1. Give Up On Diets
Diets don’t work. We know from years of research that 95% of people who diet regain the weight plus some within 3 years. If I told you that a treatment for an illness had a 95% failure rate would you still want to try it? Probably not! Diets encourage a feast/famine mentality which mess with your brain and your metabolism. The answer to any problem depends on how you are conceptualizing it. If you believe that food and weight is the problem, then of course, a diet would make sense to you. Unfortunately, for those who binge-eat, food and weight is not the problem (even though you may feel out of control or dissatisfied with both).
2. Give Up The Scale (AKA “Stop Letting Your Weight Define You”)
Weight is a number that represents the force of gravity on an object or person. Weight is not a measure of: how good a person you are, whether you are likeable or lovable, whether you are healthy or unhealthy. Weighing yourself is like playing the slot machines in Vegas…the house always wins. Weighing oneself is a self-reinforcing behavior, the more you do it, the more you want to do it. The number starts to rule your life. Starting the day by stepping onto the scale to determine how well you’re “measuring up” is a setup for binge eating. Letting the number on the scale dictate what you do with food is in exact opposition to the principles that will help you recover from your disordered relationship with food. Letting a number on the scale be the determinant for what food you put in your body serves to disconnect you from your internal cues, physiological needs, and pleasures, and ultimately doesn’t teach you what you really need to know.
3. Stop Trying To Be Perfect
Voltaire summed it up well, when he wrote, “Perfect is the enemy of good”; striving for perfection often results in no progress at all. Don’t look at things as if they’re black or white. You don’t have to be “perfectly on plan” or “completely off”. There can be a balance. Learn to find, and live in, that balance. Both food and behavior is never all good or all bad. One of my primary goals with clients is to help them start learning how to live in the gray. This is true with feelings and with food. There is no “perfect” meal plan, no “perfect weight” and striving to be perfect puts pressure on yourself that will backfire. Since perfection is not truly achievable, and certainly not sustainable, any perceived failure, disappointment, or setback, often sends people spiraling. Harsh punishments like restrictive eating (which will set you up for a binge episode later on), or depriving yourself of pleasures in others ways often follow the feeling of “failure” that inevitably arises when we try to be perfect. Other times, instead of punishing ourselves through deprivation, we get the “screw-it” voice in our head, that says “Well, I messed up, may as well keep going, I’m never going to get control of my eating.” This “screw-it” voice gives us permission to do something destructive by telling us we are weak and can’t do any better — it’s a “why bother” attitude and feeds into the part of ourselves that doesn’t think we are worth recovery.
4. Get Your Body In Balance
When your body is out of balance it throws your hunger cues out of whack. In order to get your cues back on track, it is important to follow the DBT PLEASE skills by: taking care of any physical illness (untreated or improperly treated medical issues — even just a common cold — can throw off both your hunger/fullness cues and your feelings), making sure to get enough regular sleep, moving your body in a balanced mindful way (more about that later), eating nourishing balanced meals at regular times, avoiding abusing mood-altering substances, and making sure to take any medications as prescribed. One of the most critical components of this process in helping to recover from binge eating is to regulate your eating patterns. Many clinicians and treatment programs today recommend following an Intuitive Eating model. I am a strong believer in intuitive eating, with one big caveat — I find that for clients in beginning stages of recovery from binge eating and emotional eating, that they are not able to start with intuitive eating. For someone with a history of disordered patterns of eating, your internal barometer has now become calibrated in a way that doesn’t support optimum balance. When we spend months and years eating in a non-regulated and non-intuitive manner, we need to re-learn these skills before we have the foundation in place to support intuitive eating. For this reason, I recommend clients begin working with a nutritionist who is familiar with eating disorders and specially trained to work with binge eating. Together, with your nutritionist and therapist, you will work to recalibrate your body to a place of balance. Starting with structured eating as you re-learn what constitutes a balanced meal and what a portion looks like, is only one part of the process. Eating regularly and in a balanced way throughout the day also will help to reset hunger, fullness and satiety cues, making it easier to move toward an intuitive eating approach. Metabolically and hormonally, regulating your patterns of eating will help you become better in touch with your bodies needs and will decrease physiological urges to binge. In this process, you will legalize all foods — nothing will be off limits to you, and you will get better connected with how specific foods work in your body and how they make you feel physically and emotionally. As a New Yorker, I love a good bagel! In fact, if I let myself, I probably could eat at least two at a time (boy, I miss H&H!), however, after years of intuitive eating, I am now a Mastered Eater, and I understand that when I eat a bagel, no matter what spread or topping I put on it, I typically feel sleepy afterwards and hungry pretty quickly afterward. For this reason, I usually try to save my bagel eating for times when I don’t have an early morning meeting or a busy work schedule and instead on those days, tend to eat foods that keep me alert and fuller longer; for me there’s nothing worse than being hungry 90 minutes after eating breakfast! I still eat my bagels and enjoy them, but I have an understanding of how that food works with my body. Other people can eat bagels and feel full for hours; understanding that everyone is unique is an important part of the recovery process and that what works for one will create a different feeling and experience in someone else.
