(Note…I wrote this article when I was still a working journalist, before I was health-focused and weight-neutral.)
This was more than a craving for Chips Ahoy. Something was terribly wrong…
Yes, it’s true. Oprah was as genuine in person as she appears to be on TV. That information is for all of you who haven’t run into me in Kroger and had the chance to ask in person. It’s still hard for me to believe, but, I really did it. I went national on two Oprah Winfrey shows with my story of thirty years of binge eating. Before and after each taping, I questioned my decision. What would people think of me? Then, the combined effect of the Oprah appearances and my concurrent Channel 9 News series on binge eating disorder resulted in more than a thousand emotion-packed calls and letters from people requesting help. That’s when I knew the personal risk had been well worth taking.
If you’ve never used food to cope, to “stuff down” or avoid feelings, I know it’s hard to understand how someone could continue to do so despite the physical consequences (excess weight and all associated health problems) and the emotional toll (self-loathing and worse). Then there’s the social fallout, withdrawal from activities and sometimes from friends and family because we’re so terribly ashamed of what we’ve done to our bodies. To tell you the truth, it’s even hard for those of us who do it to understand why we keep doing it and why we can’t stop.
We feel out of control with food. We try to keep what we’re doing a secret. (Not easy as my weight soared to 289 pounds.) We eat in bathrooms and we thank God for the relative anonymity of drive-throughs. We know all the most isolated parking spots in the tri-state. That’s where we do much of our eating because we wouldn’t dare do it where anyone might spot us. We hold our breath and pray for the strength to pass a UDF without going inside. When we’re not feeling numb from the effects of our latest binge, we feel shame.
We feel deprived when we don’t give in to our obsessional food thoughts, guilty and desperate when we do. The best description of what living with this disorder is like comes from a friend of mine. She says it’s just like a scene in a movie where an alcoholic says, “I’ve got to have a drink. I’ve got to have a drink.” And then, as soon as he gets that drink he’s okay. For many of us, it’s just like that, only with food.
Another friend told me she had enough weigh-in cards from one internationally known diet program to wallpaper a house. I did too. Believing that the weight is our problem, we go from commercial diet plan to commercial diet plan. Oh, the money I spent on programs and pre-packaged diet foods believing that if I could just get some of this weight off, the rest of my life would straighten itself out. I’d be happy and then I’d do all those things I wouldn’t dare to do overweight.
I thought I lacked willpower. That’s what well-meaning people, including doctors and mental health professionals, told me for years. But, I knew in my heart that there had to be more to it. I really wasn’t weak-willed or undisciplined. I had worked hard to put myself through college. I had established myself as a credible broadcast journalist, getting thin for every job hunt. I won a Peabody Award and then a prestigious fellowship for mid-career journalists to Stanford University. If I could do all that, why couldn’t I stop eating? It just didn’t make any sense.
Today, it makes all the sense in the world. Through my own therapy, research and discussions with experts in the fields of eating disorders and obesity treatment, I’ve come to understand that diets don’t work for people like me. Diets treat only the symptom, which is the weight, not the problem, which is an eating disorder.
What I have learned is this. People who eat compulsively, who use food to repress their feelings, are usually people who have trouble identifying, tolerating, expressing and regulating their feelings. Research also shows we are people who have a higher rate of (or family history of) depression, anxiety or alcohol use than those in the general population. We make food, with its immediate reinforcement, availability and social acceptance, our coping strategy of choice. Why food? Because it works.
“We think the reasons that promote this kind of overeating come from the brain.” When MIT research scientist Dr. Judith Wurtman said those words to me during an interview, I felt like I had been waiting to hear them my entire life. How many times had I tried to explain to a health care professional or to a diet center pseudo-counselor about this physical discomfort, agitation or craving that I’d get that would lead to a binge? How many times had I been told, politely, that it was all in my head? It turns out it was in my head. But not exactly the way those counselors meant it.
After seventeen years of studying the relationship between food, mood and brain chemistry, Dr. Wurtman says, “People who binge are biochemically different from the people who don’t binge. And I think this is very important in order to remove guilt from people who do use food as a way of handling anxiety.”
Dr. Wurtman says some people actually consume sweet and starchy foods, carbohydrates, in an attempt to self-medicate. Her research indicates that people like me, when stressed, crave foods like sweets, breads and potatoes because those kinds of foods lead to the production of the brain’s own calming chemical, the neurotransmitter serotonin. “Serotonin is made in the brain when carbohydrate-rich foods are consumed.” Wurtman says serotonin plays a major role in regulating our moods. “When produced in sufficient quantity, serotonin makes people feel less anxious, less depressed, more alert, more emotionally stable. But, on the other hand, when it is not available in sufficient quantities in the brain, it sets up feelings of emotional discomfort, depressed feelings, anxiety, inability to focus, and an irresistible craving to eat sweet and starchy foods. So what happens is the serotonin, which is not available in enough quantity when there is stress, is saying to the eater, eat some carbohydrates so that more serotonin will be made and emotional calm will be restored.”
Dr. Wurtman says we binge because it works and we keep bingeing because it’s self-reinforcing. I kept turning to carbohydrates to relieve emotional discomfort, just as someone with a chronic headache might keep reaching for two aspirins. “These people are driven to self-medicate with food over and over again until the underlying emotional disturbance is resolved.”
Okay. So, I was right. I wasn’t bad or weak-willed. It wasn’t my fault. There was a reason I started self-medicating, zoning out with Chips Ahoy cookies and Wonder Bread at age 4. I ate as much as I could sneak from the bread drawer because the foods my mom kept in the bread drawer took the edge off my chaotic homelife and nobody ever taught me any other healthier ways to manage uncomfortable feelings.
