Sunday, July 8, 2012

My Problem With Conventional Definitions of Recovery

I want this binge eating behavior to go away. Forever.

That's why I'm so attracted to the ideas in Brain Over Binge. The author tells the story of how she stopped binge eating permanently; she has not slipped up once in the years since.

I hate the idea that binge eating is a "disease," and that I will forever be in recovery, like an alcoholic who hasn't had a drink in five years but still identifies himself as an alcoholic in recovery. Frankly, I think that's bullsh*t. As defined by the National Eating Disorders Association,
Binge Eating Disorder (BED) is a type of eating disorder not otherwise specified and is characterized by recurrent binge eating without the regular use of compensatory measures to counter the binge eating.
Binge eating disorder requires binge eating. The disorder cannot exist without the binge eating. So if one doesn't binge, one does not have binge eating disorder.

Further, I do not believe that Binge Eating Disorder is a disease. Yesterday on my run, I was listening to a podcast by this girl, who was interviewing this girl. I thought it was a very well done podcast and I really empathized with Manda, the girl being interviewed. The podcast focused on a message of self-love, which is something I'm currently working on. I thought Manda was eloquent, tremendously kind, and someone whose struggles I identify with.

BUT. She focused a lot on how her binge eating disorder was a "disease" that was "not her fault." I gathered from her background that these messages were taught to her by Overeaters Anonymous, a group to which she belongs.

I respect her journey of recovery. Far be it from me to tell anyone else what should work for them, or that they are wrong in identifying and solving the problems in their life. Knowing how incredibly difficult it is to overcome binge eating disorder, I have nothing but compassion and love for people like Manda who are also trying to banish it from their lives.

BUT. I disagree with that portrayal of binge eating disorder as it relates to my own life. I do not think I have a disease. I do not think it is "not my fault." I do not think that binge eating disorder simply happened to me.

Rather, I believe that binge eating disorder is nothing more than a habit that I caused when I was in high school. True, I have felt powerless to overcome it in the 10-ish years since, but that's how habits work. They're tough to shake. They become ingrained. Our brain pathways literally rewire to make binge eating a conditioned response to countless stimuli in our lives.

I think that giving binge eating disorder the label of "disease," gives it too much power and stigma. You can't just will yourself to get over cancer, so why should it be any different with binge eating if it is a disease?

I believe that binge eating disorder is actually a sign that our brains and bodies are functioning normally and optimally. Before you shut your browser tab and call me crazy, just hear me out: Our bodies want to survive. Our brains want us to survive. That's why we have evolved to have things like adrenaline and fight-or-flight responses.

I think binge eating is the same thing. I began binge eating in high school when I was recovering from anorexia. I believe that many other binge eaters have similar experiences; while they may not have been anorexic, they may have been on a diet. Or, perhaps they came from families with limited means, where they were worried about having enough to eat. Whatever the circumstance, the common denominator is not getting enough food, or a fear of not getting enough food. As a result, the body's survival mechanisms took over and we binged. Logic be damned, our bodies were not going to let us starve to death!

And so began the cycle. Binge, starve, repeat. With every period of under-eating, or fear of not having enough food, our instincts drove us to overeat to compensate, or to store up for a long winter.

So why has this behavior continued in myself and so many others, despite periods where we were eating enough? I believe it persists because it has become a habit, and also because the binge-starve-binge cycle has not ended for many of us. I fully admit that I still restrict my eating too often. And even when I don't restrict, my body is so conditioned to binge in response to a myriad of stimuli (being home alone, feeling lonely, feeling stressed . . .) that I continue the behavior.

Additionally, my brain has physically changed as a result of this behavior. As Stefani describes in (yet another informative and wonderful) post on her awesome blog:
Binge eating and obese patients have decreased dopamine responses to sweet flavors.  This means that they need more stimulation to feel satisfied. Binge eaters have developed a “food tolerance,” — much like we discussed before, with drug habituation.   (Read: Food addiction: harder to kick than cocaine?)  Moreover, the more frequently someone binged, the more dopamine they required to feel satisfaction.
Our bodies literally need to eat more to feel satisfied because we have conditioned them to do so. 

