Food Weight and Addiction
By Judy Dempewolff, Ph.D.
Many people in our culture, especially women, have issues regarding food. As a practicing clinical psychologist for over 30 years, I have helped a number if individuals find peace with their eating. Some of this work springs from my own personal experience of being anorexic in my teens, and then bulimic and a compulsive overeater in my twenties and early thirties. How did I make friends with food, and how do I help others find peace? What is some of the current understanding of the causes of disordered eating?
In reviewing current research on eating behavior, several themes emerge. Often issues concerning regulation of eating arise after an individual has been on a diet for a period of time. In other words, when you have been on a structured eating plan, imposed from the outside with “good” food and “bad” food, and then you go off that plan, you do not have a sense of your body, your desires, and your hunger. Once the structure is gone there is no internal mechanism to say “I am really hungry, I would like a cheese sandwich, and if I get full before I finish it I can put it aside”. Many of my clients, whether they are anorexic or overweight, have no actual experience of hunger – true stomach hunger. The anorexic has denied her hunger for so long that it isn’t relevant to her, and the person who compulsively overeats never allows herself to reach true stomach hunger. In fact, sometimes she is very afraid to feel hungry.
So the first step in beginning to find peace with food is to come back to your self - back to your body, your needs. A book published in the 1960s was called the Psychologist’s Eat Anything Diet.1 It was not really a diet at all, but a call to return to listening – to your hunger or fullness, as well as to your emotions. It discussed foods that hum and foods that beckon. The beckoning foods are those that call to you when you open the refrigerator, or when you pass by a bakery. Once you have moved along you forget about them. The humming foods stay with you – maybe even for a day or two – until you have them. Sometimes you may deny yourself those foods and eat around them, ingesting twice as much with half the satisfaction. If you listen to your own needs and desires, the humming foods will satisfy you to the point of not needing very much.
When I first read about this and put it into practice I ended up having ice cream for supper for a week. Not just any ice cream, but homemade ice cream from a local dairy. It had been a binge food, but once I allowed myself to eat it I was able to thoroughly enjoy it and stop when I was full, knowing that I could HAVE IT AGAIN ANY TIME I WANTED IT. This point is critical, since the deprivation model says “I better eat as much as I can right now, because tomorrow I will not be able to have any”. Once it is allowed, and no longer forbidden, it begins to lose its charge.
A second theme that relates to both food and other addictions such as drugs and alcohol is something called Alexithymia.2 This refers to a difficulty in identifying and naming feelings. I think of addictions as great shields from feelings, but some people even have trouble noticing and naming feelings. For some it even extends to feeling the body, where emotions originate. Many of my clients find emotions threatening and unruly. Food is a great agent for blocking feelings and shutting them down. Biochemically, carbohydrates create a sedative effect on the brain, in a similar way to drugs and alcohol. If an individual has had trauma or unpleasant emotional memories, they may even be less willing to experience emotions for fear they will get “out of hand”. Research talks about “emotional eating”, but I would define it as eating to avoid emotions, to block them. Thinking about what you have eaten and what you haven’t eaten is a way of avoiding the bigger, more difficult and messy parts of your life. Addictions have a similar function.
Therapy necessarily involves helping the individual identify emotions – sadness, anger, fear – and expressing these feelings either by writing them3 or saying them. Often a client has not cried in years, and finds herself using most of my tissue box in therapy. And she also realizes that at some point, she stops crying – it doesn’t go on forever. I often talk about the “urge to eat” as a signal that there is an emotional need. If a client can begin to “put a wedge” between the urge and the action of eating by identifying that need, she may begin to feel that she has a choice. She may still choose to eat, which is fine. But sometimes she may realize she needs to get some air and take a walk, or tell her husband she is irritated about something, or write about her sadness. And then, sometimes, the urge to eat disappears.
Awareness of the body goes along with emotions – we all have a place where anger lives. For some it is the chest, for others the arms. Sadness may begin in the stomach, or the eyes. Fear could dwell in the throat, or the thighs. It is amazingly useful to make friends with your body – to begin to identify different states of tension and relaxation. Tension itself can be knotted or electric, hot or cold. All of these distinctions help an individual pay attention to the subtle rhythms and messages provided for us by our body. Any massage therapist knows that in the midst of giving a massage a specific area might be touched and the client will burst into tears, or begin to verbally express irritation or anger. Emotions that are initially not identified or expressed are often lodged in the muscles and tissues of the body. Massage can be a means to begin to move them out of the physical space where they have been stored.
If a person is very overweight, aerobic exercise is difficult for her in the beginning. But just acquainting herself with her body through Yoga or Pilates can begin to help erase the negative messages she has been telling herself about her capability for exercise. Establishing a routine, even for 15 minutes a day, is a place to start. Later on she can begin to add to the routine, when her body begins to need the exercise every day. Aerobic exercise for 30 minutes a day has huge benefits to the individual making peace with food and eating. It releases endorphins that last throughout the day, and has been found to decrease hunger and actually work better than the leading antidepressant for feeling positive and energized.
