As I mentioned last week, this is a book that has changed my life. I was about a quarter of the way through when I realized I hadn’t been this excited about a book since Natalia’s. I emailed the books author, Kathryn Hansen, and she was kind enough to agree to an interview. If you have struggled with bulimia or binge eating disorder, I have no higher recommendations than Brain Over Binge. More thoughts to come but until then…
1. How long were you a binge eater, how did it start, and what methods were you attempting to heal with before you were actually cured?
My eating disorder started when I was 15 like most eating disorders do – with a diet. The more I cut back on my food intake, the more I wanted to eat, until one day when I was 17 I binged for the first time. My binge eating (and purging to compensate for the binge eating, which in my case was extreme exercise) increased gradually until it became a life-consuming habit, and it continued for 6 years.
I didn’t feel I could stop my behavior on my own, so I sought therapy a little over a year after my binge eating began. In therapy, I learned the common theme of most conventional eating disorder treatment: eating disorders are not about food. I learned that my binge eating was instead a symptom of psychological problems and underlying issues like depression, anxiety, low self-esteem, and family conflicts. I learned that my destructive eating behavior signaled an inner emotional crisis, just as fever signals an underlying infection. I learned that my bulimia was a coping mechanism that I used to deal with difficult issues and feelings, and that my eating disorder filled an important need or void in my life—a need that was much more than physical.
My attempts to recover were a combination of psychodynamic therapy (addressing those supposed underlying issues, and trying to uncover the theoretical root causes of my binge eating); cognitive behavioral therapy (trying to change harmful thoughts about food/weight and attempting to deal with the “triggers” of my binge episodes); nutritional counseling; and to a much lesser extent – addiction treatment (avoiding foods I believed I was addicted to).
2. What did you learn that lead you to stop bingeing for good?
The most important thing I had to learn to recover was that there was nothing wrong with me. I was not diseased, or psychologically or emotionally unwell. I’d simply become a temporary become a victim of my own healthy brain—a brain that was only doing its job through all the years I was bulimic. I had to dismiss the belief that I binged to cope with problems and emotions, and instead learn how my brain worked to drive my destructive behavior.
My brain drove my binge eating by sending out strong urges to binge—which included all the thoughts, feelings, sensations, and cravings that led me to the refrigerator, pantry, or the nearest fast food restaurant. These urges to binge were the one and only cause of each and every binge, from my first binge to my last. If I’d never had urges to binge, I never would have binged. It was that simple. My urges to binge were not symptoms of anything; they were the problem, the only reason I was bulimic.
My urges to binge were generated in the more primitive regions of my brain—that is, in lower brain regions—the regions responsible for survival and automatic behavior. The urges first appeared when I was dieting because of survival instincts, and the urges continued because my repeated binge eating conditioned a habit into my brain. Binge eating is highly habit forming because it is rewarding and reinforcing to the lower brain centers; and furthermore, the highly palatable foods I typically binged on (foods high in sugar, carbohydrates, and fat) changed my brain chemistry to create temporary pleasurable effects that I became dependent on.
Through all the years I was bulimic, I knew binge eating was not what I truly wanted to do. The urges to binge felt like a terrible intrusion in my life, ruining any hope I had for normal college and young adult years, and driving me to do shameful and disgusting things. Even though I wanted to quit, I couldn’t just say, OK, brain, I don’t want to binge anymore, so turn off those irresistible urges. It didn’t work that way. Once my habit was established, there was no way to turn off my urges except to re-train my brain so that it stopped producing those urges in the first place. To do this was straightforward: I had to stop following my urges to binge. That was the simple truth that often eluded me in therapy as I was focusing on the deeper emotional meaning of my binge eating.
The good news for me was, when it comes to the brain, what you no longer use, you lose—not in a metaphorical sense, but in a real, physical way. The brain is an extremely efficient organ. It builds and fuels the neural connections and pathways that are frequently used, and it weakens and prunes the ones that aren’t. From the first time I had an urge to binge and didn’t act on it, I began teaching my brain that my habit was no longer necessary. In turn, my brain began to weaken the neural connections and pathways that supported the habit, and gradually shut off my urges to binge.
But, how did I stop acting on my urges?
There were five things I did that allowed me to refrain from following urges to binge:
1.) I viewed my urges to binge as neurological junk. (This means I quit believing the urges signaled a real need—physical or emotional—and stopped assigning the urges any value whatsoever. I viewed them as automatic brain messages—generated in my lower brain—that had absolutely no significance.)
2.) I separated my highest human brain from my urges. (This means I realized the urges weren’t really me, but instead were generated in brain regions inferior to my true self. My true self resided in my prefrontal cortex—my highest human brain—and it gave me the ability to say “no” to binge eating. I had to know my urges were powerless to make me binge, and my true self had ultimate control over my voluntary actions.)
3.) I stopped reacting to my urges. (This means I stopped letting my urges to binge affect me emotionally. I simply let them come and go without getting wrapped up in them. This made the urges tolerable and actually easy to resist.)
4.) I stopped acting on my urges. (This was the cure for my bulimia, made possible by the three steps above. I didn’t have to substitute any other behavior or emotionally satisfying activity for binge eating. I only had to refrain from binge eating.)
5.) I got excited. (This was a bonus. By rejoicing in my success, I sped along the brain changes that erased my bulimia.)