I believe that we can change our habits. We can rewire our brains (neuroplasticity: check it). It is hard. It is a struggle. I know this as much as the next binge eater. But I also believe that it is possible to take control over this situation and end the behavior, once and for all.

So to Manda and others in Overeaters Anonymous: I wish you the best of luck in your journeys, and I have so much compassion for you. Maybe I'm wrong, but I simply cannot accept that binge eating is a disease that happened to me, because if that's the case, I feel even more helpless and dejected than before.

Friday, July 6, 2012

Ignoring The Urges to Binge

In her book Brain Over Binge, Kathryn Hansen shares the solution to ending binge eating: ignoring the urges to binge. That's it. Plain and simple. She goes into greater detail about how to do this, but her ultimate solution is simple and profoundly smart.

For me, however, it hasn't proved easy.

Let's be real. I am not a very zen person, so the concept of acknowledging the urges to binge as "neurological junk" and then letting them pass is tough to wrap my mind around. When my brain says "look, no one is home and you have a cabinet full of food!" I seize the opportunity. What can I say, I've always been ambitious.

But at the same time, I acknowledge that the only real way to overcome this behavior that has plagued my life for a decade is to rewire my brain so that binge eating is no longer habitual. And the only way to do this is to stop acting on the urges to binge.

In the past, I had some success with this strategy by listening to the urges to binge and then reacting to them in a negative way. For example, when the above thought came fluttering through my mind, I would consciously think, "that is a stupid idea and I don't have to act on it." Fine, true, but can I be honest? Having an angry debate in my head about whether to go raid the kitchen is crazy-making.

Essentially, my strategy amounts to "white knuckling it." Trying with all my might to resist the urge to binge, almost as though I'm an ant frantically grasping the carpet fibers as a giant vacuum attempts to suck me up. Every day feels like a giant question mark. Will I be able to hold out for one more day? Will I binge tonight, or will I be good and go to the gym and eat some veggies? It's a total loss of control, when what I really want is to take control of my life and make deliberate choices about what to feed my body and how to spend my time. I mean, for f*ck's sake, I'm 26.

It turns out I have been doing it wrong. What I need to do is embrace my inner yogi and just let the thoughts pass. Don't react to them. Just acknowledge the urge, and then - miracle of all miracles - don't act on it. Let it pass. Move on.

While it's not about binge eating per se, this article, "Stop Obsessing" by Polly Campbell, has some helpful insights on this process. And surprise, surprise, it's from a website about yoga. Take it away, Polly:

  • Experience the thought. Open up to the very thing you’re trying not to think about. Touch it, feel the emotions that come. Let the memories flow. You don’t need to validate it or criticize it, ignore or abandon it. Just allow the thought to be there and notice if it has something to teach you.
  • Diffuse the energy behind it. Repeat the thought over and over until the intensity diminishes. Say it out loud in a different voice, maybe that of a cartoon character, or your mother. Create a silly song about the thought.
  • Get out of the negative stream. Don’t avoid the thought, but evaluate whether there is something more important you ought to be doing in the moment. Move toward your values, the people you love, the things that make you feel good.
  • Practice mindfulness and compassion. Go gently. Negative thoughts are normal; they offer insight to our personality. Accept them, pay attention to them in a softer, nonjudgmental way. Recognize that thoughts aren’t real. Just look at them with curiosity, as an observer. Be open to both the good and bad.
  • Hayes likens living gracefully with negative thoughts to driving a car with unruly passengers in the back. You’re the driver, moving toward the place you want to go. The backseat is filled with all your noisy worries and concerns. You notice the noise, but your focus is on the road ahead.

I don't know about this "letting the memories flow" business or repeating the thought, but I really like the last two bullets. It's so easy to berate myself for being stupid or gluttonous or out of control. Instead, why not approach this thing from the perspective of a Xanaxed-out housewife with a martini in one hand and People in the other? Totally passive and calm. So instead of reacting to the urge to binge by thinking, "No! That's a stupid idea and I don't have to listen to it," I could think, "Okay, that's nice, but I don't feel like it." Or even better, just think ... nothing.

