Saturday, March 3, 2018

Binge Eating

Recently, I was part of a panel giving a talk on eating disorders. The event was open to the public, so we got a nice mix of adults and children in attendance. Things went well overall, but some of the questions during the Q & A segment were a challenge to answer. This isn't because we didn't have the knowledge to answer but more because we are all products of our society and there are deeply fixed beliefs around eating disorders. It's incredibly difficult for anyone, struggling or not, to move away from the mindset that food is not the main issue when it comes to eating disorders.

Of all the illnesses we addressed, binge eating was the most challenging. Finally, there seems to be a better understanding around anorexia, that you can't simply force someone to eat. Unfortunately, with binge eating, people, even loved ones, are more likely to try to control the binge eater.

At one point during the evening, I brought up one of Geneen Roth's books in which she describes a child who kept gaining weight and whose mother was worried about her daughter's health. Geneen told the mother to give the child a pillowcase full of the girl's favorite snack food, which was M&Ms. Initially, the girl carried the pillowcase everywhere and ate as she pleased. She gained some weight in the process. When the mother kept reassuring her child that she was still loved and trusted, the child eventually began consuming fewer candies and leaving the pillowcase behind. I'm pretty sure some of the people in the audience were assuming two of us on the panel were suggesting that they give their kids unlimited amounts of candy. That wasn't the point of the story, and it's not something I would actually suggest. The story does illustrate a point, though.

What the story offers is a way to find out what the food represents to the child. Some believe taking the problem food(s) away is the answer, and others believe providing it in abundance is key. In the case of the girl in Geneen's book, the M&Ms represented trust and love, especially the mother's love. That's the underlying issue, but with binge eating, those close to the one struggling are desperate to find a way to fix the symptoms and fix them quickly. Nobody wants to see their child suffer, and the fear is that anyone who binges won't fit into the ideal beauty standard, the one that's unrealistic to begin with and generally unhealthy. There are also health concerns, like with any illness. We're all looking for that the magic pill, and parents can end up wanting to limit what their child eats. They want desperately to protect their child from experiencing ridicule and potential bullying if she ends up different.

I believe this kind of thinking, wanting to control someone who binges, is, in part, because of the way society looks at anyone who doesn't fit the "thin is beautiful" false narrative that's ingrained in our society. There's also the recognition that anyone, no matter what her actual size, who eats in secret, eats large quantities of food, or sneaks food probably experiences much guilt and shame, possibly for even eating at all and taking up space. You can imagine how being called out for these behaviors must feel to a child. As a society, we really need to remove the shame and guilt around our struggles.

Binge eating, any disordered eating actually, is never about willpower or self-control or a lack thereof. I can guarantee that anyone struggling with an eating disorder is tough. We have to be just to make it through the day sometimes. While I may not have the specific answers for each individual, I can assure anyone reading that the more the focus is on the food and trying to control it, the more progress will stall and backslide. In the last few years, there have been therapists who have spoken out, cautioning that a focus on the symptoms will only make matters worse. Their suggestion is to avoid all talk about food and weight and, instead, address the underlying issues. If the issues haven't been brought to the surface or are unidentified, focus on general likes and dislikes, look at identity, and practice goal-setting (related to life, not food) and saying positive mantras.

It's not an easy path for either the one suffering or the parents and loved ones. I often suggest that the family get therapy or support separately from the one struggling. Don't give up hope, though. As difficult as a supporting role can be, it's an essential one in terms of recovery. People with eating disorders need advocates. They need guidance and love, and they need reminders that they are worthy, no matter what kind of illness they have.

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