Do You Truly Want to Quit?

        Since I wrote Brain over Binge, I’ve noticed that the most common reason people give me for continuing to binge (after reading the book) is that they aren’t sure they really want to quit. Even though they may understand why they binge, even though they can recognize the irrational thoughts of the lower brain; they can’t quite convince themselves to ignore those thoughts, because they feel like they may actually want to keep binge eating.

       If you believe you truly don’t want to quit, you might think there is no line of separation between your higher self and your lower brain; you might have a hard time convincing yourself that the part of your brain urging you to binge isn’t the real you; you might identify with the messages from your lower brain and believe that you want what it wants. In my book, I wrote that I unquestionably agree with traditional therapy on one thing:  the first step in recovery is wanting to recover. Nothing is going to help you quit until you are willing to to stand up against what afflicts you. Others can educate you about the dangers of your behavior, they can help support you in your decision to quit, they can give you tools to use for when you decide to quit; but they cannot make the decision for you. You have to make that decision for yourself. The problem with traditional therapy is, once a patient wants to quit, she is put through a long, complex, and unnecessarily difficult recovery process that often doesn’t lead to a cessation of binge eating. 

         Wanting to recover doesn’t mean you have to be unwaveringly certain about it at every moment, especially in the beginning. But, it does mean you have to have some sense that you do not want to continue down your current path. I tend to believe that anyone who has read my book or any other eating disorder recovery book, or anyone who has sought out therapy or OA, or any other form of treatment for their eating disorder does not truly want to keep binge eating. If you truly wanted to keep up your behavior, why would you even bother trying to help yourself? Yes, there may still be a part of you that wants to binge, but overthinking whether or not you really, really want to recover I think can be unproductive and delay recovery. Binge eating produces harmful, uncomfortable, and shameful effects and that naturally lead to a desire to quit; and if you are reading this, you most likely already have that desire even if you may still doubt it at times. In this post, I’ll address how you might be able to overcome what you perceive as yourself not wanting to quit, and I'll also give some suggestions for those who absolutely can’t convince themselves that they desire recovery. 

       I believe the most likely reason for feeling like you don’t want to quit is because your lower/animal brain is tricking you into believing that you don't. A good test to see if this is the case for you is to ask yourself how you feel after a binge. Do you regret it? Do you wish you could go back and make a different choice? Do you feel ashamed of your behavior? If the answer is yes to any of these questions, then it was never you that wanted to binge. If you truly wanted to binge, you wouldn’t have regret afterward. You would simply do it, enjoy it, and move on without being affected much at all. I think this is best illustrated by the example of smokers. Some smokers have absolutely no guilt about what they do, and don’t give much of a thought to the health risks. They simply enjoy their cigarettes, without any plans to stop enjoying them. Other smokers seem to resolve to quit daily, and tell themselves that every pack is going to be their last. If the first type of smoker were to receive all the tools he/she needed to quit, it wouldn’t do any good because he/she wouldn’t want to use them.  But the second type of smoker would welcome and benefit greatly from those tools.

       However, even for the smoker who truly wants to quit (and likewise for the binge eater who desires recovery), it isn’t always going to feel like he/she desires recovery.  Sometimes the temptation of a cigarette/binge may take over, and the person will forget why they ever wanted to quit in the first place. This is because of the drive from the lower brain, which can be very deceptive. I know for me, the most intriguing reason my lower brain gave me to binge was that it didn’t matter what part of my brain generated the urges, that I wanted to binge nonetheless. That was the hardest reason to separate myself from, because if I slipped back into believing “I” truly wanted to binge, acting on the urge would have been soon to follow. That’s why I think it’s so important to be able to dismiss ANY thought or feeling encouraging binge eating as the neurological junk that it is. This includes those voices that tell you that it’s worth it, and that it is really you that wants to binge.

       It only makes sense that your lower brain would try to convince you that it is really you who likes and wants to binge.  It feels threatened, and wants you to hold on to the habit for dear life. Remember that the lower brain doesn’t remember pain, so when you are experiencing an urge to binge, you are only going to remember the pleasure of binge eating.  The lower brain won’t remind you of the regret, remorse, guilt, uncomfortable fullness, or the exhaustion of purging; and trying to think about those things when you are experiencing an urge will not convince or deter your lower brain. Your job is only to experience all of that wanting/longing/desire/"logical" reasons for a binge with detachment and without acting on your thoughts/feelings. After the urge subsides, you’ll again realize that you certainly don't want to binge, and you'll remember all the reasons why you don’t want to; and you’ll be so glad you weren’t tempted into believing your lower brain.

  
       A reader asked me a great question recently, which was: "Do you believe in stopping acting on the urges to binge before you fully want to?" Simply put, yes; but I'll explain in a little more detail. First of all, like I explained above, whenever you decide to quit, you will never fully want to. There will always be the resistance of the lower brain which wants to cling to the habit/pleasure. Since your urges make you want to binge, you aren't going to fully want to stop until after you stop, and the urges begin to go away. So, ultimately it can be a matter of taking that leap to stop acting on the urges, and disregarding any thoughts/feelings that tell you that you don't want to stop; and then, and only then will you realize that you never truly wanted or needed it. 

        For me, the excitement/amazement I felt at finally being able to control my behavior seemed to quickly override any nagging desires to continue the habit. I think this is because I tried to experience any feelings of  not wanting to quit as part of my binge-created brain-wiring problem. Those feelings did not indicate my true feelings, but my lower brain's. I’ve written this in a previous blog post, but I believe an important thing to remember is that no matter how much you want to quit or how well you separate yourself from the urges; at first, there are going to be times when binge eating seems very appealing. I think it’s important to accept that, and realize that at times, you may indeed feel deprived and unmotivated. However, it’s not really you that’s deprived - you are depriving your lower brain and a life-draining habit, and you are getting stronger with each conquered urge. I believe that once you can get some traction and resist several urges to binge, your desire to put this behind you will eclipse any desire to continue the habit, leaving you wondering why you ever thought you might want to keep binge eating. 

 
        But, what do you do if you’ve tried that and you still feel like you don’t want to quit?  What if you feel you are like the first type of smoker I mentioned – without much regret about your behavior or any real longing to live addiction-free?  If this is the case for you, I have three suggestions.

