Binge Eating Disorder, Anxiety and Steps for Recovery
By Leora Fulvio, MFT
People often ask me what causes Binge Eating Disorder. In truth, there is no one answer. Genetics, basic biology and evolution, dieting, availability of food, and psychological issues contribute to the development of Binge Eating Disorder. In some ways, it’s difficult to avoid. However, in this particular article, I’m going to discuss the mechanisms of anxiety and how it contributes to the behaviors of binge eating.
Diet culture tells people that they should be unnaturally thin, that they should live in a body that they don’t naturally inhabit and that in order to get that body, they should deny their hunger, only eat a certain way, eliminate specific macronutrients or food groups, and/or dramatically restrict their caloric intake. Diet culture sends a message to both women and men – if their bodies don’t fit into the societal idealization, then their self-worth should be diminished. They should hate themselves, unless they are “being good.” Diet culture equates virtuosity with thinness. And, as a result, everyone gets hurt. The people who starve themselves hurt because they have to continue depriving themselves of basic sustenance in order to achieve societal value, which incidentally doesn’t work since not taking care of oneself through basic life functions never makes a person feel worthy. “I don’t deserve to eat.” “If I’m not thin I’m not worthy.” “ I have to keep this restrictive behavior going.” People who live in larger bodies are berated by society and often berated by themselves, as well. Nobody wins in diet culture. It’s a game we have to choose to disengage from if we want to stay emotionally sane.
On the other hand, the food industry is also on the hook. Food scientists work to find the exact proportions of fat, sugar, salt and certain chemicals to make food not just highly palatable but borderline addictive. The ethics of many of the food processors are highly questionable.
So what happens when diet culture meets the food industry? People feel crazy around food. It’s like being the child of two parents living under one roof who both tell you to behave in opposite ways. You don’t know what to do. It’s confusing and crazy making.
When discussing causes of Binge Eating Disorder, consider basic human biology. Our bodies have not yet caught up with our evolution as a species. We are psychologically wired to binge eat. Prior to modern times, people spent days hunting and searching for food, and when they came upon it, they ate it. They ate as much of it as fast as they could before they were threatened by animals or other humans looking for the same food. Every time my clients come in hating themselves for a binge and berating themselves, usually lamenting something like, “Why do I keep doing this?” “Nobody else is crazy with food like this!” “Why can’t I just eat like a normal person?” I remind them that what they did was very, very human. Bingeing is a basic instinct.
In our Western society, we are expected to be thin and to achieve a particular body type, regardless of our genetic blueprint. With food choices in abundance, our confusion surges. Soren Kierkegaard said anxiety is the dizziness of freedom. And this is true.
Our levels of anxiety in this country are extraordinary. Whereas modern comforts were created essentially to make our lives easier, they can make our lives harder.
Social media creates unrealistic body images, app dating turns romance into two dimensions and commoditizes human beings and food delivery services create the ability to hole up in your house and binge without ever leaving your bed. The news is often both anxiety provoking and depressing and food can help soothe these feelings. The news is also unpredictable, scary and contradicting, whereas food is consistent, comforting and nurturing.
Human beings love eating. And we should. We are created to love eating in order to maintain and advance the species. We also love sex. The things we need to do to survive give us serotonin and dopamine and all these “feel good” chemicals make us want to keep doing them. It is reasonable then that we would eat when we feel bad. Food is the easiest dopamine hit to come by. It’s easier than drugs, sex, alcohol … it’s always there for us – and the yummier the food, the bigger the surge of dopamine that floods our brains. Though food addiction is debatable, it is possible to feel addicted to the feeling we get when we eat, to feel unable to stop. Food becomes your drug, it becomes the thing that takes care of you when you’re sad, lonely, bored and anxious. You need food to live and you become dependent on food for that hit of dopamine and the soothing effect it creates.
Anxiety is a horrific feeling. Your brain causes you to feel like you are living in your worse case scenario. Your brain feels like it’s spinning out of control. And for every worse case scenario, your brain can conceive of even more dreadful fantasies. It’s almost like being stuck in a jail between your ears. What might one do for a break in jail? What might one look forward to? Meals? Eating? It’s very hard to think when you’re eating. Your hands are occupied, your mouth is occupied and your brain is being flooded with dopamine. It’s a welcome relief to the pain of an anxious brain. But then, what happens when you binge? Guilt? Shame? Disgust? Fear? Do these thoughts go through your head, “I can’t believe I did this again? When am I going to stop? The way I’m eating is causing me to be unlovable, unworthy. I’m going to die alone and my cats are going to eat my face when I’m dead and I won’t be found for 2 weeks and I’m not going to have a face…” and the anxiety gets worse from there. And so what does one do? Binges more to calm that anxiety. The binge helps to mitigate the anxiety and to quiet the voices in the brain. The binge is a coping mechanism; it’s a form of self-care. It’s a way to feel better.
