Over-eating may be defined through one or more of the following symptoms:
Non-hunger eating that occurs on a regular basis.
Eating past the point of satiety/fullness on a regular basis.
Experiencing a loss of control with eating such that more food is consumed than is physiologically needed on a regular basis.
Experiencing ongoing cravings and ‘hunger’ which is driven by metabolic syndrome or insulin problems, meaning that physiological regulation of hunger and fullness are confounded and result in higher food intake than the body actually needs.
The type of non-hunger eating can vary from grazing to binge eating. Note that overeating is not defined by eating a certain food, like dessert. It is regular habitual eating outside of physical hunger and satiety.
There are generally 3 types of psychological overeating, and one that includes a metabolic component:
Overeating is just habitual, not necessarily eating disordered or connected to emotional issues. An example would be eating according to time of day and/or eating portions that are served, not tailored to hunger/satiety. Behavior modification is a key treatment.
Binge Eating Disorder may occur from history of dieting, or restricted food for any reason. Due to evolution, humans have a reaction to situations in which a normal spectrum of foods is limited or calories are reduced, resulting in a covetous, obsessive attitude toward foods which can spring-load into a loss of control with foods. Overeating disorders do not always take the “binge” eating form. Overeating can include ‘grazing’ or any form of eating outside of physical signals for hunger and satiety.
Binge Eating Disorder does occur in the genre of overeating as a source of emotional regulation, similar to other substance abuse, and as such may provide a needed defense system, an addiction, for comfort or stress relief. Over eating provides a sense of homeostasis, and can be a response to both positive and negative emotions. In some the weight that is gained may provide a protective function, such a boundary within the world against some types of expectation or intrusion.
4. Metabolic Syndrome
Metabolic syndrome is the result of a growing and highly prevalent physiological condition, related to and maybe even caused by high reliance on processed foods, and as such, falls into the category of politics re: social safety within big business practices.
Metabolic syndrome may have a genetic or epigenetic driver, which results in metabolic reactivity to ingredients in processed foods especially high fructose corn sugar, high levels of processed wheat and sugar in general, resulting in: increased visceral fat deposits, insulin resistance, and other markers such as high fasting glucose, high triglycerides, low HDLs, high blood pressure, and other physical signs. Here, a vicious cycle is set up, where foods are deposited more readily in fat stores instead of providing energy. The condition results in being unusually fatigued, with a tendency to insatiable hunger outside the normal bounds of calorie requirements. This combination encourages more eating and less activity, driving the fat storage and furthering the toxic metabolic by-products of processed food consumption. Meanwhile the individual feels shame due to weight gain, and seeming inability to control appetite.
Other Factors to Consider When Treating Overeating Disorders
Exercise Resistance Syndrome
is common and extremely important to recognize according to Francie White’s strategies for healing exercise resistance.
Non-Hunger Eating – Physiological Consequences
Non -hunger eating can drive up insulin production over glucagon production, encouraging a state whereupon fat storage increases, due to an insulin-driven anabolic state. The catabolic hormone glucagon which mobilizes fat and sugar stores, and results in energy production and prolonged satiety is reduced as non-hunger eating progresses over time.
The vicious cycle that results, ends up increasing appetite, craving increases, energy decreases and loss of focus and motivation, simply from the affects of food alone occur. Exercise motivation may decrease, furthering the cycle.
Weight loss diets do not help, in fact are contra-indicated for overeating disorders.
Weight loss diets have been the standard “treatment” for overeating disorders which result in ‘overweight’ bodies. Clients expect some form of controlled food program to produce weight loss, in other words to treat the symptom of the disordered eating…which is the weight gained from non hunger eating. Focusing on the symptom alone will backfire, driving the disorder deeper into its vicious cycle.
It is most often the fat, or weight gain that drives individuals to seek help, not necessarily a desire to treat the episodes of overeating
Most often, it is help for weight loss that is sought, instead of real solutions to explore and change one’s relationship to food, which can confound the treatment. Treating the disordered eating involves a progression of steps involving awareness, insight gathering, and transformative processes on both a psychological and nutrition/food level. Since the work is not weight loss focused (although weight loss can very well occur throughout the stages of recovery), clients may be distracted by the demand for weight change.
The prejudice against being overweight
Results in a population of individuals who have been the target of bullying, rejection and in most cases even medical mismanagement of their eating disorder by giving out diets and exercise regimes without the psychological treatment needed. Clinicians fall into high risk of negative transference toward them, since past weight loss gimmicks and past experiences with critical professionals and family members feed into the clients’ own highly negative self-critic. The self -critic within anyone’s psychology, will sabotage the best efforts at treatment and will be mentioned in the next blog post.
Recommended Treatment Protocol
Generally start with a timeline of the individual’s life, beginning with when body image or eating ever became problematic.
