Overeating

Being overweight is a condition that is still subject to public humiliation as a part of the social norm. It is often thought that it is one’s fault for the size of their body, and that it is entirely within their control to change the size of their body. It’s thought that if one can just “pull themselves up by their bootstraps” and try a little harder that they, too, can torture their bodies into submission to become the size that they desire [insert diet culture here].

Until 2013, it was not acknowledged by the medical/mental health community that being overweight was part of a diagnosable eating disorder, although many of those who struggled with overeating and sought help were categorized into the “unspecified” eating disorder category. Then, in 2013, the DSM-5 was published, which includes Binge Eating Disorder (BED)(see link for criteria and more information) as a diagnosis.

While the DSM-5  acknowledged one diagnosis to characterize overeating as an eating disorder, there are three different categories of overeating: binge eating, compulsive overeating, and grazing. Binge eating consists of eating the amount of food in two meals (doesn’t have to be meal food) in two hours or less. Binge eating is often associated with planned binges where large amounts of food are gathered and food is eaten in one sitting (if binge eating is followed by purging, symptoms cross over into Bulimia). Compulsive overeating has a control flare to it, and can be characterized by needing to finish a certain amount of food – such as a whole box of cereal or three containers of Twinkies. Grazing is when one eats small amounts of food continuously over a long period of time so that they end up overeating but don’t realize it because of how much time passes. I find this is very common with people who are “too busy” to sit down and eat, such as moms, who nibble as they can, but keep coming back for more and eat too much. In my experience, those who have been diagnosed with BED typically have a mix of these types of overeating when they present for treatment, but may only focus on one or two types as treatment progresses. Working with a therapist who has eating disorder-specific knowledge can be helpful to identify these patterns, discover and understand the root of the behavior, and plan and practice to change behaviors.

It may surprise some to know that one of the first questions I often ask my clients is “How were you taught to eat?” This is usually followed by a puzzled look, and some sort of reply that they never really thought of it before. Digging in, however, often they were taught disordered eating as a child, or it was reinforced in some way, or their parents had eating disorders themselves and passed down not only their genes, but also parental teachings and modeling that may have reinforced disordered eating patterns. I certainly don’t encourage anyone to play the “blame game” as far as past experiences go, but rather to just understand why people acted the way they did to the best of your ability, to try to accept it (and forgive it if necessary), and then make a plan for how to move ahead. This is in line with the DBT teachings of “distress tolerance” and specifically “radical acceptance.” For some of my clients, this meant writing letters that can be burned – as a way of letting go and/or sending the message on to someone who has passed.

For those diagnosed with BED, there is always a web of shame and guilt being carried around related to their eating and body. Some have tried any diet or diet program or diet pill that they could get their hands on in an effort to mold their bodies to the desired shape no matter the cost – literally or figuratively. They have been told, and now believe, that they are just not trying hard enough to win at the game of being able to have the “perfect” body. There becomes an acceptable fixation on losing weight, and our “diet culture” is thriving as a result.

The truth is that we don’t get to pick what shape our bodies are. If we are in tune with our bodies, eat when we are hungry, and stop when we are full, and do an amount of “joyful movement” that feels good, your body will even out to be the size that it is supposed to be – or the “set point.” For people diagnosed with BED, this may mean accepting that their body size following treatment may not look like the “goal weight” they came into treatment imagining – which is usually their lowest weight that they were as a teenager or young adult. Many feel a sense of defeat at the task – to accept their “larger” bodies would mean accepting a lifetime of have a “bad” body size that can and likely will impact how others perceive you. However, when one can give over control of the shape of their body back to their body through being in touch with cues such as hunger/fullness, they end the losing struggle of trying to shape one’s body into something it simply isn’t. It’s like setting down the tug of war rope you’ve been battling at for years – there can be a real release of tension if this can be achieved.

One way to work towards alleviating some of the shame and guilt associated with an eating disorder is to be able to put an arm’s length between one’s “authentic” self and their “beast” (eating disorder/mental health concern/trauma, etc.) by being able to characterize behaviors or thoughts from the beast. An example would be “My eating disorder got mad at my husband for showing me a video about a woman with an eating disorder” as opposed to “owning it” – i.e. “I got mad at my husband…” While this causes some of my clients to struggle with their feeling the need to have accountability for their actions, often these thoughts/behaviors are dichotomous for someone with a beast. They are inclined to do/say/think something that, at the same time,their “authentic self” can rationalize against. The internal struggle is very difficult for many, and results in an internal dialogue that can be very “loud” when triggered. One can learn to recognize these thoughts, and then start to fight back against them (see Positive Self-Talk). Eventually, with practice, it becomes easier to fight back against urges, and then they become manageable and less intrusive on one’s life.

