How To Help Someone With Binge Eating Disorder
Since binge eaters often try to hide their symptoms and eat in secret, it can make it tough for family and friends to spot the warning signs. And you cant always identify a binge eater by appearance, either. While some are overweight or obese, others manage to maintain a normal weight.
The warning signs that you can spot include finding piles of empty food packages and wrappers, cupboards and refrigerators that have been cleaned out, or hidden stashes of high-calorie or junk food. If you suspect that your loved one has binge eating disorder, bring up your concerns. It may seem daunting to start such a delicate conversation, and the person may deny bingeing or become angry and defensive. But theres a chance that he or she will welcome the opportunity to share the struggle.
If the person shuts you out at first, dont give up it may take some time before your loved one is willing to admit to having a problem. And remember: as difficult as it is to know that someone you love may be have an eating disorder, you cant force someone to change. The decision to seek recovery has to come from them. You can help by offering your compassion, encouragement, and support throughout the treatment process.
Drug Abuse As A Hindrance To Binge Eating Disorder Treatment
Treatment for binge eating disorder often includes individual and group therapy, support groups and nutrition counseling. These different interventions address a persons relationship with food as well as the underlying emotional causes of the disorder.
To make progress in treatment, a person with binge eating disorder needs to be able to connect to their emotions and maintain awareness of triggers for binging and related behaviors. The disinhibiting effects of substances increase the likelihood that someone in treatment for binge eating disorder will resume binging.
Altering feelings with drug use makes it hard for a person to process work in therapy on an emotional level. Substance abuse can also alter cognition and block awareness of thinking and behavior. Most commonly abused substances also interfere with the psychiatric medications that are used to treat BED. These medications include selective serotonin reuptake inhibitors and drugs like Topamax or topiramate.
Chemical Dependence On Food
We use the term food addiction to refer to biochemical dependency on food. This problem is described as a person relating to specific food or food in general in a different way than normal people. Food addicts experience physical craving, mental obsession, and a distortion of basic instincts and will.
Ten years ago there was little scientific research proving that food addiction actually existed, much less any research explaining a biochemical basis. Today, because of new genetic science, advances in brain scan research and billions of dollars invested in finding a medication that addresses the obesity epidemic, there is an abundance of studies in a wide variety of academic and medical fields that support a diagnosis of food addiction.
These studies overwhelming support the theory that many of the severely obese and those with advanced eating disorders are also chemically dependent on food. In fact, as a substance disorder, food addiction could be the primary medical problem in those cases.
The amount of specialization in scientific research and the fact that professional journals didnt allow the use of the term food addiction, has made it difficult to assemble all the research and correlate all the data about chemical dependency on food across sub-disciplines of science. Still, there are peer-reviewed professional journal articles establishing:
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Make It Difficult For Yourself To Binge
If you can put a tangible obstacle between you and the possibility of binge eating, you can make it more difficult to succumb to the urge. The best alternative strategies are incompatible with eating or make eating difficult. Doing something with your hands is a good bet, as its tricky to binge and draw, paint your nails, or play with your pet.
Other ways to make it difficult for yourself to binge could be to:
- Take a long bath or shower to relax.
- Soak the binge food in water so that it is ruined.
- Flush the food you are planning to binge on down the toilet.
- If possible, make it so you are unable to plan a binge. For instance, if you live with someone, make sure they do not tell you when they will be coming home.
There are a myriad of alternative coping strategies out there, but the ones listed above are some that our clients have found useful:
The key point to all these activities is that by the time you have done them, the tide will have gone out and the wave of feelings will have passed.
Once you have made your list, put it somewhere you can find it quickly, like on the fridge, or a note on your phone. Then you know exactly where to look when the feelings strike.
Most importantly, if you dont manage to overcome the craving this time, remember that you havent failed. Maybe you havent found the right coping strategy quite yet, and thats ok. Trying to overcome it is the first step. There is always another time to try and each time you do, it will get easier.
Two Examples Of Studies Conducted In Germany
YFAS 2·0 food addiction in a representative study in Germany
The first nationwide, representative study of the prevalence of food addiction was recently conducted in Germany. Point prevalence of food addiction was 7·9 % within Germans, with higher rates in underweight and obese participants .
Fig. 1. Prevalence of food addiction in three studies, according to BMI category .
Food addiction in German-speaking endurance athletes
A recent study of amateur endurance athletes examined comorbidity of food addiction, eating disorders and exercise dependence . The prevalence of food addiction was 6·2 %, of exercise dependence 30·5 % and of eating disorders 6·5 %. The highest prevalence of food addiction was found in underweight and obese subjects . Food addiction and exercise dependence were associated, thus suggesting potential overlap in underlying mechanisms for behavioural addictions .
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Signs Of Food Addiction
Researchers at Yale University’s Rudd Center for Food Science & Policy have developed a questionnaire to identify people with food addictions.
