Hunger in binge eating recovery podcast

Episode 62: Fear of Hunger in Binge Eating Recovery

Fasting binge eating

Not So Fast: Guest Post from Gillian Riley

It seems that fasting has become the new standard of dieting, and also a central focus of the health community as well. Like most diets, it’s presented as the answer (or at least a partial solution) to many health and weight issues, and even as a potential solution for binge eating.

The new year is a popular time for people to go on diets, and I’m sure you know more than one person in your life who is on a fasting-type diet. I also know that fasting can be portrayed as “not a diet at all,” but as a lifestyle and way of eating that’s “more in line with how our bodies are designed.” These are complex issues, and although I would not make an overarching statement that binge eaters or recovered binge eaters can never fast under any circumstances, I think there are many compelling reasons not to.

I get a lot of questions about fasting, and although I’ve addressed it to some extent, I want to share a guest post today from Gillian Riley, who has great advice about this topic. Gillian is the author of Ditching Diets, which I recommend on the FAQ page of this website, and I also cited Gillian’s work in my second book, the Brain over Binge Recovery Guide. You can read more about Gillian in her bio at the end of this post. As you read, know that Gillian doesn’t write specifically for binge eaters, but for anyone who struggles with poor eating habits, yo-yo dieting, and overeating. However, what she says is also applicable to those of you who binge, and I hope you find her well-informed guest post helpful.

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NOT SO FAST (by Gillian Riley)

When it was published in 2013, I bought a copy of the bestseller The Fast Diet to see what it was all about. In case you don’t know, it was published as a result of the interest in the BBC Horizon documentary about Intermittent Fasting (IF), written by the program presenter Dr Michael Mosley and journalist Mimi Spencer.

I believe that fasting is beneficial, but not necessarily advisable for everyone, so I wanted to read the book to discover new information and research, but also, I was curious to see if it contained any words of caution. There are words of caution about fasting; a paragraph on page 124 warns those with Type 1 diabetes not too fast, those with an eating disorder, children, and those who are already very slim. And anyone with any medical condition should consult a doctor first.

If you bought a copy of my book, Eating Less, between 1998 and the first half of 2005, you’ve got an edition that contains a chapter on fasting once a week. As well as instructions on how to fast in a non-addictive way, I describe some good reasons not too fast. In later editions, I took out all mention of fasting, partly because people weren’t paying any attention to those reasons. Perhaps it’s time now to put them back in (if I could) but here’s how they appeared in those first editions of Eating Less:

  • It’s not a good idea to fast if you are desperate to lose weight, or if you have a history of anorexia or bulimia.
  • It’s not a good idea to fast if you have a tendency to overeat either before or after a fast.
  • It’s not a good idea to fast if you go on a fast as a way to take control of your overeating.
  • It’s not a good idea to fast if you are not in the best of health, if you’re coming down with an illness or recovering from one, or if you suffer from a condition such as diabetes or hypoglycemia.
  • It’s not a good idea to fast if you don’t normally eat a high-quality diet at other times.

This has some similarity with Mosley and Spencer’s cautions, but also some differences. In particular, my caution not to fast if you don’t normally eat high-quality food would seem to contradict their advice to “eat what you like most of the time”. However, Mosley and Spencer say,

“You could pig out on your non-fast days…but you won’t do that. In all likelihood, you’ll remain gently, intuitively attentive to your calorie intake, almost without noticing. Similarly, you may find yourself naturally favouring healthier foods once your palate is modified by your occasional fasts. So yes, eat freely, forbid nothing, but trust your body to say ‘when’.”

So they seem to be saying that it’s fine to eat anything at all on non-fast days, but once you’ve started fasting you’ll end up eating healthy food anyway.

Now, I’m a great advocate of an if-it-ain’t-broke-don’t-fix-it approach to everything, so if IF works for you, that’s wonderful. But all too often people struggle with such advice – and they blame themselves. They conclude, “for everybody else, fasting two days a week is not only fairly straightforward, but also sorts out all the rest of their crazy eating on the other five days. What’s wrong with me that I can’t even begin to do this?”

Maybe it’s not that fasting isn’t a good idea, but that there are other important steps for you to take first. To return to my cautions:

  • It’s not a good idea to fast if you are desperate to lose weight, or if you have a history of anorexia or bulimia. Note that both authors of The Fast Diet took on fasting entirely for health reasons. The health benefits of fasting – such as dipping into ketosis from time to time and the fascinating process of autophagy – are well established (1, 2). There’s also impressive research showing a beneficial impact on brain health (3). But Mosley and Spencer seem oblivious to the fact that many people will be motivated to fast primarily to improve their appearance, and this makes a massive difference.
  • It’s not a good idea to fast if you have a tendency to overeat either before or after a fast – and – It’s not a good idea to fast if you go on a fast as a way to take control of your overeating. It’s clear that neither of the authors have ever had an addictive relationship with food – what many people call ‘food issues’. The research they cite on the success of IF from the University of Chicago studied just 16 obese people over 10 weeks. (4) I’m sure you know of people who complied with various protocols for at least 10 weeks and then regained their weight in the longer term. They were able to ‘be good’ and ‘follow the rules’ for a while, but this simply doesn’t last for the majority. I’m not saying that fasting is a bad idea; I’m saying it might not provide a complete and permanent solution for everyone who generally overeats.
  • It’s not a good idea to fast if you are not in the best of health, if you’re coming down with an illness or recovering from one, or if you suffer from a condition such as diabetes or hypoglycemia. I’m no expert on these health issues, but I’m not at all sure that fasting is good for those with Type 2 diabetes and especially hypoglycemia. This is why those with diabetes are exempt from fasting on religious occasions such as Ramadan.
  • It’s not a good idea to fast if you don’t normally eat a high-quality diet at other times. This of course depends on what you call a high-quality diet, but my view would be low on the starchy carbohydrates such as grain-based foods and sugars. It’s important for your body to be very well nourished through eating the most nutrient-dense foods, so that it doesn’t go into ‘scarcity mode’ during a fast. In addition, fasting works much better in every way if your body has developed the ability to burn fat for energy, rather than only carbohydrate. If you normally burn only carbohydrate, you may struggle much more with hunger and low energy during a fast. (5)

I’ll add that if you exercise a great deal, if you regularly sleep badly, and/or if you are under quite a bit of stress, these also mean that fasting may not be right for you at the present time.

I suspect all this is sounding a bit negative, and the last thing I want to do is to dissuade you from fasting if it’s going to work for you. By all means give it a try. Notice and manage your addictive desire to eat and you can certainly find that it fits in very well with everything you’ve learned in my books and webinars.

The Fast Diet does advise against fasting for those with an eating disorder, and I agree with this. I’d take it further, though, because there are a great many people who have a tendency towards disordered eating who would do well to sort that out first, before considering a fast of any kind.

BIO

Gillian Riley is an author and webinar host who has been teaching her course on “Taking Control of Overeating” since 1997, at first in groups in London, England, and for the past three years online.
Her clients describe themselves as yo-yo dieters or ex-dieters. Instead of recommending what, how much and when to eat, Gillian teaches how to develop an entirely new attitude towards food, eating and weight loss. This way of thinking turns the diet mentality on its head, leading to a sustainable control of overeating.
Details on her free introductory webinars and one-week free trial of the membership site – starting January 26, 2020 – can be found at: https://eatinglessonline.com
NOTES

1. “Targeting insulin inhibition as a metabolic therapy in advanced cancer.” Fine EJ, Segal-Isaacson CJ et al (2012) Nutrition 28(10):1028-35
2. “The effects of calorie restriction on autophagy.” Chung KW, Chung HY (2019) Nutrients Dec 2;11(12)
3. “Meal size and frequency affect neuronal plasticity and vulnerability to disease: cellular and molecular mechanisms.” Mattson MP, Duan W, Guo Z (2003) Journal of Neurochemistry 84(3):417-31
4. “Dietary and physical activity adaptations to alternate day modified fasting: implications for optimal weight loss.” Klempel MC, Bhutani S et al (2010) Nutrition Journal 9:35
5. “Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum.” Johnstone AM, Horgan GW et al (2008) American Journal of Clinical Nutrition 87:44-55

Episode 54: Stop Purging in Binge Eating Recovery: Interview with Ali Kerr

Episode 53: What Can Hold You Back in Binge Eating Recovery, Part 2: Weight Obsession (Interview with Katherine Thomson, Ph.D.)

Pre-Therapy Journal Entry

I mentioned in a previous post that from time to time, I’d like to include old journal entries from my eating-disordered days. I wrote the following entry a couple months after I turned 18, about a week or two before my first appointment with a therapist regarding my binge eating/bulimia. I had been binge eating for about 7 months at the time of this entry, and the binges had been steadily increasing in frequency and quantity of food. It’s evident that, at the time I wrote this, I had not been introduced to the idea of emotional eating or binge eating as a coping mechanism. However, it seems I had a couple clear ideas of my own about my binge eating: 1.) It’s out of control, and 2.) I think I might like to binge, even thought I hate it’s effects.

At this point in my eating disorder, my strong cravings and urges to binge were the result of my survival instincts – the binges were an adaptive response to my extended and extreme dieting; and those urges were generated by my animal brain. However, all I knew at the time was that I couldn’t seem to control myself around food, and I hated myself for it. I didn’t realize that the part of me that “liked” binge eating wasn’t really me at all, but my lower brain, which was both driving me to protect myself from starvation and steadily becoming more and more addicted to the binges.Each time I binged, I cemented the pattern a bit more until it became habit, and my body and brain became dependent on large amounts of the very foods that were initially so attractive to my survival instincts (the sugar/fat/carbohydrate-laden ones that might be good for short-term survival but are impossible to thrive on long-term).

