Why therapy doesn’t work for many binge eaters

I realize now, way too late, that going to therapy for binge eating back when I was 23 was a mistake. I had no way of knowing where it would all head, not back then. I started ED in 1980. Most of you were not alive then, so allow me to explain. We didn’t know what anorexia was. We had no internet to look these things up nor was anorexia very common. No one spoke of it, ever. Bulimia had barely been invented and BED would not enter the DSM until 2013. Most clinicians did not know what binge eating was, and many didn’t know what anorexia was. I remember many of them couldn’t spell anorexia and they couldn’t spell bulimia, either. How was I to get help at all?

I didn’t know what caused it. I never found any clinicians, ever, who fully explained it to me….

After anorexia, your body is still recovering even if you are eating normally and even if your weight is okay. This goes on an average of nine years. During this time you will find that you binge now and then. This is not a disease, it is part of your body’s normal process.

For those who were never anorexic but find themselves binge eating, almost all were starving prior to the onset of bingeing. Either this was due to a diet or due to unavailability of nutritious food. Some were starving and never knew! This can happen at any weight.

Yes, binge eating is extremely uncomfortable and incapacitating. However, overly focusing on it in the form of therapy will likely make it worse. I don’t think therapy that doesn’t deal directly with the behavior is the answer, either. I think therapists that won’t talk about it are avoidant and possibly aren’t comfortable talking about food issues themselves. Or the ones I remember I had were like that. They would talk about anything but!

Overtalking about it will make you obsess about the behavior. It’s just like thinking too much about not sleeping will cause insomnia. Same deal. This is also why keeping a “food diary” can be quite defeating for many people. Never mind the therapists who insist on peeking at your food diary. I always felt violated when they did that. I usually didn’t want to admit this to the nicer therapists, either.

Seeing a competent nutritionist might be the way to go. Expect to shell out big bucks to find one that know his/her stuff. Some of the alternative ones, so-called, might be better, but many of those don’t know anything about ED whatsoever.

I found it helpful to talk to my acupuncturist, just talking helped me immensely. My first one, anyway, the next one I didn’t like as much. I would say my first acupuncturist was a terrific influence on me. I would like to write her a thank you. Back then I remember going and feeling like she was the only one who would listen. It felt hugely relieving to go. I had no social life back then. Acupuncture was it. She didn’t do therapy. She hated traditional medicine as much as I do now.  She would feel my pulses and look at my tongue and then ask me some very basic questions about how things were going. She was incredibly intuitive. She and her supervisor were the ones who recommended I report to the police, after I told them I’d been raped by my neighbor in 2008. They knew I wasn’t lying.

Sadly, my appointment with the cops happened after the acupuncturist graduated. I had no way to get in touch and I couldn’t use her as a validation witness. The police told me my story “sounded fabricated.” And that was that.

We do what we can do. I stopped bingeing after I stopped therapy.  After I stopped all mental health treatment and stopped calling myself a mental patient. It didn’t happen right away, but being free of “them” was a big deal for me, as I realized that after 33 years of therapy, totally wasting my life, I had finally done something right.

After that, I taught myself many things that have helped me. I found I didn’t need a therapist after all and that therapy was holding me back.

I love my life now. I think about other things, not ED. I have many goals and I manage to achieve some of them. I love working and earning money. Paychecks are starting to come in. The next big step will be to get off the disability rolls for good.

How to end binge eating, written by a person who suffered with binge eating for several decades

Hello, my name is Julie Greene. I am not a “mental health professional” so this isn’t “professional” advice. I cannot provide “medical advice” because I don’t have MD after my name.  Actually, I was a patient in the mental health system and a silent sufferer of eating disorders for over three decades, so I think that makes me a professional, in a way, due to having lived with it for so long. This is often called “lived experience.” You may try these suggestions if you wish, but be aware that they may not apply in your situation and they could, for some people, even be harmful.

I am just going to list what I have tried and state if the results. This list is a result of decades of trial and error on my part. I had only myself to experiment on. I found that “doctors” had a poor understanding of binge eating.  The DSM also has it all wrong even though binge eating disorder is now in there as a classification of mental disorders.

I myself suffered from binge eating in massive quantities. In other words, there was a clear distinction between what I did and “overeating,” which many people suffer from.  I needed to separate out “overweight” because I realized that the binge eating itself was the danger, not the resulting weight gain.

Given this, these are the things I tried, in no particular order:

1) Therapy. It never helped. In fact, it made me needy and dependent and did more harm than good. I was in therapy for decades and had over 20 different therapists. A few helped me in other ways but therapy never helped binge eating. I had different types of therapy, and after a while, these “cures” seemed to be designed for people who were immature or uneducated.

2) Psychiatric day treatment. It made me far worse.  I was in Options Day Treatment twice, NEWW Center twice, and the MAP/GAP programs at McLean once. None of these programs were at all helpful.  I went to a few other programs over the years but I don’t count them cuz I didn’t stay long. I wouldn’t recommend these programs to anyone.

3) Gould Farm. When I arrived at Gould Farm in 1984 I was told that they didn’t treat eating disorders and that they were going to ignore my eating disorder completely. I found their program to be grueling slave work and I hated it. I used to call my parents and beg them to put me in a hospital instead.