So now what? Blaming my parents for raising me in a dysfunctional family wasn’t doing me any good. Here comes the hard part. Although none of this was my fault, recovery was my responsibility. And, as is often the case with giving up a defense that has worked well, I found the early stages of recovery sometimes more painful than the disorder itself.
“We feel out of control with food. We try to keep what we’re doing a secret. We eat in
bathrooms and we thank God for the relative anonymity of drive-throughs.”
Not long after I entered an inpatient eating-disorder treatment program, I faced the fact that I was more comfortable with my “I’m too fat to participate in life” excuses, than I was dealing with the emptiness that I’d been trying to fill with food all those years. If I gave up the food and the excess weight, what would life be like? What risks would I have to take? How vulnerable would I be? What would I obsess about if I wasn’t thinking about food all the time? What feelings would I actually have to feel and live through? If I got down to goal weight I might be tempted to start dating again. Then I might get hurt and then I would just have to turn back to the food so why take the risks to begin with, and on and on and on.
Today, after much therapy and emotional risk, I am at peace, not always, but more often than I ever thought possible. I no longer live in total fear of my feelings. I’ve learned that even the bad feelings pass without permanent damage, if I just let them. I’m learning that when I’m anxious, stressed or depressed, even angry (still the toughest one for me to deal with), I can turn to healthier coping strategies than food for mood regulation. Today I have wonderful friends and a great support network.
And I have a mission to help others (especially health care professionals) understand that not every overweight person is the same. Some overweight people do have poor eating habits, but many of us have a disorder that won’t be fixed by a 1200-calorie diet and suggestions such as “put your fork down between bites.” During a routine office visit, a friend of mine says her doctor pointed out her weight gain, as if she hadn’t noticed, then he suggested she go buy some of those “Lean Cuisines.” “They’re proportioned,” he said. I’m sure he was trying to be helpful, but his lack of understanding added greatly to my friend’s feelings of pain and despair.
Today, my mission has a name. I am part of a new, multi-faceted and much-needed treatment option in Cincinnati. With the support of my bosses at Channel 9, I co-founded the Acoria Wellness and Eating Disorder Treatment Programs. (Acoria is a word that Hippocrates coined. In the psychiatric literature it means “moderation in eating”.)
Today, I’m seeing some of those same Channel 9 viewers who called or wrote to me after the Oprah Shows take the same risks I took and they’re getting well, emotionally and physically. I can’t tell you how wonderful that is to witness!
My friend with the “Lean Cuisines” is now seeing an Acoria psychotherapist and, at last, she’s finding out why she overeats…And she is learning alternative coping strategies for mood regulation. Under the care of the Acoria Psychiatrist she is taking an antidepressant that improves her serotonin level and that has greatly reduced her need to binge. With the help of our registered dietitian she’s developing healthier eating habits. With our certified physical fitness specialist she’s working through her resistance to exercise. All of her treatment is coordinated by a team of health care professionals who feel that the emotional, nutritional and physical aspects of recovery must all be addressed simultaneously and holistically.
As I sat quietly to write this article, I thought about all the feelings I have actually felt (rather than “stuffed” down), during the past few years of my recovery. Many of those feelings have been exciting. Some very scary. And is often the case in life, some have been both. Last year I experienced two sudden and unexpected losses. A family member, who was depressed, committed suicide. My father, who was only 64 and had not been ill, died of a heart attack. After many strained years, he and I had just reconciled. It wasn’t fair. I was grateful that we’d finally begun to get to know each other, but I felt cheated out of a relationship that could have been…but now, would never be. But, I felt it all! I experienced it all, the good and the difficult feelings, without using food to blur the edges. And it all turned out okay.
Today, through all the highs and lows, I remain in recovery. And, as anyone who has ever used food as their coping strategy of choice can tell you, that’s a miracle.
Do You Have a Binge-Eating Disorder?
The first step on the road to recovery is seeking help.
The official diagnosis of Binge Eating Disorder is new. This proposed criteria for diagnosis will be included in the next edition of the manual that psychiatrists and insurance companies use to determine the need for treatment.
Research criteria for Binge Eating Disorder
A. Recurrent episodes of binge eating, an episode being characterized by both of the following:
- eating, in a discrete period of time (e.g., within a 2 hour period) an amount of food that is definitely larger than most people would eat during a similar period of time under similar circumstances
- a sense of lack of control during the episodes (e.g., a feeling that one cannot stop eating or control what or how much one is eating.)
B. The binge-eating episodes are associated with 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 physically hungry
- eating alone because of being embarrassed by how much one is eating
- feeling disgusted with oneself, depressed or very guilty after overeating.
C. Marked distress regarding binge eating is present.
D. The binge eating occurs, on average, at least twice a week for six months.
E. The binge eating is not associated with the regular use of inappropriate compensatory behaviors to prevent weight gain, behaviors that are characteristic of bulimia nervosa or anorexia (e.g.; self-induced vomiting, use of laxatives, fasting, diuretics, excessive exercise)
Ellen Shuman is a Life Coach who specializes in emotional and binge eating issues. She is the founder of A Weigh Out & Acoria Eating Disorder Treatment, Vice President of the Binge Eating Disorder Association (BEDA), and Co-Chair of the Academy for Eating Disorders Special Interest Group on “Health at Every Size”, firstname.lastname@example.org