        First, you could try to take a big leap and quit anyway. Even though you may feel one and the same with the lower brain, you could still ignore any thought encouraging you to binge, knowing that those thoughts will eventually fall silent. Even though you desire to continue binge eating, you still have control of your voluntary muscle movements, and are still capable of not acting on urges to binge. You can tell yourself that yes, right now you do desire to continue binge eating, but you can’t. Feel sorry for yourself for a while if you need to. It’s hard to realize that we can’t have what we desire, whether we are talking about binge eating or other facets of our lives. It’s human nature to have desires, but those desires can’t always be realized, and shouldn’t always be realized. This might seem like a depressing thought to you, but I believe that once some time has gone by, the desire to recover that you didn’t have can appear. You’ll realize how much time and money you wasted by being caught up in binge eating, and as the urges fade, you’ll realize that the pleasure you got from it was never worth it anyway. It’s like walking away from a bad relationship even though you truly love the person. It takes courage, strength, and it hurts; but you soon realize you are better off without that person in your life.
     
        My second suggestion is to seek “readiness” therapy  to try to find that desire to quit within yourself. As I mentioned in Ch. 35, “Bridges to Traditional Therapy,” psychodynamic therapy could possibly be used for this purpose. My book is truly intended for people who realize they have a problem and want to recover from it—or, at least, part of them wants to recover. But for those who do not feel any pull toward recovery, who are complacent in their behavior, who don’t have any desire to give it up – the separation between the self and the binge-created brain-wiring problem is irrelevant. Psychodynamic therapy could help someone find a spark of the true self who wants to recover.

        I’m not talking about “finding the true self” in the sense of becoming fulfilled and developing a cohesive identity prior to stopping binge eating, because this could put off recovery for a very long time. I’m talking about using therapy as a way to catch a glimpse of a part of yourself that wants to move on. Therapy isn't the only avenue to help you find this part of yourself. Finding things you enjoy that are incompatible with binge eating may help, volunteering to help those less fortunate than you also many help you realize a bigger picture, or reflecting on your life and creating goals for the future might give you a desire to let go of your problem. The catch in this is: why would someone go to therapy or do anything to find the desire to quit if they don’t think they’ll ever want to quit?  Like the previous suggestion, it would take courage and strength to begin trying to find that desire despite your doubts.
       

     My last suggestion is to realize you do have free choice. I would never recommend that someone continue to binge, but I do not agree with the way traditional eating disorder and addiction treatment today tends to label people with disorders/diseases when they actually have no desire to quit and are exercising free choice. As Jack Trimpey says in Rational Recovery, “self-intoxication is a basic freedom, an individual liberty.” (RR, pg. 59). Rational Recovery takes a more hard-hitting approach toward those who don’t want to quit, which I needed at the time I read it. I needed someone to tell me that if I wanted to keep doing it, I could, but I could no longer hide behind a “disease” label or the idea that I needed to sort out a lot of other problems before I could quit. If I were to continue to binge because I wanted to, that would be my choice, and I would have to own it. 

       There were countless eating disorder resources that told me otherwise – that told me it wasn’t a choice, that I was diseased, that I was justified to continue binge eating because it was serving a purpose in my life/helping me cope with problems/fulfilling my unmet emotional needs. When I believed those things, it did make me feel a little better about myself for continuing to binge because I felt less culpable, but what did that get me?  Learning all the ways I was justified to continue binge eating didn’t do anything to take the binge eating away, and binge eating made me miserable. It was better to take a one-time ego hit and realize that I was responsible, and then accept that responsibility to quit - even if there were times when I didn't quite feel like I wanted to.   

Weight after Recovery

Before I begin this post, I want to say that I’m trying to keep a narrow focus here as I did in my book, and that is: to use my own story and experience to inspire people to stop binge eating (and the purging to compensate for the binges). Being that I’m not a nutritionist, a personal trainer, or an MD, giving specific advice to people about how to lose or gain weight, or how to have an ideal diet isn’t my mission at this point in time. Nevertheless, since I’ve received several questions from readers about how to deal with a need to lose weight after recovery, or an ongoing desire to diet, I feel that it’s fitting that I should address those issues here. Please know that these are simply my own opinions about the issue of weight as it relates to recovery, and this does not substitute for medical advice.

     First off, if you’ve read my book or some of the other blog posts, you’ll know that I’m naturally thin. I wrote in the book that my natural weight is around 120, although I’ve realized over the past year and a half that extremely busy Kathryn who is non-stop all day with my three kiddos is more in the range of 114. I wrote about my weight loss in a post last May, after I had been actively trying to gain some weight with weight gainer shakes. Since that post, I've realized that trying to make my body something it isn't right now is not the best choice; forcing myself to gain a few pounds is not much better than a restrictive dieter forcing herself to maintain an unnaturally low weight. Yes, I'd rather be my less-crazy-life weight, but I'm not willing to do unnatural things to get there (Of course, I guess relaxing more would be natural....but altogether impossible right now!)


     Yes, at one point in my life when I was a teenager, it was a goal of mine to be super thin; but now I don’t feel like I’m fortunate to have a naturally very-thin body type, even though many friends/family members/strangers throughout my life have suggested that I should feel lucky. I would much rather be more shapely, but I know that worrying about my weight or wishing it were different simply isn’t worth it. I’m within a normal, healthy weight range for me– even though at the lower end – and I eat plenty of food, so I'll accept it for what it is. But, being thin doesn’t mean I have a perfect body by any stretch of the imagination! Just a few of my flaws: I’m apple-shaped (only carry extra weight in my midsection), my legs are riddled with varicose veins from my pregnancies, I don’t have a nice womanly hourglass shape whatsoever....I could go on and on…but what does it really matter?


     The point of discussing my own weight is to be up front that no, I do not have to struggle with being overweight. I honestly have a bit of a hard time discussing the issue of weight loss then, because I keep asking myself - what do I really know about this issue? I may think I know some things about weight loss and how to let go of dieting, but I’ve never been in the shoes of someone who is 30, 50, or even 100 lbs overweight, or someone whose natural body type isn’t thin but who desperately wants to be thin. However - just because I’ve never had those experiences - I have definitely had my struggles with body image; I have experienced years of weighing much more than my normal weight; I’ve  had to let go of the idea of being super skinny, and I’ve let go of restrictive dieting.

     The reality is, we are all different; and binge eaters come in all shapes and sizes. While some binge eaters might view me as knowing nothing about this issue because I’m thin, some caught up in trying to diet restrictively and maintain an extremely low weight might fear ever becoming as "heavy" as me; so really, it’s all in perception.  


     I have said in a comment on another post that even if I never would have lost a single pound after recovery, recovery still would have been 100% worth it. Binge eating brought so much misery to my life, and the weight gain was only a small portion of that misery. Sure, it was good to get back to my regular size after recovery, but that was by far not the greatest benefit. However (as I rambled on about above) I was not overweight (my highest was 140 lbs, which is on the upper end of normal for my height); and I realize that being overweight or having an extreme desire to be very thin can be factors in tempting a person to go on restrictive diets or to avoid eating normally.  


