably full. Also, eating until feeling physically ill from the quantity of food consumed.
I thought people with eating disorders were underweight?
The notion that people struggling with an eating disorder are all underweight is largely a myth. In fact, the only eating disorder that even classifies weight as a criterion is anorexia nervosa. Contrary to popular belief, although the number on the scale often becomes the obsession or fixation of someone with an eating disorder, the real problems lie outside of their weight. Many people suffering from bulimia nervosa, BED, or severe emotional overeating are actually categorized as overweight and obese.
Sometimes I eat until I’m stuffed. Is that a binge?
We have all had those experiences in our lives: Your mother cooks the best homemade dinner for your trip home and you overeat until you feel “sick to your stomach.” Or you go out for a big celebratory dinner and you eat all five courses, leaving you feeling “stuffed” and uncomfortable. Although this behavior is still not recommended, it does not automatically put you in the binge eater category. If you ask most people about this behavior, they will explain that this was an isolated event. Often times the person was so physically uncomfortable that the thought of eating again anytime soon was undesirable.
Someone truly suffering from BED will engage in this type of behavior at least twice a week for a period of at least six months. The clear and defining quality of someone suffering with BED versus someone who has an unhealthy tendency of overeating at times is the marked distress that they feel during and after the binge. Binge eaters feel guilt, shame, depression and disgust sometimes during and always after a binge. This distress is different from simply feeling like you wish you hadn’t eaten that much; it is a powerful and debilitating emotion that perpetuates the binge cycle.
What is an example of an emotional trigger?
Emotional triggers will vary from person to person. It is important to understand that everyone has emotional triggers. Think of the warm feeling you get when you eat a hot dog at a baseball game because you used to do that with your grandpa when you were little. It’s when an experience or event reminds you of something in your past and you immediately feel the feelings that you felt in the past, favorable or unfavorable. Often times, we don’t even connect the emotions we are feeling to the event.
An example of an emotional trigger might be when you smell fresh cookies baking in the oven and you automatically feel a sense of nostalgia. This is because your grandmother used to cook them for you when you were a child. You may feel the nostalgia, but the image of your grandmother may or may not even come to your mind. An example of an unfavorable trigger might be that when your boss critiques your proposal and you feel immediately defensive and attacked by him. This is because your father was overly critical of your homework and never praised you for doing it well. However, when your boss critiques you, you don’t automatically think of your father. This is where emotional triggers get tricky – feeling an emotion connected to something but not having a clear path to why you feel that way.
We don’t always have a sense of what is behind our emotional triggers. For some, this becomes very problematic and they will look to food for comfort or as a coping mechanism to help deal with the emotions that they do not understand. Some will reach for food to “numb” the feelings so that they do not experience the hurt. Some will reach for food to actively comfort the unwanted feelings. Either way, the use of food as a coping mechanism becomes a way to deal with the undesirable emotions.
What can I do for someone struggling with binge eating? How do they change?
Ideally, if someone comes to you for help with BED, you want to make them feel comfortable seeking treatment. Just like other eating disorders, BED can be severely debilitating. This is especially true if that person becomes overweight or obese due to the bingeing, as this brings with it a whole different set of complications. Certain residential treatment centers have programs designed specifically for BED that will simultaneously treat the eating disorder along with any weight issues. This is the optimal option.
Understandably, residential treatment is not always an option for everyone. If this is the case, change is still possible. It will take a consistent focus and commitment to changing problematic behaviors, but it is still possible.
First, your loved one needs to be honest with him/herself and those around them, realizing that there is a problem. One of the habits binge eaters get into is to eat in private and to hide any abnormal eating from their loved ones and their support group. This is largely due to feeling ashamed of their behavior, but it also allows them to continue the behavior without being questioned or judged. It will take an act of courage, but if you can get the person to admit that there is a problem and agree to being held accountable for their actions, this can be a very important first step.
Another step would be to practice eating mindfully. Mindful eating is not an easy practice, and it requires active attention to the problem and its solutions. It includes being aware of one’s eating patterns and behaviors.
Ask your loved one:
- Do they eat only at certain times?
- Are there certain foods that are particularly triggering for them?
- Are there certain situations that they know can throw them into a binge state?
We can’t change our patterns until we become aware of them. Practicing being mindful can include paying attention to physical hunger cues versus emotional hunger cues (which can be almost undetectable for someone who suffers from BED). Once someone has a good handle on their patterns and what their triggers are, they can begin to make small changes to the larger problem.
Practice and accountability would be the third step to take. Once your loved one is more accountable to their actions, and more aware of their behavior, they can start taking steps to make changes. Try having them keep a food diary. This not only helps them learn about their nutritional habits, but it also holds them accountable for what food choices they are making and in what quantities. If they are being mindful of their emotional triggers, have them try practicing a different coping mechanism instead of reaching for food such as taking the dog for a walk, taking a bath, reading a favorite book or magazine, or anything that will take their mind off the emotional trigger.
All of these steps are simple to understand, but not easy to implement for someone struggling with BED. At the very least, the help of a professional therapist who has experience with eating disorders is recommended.