For a large portion of her illness, Equip Peer Mentor Stacy Jones blamed herself for her eating disorder. “I spent several years thinking I just had a problem with willpower,” Jones says. “I read so many books about developing willpower and became more and more discouraged—I figured I must've been the problem.”
Jones describes a feeling many people with eating disorders are familiar with—particularly those who struggle with binge eating disorder (BED). Despite the fact that BED is the most common eating disorder in the United States, it’s arguably one of most misunderstood and stigmatized. The uncontrollable urge to eat large amounts of food (bingeing) characteristic of BED is often considered a personal failure in our diet culture-entrenched society, though we know it’s almost always a biological response to food deprivation. And because BED is more common among people in larger bodies, those with the disorder may feel even more exposed and vulnerable to fatphobia—including in doctor offices.
People with BED might be used to hearing that binges – a symptom of their eating disorder – is the result of a lack of willpower. Not only is BED not an issue of willpower, but it’s a complex neurobiological mental illness, just like all eating disorders. The physiological, psychological, and emotional components of the disease are powerful and can’t be overlooked. Here’s what everyone should know about the reality of BED.
Why BED has nothing to do with willpower
Here’s what BED is: the most common eating disorder in the U.S., affecting about 2.8 million people; an illness that, unlike other EDs, affects males and females fairly equally; a brain disorder influenced by myriad genetic and environmental factors. Here’s what BED is not: the manifestation of any sort of personal shortcoming.
“Let's remember that eating disorders provide a ‘false sense of control’ over our lives, starting with what we choose to eat or how our body looks,” Equip Dietician Gabriela Cohen says. “That ‘high’ or feeling of ‘pride’ from restricting gives a false sense of success. Ultimately, you are failing to actually take care of your body. Depriving the body of nourishment often leads to binge eating behaviors which are simply the response to that restriction.”
Cohen is describing one of many potential root causes at the heart of all eating disorders: restriction. While food deprivation is considered one of the hallmark symptoms of anorexia, restriction is also a significant component of binge eating disorder because of something known as the “binge-restriction” cycle. According to research, most binges are preceded by a period of restriction because the physical hunger and mental exhaustion of food deprivation is unsustainable. In BED, the never-ending list of food “rules” and attempts to “be good” (i.e. restrict) result in inevitable “slip-ups” (i.e. binges), leading to a frustrating and potentially dangerous cycle of restricting, bingeing, feeling shame, and restricting again.
“That idea that binges are due to a lack of willpower can cause feelings of guilt, defeat, and anxiety, which in turn trigger even more binge eating disorder behaviors and the continuation of the binge-restriction cycle” Cohen says.
Jones agrees that any form of restriction can contribute to the difficulties of BED. “Oftentimes people address physical restriction but not mental restriction,” she says. “Labeling food as ‘good’ and ‘bad,’ avoiding ‘unhealthy’ foods, and other forms of mental restriction are also likely to increase binge urges.”
Equip Therapy Lead Brittney Lauro also says the willpower mindset goes against our primal human need for nourishment. “In truth, our brains haven’t evolved all that much,” she says. “So when we apply the willpower mindset to something like cutting out sugar or carbs, it activates the deprivation fear in our brain. We were designed to operate this way because it’s what helped us survive—we would increase our intake of food when resources were available so we could survive when resources weren’t, like in a harsh winter. Even when we can intellectually understand that food is available, this primal ‘fear of deprivation’ gets activated, leading us to binge eat, or feel out of control with our eating.”
It’s also possible for BED to serve as a form of emotion regulation. “For some, it might be a form of grounding, for others it might serve as a way to check-out or desensitize ourselves when painful memories or experiences are prompted,” Lauro says. “For those who are neurodiverse, binge eating might be associated with ‘stimming,’ or self-regulating.”
How diet culture creates an illusion
“Diet culture loves to moralize foods, thoughts, and behaviors, such as how restricting ‘bad foods’ should be viewed as a sign of strength that one should be proud of,” says Equip Dietician Gabriela Cohen. “When you restrict your diet, the body craves an influx of food. Giving in to this natural response through overeating or binge eating, is then is looked at as ‘failure’ in the eyes of diet culture.’”
