OVEREATING AND OTHER EATING DISORDERS

OVEREATING AND OTHER EATING DISORDERS

by Amara Magomola

INTRODUCTION

Although there has been no official statement that overeating and undereating is considered to be an addiction or a mental illness according to DSM-IV, it can be said that there are people who suffer from eating disorders. There are mild eating disorders where people are go from the extremes of overeating or almost starving themselves as they have not been able to have learnt to eat in moderation and some people who are frequent dieters and then when they are off their diet they go through periods of extreme dieting. There are other intense eating disorders such as bingeing, anoerixa, and bulmia. The core issue with eating disorders is partially the person’s relationship with food and their relationship with their body image. Therefore, there is no such treatment as such for the person who has an eating disorder and rather a living that requires healthy eating and learning to develop a better perception of who they are.

Psychologically, the person who has an eating disorder will have had a history of feeling inadequate, lacking self-esteem, and having a bad sense of body image. This is one of the greatest similarities that they have with addicts and to a large degree it can be said that those with eating disorders are addicts. This is because they are addicted into a powerful psychological inner message that says that if they could lose so much weight, get liposuction, get implants, or generally have a different body than the one their Higher Power gave them they will finally find all the happiness, feel appreciated, and attract the right people or opportunities that those with better bodies have. People who have developed an eating disorder would have also learnt that being in the body they are is not good enough and this is primarily due the images portrayed by the media as well as having parents who were too stringent on the child and/or themselves with how they managed or perceives their own lives and have now passed on to their eating-disordered child. Physiologically, the person with an eating disorder has tried various methods of changing their body by excessive use of fad diets, laxatives, supplements, and steroids. These varieties of distorting their biology has changed the way their body works and some people will have developed problems that they never had before i.e. fertility issues, high blood pressure, hemorrhage, slower metabolisms, etc.

Recovery for people who suffer from eating disorders is possible but because the malady is so psychologically imposed, it is thereby it takes a little bit more to treat them. Unlike drug addicts or alcoholics, rehabilitation centers may not necessarily work although there have been some people who have left from these treatment centers with a new approach to their eating disorder and have successfully continued to live a healthier life and able to gradually moderate their eating lifestyle. The 12 Step Program has developed Overeaters Anonymous for the group of people who introduce themselves as food addicts as some of them are undereaters or have anorexia therefore it is not purely for overeaters or binge eaters. The Program is developed from the original Alcoholic Anonymous Program with the only difference being the core addiction as food and not alcohol being the basis of what the people are trying to get a grip around. Again, the other difference from Alcoholics, Gambling, or Narcotics Anonymous is their ‘answer’ to the problem is abstinence from these issues whereas Overeaters Anonymous cannot simply abstain from food. However, the Overeater can abstain from their various triggers whatever and wherever they may be. They also learn to find a way to encourage balance eating and a pathology surrounding the way they eat.

DIFFERENT FORMS OF EATING DISORDERS

Binge Eating

“While substance (alcohol, drug) dependence diagnoses have been defined in the DSM for decades, Binge Eating Disorder (BED) is not yet considered an established diagnosis and is currently included as a provisional in Appendix B of the DSM IV-Text Revision. Substance dependence and food addiction conceptualizations are also characterized by diminished control over substance use/consumption despite negative consequences and diminished ability to cut down or abstain use/consumption of the substance. In other words, BED and substance dependence are both associated with diminished control during consumption, as well as a diminished ability to reduce the quantity of use”. (Gerdt, Phil, Marney, White, Potenza, Binge Eating Disorder and Food Addiction, 2011). Binge eating effectively is the inability to stop eating when satisfied. Binge eating usually happens when the person with the eating disorder is dealing with intense emotions (guilt, sadness, anger, overburdened, fear, etc.) and instead of dealing with his emotions appropriately; the binge eater will find ‘comfort food’ with the hope that the feeling will disappear. There are some binge eaters who only do this on specific occasions i.e.: when they are sick; at night; when they are home alone; in their car; etc. (Note: binge eaters perform their eating disorder of choice when they cannot be discovered and so it remains a secret which tends to add onto the intensity of their emotions particularly guilt, fear, and anger).

