Michelle May, MD and Kari Anderson, DBH, LPC joined us for the following book interview on Eat What You Love,
Love What You Eat for Binge Eating: A Mindful Eating Program for Healing Your Relationship with Food and Your Body. What follows are our questions (in italics), and their thoughtful responses.
You define Binge Eating as “an attempt to use food to regulate, moderate, or balance your physical, emotional or mental state.” What happens “when reality sets in after the binge?”
Anderson: The detachment one feels while bingeing is partly a protective mechanism to distance oneself from the ego dystonic behavior of bingeing. Once “reality” sets in after a binge, immediate feelings of shame begin to surface. We recommend engaging the Self Care Voice, which is a validating response that disengages unproductive shame. An example: “Of course you fell into an old pattern of bingeing! You are tired and haven’t been feeling well. You were just trying to take care of yourself. Let’s see what else you can do to get your needs met.” Once the basics are attended to, we recommend reflecting on the incident, without judgement. This requires slowing the chain of events down through a process of analysis using the Mindful Eating Cycle.
What does hunger feel like? And, how does a “Body-Mind-Heart Scan” help one identify hunger?
May: Hunger is the physical signs that your body needs fuel, such as pangs, growling, gnawing, low energy, difficulty concentrating, irritability, lightheadedness, headache, or shakiness, depending how hungry you are.
A Body-Mind-Heart Scan helps you pause to notice what is happening in the present moment. Here’s a brief scan that you can try right now: Take a few deep breaths to become calm and reconnected. Scan downward over your body, noticing physical sensations like tension or discomfort, becoming aware of your breathing and maybe your heartbeat, then tuning into your stomach to notice whether it is empty, full, or somewhere in between. Next, become aware of your mind; what are your thoughts right now? Don’t attach to any of your thoughts; just notice them without judgment. Last, focus on your feelings. What emotions are you aware of? Where do you feel them? Take another deep breath or two.
Did this mini-Body-Mind-Heart Scan provide any information that you hadn’t noticed previously? Awareness of the present moment helps you notice what your needs are and helps you make conscious decisions rather than continuing to react (re-act) mindlessly acting out of habit.
You make a clear distinction between being “in control” and being “in charge.” Please tell us more about the differences.
May: Many people who struggle with binge eating vacillate between feeling in control as they follow their diet rigidly, then give up and feel out of control. These extremes are an example of a common mind trap referred to as dichotomous or black and white thinking. In the middle between these extremes is the “gray area” where you are aware of your options and are able to consciously choose. That’s what it means to be “in charge.”
Triggers, connections, and hardwiring new pathways – Can you please explain some of the science behind these brain activities?
Anderson: Neuroscience has made some encouraging discoveries in recent years, one being that our brains are “plastic” and can be molded and changed. The reason change is so difficult is that we are working against Mother Nature; our brains are hardwired to take the path of least resistance for the ease of survival. The frontal lobe is what makes us human; it’s our executive functioning, the ability to plan, choose, and act on our own behalf. Yet by 4 pm our brain is on overload, our resilience is down, the executive functioning is harder to access, and we shift to a well-established neuropathway—a habit. Habits are so strong that they cause our brains to cling to them at the exclusion of all else, including common sense. The good news is that we can re-route the wiring of our brains and make new pathways.
Lasting change requires mindful practice. Bringing behavior patterns into awareness is a crucial step in changing them. The Mindful Eating Cycle creates a structure for doing exactly this. Paying attention, moment by moment to the triggers (or cues) that proceed a behavior is key. This is the Why? and When? of the Mindful Eating Cycle . This slows you down in order to choose (or change) your response (your habit). By pausing and noticing your choices and behaviors with intention and attention, you can imprint a new habit. This represents the What?, How? and How Much? decision points in the Mindful Eating Cycle. Lastly, we must reinforce the new habit with a reward. The reward is what creates anticipation and neurological craving. Rewards such as feeling good and feeling empowered to live a BIG life filled with pleasure is the goal of the Where? decision point of the Mindful Eating Cycle .
“When you give yourself unconditional permission to eat what you want, you’ll notice that food quickly loses the power and strong attraction it once had.” Can you provide a scenario which highlights this within the concept of “Fearless Eating?”