Describe every phase of life along a written time line, noting weight, diets they went on, people that were significantly involved in their eating and weight issues. Note how romantic relationships were and are involved in various phases of over eating and under eating.
It is important to note each diet tried, and how much weight and actual time was spent on each diet, as the length of time on any given food regime is related to the degree of anorexia embedded in the eating disorder.
Some individuals have more of a propensity to perfectionism, willpower and black-or-white thinking which drives the pendulum swing back and forth between anorexia and overeating. Others have more of an impulsive nature with a tendency to have the “child running the show” within the makeup of inner child, inner adult, and an internal sense of the body’s feedback mechanisms (proprioceptive feedback).
When the child aspect of oneself has more inner power, there is a greater likelihood that diets will be short lived. Another possibility here is that the wild woman archetype is activated as the inner drive to overeat. This aspect of women can be rebellious and at first can seem destructive (as in baba yoga in fairy tales). The inner of women houses much true power, demanding freedom, refusing to cooperate with any authoritarian presence as is seen in the dieting/fitness culture of today.
The timeline discussion creates an opportunity for the clinician to bond with the client and other group members in group situations…
by reflecting the sanity and intelligence underlying the defenses of the eating disorder.
Connecting with each individual about the deep shame this culture puts on overweight individuals and the terrific bind they have been in, as other ways of working with overeating all involve targeting the weight itself, which only drives the overeating to new heights in the outrage that is often unconscious.
The outrage is related to the original dilemma of being put on starvation diets, a violation of our human fundamental need to be fed. Diets miss the importance of seeking to understand what the over eating was defending or satisfying, in other words, what fundamental need was not recognized and cared for?
Eating, like other symptoms are coded means of taking care of oneself, and the code must be ‘decoded’ by giving a voice to the aspect of the self that is non-hunger eating.
As the clinician offers respect and empathy, and models a belief in the client’s need to use food emotionally, the attachment and trust to continue productive work is fostered.
Next is tackling the deprivation-driven eating, in order to begin and repair the key faculty of self-trust.
This treatment is paradoxical, prescribing the feared foods or “forbidden” foods, which often end up the source of binge eating. Since our eating and exercise psychology reacts unpredictably and negatively toward restriction and rules, these externalized constraints need to be removed so that a person can ferret out for themselves how they experience different foods, and what they want to do with those foods in the long run. Surprisingly, when one is given a choice, and tools to stay mindful, the loss of control with that food surprisingly relaxes. Choice breeds empowerment toward trusting self.
In order to recover self- trust, an individual needs to learn to read their internal physical and psychological hunger cues, by replacing diets and their overlaying structure, with curiosity and awareness.
In order to diffuse the tension and pressure to overeat, one needs to remove the scarcity around food. Restrictive diets create scarcity and our evolutionary drive to prevent starvation causes a strong covetous relationship to food if scarcity looms.
Even the idea that a food is “bad” or “unhealthy” sets up an internalized standard to avoid that food, which again, only sets off a covetous relationship to that type of food. The more a food is restricted, the more the human brain is wired to want it, but not in normal amounts. The spring -loaded nature of repressed eating results in a sudden rush of impulse to overeat in greater and greater quantities.
The principles for treating deprivation driven eating are best described in the resource, Breaking Free from Emotional Eating by Geneen Roth.
She outlines the steps to diffusing deprivation driven eating with a paradoxical approach to legalizing all forbidden foods. Her eating guidelines can be modified to suit the particular client’s needs and again, results in building self trust.
Once an individual has gone through the process of Breaking Free guidelines, there is an end goal.
At this point, the goal is to distinguish how various foods feel PHYSICALLY and emotionally, and therefore which foods the individual chooses to keep in their diet or to stay away from.
The end goal is to help establish an abstinence from overeating by having integrated steps 1 and 2 and to have used Breaking Free not only to liberate choices and hand trust back to each individual, but to actually offer the experience as personal research for each person to decide what foods and fuel mixes actually feel best from a physical perspective based on their personal experience of how they feel after eating different types of foods.
In this sense it is not a ‘free for all’, rather an experiment, like all people have had as they grew up and tried different things. The body remembers and up until doing a non- diet approach, the overeater’s physical feedback information was negated by the loud, overwhelming critic and feelings of shame, panic or guilt.
With ‘legalizing’ foods comes a freedom from the relentless pining to have that food. Now the client is able to use the body’s feedback mechanism when the “inner adult” who is nutrition conscious but not nutrition obsessed, nor critical. This part of us is the “responsible part” that gets us to work, to pay our bills and achieve the goals we have achieved in life. For overeaters, this part has been mute in making food choices, and now can be taught to step up and contribute to the inner conversation about what to eat and when to eat and stop eating.