Oct. 1999,
I don’t know who I’m writing to or why I am writing, but I thought it might help me to get this out. Basically, I’m out of control. I can’t stop eating or thinking about food. I’ve been bingeing almost every other day. Since last night, I have been really really crazy. Before I went to bed, I had 3 bowls of cereal, 3 Nutri-Grain bars, 1 pudding cup, 1 bagel, a half a can of beans, a piece of cheese, a few handfuls of Fruity Pebbles, and 7 pieces of bread with butter. Then, I woke up at 12:30am and ate another pudding cup and a cup of milk, and another Nutri-Grain bar. Then, I woke up at 2:00am and ate another Nutri-Grain bar. Then, I woke up at 5:30am and had 2 more Nutri-Grain bars (totaling 7), a cup of milk, a cup of juice, then a piece of bread, then about 20 crackers, and a protein bar. I finally had to stop because it was time to go. [*I was leaving with my cross-country team to drive to South Carolina for a race, which was to take place the following day.The next part of this entry was written on the road with my team. I was sitting in the back of the team van, where no one could see my writing]

We just stopped at Cracker Barrel for lunch on our way to Clemson.I was still so full from last night so I decided to just order a turkey sandwich and a side of green beans. That would have been ok, but then I ate 2 pieces of cornbread & a biscuit as well. I was doing my best to eat slow and be normal, but I really just wanted to dig into everything. I’m like this almost all of the time now, and I don’t know why. Last night it was like I almostwanted to binge. After the first part of the binge that ended about 10:30pm, I actually felt good. But, then when I kept getting up at night and after lunch today, I just feel like a big failure. I spent so much time and energy and used so much self control to get down to this weight. And, now I’m ruining it. I weighed myself yesterday before dinner and I weighed 94, and I weighed myself this morning and I was 99. That’s absolutely ridiculous. 5 pounds in 1 night!

Do you think my body is just trying to tell me something? Or am I just crazy? Sometimes I feel like if I had a choice of what I wanted to do, I would choose to just sit in my room and stuff myself. I’ve actually gotten to the point where I enjoy it. After I binge, I just lay in bed and go to sleep. If I could just learn how to throw up, I could binge and not gain any weight.

I just need to stop being such a baby. It’s sad but sometimes I would rather eat than do anything.Every time I do it, I swear to myself that I’m never going to do it again, but I always do. Right now, I’m feeling so nauseous and sick, but if I were alone in my room, I know I would eat more. I need a babysitter 24/7. My parents and sister know some of what is going on, which is good. But, they don’t know how to help me.I told the sports psychologist about the problem this week and I went home after the appointment and binged. It was like the whole day, I just knew it was going to happen. I went to Wal-mart with [two of my friends] and I bought the Nutri-grain bars knowing I would probably end up eating a ton of them, but not thinking I would eat the whole box in one night.

I feel like no one eats as much as me in the entire world, but I’m skinnier than the majority of people I see. How is that? I know it’s going to catch up with me very soon if I keep this up. I hate myself so much right now.I just want to be normal. I just want to eat and forget about it. I don’t want to think about food all day long. I feel so alone.

I think this entry is very important because of my honesty – admitting that I liked the binges. This type of honesty was extremely rare in my journal entries after therapy, when I became convinced I binged for complicated emotional reasons and it was a coping mechanism for life’s problems. In later entries, I attributed the binges to feelings/stressors/daily events/issues rooted in my past; and rarely said what I said here – which was basically: “My cravings feel out of control, but you know what? … it feels good (temporarily) when I give in.” It only made sense that it felt good – of course there was great pleasure in the relief from self-imposed starvation!

The last paragraph in this entry is also telling in that I say I want to be normal. I didn’t want binge eating in my life, and therefore I was receptive to help – to therapy – which I began shortly after writing this. But, once I began therapy, I didn’t need to learn that all of this was a symptom of underlying emotional issues and spend years digging through and trying to resolve those issues. I needed to learn that I was starving, and my body and brain were reacting to try to protect me. I needed to learn that trying to maintain such a low weight was the cause of all this, and if I stubbornly continued to put my body in a calorie deficit, I’d likely be consumed indefinitely by my desire to binge.

I actually did learn that food restriction was part of the problem from my nutritionist, but even when I normalized my non-binge eating (which wasn’t too difficult because I was motivated to do it), the urges persisted. As I discuss in my book, this was due to the persistent nature of the survival instincts and also due to habit. Simply normalizing my diet wasn’t enough; therefore, I also needed to learn something else – how to resist each and every urge to binge in a way that worked for me.

In other words, I think my therapy – and the therapy for most bulimics/binge eaters – could be made simple, consisting of only 2 components:

1.) Learn to feed your body sufficiently

2.) Learn to resist urges to binge in a way that works for you.

I am not saying the exact same methods that helped me resist urges to binge will cure everyone; but I believe the key is finding what helps you say no to the binges and therefore decondition the habit…without making recovery unnecessarily complicated, time-consuming, and difficult.

*I want to apologize (again) for not keeping up with this blog as well as I would like. Taking care of my 3 young kids is my full time job, and I am definitely far from being a supermom! I’ll do the best I can to post more frequently.