Tuesday, February 09, 2016

How Weight Information Can Increase Overeating/Binge Eating - Four Pathways

Recently, I found myself explaining to someone’s mother how encouraging her daughter to weigh herself was exacerbating her eating disorder symptoms (binge eating, in this case). As I did so, it occurred to me that there are four pathways to this relationship. They might seem intuitive, but it helped to spell out the matrix of consequences for this family.

If someone (let’s call her Veronica) steps on the scale and sees a number that’s higher than she anticipated, she might experience distress. For many who struggle with binge eating disorder, food is the most convenient and effective coping mechanism. So, the urge to binge can increase.

If she weighs herself and sees a number that’s higher than predicted, she could also have an urge to restrict her intake in an attempt to suppress her weight. As it typically does, restricted intake will likely result in future binge episodes.

Now, if Veronica steps on the scale and sees a number that “passes the test,” or one that is lower than expected, she could similarly restrict her intake as a way to continue this weight-loss trend. Again, binge eating is a likely consequence.

And if she weighs herself and sees a number that’s equally satisfying, it’s possible she might choose to celebrate by overeating or might feel that she is entitled to eat past fullness as a reward for her success.

Many will endorse one or more of these possibilities as potential outcomes of weighing themselves in early recovery. While some professionals believe that access to weight information in eating disorder treatment is always contraindicated, I think that there are certain benefits to learning this information.

Often, those who struggle with binge eating eat sporadically and infrequently – and avoid certain foods – setting themselves up for future binges. When encouraged to eat more intuitively, they might have fears about excessive weight gain. Witnessing weight trends can provide evidence that a more regular meal plan, which reduces the frequency of binge episodes over time, will not result in significant weight gain. Here, weight information serves as an evidence-based cognitive challenge. But, patients in early recovery might still be triggered by weight information, and it’s important to determine where individuals are in their recovery and to provide space to process and learn from concerns that arise as the result of weight information.

You can find Does Every Woman Have an Eating Disorder? Challenging Our Nation's Fixation with Food and Weight on Amazon (as a paperback and Kindle) and at BarnesandNoble.com


Meliss said...

The scale is the devil, yet a powerful one - because I chose to give it so much power for most of my life.

Remuda Ranch Programs for Anorexia and Bulimia said...

Really nice information, My Name is Dorothy Smith, I am Health Supervisor for working a Eating Disorder Center called RemudaRanch. I handled Binge Eating Disorder Programs.

Jeffery said...

I can not thank you enough for sharing all of this excellent information. I have a loved one who is going through a tough time and just knowing more about the whole situation is comforting. I think the thing that has been most useful is to just understand that other people have gone through this and have come out ok.

Jeffery @ New Dawn Treatment Centers