By Shiri Macri, MA, LCMHC, Clinical Director, Green Mountain at Fox Run’s Women’s Center for Binge & Emotional Eating
To understand why mindfulness can help treat Binge Eating Disorder (BED), let’s first revisit some of the DSM 5 criteria for diagnosing the disorder. They include:
- Eating a larger amount of food than normal during a short time frame (any two-hour period)
- Lack of control over eating during the binge episode.
- Binge eating episodes are associated with:Eating until feeling uncomfortably full
- Eating large amounts of food when not physically hungry
- Eating much more rapidly than normal
- Eating alone out of embarrassment over quantity eaten
- Feeling disgusted, depressed, ashamed, or guilty after overeating
- Marked distress regarding binge eating is also present.
If we look more deeply behind some of these criteria, it becomes clear why using mindfulness-based approaches to treating and healing symptoms of BED can be particularly helpful.
- Eating large quantities of food serves as an escape. Essentially what the person is trying to escape is a barrage of painful emotions, whether they be guilt, shame, anxiety, stress, etc. Food provides a dissociative tool, if only for a period of time.
- The only way to eat very large quantities of food is by ‘checking out’ while eating, otherwise a person might not be able to keep eating and therefore may not be able to continue numbing the painful emotions. It’s through dissociation that a person can continue to eat despite discomfort or pain and continue to use food as a coping tool.
- Behind the secrecy of eating alone, we usually find a person with significant shame about it. From a societal perspective, it’s considered somewhat unacceptable and is frowned upon to eat “inappropriate” amounts of “bad” foods, especially if one lives in a larger body. Therefore, people with BED tend to isolate and hide from society and instead eat in secret. And again, the large quantities of food also serve as an escape from the running inner critical dialogue, if only for a period of time.
Behind each of these criteria are the emotions of a person who is struggling to manage their eating behavior. These behaviors tend to have a sense of mind-LESS-ness to them, again for understandable reasons.
This is why applying mindfulness-based approaches can gradually begin to counteract many of the symptoms of BED, and support the person who is struggling with the emotions.
What is Mindfulness?
Mindfulness means bringing awareness to the present moment, without judgment.
Mindfulness practice comes in many forms, both formal and informal, movement-based, and meditation-based (though these are often one and the same). A person can become more mindful (aka aware of the present, without judgment by engaging in any number of mindfulness practices. They may include meditations, yoga, tai-chi, or simply being aware of your body making contact with the seat beneath you, or being aware of the warmth of the water on the dishes that you’re washing.
By regularly engaging in any of these practices of mindfulness, we can become mindful.
How Mindfulness & BED Treatment Go Together
When people become more mindful, they become more adept at being aware of the present moment, without judgment. Consider this in the context of some of the criteria for BED.
- Instead of escaping difficult emotions, a mindful person is able to be aware of them without judgment. In other words, instead of turning to food to escape difficult emotions, mindfulness teaches us to “ride the waves” of emotions, know that this too shall pass.
- In being mindful, a person is present, aware, awake. This allows for choices with food that are present and aware, as opposed to impulsive, dissociative, or mindless. In other words, it becomes more difficult to eat past discomfort because we are noticing that the eating experience is actually creating a new pain, an additional pain to cope with. A person can then make a mindful choice to stop so as not to endure more pain.
- Non-judgment is at the core of mindfulness. In and of itself, this is the opposite of shame and self-criticism. Which is why developing mindfulness allows a person to shift from a running negative self-dialogue to one that is more self-compassionate. Which heals the associated shame, guilt, embarrassment that often accompanies BED.
Each of these examples address how mindfulness can begin to unearth the roots of symptoms of BED.
There are many third wave therapies that specifically focus on using mindfulness in psychotherapy and by no coincidence are also considered some of the more effective interventions for BED. Third wave therapies are an extension of Cognitive Behavior Therapy (CBT), which is primarily focused on supporting people in reframing internal events such as thinking patterns and emotional reactivity in an effort to manage behaviors.
Third wave psychotherapies add the component of mindfulness to skill development aimed at improving overall functioning. Examples of such psychotherapies that are effectively used in treating BED include:
- Dialectical Behavior Therapy (DBT) focuses on supporting people in being less emotionally reactive, particularly in the context of relationships. It is also especially helpful in the treatment of BED by challenging dichotomous or all-or-nothing thinking while enhancing emotion regulation skills.
- Acceptance and Commitment Therapy (ACT) uses mindfulness skills to help people behave in ways consistent with their core values while developing psychological flexibility. Those with BED benefit from ACT, again, by addressing rigid, all-or-nothing thought patterns and making room for values-based actions supporting well-being, as opposed to attempts to suppress or control emotional experiences through binge eating. People also become more adept at accepting experiences as they occur and having compassion for them, as opposed to avoiding them. This encourages a practice of self-compassion, which is also necessary in healing from BED.
- Mindfulness-Based Cognitive Therapy (MBCT) has been particularly helpful in treating Major Depression, which is often comorbid with BED. By developing an awareness of thoughts and feelings, as well as accepting them but not attaching or reacting to them, those with BED are better able to manage painful emotions as opposed to react to them with eating. Additionally, the reduction in reactivity and judgment that emerges from MBCT allows from more self-acceptance and self-compassion, again a necessity in healing symptoms of BED.
These psychotherapeutic interventions provide excellent resources for treatment when dealing with BED. Often programs will provide an eclectic use of facets of these therapies to ensure a holistic approach to the treatment of BED. Here at Green Mountain at Fox Run’s Women’s Center for Binge & Emotional Eating, our introductory Intensive outpatient group, entitled Pathway, offers just that model of treatment, where women in small groups can engage in facets of DBT, ACT, MBCT, as well as other interventions such as Mindfulness-Based Stress Reduction (MBSR) and CBT.
These interventions are all aimed at providing a holistic form of treatment that can be very effective in healing symptoms of BED. When combined with a stay at Green Mountain at Fox Run’s pioneering non-diet psychoeducational retreat, women who suffer with BED can immerse themselves in and practice a way of eating, moving and living that fosters lasting recovery.
For more information on our program at Green Mountain at Fox Run, visit our website: https://www.fitwoman.com/therapy-services-eating-disorder/ or contact our specialists at 800.448.8106. You can also find us on Facebook, Twitter and Instagram.