When addiction is defined as a love affair with the substance to the exclusion of interpersonal connectedness, eating disturbances certainly qualify.5 Addiction can also be defined as compulsive use, loss of control, and continued use despite adverse consequences. This certainly applies to compulsive overeating and to bulimia. What about Anorexia? Certainly sustained reduction of calories activates neuro-chemical systems that are rewarding and which actually encourage further restriction to maintain the “high”. The same can be said for overconsumption of various foods, especially sugars and carbohydrates.
Working with those with eating issues requires tremendous respect for their symptoms, and their experience. A balance between all aspects of this issue is necessary. Part of increased awareness involves paying attention to different foods and how they affect you. It is an experiment in listening to your body and learning about your reactions to things like sugar, caffeine, and pasta. Becoming intimately aware of your own physical and psychological reactions is much different than following the latest pronouncement that “sugar is poison” or “carbs are all bad for you”. Your own body and mind will be your guide.
And most importantly, why is it that our culture has a predominance of eating disorders of all types, especially anorexia? What do the media tell us about ideal body image, especially for women? Certainly female celebrities are valued for losing weight, and their images and lifestyles are exposed for all to see. Women find it extraordinarily difficult to maintain a positive sense of self if they are always looking at “perfect” bodies and faces. Women often complain that they never feel good enough, and they are always comparing themselves to someone who is thinner, has better hair, a better shape. Looking outside yourself for corroboration of attractiveness, comparing with the “ideal” means that you would trade all of you for that perfect body. But would you trade everything? Most women, when they think about it, say they would not. They like their generosity, or their eyes, or their assertiveness. They would not trade those things. The only way to combat the media image of rightness, of perfection, is to avoid looking at the magazines and the TV shows that promote the creation of the perfect “look”. Instead, look around you. See the beauty in varieties of human form. We don’t look at trees and say “that one is too thin, that one too large”. They are all unique. In Fiji, before television was introduced, women were content with their body images and sizes. After the advent of television and print media, body dissatisfaction and disordered eating increased significantly.
We are talking about many factors that contribute to food-related issues in our culture. Many professionals talk about different parts of the puzzle as the solution, as if they were describing an elephant by only its tail, leg or trunk. A more holistic approach looks at many aspects of eating disturbances, and combines the approaches of body and hunger awareness, massage, exercise, identification and expression of emotions, and beliefs about what is “good” and “bad” food and eating. Acupuncture and herbal supplements can also be of benefit, in addition to the therapeutic work. And above all, cultural norms of beauty need to be confronted and dismantled.
References
The Psychologist’s Eat-Anything Diet, Pearson, Leonard and Pearson, Lillian. Wyden, Inc. Publishers, NY, 1973.
Emotion-Processing Deficits in Eating Disorders, ; Corcos, Maurice; Jeammet, Philippe; Paterniti, Sabrina; Berthoz, Sylvie; Laurier, Catherine; Chambry, Jean; Consoli, Silla M, International Journal of Eating Disorders. Vol 37(4), May 2005, pp. 321-329
Emotion Awareness and Identification Skills in Adolescent Girls with Bulimia Nervosa, Sim, Leslie; Zeman, Janice, Journal of Clinical Child and Adolescent Psychology. Vol. 33(4), Dec. 2004, pp. 760-771.
Training in Emotion Regulation as a Treatment for Binge Eating: A Preliminary Study, Blampied, Neville M, Behaviour Change. Vol 21(4), 2004, pp. 269-281
Negative emotion and disordered eating among obese college students, Yates, Alayne; Aruguete, Mara S; DeBord, Kurt A., Eating Behaviors. Vol 6(4), Dec 2005, pp. 308-317.
Free Association Reconsidered: The Talking Cure, The Writing Cure, Farber, Sharon K.,Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry. Vol 33(2), Sum 2005, pp. 249-273
Eating disorders in women and children: Prevention, stress management, and treatment, DuBose, Lucy Ramsey
Exercise and mood: A selective review and synthesis of research employing the profile of mood states, Berger, Bonnie G; Motl, Robert W, Journal of Applied Sport Psychology. Vol 12(1), Mar 2000, pp. 69-92.
The eating disorders as addiction: A psychobiological perspective. Davis, Caroline; Claridge, Gordon. Addictive Behaviors. Vol 23(4), Jul-Aug 1998, pp. 463-475
Handbook of addictive disorders: A practical guide to diagnosis and treatment. Coombs, Robert Holman (Ed). (2004). (pp. 275-311). Hoboken, NJ, US: John Wiley & Sons, Inc. xvi, 584 pp.
Television, disordered eating, and young women in Fiji: Negotiating body image and identity during rapid social change. Becker, Anne E. Culture, Medicine and Psychiatry. Vol 28(4), Dec 2004, pp. 533-559.
*The statements contained in this article have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.