Did you know binge eating has many names like:
- emotional eating
- stress eating
- compulsive eating?
Whatever “label” you prefer doesn’t really matter.
What matters is that these eating problems, deep down, are basically the same.
In this article you’ll learn about:
- Binge Eating in a general sense
- Signs and symptoms of Binge Eating
- Statistics and causes of Binge Eating
- Overview of Various Treatment approaches
1. WHAT IS BINGE EATING?
What Is Binge Eating Disorder?
In 1959 Albert Stunkard, a psychiatrist and researcher, first came up with the term Night Eating Syndrome.
This is now known as binge eating disorder, and it’s not restricted to night time.
Since then there has been much research into binge eating.
The National Eating Disorders Association has conducted nationwide surveys and several binge eating statistics have become clear:
- Approximately 3.5% of women and 2% of men in the United States receive a medical diagnosis of Binge Eating Disorder.
- This means that 2.8% of people in the United States will receive a medical diagnosis of Binge Eating Disorder in their lifetime.
And that’s only counting the number of people who are officially diagnosed!
For every one person diagnosed with Binge Eating Disorder, there are probably 5-10 more who have the disorder or lesser forms of the eating disorder but who never receive a diagnosis.
For example, many people who seek weight loss will ‘fall off the wagon’ and binge eat! However, they typically are not aware that this is a form of binge eating disorder and simply wouldn’t consider this a binge.
They can justify and rationalize their binge eating by saying ‘just this one time’ or ‘never again’.
Yet, losing control is still losing control. And how many people seeking weight loss do you think lose control during their dieting?
The weight loss industry in America is worth many billions. We all know that people in the United States are obsessed with weight loss.
How many people attempting extreme dieting and weight loss end up binge eating but aren’t accounted for?
Characteristics Of Binge Eating
Binge Eating Disorder has also been known as:
- Compulsive overeating
- Emotional eating
- Food addiction
While these eating terms do overlap in meaning, Binge-Eating Disorder has its own clinical definition.
This is based on the tremendous amount of scientific research on binge eating disorder, with careful consideration being given to the clinical definition of binge eating.
We’ll cover the clinical definition shortly, but in order to keep things simple here are the four main symptoms of Binge Eating Disorder:
- Loss Of Control
- Overeating or Bloated
- Guilty / Ashamed
How Do I Know If I Have Binge Eating Disorder?
If you have the four points above, you may have Binge Eating Disorder.
All conditions must be present.
However, as mentioned earlier, Binge Eating Disorder has its own clinical definition.
Binge Eating Disorder is not loosely defined like ‘food addiction’, which lacks a precise definition.
The National Eating Disorders Association lists the criteria for Binge Eating Disorder:
- Have a Binge Eating episode at least once per week for the past 3 months.
(an episode is defined as a very large amount of food according to the person in question, eaten within two hours)
- Three or more of the following symptoms must also be present:
- eating large amounts of food much more rapidly than normal
- consuming large amounts of food until uncomfortably full
- eating large amounts of food without feeling hungry
- eating alone due to feelings of embarrassment and shame
- feelings of guilt or disgust with oneself
Furthermore, the clinical definition includes an “index” regarding the severity of the Binge Eating behaviors:
- Mild: 1-3 binge-eating episodes per week
- Moderate: 4-7 binge-eating episodes per week
- Severe: 8-13 binge-eating episodes per week
- Extreme: 14 or more binge-eating episodes per week
Other Signs You Have Binge Eating Disorder
The above criteria are used to clinically define Binge Eating Disorder.
However, we all know that eating is on a spectrum that can swing throughout the day.
You may struggle with eating, even though technically not having Binge Eating Disorder.
For example, in the quiz above, I talk about stress eating, emotional eating and compulsive eating.
This is just meant to highlight the spectrum of problematic eating disorder behaviors, even though these eating disorder behaviors aren’t technically within the definition of ‘Binge Eating Disorder’.
And you may not be aware of them. Sometimes family members, loved ones and friends may have to point these behaviors out to you before you can admit that you have a problem with food.