If you are reading this and wondering if you or someone you know might have some of the symptoms of Binge Eating Disorder, I would encourage you to get an assessment done. You could contact your insurance to ask about who might be covered for you. It is an incredibly brave step to decide to speak to a professional, but it is the first step to getting help against a difficult condition. Eating disorders can be “vicious” and may require professional support to navigate.

Finally, I would encourage everyone to be more compassionate towards themselves. As some of my RD co-workers preach, use “balance, moderation and variety” in your eating. Avoid strict rules in your eating. Listen to the signals from your body the best you can and respond to them. Understand that no one is a “perfect” eater. The goal is stability, not skinny. Love your body, you only get the one.

Mindfulness

Mindfulness has become something of a buzzword lately. Although simple at face value – mindfulness is the act of paying attention to the moment in the moment – it is a complex idea to put into action. The problem many of us face is that we are so accustomed to multi-tasking, numbing, and doing things that take our mind out of the moment, that it seems like a huge battle to try to change that. And why is it important? For the long explanation, see this video. Actually paying attention to one thing at a time in the moment that you are doing it can really change the way you think.

In what ways is multitasking built into your life? Do you have a cell phone bothering you while you are working? Is your smart watch buzzing while you are trying to have an in-person conversation? It feels that the more technology becomes a part of our daily reality, the easier it is to multitask. But the problem with multitasking is that by splitting your attention amongst various tasks, you don’t get to give your full attention to anything, and so all the tasks suffer. Are there ways in which you can cut multitasking out of your life?

In our pop-a-pill culture where we are so intensely medicated by both medical professionals and through legal and illicit drug use that is has become the norm to just numb through difficult emotions or pain instead of figuring out how to cope with them. One drug we don’t talk about as much is food – people who compulsively overeat often turn to food when they are not hungry, but rather to numb them from their negative emotions. This provides a temporary fix until the guilt sets in about overeating, and can be especially difficult, as you can’t cut food out of your life like you can with drugs. Seeking therapy can be one way to unload all of the emotions that you might have been “stuffing down” or “numbing” over time so that you can release the pressure that builds.

Sometimes people are driven not to be mindful, because when they are quiet and alone, thoughts related to depression (that usually brings unhappy memories from the past), and anxiety (which usually makes us worry about the future) or other mental health concerns. If you find it is difficult to be alone with your thoughts, then it is time to find someone safe to share them with. You might start with a friend or family member, but may find someone outside your social life, such as a therapist, helpful with this. If you have any thoughts of harming yourself or others, please seek help immediately by contacting emergency services/911 or a local crisis resource.

Part of mindfulness is being in your body in the moment. For some people, this may be somewhat of a foreign concept. We, especially as women, tend to take a position of desiring to change our bodies, never accepting them as they are, the only body we will ever have. By getting back “in” your body and getting in touch with its signals and feelings, often acceptance starts to build, and the body becomes reintegrated with the mind, which are really two halves of our whole selves. To start, you might try a body scan. This involves sitting quietly in a comfortable spot with your eyes closed, focusing on relaxing different parts of your body. This falls into the category of “guided meditation,” and can be a great way to get started with mindfulness. Try a search on YouTube or download an app – Calm and Simple Habit are some of my favorites.

If you’ve already explored some meditation, and thought “I’m no good at this,” or “I just can’t sit quietly for that long,” consider that your mindfulness skills are like a muscle to be built up over time. In the video above, Ron Siegel describes your mind as a puppy that you need to be patient with and train by being patient and bringing it back to the task at hand each time it strays. He also describes trying to think of your thoughts as clouds in the sky, just letting them float on by without getting stuck on them or judging your thoughts. During guided meditations, such as the one linked above, it can be easier to keep your mind on task, because there is a voice to focus on and to go back to. After a while you may prefer “open meditation” or just sitting quietly without any guidance, usually for a set period of time.

Once you start to be in touch with your body, you will start to realize what an amazing machine it is – it is smart enough to tell you when it is hungry, what it is hungry for, when it is full, and when it is tired or in pain. If we can listen to these signals and respond appropriately, our bodies have the opportunity to find balance and calm. For more information about how to find peace with eating through honoring your body’s signals, check out intuitive eating.  If you struggle to be able to identify when you are hungry and when you are full, or feel that you eat for reasons other than being hungry, you may consider seeking out an eating disorder assessment. Work with an eating-disorder-informed therapist and/or dietitian may be helpful in reestablishing those cues.

