'Tis Almost the Season, or the Backstory to the Binge

Binges never happen in an emotional vacuum, even though we can pretend that they do. Often, someone claims that she was in perfect control of her eating until she ate that first doughnut or piece of chocolate. "It was the sugar that set off my binge," is usually the explanation.
11/14/2012 10:56 am ET Updated Jan 14, 2013

Edna has been struggling with weight loss for decades. I first encountered her as a volunteer in one of our weight-loss studies almost 20 years ago and despite drugs, spas, herbal supplements, traditional and fad diets, and even intensive personal training, her weight has changed less rapidly than the melting of glaciers during the same period. Whenever she comes to me for a consultation and complaint session, the story is always the same: Her weight loss is derailed by a week or more of uncontrolled eating and, as her weight is gained back, her motivation to continue on a diet vanishes.

This time it was a binge lasting a couple of days followed by a total avoidance of any food with nutritional value. "I don't know what happened," she told me. "I was doing so well, felt great, was thinking of buying new clothes in a smaller size, and then I blew it. Maybe it was the oatmeal I started eating for breakfast, or the veggie patties I have been having for lunch. There was something in the food that set me off. After that, I could not control my eating."

But a few minutes later, she admitted that it wasn't the food at all that started her binges. She was extremely stressed because she had to go to major family event six weeks and was embarrassed about her appearance. She had been in one of her thinner phases the last time the relatives saw her and now, despite her weight loss a few weeks earlier, she still weighed about 60 pounds more than at that previous occasion. Her rational self should have stayed on the diet but as she admitted, her irrational self said, "What's the use? I still look fat and they will all talk about me."

So she binged.

My job was to convince her that her present and future health was more important than this family event and to go back on her diet. Just as important was our conversation about recognizing that there is always a backstory to a binge. Binges never happen in an emotional vacuum, even though we can pretend that they do. Often someone claims that she was in perfect control of her eating until she ate that first doughnut or piece of chocolate. "It was the sugar that set off my binge," is usually the explanation, followed by the "carbohydrates are evil" mantra.

My response is to ask why was the doughnut or piece of chocolate was eaten in the first place. The backstory, if the response is insightful and honest, usually involves a stressful event, exhaustion, a desire to give oneself a treat following a period of meeting the obligations of others or an unwillingness to follow the self-denial of a diet any longer. In short, the trigger to the binge had nothing to do with the doughnut or chocolate; the doughnut or chocolate were the foods at hand to make the binge happen.

But binges can be stopped. As with seemingly endless thirst after a period of water deprivation, there comes a time when enough water or enough food has been consumed to cause the brain to say, "No more." The fastest way to stop a binge (other than covering the mouth with duct tape) is to eat a food that rapidly increases the synthesis of serotonin, which is the neurotransmitter in the brain that halts eating. When enough of it is active, people will actually take food out of their mouths because eating becomes aversive and unpleasant.

Often an exceedingly sweet carbohydrate, like Marshmallow Fluff or honey right from the jar, will not only set in motion the synthesis of serotonin; its sweetness will be unpleasant and shock the binge eater into stopping even before new serotonin is made.

Yet preventing the binge from starting is much harder. This is because the question "Why did I eat like that?" is rarely answered by the person who feels guilty, contrite and bewildered once the binge is over. It is hard to look at the antecedents of any impulsive behavior, whether it is buying an unwanted item on sale, texting an ex-boyfriend, or eating too much. Sometimes there are things that we rather keep hidden even from ourselves.

The answer to the question is this: Get help.

Find someone who knows you, is non-judgmental and wise, and is willing to talk with you about why you may have lost control over your diet (or resolution never to contact that boyfriend). The story behind the binge is usually easily accessible. Edna readily admitted her anxiety over the family event, her hidden anger over the nerve of her family to comment on her appearance and her simultaneous frustration with her weight and self-perceived unattractiveness.

Once the reasons behind impulsive overeating are brought into the open, then the binger can seek the appropriate help to diminish the likelihood of future bingeing. Sometimes the solutions are pragmatic. Edna decided to stay only a short time at the event because she had another (fictitious) commitment that day. Often the solutions require therapy and/or changes in diet. For example, binges may be more likely to occur when lack of carbohydrate decreases serotonin levels in the brain, thus decreasing serotonin's power to halt eating.

Once the backstory is known, the sequel's outcome can be positive. Control over bingeing and effective weight loss can begin, and you will find yourself with tools to curb emotional overindulgence, aka the winter holidays.

For more by Judith J. Wurtman, Ph.D., click here.

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