May: Restriction and deprivation are powerful triggers for overeating. When individuals stop dieting and let go of guilt about eating certain foods, the desire to overeat those foods diminishes. For example, instead of making chocolate “bad,” you could promise yourself that you can eat chocolate whenever you really want it. At first, you may want chocolate frequently but you’ll gradually discover that you want a variety of foods to feel healthy and satisfied.
You encourage people to “Eat with intention” and “Eat with attention.” How can these practices change one’s perspective on overeating and bingeing?
May: Eating mindfully with intention and attention – or purpose and awareness – provides optimal enjoyment and satisfaction from eating. For example, eating with intention might mean eating to satisfy your body’s needs for fuel and nourishment and/or eating with the intention of feeling better when you’re finished than you did when you started. Eating with attention may include minimizing distractions, focusing on the ambience, flavors, aromas, and textures of the food, and listening to your body’s cues of hunger and satiety. As one begins to focus on self-care, overeating and bingeing are replaced by more mindful eating and the experience of feeling good after eating.
What are some of the conclusions from the pilot research study you conducted on the Mindful Eating for Binge Eating Program based on the Mindful Eating Cycle?
Anderson: We hypothesized that mindfulness-based treatment through the framework of the Mindful Eating Cycle would not only target the eating behavior, but the motivation driving it. The 10-week treatment using the Am I Hungry? Mindful Eating for Binge Eating Program was tested on thirty eight adult women with binge eating disorder. Participants went from a range of severe binge eating to a non-bingeing level on the Binge Eating Scale (BES). Other significant improvements were found in levels of mindfulness, depression, anxiety and dietary choices. At one-year follow up, twenty six participants responded. These participants not only maintained a non-bingeing level on the BES, they improved their scores on this instrument (measuring eating attitudes and behaviors) in the one year following the 10-week program. All other measures showed the same improvements. This reinforces our hypothesis, that targeting behavior and the motivation driving it, can have lasting and cumulative results rather than the temporary changes found when following a structured eating plan. Interestingly, the few that reported returning to restrictive dieting plans showed a rebound in BES scores and less significant changes in all other measures.
About the Authors –
Dr. Kari Anderson has been treating eating disorders for 24 years, with particular emphasis on Binge Eating Disorder. She is Chief Clinical Director for Green Mountain at Fox Run in Ludlow, Vermont.
She earned her Doctorate of Behavioral Health with her research project, The Mindful Eating Cycle: Treatment for Binge Eating Disorder at Arizona State University in 2012 and served as Faculty Associate in the same program. Kari is faculty for the Eating Disorder Institute at Plymouth State University in New Hampshire.
Co-creator of the Am I Hungry?® Mindful Eating for Binge Eating Program, Kari also co-authored the acclaimed book, Eat What You Love, Love What You Eat for Binge Eating: A Mindful Eating Program for Healing Your Relationship with Food and Your Body.
Kari served positions as Therapist, Clinical Director and Executive Administrator for Remuda Ranch Center for Anorexia and Bulimia for 14 years. She designed the clinical training and competency programs for the Clinical Department as well as writing and speaking for the organization. Prior to working at Remuda, she worked at The Rader Institute for five years as Family Therapist. Kari also had a private group practice for five years in Phoenix, Arizona, which still offers the successful 10 week Am I Hungry? ® Mindful Eating for Binge Eating program.
Kari, her husband and their therapy dog, Gretel, live in the Ludlow, Vermont area.
Michelle May, M.D. is a recovered yo-yo dieter and the founder of Am I Hungry?® Mindful Eating Programs and Training (www.AmIHungry.com) that helps individuals resolve mindless and emotional eating and senseless yo-yo dieting to live the vibrant life they crave. She has trained over 500 health professionals to facilitate Am I Hungry? Mindful Eating Programs worldwide. Dr. May is the award-winning author of the book series, “Eat What You Love, Love What You Eat” that teaches mindful eating for yo-yo dieting, diabetes, bariatric surgery, and binge eating. Dr. May’s passion, insight, and humor stem from her personal struggle and professional experience. She shares her compelling message and constructive approach with audiences around the country.