Marjorie Nolan Cohn

Cheat Sheet / Updated 03-10-2022

If you’re facing up to binge eating disorder (BED) or any disordered eating, adopting healthy eating habits and finding ways to outlast those urges to binge. Knowing the health risks you face may help motivate you to change your behavior. Your family and loved ones can play a key role in your recovery and can benefit from their own tips on coping.

Article / Updated 03-26-2016

Many myths persist about the circumstances and factors that contribute to binge eating and what it means to be a binge eater (or an emotional eater). Only time, continued research, and greater acceptance from the general population and the medical community will help dispel some of the myths identified below with binge eating. All binge eaters are obese This is perhaps the greatest myth about binge eaters. Weight is not a measure of binge eating disorder. Binge eating, emotional eating, and compulsive overeating don’t always result in obesity. Whether or not someone struggling with certain aspects of binge eating is obese, he may still fight other symptoms of the disorder including depression, guilt, and other negative emotions. Binge eaters have no willpower Willpower has nothing to do with overcoming binge eating disorder. If only it were that easy! If you’re on a dieting-bingeing-weight fluctuation cycle, it’s very difficult to break this pattern on your own. You have likely come to depend on overeating as a way to self-soothe and to get you through the day (or night), and although this may have worked for a long while, you now find that it causes more problems than it solves. In order to make changes to improve your physical and psychological health, you need tools, techniques, and support to break old habits and establish newer, healthier ones. Binge eating is not a real eating disorder Until recently, many people weren’t sure how binge eating disorder fit into the spectrum of eating disorders and professionals were forced to define binge eating and other types of overeating as an eating disorder not otherwise specified, or EDNOS. However, in May 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) identified binge eating disorder as its own diagnosis for the very first time. This classification is so very important not only because it may start to destigmatize people who suffer from binge eating, but also because it may promote more equitable reimbursement by managed care for related services. (The EDNOS classification no longer exists, and a new classification, other specified feeding or eating disorder, or OSFED, has taken its place.) Binge eaters just need to exercise some discipline and go on a diet The last thing a binge eater should do is go on a diet. The dieting-bingeing-gaining-weight cycle is one of the hallmarks of binge eating disorder and a symptom of the all-or-nothing thinking that gets binge eaters in trouble. While seeing a dietitian and following a healthful, structured eating plan can be helpful for some binge eaters, going on a diet specifically designed for weight loss is generally not recommended. Weight loss surgery can cure binge eating disorder Even if you lose weight after bariatric surgery, weight-loss surgery doesn’t address the reasons why you binge. Often times, whatever reasons drove you to binge in the first place remain unaddressed and often creep back up once your body adjusts to the procedure. In fact, according to the American Society for Bariatric Surgery, the average person who has bariatric surgery loses 40 to 70 percent of excess weight after one to four years but does not reach her ideal body weight. What may be more disappointing is that up to 70 percent of those who have the surgery, especially laparoscopic banding and similar procedures, often regain some or all of the lost weight in just a few years following surgery. These statistics suggest that you should carefully balance the medical indications for surgery against the risks, costs, and discomforts of the procedure and recovery. Only women binge Unlike other eating disorders that affect mostly (but not only) women, binge eating disorder affects almost as many men as it does women. About 40 percent of binge eaters and compulsive overeaters are men, and the numbers may be on the rise. Though men typically begin bingeing later in life than women, there are more similarities than differences between men and women who binge. If you’re a man who binges, effective, specialized treatment is available to you as well to help you understand and control the urge to binge or overeat. Binge eaters are always hungry Bingeing and overeating have nothing to do with physical hunger. You may want to read that sentence again. In fact, all forms of disordered eating have little to do with eating or food; food is just the weapon of choice, so to speak. For a chronic binge eater, eating beyond physical hunger or satiety has become a way to self-soothe in moments of stress, sadness, depression, loneliness, anger, and other negative emotions. Effective treatment for binge eating aims to get to the bottom of why you binge eat, promote alternate coping skills, and help you learn how to tell the difference between physical and emotional hunger. They are quite different. Only adults are binge eaters Even though children are not often diagnosed with binge eating disorder, rising childhood obesity rates across the United States and the industrialized world suggest that young people are at risk for developing binge eating disorder or other types of disordered eating as they get older. Children become overweight and obese for a complex set of reasons and circumstances. However, one of the most important things to note about children and disordered eating is that it’s not possible to treat children without treating the entire family. Medical doctors are the go-to experts for binge eating Although your medical doctor is likely an excellent resource for medical problems that arise as the result of binge eating and may well be your first stop clinically, your doctor is unlikely to have the time or expertise to coordinate the many aspects of your treatment for binge eating. To get better and healthier, it’s just as important to consult with a psychotherapist or psychiatrist and a dietitian who also specialize in treating disordered eating. Working with professionals who have expertise and insight into binge eating disorder helps ease behaviors and symptoms and also ensures that you get accustomed to recognizing the feelings and emotions that drive the compulsion to overeat. After you’re diagnosed with binge eating disorder, you’ll always have it It’s important to remember that binge eating disorder is not a life sentence. As with any psychological condition, with the right treatment and support, you can find ways to manage and overcome this disorder. Sustained recovery may take a while — and will probably require your attention to varying-but-lesser degrees for most of your life. The difference is that it need not be a lifelong burden. It could become nothing more than a daily set of choices you make for yourself.

