The word, “binge”, brings a distinct image to mind: A man or woman stuffing all sorts of foods – from chips to masala nuts to pizza to ice-cream– into his / her mouth at a frenzied pace. For some, this image is pretty close to reality.
They may even develop their own idiosyncratic way of dealing with food cravings. Take this young woman in her mid-20s who came to me with a presenting problem of depression. In the course of the first therapy session, she talked about her typical binge: hitting multiple fast food outlets. McDonald’s for a cheese burger and fries. KFC for fried chicken and more. Candies for a Double Chocolate Mousse and German Apple Cake. In none of these places did she sit down and eat. Instead, she’d ask for takeaways. “As I took the bags, I’d pretend to check off items on a fake list that I’d created. I didn’t want anyone to think I was ordering all that food just for myself.” After loading up on fast-food snacks, she would drive back home, plonk herself on the sofa, switch on the TV, and (before she even knew it) finish eating it all.
Her overeating may seem extreme, but it’s more common than believed. Research confirms that Binge Eating Disorder (BED) is the 21st century’s most common eating disorder – more common than anorexia and bulimia combined. Despite its widespread prevalence, it is extraordinarily under-recognized, both by health professionals and by the public at large.
A distinction needs to be made between the occasional binge (e.g., you go through a whole basket of chips at a restaurant while waiting for a friend to arrive; or, you nibble on a cookie while reading the morning paper only to find you’ve finished three even before you’re done with Page 1). These occasional high-caloric lapses in judgement also constitute a binge, but they do not add up to an eating disorder. The clinical level of bingeing was defined in Harvard research as “uncontrolled eating at least twice a week for at least 6 months”. The key words are “loss of control”. For every person with a clinical bingeing disorder, it has been estimated that there are three more who mini-binge at a moderate level.
Why we binge
Whatever the food that’s “gone before you know it”, the binge impetus is almost always emotional. Any downer – from insecurity to anger, from emptiness to self-doubt – can kickstart overeating. This is how the message from Binge Tower goes: “Mad? Sad? Just plain feeling sorry for yourself? Open mouth, insert food”.
But why is turning to food such a common coping mechanism? Food helps change our conscious experience. We go into a bubble. Everything feels all right, and nothing can get to us. The escapism is actually a form of self-denial. Food becomes a medication, a tranquillizer.
And this food-emotion link sets in motion an addictive cycle of eating for emotional relief that binge-eaters are painfully familiar with. The binge-eater eats when she’s feeling lonely or depressed as a way to make up for what she’s missing. Then she gets mad at herself for overeating, which causes her to eat more, which causes her to get mad again...
But why grab on to food as a crutch? Just how did we transit from eating for fuel to this dangerous eating to feel good? The association between food and comfort goes back to infancy. A baby cries and she’s fed. So, in this very first instance of learning, food is associated with survival, with having our needs met, with satisfaction. Over time, that hard-wiring can become jumbled as parents use food to pacify children, or teens discover food as a filler for boredom. From there, it’s a short pathway to “I had a fight with my boyfriend, so I’d better eat everything in sight.”
There’s more – today’s toxic environment, a society that caters to a sedentary lifestyle, easy access to high-caloric snack foods, rising incomes and ever-burgeoning portion sizes.
Bingeing can have devastating health consequences. It can lead to obesity and a host of associated diseases, including hypertension, high cholesterol, diabetes, heart disease, joint problems and certain types of cancer.
The “diet” as culprit
The association between dieting and bingeing is well established. The deprivation that most diets involve can leave the dieter starving, feeling fatigued, and in the end, with a feeling that (s)he cannot take it any more. Loss of control inevitably follows. All of this is compounded by the fact that we tend to be speedy eaters when we are hungry. Our rate of eating is faster at the beginning of any meal. And when we’re food-deprived, we eat even faster.