I will work on this approach today, and see how it goes. Now, where's my Xanax?

Thursday, July 5, 2012

I am not depressed

I am not depressed.

I thought I was clinically depressed; both my therapist and my psychiatrist told me so.  I mean, I take antidepressants. I have taken them, on and off, since the 11th grade.

And yet, I am not depressed, and I wonder whether I ever have been.

No, I’m not perfect.  I have anxiety, and sometimes I feel down.  Sometimes I doubt myself. Sometimes I feel like staying in rather than going out. Okay, a lot of the time.
But depressed? I’m not so sure. Here’s why:

I can remember thinking I didn’t measure up to others for most of my life. I know, what’s new, join the club. But the passionate self-loathing and hopelessness, that caused my doctor to whip out her prescription pad, didn’t start until I began binge eating.

When I was recovering from anorexia in high school, I was forced to gain weight. Around that time, I began the binge eating behavior that has tormented me ever since. My body had been so starved for so long that my instincts took over and I binged.  And when I began binge eating, I began to hate myself

Since then, I have gone through short periods when I don’t binge. And during those times, I have felt normal. Happy, even. The prospect of spending time with friends doesn’t send me into a panic. I have a general disdain for my thighs and the usual desire to be smaller, but it isn’t the vitriolic self-loathing I feel the day after a binge. My moods are stable. My thoughts are clearer. I can appreciate all of the wonderful things in my life. I feel good.

But when I binge, my entire psyche takes a nose dive. I feel sad, hopeless, angry, moody, pitiful, disgusting, and worthless. And then, after a day or two of eating normally, poof! The clouds have lifted, and I am me again.

Kathryn Hansen addresses this in her book, Brain Over Binge. She notes that her therapists tried to place a myriad of labels on her emotional issues, when what she really had was a problem with binge eating. She realized that the only thing she needed to do in order to regain control in her life was to stop binge eating. Imagine that.

It’s refreshing to think that I am not damaged or broken. I just have this one problem, albeit a large one, that is keeping me from being the person I want to be: Binge eating. 

Tuesday, June 5, 2012

Anatomy of a Binge

It’s 9:00 on a Friday night and I’m staying in to study for an upcoming exam. My fiance is out with friends; our apartment is quiet and peaceful. I sit at the kitchen table on my laptop with a stack of textbooks beside me, waiting to be opened.

I start feeling sorry for myself. I wish I was out with friends too, instead of cooped up inside studying. Actually, I wish I wanted to be out with friends, but really, I feel too fat to be seen in public. Without thinking, I walk over to the cabinet and pull out some almonds. “I’ll just have a snack,” I tell myself. But one handful turns into ten, and I decide to just give in. Tomorrow will be different.

I open the fridge and grab the leftovers from dinner, shoveling them into my mouth as I stand over the counter. Back to the fridge for more food. A gallon of yogurt, gone. More almonds. I start unwrapping Luna bars, one after another, hiding the wrappers in the trash as I eat them. Back to the cabinet. Grab the peanut butter and a spoon. Savor spoonful after spoonful until half the jar is gone. Now I need something salty. A handful of chips. A few glasses of chocolate soy milk. More almonds. Another Luna bar. Make sure to hide the wrapper in the trash.

I desperately want to finish off the brownies sitting on the counter, but I worry that my fiance will notice they’re gone. So I just eat one. Then two. Then five. I rearrange them in the container, hoping he won’t notice. Back to the cabinet for more chips and another spoonful of peanut butter. More almonds.
Finally, I can’t breathe anymore. My head feels foggy. I feel angry with myself for not getting any studying done, and for wasting away my twenties in my kitchen binge eating when I should be out dancing on tables and celebrating life. I feel bad about myself for missing out. For making myself fat. For losing control again.

As I lay in bed, stomach distended and grotesquely full, I feel hopeless and lost. I know that I can’t keep doing this to myself, but I can’t seem to stop. I want so desperately to eat normally. To love my body, and treat it with respect by nourishing it instead of shoving it with more food than it can hold.
I finally start to drift off, promising myself that tomorrow will be different. Tomorrow, I’ll change.