When Amanda was especially desperate, she would say she had to get something from the pantry and then hide there for five minutes, cramming cereal or a loaf of bread into her mouth as fast as she could, terrified someone would walk in on her and guilty and ashamed that she couldn’t stop herself.
Or, if she had time alone, often at night when her husband and children were in bed, the “shoving” would go on for an hour or longer, sometimes moving from food to food “until you just physically couldn’t do it anymore,” she says. The fullness was painful as well as humiliating.
She never made herself throw up, and it never entered her mind that not only did she have an eating disorder, she was struggling with what’s thought to be the most common eating disorder — bingeing.
“I knew I was eating a lot of food, but you’re not even aware on one level. You just keep putting it in your mouth as fast as you can,” never tasting or enjoying anything, says Amanda, a 38-year-old Niles mother of three, who has asked that her real name not be used for this story.
“It’s always done in secret; there’s never anyone around,” she says, adding that even her husband doesn’t have a clear understanding of what she does. “You’re in a panicked, altered state.”
It could happen as often as three or four times a week after any number of stressful events: an argument with a family member, social situations, failing to stick to a diet, being overly hungry because she’d been dieting. Even happiness could be too much to handle.
“That was my coping mechanism for whatever situation I was in,” she says. “It’s when I’m feeling bad or inadequate about myself. It’s self-punishment.” Or, “it could be a reward after a diet that turns into a binge,” she adds.
Every day she vowed never to do it again, and every day she was devastated when she couldn’t keep her promises to herself.
“I thought it was a willpower thing,” she says. “But it’s really not that simple. You can’t just say one day, ‘I just won’t do this anymore.’ ”
Instead, Amanda found help by joining a therapy group led by University of Notre Dame psychology researcher Lora Smitham. Based on the book “Intuitive Eating,” herprogram teaches participants to reject dieting, release their guilt and listen to and respect their bodies.
Amanda started the sessions just before Thanksgiving and finished in early February.
With the help of the group, her urge to binge has decreased to about once a week. And when she does eat for emotional reasons, she eats about a quarter of the amount she used to binge on, which is exciting progress, she says.
“It’s learning to love yourself and saying before you start, ‘Hey you’re going to have a binge and this is not going to make you feel better later,” she says. “It’s learning to ask ‘What else do I need to do, where else do I need to turn before I turn to the food?’”
The program “really gave me my freedom and my life back,” Amanda says. “I didn’t have a way out.”
Unique challenges
Not seeing a way out is a typical way of thinking for people who binge-eat, researcher Smitham says about the cycle of bingeing.
“Maybe the person originally starts bingeing because of emotional reasons or because of a diet,” she says. “But once they binge, they try to restrict themselves by eating less. And then that restriction in itself drives the future binge.”
Other unique complexities of bingeing make it not only difficult to stop, but difficult to get help.
“This disorder is under-recognized even by the people who have it,” Smitham says. She describes bingeing as an activity that can be largely “unconscious,” after which people “wake up” to discover what they’ve done.
This despite the fact that bingeing is thought to be the most common eating disorder as well as a long-lasting disorder. A 2007 Harvard Medical School study showed people with binge-eating disorder are affected an average of 8.1 years. In contrast, the average span of anorexia nervosa is 1.7 years and bulimia, 8.3 years, the study found.
Binge-eating disorder affects women slightly more than men, 60 percent to 40 percent, respectively, according to the National Institutes of Health. It’s thought that 2 percent to 5 percent of the general population are binge-eaters and that up to 15 percent of those who are obese suffer from the disorder.
Smitham says the actual number of binge-eaters likely is much higher, but because of the secretive nature of the disorder, it is well-hidden, even from spouses and family members who live in the same home.
That secrecy, and the accompanying feelings of shame, guilt and failure, presents another hurdle to getting help.
And perhaps the greatest challenge is getting people to understand that they need to let go of their dieting rules and distorted ideas about eating.
