Tuesday, September 19, 2006

Pathways

In Overcoming Binge Eating, Dr. Christopher Fairburn describes a common pathway for how patients arrive at bulimic behavior:
Typically the person begins dieting and losing weight in the mid-teenage years, despite in many cases not having been overweight in the first place. When the weight loss is extreme, it leads to the development of anorexia nervosa. Eventually, after a varying amount of time, the person’s control over eating starts to break down and he or she begins to binge. Control progressively deteriorates, and the person’s weight gradually returns to near its original level.
Once bingeing begins, it may only be a matter of time before the fear of weight-gain escalates to the point of necessitating the purge.

Sound familiar?

Of course, anorexia is not a required stop in this journey—many people swing from dieting to binge eating without a descent into full-blown anorexia. In either case, one of the easiest points of intervention in this dieting-->anorexia (or not)-->binge eating-->bulimia cycle is the dieting stage. Dr. Fairburn talks about three forms of dieting, including:
1) Trying not to eat for long periods of time 2) Trying to restrict the overall amount eaten 3) Trying to avoid certain types of food
According to him, any of these restrictions can eventually lead to a binge. What I find interesting is how creative we are with our dieting attempts—we may think we’re not dieting because we’re not on a specific plan or because we eat three meals a day, but when you consider the restrictions above, it’s clear how the diet can cleverly masquerade as “I’m too busy to eat” or “I’m just being healthy.” Will dieting always segue into an eating disorder? No. But, for many it will, and it’s important to be aware of this outcome and to be on guard for the plunge into anorexic or binge-eating behavior.

5 comments:

PalmTreeChick said...

I agree with that. I think you get physically and mentally tired of starving yourself and that one time you start eating, you can't stop and then you feel like doody afterwards to you puke it up. You just break down and can't take it anymore so you eat. The complete and utter feelings of guilt and disgust take over and that's when you head for the toilet.

Wow, I sure sound like I "get it" even though I've never really gone on an out of control eating binge before.

wading through recovery said...

Very interesting. I don't consider myself 'on a diet', and I hate the concept of dieting.

Yet, I do ALL of these things sometimes:

1) Trying not to eat for long periods of time 2) Trying to restrict the overall amount eaten 3) Trying to avoid certain types of food

Ugh.

PalmTreeChick said...

Ditto, WTR!

Anonymous said...

Yes yes, I was trying to uncover the reasons that I binge sometimes, and here is part of the reason:

Though I don't "diet", if I feel I ate too much one day, I try not to eat as much the next day, even if I'm hungry.

I'm starting to now give my body the food it needs, when my body calls for it, and exactly how much my body asks for...but it's a difficult path to walk.

What an adventure!

drstaceyny said...

ptc--"out of control" eating may be relative (even small amounts for some). You've identified some core emotions which seem to drive the process--guilt and disgust.

wtr--Kind of eye-opening, huh?

ptc--ditto to you! ; )

anon--it's difficult and quite scary. I think "adventure" is a good word, b/c while it's accompanied by fear, there's this sense that what's on the other side may be illuminating.