This is a question that came up in a recent conversation with a colleague. And if you are someone who have been diagnosed with an eating disorder or feel like your relationship with food and your body is not in a great place, you might be thinking the same.
How do you know that you are in eating disorder recovery or how do you know that your relationship with food has improved?
This is one of those questions that don’t really have a definitive answer. Because unlike dieting and intentional weight loss pursuits where the scales clearly defines success or failure, our relationship with food, eating and our bodies are not as clear cut as that.
Alongside this, when we’re in the throes of feeling obsessed and out of control around food, reimagining something else, is unthinkable.
This journey and the outcomes in not about a specific number at all. It is about a reduction in certain behaviours, yes, and it is about the spaciousness that comes with you and your body being on the same team. Respectfully caring for one another.
When I think about my own journey, I notice how many shifts have occurred over time, sometimes a very long time. Often it wasn’t until a big new life stressor hit that I realised that stuffing my feelings down with food was no longer my main coping tool.
Or like when I discovered that I still body check from time to time (because it is such an unconscious ingrained habit) but that the harsh inner critical voice has soften significantly. The old familiar feeling of dread, panic and self-loathing towards my body when noticing some recent weight gain, was not there. Instead, an open and kind newfound acceptance is there, in its place.
Our journey towards peace and freedom around food and eating looks different for everyone one. Your journey might not look like mine, and that is ok. I see this with my clients all the time, each person’s journey is unique to them, and there are many elements and steps on the way that overlap and are same or similar.
The Journey towards healing our relationship with food might include any and all of these:
Giving oneself unconditional permission to eat all foods
Wearing clothes that fit and are comfortable for the hear and now body
Learning about Diet Culture / weight stigma / anti-fat bias both culturally and internalised ones
Practicing body acceptance
Practicing self-compassion (over and over and over)
are just some of the parts that make up disordered eating recovery.
These are not just ideas but practices and explorations that often requires time, curiosity, patience and self-kindness.
Getting curious about what got us into a disordered relationship with food, eating and our body and connecting some of the dots often provides not just a deeper understanding of it all, but often we can hold our past self with greater kindness and compassion, knowing that we did the best we could with what we had. From here it becomes easier to explore what a different less chaotic or rigid (or both) relationship with food can be like.
What do you expect a more peaceful relationship with food will look and feel like?
Often the goal or intention is something like, stop bingeing / purging or restricting. But the benefits of recovery extend far beyond that.
It is important to mention here too, that perfectionism is NOT a goal of disordered eating recovery. It is unlikely that you will never ever binge or purge or restrict ever again. But instead of this being one of your major coping skills you will have built a full toolbox of skills to choose from, many that offer relief in the moment but also beyond.
One of the things you will find is that you have more tools, practice and skills for dealing with life.
Another one is that you have more capacity and resourcing to deal with life in general. I hear this again and again from my clients when their bodies and brains are better nourished. A fully nourished body and brain simply have more capacity to deal with everyday living, than one that is continuously underfed or starved. (Looking at you 800-1200kcal diets!)
You will find that you are not thinking about foodall the time. This is also a physiological consequence from eating regularly and adequate meals. When your body is getting enough, typically the only times we think about food is when we are getting hungry and when we need to shop / plan / prepare meals.
Typically, improved sleep, more energy and a reduction of headaches (if that is something that you suffer with) is other things I hear my clients often talk about when their bodies are feeling fully nourished again.
Having more energy and more executive functioning means that the gap that the preoccupation with food and weight has left can be filled with things you really enjoy that feels nourishing beyond the physical. Like friendships, hobbies, creativity, fun!
I have often witnessed that the further people get in their recovery journey, the less food and weight takes up space in their lives. Even when the desire to lose weight was there (and sometimes dominant) in beginning of the journey, the further you get in recovery the less this feels like a meaningful goal to pursue, because the cost of it has become too high.
That’s not to say that we will never desire a smaller body again (and this might even be truer if you are at the receiving end of weight stigma and anti-fat bias), and that’s ok. As long as the world around us is fixated on thinness as the most important thing to be, do, have, it is likely that this thought and desire will pop up at times. Thinking something is not the same as acting on that thought. And remember recovery is not about perfection!
All of these things are great and important but I think the most powerful shifts that come from working through any disordered eating behaviours and healing your relationship with food, eating and your body is the peace that comes with acceptance and the nourishment that comes from the practice of self compassion.
Being able to hold space for the challenges that comes with being human in a body, with acceptance and kindness changes things at the root. Any sharp self-critical edges can soften and we can meet ourselves where we are at, at any time, with gentleness and care.