Some of the eating disorder behaviors and signs your loved ones may point out, or you become aware of on your own, include:
- Not eating certain foods like carbs, fats or sugars (but then secretly eating them during a binge)
- Obsessively staring in the mirror
- Afraid to eat with friends, family or in public
- Dieting, yo yo dieting, regaining weight from dieting
- Eating alone oftentimes because of embarrassment or fear that you will lose control
- Feeling depressed, horrified, and guilty about eating
- Low self-esteem
Rituals, Secrecy and No Purging
One major difference between Binge Eating Disorder, as opposed to other eating disorders, is that there is no ‘compensation’ or ‘purging’.
In other eating disorders, like in the case of bulimia nervosa, a person will compensate for their binge eating episode by forcing themselves to vomit.
Other times, as in anorexia nervosa, a person may perceive themselves as binge eating, and will compensate by exercising excessively.
Sometimes a person may run for 3 hours on the treadmill because they had a slice of pizza!
Across all eating disorders, though, in addition to the signs listed above, there are two other general behavior patterns:
Rituals vary from person to person.
A person may need to arrange the food on their plate perfectly. Or a person may need to have precisely the right amount of food.
Another example is having to arrange food in the refrigerator perfectly. Or spending tons of time, like hours, preparing a grocery list.
Secrecy is another common eating behavior pattern that indicates potential problems with food.
Secrecy is pretty obvious. It’s where you binge on large amounts of food alone.
Secrecy also refers to where you hide the food or that you only eat in your room. Oftentimes people will get secretive around food wrappers too.
One client of mine would exclusively use fast food restaurants to binge large amounts of food throughout the week.
First, he would describe a hungry eating urge. Usually these hungry eating urges would be related to stressful events. By going alone to a fast food restaurant, he could get tons of food.
He would sit in his car and binge in the parking lot. Then he’d throw away the wrappers and none of his friends, family, or co-workers would know.
What Are The Symptoms Of Binge Eating Disorder?
So let’s review, again, the many symptoms of Binge Eating Disorder.
The most common symptom is what’s commonly known as ‘yo yo dieting’. Other terms for yo yo dieting are:
- Falling off the wagon
- Stopping and restarting
- Weight cycling
As we mentioned before, another symptom of binge eating disorder is feeling guilty, ashamed or terrible about oneself.
This guilt can be deep and painful.
Unfortunately, this guilt can and does worsen in association with other mental health problems:
- Extremely low self esteem and self worth
- Attempting suicide
- Cutting, burning or other forms of self-harm
- Social isolation
- Depending on substances like alcohol or marijuana
And of course it goes without saying that binge eating disorder (and eating struggles in general) can have negative health consequences as well:
- Problems with breathing
- Joint pain
- Pain in stomach, cramps
- Low energy, exhaustion, fatigue
- Weight cycling (this is harmful on the heart)
Despite these negative health consequences, it’s very common for a person to continue binge eating.
Even so, it must be mentioned that binge eating does provide ‘temporarily positive symptoms’ as well.
For example, some ‘temporarily positive’ symptoms of binge eating include:
- Mind becomes blank
- Stop thinking / stress relief
- Calm down, soothe nervous system
- Excitement about food choices if bored
- Escape from life’s problems
- Fantasy about what foods to eat
- Temporarily stop feeling ashamed and low self esteem
These ‘rewards’ can become quite addicting.
However, these temporary rewards, whether they are addicting or not, keep you on the wrong treadmill.
There are ways to deal with binge eating that lead to better health and positive outcomes without the negative consequences.
If a person hasn’t developed other ways of handling stressors in their life, then little triggers can send a person into a binge eating episode.
What Is The Definition Of “Binge Eating Disorder”?
Binge Eating Statistics
Do you know Binge Eating Disorder is more common than breast cancer, HIV, and schizophrenia?
Binge Eating Disorder is also three times more common than Bulimia Nervosa and Anorexia Nervosa combined.
This makes Binge Eating Disorder the most commonly diagnosed eating disorder by far.
The official numbers are staggering.
According to a national survey, Overall, around 2.8% of people in the United States will be diagnosed with Binge Eating Disorder in their lifetime.
That’s close to 9 million people officially diagnosed with BED.
What Factors Cause Binge Eating Disorder?
1 – Dieting
Dieting is the gateway to binge eating.
Oftentimes diets promote two unhealthy behaviors which lead to binge eating:
- Skipping meals
- Eating too little
And there is a common statistic that 95% of diets fail. Oftentimes when someone fails their diet they say they ‘fell off the wagon’.
