Psychology: Binge eating disorder

‘Will the real Newman please stand up’; Compulsive overeating is often followed by feelings of self-loathing, shame and guilt.

By MIKE GROPPER
Blurry Newman 311 (photo credit: MCT)
Blurry Newman 311
(photo credit: MCT)
I was and still am an avid Seinfeld fan. In one episode called “The Muffin Tops,” Elaine convinces her ex-boss, Mr. Littman, to sell muffins with the stumps removed. Elaine must get rid of the muffin stumps. The homeless agency refuses to accept muffins without their tops. Elaine next turns to Kramer for help. No luck. Not even the sanitation department will accept them.
For Elaine, there is only one solution. She hires the “cleaner,” Newman. Jerry Seinfeld’s hefty nemesis shows up with his equipment – an enormous appetite, cartons of milk and his favorite activity, binge eating.
Binge eating, also called compulsive overeating, is characterized by eating large amounts of food while experiencing a loss of control over the amount consumed. This perceived loss of control is an essential feature of compulsive overeating.
Binge eaters often begin eating when they are not hungry, and then continue to eat past the point of physical fullness. They typically eat very rapidly and may eat alone due to embarrassment about the quantity of food they are consuming. During the eating episode, some individuals describe feeling distracted, numb or in a trance-like state. Afterward, most experience self-loathing, shame and guilt.
Binge eaters are often caught in the vicious cycle of binge eating and a multitude of stressors.
Somewhere in their lives, they have learned to turn to food as a way of comforting painful emotional states or just to alleviate tension, anxiety, boredom and, for some, being alone. There is a difference between the binge eating that occurs in compulsive overeating and binge eating in bulimia. Bulimics binge eat and then purge – self-induced vomiting. Non-bulimic binge eaters do not purge.
Binge eating meets all the criteria of an addiction – loss of control, compulsive use of food and the inability to cut back on this behavior even when the individual is risking potential health problems such as heart disease, diabetes, stroke, hypertension and impotence.
Like other addictions, once a person learns to use food in such a compulsive and overindulgent manner, compulsive overeating becomes conditioned or associated with all types of situations, people and places where the behavior takes place. These subtle and not-so-subtle cues trigger the impulsive eating bouts.
One can see that regardless of the origins of the use of food to deal with emotions, the behavioral pattern has a life of its own. For example, many compulsive overeaters cannot refrain from binge eating when they are in the kitchen. The kitchen triggers an all-or-nothing perception of food that doesn’t allow the individual to set limits and control his/her eating.
For someone else, a negative emotional state such as having a marital fight can trigger a full-scale overeating episode.
It is not uncommon for binge eaters to eat normally or even restrictively in front of others and then make up for eating less by compulsively overeating in private. Compulsive overeating late at night when others are asleep is very common.
The bottom line is that somehow eating has been chosen as the preferred way to handle negative emotions. This psychological pattern makes you fall off the diet wagon time and time again.
Help A person with a binge eating disorder has to be ready and motivated to change. This often happens because of fear of illness or compromising one’s responsibilities as a parent, spouse, student or worker or just being sick and tired of being out of control.
Cognitive-behavioral therapy, which teaches clients to identify and modify irrational thoughts and learn new behavior, is at the core of treatment. Motivational enhancement, regular exercise, nutritional guidance and support from others, such as attending a 12-step program like Overeaters Anonymous, all aim to help the individual achieve the goal of losing weight and maintaining the change.
Shortly after the Seinfeld series ended, the real life actor who played Newman, Wayne Knight, a self-confessed binge eater, heeded the warning of his cardiologist that unless he got his 327 lb.
(148 kg.) weight down, he was heading toward either a stroke or early death. This was enough to get Knight motivated and a combination of a 1,500-calorie-a-day diet with regular workouts and a lot of persistence and determination plus loads of emotional support gradually helped him get his weight down to under 200 lb.
His advice to others is to be persistent and don’t give up. “It’s like you’re climbing a mountain,” he says. “Look down, look how far you’ve come, wow!” (48 Hours interview, CBS, September 3, 2004)
12-step meetings in Israel can be found at the following sites.
www.ceahow.org/meetings/meetings.php?Area=7
www.oa.org

Dr. Gropper is a marital, child and adult psychotherapist practicing in Jerusalem and Ra’anana. drmikegropper@gmail.com