This is what having a peaceful, supportive and caring relationship with food and with yourself.
It is possible for you too and you are so worthy of having it.
When someone comes to me to work on their relationship with food, and in this case binge eating and emotional eating I often find myself starting by showing them a visual of the Diet – Restrict – Binge Cycle.
I do this for two reasons.
To show my client that they, nor their body is broken
To show my client that the binge or emotional eating is s symptom, and not the root cause of what’s typically going on.
When you find yourself in a binge episode, it feels so out of control. It is so uncomfortable, both physically and emotionally. It really *feels* like the food and the lack of control is the problem that we have to fix.
And if you’re gaining weight as a result of the binge or emotional eating then you might panic even more and this thing with food and eating *really* have to get under control. I know for sure that this is how I felt, when I was smack bang in the middle of it.
Years later, I learned about the Diet – Restrict- Binge Cycle and I felt such a relief. No wonder I had spent years going around this cycle. Any and all of the diets that I tried was never going to work to get my binge eating under control.
Why? Because they all implied some kind of restrictive eating. It was either restricting calories or sugar or gluten or fat or some other kind of food group. The restriction kept fuelling my binge eating.
And I had no idea (at the time) that these two were connected and that it in order to stop bingeing I would have to stop restricting.
How does restriction drive binge eating?
The cycle will always start from some kind of restriction. It might be a diet, a need to cut out some specific foods for medical reasons or it might be as a result of not having enough food available for awhile due to lack of financial means. It doesn’t really matter why you are restricting as the body will experience the lack of food the same, as a state of famine.
(Step 1 – Restriction) For this example let us imagine that you are starting a new diet. One that is going to support your “health”. (I have health in quotation marks here because diets are rarely about actual health but about thinness.)
(Step 2 – Feeling hungry / starvation)The diet is going well… until you find yourself hungry, and perhaps also tired and stressed out. It is hard to have the bandwidth to deal with life on an empty stomach and undernourished brain.
(Step 3 – Breaking the Diet ) Maybe someone has brought in a cake or donuts to work and even though you say no to when offered, you still find yourself eating a large slice in secret afterwards.
Once you’ve stepped outside the confines of the diet a few things tend to happen:
You find yourself thinking “Well I have already blown my diet so I might as well keep going now”. And then proceed to binge on all or the foods you don’t normally give yourself permission to eat. Or you might polish off the rest of the cake / packet of biscuits, even though you don’t really feel like eating them but you want them gone now, so that they won’t be there tempting you in the future.
(Step 4 – Shame / Guilt / Frustration / Anger) Another thing that can happen is that the shame and guilt over eating in secret and eating more than / something that wasn’t on your diet plan sends you into a spiral and because food is the main coping tool you have, you find yourself planning a binge later. Or maybe you just keep eating because why the H*ll not?!
This backlash binge eating often comes from hurt, pain and wanting to punishing ourselves for the initial “transgression”. And the initial “transgression” happens as a result of undereating, leading to feeling overly hungry and food being present.
It is natural to eat when we are physically hungry! And when we are overly hungry, it is even harder to make executive function decisions, so grabbing what is available makes total sense.
(Step 5 – Fear of weight gain / desire to get back in control) This is where you’ll find yourself in the aftermath of the binge episode. Often sitting a pool of shame, self-blame and self-loathing, it makes sense to reach back out for another diet or to “get back on the diet-wagon” again. Something that will simply put you back in the place of restriction, and so the cycle continues.
This is why we have to address the restriction in order to heal the binge eating.
This cycle can happen is a day or it can happen after days or weeks or even months of restricting. If the restriction has been going on for weeks or months, then it is not unlikely that the binge eating will happen over several days or weeks too.
With the Diet – Deprivation – Binge Cycle we are trying to fight physiology, and that is not supposed to work. If you are finding yourself binge eating after restricting food (or food groups) for a while, there is nothing wrong with you. In fact I would argue that your body is working quiet well.
Our bodies don’t want to be in a state of famine, that is not helpful to survival so when food becomes available we will naturally eat more than we need, because we are trying to make up for the restriction and as well as that we might also eat more because who knows when food will become available again??
It is important that this is often happen subconsciously. This is your body doing its best to keep you alive.
How do you step out of the Diet – Deprivation – Binge Cycle?
In my 3 part mini course I will take you through three practices that can help you get out of this diet – restrict binge cycle. You will get access to the course when you join my weekly newsletter (which is full of supportive things, I promise!)
Have you ever heard the term “Last Supper Mentality”? I bet that even if you haven’t heard the term before, you have probably engaged in it, at least if you have ever prepared for any kind of diet.