Obesity is one of the biggest characteristics of binge eating as well as high blood pressure, high cholesterol levels, a congested respiratory system, and diabetes. Binge eating disorders have plenty of psychological side effects usually dealing with the way the person feels about his weight i.e. guilt, embarrassment, shame, low self-esteem, and levels of insecurities. Binge eaters feel as though people judge them purely for their appearance whereas there are others who are in denial or hide their excessive weight with humor, pseudo-confidence, and other irrational cognitive ne behaviors. The reality is that at some point in their lives, binge eaters have tried many courses of weight loss schemes particularly fad diets. However, because their behavior is entirely psychosomatic they become unwilling to admit that they have the inability to control their level of food. These people are substance dependence and their dependency is ultimately indulgence as opposed to food as rarely does the binge eater specific on food preference as they are willing to consume pretty much anything without paying much attention to taste.

Bulimia

People who suffer from bulimia are similar to binge eaters except bulimics purge their food almost immediately after eating. The act of purging for the bulimic comes from the irrational idea that whatever calories they have consumed will immediately be rid of by vomiting afterwards. However, that is not really the case because most of the calories ingested during the binge goes directly into their body and what is vomited tends to be the nutrients. Bulimics, like the anorexic, has issues dealing with perfectionism and are usually controlling people. They have the need to control everything and everyone around them which is typical addict behavior and when under this unnecessary pressure; the bulimic finds himself under extreme anxiety and stress. They usually turn to food to bottle their pain and tension instead of learning to handle their emotions in a healthier manner and immediately after they have wolfed down the food they purge which temporarily gives them a sense of relief from whatever is going on inside of them. After a certain amount of time of becoming dependant on the ritual of eating and purging, the bulimic will build a tolerance for this habit and the habit can become a subconscious second nature where they will even purge after a normal meal.

Some specific characteristics of the bulimic are: dramatic irregular changes in weight; scarred knuckles; isolation; disappearance soon after meals; obsession of weight and calories; starvation periods; depression; anxiety; rotten teeth and gums; dehydration; infertility; seizures; and diabetes. They physiological signs of a bulimic are most noticeable from their mouth both through their odor which is rotting away and often is hidden by the use of mouthwash or breath fresheners particularly after meals when they have purged the food recently consumed. Again, because of the excessive purging, the excessive amount of acid in the stomach will erode the gums and teeth enamel and can corrode the stomach walls causing ulcers. The lack of minerals, vitamins, and other nutrients also will be manifested in the dryness and brittleness of the hair and nails of the bulimic, (this may cause eventual hair loss). The bulimic also suffers from dehydration from the constant vomiting. Mentally, the bulimic will be obsessive about weight, calories, and food intake to the point of compulsion. This will cause the bulimic to present himself as a knowledgeable in his health well-being yet be so fearful of any weight gain that he will have a distortion in his thinking where he will punish himself frequently by starving himself when he feels he has achieved badly during the day or failed at some matter.

Anorexia Nervosa

Anoerixa nervosa is the act of starving the body due to the false and is about being in control and a perfectionist which is why most people who have this disease tend to be athletes (primarily professional ballerinas and dancers); models; and adolescents. “The term anorexia, or absence of appetite, is a misnomer because patients are often hungry and can be preoccupied with food. They may cook elaborate meals for others, hoard food, or establish intricate rituals around the food they eat. The hallmark of anorexia nervosa is denial and preoccupation with food and weight. These behaviors resemble those seen in patients with obsessive-compulsive disorders”. (Rutigliano, Anorexia Nervosa: An Issue of Control,2003). Therefore, with this obsessive-compulsion of controlling food implies the anorexic as an addict but his addiction is one of control. The anorexic also has the need to control his ideal weight, body image, and some have the compulsion to control the need to appear pre-puberty. Particularly with women, the association of the need to appear pre-puberty may be due to mental obsession of wanting to stay treated as the ‘baby’ or ‘princess’ where she was spoilt with love, affection, and material items from her parents alternatively it may be from having a history of sexual assaults/molestation and therefore appearing pre-puberty may be the feeling of being able to control further sexual attacks.