5. Make the Distinction Between Physiological & Emotional Binges
Physiological binges occur mainly as the result of restriction of food and sometimes in response to metabolic/hormonal imbalances or substance use. Emotional binges occur in response to “mood reactivity”. Most individuals with binge eating disorder or emotional overeating, experience both types, and thus in recovery, we make it a treatment goal to help you address both physiological and emotional binge and overeating episodes. When you have regulated your eating patterns through consistent structured eating, most individuals will experience a significant decrease, and ultimately total elimination, of physiological binge episodes. Emotional binge episodes occur in response to an external event or internal experience that triggers strong feelings within us. Understanding the precipitating/activating event using DBT chain analysis can help you overcome emotional binges.
6. Figure Out the Feels
If you want to conquer emotional eating/binge-eating, it is imperative to figure out what you are feeling. Often, individuals are very disconnected from thoughts and feelings during a binge-eating episode and have trouble understanding emotional cues that led to the overeating. Using the DBT skill of chain analysis helps break down what was underneath the impulse to binge and can de-mystify the confusion people often feel around their binge-eating; when you are skillful, you will no longer be saying “I don’t know what happened, but one thing led to another and the next thing I knew I was in a full-blown binge.” As an added tool, I recommend clients employ “HALT the BS” to figure out what you’re feeling. Now is the time when I tell people to go deep! Really dig in to figure out what you are truly feeling and if it really is the food that you’re chasing.
7. Practice Self-Care
This cannot be said enough — love yourself first. The relationship with yourself is the most important one you will ever have. When you love yourself and respect yourself it is easier to take care of yourself body, mind and soul. Self-care is more than just “treating yourself” with a manicure or a massage. I encourage people to look at the Wellness Wheel and consider each of the nine dimensions. Which areas are vulnerable right now? Which areas could benefit from nurturance and attention? Are you able to identify one act of self-care from each area that would enhance your quality of life, nourish your soul, and make you feel more connected? Often, when we are engaging in disordered eating, other areas of our life are out of balance as well. At first it may feel overwhelming to consider all of these dimensions, but remember, there is no “perfection”. Try and non-judgmentally review the dimensions and consider what it would feel like to make a small change. I had one client who wanted to enhance their intellectual dimension as they felt they were not educated enough about national politics; their first instinct was try to read the New York Times cover-to-cover which resulted in a feeling of inferiority and defeat. Reframing the goal as an opportunity to gently foster a curiosity, allowed this client to consume political information through a variety of sources including online blogs and TV shows (yay for The Daily Show!) as she worked toward deepening her awareness of political issues. When we give mindful attention to the many parts of ourselves, we feel greater sense of emotional fullness and connectedness, which can help decrease urges to binge eat.
8. Fight the Urge to Binge
I know this one feels easier said than done, and sometimes that will be true. Sometimes, in the beginning stages of recovery, you won’t be able to talk yourself out of a binge, however over time, and with practice, as you become more skillful, it will be easier to say to yourself, “Just because I want it doesn’t mean I have to have it.” In moments where the urge to binge is strong I ask clients to employ the 4 D’s — delay, distract, determine, decide. Remember that wanting to binge isn’t enough of a reason to binge. DBT skills can also be particularly useful when urges and feelings become overwhelming. Remind yourself that you are stronger than the urge to binge, but don’t beat yourself up if you do binge. Try to differentiate between hunger and cravings, especially if the crave is for a risky food that you have a history of binging on and you are early on in your recovery. Cravings typically come on suddenly as a result of external cues or internal shifts (walking by a bakery and suddenly craving pie, having a big fight with someone and craving a “comfort food”). In these moments I find it sometimes helpful for an individual to “plan a crave”. Instead of eating the food at a moment when you are feeling vulnerable, plan to eat this food for a different day that week as a snack or meal. You never want to deny yourself the food (that will just perpetuate the restrict-binge-repent cycle), but with risky/challenge foods it is often better to enjoy them in non-impulsive moments when you are less vulnerable to overdoing it.
9. Reframe Your Relationship to Movement
For many with binge behaviors exercise is a dirty word…which is why I prefer the word movement! Stop thinking of movement (exercise) as a way to repent for wrongdoing with food choices. You can’t exercise your way out of a binge. Work to un-pair these things in your mind. Food is one way to nourish and care for your body and give it pleasure; movement is another. Think about forms of movement you do enjoy: walking around the city, going on a hike, having a dance party alone or with a friend, having a rolling office chair race down the hallway, horseback riding…the possibilities for movement are almost limitless. Find what you like to do and reframe your thoughts around it.
10. Get Support
Get help from an expert…not Oprah, not WebMD, not that great new cleanse that your spin teacher’s best friends cousin told you about — you need help from an expert who knows best treatment practices and really understands what is effective for binge eating disorder. Make sure to find your tribe. Even though I am not in support of programs like Weight Watchers and Overeaters Anonymous, they both have something that does work well — COMMUNITY. You need a tribe, a wolf-pack, a group of supporters to be on your side to celebrate the setbacks and the victories. This can be friends, family, your treatment team, online communities, etc. Find them, and use them. Stay connected. Don’t hide out when things get hard or when you get in the shame spiral. Eating disorders thrive in darkness, silence and secrecy. If you really want recovery, you need to practice courage and stay connected, especially in the moments where that feels hard to do.