     Although the issue of weight in recovery will affect everyone differently, I do think that wanting/needing to lose weight and actively trying to do that while also trying to stop binge eating can complicate things. Some bulimics may fear recovery because they worry that life without purging will inevitably lead to weight gain; some of those with BED may fear recovery because they are overwhelmed at the thought of losing the weight gained from binge eating. I strongly feel that anyone who wants to quit binge eating – regardless of how much they weigh or how much they desire to weigh -  should try not worry about weight loss until after binge eating stops for good.  


There are two primary reasons why I feel this way:

1     1.)    Weight will likely take care of itself after binge eating stops.

     For me, stopping the binge eating was all I needed to do to lose weight. My metabolism started working the way it should and there was no need to “try” to shed those extra pounds. I believe this will be the case for the vast majority of people with BED or non-purging bulimia, and even most bulimics who self-induce vomiting. Some people seem to think that extra weight from binge eating just stays there until you do something (diet/exercise) to make it come off, but that's usually not true. Some patience may be needed while the body regulates itself, but pounds should come off by stopping binge eating alone. Here is why I think it happened for me and can happen for others: 

     Caloric expenditure increases with body weight (overweight people burn more calories per day than slender people). The reason is because it requires more energy to carry around extra weight, and extra surface area also means more energy lost as heat. For example, one study showed that slender people used 2,481 calories per day, and obese people used 3,162.*  This fact comes to the aid of those who have gained weight from binge eating, and let me explain that using myself as an example:


     I was about 140 lbs when I stopped binge eating. My normal diet was about 2,300 calories, but with the binges added (let's say approximately 4 binges per week, around 8,000 calories each), it upped my weekly caloric intake by 32,000 calories. Spread that out over 7 days, and my daily average was around 6,870 calories. Yes, I was exercising frantically to try to compensate for that, which is why I didn’t gain even more weight, but my “purging” only burned a minimal amount of all of those calories. Even if I would have been dieting restrictively between binges (which I was doing in the earlier years of my bulimia) - eating let’s say only 1,000 non-binge calories each day, the daily average with the binges added would still be 5,570 calories. So, in short, quitting binge eating obviously reduces calorie intake...big time.

     But, how does that automatically lead to weight loss? Eating around a 2,300 calorie diet now allows me to maintain my weight, so why did that same amount of food allow me to lose 20 lbs after recovery? Because of the fact I mentioned previously – more body weight means more calories burned. At 140 lbs, I may have been using around 2,600 calories a day, but eating less than that (2,300), leading to gradual weight loss. This is not starvation or putting oneself in a calorie deficit; this is just how people naturally lose weight after consuming too many calories for too long. The body gravitates back to it’s normal size, because the larger size can only be maintained with an overabundance of calories.

     To sum it up: while there is something you need to do (binge) to maintain a larger size, there is often absolutely nothing you need to do to slowly gravitate back to normal. For most binge eaters, the weight is likely only staying there because of the binges; it’s not permanently stuck there until you diet it away. No it won’t come off overnight like it might with some fad/crash diet, but it’s healthier in the long run to lose it naturally, and it can help you avoid repeating the diet/binge cycle in the future.   

   What about those who “get rid of” those binge calories by self-induced vomiting?  It’s not much different logic there either. Most people who self-induce vomiting probably already know that it does not actually get rid of all of the binge calories. Studies have shown that calorie absorption may even begin much earlier in the body when you have bulimia - another one of the body's natural ways of protecting itself. If you binge and self-induce vomiting, your daily calorie intake is likely still much greater than the number of calories you’d consume through a normal diet with no binge eating or purging.  Another factor is: purging can slow down metabolism, so that calories a bulimic consumes are stored instead of being used as energy; but once the binge eating and purging stops, metabolism can get back to normal allowing for weight to regulate.    

2.)  If weight doesn’t take care of itself, you’ll be in a much better position to tackle the problem.

     I don't believe weight loss is always a simple calories in/calories out math equation, so the above explanation might not hold true for every unique body. If you are overweight and don’t gradually lose weight after stopping binge eating, even after you are very patient about it; I still feel it’s vital not to try to address it until after you are confident the binge eating is done for good. Once you are sure of your ability to not binge, you’ll be better able to tackle the problem with a healthy solution. 


     During the time that you are becoming binge-free, I think it’s also important to be aware that your lower brain might use a lack of weight loss as fuel for the binge urges. If you don’t see the scale dropping (and I wouldn’t even recommend getting on one during this time), you may hear thoughts like, “You are not losing weight so you might as well binge.” Rationally, you know how ridiculous that sounds, because obviously binge eating will only bring you further away from ever finding a solution to your weight issue; but in the moment, it can seem like a convincing thought. Always remember that you can stop binge eating for good even if you are not the weight you want to be.   

     I do think we come in all different shapes and sizes, and what’s a healthy weight for one person of a certain height might not be a healthy weight for another person of that same height, and I also believe it’s possible to be fit and healthy even if you technically overweight (I don’t think BMI is the best indicator of health); however, there are some who would unquestionably benefit from weight loss. I don’t subscribe to the belief that we can be extremely overweight or obese, yet still be very healthy. (On a side note, I also don’t think being thin is a guarantee of health either.  I’ve read some about how belly fat on skinny people gives them some of the same health risks as obese people http://www.webmd.com/diet/features/the-risks-of-belly-fat.  This is actually one of the main reasons I stopped drinking the weight gainer shakes last year, because the only place I can seem to gain weight at this point in my life is in my midsection.)       

     I am not against healthy weight loss, but I feel strongly that advice to simply restrict calories and eat low-fat/low-calorie food is completely misguided and does more harm than good (especially in those susceptible to binge eating), and just doesn't work in the long run. I think binge eaters should avoid starvation (calorie-restrictive) diets at all costs. For example, I think the typical 1200-1400 cal/day weight loss diet for a woman is starvation, unless she is lying in bed all day and not moving at all. Low calorie diets usually lead to a slower metabolism, malnourishment (which some claim is one of the causes of obesity), and more weight gain in the long run. It’s also simply unrealistic to think you can maintain a 1,200 calorie per day diet to lose weight and then keep that weight off for life.       

     So, then how does one lose weight without ever restricting calories? First of all, when I say “don’t restrict,” I don’t mean eat excessively. I mean eat enough, eat to nourish yourself well, eat what your body needs. Of course, a bit of overeating happens from time to time even in normal people; but as a rule, daily intake should be within a normal range.  That being said, I know that excessive eating isn't usually to blame, and I definitely think there are a myriad of other problems that can contribute to not losing weight (for example: hormonal imbalances, insulin resistance, leptin resistence, food allergies/sensitivities, thyroid problems, infections, damage to the organs involved in metabolic control, too many toxins in the diet, not enough activity, too many processed foods, not enough water, not enough sleep, too much stress...etc). 


