Kickstarting Binge Eating Disorder Week: Q&A With Amy Pershing
Today marks the first day of Binge Eating Disorder Week, an online campaign to educate people about what binge eating disorder really is (and what it isn’t).
This week I’m republishing Weightless posts that focus on dispelling common (and damaging) myths about BED, along with information on treatment and recovery. (I’ve edited these pieces and combined the interviews.)
Please learn more about this campaign here.
Also, today, is Memorial Day here in the U.S. It honors the men and women who have fought and sacrificed for our country. I’m incredibly grateful to our military. And I’m incredibly grateful to this country.
Like other eating disorders, binge eating disorder (BED) is terribly misunderstood, and myths run rampant in the media and public. Misinformation not only creates confusion in our society. It also creates stigma.
And it means that people struggling with binge eating may feel ashamed, and may not seek treatment.
They may feel totally out of control and blame themselves for their wilting willpower. They may beat themselves up because they think they should be able to stop bingeing on their own or that binge eating somehow makes them a bad person.
But please know several facts: The above statements are myths (BED is a real disorder that has zero to do with willpower); you’re not alone in struggling with BED (BED affects 3.5 percent of American women and 2 percent of American men.); and, with treatment, recovery is absolutely possible.
Below, Amy debunks the biggest myths about BED, reveals her own struggles with the disorder and talks about treatment and recovery.
Q: What are the biggest misconceptions about binge eating disorder (BED)?
A: The biggest public misconception I see is the idea that binge eating is about willpower, about a weakness of character in some way, and that somehow people should just be able to “stop.” The general understanding is still that this is “diet failure,” not an eating disorder, with a biopsychosocial etiology, deserving (and requiring) treatment on the same order as anorexia and bulimia.
The biggest clinical misconception is to focus too much on behavioral change (specifically weight loss) instead of real recovery and real healing. The clinical community is a product of our weight-biased culture, and the impact of this on treatment of BED must be addressed. The primary focus of BED treatment needs to be understanding the psychological role food plays and how to care for the body, not weight loss.
The biggest internal misconception for clients is that BED is evidence of their pathology, of craziness or weakness. I firmly believe that BED, for the vast majority of people, is an attempt at self care. To view BED as an attempt to survive, to soothe, to escape, is to meet the behavior with compassion and understanding.
Q: You’ve also struggled with BED. Can you talk about your own struggles with the disorder?
A: I started bingeing when I was about 11 years old. I had dieted before that, as early as 9 or so. I came from a family of women who all were dieting, who all hated their bodies. I remember eating 800 calories a day, then bingeing on the weekends.
Overhunger was a contributor for sure, but it was about far more than that. My family didn’t talk about real feelings, so I couldn’t express all that was going on for me. Bingeing soothed all my fears and confusions. I was expected to be a “good girl” and follow the rules. Bingeing allowed me a private way to break all those rules. It helped me save my voice.
My recovery took place over some time, starting with therapy in college. It has been a rocky road, to be sure, but in the end, my eating disorder was a great gift. To recover, I had to find my voice, and learn to hang on to it. I had to accept all of me, including my depression, my history, and my body.
I also had to learn that recovery is not a destination, or some fixed point. It means being able to “course-correct,” as I call it, to deal with feelings, needs and boundaries as they come up. It is an ongoing learning. Finally, I am ok with that!
Q: How were you able to recover?
A: Treatment, treatment, treatment! I used to not say that so clearly because, as a therapist, it sounds self-serving! But the reality is eating disorders almost always require treatment.
These disorders develop in isolation; a good therapist helps us understand how and why we have the relationship with food that we do, why we might be afraid to change it, and how to overcome those fears.
Treatment too can help us deal with depression or other mood issues and the effects of trauma. It is completely unreasonable to expect ourselves to deal with all these issues alone. But most of us who have dealt with BED are not great at asking for help (myself included!). So take one small step at a time!
Q: What are the top recovery strategies that readers can try at home?
A: There are lots if things we can do at home to augment treatment. Top of the list is stop dieting and start listening. There are some great books out there about intuitive eating.
Also, build a support community, online or via a support group. Read about recovery and stories of the journeys of others (Aimee Liu’s books are great). Surround yourself with people and ideas that are supportive of recovery.
Think about triggers to binge as well, and try to avoid them as best you can. Once a behavior is ingrained, anything associated with it tends to trigger the urge to binge. If you have decided to binge, try and be as conscious as possible.
Ask yourself what food you really want, and have that food, not a lot of other things you don’t want. Try eating a portion or two, and ask yourself, honestly, if you need more, or if you are ready to stop. If you want more, have another portion, and ask again.
I have found this strategy extremely helpful once a binge is triggered. It allows people to have some impact on a binge, and feel less out of control.
And finally, once a binge is over, the worst thing you can do is shame yourself about it. If you feel shame, notice it, remind yourself that you were doing your best, and see if you can figure out how and why the binge occurred. The best way to guarantee another binge is shame; the best way to lessen the odds is to understand it, and meet those needs in another way.
Finally, remember you will not stop bingeing until there are other tools in the toolbox. You have to meet the needs bingeing has tried to meet. Without that work, recovery cannot happen. It will only be temporary behavior change.
Q: Anything else you’d like readers to know about BED?
A: Know you are not alone, and you are not weak or crazy, or out of control. You are doing the very best you can to take care of yourself. Try to be clear about all the ways you might use food (to soothe, to avoid, to set limits around your time, to have a treat and break the “rules,” or anything else).
I firmly believe recovery is possible. It is not a “perfect” place, with no food or body image issues. It is a place of tolerance for the journey, and compassion for stumbles. With work and love, we can get there. And maybe even be grateful for the journey.
More About Amy Pershing:
Amy Pershing LMSW, ACSW, is the Executive Director of PershingTurnerCenters, a full-spectrum outpatient center for the treatment of eating and related disorders in Annapolis, MD, and Clinical Director of the Center for Eating Disorders in Ann Arbor, MI.
She is the founder of Bodywise, a comprehensive treatment program for binge eating and related disorders offered at both centers. She speaks nationally and writes extensively on binge eating treatment, weight stigma and the intuitive eating model. Amy maintains her clinical practice in Ann Arbor.
Tartakovsky, M. (2013). Kickstarting Binge Eating Disorder Week: Q&A With Amy Pershing. Psych Central. Retrieved on May 30, 2015, from http://blogs.psychcentral.com/weightless/2013/05/kickstarting-binge-eating-disorder-week-qa-with-amy-pershing/