With a heavy heart, I read a recent New York Times piece called “Food My Frenemy” by Jen Gunter. In the piece, Ms. Gunter shares her agonizing struggle with a lifetime of binge eating – and the self-loathing and shame that can come along with it. She also references her ongoing battle with weight management in the shadow of her binge eating disorder.
Ms. Gunter aptly captures her body shame and hatred – so common in those who struggle with BED. She admits that most of her life, her body was not even in an overweight range, yet still, she felt inadequate, unappealing. She continued to invest her energies in the search for a miraculous method to bring her body weight down to a magical number where she could find peace.
This personal portrayal of the struggle with BED while a meaningful and accurate depiction of common BED realities, was also somewhat misleading in that the writer insinuates that a diet might have finally contributed to relative control of her binge eating struggle. The reality – that I share from treating countless individuals with BED – is that dieting to BED is like pouring gasoline on an open flame. Dieting/restriction is the number one trigger to binge eating behavior.
People who struggle with BED often experience body hatred; an endless quest to lose weight can become a central drive. So often there’s a mix of horror but also some relief when we explain that dieting and weight loss need to be placed on the back burner in order to finally address and eradicate the binge eating once and for all.
Ms. Gunter references logging food intake as a strategy she used to gain control of her binge eating. Food logging makes complete sense as a strategy for eating management. This exercise – not a diet – for Ms. Gunter was likely central in helping her steady her eating. The first step in changing a behavior is being able to look at it – to understand the circumstances that tend to trigger or fuel the unwanted behavior.
The writer also mentioned counting calories and weighing/ measuring foods as a method of regaining control. Much more often than not, weighing/measuring food not only fuels an obsession but it inadvertently leads to overeating. Using arbitrary measures of how much to eat directly challenges the most important skill for long term weight management: listening to your body’s hunger and fullness cues. When you eat by calories (often chosen at random based on a diet prescription) you’re completely disconnecting from your body and its own inner wisdom about what you need.
In treatment for BED we start with building awareness of the patterns of our eating (via logging) and gain an understanding of the function of over-eating. Does it self soothe? Keep you busy? Quell loneliness? Invariably we’re going to start thinking about alternative skills for coping. But first, we’re going to put aside restriction and dieting and instead adopt a more structured, even robotic approach to regular consistency eating – 3 balanced meals, 2 snacks daily. We’re going to working on helping you trust that starvation is no longer right around the corner. You will not have to be hungry. There is no food off limits. We may stay away from foods that are inherently challenging as triggers to overeating – at least at the start. But ultimately all foods will be on, not off limits.
If someone is binge eating regularly and then stops, you can see how there might be some natural stabilization of weight…. or even some reduction in weight. That said, this would be a natural bi-product of a regular, stable eating pattern rather than the intention of the treatment.
Over time, increased awareness of patterns, regular consistent nourishment, effective, health-reinforcing skills for coping and an increase in self-acceptance and self-compassion are key to recovery from BED. Contrary to what Ms. Gunter expresses in her NY Times, piece, a restrictive, diet lifestyle is not.
Columbus Park outpatient eating disorder treatment center in NYC specializes in the treatment of emotional eating and binge eating disorders. We use structured, time-limited, targeted treatments. The majority of patients who struggle with binge eating or emotional benefit from Enhanced Cognitive Behavioral Therapy which is recognized as the leading psychotherapeutic treatment for BED. Contact us to learn more.