THREEGREATMYTHSOFBINGEEATING
• #1BingeEatingisthesameasovereating
• #2Peoplewhobingearelazy&self-indulgent;theysimplylackthestrengthofcharacter&motivationtochange
• #3“IfIcouldjustfindtherightdietandexertenoughwill-power,Icouldsolvemyproblem”
Myth#1BingeEatingistheSameasOvereating
• Threemaincomponentsofbingeeating• Eatingwhatmostpeoplewouldconsideraninappropriatelylargeamountoffood• Feelinglossofcontrol• Extremedistress
• Othercommonelementsofbingeeating• Soothed&comforted• Euphoria&relief• Frenzied&accelerated• Numb&disconnected• Alone&insecret• Shame&remorse
• Reading*
BingeEatingDisorder(BED)
• Bingeeatingdisorder(BED)isaneatingdisorderinwhichapersonbinges,onaverage,onceaweekoverathree-monthperiod(AmericanPsychiatricAssociation’sDSM-5)• Morecommonthananorexiaandbulimiacombined• 8millionAmericansmeetthiscriteria• Another8-10milliondon’tmeetthecriteriaforBEDbutare,nonetheless,affectedbybingeeating• BEDistheonlyeatingdisorderthataffectsmeninlargenumber
Myth#2Peoplewhobingearelazy&self-indulgent;theysimplylackthestrengthofcharacterandmotivationtochange
• Deepdown,mostofuswhobingefeelthatoursecreteatingistheresultofsomedarkcharacterflaw,somemoralfailing• Obeseindividuals,especiallythosewhobingeeat,haveasenseofworthlessnessinstilledearly• Studieswith5th graders&preschoolers*• PeoplewithBEDareoftenhighlycompetitiveperfectionistswhoareextremelyself-critical• OnestudyexaminedperfectionismandBEDandfoundthattheobesebinge-eatinggroupscoredsignificantlyhigheronperfectionismthantheobese,non-bingeinggroupandthenormalweightgroup• Thehighstandardsthatwesetforourselvesmayhelpusbecomesuccessful,buttheyactuallycontributetoourbingeingbehavior• Soifit’snotacharacterflaw,whatcausesapersontodevelopBED?
FactorsThatContributetotheDevelopmentofBED
•EarlyChildhoodTrauma•Psychological&EmotionalFactors•Genetics•Dieting
FactorsthatContributetotheDevelopmentofBED
• EarlyChildhoodTrauma*• Highcorrelationbetweenanunsafehome&thedevelopmentofBED.Why?• Amygdala:theprimitivepartofthebrainresponsiblefortriage&emergencyaction(fight-or-flight)• Beingconstantlyvigilanttodangerintheearlyyearschangesthephysicalarchitectureofthebrain.Theroutethroughtheamygdalabecomesrutted&wedevelopahair-triggerfight-or-flightresponse• Theamygdalalearnsthatcertainsights,sounds,andsmellsinourenvironmentaredangercues(theseareespeciallyimprintedduringourearlyyears)• Astensionsrise,weareforcedtoseekimmediaterelief,andfoodistheearliestandmostprimalofsoothingbehaviors• Plus,dangeroushomesgiveuslittleopportunitytolearnself-soothingskillsinthoseearlyyears
FactorsThatContributetotheDevelopmentofBED
• EarlyChildhoodTrauma• Psychological&EmotionalFactors• Depression• Anxiety• Suicidalthoughts&actions• Poorself-esteem• Poor&inaccuratebodyimage
FactorsThatContributetotheDevelopmentofBED• EarlyChildhoodTrauma• Psychological&EmotionalFactors• Genetics• Somefamiliesaresimplymorepronetocertaineatingdisorders• Twinstudiesshowtheinheritabilityofbingeeating
• BEDis3Xstrongerbetweenidenticaltwinsthanfraternaltwins• Severalstudiesshowbingeingisabout50%heredity&50%environment
• HighcorrelationbetweenBEDandalcohol&drugabuse• 10%inthegeneralpopulationvs.50%inBEDpatients)
• Brainscans• Studiessuggestthereisagenetictraitforimpulsivityandrisk-takingthatiscommontobothBED&otherimpulsivebehaviors(likegambling,shop-lifting,sexualaddiction,compulsiveshopping,alcoholism,drugaddiction)• Fred
Genetics(continued)