     If you go from binge eating to eating a normal diet, and you don't eventually lose weight; then I believe it makes sense to look into what might be preventing that from happening.  Reasons for not losing weight can be multifaceted, and science currently has an incomplete understanding of why some people can lose weight easily and for others, it’s a struggle; but I don’t think the complexity should prevent us from looking for answers.  


     I believe that making some changes to the composition of one's diet (without letting it become an obsession and still allowing for flexibility) can help many, and is a much better approach than simply slashing calories. Focusing on eating a lot of nutrient dense, nourishing foods can lead to more weight loss in the long run without ever putting the body in “starvation mode.”  Everyone is different, and some people might find that changing diet composition to make it more “paleo” helps them feel better and lose weight, while others find that eating more “vegan” foods help then achieve the same results. I also am a big advocate of healthy exercise as a way to achieve weight loss, although I think it should be enjoyable as well.   

     In my opinion, the goal for anyone trying to lose weight, whether they have a history of an eating disorder or not, should be to gain better health, not to simply lose weight fast. I think when people are truly focused on becoming healthier, it becomes an effort to nourish the body well, to feel better, to gain energy for living, to prevent disease; and it ceases to be about how many pounds they can lose or what size jeans they can fit into. And, usually, if one focuses on becoming healthier (and he/she does need to lose weight) the weight will come off naturally. In those who desperately want to be super-thin, focusing on health can help them realize that trying to maintain an unnatural weight is not good for their body. Focusing on health can also allow them to appreciate food for it's nourishing qualities, without worrying about how many calories foods contain or if they can possibly lead to weight gain.  


      But focusing on health is usually not possible when binge eating is still occurring, because when you fundamentally feel like you don’t have control of what or how much you eat at times, it’s hard to implement healthy changes. This is why I believe those who want to quit binge eating should not address weight issues until after recovery. 


     Improvements in health, weight, and attitudes toward your weight are just some of the positive changes that recovery can free you up to make.    

    

     

*Leibel RL et al.  Changes in energy expenditure resulting from altered body weight. N Eng J Med. 1995 Mar 9;332(10):621-8

Facing Fears

     I want to share a personal experience I’ve had recently - which isn’t food related, but which I thought had implications for those with eating disorders. It has to do with overcoming a fear, and since those struggling with bulimia/BED/anorexia/EDNOS often have fears around food or fear giving up their habits, I thought this experience of mine might be helpful to someone in some way.

     For about 5 years, I was afraid of driving on expressways (interstates/freeways… whatever you may call them). I rarely drove on expressways; and by rarely, I mean maybe twice a year. I had no problem riding with someone else driving, but every time I tried to drive myself I became extremely anxious. I found it easier on my nerves just to stick to the surface streets. When I lived in Phoenix, this was not much of a problem, because you can actually get anywhere you need to go in the metro area without ever getting on an expressway – even though it does take longer.

    When we moved seven months ago, I decided it was time to change. Both my mother-in-law and my mom have trouble driving on expressways, and their current problems date back to when they were about my age. Maybe it’s a self-preservation instinct in a young mother to become more fearful of things; but whatever the cause, I didn’t want this fear to stick around and limit my travel options now and in the future. We are lucky enough to live a bit closer to my family now, and I want to be able to pack up and drive 6 hours on the expressway to visit my relatives whenever I have a chance.

     In the 7 months since we moved, I’ve overcome this fear about 85/90 percent. I take expressways nearly every day; I’ve driven on them for 8 hours to get to Tennessee, 6 hours to get to New Orleans and back twice; and I’ve gone through Atlanta rush-hour interstate traffic three times. I now feel I could conquer nearly any driving situation. Although I don’t think I’m ready to drive through Los Angeles during rush hour; I still get a bit nervous passing 18-wheelers; I go way too slow in the rain; and I still feel anxiety going over tall bridges - I feel so much more free.  

     I know it was an irrational fear, although there is obviously real danger in expressway driving. Most people drive on expressways without fear or with minimal nervousness, just as the majority of people eat normally without any (or at least without much) anxiety. This week, I was thinking about the way in which I conquered this problem and its relationship to fears often experienced by those with eating disorders. In my book, I talk about how binge eating is usually ego-dystonic – meaning not in line with what the true self wants; and anorexia/restrictive dieting is often ego-syntonic – meaning in line with what the true self wants. When I was stuck in fear of the expressway, I believed my problem was ego-syntonic. After all, I felt really scared; I thought the fear was not worth addressing because taking surface streets didn’t take that much longer; I believed my kids and I were safer on surface streets. In other words, not taking expressways felt like a desire from my true self.

    However, after thinking this way for years, and after becoming pretty complacent about it - not really having any desire to change; I realized that just like my bulimia, this too had become habit. Maybe it started out as me truly being scared, but each time I avoided an expressway, I cemented the pattern until it became the norm and taking expressways began to seem so foreign. It became something I just didn’t do, and for years, I rarely even entertained the option. It was only when we moved, and visiting family whenever I wanted required hours of interstate driving that I snapped out of my complacency and felt a desire to change. It was then that I realized that what started out as an ego-syntonic drive to avoid my fear had indeed become habit and was now ego-dystonic based on my current goals. 

     All the thoughts I told myself to avoid taking expressways were well-ingrained and had become automatic, just like my urges to binge. Those thoughts discouraging me from expressways certainly weren’t going to stop just because I now wanted to drive on them. Just like with binge eating, I decided to try to get those thoughts to go away with action. I didn’t bother trying to go back and figure out where the fear stemmed from or what else I could change in my life to help make that fear go away. I didn’t even read driving statistics to try to convince myself I would be just as safe on the expressway as on the surface streets. I knew the fear was irrational and had become habit; so I decided I’d simply begin driving on the interstate day after day and hope those fears would subside like the urges to binge did. I had doubts in my mind about whether or not it would work, because I certainly don’t believe that the way I overcame binge eating is the solution to every one of life’s problems.    

     The first few times I entered the on-ramp of an expressway, I felt rather terrified. But, I knew that despite the feelings of fear welling up in me, I could control my motor movements - I could check my mirrors and merge left even if my hands were trembling a little. (I just want to say here that I realize that some people with phobias actually experience a panic reaction that they physically cannot control, and may actually lose control of their motor movements. I am not discounting that or saying that those people need to face their fears head on; my fear was more of an everyday variety – not a panic disorder). I reminded myself that my reactions were automatic, and I tried to detach myself from them, focusing instead on the motor movements I needed to perform to drive the car - something I knew I could control.   