Because this diet culture mentality is woven in the fabric of our modern society, it plays an undeniable role in the shame spiral. “We live in a society where we are conditioned to believe that if we just work harder we can do anything, like losing weight,” says Lauro. “The reality is that life isn’t that simple. The myths around willpower generate billions of dollars in revenue to the diet industry.” When willpower is marketed as the solution to everything, those with BED can be consumed with shame that their eating disorder behaviors are the result of their own lack of discipline.
Lauro adds, “In nearly all instances where I have professionally treated BED, as well as when I worked in the fitness industry, I have seen folks come in with the idea that their willpower will change it all,” she says. “I can see so clearly how this idea is normalized. We see it in the media, written on the walls of workout centers, and we hear it from healthcare professionals, colleagues, friends, and family.”
How to overcome the “willpower” mindset and actually heal BED
Considering the diet culture we’re all immersed in, separating from this mindset might be difficult—but it’s possible. Accepting and understanding the need for self-compassion and actionable steps toward treatment will help ensure long-lasting recovery from any eating disorder.
“The good news is, nearly all effective strategies for coping with and treating binge eating don’t require or involve willpower,” Lauro says. “Moreover, they don’t involve removing certain food groups from your life or home—in fact, this is often a surefire way to increase the probability of binge eating in the future.”
Establishing regular eating patterns
Because the restrictive behaviors at the root of BED inevitably perpetuate the cycle of disordered eating, experts say establishing or re-establishing consistent patterns around food is critical to recovery. “First and foremost, I can’t emphasize enough the importance of a regular pattern of eating,” Lauro says. “What that means is three meals and two to three snacks eaten at regular intervals of time throughout the day, making sure to never go more than three to four hours without an instance of eating.”
While the contents of those meals and snacks may differ from person to person, the goal is to adequately satiate the body and brain to prevent the fear of deprivation. “For some people, having consistent eating instances as well as dietary variety will resolve or quiet down the binge eating,” Lauro says.
Cohen agrees that the primary treatment strategy for BED must focus on building regular eating patterns with the support of a team. “Yes, you actually need to eat to overcome BED,” she says. “With the support of a team, you’ll also be challenged to break your food rules and restrictions, and eat your fear foods consistently, because if restriction persists, the binge-restrict cycle will continue.”
Working with a team in Enhanced Cognitive Behavior Therapy
Another effective strategy experts used to treat BED in an evidence-based modality called Enhanced Cognitive Behavior Therapy or CBT-E. This modality is a multi-stage, highly individualized approach that includes monitoring and noting thoughts, which is vastly different from a typical food log or what you might see in a fitness app says Lauro. Monitoring is designed to be completed ‘in the moment’ which in and of itself serves as a way to slow down, or disrupt, the process of binge eating. Oftentimes, folks describe feeling like they get into a ‘spiral’ during binge episodes that leads to feeling out of control. By utilizing an evidenced-based tool like a monitoring record, you can intervene with the spiral and create an ‘in the moment’ pause.”
Establishing distress tolerance techniques
While binges can often occur as a result of longtime restriction, there are other potential psychological and emotional factors at play that people should be aware of as they move toward recovery. “Many people end up binge eating as a way to avoid emotions—and this can even serve as a survival technique, like in cases of trauma,” Lauro says. “Healing from binge eating involves learning to sit with discomfort and tolerate distress. You can certainly practice this on your own if you feel it’s accessible and safe, but if you’d like more support, or binging is tied to more intense experiences, I highly recommend working with an eating disorder specialist to assist creating a strategic guide to building up distress tolerance.”
Jones says it’s imperative to explore the emotions that arise in the moments leading up to, during, and after a binge from a place of curiosity to help better understand the causes behind it. To truly work through the challenges of the illness, confronting and navigating the unpleasant feelings underlying the disorder is paramount. “One of the foundations for recovering from BED is working through shame,” she says. “If you experience shame, know that society has placed it on you and it’s not yours to carry. When we relate to binges from a place of compassion it holds less power. This creates space for healing and moving beyond BED.”
If you or someone you love might be struggling with binge eating disorder, know that there’s support available. Schedule a consultation with our team to learn more about virtual eating disorder treatment at Equip.
- Bray, Brenna, Chris Bray, et al. “Mental Health Aspects of Binge Eating Disorder: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts’ Perspectives.” Frontiers in Psychiatry 13 (2022). https://doi.org/10.3389/fpsyt.2022.953203.
- CBT-E. Accessed October 24, 2023. https://www.cbte.co/.