Here’s a sample of questions that can help determine if you have a food addiction. Do these actions apply to you? Do you:
- End up eating more than planned when you start eating certain foods
- Keep eating certain foods even if you’re no longer hungry
- Eat to the point of feeling ill
- Worry about not eating certain types of foods or worry about cutting down on certain types of foods
- When certain foods aren’t available, go out of your way to obtain them
The questionnaire also asks about the impact of your relationship with food on your personal life. Ask yourself if these situations apply to you:
- You eat certain foods so often or in such large amounts that you start eating food instead of working, spending time with the family, or doing recreational activities.
- You avoid professional or social situations where certain foods are available because of fear of overeating.
- You have problems functioning effectively at your job or school because of food and eating.
The questionnaire asks about psychological withdrawal symptoms. For example, when you cut down on certain foods , do you have symptoms such as:
- Other physical symptoms
The questionnaire also tries to gauge the impact of food decisions on your emotions. Do these situations apply to you?
Clinical Implications Of The Relationship Between Bed And Food Addiction
The relationship between BED and food addiction may have many important clinical implications. Cognitive-behavioral therapy , which is the best-established treatment for BED , effectively targets aspects of BED in a manner similar to how CBT targets aspects of substance dependence . For example, CBT for BED and CBT for substance dependence monitor consumption, identify automatic thoughts about use, develop alternative coping strategies, and identify triggers for problematic behaviors . Furthermore, most techniques associated with CBT for BED and CBT for substance dependence do not inherently conflict with one another . Thus, for BED patients that exhibit attributes of food addiction, CBT techniques used in the treatment of BED and CBT techniques used in the treatment of substance dependence could be incorporated. An important next step will be to evaluate whether the integration of other interventions developed for substance dependence or other addictive behaviors into treatments for BED provides any added benefit to treatment outcomes in individuals experiencing addictive-like eating behaviors.
Effects Of Substance Abuse On Binge Eating Symptoms
Both drug and food binges are often followed by negative feelings, including those of depression and anxiety. Withdrawal and post-use effects are significantly intense for people who combine binge eating episodes with substance abuse.
People with binge eating and substance use disorders often feel shame because of the social stigma attached to these disorders. People can get caught up in a worsening cycle as they use food or drugs to cope with these feelings, only to feel more ashamed after they binge or use a substance.
In treatment, people learn the behaviors associated with their disorders do not reflect moral shortcomings. However, before a person enters recovery, they might absorb social messages that these behaviors make them a bad person. This can cause people to use substances after binging, or binge after using substances, to overcome feelings of shame or guilt.
Both binge eating and substance use disorders can cause medical complications, including increased blood pressure and gastrointestinal problems. These issues can arise more rapidly and intensely for people with co-occurring binge eating and substance use disorders. Adding health problems can worsen comorbid depression and anxiety and increase the risk of self-destructive behavior and suicide attempts, which are already heightened for people with binge eating and substance use disorders.
How Binge Eating Disorder Is Treated
A binge eating episode can seem as though it arrives out of the blue, with no warning whatsoever.
When asked why they ate as they did, many people with this disorder seem baffled or simply confused. Theyre just not sure why, and that means theyre unable to stop this kind of eating before it starts.
Learning to identify triggers can be a big part of getting well, and according to the American Psychological Association, those triggers often involve negative thoughts about body shape or image. People with this disorder are often disgusted with the way they look. Its those feelings of disgust that can lead to negative self-talk, and that leads to binging.
For example, a woman with a binge-eating disorder might look in the mirror and think, I am so fat, and no one will ever love me because of that. The thought rattles around in her brain all day, making her feel just terrible, and at the end of a day like this, she binges.
Arresting that binging cycle means stopping that thought, and therapy can make it happen. In therapy sessions, people with this disorder learn how to identify and name damning thoughts, and they use techniques like meditation or exercise to amend those thoughts so they wont be compelled to binge. Its a powerful and transformative way to address this disorder.
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The Evidence For Food Addiction’s Overlap With Eating Disorders
Some evidence exists to suggest that food addiction may overlap with the DSM-5 criteria for eating disorders . That is, Table 3 summarises evidence for similarities of food addiction and each eating disorder variant. The extant literature suggests little evidence for the overlap with anorexia nervosa and food addiction. However, the tolerance, loss of control, consequences and problems subscales of the YFAS 2·0 may in fact be assessing several key aspects of DSM-5 criteria for BED. Finally, some evidence suggests that tolerance and loss of control aspects of food addiction may reflect DSM-5 criteria for BN .
