As nutrition coaches, people come to us when they are stuck and not making progress. One particularly challenging and recurring example of this is people who struggle with binge eating and excess weight, both of which they would like to lose for good. It's not hard to see that binge eating (consuming objectively large amounts of food in a single sitting while feeling out of control) is counterproductive to weight loss. What's harder to see is why someone in this situation actually shouldn't try to work on both goals at the same time.
Working on losing weight is counterproductive to binge eating recovery, however binge eating recovery is the single best step toward attaining a healthy weight.
Is that a mind-bender or what? Let's explore.
Friends and families of our clients who fit this profile often know them as the Super Healthy Eaters, who never seem to eat any sweets, or maybe they are the strict Paleo dieter in their circle of friends. They may have "always been on a diet." But behind closed doors, all the restriction drops away at some moments, and hundreds or thousands of calories are eaten in numbing desperation.
Sometimes no one knows; Sometimes everyone suspects but no one says anything. And sometimes other people do know and try to help, yet just don't know how.
Binge eating and restriction become a frustrating cycle that batters a person's body and self-esteem. It feels like a prison of shame, where every escape attempt ends up back in the same place.
One typical client, whom we'll call Beth (not her real name), despaired each time she looked in the mirror or tried on an outfit before work. The twenty-five extra pounds she saw in her reflection just didn’t belong on the person she wanted to be. She described how she imagined her friends and colleagues wondering about her. After all, she gets up at 5 am to workout intensely almost every single day, how come she isn’t absolutely ripped? She felt like the extra weight on her body told she must have a secret eating life. They must think she has no willpower, she worried. She was disgusted with herself.
She re-committed to sticking 100% to her very structured diet and vigorous exercise. She made rules for herself to make sure that she would stay in control and on plan. If only she could follow her diet to the letter, then this time she would be successful. Day after day she logged her calories and macronutrients. She skipped the takeout place, and eliminated all junk food. She didn't eat fruit (too much sugar) or nuts (too much fat). She stopped eating dairy and swore off gluten, too, because so many people said they were bad.
Then one day as she walked home after a particularly stressful day at work, she became embroiled in some familiar thoughts. Overwhelm and unhappiness swirled all around her. She just wanted to feel better; desperately needed to escape this moment. There must be a release valve. Why not just get stop by the convenience store....one time doesn’t matter. She could worry about it again tomorrow. Her palms started to sweat when she imagined the cold deliciousness of her favorite ice cream. Her heart raced.
Once the floodgates opened she found herself eating uncontrollably.
She went through the ice cream and cookies she brought home, then ravaged the pantry. Cereal, peanut butter, even crackers she didn't really like. She felt like she was in a daze, unaware of what she was doing, or like it wasn’t real. There was some relief that at least the tension about whether or not to binge was gone. The workday seemed far away, there was just food, food, and more food.
However, waking the next day it was all too clear how real it was. Packages and crumbs littered the counters, evidence was all around. She felt sick, bloated and demoralized as she cleaned. She wondered how she could do this yet again when she promised herself that this time would be different. It felt like she would never get rid of this problem. It wasn’t even worth trying.
Beth’s story illustrates how strict dieting as a way to control binge eating can backfire, but it’s almost always the route people take when they are overweight and unhappy. After all, isn’t the entire world of magazines and the internet telling us, if we want to lose weight we need to eat less and move more? Then why isn’t working? If we want desperately to lose fat, how can we not try and eat less?
For someone with binge eating disorder or a habitual tendency to binge eat, cutting calories to encourage weight loss just stokes the fire of burning urges to binge. The stress of restraining and limiting food intake makes a person want to binge from a psychological trigger, while the state of drastic calorie deficit amplifies the physiological drive to eat uncontrollably.
Dieting is a one way street for someone who binge eats. Actually it’s more like a traffic circle, leading round and round, but never getting anywhere. Not to weight loss. Not to binge freedom, just endless circles of demoralization and shame.