     To my surprise, the fear subsided very quickly.  Within a couple weeks, I was using the less-busy expressways in our city with ease - and with much, much weaker fear reactions.  I began challenging myself by driving longer distances, on busier stretches of interstate, through traffic, and even straight over the Smoky Mountains (well, that wasn’t expressway, but still something I would have NEVER done just a year ago). Yes, there was anxiety, and like I said earlier, there are still driving situations that make me nervous. Nevertheless, I feel like I’ve come a long way in a short time; and taking the interstate feels so normal to me again that I sometimes wonder why I was ever so scared.

     I actually think this experience applies more to giving up restrictive dieting – which binge eaters often struggle with - than it does to giving up the binge eating itself.  A binge eater/bulimic can usually see that she doesn’t truly want to binge, but can sometimes have a hard time believing that she doesn’t want to diet restrictively. In other words, restrictive dieting feels ego-syntonic. The bulimic wants to lose weight or maintain a low weight, so she fears eating normal amounts of food or certain types of food. In order to avoid the anxiety that eating causes, she sticks to strict, low-calorie diet which then becomes the norm, and ends up initiating or exacerbating the urges to binge.         

     To a bulimic who diets restrictively between binges, it can seem scary to sit down at a normal-sized meal. For whatever reason she started dieting in the first place, dieting has become her standard and not dieting doesn’t feel right anymore. It can feel terrifying, and like something she simply should avoid in order to avoid that anxiety and fear of weight gain. But, avoiding it over and over only perpetuates the problem.

     Once a bulimic does have the motivation to eat normally, I think it’s important for her to keep the fear and anxiety in perspective. She needs to know that despite the anxiety response she experiences around food, she can still control her motor movements to pick up the fork and put food in her mouth. This takes a lot of courage initially, probably much more so than me merging onto the interstate the first several times; but it is well worth it. Then, as the act of eating normally is repeated, the more normal it becomes. It can be the same for those who are fearful of giving up binge eating. The more a binge eater can experience the fear of giving up the habit without letting that fear lead them into the wrong actions, the less threatening the fear should become as being binge-free becomes the norm.   

     It’s common for people to think that restrictive dieters/anorexics have an abundance of self-control. The fallacy in this is: what looks like self-control to an outsider is actually far from it. It takes much more courage for an anorexic or restrictive dieter to eat normally in spite of her anxiety and fear, than it does for her to keep restricting. Once the disorder is in place, avoidance of eating for an anorexic takes about as much self-control as binge eating does for a bulimic (and just about as much self-control as it took me to avoid the expressway when I was afraid of it). An anorexic feels driven to restrict in the same way a bulimic feels driven to binge - her restriction is not a sign of willpower. What should be admired, and takes a lot of courage and self-control, is for a restrictive dieter/anorexic to eat despite her fears.   

     Fear is a natural human emotion, and it can’t always be controlled. You can’t tell yourself not to be scared of eating normally and expect the fear to simply subside.  Sometimes letting go of fear can take time and practice. Sometimes - even if you are doing well - situations can catch you off guard, and you can find yourself panicking a little about giving up dieting or binge eating; but if you can remember that you maintain control of your motor movements and focus on that, it can help you keep performing the right actions, regardless of what messages you might be receiving from your brain.  

     There was one time during my re-learning to drive on the expressway when I was caught by surprise. It was on a drive to New Orleans to visit my family about 4 months ago. There is a bridge on Interstate-10 in New Orleans called the High-Rise, which I’ve always been weary of, even if someone else was driving. I drove on it maybe once when I was in college, but avoided it ever since. On this trip, I decided I wanted to avoid the High-Rise because I had all of my kids in the car, and I thought it would be best for me try it for the first time by myself. So, I took the exit just prior to the bridge, and turned on the navigation system on my phone to allow it to find me another route to my parent’s house.

     It found me another route all right - the quickest and most direct one - which was to enter a road that led to an alternate on-ramp, which led right to the top of the bridge and then quickly merged with interstate traffic at the peak. As soon as I realized where the road was taking us and there was no way out, I started to panic a little; I was shaking, terrified. But, I also knew I had to keep control of my motor skills, as I had 3 kids in the backseat depending on me to get them to their grandparents’ house safely. I was caught off guard in a situation I’d never had to handle before, and it wasn’t easy; but because I tried to focus on my motor movements instead of the fear, it was doable. I imagine this is how elite athletes are able to perform in extreme pressure situations– by focusing on what they know they can control (motor movements) instead of their anxiety. 

     I’m not saying learning to drive on the interstate is an extraordinary feat that I accomplished; people in this world have conquered much bigger fears and roadblocks in their lives.  And, I'm also not saying that we should all simply face our fears head on right now.  I’m only sharing this experience to encourage those who may be fearful of giving up restrictive dieting or binge eating that it’s okay to be scared, but that fear can be worked through and overcome. It’s easy to become complacent in avoiding the things that cause our anxiety, and sometimes it takes an external or internal motivator to give us a reason to face our fears; but it’s well worth it to change a habit or challenge yourself to accomplish new things. 

*This post begs an important question:  Why shouldn’t a binge eater be scared of eating normally? Won’t giving up dieting make her gain weight? It can seem like a legitimate fear to many people, just as driving on the expressway seemed like a legitimate fear to me. Yes, it is possible that I could get in a wreck, blow out a tire, be caught in a terrible storm…etc. The more legitimate a fear seems to a person, the less likely she/he is to try to overcome it. I’ve received several questions from readers about how to deal with a need or desire to lose weight during or after recovery, and how to address an ongoing desire to diet. I am not an expert on weight loss or how to accept your body for what it is, but I do have several thoughts on the topic, which I’ll share in my next blog.   

Pre-Therapy Journal Entry

     I mentioned in a previous post that from time to time, I'd like to include old journal entries from my eating-disordered days. I wrote the following entry a couple months after I turned 18, about a week or two before my first appointment with a therapist regarding my binge eating/bulimia. I had been binge eating for about 7 months at the time of this entry, and the binges had been steadily increasing in frequency and quantity of food.  It's evident that, at the time I wrote this, I had not been introduced to the idea of emotional eating or binge eating as a coping mechanism. However, it seems I had a couple clear ideas of my own about my binge eating:  1.) It's out of control, and 2.) I think I might like to binge, even thought I hate it's effects.
   

      At this point in my eating disorder, my strong cravings and urges to binge were the result of my survival instincts - the binges were an adaptive response to my extended and extreme dieting; and those urges were generated by my animal brain. However, all I knew at the time was that I couldn't seem to control myself around food, and I hated myself for it. I didn't realize that the part of me that "liked" binge eating wasn't really me at all, but my lower brain, which was both driving me to protect myself from starvation and steadily becoming more and more addicted to the binges. Each time I binged, I cemented the pattern a bit more until it became habit, and my body and brain became dependent on large amounts of the very foods that were initially so attractive to my survival instincts (the sugar/fat/carbohydrate-laden ones that might be good for short-term survival but are impossible to thrive on long-term).
     