“Last Supper Eating” is the eating that happens *before* intentional attempts of restriction. It can also be seasonal like Easter, when the chocolate bunnies are out in full force and you are gearing up for another diet to start a “get beach ready” diet as soon as Easter is done, which might mean that you end up eating more chocolate than what you had planned or what even feels good, just because in the back of your mind you know that chocolate will be off the menu for the coming weeks. So that means best to get in some extra now!
Like one of my recent Reclaiming Body Trust participants said “you do more damage in that anticipatory eating leading up to the next diet than when you are not restricting”. Revelatory!
Last Supper eating is part of the same Diet-Restrict-Binge cycle where backlash binges usually happens as soon as we finish the diet or when we can no longer keep up the restrictions. The same mechanisms are at play here – restriction. But in this case it is the anticipation of restriction that is driving it.
So how do you move away from “Last Supper Mentality” and this kind of binge eating?
My invitation to you is to explore this: What if restriction is not the answer?
What happens when you sit with this question? What comes up for you? What are you feeling in your body?
Restricting food, food rules, diet plans and any other variation of these often feel like safety. And it is really hard to let go of something that feels, on some level, that it would threaten our survival.
And… at the same time, at some point, we may arrive at a place where the cost of continuing dieting over and over, is simply too high and that it is time to do something different.
But if not Dieting then what?
For me I did arrive at a point where I could not put myself through that restrictive misery One.More.Time. As I stood on the scales for the umpteenth time and expected it to tell me that I deserved to be happy I had a lightbulb moment!
Why did I give so much power to this inanimate object? I didn’t have to wait to be happy until I weighted x kg /lb. It was something that I could give to myself now. Perhaps there where other ways to find happiness that had nothing to do with the scales?
Ever since that day I have been on a quest to find happiness that is not tied to what my body looks like.
Diet Culture keeps telling us that if our bodies just look a certain way, life will be good. And that’s not to say that living in a smaller body might not make life easier due to the privileges that can bring.
However, things that losing weight does guarantee us is this: health, friendships, intimate relationships, happiness, joy, contentment, creativity, freedom.
I get that the idea of giving up dieting can feel scary, especially if your eating feels chaotic right now.
Here’s a suggestion to start with: Take a sheet of paper, fold it down the middle and then write down all the benefits of being on a diet on one side and on the other side write down all of the costs of dieting.
Which list is longer? Are there any benefits that would be still beneficial even if weight loss was not the outcome main outcome? If so, are there ways to reach these that does not hyper focus on altering your body size / weight?
I hope this was helpful to explore letting go of those things that no longer serves you.
Disordered eating, dieting, restriction, and emotional eating is rooted in wisdom and the coping skills that came from it were helpful at one time, but they may no longer serve you now.
Separating the idea that your body must look a certain way to be worthy of care, food, love, belonging might feel new AND radical. That is because it is.
Living in a culture that places certain bodies in a hierarchy over others makes it radical to take up space and letting yourself live fully and unapologetically as you.
It doesn’t mean that a) You are not worthy to do so. You are worthy simply because you exists. And b) this is something that is only possible for others. It is possible for you too.
If you do work that includes guiding people around food, nutrition and health you have most likely heard someone say, “I am addicted to sugar, once I start it seems impossible to stop”. If this is how you feel, know that you are NOT alone. I hear this statement over and over in my clinical practice.
In the past, I too felt like I was a sugar addict. My desire for anything sweet seemed to stretch far beyond just having “a sweet tooth”. There was a compulsion to head straight for the cupboard in our house that had all the biscuits, or for the freezer for the ice cream. If I bought a bag of pick n’ mix sweets, I seemed to have a total inability to stop and put the remainders away, even if my body was telling me that it clearly had had enough. I simply had to keep eating until the bag was empty… It felt like all “the evidence” (read lived experience) pointed to an addiction to sugar.
So let’s look at it, is sugar addiction real?
When it comes to the evidence for sugar “addiction” you can, if you look hard enough usually find evidence that backs up this point of view. But what happens if we dig a little deeper?
Some schools of thought support the hypothesis that it is indeed a real condition and there has been a push to get Food Addiction, of which sugar addiction would be a subgroup, to be included in the DSM. Organisations like Overeaters Anonymous, OA, which is based on the same premise as Alcoholics Anonymous, believe that any “white” foods such as white flour, white rice and white sugar is an addictive substance and thus the only way to overcome this addiction is total abstinence. This may very well work for some, but it may also be an approach that keeps people stuck in a loop of self-blame and self-shame, reinforcing the belief that they are broken because they fail to stay off the white stuff, again and again. (Hint – you are not broken; your body is simply doing its best to try and keep you alive!)