3. What do you think your life would be like if you had never come across this information?
At the time I recovered, I was on my way from being bulimic (binge eating and purging through extreme exercise) to having binge eating disorder (binge eating without purging), because my exercise routines were becoming too exhausting to keep up. I believe I would have continued to gain an unhealthy amount of weight, and I would have surely experienced many physiological and psychological consequences – likely including an increase in depression, anxiety, social withdrawal, fatigue, and gastrointestinal symptoms.
Today, I have 3 children and another one on the way, and I don’t think that would have been a possibility if I would have continued binge eating. It does make me sad to think about what my life may have been like had I not some across some useful information; however, I do want to mention that I do not believe what worked for me is the only way to recover. I’d like to hope that I would have eventually found a way to overcome my urges before my binge eating wasted too much more of my life.
4. How do you feel traditional forms of therapy failed you?
Let me start by saying that traditional therapy does help some people, and I’m not trying to take away what works for others. I am only explaining why it didn’t work for me, and offering an alternative voice for those like me who are not healed by traditional forms of therapy, and for those who are unable or unwilling to receive it.
Therapy failed me because it did not target my problem directly. Instead, my therapists tried to cure me in round-about way, addressing all sorts of issues that didn’t have much to do with my real problem—binge eating. No one told me I had the power to quit binge eating anytime I chose. Instead, I learned I didn’t have much control over my own behavior; that is, until I addressed the underlying emotional issues. So, I set out on a path of self-discovery, hoping to find some answers to why I binged, hoping that if I made some changes in my life, healed past hurts, or built new relationships, the incredible urges to binge would go away. I learned ways to deal with depression, reduce anxiety, and build healthy self-esteem. I worked on my nutrition, battled my perfectionism, and learned to cope with the events and feelings that supposedly triggered my binge eating episodes. I tried to figure out what purpose the bulimia served in my life. But all the while, I continued to binge and purge.
The view of my bulimia as a complicated problem that helped me fill some sort of emotional need gave me countless excuses to indulge my habit and countless reasons to avoid responsibility for my own actions. When I believed I was binge eating to deal with depression, cope with anxiety, avoid feelings and problems,ease pain from the past, or because I had a disease; it gave me all the more reason to go ahead and binge. In this way, I think therapy actually prolonged my recovery and made the recovery process much more complex than it needed to be in my case.
5. What sort of advice do you give to someone who resonates with your approach but is still struggling? After so many people have read your book, are there any common questions readers have?
I have heard from many readers who have followed the same approach and recovered for good, and I have also heard from some who have had trouble putting it into practice. I recently wrote a blog post titled “Tips for Beginners” to help those who resonate with the approach but are still struggling. Three of the common issues that hinder people are: 1.) They are still depriving the body of necessary calories, which can cause urges to be more difficult to resist, 2.) They aren’t sure they truly want to quit, and 3.) They are having trouble detaching/separating the true self from the lower brain.
The most common questions I get from readers are: how do I eat normally again after binge eating stops? and how do I address weight gain from binge eating? I’ve tried to address these common questions in my blog, specifically through the following posts: “Weight After Recovery”, “Non-Hungry Cravings” , and a blog post about my own diet when I recovered.
6. Before your book I read in many eating-disorder style books that we should never restrict anything, or omit any food from our diets or we’re guaranteed to binge on it. On some level I believed this so yes, it lead to bingeing. What are your thoughts on someone who wants to take on a healthy diet/lifestyle that may omit certain foods (processed foods, etc)?
I certainly don’t believe that omitting something from your diet guarantees that you will binge on it. There seems to be a divide in the eating disorder community with the majority of eating disorder experts saying that we should not omit any foods, but other treatment groups – like Food Addicts Anonymous, and Overeaters Anonymous – saying that eliminating problematic foods is necessary for recovery. Quite simply, I don’t believe that the types of food you eat or don’t eat cause binge eating – the urges to binge cause binge eating.
Might eliminating a certain food – or on the flip side, eating a certain food – lead to an urge to binge? Absolutely. But, we always remain in control of what we do when we experience an urge to binge. So, whether you chose to eliminate certain foods for health reasons or not, it doesn’t have to affect recovery. I personally believe that, when recovering from binge eating, it’s most helpful to allow all types of foods in moderation so that you can de-condition associations between eating certain foods and binge eating. The good news is: when you feel you can control yourself around any food, you are free to make any dietary changes you see fit.
I am trying to keep a narrow focus on using my own experience to help people stop binge eating, not necessarily to have a perfect diet or maintain a perfect weight, because I am not an expert in those areas. However, I will mention a few things I personally believe are important to remember if someone wants to implement healthy dietary changes. First, I think it’s very important to make sure to eat enough. It’s easy to become overzealous about a healthy diet, and in so doing, deprive the body of necessary calories, which can lead to strong survival-driven cravings and even urges to binge. Second, I think it’s helpful to remember that the body and brain will likely protest even a healthy change in diet. We become accustomed to eating certain types of food, and even though avoiding them might be beneficial, the body/brain may still react with strong cravings for the foods we are used to. However, if we can stick with it, healthier eating habits will become the norm, and cravings for the unhealthy habits will subside.
The third thing I think is important to remember is that maintaining an extremely healthy diet is difficult, so I think it’s important to cut yourself some slack if you can’t always eat perfectly. I think having the mindset that you can never “break” your healthy diet can cause some people unwanted stress, and it can also lead to a tendency to overindulge when they do eat something that’s not healthy. Sure, you might chose to have some processed food now and then even while trying to lead a healthy lifestyle; but it doesn’t have to lead to overeating or binge eating.