Oct. 1999,

I don’t know who I’m writing to or why I am writing, but I thought it might help me to get this out.   Basically, I’m out of control.  I can’t stop eating or thinking about food.  I’ve been bingeing almost every other day.  Since last night, I have been really really crazy.  Before I went to bed, I had 3 bowls of cereal, 3 Nutri-Grain bars, 1 pudding cup, 1 bagel, a half a can of beans, a piece of cheese, a few handfuls of Fruity Pebbles, and 7 pieces of bread with butter. Then, I woke up at 12:30am and ate another pudding cup and a cup of milk, and another Nutri-Grain bar. Then, I woke up at 2:00am and ate another Nutri-Grain bar. Then, I woke up at 5:30am and had 2 more Nutri-Grain bars (totaling 7), a cup of milk, a cup of  juice, then a piece of bread, then about 20 crackers, and a protein bar. I finally had to stop because it was time to go.  [*I was leaving with my cross-country team to drive to South Carolina for a race, which was to take place the following day. The next part of this entry was written on the road with my team. I was sitting in the back of the team van, where no one could see my writing]  

We just stopped at Cracker Barrel for lunch on our way to Clemson. I was still so full from last night so I decided to just order a turkey sandwich and a side of green beans.  That would have been ok, but then I ate 2 pieces of cornbread & a biscuit as well.  I was doing my best to eat slow and be normal, but I really just wanted to dig into everything.  I’m like this almost all of the time now, and I don’t know why.  Last night it was like I almost wanted to binge. After the first part of the binge that ended about 10:30pm, I actually felt good.  But, then when I kept getting up at night and after lunch today, I just feel like a big failure.  I spent so much time and energy and used so much self control to get down to this weight. And, now I’m ruining it. I weighed myself yesterday before dinner and I weighed 94, and I weighed myself this morning and I was 99.  That’s absolutely ridiculous. 5 pounds in 1 night!

Do you think my body is just trying to tell me something? Or am I just crazy? Sometimes I feel like if I had a choice of what I wanted to do, I would choose to just sit in my room and stuff myself.  I’ve actually gotten to the point where I enjoy it.  After I binge, I just lay in bed and go to sleep.  If I could just learn how to throw up, I could binge and not gain any weight. 

 I just need to stop being such a baby.  It’s sad but sometimes I would rather eat than do anything.   Every time I do it, I swear to myself that I’m never going to do it again, but I always do.  Right now, I’m feeling so nautious and sick, but if I were alone in my room, I know I would eat more. I need a babysitter 24/7.  My parents and sister know some of what is going on, which is good.  But, they don’t know how to help me. I told the sports psychologist about the problem this week and I went home after the appointment and binged.  It was like the whole day, I just knew it was going to happen.  I went to Wal-mart with [two of my friends] and I bought the Nutri-grain bars knowing I would probably end up eating a ton of them, but not thinking I would eat the whole box in one night.

I feel like no one eats as much as me in the entire world, but I’m skinnier than the majority of people I see.  How is that?  I know it’s going to catch up with me very soon if I keep this up.  I hate myself so much right now.  I just want to be normal.  I just want to eat and forget about it.  I don’t want to think about food all day long.  I feel so alone. 




     I think this entry is very important because of my honesty - admitting that I liked the binges.  This type of honesty was extremely rare in my journal entries after therapy, when I became convinced I binged for complicated emotional reasons and it was a coping mechanism for life's problems. In later entries, I attributed the binges to feelings/stressors/daily events/issues rooted in my past; and rarely said what I said here - which was basically: "My cravings feel out of control, but you know what? ... it feels good (temporarily) when I give in."  It only made sense that it felt good - of course there was great pleasure in the relief from self-imposed starvation!      
  
     The last paragraph in this entry is also telling in that I say I want to be normal. I didn't want binge eating in my life, and therefore I was receptive to help - to therapy - which I began shortly after writing this.  But, once I began therapy, I didn't need to learn that all of this was a symptom of underlying emotional issues and spend years digging through and trying to resolve those issues. I needed to learn that I was starving, and my body and brain were reacting to try to protect me. I needed to learn that trying to maintain such a low weight was the cause of all this, and if I stubbornly continued to put my body in a calorie deficit, I'd likely be consumed indefinitely by my desire to binge.


     I actually did learn that food restriction was part of the problem from my nutritionist, but even when I normalized my non-binge eating (which wasn't too difficult because I was motivated to do it), the urges persisted.  As I discuss in my book, this was due to the persistent nature of the survival instincts and also due to habit.  Simply normalizing my diet wasn't enough; therefore, I also needed to learn something else -  how to resist each and every urge to binge in a way that worked for me.    


     In other words, I think my therapy - and the therapy for most bulimics/binge eaters - could be made simple, consisting of only 2 components:
1.) Learn to feed your body sufficiently
2.) Learn to resist urges to binge in a way that works for you


     I am not saying the exact same methods that helped me resist urges to binge will cure everyone; but I believe the key is finding what helps you say no to the binges and therefore decondition the habit...without making recovery unnecessarily complicated, time-consuming, and difficult.          




*I want to apologize (again) for not keeping up with this blog as well as I would like.  Taking care of my 3 young kids is my full time job, and I am definitely far from being a supermom!  I'll do the best I can to post more frequently.  

Paleo eating, my diet, and fudge

     People have asked what I ate during recovery. I didn’t share exact details in my book because I didn’t want people to feel like they should follow what I ate, because everyone has different needs. I certainly didn’t recover because of my diet (I am using the word "diet" in this sense to mean way of eating, not a restrictive “diet”); and my diet during that time was only questionably healthy, based on current nutritional research. 

     For example, nearly 7 years ago when I recovered, whole wheat/grain food items were mostly considered healthy; now some experts think they are at the root of many health problems, diseases, and obesity (see this article: http://www.huffingtonpost.com/dr-mark-hyman/gluten-what-you-dont-know_b_379089.html). Also, low-fat dairy seemed to be considered healthier than full-fat dairy; now many experts claim the opposite (see this article: http://www.care2.com/greenliving/why-whole-milk-is-the-healthiest-choice.html) or that dairy isn’t healthy in any form (http://saveourbones.com/osteoporosis-milk-myth/).  What I considered a pretty good diet almost 7 years ago isn’t what I consider healthy today; and sometimes I am not even sure what I consider healthy (see my What is Healthy? post for a discussion about this). Nevertheless, below is a general idea of what I ate when I stopped binge eating.  

