Triggers of binge eating

    Binge eating is a serious eating disorder characterized by episodes of eating large amounts of food in a short period of time, while feeling out of control and unable to stop. Binge eating can be triggered by a variety of factors, including:

• Emotional distress: Binge eating is often triggered by negative emotions, such as stress, anxiety, depression, or boredom.
• Dieting: Dieting can lead to binge eating in a number of ways. First, dieting can create feelings of deprivation and hunger, which can make it more likely to binge eat. Second, dieting can lead to feelings of shame and guilt, which can also trigger binge eating.
• Lack of self-esteem: People with low self-esteem may be more likely to binge eat as a way to cope with negative emotions.
• Body image issues: People with negative body image may be more likely to binge eat as a way to cope with these feelings.
• Genetics: There is some evidence that genetics may play a role in binge eating.

Disordered eating and guilt

    Guilt is a common emotion experienced by people with disordered eating. It can be triggered by a variety of factors, including eating foods that are considered "forbidden," overeating, or not eating enough. Guilt can lead to a number of negative consequences, including further disordered eating behaviors, low self-esteem, and depression. When people feel guilty about eating, they may try to restrict their food intake in an attempt to "make up" for what they've eaten. However, this often backfires, leading to binge eating. Additionally, people with eating disorders may avoid social situations where food is present, out of fear of eating too much or of being judged for their food choices. Guilt can also contribute to feelings of depression and anxiety, which can make it more difficult to cope with disordered eating.

Vacation nutrition

    Sometimes my patients raise concerns about their nutrition over a vacation or another time when they are off their typical schedule. My instinctual response is to assure them that vacation represents a small minority of their life, and to not give it too much importance. But that answer does not really address the core fear. The bigger worry behind this is the fear of loss of control. When you are on your routine, it is easier to stay in control. You can set up your life to make sure you always have the specific food you need when you need it. You can avoid every triggering situation. You can avoid people who might have "forbidden" foods or talk about disallowed topics. It seems that the real work is to be open to all possible circumstances and the real human likelihood of imperfection. 

I was bad yesterday and ate pizza

    The ideals behind this statement bothers me. "Bad" should be reserved for things that are morally wrong. Maybe for insulting a friend or stealing. Eating food doesn't meet that criteria. I understand why people say this and I want to unpack it. There is a perception that pizza is unhealthy. There is a perceived rule that one is supposed to eat healthy foods. There is a feeling of guilt for violating that rule. Then comes the conclusion that eating pizza equates with being bad. Now we need to acknowledge why people eat pizza. A few potential reasons are: hunger--a basic human drive that we all experience and act on every day, desire for pleasure--another normal human drive, and anxiety--who would not use a coping mechanism for anxiety if they can reduce their anxiety with it? Do any of these reasons to eat meat our definition of bad? 

Reasons my patients want to make healthy lifestyle changes

• so I can be around to play with my grandchildren
• to lower my risk of a heart attack
• to improve my blood sugar
• so I can have an easier time climbing up the stairs
• to have more energy
• to improve my mood
• to have less nausea
• to have less bloating
• so I don't eat until I am uncomfortably overfull
• to feel better
• so I can walk further without getting out of breath
• to improve my blood lipid levels
• to feel stronger
• to feel good
• so I can take care of myself
• because only I can do this for myself

I want to lose weight!

     "I want to lose weight!" This is the most common goal of people who I speak to for a nutrition consult. If there is one thing I have learned through my years of being a dietitian, it is that I can't guarantee weight loss. My patients can tell you better than I can tell you that weight loss is really hard to achieve and even harder to maintain. Generally, in the best case scenario, diet alone will lead to 5-10% weight loss, which is often not enough to meet the patient's goal. Fortunately, nutrition changes, even with no weight loss, can lead to real improvements in health and health risk reduction. 

Fear of deprivation

     One of concerns that my patients have is that once they change their eating habits, certain foods will become forbidden, and they will constantly feel deprived of these foods. This fear leads to the "last supper" phenomenon that precedes a diet. The thought is, "I will never be allowed to eat donuts again, so I better get them all in now before they become banned in my next diet." In reality, the idea of prohibited foods is a concept we create ourselves. The extension of that thought, that deprivation is inevitable, is also self-created. 

    I would like to point out the fallacies in both statements. First, we do not have to outlaw foods. I am not even talking about promoting the "everything in moderation" theory. I am simply talking about the black and white/all or nothing thinking that goes into banning foods. The "never again" mindset. Regarding the fear feeling deprived, there are a few other possibilities. Some of that fear stems from the fact we decide foods are forbidden. It is human nature to want what is not allowed. Easing up on the rules can help us avoid the feeling of deprivation. Additionally, there are other helpful and more accurate thoughts we can have. Perhaps a more accurate thought might be, "Let's see what happens if I have oatmeal for breakfast today instead of a donut. I don't need to make plans for the rest of my life right now. I am just deciding about right now" Or the thought could be, "I want to eat a donut when I can really enjoy it, like on a relaxed Sunday morning when I can sit down and savor the taste. Now I am rushing to work and will scarf it down and barely taste it." Or the thought can be, "I would like to sit down and enjoy a donut now. Not because I earned it or because I was good. But because right now I am choosing to eat and enjoy a donut." 

    Remember, knowing these ideas does not immediately translate into feeling and living these ideas. It takes a lot of effort, practice, and reminding ourselves of the perspective we prefer to have. Bumps in the road towards this are just moments to notice what happened. Each new moment is a new opportunity that does not have to depend on the past.