And oftentimes when someone says they ‘fell off the wagon’ what they mean is that they had a binge eating episode.
Nowadays many diets no longer call themselves diets. For example, the following are all diets in disguise:
Be careful when dieting because dieting is one of the biggest causes of binge eating.
Here’s the bottom line:
If you eat too little whether due to skipping meals, removing foods from your diet, or just not eating enough in general, you put yourself at higher risk for binge eating.
2 – Genetics
Genes play a huge role in binge eating.
The Boston University School of Medicine published a study showing how they were able to locate a gene responsible for binge eating in mice.
While mice are different from humans, research does show conclusively that many people who struggle with eating have parents who also struggle with eating.
Perhaps you can answer this question for yourself:
- Do you struggle with food?
- If so, do you have a parent who struggles with food too?
Research would suggest that if you answer “Yes” to the first question, you’ll probably answer “Yes” to the second question as well.
3 – Negative Body Image
Many people who binge eat have a negative body image. This negative body image motivates the person to diet.
However, remember dieting often leads to binge eating!
Why does a person have a negative body image in the first place?
Our culture with all of its social media often promotes a body image that is too thin.
For example, it’s estimated that we see between 400-600 body images per day on average.
But many of these images are of thin women.
This leaves many women who are just fine the way they are with a not-perfectly-thin body with a negative body image and seeking to lose weight.
But remember, dieting is the most common form of weight loss and it often leads to binge eating.
Many people are actually fine with a bit more fat on their bodies than what the modeling images in the magazines show.
But if you only see images of thin bodies, you’ll think you’re fat and unhealthy, when in reality you’re just fine.
These negative body image thoughts will then drive you to dieting … which has all sorts of negative consequences.
4 – Stress
Many people often rely upon eating to calm themselves down.
Using food to cope with stress is called ‘Emotional Eating’.
However, emotional eating can turn into binge eating if other factors are present.
For example, if a person is under stress, has a history of dieting, and has the genetics for binge eating …
These factors can combine to make emotional eating turn into binge eating.
Stress is a major common factor behind why people binge eat.
5 – Depression
Depression and binge eating are difficult to separate.
What comes first? Do people binge because they are depressed? Or is someone depressed and then they binge?
It’s like the chicken and the egg. However, it doesn’t really matter.
According to WebMD, studies have shown that up to 50% of people with binge eating disorder have also been diagnosed for depression.
6 – Social Relationships
Family and other social relationships can greatly influence the chance that someone will become a binge eater, in part by enhancing some of the factors discussed above.
For example, oftentimes a parent will criticize their child’s body, causing the child to have a negative body image.
This child may then turn to dieting out of a mistaken belief that they need to look a certain way to get their parent’s love.
And maybe as a child you saw that your parents handled stress by eating food.
As a child, you could have great parents. However, even if your parents were great, if your parents:
- Taught you how to organize information instead of your emotions you could still have a tendency to binge eat
- If your parents were overly strict with you in your education
- Didn’t properly attune to your emotions
All these parenting factors could lead to someone binge eating down the line.
And social relationships extend beyond the family too.
Perhaps you have other friends or relationships with people who tend to use food to cope with difficult emotions.
Oftentimes, people will make friends with other people following a diet and then they too become more involved with dieting.
And as dieting increases then binge eating follows.
7 – Why Do We Want To Binge Eat? Chemicals
There is incredible stress and guilt associated with binge eating.
It might seem strange …
But many people actually like binge eating in some ways.
Oftentimes people think that giving up binge eating would mean a loss of something important.
Why is this?
It turns out that binge eating is linked to a release of ‘happy’ chemicals as well.
Oftentimes when people binge eat they are running away from their emotions.
In these cases binge eating can provide a rush of serotonin and dopamine, which can ‘numb’ the person’s emotions.
When numb, a person is no longer in pain. They are temporarily ‘happy’.
Here’s how this looks like in a binge scenario:
- Incredible stress as a person feels themselves losing control
- Numbness / disconnection as a person eats
- Horrible guilt and shame afterwards
While binge eating overall is negative, we cannot forget that powerful chemicals are a major reason why people binge eat.
8 – Low Self-Esteem
Low self-esteem is the final factor.