Psychologically, the symptoms associated with anorexia are: control; perfectionism; obsessive need to lose/control weight; regulate mood; body dismorphia; manipulation; and genuine need for love and approval. It has been observed that even when anorexics agree to go into treatment they do so using forms of manipulation of being promised certain elements from their parents once they have gained x-amount of weight which often means that he will go in and out of treatment centers to gain love, approval, or whatever needs they require from their parents or caretakers. The anorexic regulates his mood by starving himself which can create a ‘high’ which is caused from the release of dopamine and adrenalin which is a natural state caused by food deprivation. Physiologically the signs of anorexic are quite obvious aside from the body looking emaciated; what also happens to the body is: skin becomes dry developing a yellow hue and grow fine hair (called lanugo); body temperature altered therefore common complaints of cold; become tired easily, and have hormonal changes.

Nocturnal Eating Syndrome

Nocturnal eating syndrome affects only about 1.5% of society equally amongst men and women. This is usually when a person gets up in the middle of the night to eat either a full meal or snack on tidbits frequently during the week because of genuine hunger or a craving of some sort. This occurs largely in those who have a history of substance abuse and/or are high achievers may have picked up this habit either in high school or in college perhaps due to a heavy workload or the working through out the night. This usually occurs when the person has bad eating management where he either does not have the time or forgets to eat during the day and then overcompensates at night. The nocturnal eater often binges in the evening with eating a higher quantity of food or calories which results in becoming overweight. Nocturnal eating may result from unusual hormonal patterns (often caused by substance addiction) and this results in the individual reversing their eating pattern where the body cannot regulate the correct time to consume food.

Psychologically, the person may have issues with depression, guilt, anxiety, perfectionism, bad sense of body image, disgust, and a general sense of inadequacy. The nocturnal may inherently feel like that they are living out of control where they seem to be powerless over the unnatural habit of compulsively having to get up each night to eat being aware that they are gaining unnecessary weight, losing sleep, and will inevitably have an unleash of guilt and anger towards himself for not being able to stop himself. Insomnia may be a large part of the problem where the nocturnal eater is unable to sleep so he hopes that by stuffing his mouth with food he will create the drowsiness that comes from eating therefore he is most likely to go for starchy, fattening foods. The nocturnal eating binger may have had periods where he has attempted to quit the habit and would have succeeded for a certain amount of time until he finds himself having relapsed which, naturally, attributes to remorse, anger, and depression. Nocturnal eating is a psychological problem and no diet or exercise will treat the problem, however, daily management of eating and sleep may improve the issue drastically.

THE PSYCHOLOGY BEHIND OVEREATING AND OTHER EATING DISORDERS

People with eating disorders do so mainly because they have core issues that deal with feeling of guilt and embarrassment. It is not just that their body that binge eaters are ashamed about as it can do with many aspects in their life which is what causes their basic sense of low self-esteem. As a child, the environment of the binge eater may have been overwhelming possibly as he was inherently born with a highly sensitive personality making it difficult for him to understand his own emotions thereby his relation with other people and their feelings may have been overdramatized and/or oversensationalized. The binge eater or anorexic was probably brought up in a family who were more rational and to a certain degree removed from their feeling making him feel more different and as though he didn’t really belong in his family. This perception would have most likely continued as he started going to school and making friends with others.

The binge eater avoids stressful situations and other intense emotions and will isolate himself in a place where he will not be disturbed as he gorges on food often to the point of overconsumption. In the beginning when the binge eater forms the habit of escaping towards food, he may find that he eat himself to a point where he feel nauseous and will vomit his food. Afterwards, he will feel guilty and embarrassed about the recent activity. The guilt will come from various thing i.e. spending so much money on the food he acquired (take away, chocolate, chips, and sweets), the awareness of his strange behavior, the fact that he ate himself to the point of regurgitation, and whatever intense emotion that he has escaped. Binge eating is a deep secret that even if the person was aware out of it, he would do embarrasses him to admit to anyone that he has a problem with food which makes seeking treatment for his disorder all the more difficult.