Yet, when people binge, they hate themselves. Diet culture tries to have everyone believe that they have no self-control, that they’re bad, that they’re worthless. And self-hatred doesn’t equate to good self-care. It’s hard to love and care for something you hate. Yet, it’s not your fault. Look at how the external forces are against you. Look at how diet culture and the food industry are both working against you. Look at how your abundance of choices are creating anxiety. Sometimes people go on diets just to get away from so much choice because choice is difficult. Choice is dizzying. And then, what happens when you’ve been depriving yourself of choice? And then you “accidentally” eat something that isn’t on your approved list? All of a sudden your choices open up and they open up like a flood, like a damn that has burst. A person on a no-carb or a keto diet grabs a piece of bread from a bread basket… they then become distressed because diet culture tells us that we have to be perfect, that we can’t mess up and so this creates a sense of failure. They believe they’ve broken their diet and so they go to the store and allow the choices to flood them. They tell themselves “tomorrow, tomorrow I’ll go back to my diet, this is the last time ever…but today, today I can do what I want.” They buy all the things they’ve been depriving themselves of – it’s a dizzying freedom.
And then, perhaps they go home and hide in their bedroom and eat, or sit in their car in a parking lot and eat. The feelings of distress melt away temporarily as they experience the joy of all those awesome brain chemicals flooding their serotonin receptors. But then the anxiety returns. It returns quickly. And the cycle begins again. It’s exhausting. It creates depression, self-loathing and self-harm.
Binge Eating Disorder is neither about self-control nor about willpower. It is about being human and having so many different emotions and so few coping mechanisms to deal with these emotions.
Anxiety is of course also evolutionary. We needed to anticipate that lion busting into our cave. We needed to anticipate a famine. We needed to plan ahead for those things. But those issues no longer threaten our survival. However, we are still wired for anxiety, just as we are still wired for binge eating. These mechanisms help to maintain our survival and further the species. But we forget that and we hate ourselves. We think we’re the only ones.
Anxious attachment can also be a component of binge eating and eating disorders in general. People who have anxious attachment did not feel unconditional love from their primary caretakers. A caretaker might have left them physically due to divorce or death or the caretaker might have also been emotionally distant and not given them the love and adoration all children require to feel safe. The caretaker might have only given the child praise when they got good grades or when they looked pretty or when they behaved well. Sometimes they withheld it completely. This then created a belief for the child that they were not good enough unless they looked or behaved or performed appropriately. One result is severe anxiety, as the child believed every time they did something “wrong,” they were at risk for losing the love of their parent or worse yet being abandoned and left to survive alone. This can lead to an adult who believes their worth is tied up in how well they perform or look. In adult relationships, the anxiously attached adult starts to cling to their object of affection because it feels very survival based. It feels like without that person, they will die. So they do things like diet obsessively to be “good enough” because being thin is supposedly the ideal and they believe if they are thin enough, they won’t be rejected. They then binge again because they are hungry and restrict because their anxiety about being left is activated. It is a complicated cycle.
You are NOT alone. Binge eating is a way that you’ve learned to soothe yourself. It’s the way that you are caring for yourself and it’s the way that your body makes sure that it’s not going to starve. Yet, it causes anxiety and pain.
So how do we deal with this? How do we get past this coping mechanism that both helps us and hurts us?
Well, the first thing we do is look for love from within. We love and respect ourselves without waiting for it from outside of ourselves. We are all worthy of love and respect, no matter what size our body is, no matter how much or how little we eat. Our body is just a vessel for our beautiful souls, just the vase for the sweet smelling beautiful roses. It can be a mason jar, or a plastic cup or a Ming vase. It doesn’t matter, it’s just a vessel. It’s what’s inside that people want to experience. Until you believe you are worthy of love, you won’t allow yourself to receive it. I’m not saying others won’t love you. I’m saying you won’t believe it or accept it or be able to take it in. You ARE worthy of love and respect. I don’t care if you just ate five pizzas in less than five minutes, you are still worthy of love. If you’re looking for love from people who aren’t capable of giving it to you, please walk away. It’s not about you. When you can give love to yourself, you can give love to others. Surround yourself with people who freely give and receive love. There are so many people out there capable of this. You just have to be open and receptive to it.
