BREAKING THE CYCLE OF COMPULSIVE EATING
William C. Shearer, Ph.D., M.P.H., M.B.A.
Robin L. Shearer, M.A., M.P.H., R.N., M.F.T.
In our work with eating disorders, we have often been tempted to come up with lengthy and complex prescriptions for recovery. Although there is seemingly no end to usable information and productive strategies for breaking the cycle of eating disorders, our clients have sometimes protested that rather than volumes, they need a few simple guidelines.
One client groaning under the weight of several suggested books and numerous reprints asked if she could have “ just five things to do.” She claimed that is given “just five things,” therapy would seem infinitely more manageable and she could pursue recovery with greater ease and sense of purpose. That was the origin of our five steps for breaking the cycle of compulsive eating.
For several years we got a lot of mileage out of these five steps in both individual and group therapy, seeing increased progress in the recovery journey of many of our clients. Recently, we couldn’t help ourselves – we had to give in and add a sixth step, Mindful Eating, after deciding that this one last ingredient was an important addition for making the previous five even more effective. The resulting six steps are meant to work together. No one step has total power by itself, but taken in combination, they provide a great strategy for breaking the cycle of compulsive eating. The following are our six steps, the original five plus one.
1. All Food Must Be Legal.
Most people who suffer from compulsive eating have been conditioned to think food is wrong. They believe, at a deeply personal level, that they are wrong if they eat, that there are taboo foods that should never be touched, and they of course should feel guilty if they eat those foods, or in some cases any food at all. How often have you heard someone talk, only partly in jest, about "sinful" foods or "decadent" chocolate or pastries?
In previous articles, we explained at length how people in our society are conditioned to think in such a manner. This thinking would indeed be considered bizarre in a third world country where food scarcity is the norm. In our society however, we have been conditioned to be chronic and obsessional dieters and to feel overwhelmingly guilty for eating “the wrong foods.”
Unfortunately, the more you restrain yourself, the more you are going to obsess about the very things that are forbidden, and this is certainly the case when it comes to food. It is a case of suppress now, obsess later. A major part of the problem for compulsive eaters is that they tend to have endless lists of forbidden foods and a profound sense of not being entitled to nurture themselves through food. The guilt and anxiety over food is central to the problem. A major part of the solution is therefore freeing oneself from guilt and anxiety related to food, in fact, making friends with food, which makes this point vitally important. When we say “All food must be legal,” we mean exactly that. There are no “bad” foods and eating cannot make you “bad.” It is necessary for you to believe you are a free adult who can eat anything you please. The choice is yours. That means being able to eat without any trace of fear, guilt, or shame. As mentioned before, this step by itself will not suffice. It has power only in combination with the following five steps.
Recently we read a fascinating book entitled French Women Don’t Get Fat by Mireille Guiliano, a book written for “anyone who has slipped out of her Zone, missed the flight to South Beach, or accidentally let a carb pass her lips.” The author discusses the “French Paradox”–the fact that French women seem to enjoy food while staying slim and healthy. It comes down to a different attitude, a mindset very different than the prevailing American diet mentality. According to Ms. Giuliano:
“At the outset, let’s state that French women simply do not suffer the terror of kilos that afflicts so many of their American sisters. All the chatter about diets I hear at cocktail parties in America would make any Frenchwoman cringe. In France we don’t talk about ‘diets,’ certainly not with strangers...Mainly we spend our social time talking about what we enjoy: feelings, family, hobbies, philosophy, politics, culture, and, yes, food, especially food (but never diets).”
She goes on to state that French women take pleasure in staying fit by eating well, while American women generally see food as loaded with conflict and something to obsess over. French women don’t skip meals. They enjoy food. They’re mystified by Americans squeezing in fast food on the run, and endlessly dieting. The overall result – a dramatically different and lower level of obesity in the French population. The French eat with their minds and seem to have discovered “Mindful Eating” centuries ago. Americans aren’t there yet. We continue to squeeze junk food into a busy work schedule and obsess about the latest diet craze that promises instant and painless slimness. We still haven’t awakened to the fact that should be obvious by now – diets don’t work! Diets are central to the problem.
2. Nurture Yourself in a Wide Variety of Ways.
This step powerfully undercuts the habitual use of food to meet a variety of your non-food needs. Compulsive eaters tends to use food to nurture themselves, to sooth a hurt, to distract themselves from things they do not know how to deal with, to numb emotional pain, to entertain themselves, or to avoid difficulties. There are a number of other additional reasons why people eat compulsively, such as dealing with loneliness, anger, fatigue, and stress. The bottom line is that they are trying to do something for themselves, give themselves something that they do not have or do not believe they can attain.
In the most simple and direct way, compulsive eaters are trying to nurture themselves. This is not wrong. In fact, self-nurturing is a must for people recovering from an eating disorder. The solution is for people to learn how to give to themselves in many different ways without feeling guilty, selfish, afraid, or unentitled. This step works especially well in combination with step number one. If all food is legal and there is nothing wrong with eating, yet you can readily take care of yourself in many non-food ways, compulsive eating is dealt a major blow.
