Before I begin this post, I want to say that I’m not a nutritionist, a personal trainer, or an MD. This post is not to be taken as medical advice about how to lose or gain weight, or how to have an ideal diet. Please know that these are my own opinions about the issue of weight as it relates to recovery, and this does not substitute for nutritional advice.
Although the issue of weight in recovery will affect everyone differently, I think that wanting to lose weight and actively trying to do that while also trying to stop binge eating can complicate things. Some bulimics may fear recovery because they worry that life without purging will inevitably lead to weight gain; some of those with BED may fear recovery because they are overwhelmed at the thought of losing the weight gained from binge eating. I strongly feel that anyone who wants to quit binge eating – regardless of how much they weigh or how much they desire to weigh – should try not to focus on weight loss until long after binge eating stops.
There are two primary reasons why I feel this way:
1.) Weight will likely take care of itself after binge eating stops.
For me, stopping the binge eating was all I needed to do to lose weight. My metabolism started working the way it should and there was no need to try to shed those extra pounds. I believe this is the case for the vast majority of people with BED or non-purging bulimia, and even most bulimics who self-induce vomiting. Some people seem to think that extra weight from binge eating just stays there until you do something (diet/exercise) to make it come off, but that’s usually not true. Some patience may be needed while the body regulates itself, but pounds should come off by stopping binge eating alone. Here is why I think it happened for me and can happen for others:
Caloric expenditure increases with body weight (overweight people burn more calories per day than slender people). The reason is because it requires more energy to carry around extra weight, and extra surface area also means more energy lost as heat. For example, one study showed that slender people used 2,481 calories per day, and obese people used 3,162.* This fact comes to the aid of those who have gained weight from binge eating, and let me explain that using myself as an example:
I was about 20 pounds above my natural weight when I stopped binge eating. My normal diet was about 2,300 calories, but with the binges added (let’s say approximately 4 binges per week, around 8,000 calories each), it upped my weekly caloric intake by 32,000 calories. Spread that out over 7 days, and my daily average was around 6,870 calories. Yes, I was exercising frantically to try to compensate for that, but my “purging” only burned a minimal amount of all of those calories. Even if I would have been dieting restrictively between binges (which I was doing in the earlier years of my bulimia) – eating let’s say only 1,000 non-binge calories each day, the daily average with the binges added would still be 5,570 calories. So, in short, quitting binge eating obviously reduces calorie intake…big time.
What about those who think they are “getting rid of” those binge calories by self-induced vomiting? It’s not much different logic there either. Most people who self-induce vomiting probably already know that it does not actually get rid of all of the binge calories. Studies have shown that calorie absorption may even begin much earlier in the body when you have bulimia – another one of the body’s natural ways of protecting itself. If you binge and self-induce vomiting, your daily calorie intake is likely still much greater than the number of calories you’d consume through a normal diet with no binge eating or purging. Another factor is: purging can slow down metabolism, so that calories a bulimic consumes are stored instead of being used as energy; but once the binge eating and purging stops, metabolism can get back to normal allowing for weight to regulate.
2.) If weight doesn’t take care of itself, you’ll be in a much better position to tackle the problem.
During the time that you are becoming binge-free, I think it’s also important to be aware that your lower brain might use a lack of weight loss as fuel for the binge urges. If you don’t see the scale dropping (and I wouldn’t even recommend getting on one during this time), you may hear thoughts like, “You are not losing weight so you might as well binge.” Rationally, you know how ridiculous that sounds, because obviously binge eating will only bring you further away from ever finding a solution to your weight issue; but in the moment, it can seem like a convincing thought. Always remember that you can stop binge eating for good even if you are not the weight you want to be.
We all come in all different shapes and sizes, and what’s a healthy weight for one person of a certain height might not be a healthy weight for another person of that same height, and I also believe it’s possible to be fit and healthy even if you technically overweight (I don’t think BMI is the best indicator of health); however, there are some who would unquestionably benefit from some weight loss. I don’t subscribe to the belief that we can be extremely overweight or obese, yet still be very healthy. (On a side note, I also don’t think being thin is a guarantee of health either. For example, belly fat on skinny people gives them some of the same health risks as obese people http://www.webmd.com/diet/features/the-risks-of-belly-fat.)
I am not against healthy weight loss, but I feel strongly that advice to simply restrict calories and eat low-fat/low-calorie food is completely misguided and does more harm than good (especially in those susceptible to binge eating), and just doesn’t work in the long run. I think binge eaters should avoid starvation (calorie-restrictive) diets at all costs. For example, I think the typical 1200-1400 cal/day weight loss diet for a woman is starvation, unless she is lying in bed all day and not moving at all. Low calorie diets lead to a slower metabolism, malnourishment (which some claim is one of the causes of obesity), and more weight gain in the long run. It’s also simply unrealistic to think you can maintain a 1,200 calorie per day diet to lose weight and then keep that weight off for life.
So, then how does one lose weight without restricting calories? First of all, when I say “don’t restrict,” I don’t mean eat excessively. I mean eat enough, eat to nourish yourself well, eat what your body needs. Of course, a bit of overeating happens from time to time even in normal people; but as a rule, daily intake should be within a normal range. That being said, I know that excessive eating isn’t usually to blame, and I definitely think there are a myriad of other problems that can contribute to not losing weight (for example: hormonal imbalances, insulin resistance, leptin resistence, food allergies/sensitivities, thyroid problems, infections, damage to the organs involved in metabolic control, too many toxins in the diet, not enough activity, too many processed foods, not enough water, not enough sleep, too much stress…etc).
If you go from binge eating to eating a normal diet, and you don’t eventually lose weight; then I believe it makes sense to look into what might be preventing that from happening. Reasons for not losing weight can be multifaceted, and science currently has an incomplete understanding of why some people can lose weight easily and for others, it’s a struggle; but I don’t think the complexity should prevent us from looking for answers.
I believe that making some changes to the composition of one’s diet (without letting it become an obsession and still allowing for flexibility) can help many, and is a much better approach than simply slashing calories. Focusing on eating a lot of nutrient dense, nourishing foods can lead to more weight loss in the long run without ever putting the body in “starvation mode.” Everyone is different, and some people might find that changing diet composition to make it more “paleo” helps them feel better and lose weight, while others find that eating more “vegan” foods help then achieve the same results. I also am a big advocate of healthy exercise as a way to achieve weight loss, although I think it should be enjoyable as well.
In my opinion, the goal for anyone trying to lose weight, whether they have a history of an eating disorder or not, should be to gain better health, not to simply lose weight fast. I think when people are truly focused on becoming healthier, it becomes an effort to nourish the body well, to feel better, to gain energy for living, to prevent disease; and it ceases to be about how many pounds they can lose or what size jeans they can fit into. And, usually, if one focuses on becoming healthier (and he/she does need to lose weight) the weight will come off naturally. In those who desperately want to be super-thin, focusing on health can help them realize that trying to maintain an unnatural weight is not good for their body. Focusing on health can also allow them to appreciate food for it’s nourishing qualities, without worrying about how many calories foods contain or if they can possibly lead to weight gain.
But focusing on health is usually not possible when binge eating is still occurring, because when you fundamentally feel like you don’t have control of what or how much you eat at times, it’s hard to implement healthy changes. This is why I believe those who want to quit binge eating should not address weight issues until after recovery.
Improvements in health, weight, and attitudes toward your weight are just some of the positive changes that recovery can free you up to make.
*Leibel RL et al. Changes in energy expenditure resulting from altered body weight. N Eng J Med. 1995 Mar 9;332(10):621-8