Binge and Emotional Eating 101 - Understanding Binge Eating

Binge and Emotional Eating
101
Understanding Binge Eating
Dr. Kari Anderson LPC, LCMHC, CEDS
WOMEN’S CENTER FOR BINGE & EMOTIONAL EATING

Your Presenter
Kari Anderson
DBH, LPC, CEDS
President & Chief Clinical
Director
Women’s Center for Binge
& Emotional Eating
25 years of experience
treating disorders
Personal & professional
understanding of BED
© Green Mountain at Fox Run Women’s Center for Binge & Emotional Eating

My Story…

Binge and Emotional Eating 101:
Understanding Binge Eating Disorder
• What is Binge Eating
• Purpose Binge Eating Serves
• Undiagnosed and Undertreated
• Treatment Approach

Continuum of Behaviors
Emotional Eating Emotional Overeating Binge Eating

Other Terms Related to Binge Eating
STRESS eating
COMPULSIVE eating
FOOD addiction

Binge Eating is More Than Overeating
While overeating is a challenge for
many and part of normal eating,
recurrent binge eating is far more
severe, and associated with significant
physical & psychological struggles.

• Eating an amount of food, in a discrete
period of time, that is definitely larger
than most would eat in a similar
period of time under similar
circumstances
• A sense of lack of control over eating
during the episode
• A feeling that one cannot stop eating or
control what or how much one is eating
Diagnostic Criteria - DSM5

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

• Marked distress regarding binge
eating
• The binge eating occurs on
average at least once a week for
three months
• The binge eating is not associated
with the recurrent use of
inappropriate compensatory
behaviors (purging) and does not
occur exclusively during the
course of anorexia or bulimia

Binge Eating vs. Obesity
• Those who are overweight or struggle with obesity do not
necessarily struggle with binge eating, but those with
binge eating often struggle with weight.
• More impairment in daily living
• Greater self-reported distress
• Impaired quality of life
• More coexisting emotional struggles

BED Not Always Overweight
BED occurs in normal weight, overweight,
and obese individuals.
19% normal weight
36% overweight
45% obese

More Clinical Conditions
• Depression, Anxiety, ADHD
• Subset of those with BED (30%) have higher
level emotional struggles, including suicide ideation,
unstable emotions, panic with severe isolation which
require more clinical support than traditional BED.

Of Course!
The behavior is reasonable and
understandable given someone’s needs and
life circumstances
“I’ve never met anyone who didn’t have a
good reason for their eating disorder”.

Soothes, Calms, Numbs
Physical and emotional states are altered through binge
behavior
Mechanically:
crunching, chewing, swallowing, digesting, distending
(digestive pathway often holds emotion)
Chemically:
food floods the pleasure centers releasing feel good
compounds throughout the body (systemically)

Dissociation and Distraction
Bingeing becomes a trance-like state:
• To escape emotions
• To escape thinking about the long-
term consequences of actions or to
procrastinate unpleasant activities
• To escape one’s critical thoughts and
feelings of inferiority

Protects from Harm
Binge eating may be a valuable tool in helping
someone protect themselves from harm, rejection,
failure, power or other threatening situations. This is
supported by a strong belief system.
An unconscious decision occurs when faced with the
choice to do it differently.

Punishment
• For some, especially those with some
form of trauma history, may use
bingeing as a form of punishment
• The very act of bingeing is abusive.
Stuffing until it hurts creates pain
which is distracting (similar
function as cutting)
• Some punish because of their lack of
perfectionism on their diets, self
loathing.

Sometimes “Just” Habit
• Long standing cue-response-reward
neuropathways
• Automated, mindless patterns created by the
brain for the ease of survival

Found Seeking Weight Loss
• Over 30% of those with BED:
• Seek professional help for weight loss
• They don’t know that these solutions only aggravate the
disorder

Society Has Internalized Thin Ideal
• Advertising, media and culture
• Public health “obesity” campaigns
• Overvaluation of weight and shape
• Multi billion dollar diet Industry
• Food fads and trends

Misunderstood Medical Complications
• Chronic GI symptoms (GERD, IBS, bloating)
• Bingeing creates high demand on insulin response
creating insulin resistance over time.
• BED has behaviors that lead to chronic disease states
(we focus on weight as problem instead of eating behaviors)

Shame and Secrecy
• Binge Eating Disorder goes largely
unnoticed because people who have
it do not readily disclose the
behaviors done in private
• Many with BED eat normally around
others, or may exhibit restrictive
eating and yo-yo dieting.

Treatment Confusion
Eating Disorder Treatment or
Lifestyle Intervention…

Heal Relationship with Food
CONTROLLED EATING
(PRESSURE/RULES)
AUTONOMOUS EATING
(PERSONAL CHOICE)
Appearance focus Health and wellbeing focus
Rigid eating Flexible eating
Avoid food Approach food
Quantity of food Quality of food
Depleted energy Sense of vitality
Having to change Wanting to change

Structure and Choice

Mindful Eating
• Be mindful of internal and external eating experience.
Focus on eating process, before, during and after.
• Re-set hunger through predictability and nutritional
balance
• Limit choices in beginning with goal of experimentation
and wonder.
• Encourage visualizing balance and portions (the plate
model) without weights and measures.

Challenge Perfectionism
• Inability to live in ambiguity, things are right or
wrong, good or bad (including themselves)
• Learning to live in a mostly and sometimes world

Neutralize Thin Ideal
• Developed through long term exposure to our culture
• Stop evaluating self-worth based on body size and
weight

Self Compassion
• Disengages the fear response (stress)
• Creates a positive, safe environment for change
• Replaces the critical thought dialogue

Merge Mind and Body
• Adopt “body neutrality”
• Mindfully embrace
movement
• “Something is better than
nothing”

Stop Binge Eating
• Empowerment through skills and strategies for self
regulation of emotional and physical states without using
food to cope. May overeat sometimes, but the goal is to
stop bingeing.
• Cognitive Behavioral Therapy is the gold standard
therapy, including DBT, ACT, MBSR.
• Group Interpersonal Therapy
• May need individual trauma work.

Mindfulness Lifestyle
The ability to be aware of your thoughts,
emotions, physical sensations, and actions
in the present moment without judging or
criticizing yourself or your experience.
— JON KABAT-ZINN

Stop Focusing on Weight

A “Healthy Weight” is supported by
Essential Self Care
• Sleep and rest
• Predictable, nourishing and mindful eating
• Joyful movement and physical activity
• Finding a safe, supportive environment to heal
• Stress management

Support
• Surround yourself with others that “get you”.
• Decrease isolation, get out there and live life now!

Upcoming Weekend Intensive Program for
Binge & Emotional Eating
Reserve by October 31st to Save 10%

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Eating: Opening Soon!
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Questions?
Contact me at kari@fitwoman.com
DR. KARI ANDERSON, LPC, LCMHC, CEDS
Binge Eating Specialist
President & Chief Clinical Director
Green Mountain Fox Run
Women’s Center for Binge & Emotional Eating
Ludlow, Vermont
802-975-0435
www.FitWoman.com

Binge and Emotional Eating 101 - Understanding Binge Eating

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Binge and Emotional Eating 101 - Understanding Binge Eating