Binge Eating Disorder Series: How Does Eating Regularly Impact Binge Eating

WHAT IS BINGE EATING DISORDER?

Binge eating disorder (BED) is the most recently added eating disorder to the diagnostic manual and yet, it is currently the most common. So what does BED mean?

Binge eating disorder consists of binges of which are characterized by recurrent, perceived out-of-control eating within an isolated period of time. In addition, they often occur with three or more of the following: eating rapidly, feeling uncomfortably full, eating large quantities of food when not hungry, eating in secrecy due to embarrassment, and feeling disgusted with oneself afterward. These binges cause one to feel distraught, they occur at least once a week and are not always associated with behaviours such as vomiting or laxatives.

While those are the "diagnostic criteria", it is not uncommon for individuals to have various levels of experiences with those characteristics, among others as well. Dealing with bingeing can be utterly exhausting and take up valuable space in one’s life. Unfortunately, a lot of people blame themselves for struggling and therefore turn to strict dietary changes in the effort of correcting them. Little do they know; this can fuel the fire.

WHAT CONTRIBUTES TO BINGE EATING DISORDER?

Eating disorders are complex. There are biological factors such as dieting, genetics, and neurochemistry; there are environmental factors such as social media, family, and culture; there are psychological factors such as trauma, coping, temperament, and anxiety. These are just some of the endless contributors and risk factors that can build on each other. With that said, an eating disorder might not be caused by one single thing. This very reason is what makes recovery more challenging than just reducing symptoms.

A common theme that leads to maintaining eating disorder behaviors is dietary restriction (AKA food rules, weight loss programs, obsessing about only eating healthy foods, strict efforts to be thin etc.). Trying to control weight or shape leads to restricting, bingeing, feeling overwhelmed, and overcorrecting by restricting and then bingeing again. You can see this pattern outlined below.

How can we stop this cycle?

BINGE EATING DISORDER & COGNITIVE BEHAVIORAL THERAPY SELF HELP GUIDE

There is a Cognitive Behavioral Therapy-based self-help program called Overcoming Binge Eating, developed by Christopher Fairburn and Jacqueline Carter. This program consists of five steps that you can complete on your own or with guidance from a professional. This is a well-studied, easily accessible, and affordable option for many. Like any program, it will be most effective if you are open-minded and ready to change. Its five steps include starting well, regular eating, alternatives to binge eating, problem-solving, and taking stock. Of the five, the most significant change you can implement into your healing is regular eating.

THE IMPACT OF REGULAR EATING – A PROTECTIVE FACTOR

The most effective pattern of regular eating consists of three meals with two to three snacks per day. For example, your day might look like this:

Breakfast

Morning Snack

Lunch

Afternoon Snack

Dinner

Evening Snack

This form of regular eating has been associated with a decrease in binge eating symptoms. There is one exception to this.

Because bingeing is least likely to occur midday if the morning snack does not feel comfortable it is okay to skip. Bingeing is more likely to happen in the evening, consistent eating in the evening has been proven to be effective at preventing bingeing.

Starting this process can be overwhelming. If you need to begin slowly by starting with three meals and one snack and working your way up, it is okay to do so. As you progress, do your best to not skip meals or snacks. With time, regular eating will help you reset your hunger and fullness cues.

The timing of meals and snacks is guided by you, but it is recommended to eat enough and to not have more than three or four hours between meals to avoid the psychological and physiological pressures to eat. Not eating enough during the day will encourage the binge - restrict cycle.

Lastly, this eating might feel like you're eating more food than usual. This is a typical feeling and occurs because often people have gone for many years not eating enough of the right food. If you are struggling with binge thoughts keep yourself comfortable and distracted between meal and snack times. Your eating plan can be adjusted to suit you and your lifestyle. If you struggle, try avoid the all-or-nothing mentality that fuels the cycle. Be patient with yourself and remember - you do not have to be perfect.

References

1. Lord VM, Reiboldt W, Gonitzke D, Parker E, Peterson C. Experiences of recovery in binge-eating disorder: a qualitative approach using online message boards. Eating and weight disorders : Studies on Anorexia, Bulimia and Obesity. 23(1):95-105. doi:10.1007/s40519-016-0335-z

2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders : DSM-5. Fifth edition.. American Psychiatric Association; 2013.

3. Shah, Neha, Passi, Vandana, Bryson, Susan, Agras, W. Stewart. Patterns of eating and abstinence in women treated for bulimia nervosa. The International journal of eating disorders. 2005;38(4):330-334. doi:10.1002/eat.20204

4. Fairburn CG. Overcoming Binge Eating. Guilford Press; 2013. ISBN 978-1-57230-561-8

5. Agras WS. Cognitive Behavior Therapy for the Eating Disorders. Psychiatric Clinics of North America. 2019;42(2):169-179. doi:10.1016/j.psc.2019.01.001

6. Ellison, Jo M, Simonich, Heather K, Wonderlich, Stephen A, et al. Meal patterning in the treatment of bulimia nervosa. Eating behaviors : an international journal. 2016;20:39-42. doi:10.1016/j.eatbeh.2015.11.008

7. Zendegui, Elaina A, West, Julia A, Zandberg, Laurie J. Binge eating frequency and regular eating adherence: The role of eating pattern in cognitive behavioral guided self-help. Eating behaviors : an international journal. 2014;15(2):241-243. doi:10.1016/j.eatbeh.2014.03.002