Similarly, anorexics believe that they aren’t entitled to food and shouldn’t have needs at all. They steadfastly guard against giving in to food cravings, in essence guarding against any form of self-nurturance. For anorexics especially, learning how to nurture herself in a wide variety of ways is central to recovery.
3. I Matter.
For many compulsive eaters, this is the hardest step. It is important to have a deep faith in self and a deep appreciation of one’s worth. You need to believe that you have a right to exist on this planet and that since you exist, you matter. This is not selfish or self-centered. It is simply good mental health. In fact, without this deep conviction, mental health cannot exist.
This step means being able to look at yourself in the mirror and tell yourself, “This is the only me I am ever going to have, and so no matter what happens, I am going to be there for me. I am going to be my own best friend. No exceptions! I am going to skip the criticism and give myself a pat on the back whenever I am moving in a direction that is good for me and consistent with my values. This means praising myself for big steps and for small steps, omitting self-condemnation and the incessant self-criticism that has been a part of my life in the past.”
We are talking about learning how to be consistently there for you, never abandoning yourself, and learning how to live your life as though you are worthy, special, important--at least to you. This means that you have the same rights as anyone else, and along with that belief comes the right to be assertive, to tell others what you think and feel, believing that you have a perfect right to do so. This is not selfish. It is not aggressive. Aggression means violating the rights of others.
Along with believing you have the same rights as others, there is the solid commitment to never abdicate respecting your own rights. If there is a difference or conflict in rights between you and someone else, you have the right to negotiate. Above all, this third point means that you choose to believe in you, in your fundamental worth, and in your capacity for positive change, healthy relationships, and a decent, productive, satisfying life.
4. Weight Is Merely an Aspect of Yourself.
Whenever you are seeking to change anything, the change will be facilitated by a realistic view of the problem. If the problem is so huge in your mind as to dwarf everything else in the universe, the chances are that the problem is beyond any solution. If however, the problem is realistically appraised and seen as something that can be tackled and overcome, then the possibility of a solution is greatly increased.
We have never seen any success with those that think their weight in the central problem of their life and is in fact their identity, who they are as a person, their essence as a human being. Your weight is none of those things. Your weight is merely an aspect of who you are. It is not who you are.
Weight is often a temporary, transient, superficial, and not particularly meaningful aspect of you. The paradox here is clear. If you view weight for what it is, merely an aspect of you and not your identity nor your worth as a person, then you actually have your best chance of managing a weight problem. Those who whole-heartedly approve of themselves and refuse to condemn themselves because of extra pounds are headed in the right direction.
Believe it or not, weight management is not a difficult task if you begin with a strong liking for yourself, believe you have power over your life, and see weight as merely an aspect of your total life situation, one that you have the power to change. Much compulsive eating has as its core a belief that one is fatally flawed, condemned by excess weight and imperfect eating behaviors. Compulsive eaters perceive themselves as powerless and weak. If the most terrible thing you can imagine is being overweight and if you view your weight as your very identity and your essence as a person, then you are in fact trapped an powerless.
Instead, change your belief system. Broaden your focus. Believe there are many aspects of you to appreciate. You could be described in terms of thousands of qualities. By believing your weight is merely one aspect of you and not something that justifies self-hatred, you have taken a giant step toward resolving the compulsive eating dilemma. You have found real power for change.
5. Deviations Are Expected and Are Not Failures.
In any plan you undertake, there will be deviations. This is because you are a human being and incapable of doing things perfectly. There will always be departures from the plan. This is not a sin, and it need not lead you to scrap the entire plan. When trying to deal with food and weight issues, it is important to keep in mind that you will deviate and that this is okay.
The idea is to aim for lifestyle change. This means changes that will last you for the rest of your life, which you will be fine tuning for as long as you live. There is no finish line, no test you have to past, no final grade. It is for life, and no matter how many times you deviate from the plan, you simply cannot fail as long as you keep correcting your course and steering back in the direction you have laid out for yourself.
This is a tremendous idea. So much compulsive eating, as indicated in the preceding discussion, has to do with a sense of powerlessness, futility, and failure. Labeling oneself a failure, promising to start anew on Monday or at the first of the month leads to out-of-control eating until then. Each new attempt at restrait collapses upon the first perception of “failure,” and the cycle is then repeated.
This fifth step means you do not have to perform perfectly. If you believe that, you are freed from perfectionistic thinking and constantly fearing failure. Change your thinking and there is no possibility for failure. If we are talking about shifting to a focus on lifestyle change and predictable deviations that are short lived and simply serve as indicators to help you correct your course, you can then banish the word “failure” from your vocabulary and from your view of self. If you cannot fail, then there is nothing to fear. Not eating perfectly is no longer a cause for beating yourself up. You simply get better and better at moving in your chosen direction. You will deviate. You cannot fail!
6. Mindful Eating
For the past seven years, we’ve incorporated the concept of “Mindfulness” in virtually everything that we do in therapy, and in our personal lives. We find great utility for this concept in treaty eating disorders. To tell you what Mindfulness is we’ve anticipated the following questions to which we have supplied our answers:
What is Mindfulness?