When a person suffers from low self-esteem they are less likely to care about their well being.
This person might:
- Skip meals
- Not sleep well
- Have less resilience to stress
- Be more easily swayed to diet
Sadly, many people who binge eat think to themselves that their binge eating is a form of punishment.
(It’s interesting how a person can ‘think’ binge eating is a punishment, while chemically speaking their body becomes addicted to the chemicals. You can think one thing and feel the opposite.)
For example, a person with low self-esteem might have a rule to not eat more than 1000 calories per day.
This is extremely low! And not eating enough will cause binge eating.
So eventually this person will end up eating more than 1000 calories.
However, this person may then view their failure to mean they need to binge to ‘punish’ themselves.
This is how an overeating episode turns into a full blown binge in some cases.
What Is The Main Cause Of Overeating?
We just listed 8 factors behind why people binge eat:
- Negative Body Image
- Social relationships
- Low self-esteem
While all of these can be important, the main cause of binge eating is dieting.
The reason is simple. Except for genetics, all these factors lead back to dieting.
Now, a person might ‘accidentally’ diet if they are under lots of stress.
For example, in stressful situations a person might skip meals or undereat accidentally.
Sometimes people undereat when they are depressed.
Other times the link is more direct. With negative body image and low self esteem, for example, a person could become more likely to diet.
Relationships can also impact a person to have a negative body image and low self-esteem, which again leads back to dieting.
What Happens To Your Body When You Binge Eat?
There are 3 primary time periods to consider when you binge eat:
Body Before You Binge Eat
Before you binge eat you will start to lose control.
During this phase, your neocortex starts to get shut down by your limbic brain.
In other words, your ‘thinking’ self gets shut down by your ‘animal’ self.
This is called ‘tunnel vision’.
In tunnel vision you will start to feel like you ‘must’ binge eat.
You will start getting powerful cravings.
These cravings will feel impossible to ignore, for cultural and even hormonal reasons.
Your body will begin to tighten to resist the cravings, but you won’t be able to.
Soon your body will be under so much tension and stress that the only way to release the stress will be to binge eat.
Body During A Binge
On a binge your sense of time may be distorted because your ‘thinking’ brain was shut down beforehand.
Oftentimes time will fly by. Hours will pass.
You eat such a large quantity of food, bags upon bags of food.
Your memory of what you eat almost gets wiped out.
It’s like life is in a haze.
You’ll become very fatigued, tired, and slow.
You may go back several times to eat again.
There are sharp pangs of guilt.
Often a thought of ‘self-punishment’ begins to repeat itself.
- I always fail
- Might as well keep eating because I already f*cked up today
- I can’t stop
Many times people will continue overeating as:
- As a way to avoid the inner critic
Body After A Binge
One of the main “benefits” of a binge is the stupor you go into afterwards.
This stupor is what’s known as ‘escapism’.
You’re mind is blank, temporarily.
Essentially you’re high on drugs.
Your body has been racked with stress.
You’ve eaten sometimes 2000+ calories.
(A binge is on average 1000 calories, with 25% over 2000).
Multiple times driving through fast food places.
Getting a box of donuts and polishing them off while on the way home from work.
Getting up in the middle of the night for bowls of food and going back to bed.
1 – FindThe Right Counselor / Therapist
There are a few primary binge eating disorder treatment approaches:
- Cognitive Behavioral Therapy
- Acceptance and Commitment Therapy
- Dialectical Behavioral Therapy
- Intuitive Eating
I’ll tell you about CBT treatment later in this article.
But first, let me tell you about an important binge eating disorder treatment mindset:
The most important thing is to begin your treatment with a competent mental health therapist or counselor.
These days therapists, counselors and coaches often have direct specialties in eating disorders.
There is no single ‘best’ treatment option.
Instead, a competent therapist or counselor who specializes in eating disorders will effectively combine different binge eating disorder approaches.
The reason this mindset is important is because it’s easy to get stuck in decision mode. A person on their own could potentially spend years trying things out and debating between which treatment for binge eating is best.
While it’s true that there are different eating disorder approaches, the differences between them are small.
- Little unique nuances.
- Slightly different theoretical underpinnings.
- Slightly different therapeutic tools.