The sugar addiction model is based on a comparison between refined sugar and drugs of abuse such as cocaine and heroin. This evidence comes from studies on rats where the rats where fed either sugar solutions or cocaine and it seemed that the rats much preferred sugar over cocaine. These studies have a few problems when it comes to see them as conclusive evidence for sugar addiction being a real thing.
In the very comprehensive review study Sugar Addiction: the state of the science (Westwater 2016) the researchers looked at and compared both animal studies and the limited number of human studies available to compare the substance of sugar to the drug of heroin and cocaine. In doing so they found a few variables in the rat studies that questions the validity of sugar addiction as a true substance addiction. They also question the validity of Food Addiction (FA).
One of these where that the rats only expressed binge like behaviours when they were in an intermittent feeding schedule with either 16h or 24h fasting. They also binged / consumed the highest amount of sugar in the immediate time of reinstated access to the sucrose solution. This is different to how they would consume the drugs where they tend to consume more and more to get the same initial hit. What was really interesting is that when the rats had ad libtum access to food and sugar solutions they did not express the same binge-like behaviours as when they did not.
Humans aren’t rats of course and Westwater et.al also looked at the more limited research on humans when it comes to Food Addiction and sugar addiction. In this case most of the current research is done by using the Yale Food Addiction Scale (YFAS) and the more recent YFAS 2.0. This is a scale where several things are measured such as persistent eating despite negative consequences, unsuccessful attempts to cut down and impairment of functioning because of overeating. It also provides 21 examples of foods from five different categories. These are sweets, starches, fatty foods, salty snacks and sugary drinks. Depending on the scoring an individual can be “diagnosed” with “food addiction”.
The biggest question when it comes to YFAS is: Is it measuring what it thinks it is? Food Addiction shares many overlaps with Binge Eating Disorder (BED). Binge Eating Disorder is already included in the DSM-V with very specific criteria for diagnosis. It was added in 2013, yet many people never receive a diagnosis or isn’t considered sick enough to fit all the criteria for a diagnosis but could still do with support to recover, but that is an article for another day!
The criteria for BED is:
Recurrent and persistent episodes of binge eating
Binge eating episodes are associated with three (or more) of the following:
Eating much more rapidly than normal
Eating until feeling uncomfortably full
Eating large amounts of food when not feeling physically hungry
Eating alone because of being embarrassed by how much one is eating
Feeling disgusted with oneself, depressed, or very guilty after overeating.
Marked distress regarding binge eating
Absence of regular compensatory behaviours (such as purging).
What differs from BED and Food Addiction, is that BED is an eating disorder with a multifactorial aetiology and Food Addiction is seen as the cause of food / sugar being an addictive substance that drives the addictive behaviour and compulsion to eat beyond what feels physically comfortable to the individual.
The science doesn’t seem to conclude that sugar addiction as a substance type addiction is real, however for the individual struggling with binge eating the feeling of addiction is very real. I very much believe in validating our clients that what they feel they are experiencing is a real valid lived experience. However, it is not because sugar itself is an addictive substance. What we need to remember is that restriction drives binge eating. This means that total abstinence is not the answer. Instead, we need to together with our client explore any and all potential underlying triggers and causes to the binge eating behaviours.
Questions you may want to explore are:
Are you currently actively restricting food intake or food groups?
Are you currently dieting or have in a recent past?
Do you have a history of food insecurity?
Are you actually eating enough, throughout the day?
Bingeing might also be functioning as an emotional coping mechanism and/or as a trauma response, which does still not make your bingeing on sugary foods a substance addiction.
What’s next?
Things that I work with people on to support their relationship with food is:
Establish a regular eating pattern
Work on blood sugar regulation through the pairing of carbohydrates with fats and proteins
Work on letting go of food rules and invite them to give themselves permission to eat ALL foods.
This might seem like really basic suggestions but in my work with clients for over almost a decade, many of which have struggles with feelings of addiction around food, I have seen this simple nutrition advice to be incredibly effective in calming down binge eating behaviours, so don’t underestimate how powerful regular eating and simply eating enough food for the body to feel adequately nourished consistently can be.
Conclusion, the topic of Food Addiction is still controversial, but the current science does not support evidence of such. However, the lived experience of feeling addicted to food is very real and may form part of a binge eating disorder. There is almost always an element of some kind of restrictive eating behaviours, and often but not always, food is being used as an emotional coping tool / trauma response. Both are of importance to address for healing and recovery to occur.
References
Margaret L. Westwater, P. C. F. H. Z., 2016. Sugar Addiction: the state of the science. European Journal of Nutrition, Issue 55.
