Monday, May 1, 2017

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 borage 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.

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