Making Your Body an Ally in the Treatment and Recovery of Binge Eating Disorder
By Kari Anderson, DBH, LCMHC, CEDS with Shiri Macri, MA, LCMHC
Like other eating disorders, body shame is at the root of binge eating disorder. This shame can spring from many places: an internalization of society’s “thin ideal,” trauma, or simply from a long history of dieting. But unlike the restricting or purging involved in other eating disorders, the act of bingeing is an egodystonic behavior, meaning it leads one away from his or her value of thinness. That only compounds the shame. Add to that the trauma of living in a plus size body in our culture and many come to feel that they are unworthy—and, worse, that it’s their own fault.
Being present in a body that harbors so much shame is intolerable. As a protective measure, many sufferers binge eat to disconnect from painful thoughts and feelings. The mind of someone with binge eating disorder includes a barrage of judgment and shame—judgment about the food, the body, the person themselves. People can get so caught up in these narratives that escape through binge eating seems to be the only possibility. But shame and self-loathing peak in the aftermath of a binge, further perpetuating the cycle. As a counter measure, many with binge eating try and restrict, but in an attempt to regulate the arousal system, the body “takes over” and this eating behavior becomes compulsive and reactive, leaving people feeling out of control.
Reconnection to the body is part of the healing process, which is why mindfulness—bringing awareness to the present moment without judgment—is an ideal intervention for binge eating disorder. Our western diet culture teaches us not to trust our decision making around food and to hate our bodies, forcing us to turn to outside “experts” for the answers. A mindful practice helps to reverse this, allowing us to notice what truly feels good—instead of a focusing on being good or looking good. In the practice of mindful meditation, we gain the ability to simply observe our thoughts and feelings. That, in turn, empowers us to take charge of our responses and disengage from automatic reactivity.
Third-wave cognitive behavioral interventions that are infused with mindfulness, such as dialectical behavior therapy, help shift someone from dichotomous, all-or-nothing thinking to a more flexible perspective, and encourage a more self-compassionate inner dialogue.
Mindful movement also plays an important role for those recovering from binge eating, helping them to gently and gradually reconnect with their physical bodies. In a preliminary study, Dr. Shane McIver, at Deakin University in Melbourne, Australia found a 12-week yoga program decreased binge eating and improved other health measures. Numerous studies by D. Vancampfort have found that combining physical activity and cognitive behavioral therapy improves outcomes for those with mental disorders including those with binge eating disorder. Body-based interventions can be very effective in healing underlying trauma, extensive work by Dr. Bessel Van Der Kolk has found. When the arousal system is overactivated as a result of trauma, the body enters a fight-flight mode and a person can become hypervigilant to “threats,” real or imagined. Body-based treatments such as yoga allow a person to literally move through the hyper-aroused state and into healing.
Intentional focus on merging the mind and body, healing one’s relationship with body through acceptance and forgiveness techniques, and ongoing self-care can help shift someone suffering from binge eating disorder from body shame to a functional focus on his or her body, therefore, neutralizing the shame that has so far kept them locked in the disordered behavior.
About the authors:
Dr. Kari Anderson has been treating eating disorders for 25 years, with particular emphasis on Binge Eating Disorder. She has served in several clinical and administrative roles for inpatient treatment centers, The Rader Institute and Remuda Ranch Programs. She currently is Executive Director for Green Mountain at Fox Run and President of their Women’s Center for Binge and Emotional Eating in Ludlow, Vermont.
She earned her Doctorate in Behavioral Health at Arizona State University in 2012. Kari is faculty for the Eating Disorder Institute at Plymouth State University in New Hampshire. She also serves on the Eating Disorder Specialist Certification Committee for the International Association of Eating Disorder Professionals.
Co-creator of the Am I Hungry?® Mindful Eating for Binge Eating Program, Kari also co-authored the award-winning 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 holds licenses to practice in Vermont and Arizona.
She lives in the Ludlow, Vermont area with her husband, Brian, and therapy dog, Gretel.
Shiri Macri is Clinical Director for Green Mountain’s Women’s Center for Binge and Emotional Eating. She has bee a Licensed Clinical Mental Health Counselor since 2005. Always passionate about her work, she takes a holistic approach to support clients in moving to emotional health. Shiri complements the philosophy of Green Mountain with her extensive background in working with mindfulness-based approaches to anxiety, binge and emotional eating, and post-traumatic stress.
The Limits of Talk: Bessel van der Kolk Wants to Transform the Treatment of Trauma Psychotherapy Networker Sykes Wylie, 2004, 28 (1) pp. 30-41. http://www.traumacenter.org/products/pdf_files/Networker.pdf
Effectiveness of an Extended Yoga Treatment for Women with Chronic Posttraumatic Stress Disorder. Price, Spinazzola, Musicaro, Turner, Suvak, Emerson, van der Kolk, The Journal of Alternative and Complementary Medicine, Vol. X, Number X, Pages 1-9, 2017. http://www.traumacenter.org/products/pdf_files/Effectiveness_Extended_Yoga_Treatment_Women_Chronic_PTSD_P0005.pdf
Trauma Treatment: A Controlled Pilot-Outcome Study of Sensory Integration (SI) in the Treatment of Complex Adaptation to Traumatic Stress
Kaiser, Gillette & Spinazzola, 2010, Journal of Aggression, Maltreatment & Trauma, [19:69]9-720 http://www.traumacenter.org/products/pdf_files/SI%20Txt%20for%20Adult%20Complex%20PTSD%20article-Spinazzola.pdf
Yoga as a treatment for binge eating disorder: a preliminary study. McIver S1, O’Halloran P, McGartland M. Complementary Therapies in Medicine, 2009 Aug; 17(4): 196-202.
Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Katterman SN1, Kleinman BM2, Hood MM1, Nackers LM1, Corsica JA3. Eating Behavior 2014 Apr; 15(2): 197-204. doi: 10.1016/j.eatbeh.2014.01.005. Epub 2014 Feb 1.
Dialectical behavioral therapy for binge eating disorder. Telch, C.F., Agras, W.S., & Linehan, M.M. Journal of Consulting and Clinical Psychology 2001. , 69, 1061-1065.
Changes in physical activity, physical fitness, self-perception and quality of life following a 6 – month physical activity counseling and cognitive behavioral therapy program in outpatients with binge eating disorder Vancampfort, D., Probst, M., Adriaens, A., Pieters, G., DeHurt, M., Stubbs, B., Soundy, A., Vanderlinden, J., 2014. Psychiatry Research. June.