The next thing to do is to choose not to participate in diet culture. Although it is so widely accepted, it is toxic. People used to believe that the world was flat. It was a commonly accepted belief. We now understand that it was flawed thinking based on nothing scientific. The same applies to the diet culture. You can be amongst some of the forward thinkers that choose not to participate in diet culture. Consider telling your friends you love and accept them, but you don’t want to have diet talk with them and that you are on a path of self-love and self-kindness for who you are without working tirelessly to change your body.
Do things that help you to feel good. If you like to exercise and move your body, do it! I believe strongly in the benefits of exercise for anxiety and depression relief. Exercise isn’t for weight loss. It should not be punishing and abusive. It should be fun. You don’t have to run endlessly on a treadmill or pump iron, you can walk outside and take in the sunshine, and smile at people… just move your body. It’s a great way to let go of excess anxiety. If you have a body that cannot exercise or move well, that’s okay, there are other natural ways to calm anxiety.
Your breath is your internal Prozac. If you spend just a few minutes doing deep breathing, you can calm your nervous system and create an inner peace that calms your brain. Make it a practice and anxiety will reduce. I like to tell my clients to do a visualization and to count while they breathe. Breathe in to the count of 5 hold it to the count of 10 and exhale to the count of 15. As you do this, imagine something in front of you that is consistent and soothing, like waves of an ocean or a ticking clock. In this way, you are bypassing your brain by occupying your thoughts, your visions and your body. It’s almost impossible to think when you are practicing this kind of breathing that engages your senses.
Feed your body. Your body needs to eat. Give yourself food, give your body as much food as it needs and if you find yourself in a binge, be kind to yourself and realize that you were hurting or needing something which is one reason you binged. The last thing you need is more negative self-talk after a binge. You need love and compassion most of all from yourself, the only person who you will live with for the rest of your life, the only person who is with you 24/7, the only person whose thoughts really matter. When you give too much worry about what other people think of you, you allow them to put you in a jail and they become your prison guard. Your own thoughts are the only ones that actually affect you.
Lastly, if anxiety persists, get help. You can talk to a therapist who specializes in Eating Disorders, or you might even talk to your doctor about anxiety medication.
Binge eating disorder and anxiety are difficult and painful, but they are common and you’re not alone. The more you spend time looking within and finding the beauty inside of you, really looking for it and naming it, the less the external pressures will seem relevant to who you are as a human being.
About the author:
Leora Fulvio, MFT is a San Francisco based psychotherapist specializing in the treatment of eating disorders and the author of Reclaiming Yourself from Binge Eating: A Step-by-Step Guide to Healing. You can find her at bingeeatingtherapy.com
Avena, N. M. (2008). Binge Eating: Neurochemical Insights from Animal Models. Eating Disorders, 17(1), 89–92. doi: 10.1080/10640260802371604
Davis, C. A., Levitan, R. D., Reid, C., Carter, J. C., Kaplan, A. S., Patte, K. A., … Kennedy, J. L. (2009). Dopamine for “Wanting ” and Opioids for “Liking”: A Comparison of Obese Adults With and Without Binge Eating. Obesity. doi: 10.1038/oby.2009.52
Friederich, H.-C., Wu, M., Simon, J. J., & Herzog, W. (2013). Neurocircuit function in eating disorders. International Journal of Eating Disorders, 46(5), 425–432. doi: 10.1002/eat.22099
Han, S., & Lee, S. (2017). College Student Binge Eating: Attachment, Psychological Needs Satisfaction, and Emotion Regulation. Journal of College Student Development, 58(7), 1074–1086. doi: 10.1353/csd.2017.0084
Keating, L., Mills, J. S., & Rawana, J. S. (2019). Momentary predictors of binge eating: An attachment perspective. Eating Behaviors, 32, 44–52. doi: 10.1016/j.eatbeh.2018.12.003
Kuipers, G. S., Loenhout, Z. V., Ark, L. A. V. D., & Bekker, M. H. (2016). Attachment insecurity, mentalization and their relation to symptoms in eating disorder patients. Attachment & Human Development, 18(3), 250–272. doi: 10.1080/14616734.2015.1136660
Moore, C. F., Panciera, J. I., Sabino, V., & Cottone, P. (2018). Neuropharmacology of compulsive eating. Philosophical Transactions of the Royal Society B: Biological Sciences, 373(1742), 20170024. doi: 10.1098/rstb.2017.0024
Tasca, G. A. (2019). Attachment and eating disorders: a research update. Current Opinion in Psychology, 25, 59–64. doi: 10.1016/j.copsyc.2018.03.003