Addiction is most commonly associated with drugs and alcohol but the disease of addiction can manifest itself in many ways. For example, some other common problem areas of addiction are gambling, pornography, and eating. People sometimes get addicted to multiple things. While the manifestations differ, the causes are often the same. These can include fear, insecurities, and escape from the reality of a situation with which we are not happy. The same causes that lead to addiction can lead to other manifestations that are not always associated with addiction such as eating disorders. There are several different kinds of eating disorders but the one that most closely mirrors drug addiction is binge eating disorder (BED).
Binge eating is compulsively eating large amounts of food in a short period of time. These episodes are followed by feelings of guilt, disgust, and depression. For an official diagnosis this has to occur at least once a week for at least three months. Millions of Americans suffer from a binge eating disorder. BED was only recognized as a disorder recently, in 2013. Anorexia and bulimia tend to be what people think of when they hear about eating disorders but BED is much more prevalent.
BED shares many similar characteristics with drug addiction. It often is a result of childhood trauma and abuse, low self-esteem, and stress. Sufferers often have poor body image. BED becomes part of a cycle. People restrict their diets and make certain foods off-limits. Sometimes they resort to excessive exercise. Eventually this leads to binging, feelings of guilt and shame, and then restriction to start the cycle over again. It is a difficult pattern to break. Binge eaters want to stop but find that they can’t. Marsha Hudnall, president of a group in Vermont that helps women who overeat, says that “when you limit something that is naturally appealing and comforting, it just makes that food more attractive and harder to resist.” There is a great deal of scientific research showing the inefficacy of severely restrictive dieting practices.
People with BED will also continue to overeat compulsively despite negative consequences. Long term binging can cause psychiatric disorders, social impairment, and physical health problems that are associated with weight gain and obesity. BED appears to be hereditary. Binge eaters typically hide their compulsive eating habits from others.
Treatment methods for BED also share similarities with drug addiction treatment. Cognitive behavioral therapy (CBT) has been found to be very effective. CBT involves being mindful and thinking about your thoughts, recognizing that they are just thoughts and that you don’t have to act on them. In the context of BED you can pause and ask yourself why do you want to eat. Are you actually hungry or is it more of a compulsion? It sounds simple but can be difficult to implement into your everyday life. CBT does get easier with practice and it does help reduce compulsivity and impulsivity. There are inpatient and outpatient programs for eating disorders, nutritional counseling, and support groups available. Antidepressants have been found to be effective as well. 1
Just like NA and AA there are 12-step anonymous organizations for eating disorders known as Overeaters Anonymous. OA has meetings in several different countries and across the U.S. There are several held every day right here in San Diego. The 12 steps and 12 traditions are the same as in AA and NA, however, OA has its own literature. On the website there is a quiz to help people determine if they have a problem with questions like: “Do I eat when I’m not hungry or not eat when my body needs nourishment?”; “Is it affecting my health or the way I live my life?”; “Do I fantasize about how much better life would be if I were a different size or weight?”. I also found another 12-step anonymous group called FA, Food Addicts in Recovery, but they don’t seem to be as widespread as OA.
There is one major difference between drug addiction and BED. Abstinence from drugs is part of normal treatment but people can’t abstain from food. We have to eat. While it may be possible to remove oneself from drug-using environments, it is impossible to avoid food. It must be terribly difficult for a binge eater to gain control even with help and support.
I would imagine that the guilt caused by compulsive overeating is magnified by our cultural obsession with body image and being thin. In American society we are bombarded with advertising for workout programs, weight-loss pills, supplements, and specialized diets. It’s like we can’t feel good about ourselves unless we wear 32-inch-waist jeans or can fit into a size 2 dress. We aspire to look like celebrities and models on TV and in magazines who have physiques that are unattainable for many of us. Pop culture presents us with a singular beauty standard that leaves no room for different body types and shapes. I think this whole attitude can be summed up in that famous quote from fashion model Kate Moss: “Nothing tastes as good as skinny feels.” What a terrible message for people. It’s no wonder that eating disorders are so widespread.
BED can be a co-occurring disorder with drug addiction. Some people use drugs to get or stay skinny. I know I thought all the weight that I lost while using was a good thing. It became one of those trivial excuses to keep using. It can also become a problem after someone quits using drugs and gets clean. People often gain weight after getting clean. That happened to me, I put about 50 lbs. back on in treatment and body image became a real source of insecurity for me. In recovery we have to feel good about ourselves mentally, emotionally, physically, and spiritually. All these aspects of ourselves are intertwined, they don’t exist separately. The disease of addiction may manifest itself specifically in one of those areas but it will ultimately affect the rest of them. The weight gain that can be caused by binge eating appears physically but BED is a psychological problem that stems from those three other areas.
The Serenity Prayer is one of the most common ones you hear in the rooms of NA and AA. “God. Grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” Our physical appearance is partly within our control. Diet and exercise can help us to lose weight but everyone’s body is different. Two people on the same diet and exercise regimen may have very different results. We may have an exact weight we want to get to or a specific idea of what we want to look like but the pursuit of that may lead us to unhealthy eating and workout practices. Those goals may not be realistic.
We have to abstain from drugs. We’ve found that we can’t control our use or stop once we’ve started. That’s what it means to be an addict. So how does someone who is binge eating learn moderation and break out of the addictive cycle of binge-guilt-restrict-binge? Whatever treatment methods end up working for an individual, it comes down to understanding that God made us exactly as we are and loves us. When we are ok with that, then we can love ourselves and allow others to love us.