Challenge yourself to integrate mindfulness into your life one bit at a time – such as setting an alarm to do a 5-minute meditation during your break at work, or finding a meditation that helps you fall asleep. See what sort of calm and peace you can bring to your life by being mindful in this moment, using all your senses, and observing all that is going on inside and outside of you without judgment. Be your body’s own best friend and figure out how to receive all the communication it is sending you, and how to take care of yourself best.

Relationships with food

When we are babies, we associate our parents with love, and with their love, the nourishment they provide for us. As children, we may be rewarded with food, or maybe punished by taking it away. We may be taught to clean our plates, and taught that over stuffing ourselves is preferable to wasting food. As adults we may use food to comfort ourselves when we are down, or reward ourselves for a job well done. For those enmeshed in the diet culture, food may incite a myriad of emotions.

Although, biologically speaking, we only need food and drink as basic nourishment to fuel our bodies, we, as a culture, have expanded the use of food far beyond that. We learn to use it in many ways other than its actual purpose. As a result, our bodies are fed inappropriately, and we overfeed or underfeed ourselves, convinced that trying to morph our bodies is somehow a more logical answer than getting in touch with our bodies and finding the balance in which they function the best. We are taught that each passing diet fad is a “better” way to eat, and that by eliminating entire categories of macronutrients we will finally be able to turn our body into the body we have wanted for so long. We have hammered it into our heads that strict rules for health, like the BMI chart, must mean that being “obese” means being in very poor health, and that it is likely more of a character flaw than anything to blame, and that one must just buckle down and try harder.

Try to break away from all of the Netflix food documentaries and the Pinterest “nutrition” articles, and think about this. Your body is actually a highly-intelligent, self-driven machine that knows what it wants to eat, when it is hungry, and when it is full. If we can actually get in tune with these signals and are able to follow them, our bodies will find the balance they crave and will become the size and shape that they were intended to be. No two bodies are identical, and trying to have someone else’s body is futile – it is already taken, you only get the one you were given.

So many of us have gotten so far away from the signals of our own bodies, trying so hard to silence the hunger cues, or feeling that a sense of hunger is somehow a triumph over will. Consider that feeding your body appropriately will actually help you to think about food less. If you are constantly hungry throughout the day, your brain isn’t being fed properly, and will focus on food in an effort to get its needs met. If you allow yourself to eat what you crave in an appropriate way (an appropriate portion at an appropriate pace), or decide to eat it at the next appropriate time instead of making foods off limits, you take your focus off of those foods you are craving. If you respond to the signals from your body, it will stop sending them, and you can decide what to do with all that brainpower that is left over.

How do you get back in touch with the hunger and fullness sensations in your body if you have moved too far away from them? I would suggest seeing a RD (registered dietitian) who is eating disorder informed (it will help them be more sensitive to eating concerns) and getting on a sort of meal plan. Typically, the clients I see are on meal plans that consist of three snacks and three meals daily. After you get used to being on this pattern, your body starts to anticipate when it can expect food, and gets in sort of a rhythm. Then, when it is meal time, you should start feeling hunger. Concerning fullness, you want to shoot for being about 80-85% full, with the idea that it takes about 15 minutes for your brain to get the signal that your body has the food that is in your mouth right now, so about 15 minutes after you are done eating, you should be closer to 100% full.

The most common complaint I hear about being on a meal plan is that it feels like you are eating all day. It’s because you are, and you are supposed to be.  It is incredibly common for my clients to tell me that they “eat healthy” in the morning – which means that they restrict their food intake and only eat very low-calorie foods that often are not rich in fats or carbs. Then, when in comes to the afternoon or evening, they have been trying so hard not to eat the “unhealthy” foods that it becomes too much and they end up eating something they didn’t really want to be eating, and sometimes in an amount much greater than they had intended. If you are eating throughout the day, you are appropriately full on the things you crave, so there is no need to overindulge later.

Speaking of foods you crave – what about dessert? Dessert is just food. If your authentic self likes the taste of sweets, you should allow yourself about desserts. Again, it is important to consider “loving limits” and having about a maximum of an average of one serving per day. If you struggle with this idea, consider having dessert with dinner each night. If you find yourself waiting until the end of the meal to eat your dessert because “it is the best part,” you may want to try “eating in the round” – having a bite of each of the dishes on your plate, as well as a bite of dessert before going back and having a bite of each again.  This reinforces the idea that each of the bites is just food.

I can already see the eye-rolls from the iron-clad diet fans out there, but consider how much of your life, and your free time you devote to your food and your body. What would it be like to take some of that back? What would it be like to accept and respect your body for the incredible machine that it is, instead of rejecting it and constantly fighting it to change? What would it like to be at peace with your food?

If you or someone you know is struggling from an eating disorder, please seek help. They can be deadly serious, and are not your fault. Please see warning signs and symptoms here or call 1-800-931-2237 for help.