• PatientswithBEDandtheirfamiliestendtobeimpulsive,unrestrained,stimulus-seekingpeoplewhogoaftertheexciting,novel,intenseexperience.Ourhomesareoftenloudandrancorous.Weareoftenrisk-takers,whichcansometimesleadtodangerousbehaviors.• Thisislikelywhyyoufindmanywhohavetheseimpulsivetraitsamonginmatesinprisonsandamongpatientsinrehabcenters• BUT…• It’salsowhyyoufindmanywithBEDandotheraddictionsamongentrepreneursandbusinessleaders(especiallysinceoftenpairedwithperfectionism)• Thereisaconnectionbetweenaddictivepersonalityandsuccessfulleaders*• Ontheotherhand,patientsw/anorexiaandtheirfamiliesareoftenhighlyaversetorisk-takingandshowmuchmoreemotionalcontrol,followtherules,andavoidconflictandconfrontation
Genetics(continued)
• Onestudyexaminedthegeneticmakeupof1000’sofseverelyobeseindividuals(whobecameobesebeforetheageof10)• 1in20hadavariationintheMC4Rgene• Peoplewiththisvariationaremissingcertainneurochemicalreceptorsthatcontrolsatiety.Theirbrainssimplynevergetthemessagethattheyarefull.• Firststudythatdirectlylinkedgenestothebehavior ofbingeing• Pairedthosewiththegenevariationtoanequallymatchedpersonsinthestudy(age,gender,ethnicity,BMI,%bodyfat,etc.)butwithoutthevariation• 100%ofthosewiththisvariationmetthecriteriaforBED• Only14%ofthosewithoutitmetthecriteriaforBED
Genetics(continued)• Variationsindopamineandopioidreceptorgenestremendouslyaffectaperson’slikelihoodofdevelopingBED(ex:DRD2,OPRM1)• Thegeneticconnectionisstillinitsinfancy,butholdspromiseforallsortsofaddictions—andtheirtreatment• Ex:naltrexoneisanopioidblockersometimesusedforalcoholism&certaindrugaddictions• StudiesshowthatalcoholicswhohaveacertainvariationintheirOPRM1genearemorelikelytorespondtotreatmentwithnaltrexone• OneresearchertoldmehewasgettingareductioninbingeingwithsomeBEDpatientswhenheusednaltrexone• …thosewithapersonalorfamilyhistoryofalcoholism
• NaltrexoneisoneoftheingredientsinContrave(aobesitydrug).Theotheringredientinthatmedicationistheanti-depressantWellbutrin(wellknownforit’suseinnicotineaddiction)
FactorsThatContributetotheDevelopmentofBED
• EarlyChildhoodTrauma• Psychological&EmotionalFactors• Genetics• Dieting• Definitionofdiet• Di’-et:theusualfoodordrinkofapersonoranimal• Di’-et:restrictoneselftosmallamountsorspecialkindsoffoodinordertoloseweight
• Dietingisthemostimmediatetriggerforabinge• Leadsustothenextmyth
Myth#3“IfIcouldjustfindtherightdietandexertenough
will-power,Icouldsolvemyproblem.”
Dieting,especiallychronic,stringent,low-caloriedieting,isABSOLUTELYthewrongapproachtosolvingabingeproblem.WHY?
• Hunger&deprivation• Chronic,stringentdietingoveraperiodoftimechangesthebrainchemistry• Reducescertainneurochemicalsthatcontrolsatiety;dampensourinnatesignalsofhungerandfullness
• InBED,foodisnotbeingusedtonourishthebodybutrathertomanageemotionalneeds• Foodissimplyourdrugofchoice
Dietingisourworstenemy!!…sowhatsolutionsdidIuse?
AnatomyofaBingeCycle
NegativeEmotions
Binge
Shame&Remorse
Resolve:NewDiet
DietFails
Eatsomethingtorelieveincreasingtension
All-or-nothing:“I’veblownit…”
Relieved,soothed,euphoria,numb,disconnected
“ThistimeI’llbeperfect.”
“Ihavenowillpower…I’msuchafailure…Whataloser…”
Hunger,deprivation,depression
Exhausted,humiliated,embarrassed
Conclusion
Take-awayOvercomingbingeeatingisaboutsomuchmorethanstoppingthe
behaviorofbingeingorlosingweight*
Itisabouttransformationandpeace
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