A competent therapist who studies multiple approaches will be able to combine different treatments and fit treatment to the individual client.
The key is finding a therapist who can integrate these different mental health treatments to meet you where you are at.
So don’t worry about finding the perfect health treatment.
Find a great therapist or counselor who may genuinely help you.
2 – What Should You Know Before You Commit To A Treatment Path?
Weight loss is secondary.
It should not be the primary focus when changing your eating behavior.
Bad things happen to your health when you focus on weight loss and try to stop binge eating at the same time.
The truth is that dieting and most weight loss attempts as measured in the United States:
- Leads to WEIGHT GAIN!
- Is a direct cause of binge eating
- The cause of being at war with food and having no peace of mind
For many people dieting and purposeful weight loss simply hasn’t worked.
You can evaluate this statement from your own experience. Has dieting worked for your health? Or has it made your health worse and backfired?
If dieting and purposeful weight loss haven’t worked for you, then this means that you have to reset.
Resetting is the first focus of treatment to end binge eating disorders.
You need to become more normal and happier with food again.
A key part of this is to understand how dieting and your previous attempts at weight loss may actually cause you to self-sabotage your health, gain weight, and binge eat.
After you stop binge eating and can understand your health and body in an entirely different, more positive way …
After you gain this understanding and address your unhealthy eating patterns, then and only then will you be in a much better position to think about weight loss.
So first, stop binge eating!
This chart shows how ending binge eating is the first step, no matter your goals.
This chart shows the progression you’d go through if you reset and take this more positive approach. Please note that this diagram is not meant to highlight ‘weight loss’ as a treatment goal.
While you may need to lose weight, if you suffer from bingeing habits then it’s best to get binge free stability first.
However, many people new to binge eating disorder treatment sometimes need to see how their deeply desired goal of weight loss fits into binge eating disorder treatment in order to be willing to begin treatment.
So that’s why the above diagram is useful – it shows that you eventually can get to the weight loss phase after you stop binging. .
But still, while you are ending binge eating, don’t think about weight loss!
3 – Binge Eating Disorder Treatment – Various Treatment Paths
The following therapeutic approaches have all passed a high bar of scientific scrutiny:
- Cognitive-behavioral therapy (CBT): This is where you learn more about the thoughts and emotions that are running in your subconscious mind and start to make changes
- Dialectical Behavior Therapy (DBT): This therapy is for when you “emotionally eat’ all the time. It’s for dealing with intense emotions.
- Acceptance and Commitment Therapy (ACT): This style involves facing painful emotions and staying flexibly committed to a course of action based on your innermost values.
- Intuitive Eating: This style combines aspects of all the above in a flexible approach. It’s slightly different than CBT, with more of an emphasis on body instead of thinking.
There is also another well-known treatment for binge eating disorder treatment called Interpersonal Psychotherapy (IPT).
Additionally, there are medications that may help binge eating disorder treatment in more extreme situations.
Most people who binge eat, have food compulsions or struggle with emotional eating will not need medications. But there are more severe cases where medication may help.
Because I am not a licensed psychiatrist, I will not comment further on medications. If you would like some initial information about potentially appropriate medicines, see this WebMD article .
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is the most well-studied therapy approach.
Out of all the useful therapeutic models, CBT is the most well-researched.
There is a specific form of CBT, called CBT-E, for eating disorders.
The E stands for ‘enhanced cognitive therapy’ and refers to ‘transdiagnostic’ treatment for eating disorders.
This means CBT-E can be used for different eating disorders such as:
- Bulimia nervosa
- Anorexia nervosa
- Binge eating disorder
CBT-E typically consists of 20 sessions spread across approximately 5 months.
This time frame is considered an average length for binge eating disorder treatment across therapy models.
The goals of CBT-E are to educate clients about binge eating disorder and to stop binge eating disorder.
These CBT-E goals tend towards changing a person’s thought patterns.
Dialectical Behavior Therapy
Dialectical Behavior Therapy (CBT) is also used in binge eating disorder treatment.
While Cognitive Behavioral Therapy is more of a generalized approach for every person and every type of eating disorder, DBT is very focused on people who also have borderline personality disorder.
A person with borderline personality disorder may have extreme mood swings. They may feel abandoned or be very emotionally sensitive.
They may be impulsive, and have unclear shifting relationships.
