Dieting: The gateway drug to binge eating disorder
Our eating disorder expert digs in to the dangerous relationship between binge eating and dieting
The word binge has been all over our culture lately. People say things like, “I binged at Thanksgiving,” or “I binged on Doritos and Netflix all weekend.” But there’s a big difference between overeating and binge eating. If meals are planned, slow or in control – it’s usually not a binge.
What is binge eating disorder (BED)?
When people binge, it’s not just about how much they are eating, but also about the process of eating. The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), is the encyclopedia of mental health diagnosis. It states that the key features of binge eating disorder are:
- Recurrent and persistent episodes of binge eating
- Episodes including three (or more) of the following:
- Eating much more rapidly than normal
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling hungry
- Eating alone because of being embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed, or very guilty after overeating
- Marked distress regarding binge eating
- Absence of regular compensatory behaviors (such as purging)
Signs of binge eating disorder
People who binge, typically binge alone. They might do it when everyone is sleeping or when they’re home alone or in the car. If someone you care about seems to be eating normally but gaining large amounts of weight, they may have a binge eating disorder – especially if they also have signs of depression and anxiety. Another sign of binge eating disorder is the practice of “hiding the evidence.” Examples include: finding wrappers under the bed, empty boxes stuffed in the closet or noticing that large amounts of food are missing.
Diet, binge, repeat
Most people say that their eating disorder started with a diet. A diet is any form of food restriction. The more people restrict, the more likely they are to binge. And the more they binge, the more weight they may gain. Which puts increased pressure to restrict, repeating the cycle.
Binge eating can produce a full-body calming effect that feels very rewarding. We’ve seen binge eating used as a coping mechanism by those with a history of trauma and PTSD. When the calming effect sets in, emotional pain goes away for a while. Many who binge experience a feeling of being out of control, saying they didn’t even really taste the food or enjoy it. Almost all individuals struggling with binge eating disorder report feeling sick to their stomach, depressed and filled with shame after binges. To avoid those feelings, they binge again, repeating another cycle.
Therapy is the best method for treating binge eating disorders
We help our patients create loving limits with food and their bodies. For example: it’s ok if they want to have a piece of cake every day for the rest of their lives, if they allow themselves to have that. Patients who label food as “bad” think they don’t deserve it, so they never eat foods like cake. Then one night their spouse brings home a cake, they eat a piece, feel bad about it and to deal with the shame and guilt – they eat the whole thing. When it comes to binge eating disorder, we need to stop focusing on weight and food as the issue, and focus on the idea of being healthy at any size – both physically and mentally. Therapy can get us there.
Start healing today
At Melrose Center we’ve seen success treating binge eating disorder by combining regular sessions of cognitive behavioral therapy with an eating disorder specialist and sessions with a dietitian. When treating our patients, we educate them on binge eating disorders and figure out how bingeing functions in their lives. We help instill the belief that all foods fit, practicing natural restraint – not restriction.
Andrea Zuellig PHD, LP
Dr. Andrea Zuellig is a licensed psychologist and clinical lead of the Binge Eating Disorder treatment program at Melrose Center. She uses behavioral, cognitive-behavioral, DBT, relational, dynamic and mindfulness-based approaches to help her patients heal eating disorders.