Eating disorders
What is binge eating disorder (BED)?
Understanding compulsive overeating
Article by Judy Lightstone, LMFT
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Binge eating disorder, or BED, follows predictable patterns. Compulsive
overeating patterns can be understood by following the diet/binge cycles
described below on this page. You may stay in one cycle or move repetitively
back and forth between the two, alternating periods of compulsive overeating
with periods of compulsive restriction, or you may never restrict, although
the wish to do so is part of what drives the binging. Whichever pattern
you follow, understanding the triggers to your eating and being able to
slow down the binges are the key to breaking the cycles.
Let’s start by defining compulsive eating as any eating out of relation
to physiological hunger and satiation. This means that anytime one eats
for reasons other than hunger or bringing hunger to satiation, we say
that eating was compulsive in nature. Which is to say we all eat compulsively
at times (i.e. for reasons other than physiological hunger).
People with eating problems, however, eat compulsively consistently and
feel terrible shame about both the behavior and the effects of the behavior
(perceived or real) on their body size. In fact, each compulsive eating
episode tends to be accompanied by a great deal of shame, as shown in
the cycles below. Indeed it could be said that shame is the main ingredient
that turns a "normal" experience of compulsive eating into a
repetitive anguished pattern.
Individual therapy for eating problems
In my work with people with eating disorders, I listen to them carefully
as they describe their eating in detail to me. Below is the common pattern
I have distilled from underneath the many stories I have heard. When you
come in for your first appointment, you may have a lot to say, or you
may be so nervous that you don't know what say. Trust is a key issue,
and you may feel afraid to trust or you may want to dive right in. Either
way, we will both come to understand that trust is not a static thing—it
comes and it goes, and generally has to be earned to be meaningful.
While we are exploring these complexities, it's often a relief to start
talking. We begin by helping you explore your personal experiences with
food, feeding, fat, and body size, and why these issues are so painful
for you.
Techniques for Working on Eating Problems
You may have been put on diets or diet pills, forced to eat when you
weren't hungry, weighed and lectured by well-meaning (or not so well-meaning)
doctors or relatives, or felt otherwise disrespected and intruded upon.
I will not be weighing you or telling you what or what not to eat. This
may feel like a relief, or you may not like that. Some people become dependent
on others to tell them what to eat. I will simply be encouraging you to
sense your hunger and satiation points, and to notice when you can follow
them as guides, and when it seems too difficult.
We may choose to include journal, art, or movement work, and guided fantasies
to help you express what the eating problem has been trying to say. Ultimately,
you will learn to eat when you are hungry and stop when you are full.
But in the meantime, when you cannot always do this, we will use the symptoms
to point us to the triggers and issues in your life that you have been
using binging, and/or dieting to solve. We work these through one by one,
until you feel strong enough to face these difficulties without depriving
or punishing yourself with food.
