Binge Eating Disorder: The Connection Between Food and Feelings

Jenni L. Harshbarger, Ph.D.Robert J. Dole VAMC03/05/2013

Activity

As I See It. . .

What is Binge Eating Disorder?

Binge Eating Disorder (BED) is a type of eating disorder.

It’s normally characterized by recurrent binge eating without the regular use of compensatory behaviors.

What is a binge?

What are the characteristics of BED?

Frequent episodes of eating abnormally large amount of food.

Frequent feelings of being unable to control what or how much is being eaten.

Characteristics of BED cont.

Several of the following: Eating much more rapidly than usual Eating until uncomfortably full Eating large amounts of food, even when

not physically hungry Eating alone out of embarrassment at

the quantity of food being eaten Feelings of disgust, depression, or guilt

after eating

How common is BED?

BED is probably the most common eating disorder.

BED is estimated to affect 2% of all adults (about 1 million to 2 million Americans.)

BED is slightly more common in women than men (about 60% of people with BED are female).

BED is equally distributed across different races and ethnicities.

Where Do Eating Disorders Come From?

Bio-Psycho-Social Model

Bio Psycho SocialGenetics Personality Styles MediaMood Disorders Family Styles Peer Pressure Obsessive Compulsive All or Nothing Thinking

Messages re DietingPhysical Effects of Dieting TransitionsAddictions Stress

What are the complications of BED?

Diseases that accompany obesity, including: Diabetes High blood pressure High cholesterol levels Gallbladder disease Heart disease Certain types of cancers

Other Complications

Lowered Self Esteem

Decreased productivity through missed work, school, or social activities to binge

Increased depression, anxiety and other mental health disorders

What is the connection between food and feelings?

As humans we are biologically programmed to focus on food when we’re under stress

As a culture, food is a cornerstone of tradition, family and connection

Food can serve as a distraction or a numbing agent

Emotional Hunger v/s Physical Hunger

EMOTIONAL HUNGER

Is sudden Is specific for food Is “above the neck” Is urgent Is paired with an

upsetting emotion Involves automatic

eating Does not notice

fullness Feels guilty about

eating

PHYSICAL HUNGER

Is gradual Is open to different

foods Is Based in the

stomach Is patient Occurs out of physical

need

Involves deliberate choices

Stops when full Realizes eating is

necessary

Activity

The Food-Feeling Connection

What treatments are available for BED?

Cognitive Behavioral Therapy How do our thoughts, feelings and

actions interact?

Interpersonal Psychotherapy What is the role of relationships,

disputes, intimacy and feelings of loneliness?

Treatments cont.

Medications The role of antidepressants

Self-help groups The role of support

Researchers are still trying to determine which method or combination of methods is the most effective for controlling BED.

Short Term Planning for not Bingeing

Incorporate relaxation techniques into your daily routine. Take a yoga class, meditate for 20 minutes every morning and night, or simply take “quiet time” to be away from others an alone with your thoughts

Give yourself permission to eat what you crave, but do it with a capable support person who understands your goal is to increase self-awareness, not to binge. Then spend time talking about your feelings or writing them down.

Short Term Planning for not Bingeing cont.

Call or visit a “long lost” childhood friend whom you have thought about over the years but haven’t seen. Track them down. Catch up on each other’s life. They will not judge you for your binge eating; they have their own stories to tell.

Make lists about your life: likes and dislikes; goals; priorities; accomplishments; things to do; people to call etc… Lists are good for organizing your thoughts instead of letting them spin.

Short Term Planning for not Bingeing cont.

Practice saying “NO.” Be assertive and express your needs, small or large. Set your own limits and boundaries. This may feel risky at first, but it gets easier as you get stronger. Always remember you have a fundamental human right to your own opinions and decision.

Short Term Planning for not Bingeing cont.

Take a vacation. Get away from your usual routine, and decide not to binge while away. Be a “new” you while you are gone, and think about ways to continue with that attitude when you return home.

Short Term Planning for not Bingeing cont.

Try visual imagery, which can help you to later act out a situation in a positive way. Picture yourself doing something before you do it. For example, before dinner, mentally see yourself walking into the kitchen, preparing a healthy meal, eating it in a pleasant environment, and cleaning up afterwards. Imagine the scenario as purely enjoyable, then replicate it in reality.

Be wary of the scale!!!!

Remember!!!

Perfection is not possible – or necessary!

When you make a mistake – don’t miss the lesson!

Small changes slowly add up to big changes.

Activity

Mindful Eating Exercise

Autobiography in Five Short Chaptersby Portia Nelson

Chapter 1I walk down the street.There is a deep hole on the

sidewalk.I fall in. I am lost. I am helpless.It isn’t my fault.It takes forever to find a way out.

Chapter 2I walk down the same street.There is a deep hole in the

sidewalk.I pretend I don’t see it.I fall in again. I can’t believe I am

in the same place, but it isn’t my fault.

It still takes a long time to get out.

Chapter 3I walk down the same street.There is a deep hole in the

sidewalk.I see it there. I still fall in. It’s a

habit.My eyes are open. I know where I am. It is my fault.I get out immediately.

Chapter 4I walk down the same street. There is a deep hole in the

sidewalk. I walk around it.

Chapter 5I walk down another street.

Questions?