Eating Behaviors

"And that's precisely where the magic happens: when we own our problems and recognise that we are the source of the solutions. Especially when it comes to eating, because that can be so completely within our control."

"Accepting your addictive desire to eat means being willing to feel it, without satisfying it, fighting it, avoiding it or doing things to make it go away. ... Simply allow yourself to feel it, because it's your resistance to it that makes it more persistent and more intense. … [I]t's in your best interest to accept your addictive desire to eat, relaxing as much as you can and letting it be there. Remember that the only reason you're feeling the desire is because you ate addictively in the past … And probably the main reason you ate addictively in the past is because you live in a food-addicted culture."

"In order to achieve your goal of eating less at meals, you will need to be willing to feel unsatisfied - and not 'full' - at the end of your meal. When you make a Plan before you start eating, you decide on a stopping point where you have the opportunity to confront your addictive hunger (see page 106). The last thing you want is a feeling of fullness and satisfaction. That's what got you into this problem in the first place!"

"If you want a reason to keep overeating, you'll always be able to find one. Alternatively, you could make some different decisions about one thing you have complete choice about: what and how much you eat."

"If you call your overeating 'comfort eating', start to think of it as 'addictive eating'. Calling it 'comforting' focuses on the perceived benefit only, which is how you justify it. It's more honest to call it 'addictive eating'."

"Because the symptoms of bingeing, vomiting, exercising, or starving can be so disruptive and frightening, it is easy to pay attention only to those behaviors. To do so, however, misses the point. The overt symptoms are just the tip of the iceberg. Beneath the surface lies a much larger piece of the picture - a complicated world of feelings and experiences that are very much part of the eating disorder. Both the visible and invisible parts need to be acknowledged in order to understand the disorders of bulimia nervosa, anorexia nervosa, and binge eating."

"The goal of treatment should not be merely to stop the behavior, but to understand how and why the person has used food to attempt to meet developmental and emotional needs."

"Nutritional counseling. Nutritionists, who are trained to assess imbalances in food intake and develop dietary programs, can help correct nutritional deficits and guide someone with an eating disorder to develop healthy eating habits, perhaps for the first time. Some people with eating disorders have extremely chaotic eating patterns or have not eaten a "meal" in years."

"Sometimes a nutritionist is sought to provide a diet as an answer to the problems with bingeing. However, a diet is not the answer to an eating disorder. Many eating-disordered people are experts themselves on diets and food intake. They know what is healthy. They know the caloric intake of every morsel they put in their mouths. Some are professionals in the area of nutrition. This underscores that eating disturbances are not due to lack of information about a good diet, but have to do with psychological factors that keep people from putting this information to use. Often, a nutritionist and therapist work concurrently. The nutritionist sets the stage for healthy eating, and the therapist examines what gets in the way when someone can't keep to her food plan. The goal overall is that of allowing someone to eat when hungry, in moderation, and to understand what motivates problematic eating so that better choices can be made."

"Unless the reasons underlying disturbed eating are understood and addressed, the eating-disordered person […] will remain vulnerable to maintaining disordered food rituals when faced with difficult times or distressing internal experiences."

"Surgery. It is important to note that while surgery is considered the most effective treatment for the morbidly obese patient, studies are just evolving considering the long-term effect of this kind of treatment and whether this treatment is ultimately helpful for the binge-eating patient. In general, at one and a half to two years postsurgery, weight loss stabilises, and a substantial portion of individuals even begin to regain lost weight. What is clear is that a presurgical history of binge-eating disorder is associated with poorer long-term weight outcomes. There are many stories of patients who have reached their ideal weight following surgery, only to quickly regain all of the weight once their goal has been reached. In these cases, bingeing begins again despite severe physical pain, vomiting, and the obvious despair of watching the scale skyrocket again. One patient described losing and gaining over 100 pounds in less than two years. Bariatric surgery thus can initially achieve substantial weight loss, but surgery alone may not alter the underlying eating disorder. If the eating disorder remains, positive results can be significantly compromised. Without a deeper understanding of the psychological role of bingeing, without the possibility of medication to address physiological cravings, and without an ongoing program to develop new means of dealing with feelings and stress, surgery may just be a bandage that only temporarily covers a longer-term and deeper problem."

"With bulimia or binge eating, the benefits of therapy cannot solely be measured on the basis of changes in the eating disorder itself. Sometimes quick improvements in the eating patterns are short-lived, prompted by a display of "white-knuckle" willpower or a wish to please the therapist. Developing a trusting relationship, expressing feelings, and increasing one's self-esteem have to be established before a more sustained change in the eating can occur. These less observable changes are crucial as a basis of long-term growth."