Part Three: Binge Eating to Ease Emotional Pain
Melissa came to see me just before the holiday season began. As she sat in my office, I noticed the way she folded her arms around her body, as if trying to hide it, or avoid being seen. “I’ve been feeling depressed lately, and I feel as though I might never find love again.” Her stated concerns made sense: The holidays can often be a challenging time for singles, who cannot avoid tv commercials, print ads, and even in-person exchanges all emphasizing the warmth of family as the days get shorter and the temperature begins to fall. In addition, Melissa, a twice-divorced mother of two reaching middle age, had harbored deep hurt in her heart from prior relationships for decades. I felt for her, and wanted to help. But then she added, almost as a side-note: “I’m one of those holiday binge eaters, and I’m worried about over-indulging again this year. Is that something you could help me with?” Suddenly, I had a sneaking suspicion there was more to Melissa’s story. There often is. She had gained over thirty pounds in the last five years—and ten of those in the last year alone. Numbing her fears with the comfort of food, Melissa was a Self-Saboteur—and we were about to get to the bottom of her sabotaging patterns.
At age 25, Melissa married Ted, and together they had two children: Noah and Sara. For a few years, all seemed fine: Fine enough until that fateful day when she heard the news that her husband was cheating on her with her best friend. Melissa felt as though the floor had dropped out from under her feet, sending her into an overwhelming spiral toward some unknown bottom. She was devastated. Who wouldn’t be? She threw Ted out of the house—but while she expected this to be her “rock bottom” from which she could rebuild, her problems only compounded. After their divorce, Ted was unreliable with his alimony and child support payments, placing Melissa and their children under serious financial distress. Having suffered the loss of two of the most important people in her life—her husband and her best friend—she began to become emotionally isolated from everyone around her.
Devastation and loss can trigger an ever-worsening cycle: we may isolate ourselves out of protective instincts, but ultimately such isolation only leaves us more vulnerable to new hurt. When Melissa would attend her child’s school events, she found herself envious of the other parents, who all seemed to be coupled and happily married. These feelings only served to strengthen her self-perceived “outsider” status. She felt so unwanted and unattractive—that when she met Scott two years after her divorce, she was ready to be swept off her feet. Desperate to feel like she belonged again, to feel whole, she began to fantasize about marriage. Her wish was granted three months later. Not surprisingly, after the drug-like effects of lust and desire wore off, she had to reckon with the fact that Scott was not the person she thought he was. He drank too much alcohol, yelled at her and her kids, and called her names like “fatso” and “stupid”. Melissa left the marriage after just one year, broken once again by misplaced trust.
She threw herself into her kids and her career. Her children were thriving in school and passionate about their after-school activities. They were popular, with lots of friends. Meanwhile, she became highly respected in her place of work, receiving promotion after promotion and developing friendships of her own.
After two failed relationships, Melissa’s heart had been ripped apart—now exposed like an open wound—and she was applying band-aid after band-aid to try to cover it up, protect it from further injury. But healing starts from the inside, and you can’t stop the bleeding until you have the courage to uncover and mend the deepest hurts. Melissa knew something was missing from her life, but her busy schedule distracted her both from thinking too much about what it could be, and from the healing she knew she had to do—and sometimes, she would feel that bottom drop out again. When this occurred, she would do whatever it took to distract herself from the awful thoughts that would bubble to the surface: Am I good enough? Will anyone ever love me again? Am I lovable in the first place? Some turn to alcohol to numb the pain—but Melissa turned to food.
Following the breakup from Scott, she began to turn to comfort foods, like pretzels, chips, chocolate chip cookies, and candy bars at times when she felt depressed or stressed, or other kinds of emotional pain. Then, she began binge eating—always in secret—to the point where she was overly full, with nausea and abdominal distress. For a day or two after her binge, Melissa would feel deep shame and guilt about her eating behavior: feelings that masked the deeper pain she felt in her heart. This pattern continued until she’d gained a noticeable amount of weight.
As we talked through her past, I recognized the patterns of a self-saboteur: Melissa was self-sabotaging her chances for a new life: one that is revitalized and open to romance. Her unshakeable narrative was that men were incapable of loving, and bound to betray her. Whenever Melissa felt the urge to dig into a bag of chips or other comfort food, she was engaging in reflexive responses to “triggers” that took place in her life. Her response to those triggers—feelings of aloneness after a school or work function involving significant others, calls from friends describing their happy family life—was to lean on a comforting repertoire of behavior. When she binged, she was allowing herself to forget the present moment. Then, when she stopped, her feelings of shame would mask any other emotion that she felt she simply could not come to terms with.
Binge Eating Disorder is a common form of self-sabotage, and as Melissa’s psychiatrist, I knew I could help her end this destructive self-sabotaging cycle. But while the disorder may be common, each patient is always one-of-a-kind—and with this in mind, I wanted to treat Melissa using the highly individualized biopsychosocial model. Prescription medication, supplements, and talk therapy can go a long way towards ending the binge-eating cycle and improving mood, so I began by prescribing a medication for her called Vyvanse, an FDA-approved medication for the treatment of binge-eating disorder. She was also deficient in vitamins D and B12, and her magnesium level was low; so I recommended supplements to correct these deficiencies. Her binge eating episodes largely subsided—enough that we could begin to explore the underlying reasons this self-saboteur was eating to the point of developing worrisome chronic health conditions. Together we mourned her loss of Ted, and of her best friend. As she poured her heart out to me, at times I quietly wept along with her. Losing someone so important is like losing a part of ourselves, and it is so critical to allow ourselves ample time to truly grieve that loss. The loss of Scott only compounded Melissa’s wounds.
Over time, we began to understand that her binge eating, her continuing overweight, were unconscious efforts to ward off men, to keep them at a distance, as she believed that her weight gain would make dating an impossibility – that no man on earth would find her attractive. As this realization began to emerge, Melissa would cry frequently. I felt so sad for her, as she really was quite appealing, and, like everyone, deserved to find love and happiness in her life.
Our work continues, yet her wounds are deep. She has begun losing weight and has now lost 15 of those 30 pounds, and has just begun considering a listing on a popular dating site. Time will tell, but I feel optimistic for her. She is such a fine person, and has so much love to give, that the two of us will work as hard as we can to enable her to put her heart out there once again. This time to the right kind of man, one who is capable of loving.
Begin to Heal
If you are overweight, perhaps, like Melissa, you binge eat at times. If this is infrequent and does not persist (for example, occurring at holidays and the occasional birthday celebration), most likely you are not suffering from Binge Eating Disorder.
Ask yourself the following questions:
- Do you suffer from recurrent and persistent episodes of binge eating?
- Are your episodes of binge eating characterized by 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 you are eating
- Feeling disgusted with yourself, ashamed, depressed, or guilty after overeating
- Are you in emotional pain over your binge eating?
- Does it cause you to feel self-loathing or self-hatred?
- Do you try to compensate for the bingeing by inducing yourself to vomit?
- Do you eat fattening foods to soothe yourself? To bring comfort when feeling stressed? To try to feel better when you feel down about yourself or life in general?
If your answer is “yes” to some of the questions above, seek out professional help. It may be as simple as working with a talented nutritionist to develop a healthier diet. If you are concerned that may not be enough, that your eating behaviors may be a form of self-sabotage, consult with a psychiatrist who will evaluate and treat you as a Whole Person under what is known as the biopsychosocial model.