     

     Most of the time, I ate 3 meals plus 3 or 4 snacks per day, likely averaging about 2300 calories per day. I usually stayed in the range of 2000-2500 calories, sometimes slightly more, sometimes less. I didn’t count calories at the time, nor do I today; but I was pretty knowledgeable about calories (as most people with a history of eating disorders are), so I knew generally how much I was getting. I was very active at the time, because I was on my feet all day working in a special education classroom with kids who had severe and profound disabilities, and I exercised about 5-6 times a week for 20-30 min. Even though I ate pretty regular meals and snacks, the meal/snack times and what I ate were very flexible; sometimes I’d inadvertently miss a meal, sometimes I’d eat more at a meal, sometimes not as much.  

     I’ve included a small sample of some of the meals/snacks that I ate (obviously, I’d only eat one meal from each category per day).  Any measurement I give is just an average; I didn't measure my food.  Just to let you know in advance, this is quite the opposite of any sort of "paleo" diet.

    

 Breakfast:

- Bowl of cereal (about 1 ½ cups dry cereal and 1 cup of 1% or 2% milk). It was usually something low-sugar/whole grain like Bran Flakes, but maybe twice per month I'd chose a more sugary option like Frosted Shredded Wheat or Honey Bunches of Oats.  I'd also eat fruit with most breakfasts - something like an apple, ½ or whole banana, some chunks of watermelon, about 15 grapes, an orange, a peach, or a plum.

- 2 whole grain waffles with about 2 tbsp peanut butter, fruit 

- Whole grain bagel with about 2 tbsp Cream cheese, fruit

- 2 eggs (scrambled, fried, or hard-boiled) with 1 or 2 pieces of  whole grain toast and small amount of butter, fruit

- Bowl of oatmeal (2 servings on the container) with a little low-fat milk and some banana cut up in it.

Snack:

-8 oz container of flavored yogurt

-Granola bar

- Protein bar

- low-fat cookies like Snack Wells  (about 4)

 - cheese or peanut butter-filled cracker sandwiches (I believe 6 came in a pack)

Lunch:

- Turkey and cheese sandwich (2 pieces whole grain bread, about 1 tbsp mayonnaise, 1 piece of cheese), chips (about 15), vegetable (usually a small can of green beans, carrots, or spinach; or fresh celery or carrot sticks)

- 1 whole can of soup (lentil, chicken noodle, black bean, tomato) with about 8 wheat crackers or a piece  or 2 of whole grain toast, fruit

- Lean pocket (usually 1, sometimes 2), vegetable, wheat crackers (5-10) or chips

Snack #2:

Generally the same types of snacks as above.  

Dinner:

- Whole wheat pasta and meatballs (maybe 1 1/2 cup prepared pasta, 2 medium meatballs, pasta sauce), caned veggies like corn or green peas (3/4 cup), a roll with a little butter

- Pork Chops (2 or 3, depending on the size), Brown Rice (maybe 1 ½ cup prepared) and gravy, veggies, piece of garlic bread

- Tuna salad sandwich: 2 slices of whole wheat bread (I always bought the larger, heartier looking bread), 3/4 can of tuna, mayo, mustard, lettuce, tomatoes, and chips (10-15)

Snack #3:

Bedtime snack was usually a bowl of cereal (same serving size as I had for breakfast, maybe a little bigger if I was hungrier). It was usually a cereal I thought was pretty healthy; but I’d have the more sugary options probably once every couple of weeks.  

Desserts:

I probably had desert an average of 2 times a week (usually this occurred after dinner). Deserts could have been 1 cup of ice cream, 1-5 oreos or another type of cookie, an average size piece of cake, ½ of a chocolate bar, or just a couple hard candies after a meal. My husband and I used to like to get ice cream from an ice cream shop near our house, and I'd get the small or medium size cup.

Eating out:

My husband and I were not (and still aren't!) the greatest cooks, and we did eat out a lot. We ordered pizza maybe once every two weeks for dinner, and I would usually eat 2 to 3 slices, depending on the size of the slices. If we went to McDonald’s, I’d get a fish sandwich, a spicy chicken sandwich, or a hamburger, and have fries with it (usually a small size order of fries but sometimes a bigger size).

Drinks:

I drank mostly water at the time, but I'd usually have a cup of orange, grape or apple juice sometime during the day, and I drank a diet soda a couple times a week.  I also drank coffee each day with 1% or 2% milk in it. I had an alcoholic beverage such as 1 beer or glass of wine approximately once or twice a month.

      Considering that I thought whole grains/whole wheat were healthy, this seemed like a decent diet to me. It allowed me flexibility, foods I liked, and variety. But, as it turns out my diet was nearly the antithesis of what many experts are claiming is healthy today –  “paleo” eating (here is a summary of the diet: http://en.wikipedia.org/wiki/Paleolithic_diet). This diet has been popularized especially in the past couple years by books like “The Paleo Solution” by Robb Wolf (2010), and “The Paleo Diet” by Loren Cordain (2010). The paleo diet basically argues against consumption of all wheat/grains, legumes, dairy products, sugar, and processed oils. In this post, I’m going to talk primarily about the elimination of wheat/grains (and legumes), and it’s implications for binge eaters. 

   

     When I first heard about the “grain debate” - whether or not grains (not only the refined ones but unprocessed whole grains as well) are healthy or unhealthy, it honestly caught me off guard. “What?” I thought. “Whole grains are not good for you?” From a health standpoint, I could completely understand why someone would chose to give up sugar/refined carbohydrates/processed food, but whole grains? As it turns out, legumes – another food I assumed was healthy for many years – is included in this debate too.

     

     From a little research, it seems there is some real evidence behind the idea that whole grains and legumes are not the best for us. In short, many believe we are not genetically adapted to digest them, and they act as toxins to our system. There is still a lot of controversy about this, and I’m not saying I’m sold on the idea. There are many studies and experts who refute it (for example, see here:  http://paleohacks.com/questions/82618/anti-paleo-studies#axzz1hn2MaBvO), and some say it’s just another fad diet (http://thechart.blogs.cnn.com/2011/09/09/is-the-paleo-diet-healthy/). 

     Personally, I still eat grains and beans, albeit less and especially less wheat; and I’ve been eating more meat/eggs, fresh veggies, and lots more fat - in the form of coconut oil, olive oil, nuts, seeds, and avocados. (On a side note, I still eat dairy as well; but now I always buy full-fat dairy.) If grains are a culprit in a lot of health problems in our society; I for one, find this news really hard to take. One walk through the grocery store shows that most food manufactures promote “whole grain” food as a healthy option, or a positive addition to any food. It’s one thing when you eat sugar/processed food and you know it’s not the best for you, but also fine in moderation; but it’s quite another when you eat something for years and years thinking it’s healthy, and you find out it might not have been healthy after all. 

