Binge Eating Disorder
Binge eating disorder typically includes periods of excessive overeating. However, a person with a binge eating disorder does not subsequently induce purging (vomiting), as is the case with bulimia.
Binge eating can occur on its own, or alongside other disorders or conditions, such as Prader-Willi disorder, or a lesion of the hypothalamus gland.
Negative Thoughts.
It is important when in recovery to identify negative thoughts. When you start to do this it will help you break the links between dysfunctional attitudes and negative feelings. For example Sophie was in early recovery and was struggling to increase the number of daily calories she was taking. She knew on a conscious level that this would get her closer to her expected weight for her height, but the irrational pat of her mind bombarded her with thoughts such as “I’ve eaten too much”, “I feel so bloated”, I am getting fat now and everyone will see it”, “I look huge in these jeans now”. In her work with her therapist she identified that these thoughts were demotivating her and she was reverting to the old patterns of skipping meals. With the support of her therapist and her boyfriend she began to question the validity of these thoughts and look for healthier ways of dealing with them. This had the added effect of lifting her mood and increasing her motivation for change.
Some typical negative eating disorder thinking:
I was miserable when I was overweight so if I gain weight I will feel horrible again.
I can’t eat carbohydrates; they bloat me and make me fat.
If I gain a pound in weight I will carry on gaining and won’t be able to stop.
I can never eat chocolate again.
I can’t eat in public because people are watching me and will think I am a glutton.
If I eat anything with fat in it, it will turn immediately to fat on my hips.
So what if I lost 2 pounds this week I should have lost six by now.
I weighed myself and I have put on 2 pounds I’m not eating again for 2 days.
I have completely messed up my diet after eating that Chinese; I might as well just forget about it and keep eating now.
Watch out for the “Shoulds”! When you are using the word should it can mean you are being harsh and critical of yourself, it is one of the most common words people with low self esteem use. “I should be keeping to my diet”, “ I should be thinner”, “ I should be doing more exercise”.
Dealing with Negative Thoughts: A good way of learning to deal with negative thoughts is to make a list of the thoughts you are getting in a diary on a daily basis. Put a column in for:
The situation you were in (what, where, with whom);
The automatic thought and the feeling that went with it;
A more reasonable, less harsh response.
The outcome (Did it make a difference? how do you feel now?)
Guidelines / Tips for Family and Friends
Guidelines / Tips for Family Members and Friends:
- It is important to learn and educate yourself as much as possible about eating disorders. Eating disorders are caused and maintained by many complex underlying factors. Therefore it is very difficult to break the cycle of an eating disorder. Don’t be expecting your loved one to overcome her eating disorder overnight, recovery takes time.
- Affirm your loved one on her strengths and abilities that are not related to her eating disorder. This can help your loved one help separate her self worth / esteem from weight, shape.
- Engage in pastimes/ activities together that will not raise their anxieties/worries about food, weight etc. Again this can help your loved one to learn to base their self worth on strengths and abilities that are not related to food, weight and shape.
- Communicate openly and express your worries and fears directly to your loved one. This can prevent you sending mixed messages and will help prevent confusion.
- Don’t demand change or set ultimatums re: change. Respect that your loved one has a difficult road of recovery ahead and being patient can be supportive.
- Don’t take control of their eating disorder and try to fix it yourself as this can cause your loved one to feel inadequate dependent and incompetent. Depending on the severity of the eating disorder, it can be appropriate to intervene. For example, if you ever felt your loved one’s life is at risk it is important seek medical professional help. Encourage her to attend a GP because of the health implications associated with an eating disorder it is important for your loved one to have her bloods, BMI, weight, bone density checked and if necessary monitored throughout her recovery.
- Don’t brush the eating disorder under the carpet. Your loved one will benefit from your support and concerned interest.
- Don’t blame your loved one or yourself for the eating disorder. This will only lead to anger, guilt and conflict. Gaining an understanding about the eating disorder can help both you and your loved one to cope with recovery.
- Encourage your loved one to seek professional help if necessary. If your loved one chooses not to discuss her recovery with you and confides in a source/professional outside of the family, embrace this decision.
- Be aware of your own beliefs/attitudes about weight and shape as your beliefs can be indifferent to the approach your loved one needs.
