I’m freaked out that I’m going to gain all my weight again but I can’t stop myself.
That’s one of the lines in an email from Sarah, 24, that really stood out for me. Why? Because I remember being there. I remember coming off of a “successful” diet when I was 19, feeling thin and in control, then falling “inexplicably” into bingeing. Day after day, bingeing, bingeing, bingeing, until I had gained all the weight back and more.
The thing is, that binge reaction wasn’t inexplicable. Bingeing is an absolutely normal response to dieting and deprivation. Even people who are normal about food to begin with find that they have the urge to binge after being deprived! In fact, scientists who study binge eating and obesity often turn rats and mice into binge eaters in order to study them…and guess how they do that? Giving them servings of their favorite (usually sugary or chocolatey) food then taking it away over and over. The next time they get a hold of that food, they cram it in like there’s no tomorrow. (Sound familiar anyone?!)
Anyhow, let me run the rest of Sarah’s letter so we can get to the happier, more hopeful part!
Q: I’m currently struggling with food and body image right now and I’m frustrated because I can’t find a psychiatrist in my area who specializes in eating disorders. At my heaviest weight in 2004 I weighed 210lbs which I lost through Weight Watchers. I maintained 130lbs for about two years but something snapped and I took weight loss too far. My doctor diagnosis me as anorexic a year and a half ago (a year of which I followed a vegan diet). My lowest weight was 100lbs (I’m 5’4) but typically averaged 106-108lbs during that year and a half. However in the past month I’ve had huge bingeing episodes and gained 10lbs (which I needed to but not in this manner). I’m still working out 6 days a week (hour plus of cardio plus weights) and I’ve binged the past 8 days in a row. I’ve left my apartment to go walk to CVS at midnight to buy candy (I haven’t really bought myself candy or any junk food since joining WW in 2004).
I’m freaked out that I’m going to gain all my weight again but I can’t stop myself. I feel confident during the day but around 9pm I just go crazy and I will walk to the store to get food to eat. Or just eat whatever I have (last night part of my binge included two bowls of oatmeal). I’ve been trying to find a psychiatrist who takes my insurance who I’m compatible with and I can’t find anyone. I’m frustrated and lonely and I’m hoping you can offer me words of wisdom. I have the book Intuitive Eating and Why Weight and I’m reading them while I’m bingeing (WHO DOES THAT). Thank you so much for reading this. And if you have any advice I’d gratefully appreciate it.
A: Hi Sarah. First, take a really deep breath and know that all of this back and forth, this weird, winding, crazy road is OK. Most people who get sane about food and recover from disordered eating don’t just get there in one straight shot. Your experiences—including your binges—have all gotten you where you are right now, looking hard for the next step because you very much want to get all the way better.
I bolded a couple of lines in your email, above, because I think they provide a lot of insight into what’s going on. Do you think your body and heart might be trying to tell you something? During the day, when you’re feeling confident about eating, is it possible that you’re still “restricting” in some way? Not necessarily calorie-wise, but in any way? You obviously have had some pretty strong feelings about which foods are “healthy” and which are not. Could it be that you are still putting a lot of pressure on yourself to eat “perfectly” and “healthily”? If so, it’s not a huge surprise that your body is rebelling at night. In fact, your subconscious may be trying to save your life! It’s like, “NO. NO MORE.” It doesn’t want you to be obsessed anymore. It doesn’t want you to think about weight and numbers constantly. Your body, through this bingeing, is forcing you to look for a type of recovery and help that is beyond anything you’ve sought before.
That’s something I came to believe very firmly through my recovery: My urge to binge was my body’s way of telling me something was up. It kept me striving for sanity because it made me so miserable I couldn’t ignore it! So don’t ignore it! You’ve been trying on your own with books like Intuitive Eating and Why Weight, but maybe your body is trying to tell you it’s time to take the next steps in your journey.
Speaking of next steps, it sounds like you’ve been trying to find a psychiatrist. Good! But since you haven’t found one you love yet who specializes in eating disorders, here are a couple of other things you can do:
1. Check into psychiatrists or psychologists at large university medical centers near you. Big colleges often have the most cutting-edge therapists. Even better, they often offer discounted therapy with masters-degree-level students who are doing practicum work under the supervision of experienced specialists.
2. Search EDReferral.com, or Something Fishy for eating disorder therapists in your area.
3. Look into eating disorder clinics near you that may offer outpatient therapy. The Renfrew Center, for example, has locations in Florida, NY, Texas, and Maryland among other places. Their therapists are amazing.
4. Expand the type of expert you’re looking for. Have you ever considered cognitive behavioral therapy? There is solid evidence that CBT works in binge eating. (Try Googling”cognitive behavioral therapists in XX city.”)
5. Know that even if the therapist you choose doesn’t take your insurance, you can often send in your receipts for reimbursement from your insurance company. Insurance companies must cover mental health at the same benefit level as “medical” health, which means that if your company covers 65% of out-of-network costs for regular docs, it’ll cover 65% for mental health people, too.
You’re on your way, Sarah. And it sounds like you are determined to get better (and that your body is loudly pushing you toward it!).
Now, to the rest of the HealthyGirl.org community: If you’ve seen a therapist, how did you find him or her? How did you pay for it? How did it help? What other wisdom can you share with Sarah? xo…Sunny