But some research suggests bingeing is not just triggered by the lower calorie intake during dieting. Instead, it is related to chronic, unsuccessful attempts at losing weight with one diet and then another. With each failed diet, the dieter tends to adopt new unhealthy patterns of eating – including bingeing.
Putting the brakes on emotional eating
The good news is that it’s possible to stop bingeing. Here are the strategies that have been found to work:
» Eat several small meals during the day – instead of three big meals with long intervals in between. Frequent small meals (apart from the other health benefits they bring) can help prevent you from feeling so deprived that you speed-eat the chips and salsa before dinner.
» Cut yourself some slack when you’re on a weight-loss programme. If you don’t consciously and deliberately allow yourself a little flexibility and an occasional indulgence, you’ll end up feeling so deprived that, when you do cheat, you’ll do it on a scale that will send your self-control spiralling backwards. In other words, before you know it, you’ll be inhaling a whole big bag of wafers – bingeing, that is. Instead, allowing yourself a small indulgence now and then (say, a small nugget of chocolate after dinner each night) will help to keep desperate cravings at bay.
» Deal with the emotional issues that fuel bingeing. This step may not be as simple as timing meals or controlling portion size. For many, the feelings that trigger the cravings and overeating are almost unconscious. That’s why mindfulness has become the #1 way to gain control. How to start? By trying to get in touch with the feeling that triggers the binge.
Instead of numbing whatever it is – loneliness, frustration, anxiety – with food, ask yourself, “What am I really feeling?” Then ask, “If I eat this food, or go on this binge, what will it cost me?” Most cravings pass within 15 minutes, so if you can fight the urge to eat while exploring the underlying trigger, you’ll be working on your issues while keeping the overeating at bay.
» Eat sans distractions. This will help you to savour food instead of inhaling it. Make a deal with yourself that you can eat what you want, but you must sit at the table. Parking yourself in front of the TV with a generous supply of snacks is conducive to mindless grazing because you’re not really conscious of what you’re eating. Instead, when you eat at table, you’ll eat more slowly and you’ll also be more conscious and attentive when your brain sends out that satiety signal that tells you you’ve had your fill.
» Eat mindfully. A recent study has found that if a woman places her fork down between bites of pasta, then purposefully chews 15 to 20 times, she realizes that she’s fuller faster and she ultimately consumes about 70 calories less per meal. These tricks actually help you pay attention to what you really need.
» Try stress-reduction techniques such as yoga or walking which may help reduce the negative feelings that trigger emotional eating.
» Medications may help some binge-eaters. Research is still ongoing into some drugs that may help some (but not all) of those afflicted by food cravings. Those helped are binge-eaters who crave high-carb foods. There’s a reason for this kind of craving: research has established that carbohydrate consumption helps the release of a feel-good chemical in the brain which, in turn, improves mood. So, if you are magnetically drawn to a heaped platter of French fries because it makes you feel better, the fact is – it does. The high load of carbs in potatoes helps to release that feel-good chemical. The antidote, some studies indicate, is medication that works to release more of this brain chemical – so that you don’t feel the need to get your feel-good fix from that platter of fries.
» Cognitive behaviour therapy. This approach, used in counselling therapy, has been found to work better than drugs. It teaches binge-eaters how to monitor their eating, and how to change unhealthy eating habits, particularly in sticky stress-induced situations.
For the 25-year-old whose problem I cited at the beginning of this column, her wake-up call had come when testing found her blood triglycerides were elevated, and her doctor said it was most likely brought on by her poor eating habits.
Following the therapy sessions, she found she had arrived at a point where she refused to “diet” anymore because, for her, the word had become synonymous with unhealthy eating. Instead of denying herself, she began enjoying a variety of foods in moderation. And because moderation was the key, she began dropping the extra kilos. “I silenced that inner critical voice that came on if I picked up a bar of chocolate,” she said. “And now I pick up just one slab.”
Ultimately, getting your out-of-control eating in hand is hard work, but it can be done.
(The author is a former editor of 'Health & Nutrition' magazine, and now works as a counseling therapist)