     The most bothersome part about this is that I’ve fed a lot of whole grains and beans to my children, basically since they started eating solid food. I bought a book called “Super Baby Food” by Ruth Yaron when Max - my first born - began solids. This book, which was more vegetarian in nature, recommended starting a baby's day with a breakfast of homemade porridge, consisting of natural whole grains and beans blended together. It argued against meat, and said that all protein could be received from grains/beans/nuts/seeds/eggs/dairy/veggies. When I think of all the whole grains and beans I bought in bulk from Whole Foods, and all the nights I stayed up late cooking beans and grains for my babies, and how I went through a lot of extra trouble to lovingly feed them something I thought was healthy; I feel a little sick to think all of it may have been in vain, or even toxic to their systems. Again, it’s one thing to give your kid a cookie or candy knowing it’s primarily for pleasure and they aren’t getting much nutrition from it; but it’s quite another when you find out the majority of the “healthy” food you’ve fed your kids might not have been healthy at all.

But enough of me venting,…how does this relate to recovery from bulimia/BED?

...Because I’m noticing more and more that “paleo” eating is suggested as a cure for binge eating.

     Special diets as cures for binge eating/bulimia is nothing new. In my book, I talk about the “Addiction Model” of treating binge eating. Addiction treatment is based on the idea that the foods a binge eater typically binges on – usually foods high in sugar and carbohydrates – are physically addictive; and to recover, the binge eater must abstain from those addictive foods, often indefinitely. One of the pioneers in the addiction model of treating binge eating/compulsive eating/food addiction (not necessarily bulimia) was Anne Katherine, author of “Anatomy of a Food Addiction." In her book, Katherine recommends avoiding what she believes are the culprits of a food addiction – sugar and refined carbohydrates. She recommends “converting to whole wheat eating." She says that “nearly every beloved flour product can be replaced with a sugar-free, 100 percent whole-wheat product.” She also recommends converting to other whole grains, like eating brown rice instead of white rice.[i] 

     Now, some are taking it one huge step further, by making a paleo diet a requirement, or at least an important step in recovery (for example see this link: http://paleopepper.com/2011/02/curing-physiological-drivers-of-binge-eating-with-a-paleo-diet/). The author of the blog I’ve linked above also recommends giving up all fruits, which is more strict than most forms of a paleo diet. While this might work for some, I would hate to see a situation where binge eaters using the addiction model of recovery are told they must give up everything but meat/veggies/healthy fats in order to live free of binge eating. To make these types of sweeping changes in the way you eat is very, very, difficult. I know several extremely health conscious people, and none of them follow a perfect paleo diet, and all of them certainly eat fruit. Quite simply, asking binge eaters to only eat paleo foods is asking too much, when even a normal eater can struggle greatly with this. 

     The reality is, grains are everywhere and we have learn to live with them. If we choose not to eat them, I believe it has to be just that – a choice – not a requirement for recovery.  Avoiding those foods for health reasons might indeed be a healthy choice (even though there is no absolute proof either way) as long as the individual is making sure they are eating enough and getting enough nutrients/vitamins/minerals. However, as far as being helpful in recovery from bulimia/binge eating, I think there are several reasons why a paleo diet might not be the answer, which I’ve listed below.

1.  Avoiding certain foods with the belief that one bite will spiral into a binge can be self-fulfilling.  What happens if the former binge eater decides to eat grains again one day? Does this mean they are destined to relapse?  Feeling like you can control yourself around any food seems to be the safer option.    
2.  Binge eaters can binge on ANYTHING.  Even though carbohydrates are the most common binge foods, the reality is that binge eaters can and do binge on all types of foods. Without breaking the binge eating habit, the animal brain will be looking for opportunities to binge, and will likely find them on any eating regimen, including the paleo diet.
3. The pleasure problem – binge eating alters the reward system in the brain and it becomes a habit of pleasure. A paleo diet is not going to take away that desire for the pleasure of binge eating…at least not right away. It might take a while for a paleo diet - if it’s going to work in altering brain/body chemistry - to work; and the binge eater has to know how to deal with the urges for the rewarding nature of the habit until then.
4.  Telling a binge eater to eat a paleo diet fails to address behavioral conditioning. The habit becomes wired into the brain so that the brain can produce cravings for it automatically, regardless of what one is eating. 
5.  The self-control issue. A sense of lack of control over eating is fundamental to all cases of bulimia and BED; so telling a binge eater to simply avoid grains (which requires a ton of self control) doesn’t seem to make much sense. When one feels they can control themselves around any food, they are free to make any dietary changes they see fit.  

     Getting past these reasons, if binge eaters could manage to eat a paleo-type diet for a while, would it eliminate the urges to binge?  If they managed not to binge during that time, then yes, the urges would fade.  If they did binge on paleo foods, then no, the urges would persist.  But beyond the obvious...assuming they managed to not binge, would the urges go away quicker than mine did, and would they have less urges to deal with?  Possibly.  If grains/sugar/carbs are “trigger” foods, then eating a paleo diet would eliminate some triggers and eliminate some urges. But, on the other hand, feelings of deprivation are also very common triggers for a lot of binge eaters, so might the elimination of all grains/sugar/carbs create even more urges to binge?  Absolutely.  Furthermore, given that many binge eaters claim stress triggers urges to binge; then it's possible that the time, effort, and money it would require to eat a clean paleo diet might end up triggering more frequent urges. 

    I didn't eat a paleo diet, and neither have many others who have found recovery; yet somehow we managed to recover. Maybe if I would have eaten no sugar/dairy/wheat/grains/legumes/fruit, I would have had less urges to deal with...or maybe more?  Either way, looking back, I’m glad I recovered the way that I did; because now no food is dangerous to me.  I can eat whatever I want without having to worry about it leading to urges to binge or to relapse. And, I don’t have to worry if (and when) science makes new discoveries that change what we currently know about nutrition, and gives us a whole new set of guidelines to remain food-addiction free.    

     

     To end on an amusing note, my husband tried to eat a little more hunter/gatherer like for a while, to see if it would help him gain more energy and feel better. During about a three-week time frame, he was pretty strict about it; and during that time we also vacationed to Gatlinburg, TN with some friends. One of our friends bought some fudge from a candy store and brought it back to the cabin where we were staying, and offered us some. I had a couple pieces and so did he. I sort of looked at him funny (in a joking way) when he was eating it and he laughed and said, “what? she (our friend) went out and gathered the fudge, didn’t she?... It’s not about eating what a caveman would eat thousands of years ago, it’s about eating what they would eat if they were alive today.”  We all had a good laugh and agreed that if the cavemen were here today, they would certainly gather some fudge.   

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[i] Katherine, Anne.  Anatomy of a Food Addiction:  The Brain Chemistry of Overeating.  Carlsbad, CA:  Gurze Books, 1991.  P. 189-190