The irony of dieting
In other words, Smitham says, binge-eaters need to get back to “intuitive eating.” She decided to apply the concepts of the book to group therapy as a study for her doctoral thesis.
Written by nutritionists Evelyn Tribole and Elyse Resch, “Intuitive Eating” contends, with the backing of independent research, that diets are doomed to fail and actually can lead to weight gain, eating disorders and poor health. Instead, people need to understand and listen to their bodies’ wants and needs and eat in response to biological hunger instead of emotional hunger.
An “intuitive eater,” the book reads, “makes food choices without experiencing guilt or an ethical dilemma” and “honors hunger, respects fullness, enjoys the pleasure of eating.”
With permission from Tribole and Resch, Smitham developed an eight-week support group that taught the principles of the book and that offered therapy and discussion among those who binge-eat. The first groups started in November and the last are just finishing.
The preliminary results, which Smitham hopes to publish, have been impressive.
Of the 25 women who have completed the therapy, 84 percent would no longer be classified as having a binge-eating disorder. And though one of the requirements to be eligible to join the group was bingeing at least twice a week for six months, by the last week of the session, 64 percent of participants reported they had not binged that week.
Amanda decided to try Smitham’s group after seeing a request for participants in the South Bend Tribune and identifying with the definition of who’s considered a binge-eater. Until that point, she had no name for what she was doing and wasn’t sure there was help for it.
“At the first meeting, I felt excited, very nervous, though, because a lot of what she was asking us to do, my whole life was based on,” she says. “She was asking us to stop weighing ourselves, and I said ‘Are you kidding me?’
“And we had to stop dieting and stop counting calories. Our diet books had to be put away. And losing all that structure? I flipped out. That was what my whole life was based on. But I knew I had to do it.”
Smitham says the participants have been surprised at how ingrained dieting has become in their minds, and discovering why they binge also has been eye-opening. “It’s definitely different when the food kind of loses the power to soothe, but at the same time, everybody is discovering a lot about themselves.”
A support network
And they’re discovering the power and comfort of knowing they’re not alone.
“The most valuable part was meeting the other people and knowing someone was going through what you were,” says participant Meredith Terpeluk, 30, a Notre Dame graduate student. “You wanted to help each other. You wanted to learn from each other.”
Even though the therapy sessions are over, Terpeluk, Amanda and a few other women from their group still meet weekly. Their healing camaraderie is something that Terpeluk feels will be “part of my life forever.”
In fact, her lifelong struggles with her eating issues has inspired Terpeluk to devote her career to wellness issues including obesity and its causes after she finishes her master’s in nonprofit administration.
In coming forward with her problem, Terpeluk wants others to know that they don’t have to live with the feeling of being lost that binge-eating disorder brings.
“Because I wasn’t anorexic or bulimic, I didn’t think I had a problem,” she says. “I knew the term ‘binge and purge,’ but I didn’t know you could separate them.”
So, since childhood, Terpeluk never had a clear understanding of the force that would make her turn down friends to spend an evening at home with a box of cereal, a jar of peanut butter or plate after plate of pasta.
“A lot of it is perfectionism,” says the marathon runner and former employee at the White House. “Everything goes back to your weight. When you feel stress, you think the fix is to fix your weight.”
After taking part in the support group, Terpeluk is bingeing less often and on less food — instead of two or three times a week, it’s once every 10 days on average, she estimates.
“I’m a lot nicer to myself,” she says. “I tell myself, ‘You have a lot of stress right now. Quit beating yourself up. I just look at it and say ‘It’s OK.’”
Now, she’s motivated to run to relieve stress and take care of her body instead of to compensate for bingeing episodes as she’d done during the past 12 years.
And she’s allowing herself to experience her true feelings instead of numbing them with food.
Recently, she’s gone through a significant, personal life change that would have caused bingeing in the past.
But, “I didn’t turn to the food,” Terpeluk says. “I sat down with my feelings and I cried. My friend said, ‘I think it’s great that you’re crying. The flood gates are opening.’”
