A couple weeks ago, one of the students at work presented on Loss of Control Eating and Binge Eating Disorder (research she's involved with). Binge Eating Disorder is characterized by recurrent episodes of binge eating (2x/week for 6 months, no compensatory behaviors, and distress over the binge eating) and is associated with at least three of the following:
- eating more rapidly
- eating until feeling uncomfortably full
- eating large amounts when not feeling physically hungry
- eating alone (embarrassed)
- feeling disgusted, depressed, or guilty over eating
The prevalence rate of Binge Eating Disorder varies (3%-29%), but is much more prevalent among those who seek weight-loss treatment. Individuals who meet the criteria for Binge Eating Disorder are more likely to be overweight/obese, have other mental health issues, have poorer physical health, struggle socially, gain weight over time, and be unsuccessful with weight loss efforts.
She presented a couple of theories behind binge eating, which I think are actually tied into each other. Basically, there can be societal pressures to be thin which then put greater importance on attitudes toward weight, shape, and eating. This can also distort perceptions and attitudes. From this, the individuals thoughts and actions around food can become more rigid and restricted. And the more one feels restricted and limited, the more likely one "rebels" with a binge. In addition to the larger societal factors, there are more intimate, interpersonal elements. When there are personal/interpersonal difficulties, an individual is more vulnerable to a negative emotional state (depression, low self-esteem, anxiety). Food is turned to as a way to help regulate this mood and, when the mood is powerful enough, eating can become binge eating. Her treatment interventions focused on the interpersonal aspect and building relationships in teens so they'd be less likely to turn to food.
Sometimes we don't have much insight into why we're reaching for food. Sure, there's physical hunger, but there's also emotional hunger. This is often in response to negative emotions ("emotional eating") where food is turned to as a coping mechanism. What was interesting in this research was that there was also a lot of eating going on when experiencing fatigue or boredom. This could be due to a misattribution of internal sensations (feeling a negative emotion but labeling it as boredom). It's also pretty common for bored hands to reach for food, just for something to do - a distraction from doing nothing. That's where I think the Loss of Control can be a lack of awareness as to how much food has actually been consumed because there's more of an on-going grazing going on between meals that isn't as easily regulated as a "defined" meal.
The foods most often reached for? Dessert-type foods were chosen over lunch-type foods. Some of this was possibly due to the convenience factor (grabbing a handful of cookies is much easier than making a sandwich). There's also greater comfort from foods that are higher in fats and carbohydrates. I would expect this to be a combination of physical and psychological factors, though I don't know the research for certain. These types of foods don't really satiate a person, so there's a greater chance of coming back and eating more despite the number of calories already consumed.
What I found particularly interesting in this presentation was the characterization of "loss of control" and how people (children and adolescents in her research) were not very accurate in evaluating these behaviors. How do you determine when an amount of food is "large" as opposed to "normal" or "typical"? This can be measured objectively (measuring actual quantities of food consumed) and subjectively (how the person feels about the amount of food consumed). Either way, it's the sense of losing control that is most relevant to the binge eating behaviors. I wouldn't think of this solely as a Tasmanian Devil rampaging through the kitchen. Depending on the situation, it also could be conceptualized as a lack of regulation or even a disconnect between the mind and the body.
This gets me wondering about the societal factors that encourage eating and encourage overeating, while at the same time conveying a message that an individual is expected to be thin. The typical restaurant portion is 2-4 times the government's recommended service size, with 60% more calories than a home-cooked meal (From a USA Today article). Given that Americans eat out 4-5 times a week, imagine how this can distort the expectation of what a meal should look like! So this is the amount of food we're "supposed" to eat at a meal and, while eating all this, we're "supposed" to be thin? That's just setting us up for negative feelings about ourselves and our bodies! For those who struggle with binge eating, it can easily be a self-perpetuating cycle that literally feeds on itself.
There's no doubt that eating behaviors are complex and dynamic across the spectrum (from healthy to less healthy to unhealthy). It goes beyond the number of calories consumed, though that's one of the more straight-forward factors to identify and measure. There's also the cognitions associated with eating and one's body. Then there are other emotional and psychological factors that can play out through eating. Don't forget the interpersonal relationships (current and past), the socioeconomic variables (eating healthy is expensive!)
With all of this, I think it's even more important for people to take care of themselves. Be in touch with your emotional needs and how you can meet them in a healthy, constructive manner. Surround yourself with positive relationships where other people can support you in meeting these needs. Don't be afraid to question what you're going through and why you may be responding in a particular way - building insight and understanding can reduce the likelihood of reaching for food.
Eating a large amount of food, by itself, isn't indicative of binge eating disorder and it doesn't mean that you've lost control. But if there's a pattern of behaviors (remember 6 months!) and it's occurring with the pattern of thoughts and feelings. Sometimes a cigar is just a cigar, but sometimes it's a sign of something bigger going on.
Food Log:
- Meal 1:
- 3 egg whites
- 30g dry cream of rice (cooked in water)
- 1 tbsp coconut oil
- Meal 2:
- 0% flavored Chobani Greek Yogurt
- Meal 3:
- 3 oz chicken
- Green beans
- 1/2c cooked rice
- Meal 4:
- 3 oz chicken
- Green pepper and onions (red and yellow)
- 1/2c cooked rice
- 1 tbsp coconut oil
- Meal 5:
- 0% flavored Chobani Greek Yogurt
- 1 tbsp coconut oil
Exercise:
- Time: 63 minutes on the elliptical (but was off for 3 minutes when changing laundry)
- Level: Level 1 for 1 minute; Level 4 for 61 minutes (though really 58); Level 1 for 1 minute
- Calories: 700+
- Average HR: 148
- Max HR: 162
- Distance: 5+ miles
Weigh-In: 145.2 / 144.0
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