- Avoid giving your loved one ‘special’ treatment because of the eating disorder. This approach can cause your loved one to feel labeled; and identified with the eating disorder while at the same time reinforcing her eating disorder symptoms. Treat your loved one like any other friend /family member.
- Be aware of your own needs and your family’s needs too. As eating disorders can be very distressing and consuming for the family it is important to take care of yourself and find support that will help you cope. Know your own limitations.
- Allow your loved one to take responsibility for her own recovery by you offering her support, providing a listening ear while at the same time letting her make decisions by herself. This can increase her positive self belief re: recovery.
- Remember recovery can take some time and it is about ‘trial and error’ for your loved one. Slips can happen, it is a normal part of the recovery process but it doesn’t mean that your loved one has ‘failed ‘ or is back to the start. Remember it is important to keep in mind that people do recover.
Bulimia Triggers
Bulimia Triggers: How to cope with urges and impulses.
What is an urge or a craving? These are an intense impulse to perform a behavior which often has negative consequences. When you act on an urge it becomes a symptom i.e. binge, vomit, restriction, laxative use, etc. Urges or cravings can be so intense that it often feels like you have no choice but to act on them and when you do, you may feel an immediate sense of relief , emptiness, or you may feel guilty and disgusted with yourself. When you get an urge, it can intensify as time goes by and this can be very difficult to cope with. However, urges do eventually pass and settle down.
It is very helpful to know what triggers an urge for you and also to develop healthier ways to cope with an urge rather than acting it out. To manage your recovery from an eating disorder it is vital to both understand your triggers, and raise your awareness of your triggers/ urges to binge, vomit or restrict.
To recover it is necessary to develop some coping strategies that help you avoid acting on your urges every time you get one. Applying coping strategies can be very problematic as acting on urges becomes a very automatic response, therefore making it tough to break the pattern. The more times you avoid acting on an urge the easier it becomes to manage them.
Coping Strategies: Here are some examples of coping skills that may help you deal with your cravings.
Coping Strategies are very personal as what might trigger you to binge/purge might not necessary trigger another person. Therefore it is important to develop a ‘TRIAL AND ERROR’ approach and not necessarily give up if one attempt has not worked out while trying a new coping strategy.
1. Delaying Tactics When you get an urge to binge/purge, try delaying it by a specified amount of time. For example, initially, you can make a decision to delay acting on an urge by 10 minutes by doing some other activity in the meantime to distract you while you try sit out the urge. After the ten minutes check to see how strong your urge still is, if you can, try delaying it further. If you do end up acting on the urge after delaying it, try increase the delay time when you get your next urge as this will help you try gain some control over your impulse to act to an urge every time you get one. The more times you try to do this, eventually you will be able to manage your urges without reacting by binging or purging.
2. Distraction This involves doing something that will take your mind off your cravings. This activity needs to be somewhat pleasurable so as to keep your mind occupied. Examples could be phoning a friend, surfing the web, downloading some music, pampering yourself, go for a walk or taking a bath.
3. Self talk coping statements. Repeating a statement sentence or a word that is helpful and motivational to your recovery can be a very useful tool. You can say it out loud or in silence as long as it reinforces your commitment to your recovery. Try and make the statement a positive one and make sure it is not harsh and critical. An example could be; “ I deserve to be healthy”; “This craving will pass”, “Every day I am getting better and better”. “I will be good to myself today”. “I am a good person” “I will succeed”. These are only samples and it is better to tailor your own statements so that they have a special meaning for you.
4. Making your environment safe. A major part of recovery is to become aware of your high risk situations. Some of these are quite obvious however there might be some that you are not aware of. A daily journal is a good way to track situations that are triggering you to binge. Make a list of your thoughts feelings and behavior in these situations and when you have clearly identified your own high risk situations then you can plan to either avoid them completely or put strategies in place to stop you acting on the urges that develop. Some examples of risky situations could be: Spending time with a friend who is critical of you or makes negative comments on your figure. Spending time with family if this brings up overwhelming negative feelings for you. “Chinese take aways” A lot of people with Bulimia find these are a trigger for a binge or laxative use. Try and avoid as much as possible. After shopping for clothes be aware of your harsh critic and try not to purge, restrict, take diet pills or over exercise. As time goes by and you get stronger in your recovery you will find that these situations become more tolerable and you will not need to be as diligent.
