Fiona, 34, has recently returned to part-time work after having her second baby and admits she’s not enjoying it. “I don’t want to be there,” she says. She is bored and resentful, and would rather be at home with her children. And although Fiona has high standards for her work, her heart just isn’t in it. Meanwhile, her attractive, slim, 20-something colleagues always seem to be talking about how much exercise they do.
In the bottom drawer of her desk, Fiona has a stash of salt-and-vinegar chips and chocolate macaroons – both of which she secretly indulges in when her colleagues aren’t looking.
After she gets home, she takes care of the children, and once she’s put them to bed, she relaxes by eating whatever she can from the pantry. Fiona feels disgusted with her behaviour and berates herself for not taking better care of herself. She resolves to be more disciplined in the future.
Fiona is using food to cope with a difficult feeling or situation, such as feeling inadequate when comparing her colleagues’ body shapes with her own postbaby body, or as a distraction from the reality of her work situation. Fiona is suffering from binge-eating disorder (BED).
What is BED?
Although they’re not as highly publicised as anorexia and bulimia (the two eating disorders with which the general public is most familiar), BEDs are actually the most common. They fit in a category known as “eating disorders not otherwise specified” (EDNOS). And although many people don’t meet the criteria for a specific eating disorder, they may still experience issues with their body image and relationship with food.
According to the National Eating Disorders Collaboration, BED is defined as “a serious mental illness characterised by regular episodes of binge eating,” and involves two key features: eating an excessive amount of food within a short period of time (two hours) and feeling a loss of control while eating. BED can occur in people of all ages, genders, socioeconomic groups, and cultural backgrounds.
At the more extreme end of the spectrum, BED is an eating disorder characterised by periods of recurrent binge eating without compensatory measures (for example purging, using laxatives, and doing excessive exercise, which you would see in bulimia). People with a BED diagnosis often eat very large amounts of food, even when they aren’t hungry. They also regularly experience feelings of guilt, depression, shame, and disgust after a binge-eating episode.
A recent study by researchers at Harvard University, published in the International Journal of Eating Disorders, has led to a revision of the criteria for determining this disorder.
Previously, BED was diagnosed if a binge-eating episode occurred on average at least two days a week for six months. Now, the criteria states that someone who binges at least one day a week for three months has BED. The study also found that the lifetime prevalence of BED in the US is 3.6 per cent for women and 2 per cent for men. However, most of us can relate to some extent to overeating or binging on food.
Indeed, clinical psychologist Lize Strauss says that although many of her clients wouldn’t fit a formal eating-disorder diagnosis, disordered eating occurs in approximately 80 per cent of us at some point in our lives. She defines disordered eating as “using food to do something it can’t do – for example, eating away loneliness or anxiety.”
Research confirms this: For example, a 2009 study by the University of South Carolina in the US found that 74.5 per cent of women reported that their concerns about shape and weight interfered with their happiness.
Instead of using the term “binge eating,” Victoria Marsden, a counsellor working with people with eating disorders, uses the term “eating past fullness.” She finds this language takes away the stigma often linked with labels associated with eating disorders.
She says that eating past fullness becomes a problem for people when it starts interfering with daily life, such as at work or in relationships with others or when it impacts how people feel about their bodies. It’s problematic for people when it occurs regularly and leaves them feeling uncomfortable and bloated.
Food and emotions Many people commonly use food as a tool to numb or avoid uncomfortable emotions, such as in the following cases:
1 Loneliness/rejection/feeling unloved
As many of us know from experience, going through an emotional period can lead to drowning our sorrows in a tub of ice-cream or a block of Dairy Milk chocolate in search of comfort. Marsden gives the example of breaking up with one’s partner as a common trigger for eating past fullness and using food to make ourselves feel better. It doesn’t help that we also support each other by bringing around “comfort food” when we hear that friends’ relationships have broken up. When we use these coping methods on a regular basis, it becomes a problem.
“The first thing to go when we are stressed is recognising what our body needs,” says Strauss. This can be especially true at work, where we may find ourselves in the habit of missing lunch or eating at our desks, telling ourselves “I’m too busy” and “if I don’t do this now, it won’t get done.”
Workplace culture, in which employers and colleagues see multitasking as productive and efficient, can reinforce this behaviour. Interpersonal and work-related stressors were significantly associated with increased snacking of high-fat and high-sugar foods in a 2008 study by the University of Leeds in the UK.
Strauss also points to new mums, who may be having difficulty figuring out what their babies want and feeling constantly tired and harassed by the demands of a new baby. These women may not have time to eat, their blood-sugar levels drop, and they may reach for chocolate as a quick pick-me-up. Binging may also be covering up underlying anxiety, depression, or both.
