How to overcome the “willpower” mindset and actually heal BED
Considering the diet culture we’re all immersed in, separating from this mindset might be difficult — but it’s possible. Accepting and understanding the need for self-compassion and actionable steps toward treatment will help ensure long-lasting recovery from any eating disorder.
“The good news is, nearly all effective strategies for coping with and treating binge eating don’t require or involve willpower,” Lauro says. “Moreover, they don’t involve removing certain food groups from your life or home—in fact, this is often a surefire way to increase the probability of binge eating in the future.”
Establishing regular eating patterns
Because the restrictive behaviors at the root of BED inevitably perpetuate the cycle of disordered eating, experts say establishing or re-establishing consistent patterns around food is critical to recovery. “First and foremost, I can’t emphasize enough the importance of a regular pattern of eating,” Lauro says. “What that means is three meals and two to three snacks eaten at regular intervals of time throughout the day, making sure to never go more than three to four hours without an instance of eating.”
While the contents of those meals and snacks may differ from person to person, the goal is to adequately satiate the body and brain to prevent the fear of deprivation. “For some people, having consistent eating instances as well as dietary variety will resolve or quiet down the binge eating,” Lauro says.
Cohen agrees that the primary treatment strategy for BED must focus on building regular eating patterns with the support of a team. “Yes, you actually need to eat to overcome BED,” she says. “With the support of a team, you’ll also be challenged to break your food rules and restrictions, and eat your fear foods consistently, because if restriction persists, the binge-restrict cycle will continue.”
Working with a team using evidence-based approaches, like CBT
Cognitive behavioral therapy (CBT) is a well-established, evidence-based therapeutic approach that’s often used to treat a wide variety of different mental health conditions. CBT is based on the idea that our thoughts and emotions influence our behavior, and if we can adjust problematic thinking patterns, we can also stop the harmful behaviors associated with them.
CBT on its own can be helpful, but there’s also a version specifically designed to treat eating disorders, known as CBT-E. CBT-E can be helpful, as long as you make sure to work with a weight-inclusive, HAES-informed professional (some of the CBT-E literature includes unhelpful diet culture-informed recommendations, so you’ll want to make sure that your team excludes this kind of thinking). CBT-E for BED might focus on areas like problem-solving, tackling strict dieting or restriction, addressing shape concerns, and maintaining progress, among other aspects of the eating disorder.
This modality is a multi-stage, highly individualized approach that includes monitoring and noting thoughts, which is vastly different from a typical food log or what you might see in a fitness app, says Lauro. Monitoring is designed to be completed in the moment, which in and of itself serves as a way to slow down, or disrupt, the process of binge eating. Oftentimes, folks describe feeling like they get into a ‘spiral’ during binge episodes that leads to feeling out of control. By utilizing an evidenced-based tool like a monitoring record, you can intervene with the spiral and create an ‘in the moment’ pause.”
Establishing distress tolerance techniques
While binges can often occur as a result of longtime restriction, there are other potential psychological and emotional factors at play that people should be aware of as they move toward recovery. “Many people end up binge eating as a way to avoid emotions—and this can even serve as a survival technique, like in cases of trauma,” Lauro says. “Healing from binge eating involves learning to sit with discomfort and tolerate distress. You can certainly practice this on your own if you feel it’s accessible and safe, but if you’d like more support, or binging is tied to more intense experiences, I highly recommend working with an eating disorder specialist to assist creating a strategic guide to building up distress tolerance.” Dialectical behavioral therapy (DBT) is a therapeutic modality in which patients develop a variety of different distress tolerance skills, which can be a very helpful approach when working to overcome BED.
Jones says it’s imperative to explore the emotions that arise in the moments leading up to, during, and after a binge from a place of curiosity to help better understand the causes behind it. To truly work through the challenges of the illness, confronting and navigating the unpleasant feelings underlying the disorder is paramount. “One of the foundations for recovering from BED is working through shame and learning binge eating disorder facts,” she says. “If you experience shame, know that society has placed it on you and it’s not yours to carry. When we relate to binges from a place of compassion it holds less power. This creates space for healing and moving beyond BED.”
This article originally appeared on equip.health.