DBT is more targeted to help these individuals.
DBT tends to lean towards managing stressful emotions, instead of emphasizing changing thought patterns as in CBT.
Here’s an example of how the DBT “ACCEPT” technique teaches people how to help manage stressful feelings.
Let’s say you get a call from your boss.
Your boss’s voice is tense and your boss says that you need to come in to the office and be at your desk in exactly 60 minutes.
Your heart starts to race.
Do you go use food to cope with these intense emotions? Or do you ACCEPT?
- Activities – distract yourself with activities like reading
- Contributing – some how make someone’s life better, for example even something simple as saying “happy birthday” to someone on facebook
- Comparisons – put things in perspective – has this situation happened before?
- Emotions – Do something to counter negative emotions. If you are feeling anxious, go on a walk. If you are feeling depressed, go watch funny cat videos
- Pushing away – it’s okay to push the thought out of your mind. Say to yourself that you will come back to the thought when you are ready
- Thoughts – Use a mantra to overcome negative thoughts.
- Sensations – Some how use your sense to de-stress – splash your face with water, take a bath, listen to music, etc
Acceptance And Commitment Therapy
Acceptance and Commitment Therapy (ACT) and DBT both tend to focus on managing difficult thoughts and feelings.
They both differ from CBT, which focuses more on changing thought and eating patterns themselves.
ACT is different from DBT primarily because it uses a different approach to managing difficult feelings.
As mentioned above in the ACCEPT technique, DBT tends to train individuals in using certain tools to handle emotions.
While ACT does greatly emphasize acceptance in its methodology, and while both ACT and DBT emphasize mindfulness …
ACT overall trains individuals to handle difficult thoughts and feelings by identifying their values.
A value is highly individualized, but every person has certain values. This means the value is more important than feeling good.
A person is trained to evaluate their actions on whether they are acting towards their values, or just trying to feel good.
This can help a person manage their difficult thoughts and feelings by taking a new perspective.
Intuitive Eating, I would say, is a hybrid between all these approaches.
However, Intuitive Eating is slightly different in placing more emphasis on the body in comparison with the other approaches.
The body plays an important role in Intuitive Eating with core principles related to hunger, satisfaction.
Of course, Intuitive Eating also talks about binge eating disorder education, as does CBT, and helps individuals with soothing skills, as does DBT.
Practical Lifestyle Tips
Finally, as we wrap up this piece, let’s talk about some general tips that I recommend no matter what binge eating disorder treatment approach you take!
We’ll call these Practical Lifestyle Tips.
Again, remember all the treatment approaches described above have more in common than not!
They give therapists and counselors a variety of effective tools to use when helping clients.
With that being said, let’s look at some general pieces of advice that are relevant no matter what binge eating disorder treatment is being used.
- Don’t diet – purposeful weight loss attempts usually backfire.
- Eat Regularly – breakfast, lunch, and dinner at a minimum every day
- Eat Nutritiously – eat nutrient-dense foods, or whole foods. Examples include beans, nuts, whole grains
- Get Healthy Fats – Olive oil, nuts, yogurt are all sources of healthy fats
- Remove Certain Foods From Sight – I recommend that, at a minimum, you remove all those sugar foods from eyesight. You can have them in the closet somewhere, but seeing all these foods can sometimes trigger binges.
- Manage Stress Better – There are a thousand ways to manage stress. The key is realizing even a little stress is important to manage.
- Maintain Positive Relationships – Ask questions, show interest, make eye contact. Practice saying no and setting boundaries.
- Movement – Whether gardening, yoga or walking, find some type of movement that you enjoy. It’ll help with the stress relief too 🙂
Cognitive Behavioral Therapy For Binge Eating – An Overview
Let’s now explore Cognitive Behavioral Therapy in more depth.
First I’ll give an overview and then I’ll provide direct links to powerful scientific articles.
Overview: Cognitive Behavioral Therapy (CBT) is the most popular and researched therapy treatment approach for mental struggles like anxiety and depression in the United States.
CBT has been extensively researched for eating disorders as well and is a cornerstone of practical medical advice in treating these disorders.
CBT posits that your thoughts, emotions and bodily sensations combine into behavior. Your behavior, in turn, shapes your thoughts, emotions and bodily sensation. It’s all interconnected!