Table 3. Diagnostic and Statistical Manual of Mental Disorders criteria for eating disorders and potential fit to Yale food addiction scale food addiction criteria
Empirical Evidence Of The Relationship Between Bed And Food Addiction
Another recent study investigated the neurobiology of food addiction in individuals who do not currently meet criteria for BED. In a functional magnetic resonance imaging paradigm, the neural correlates of food addiction as measured by the YFAS were examined in a sample of young women, none of whom had an eating disorder diagnosis . Participants who endorsed a greater number of food addiction features exhibited greater activation in the amygdala, anterior cingulate cortex, caudate, dorsolateral prefrontal cortex, and medial orbitofrontal cortex during exposure to a palatable-food cue relative to a neutral cue . This pattern of neural activation has been implicated in cue-induced craving and incentive salience in substance dependence . Further, participants scoring highly on food addiction severity also displayed reduced activation in the lateral OFC during consumption of a milkshake relative to a tasteless solution , similar to neural patterns observed in association with disinhibition in cocaine abusers . In sum, behavioral indicators of food addiction in the absence of BED appear related to patterns of neural activations implicated in drug addictions. Examining the neural correlates of food addiction in the presence of BED will be an important future direction in understanding the potential role of addiction in binge eating in BED.
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Learn To Tolerate The Feelings That Trigger Your Binge Eating
The next time you feel the urge to binge, instead of giving in, take a moment to stop and investigate whats going on inside.
Identify the emotion youre feeling. Do your best to name what youre feeling. Is it anxiety? Shame? Hopelessness? Anger? Loneliness? Fear? Emptiness?
Accept the experience youre having. Avoidance and resistance only make negative emotions stronger. Instead, try to accept what youre feeling without judging it or yourself.
Dig deeper. Explore whats going on. Where do you feel the emotion in your body? What kinds of thoughts are going through your head?
Distance yourself. Realize that you are NOT your feelings. Emotions are passing events, like clouds moving across the sky. They dont define who you are.
Sitting with your feelings may feel extremely uncomfortable at first. Maybe even impossible. But as you resist the urge to binge, youll start to realize that you dont have to give in. There are other ways to cope. Even emotions that feel intolerable are only temporary. Theyll quickly pass if you stop fighting them. Youre still in control. You can choose how to respond.
For a step-by-step guide to learning how to manage unpleasant and uncomfortable emotions, check out HelpGuides free Emotional Intelligence Toolkit.
What Does The Research Show
In 2015 a meta analysis on the temperament in eating disorders showed high harm avoidance in all eating disorder types as compared to controls . In bulimic patients, high novelty seeking temperaments were notices and higher persistence in both anorexic and bulimic participants. In another 2010 study, lab rats were given high-fat, high-sugar foods and changes in their brain activity were seen . Changes in brain activity were similar to those caused by drug abuse.
Food addiction can be defined as a constant obsession with what to eat, when to eat, and how to obtain more food overeating behaviors hiding or hoarding foods, secretive behaviors, and inability to stop overeating or continued eating . Food addiction is a psychological and emotional addiction to specific foods and substances . Even though not directly the same as a substance addiction, food activates the taste-reward and pleasurable regions of the brain.
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Understanding A Food Addiction
For those with a food addiction, the issue is the food itself but for those with an eating disorder, the behavior is psychological .Treatment for eating disorder professions uses a psychological approach to include cognitive therapy, behavioral modification, and mindfulness to help sufferers learn a healthy relationship with food and resolve underlying mental health disorders. For food addictions, treatment focuses on identifying and encouraging abstinence from the foods that create the addictive response.
Understanding the Differences Between Food Addictions and Eating Disorders means looking at the basis of both. Food addiction is a disorder which can cause loss of control over the ability to stop eating certain foods . Food addiction can be defined as a cluster of chemical dependencies on specific foods, after the ingestion of highly palatable foods such as sugar, fat or salt, and develop physical cravings for those foods.
Over time, like drug and alcohol addictions, the progressive eating of these foods distorts the thinking around food, and the individual is unable to stop. A study in 2010, published in the Current Opinion in Gastroenterology showed that food addictions are the result of changes in the persons neurochemistry and neuroanatomy .
Assistant Professor Of Clinical Psychology University Of Michigan
Can you describe organization rationale and outcomes of the historic Yale Conference?The Yale Conference on Food Addiction was the first gathering of experts across the fields of addiction, obesity, and feeding behavior to focus on the question of whether certain foods can be addictive. The presentations and conferences that took place over the course of that meeting influenced much of the foundational thought about how addictive processes may be contributing to overeating and supported the emergence of this new area of study.
How do you describe food addiction in 10 words or less? How is it different than sugar addiction?Compulsive overeating triggered by repeated exposure to highly rewarding food. While I see sugars as one of the most relevant ingredients to addictive-like eating, other ingredients also appear to be implicated. For example, potato chips and French fries are commonly eaten in an addictive-like way, but they have a low sugar content. They do have a higher starch content and fat content. The food addiction term broadens the scope of focus beyond sugar.
Can you describe the genesis, evolution and validation of Yale Food Addiction Scale ? Are some foods most addicting, more addicting and non-addicting?
. Development of the Yale Food Addiction Scale 2.0. Psychology of Addictive Behaviors, 30, 113-121.)
. Which foods may be addictive? The roles of processing, fat and glycemic load. PLOS ONE, 10: e0117959. doi:10.1371/journal. pone.0117959)
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