Key to this powerful shift is moving from Self Critic to Self Inquiry.
No one can recover from an overeating disorder without profoundly changing the negative, critical relationship to self.
CHANGE FROM THIS DYNAMIC:
The Inner Child / Wild Woman / Rebel vs. The Inner Critic / Inner Dieter
The Inner Child / Wild Woman / Rebel who gets to eat desired foods
+ The Input of the Adult Self (Kind/Firm, Nutrition-Aware)
+ The Physical Body’s Input (Body Memory/Desire to Feel Alive)
In short, this means that the choice to eat a food or not, and to what amount of food is eaten, is transferred from the warring eater versus dieter/critic to the internal memory of eating any given food amount and to the individual’s own internal desire to eat a given food or given amount.
From the trial and error experience of Breaking Free or other intuitive eating learning process, the individual learns through experience what he or she actually wants and needs.
Prior to that, the critical self talk overrides and blocks out the body’s feedback. Although proprioceptive signals are sent to the brain after eating throughout life, negative self talk can block awareness or use the signals of sickness and fatigue to fuel even more self loathing.
During the process of exploration as all foods become “legal”, the physical consequences of eating become simple, objective feedback for the individual.
This type of feedback is to have no judgment attached, like touching a hot stove and pulling one’s hand away is a natural response to high heat. So, a natural response to over eating is discomfort alongside possible desired effects, and the discomfort can register with the client as useful feedback to make choices in the future.
From the accumulation of physical and emotional awareness throughout the legalizing food process, people can evolve to eliminate or drastically reduce the overeating that was driven by restricting.
The wound-up springs inside the eating drive are no longer loaded, as the judgment is replaced by curiosity and self-understanding. At this point, the remaining non-hunger eating is often the emotional overeating.
This emotionally driven non-hunger eating pattern is more related to mood regulation, dampening or numbing unwanted feelings or creating a high, or arousal state from the initial association with unbounded eating, even though it is followed by self- defeating emotions.
Like any addictive substance, food can be both depended on and dreaded in the end. It was suggested by psychiatrist and eating disorder specialist, Dr Mike Strober at UCLA that about half of all individuals have the gene to make food calming and others do not. For those who do, the likelihood of reaching for food outside the bounds of hunger and satiety are ever-present in a culture that has an abundance of highly palatable food.
The key to treating emotional overeating involves getting to the heart of why the eating is needed; what it is feeding, or covering up that does not want to be faced.
That inner work is important as the individual’s life will evolve to new levels of freedom and contentment as they are able to own and navigate their agency, power and will.
Out of the 4 stages of recovery:
“I just love food”
Inner exploration and discovery –use of reading, exploration of eating through journal writing and groups
Fork in the Road:
“I know what I need to do but I’m not ready to take the actual step of doing it” which by the way is the most common place to get stuck in healing an overeating disorder.
Action & Transformation:
Here is where actual steps are taken, risks in eating, not eating, communication, self care, actually replacing the overeating with what is truly needed as the person uses their will and agency to bring about transformative changes in day to day life.
Here, the goal is to evolve one’s life to a new level through giving oneself what one truly needs. Food when not hungry is always second best to what is desired, and so this process involves graduating to a higher level of true self awareness and self care. A new level of life evolves and transformations can be profound.
Creating a self care eating plan
Now is the opportunity to define a personal self care eating approach – a commitment to facing life on life’s terms, and eating for physical versus emotional reasons. Each person decides when and how they wish to create their own personal eating plan, omitting the addictive eating and replacing it with actual real-life changes in self comfort, self care, even Soul care.
Although individuals still may be inspired to this step because they want to actually lose the weight or lose more weight, they can be reminded that any overt attempt to start dieting or restricting their overeating (different than dieting) for the sake of the ego versus the soul will backfire. It is a rigged system.
The two key things that must be in place, that are non-negotiable are:
1. The Shift to a Compassionate Relationship to Self
2. A Shift to Real Self Care and Actual Experiences That are Deeply Fulfilling to Replace the Actual Overeating.
No one can escape these fundamental responsibilities in life, eating disorder or not. Our responsibility to our self is outlined in the Karpman Triangle, and is infallible.
Furthermore, a commitment to enhance our connection to our inner life (not just external life) can be done through a variety of consciousness raising, inner paths; such as ACT – Action and Commitment Therapy.
These paths are not necessarily spiritual. They are found in Buddhist and other contemplative practices as habits, not as a search for a religion, although religious practice may also help those inclined toward an evolution of consciousness.
Maintaining a loving, open sense of humor, this work passes through many stages that can take years, although the bulk of it can occur in 6 months.
A reminder to clinicians to continue to turn over personal responsibility to their clients, and clients to continue to work toward separating their personal responsibility for their own destiny from loved ones as well…