Article / Updated 03-26-2016

If you're the friend or loved one of a binge eater, you may be wondering what you can do to help. Like any eating disorder, the right kind of support can be critical as someone begins the journey to overcome binge eating and begins to make healthier, more sustainable choices about food. Educate yourself about binge eating Becoming familiar with the basics of binge eating disorder is the best place to start if you want to help a loved one suffering from it. It's painful for people who use overeating as a coping mechanism to explain the ins and outs of their behaviors. If you take time to read and learn about the thoughts and feelings that go along with binge eating, you're better equipped to help. Let your loved one take the lead Those who binge or chronically overeat can't expect to get better without seeking out treatment and/or making changes themselves. You can be there for support, but it's up to the sufferer to tackle the problem in his own way and in his own time. If the binge eater seeks treatment for you or because he "should," his efforts to stop binge eating will be short-lived. Listen without judgment At times, everyone needs someone to sit down and quietly listen to them without expectation or judgment. Someone who binge eats probably needs a sympathetic ear now more than ever. If your loved one suffers from disordered eating, she wants to be understood, to find ways to express what she thinks and feels, and to come up with ways to stop the madness. Eating disorders are personal, so lending an unconditional and understanding ear is critical to helping someone recover. Know your limits No matter how supportive you hope to be, don't feel that you must take on the role of therapist. Even if you've done your research, therapeutic advice should come only from a trained professional. People develop binge eating and other eating disorders for a complicated set of reasons and circumstances, and treating these disorders can be complex and sometimes precarious. Effective long-term treatment often depends on a collaborative approach from a team of eating-disorder professionals. Practice patience As people come to terms with their disordered eating, it may take a while to open up to friends and loved ones. It's scary to admit to anyone that food and eating have taken over their lives, and some people may also be frightened by the thought of trying to change their behavior. If someone comes to you to talk about binge or emotional eating, let him know that you understand how serious the situation is and that when he's ready, you'll be there to help in whatever way you can and are available for the long haul. And have patience because the process will, in fact, take time. Remember that recovery is day to day Every eating disorder is different, and each person who binge eats is unique. Although there are certainly some promising tried-and-true approaches, there isn't a standard treatment plan that applies to every person and every situation. Focusing on the here and now, literally one bite at a time, will ultimately help your loved one in the long run. Do not suggest your loved one go on a diet! Tempting as it may be to offer a solution to someone you care about, dieting is actually a frequent contributor to binge behaviors for many people because it creates a pendulum swing due to its restrictive nature. Instead, suggest that your loved one start by getting proper evaluations and creating structures for support and slow but steady insight and change. Understanding her triggers and examining the root causes of her disordered eating is the first set of primary tasks. Help tackle some of the day-to-day stressors for your loved one One significant way to reduce triggers for many bingers is to keep life simple. By helping your loved one reduce his daily stress, you can ultimately make a huge impact. Work together to see what may be helpful in freeing up some time for him to start the process of healing and treatment. Often the little things make a big difference. Don't talk about how other people look Those with binge eating disorder are generally very self-conscious about their appearance. Even though many of us do it, by pointing out others' sizes, whether large or small, you may be unintentionally triggering a binge by contributing to your loved one's self-consciousness. Allow yourself to be a distraction Boredom is often cited as the number-one trigger for bingeing, so one great way to help your loved one is to try to keep her occupied when she may be at risk. Of course, there's a lot more to it than that, but at the outset, that's what it seems. One common therapeutic technique is to create a list of activities that bingers can turn to when they feel urges. Let your loved one know that if you're available, you can be on call for her and that you can spend time on the phone or in person until the cravings pass. By all means, suggest but do not pressure her into pursuing a list of alternate activities. If you nag, you may start to be perceived as a trigger yourself. The idea is for someone to slowly become self-motivated and to know that no matter what, you can be counted on for nonjudgmental support. Make positive comments only Pointing out the negative, even when your intentions are well-meaning, just make a difficult situation more difficult. Try to refrain from asking questions like, "Did you eat the whole chocolate cake last night?" or "I thought we had more peanut butter in the cabinet. Did you finish it?" Chances are this will only embarrass, shame, or anger your loved one even if you don't mean to be mean or hurtful. Binge eaters feel bad enough after the numbing effects of a huge binge quickly wear off; the last thing they need is someone else, particularly someone important to them, inadvertently contributing to their feelings of guilt, shame, and helplessness. Plan fun, food-free activities Many social gatherings revolve around food, but you can find tons of fun things to do that don't involve food including going for a walk, attending a concert, or making an appointment at a spa. Anything that's fun, relaxing, and does not involve food should be included on the list of options. Make sure to ask your loved one what he would like to do. Don't become overly involved It's commendable to want to help someone recover and live a healthier life, but you can't make someone else change. Once your loved one has committed to working towards recovery, it's best to take a backseat and take your cues from her. One exception to this rule is to know what to do in an emergency should one arise due to your loved one's disordered eating. Be aware of community resources and gather information about resources for treatment.