The anorexic avoids most emotion as he finds himself powerless over the good and the bad polarities as himself. Often, the anorexic is attempting to become the perfectionist of how he acts, behaves, thinks, and eat (or rather his weight so he avoids eating). One of the reasons why this behavior is often exhibited in athletes (particularly dancers, gymnasts, and ballerinas) and models is because body image is portrayed as the prime importance of everything in the artistry of dance and beauty/fashion. Not only is the anorexic a perfectionist but he can be quite competitive and a general high achiever which mean that he is willing to do anything to be the best even if that means overexerting himself and starving himself.

Both the binge eater and anorexic also have characteristics of a person who has body dismorphia (which is the distorted perception of how one sees their body). Anorexic perceive their body as being overweight and/or fat regardless of what the truth is. It has been observed from psychologists that even when they do such experiments in the attempt to get rid of this perception where they will ask the anorexic patient to lay or stand against a piece of paper and the psychologist will outline their body with a marker then have the same picture standing against several others of skinny, fat, and average weight people; the anorexic will always point to the fattest one and claim it is their drawing. Equally, the binge eater will either perceive their body as either being too fat, slender, and sometimes even at their ideal various states of feelings from being overconfident, secure, and ashamed for the way he looks which always triggers him to binge because a) he feels his weight is hopeless; b) he need to gain a little more flesh; or c) he can treat himself.

Binge eating is similar to the alcoholism/substance abuse due the faulty perception of control, “for example, if someone plans to have only one or two drinks after work, but proceed to drink late into the night, this person would exhibit signs to diminished control over consumption according to dependence”. (Gerdt, Phil, Marney, White, Potenza, Binge Eating Disorder and Food Addiction, 2011). This shows the tolerance that is built regarding the consumption of food where with alcoholic he has no longer been able to control his ability to drink only one or two drinks and has to continue during the evening as his ‘high’ has decreased. This is the same for the binge eater except his tolerance level is decreased because he has gradually been expanding the size of his stomach as time goes on which is why it takes more food to make him feel satisfied. The anorexic does not build his tolerance for hunger but he does build a psychological tolerance to feeling hungry. Therefore, if it is possible that the binge eater and anorexic can alter his own stomach or psychological tolerance by self-will, this effectively makes eating disorders even more complex then diagnosed mental illness disorders such alcoholism and substance abuse.

HOW THE 12 STEP PROGRAM CAN ALTER THE EATING DISORDER’S PERCEPTION AND ATTITUDE

The 12 Step Program, in particular Overeaters Anonymous, is a Fellowship of people of every gender, race, sexual orientation, age, and creed (or lack of) who come together to share similar stories of their life with their addiction to food/control. The main purpose of the group is to find strength, experience, and hope for recovery to living a life of self-regulation of emotions and behavior which alter attitudes and the relationship with food. It is an offspring of the Alcoholics Anonymous 12 Step program and has the Steps, Traditions, and much of the literature based on the concept with the only difference being that the focus is the addiction to food. Anorexics may find it ludicrous for them to have to go through a Program such as this considering it implies overeating when the anorexic seems to have the opposite problems (despite episodes of binge eating). However, the anorexic will find the program and meetings beneficial especially when they come to realize that they have issues surrounding control and therefore how controlling their weight is not what they should be focusing upon. A good number of the people who enter Overeaters Anonymous have various addictions from substance abuse and problem gambling, to sex abuse and hoarding.

The Promises that are found from the Overeaters Program are that everyone will find a new sense of freedom and serenity from living a life controlled over and around food and the ability to find security within self to find new associates as well as a structured life and routine that they can replace the preoccupation over food, dieting, and exercise. When practicing the 12 Step program, the binge eater/anorexic must do as much reading of the literature available including the Big Book of Alcoholics Anonymous (even though the person may not be an alcoholic the principles and tools in the Program come from various parts of the Big Book so it generally becomes a great foundation for their recovery). The binge eater/anorexic must feel comfortable both in talking about his relationship with food, his body, and his feelings in order to get an all encompassed perspective of the addiction as it like alcohol it is ‘baffling, cunning, and powerful’.