With her clients, dietitian Claire Turnbull works through specific examples in which people have eaten more than they’ve planned to, to allow them to better understand their behaviour and cope in a different way. This might include helping clients feel safe around all types of food and moving away from the notion of “bad” food.
In addition to the role that emotions play as primary drivers of binging behaviour, we must also be aware of the multiple – often contradictory – social messages we encounter around food.
On one hand, we commonly use food to celebrate or lament major events in our lives, and we often associate food with states of belonging, connection, and comfort. Conversely, we might judge certain foods as bad, fattening, and anxiety-provoking. It can be useful to unscramble these messages or at least to take an objective look at the paradoxes around us.
With the current fascination with all things food, and cooking programs and cookbooks a huge hit with consumers, we’re all hearing the message to cook and indulge, while newspapers and news programs inform us on the dangers of the obesity epidemic.
Society exerts a big influence on messages about changing the way we look to be acceptable, says Marsden. Parents of children as young as seven years old, who are worried about how they look, have contacted her. Researchers at the University of Minnesota in the US found a link between exposure to dieting-related media, distress, and unhealthy dieting in young women.
Turnbull also believes our culture of dieting contributes to binge eating. “After a period of restrictive eating, dieting, or being ‘super in control’ of everything that goes in your mouth, at some stage, it’s very common for people to go the other way and binge when they feel out of control,” she says.
There are many unhelpful assumptions that we may make about people based on their weight and size. Frequently, these include the assumption that being overweight is equal to not respecting one’s body or that it’s a sign of laziness or lack of willpower. Marsden points out that these internal assumptions prevent people from asking for help because they fear the judgement of others.
But it’s not all bad news. There are indications that things are changing on a societal level. Globally, there is increasing pressure on magazines to identify when they have digitally altered an image using software such as Photoshop. (For now, however, whether magazines abide by this trend is voluntary.)
Being aware of our own language and not commenting on weight, body size, and dieting are other important steps in creating a positive message about body image. Looking at other health indicators – for example, cholesterol levels, energy levels, and happiness – are equally significant.
So, how do you change binge-eating behaviour?
• Tune in to your own hunger and fullness. Examine how certain foods affect how your body feels.
• Slow down the process of eating; consider what type of food you are craving – sweet or savoury, for example – and what texture and flavour you might prefer.
• Be aware of your body; it’s an important part of finding a healthy relationship with food. Try body work, yoga, Pilates, meditation, and dancing as possible methods of changing the way you relate to your body.
• Eat regularly in a balanced way and go to a nutritionist or dietitian for expert input.
• Spend some time working out what messages you are sending yourself through eating. Do you eat for comfort? Is eating a distraction from bothersome thoughts and feelings? Is it a habit? Or a form of self-care? Do you eat when you’re bored? This may provide clues as to what other skills you might need to strengthen, such as the ability to say no, accept imperfection, enjoy the moment, or enjoy food for its taste. Also, books such as Susan Albers’ 50 Ways to Soothe Yourself Without Food can provide alternative ways of taking care of yourself.
• Eat without distraction. Psychological literature is increasingly noting this “mindful eating” as a way of accepting our experiences rather than having our bodies and minds on autopilot and avoiding difficult feelings and situations. Set aside one meal a week (more if you can) during which you consciously turn off the television; close the book; put your phone on silent; and focus on the texture, sight, smell, and taste of the food you eat. Take note of any differences between this experience and the way you usually eat.
• Consider how alcohol and other drugs impact our awareness of our bodies. These substances can disconnect us from our emotions, not only when we’ve had too much to drink, but also afterwards, when we’re hungover. In both states, it can be hard to gauge hunger and fullness, leaving us more vulnerable to binging. If binging occurs alongside alcohol or other drug use, begin to track this.
• Get support from others. A message of nonjudgement is key, says Turnbull. “It can be very easy to see someone scoffing everything in sight and just think they are being greedy. For someone with a binge-eating issue, this is not about greed; it’s about coping. Instead, just be there, listen, talk it through, see whether you can help them understand why they are using food as a coping mechanism, and encourage them to seek help,” she says.
• Have hope. If binge eating is a problem for you, Marsden emphasises that there is hope for having a life that is not dominated by food. Both psychological and dietary approaches to binge-eating treatment show good effectiveness in reducing binge eating.
By working through these methods, it’s possible to substantially reduce how much you rely on food for comfort. Once you pinpoint the triggers of your behaviour, you’ll be better prepared and less vulnerable to binge eating.
Where To Get Help
The Butterfly Foundation provides support for Australians who suffer from eating disorders and negative body-image issues and their carers. Visit thebutterflyfoundation.org.au, or call 1800 334 673.
The National Eating Disorders Collaboration (NEDC) is an initiative of the federal Department of Health and Ageing. It offers information on binge eating as well as resources to help those affected with eating disorders. Visit nedc.com.au or call (02) 9412 4499.