The Science Behind Cognitive Behavioral Therapy
Below are some direct links to compelling scientific articles that demonstrate tremendous proof behind CBT as a methodology to treat binge eating.
For starters, check out this meta-analysis of meta-analysis studies on Cognitive Behavioral Therapy. This paper looked at 269 meta-analyses!
Most therapeutic approaches, even if they are highly effective, have only a few meta-analysis studies, but Cognitive Behavioral Therapy is so simple, popular and effective and has been studied so much that there are over 269 meta-analysis studies!
One meta-analysis study usually combines around 30 normal studies. So this number of studies for CBT is insane!
To get more specific, here’s a meta-analysis study on CBT and binging that shows that 42% of clients succeeded in abstinence from binges after learning CBT.
This. is what I see in my private coaching and counseling business too. I see that about 40% of people are fully cured within 3 months, but 60% it takes between 3-12 months.
Other CBT Components:
- Structured Eating Meal Plan: This is the hallmark of bulimia treatment. 3 meals per day and 3 snacks.
- Nutrition: Eating a balance of carbs, fats and proteins at meals and eating enough food in general.
- Get support from family & friends: Isolation is a hallmark of bulimia. While talking to family or close friends can be difficult, it’s worth the tradeoff. Support groups are another option in most evidence-based treatment options as well.
- No skipping meals: Don’t skip your meals and snacks!
- Identify triggers: Study the patterns and situations that leave you feeling vulnerable. By being able to see clearly that XYZ seemingly always precedes a binge, you will find more motivation to avoid these things.
- Journaling: Oftentimes a record of thoughts is a good tool to see triggers. Since weight loss or fear of weight gain can be a trigger but easily missed, a thought journal can help to catch those thoughts.
- Distraction: How do you take your mind off the stress of life? Music? Games? You must have some healthy outlets for yourself!
- Practice compassion: Learning to forgive yourself is highly important. As you work to identify your thoughts, you will also start to hear your inner critic. As you hear your inner critic more, you’ll see how horrible this voice is and you can start practicing a kind inner voice instead.
How To Use A Real-time, Before-You-Eat Food Awareness Journal
A critical component of CBT is keeping a Food Awareness Journal. This journal sometimes reminds people of an old calorie log, but an Awareness Journal is the exact opposite.
I will explain how to keep a Food Awareness Journal in depth right now so that you can get a feel for how treatment in the Cognitive Behavioral Therapy approach might look.
For starters, let’s talk about the two keys to this Food Awareness Journal:
- You journal in the present moment
- You journal before you eat, not afterwards
Here is a video where I keep a CBT food awareness journal for 1 day.
Now what exactly are you journaling? Here is an example template of the Food Awareness Journal with an example entry:
Why The CBT Food Awareness Journal Works
The main benefit of using this food journal is increased awareness. This awareness in turn leads to food cravings naturally decreasing.
Why do food cravings decrease when you journal? There are several reasons:
Delay of Gratification:
By following this simple rule, ‘journal before you eat’, you will be practicing delay of gratification. Sometimes you’ll find that by the time you are finished writing down your craving, you are no longer hungry, or realize how pointless it is to have food at that time!
Awareness of Triggers:
By writing down what you eat before you actually eat the food, you’ll be forced to bring some awareness of your triggers.
For example, many times binge eaters binge at specific times or places or have certain thoughts before a binge.
Therefore, this journal will help you see clearly which triggers and thoughts are impacting you and causing you to binge. As you see the pattern in writing, you will naturally start to avoid these situations and triggers.
This journal will also clearly help you see your food patterns with much, much greater understanding.
Over time you’ll gain incredible awareness into these underlying thoughts, emotions and bodily sensations that drive your eating behaviors.
Plus, you’ll also be able to see how skipping meals, getting really hungry, restricting food and other food intake patterns end up causing negative eating habits at the end of the day.
Finally, there’s no no mention of amounts, serving sizes, or calories! This totally differs from previous food journaling approaches.T
Summary: By writing down your ‘why’ before you eat, you’ll be much better prepared to stop eating before you get too full.
Now that you’ve gotten a feel for binge eating and the CBT science that inspires our approach here at Eating Enlightenment, let’s wrap up this blog article!
If you have any questions email me or leave a comment below!