If you do have initial success with reducing calories, even lose a few pounds, you feel excited! But often that confidence causes trouble. Perhaps you try to let yourself celebrate with a little treat… and it leads to a wipeout that erases any progress you made in weight loss and leaves you feeling hopeless (yet viciously motivated to get back on that diet and do it right this time.) Overeating followed by strong feelings of remorse as well as undereating can set you up for a vicious cycle. You might hear other people talk about hungry and satisfied feelings, but feel like yous must be busted. You never feel like that, you just want unending quantities of food, so how would you ever lose weight unless you stay controlled?
As glum as this scenario is, there is a different, more effective way to approach the problem. Instead of trying to accomplish two things at once: stopping bingeing and losing weight, we get great results because we separate the journey. The first step is to stop binge eating without attempting weight loss. Aiming for calorie balance gives someone the best possible set up to combat binge eating and win for a change. Life is hard enough, isn’t it, without adding a calorie deficit to the mix? We all have pressures and stresses, emotional sore spots and people who grate on us. Family issues, work concerns, identity, sex, finances…. There are plenty of emotional challenges which pose binge eating triggers, we believe you can cross intense hunger off the list for the first chapter. There’s plenty of other tough stuff to learn to work through in the initial phase.
First, the goal is to stop bingeing.
For this portion we follow the recommendations of the most widely studied and most successful treatment available based on Cognitive Behavioural Therapy. We also include elements of Acceptance and Commitment Therapy to provide a framework for resilience in the face of difficult emotions. Equipped with tools and strategies to use for emotional management, the binge becomes an outdated coping mechanism. One that gets less and less use, and eventually gathers dust.
The key components are to establish a pattern of regular eating and to practice detaching from urges to binge. Many people who binge eat are erratic eaters. They may skip breakfast or skip meals post binge. Or perhaps they are trying to accomplish a low calorie diet. This feast or famine eating can add to the physiological pressure to binge. To counteract this we recommend a regular eating schedule of 5-6 meals per day. These meals act like stepping stones to get you through the day binge-free. In this way you are only a couple of hours at most from your next meal. This gives our bodies time to grow accustomed to an even, predictable feeding pattern, and to allow our natural hunger and satiety cues time to normalize.
Then, a period of time needs to pass for things to settle. Since they’re new, the cognitive tools and self-regulation strategies need to be practiced, so they become easier to remember and grab at the right moment. After several weeks, of regularly spaced, normally-sized meals, the digestive tract and central nervous system have changed in a positive way. Frequent binge eating leads to distorted reward signaling in the brain, abnormal motility in the digestive tract (causing digestive symptoms such as pain, bloating, constipation), and a dulled or absent perception of hunger, satisfaction or fullness. Thankfully each of these will improve during the recovery process, it just takes some time of normal, regular eating.
Once the frequency of binge episodes have markedly subsided and stabilized, and the hunger and satisfaction signals have begun to emerge, it’s finally time when weight loss is possible. It’s difficult to be patient enough to get to this point, but the investment in mental and physical wellness allows a person to finally, FINALLY, escape that prison. If someone still wants to lose weight, in the third phase we gradually introduce weight loss habits using the successful Lean Habits system.
As for the best weight loss approaches, we recommend that anyone make changes that are sustainable and not exceedingly uncomfortable, we not fans of the rapid or drastic for anyone. But for someone with a history of binge eating, sustainability and reasonableness is even more crucial, because the old coping mechanism of the binge might be gathering dust, but it’s still there. Overwhelm, extreme physical discomfort or emotional pain can increase the urge to relapse. So it important to protect yourself from unnecessary strain (like a 7 day juice fast) and treat yourself lovingly. You have time to lose any excess weight, there is no urgency, and managing your environment to eliminate avoidable triggers is wise. Your health and happiness are worth it, and by reaching this point you will have accomplished something extraordinary. It’s well justified to treat yourself like a pretty amazing person, who has come through a hard road but stood strong and changed their life for the better.