Having to look at only the food perspective of recovery will not make one feel adequate with whatever their body looks like and may lead to a new obsession of liposuction and other various skills offered by plastic surgeons or cross-addict to exercising, steroids, diet pills, and other supplements. Remember, the eating disorder is psychological and is based on a low self-esteem of feeling the body is not ‘perfect’ or fits in to the ‘ideal society’. However, only focusing on body image will also allow for the binge eater/anorexic to become dishonest on the last time he hid food, gorged on food, got too sick to go to work from overeating the night before, or fainted at work from not getting enough food in the body. Finally, evading topics like exercise will allow the binge eater to become dishonest and become fearful of going to the gym, taking a run, or doing vigorous and fun exercise like kayaking, hiking, or horse-riding. Likewise, the anorexic will be in denial of his reservations or excuses for why he trains i.e. the fact that he uses how much he eats to rationalize why he can train, if he weighed x-amount that he will avoid or abuse the gym, he refuses to stop training despite the fact that it is a trigger if he has to eat, etc.

CONCLUSION

A member of Overeaters Anonymous once said: “I believe nothing in my life makes it necessarily to eat compulsively. My first sponsor used to ask the question ‘what would make it necessary for you to eat compulsively today?’ That phrase stopped me from compulsive eating on more than one occasion. I would run through imaginary conversations in my mind, trying to convince her that I ate compulsively because I had to. Twenty-three years of sustained abstinence and recovery have proven to that there is nothing that makes compulsive eating necessary. I have lived through illness, disability, and death of those closest to me. I have gotten fired, and I have lost my job through no fault of my own. I have lived through the myriad tiny disappointments and the OA program has never let me down”. Abstinence for binge eaters is, obviously, compulsive eating whereas for anorexics would be the compulsiveness of thinking about food (calories, food intake, rituals around eating, etc.). It is possible through the 12 Step program to maintain abstinence but it takes surrendering, open-mindedness, honesty, and willingness to reach this place.

Step Three of the Overeaters Anonymous program suggests that in acknowledgement of the powerlessness and acceptance of the unmanageability of life in compulsive-obsessive eating behavior that it believing a Higher Power faithfully will help the binge eater/anorexic recover. This is about surrendering the ideology that the binge eater/anorexic has the answer that he can do it by himself and in his own way and that he needs help from those who know better (a power(s) greater than himself), a program, and a Higher Power if he wants to restore himself from his insane thinking, attitudes, and behaviors. Commitment to the Program which involves having a sponsor, going to meetings, doing service work wherever possible, reading the literature, and continuing doing the stepwork from the workbooks available from the Overeaters Anonymous group will ensure that the binge eater/anorexic will be able to have the strength to ignore his self-will, be open to any advice given, and various stories and shares to give him hope via strength, experience, and hope that he too can recover.

Treatment is not always suggested or even required for the binge eater/anorexic, however, seeking professional help from a social worker, counselor, clinical psychologist, and/or psychiatrist is , however, a must because of the beneficial work done as the binge eater/anorexic works with both blatant and subtle triggers, has enmeshment and other codependency issues, may have other mental illness and personality disorders, and other personality/psychological. Those who cannot afford or for whatever reason refuse to seek treatment can still get benefits from OA literature as well as other 12 Step programs. Should one seek self-help books, it would be recommended but it would still be advised that they seek the guidance from the Fellowship or professionals so they don’t find themselves confused or off-topic. Recovery from binge eating/anorexia is possible and one shouldn’t fret if they find themselves in a position where they have relapse by bingeing or obsessing again as that probably will happen time and again but the point is should such behaviors demonstrate themselves, the binge eater/anorexic must call his sponsor and take on the advice given so he can get himself back wagon again.