The idea of Mindfulness comes from an ancient Buddhist practice of meditating to be calm and fully conscious in the present moment, and fully aware of the choices that we face. We tend not to be fully present in the here and now, calm and focused, and able to purposefully make effective decisions. We're often living in the past, worrying about the future, bombarded by confusing and conflicted thoughts and feelings, often out of touch with our bodies and our emotions. What we are left with is a feeling of tension, an uncomfortable state that we want to avoid or distance ourselves from. We’re distracted and often clueless as to real issues and real solutions.
What are the therapeutic uses of Mindfulness and Mindfulness Meditation?
We specialize in three areas, eating disorders, anxiety disorders, and relationship difficulties. For years we've been using Mindfulness in treating anxiety problems such as panic disorder, and relationship difficulties such as not dealing well with conflict. We have increasingly used mindfulness in the treatment of virtually all psychological difficulties involving stress and anxiety. Eating disorders almost always involve an underlying anxiety disorder.
Anxiety disorders treatment (and eating disorder treatment as well) requires that anxious people gain control over their minds and bodies. We do breathing retraining along with training in corrective self-talk. Mindfulness meditation combines the two in a powerful way resulting in much greater awareness of one's level of anxiety. It also allows for practiced development of substantial ability to calm yourself and act purposefully and effectively.
What's the connection with Emotional Intelligence?
Emotional Intelligence is a vital quality that involves being intelligent about emotions. It means acting intelligently with the aid of full awareness of emotions. It means managing your emotions, not stuffing and stacking them -- or avoiding them altogether. It means being in touch with your feelings and in touch with the feelings of others. It means not being threatened by emotions but seeing emotions as very useful in understanding self and others. It means being able to not only be aware of feelings but able to verbalize feelings to others without fear or guilt. Emotional Intelligence is far more important than IQ in being effective in career and relationships. The lack of Emotional Intelligence, and the lack of awareness of feelings, is often part of extreme inner distress, conflict with others, and addictions used to avoid painful emotional states. Mindfulness Meditation is extremely helpful in building emotional intelligence, which unlike IQ can continue to develop.
How is Mindfulness used with binge eating?
Mindfulness-based eating awareness training utilizing meditative exercises with food, and exercises aimed at becoming more aware of needs, feelings, and choices in the present moment, suspending automatic reactions and negative self-judgments. In our Mindful Eating Program, members learn the skills to subdue binge eating, experience their hunger, rely upon their taste buds, and become deeply satisfied with the quality of food ,being reasonable and realistic with themselves about quantity. Members take charge of their food and their lives in a relaxed, satisfying non-compulsive way.
This short discussion of Mindful Eating doesn’t begin to do the subject justice. Look for an extended article from us on the specific steps in developing your own Mindful Eating practice.
Now you have the five steps– plus one. Earlier we stated that they work in combination and that no step can stand alone. Now that you can see all six steps, you are able to understand how they work as a team. For example, if all food is legal, you know that you can eat anything you please. If you choose to do so, you could at this moment get up from reading this paper and go order a family size pizza just for you. You could follow that up, if you wish, by a trip to Baskin Robins for a Cappuccino Blast. You can eat anything you please.
But then if all food is legal, we have taken the compulsiveness out of it. If all food is legal, then you are actually in a position to ask yourself, “What is it that I really want to eat?” Chances are that if you get this far, you will find yourself considering so called healthy foods. In fact, if all food is legal and you are busy nurturing yourself in a wide variety of non-food ways, then you are actually in a position to eat healthy foods without feeling boxed in, deprived, or punished.
This may be the first time in your life you are actually able to make a free choice and freely choose healthy foods and have a feeling of pride in doing so. Additionally, if you deeply believe you matter, then choosing to eat healthy foods can now be seen as an expression of self-love, as a way of giving to yourself because you deserve it. Now you are able to have real satisfaction in healthy behaviors while being clear that this is your free choice. As with all positive changes, these new behaviors will last if they meet three requirements. They need to be satisfying, freely chosen, and ego enhancing. This means they are embraced as essential to a positive view of self. Mindfulness completes the recipe, providing a stress free way to focus on food enjoyment, not guilt, and make genuinely satisfying choices.
By working these six steps in combination, you have the means to enact very positive changes in the way you eat. You will break the cycle, once and for all, of compulsive eating. More importantly, you will have found a new relationship with you. After all, an eating disorder is not about your relationship to food. It is about your relationship with you.
This is our “short list.” It is not an easy list, as it involves major changes in thinking. It may be the hardest thing you have ever attempted. Making these changes a comfortable part of your new life is what individual and group therapy is all about. DO NOT GIVE UP! Remember, you may “deviate” from the plan, but there can be no failure if each time you forgive yourself and come back to working the plan.
© 2005 William C. Shearer, Ph.D., M.P.H., M.B.A.
Robin L. Shearer, M.F.T., M.A., M.P.H., R.N.