4) Hospitalization. I was in a hospital, that is, a psych ward a few times before Gould Farm and continued to end up on psych wards over a period of decades. What hospitalization did for the most part was to stop the binge eating for the time that I was hospitalized.  I began to see these places as refuge or safety. But the personnel there hardly understood what my problem was. Back in the 1980’s they said eating disorders were trivial problems that rich kids had. Until 1983 when Karen Carpenter died, the personnel in hospitals had no awareness of how dangerous eating disorders were. They had no clue how to deal with me and so they ignored my eating problems entirely. Even if I lost a bunch of weight while there. And the problem returned as soon as I left.

5) OA. I do not suffer from overeating. I usually eat reasonably okay and have no “control” problem for the most part.  I suffered from binge eating. I usually wasn’t overweight. Often, I was underweight to some degree, or so thin that I was clearly anorexic. I found that I am not a sugar addict.  OA is based on the assumption that all sufferers are sugar addicts and all you have to do is stop sugar (and white flour) and you’ll be cured. It never worked for me.  It seemed that what OA was saying didn’t apply to me.  People would look at me and assume, “Oh, so you must have been abstinent for years to be that thin.” Seriously. I found that OA varies from group to group. I tried many of these groups but still, I found their sugar theory to be irrelevant.

6) Group therapy. I think it was nice to share with other people who may or may not have similar problems to my own. I felt relieved, in a way, to meet other people from different walks of life. Group therapy was helpful if the group was comprised of mature people who didn’t whine. But it never helped my eating disorder. It only provided a social outlet, I suppose. After a while, I realized I’d rather find companionship some other way. Plus, I felt that these groups were a waste of time in a way. I felt that I should be spending my time doing something more meaningful and productive. I didn’t want my life centered around “group.” Especially since “group” wasn’t helping my eating disorder at all.

7) Medication- lithium. I tried many.  At first, I begged for drugs because I figured this was the answer. But most medications made binge eating worse, not better. Oddly, lithium reduced my appetite enough to stop the binge eating for several years. I wasn’t bipolar. But I felt far less depressed with the binge eating out of my life. So “doctors,” seeing my brighter outlook, assumed this was directly caused by the lithium, when really, it was secondary. Only now, decades later, they are uncovering statistics that show that lithium does indeed stop binge eating. I wouldn’t recommend it though, because this drug also destroys the thyroid and kidneys. This damage is often permanent. Kidney damage will shorten a person’s life. Some people are immediately affected and die of kidney failure even after taking lithium for a short time. Therefore, I think this drug should not be given to anyone. I took it for 16 years and was totally convinced this was The Way. I had no clue it was slowly destroying my body, nor was I fully informed of just how serious the risks are. The other effects included the “shakes” and pimples, which affected my social life. I was shaking so much that trying to get a job was a joke.

8) Other drugs- antidepressants. These drugs either did nothing or made the binge eating far worse. One did help binge eating, Imipramine. I took it on two occasions and the first time it did nothing for binge eating. The second time, it was helpful.  But it gave me the “black box warning” effect. My doctors had no clue and didn’t respond to my reports of agitation (mental and bodily) and other physical complaints. They told me these were “nothing.” I lost many friends due to the way I acted on that drug. I also nearly committed suicide. These near misses with suicide occurred in 1984 and 2012. The “black box warning” effect lasted long after I got off the drug, in fact, during the withdrawal period I was a raving maniac. Please be careful with antidepressants!

9) other drugs – antipsychotics. These, of course, all made binge eating far worse. They caused weight gain, akathesia, sunburn, Tardive Dyskinesia, insomnia, confusion, too much sleeping, sedation, heart damage, trouble with balance and walking, slurred speech, mental lethargy, and many other problems. I wouldn’t recommend even giving these a try nor would I recommend taking them for sleep.

10) other drugs – sedatives. I tried a few and they did absolutely nothing. No effect. They didn’t do anything for so-called “anxiety.” They weren’t usually helpful for sleep.  Anxiety wasn’t my problem and I didn’t binge eat when anxious necessarily. Occasionally, I tried taking one of these pills if I thought I was going to binge, but this never worked. I had treatment-induced panic attacks for a year and these drugs didn’t help the panic attacks. These drugs are addicting and you develop a tolerance or dependency very quickly. I saw no point in taking them and never asked for them or any type of sleeping pill again.

11) other mood stabilizers – I tried Depakote, Trileptal, Tegretol, and Lamictal. The latter two literally made me unable to stand up. Trileptal made me “sway.” I found out this is a dangerous condition called ataxia and it’s ankle weakness that made me sway. Trileptal clouded my thinking so much that it made me into a “basket case.” Lamictal caused double vision and finally, when I couldn’t even stand up, I stopped the drug. Depakote didn’t do anything but made me put on lots of weight and I became overweight.

12) Naltrexone – this drug is designed to eradicate the pleasure part of addiction. The theory was that if you don’t get high from doing the addiction, you’ll stop. This never worked because I never derived any pleasure from binge eating. It was incredibly painful. It ripped my mouth apart and my throat and stomach were killing me the entire time. I did try Naltrexone but it never did a thing for me.

12) Topamax – this was the only drug that really did stop binge eating with minimal side effects. Yes, it can cause a dopey feeling or make a person spaced out. It didn’t do that to me. Of course, it “cured” depression because I was so happy to have stopped binge eating. I was on this drug from 2006 until recently. There is a possibility of poop-out, meaning that it stops working and has no effect after a while. Because it was no longer working as of a few months ago, I tapered off the drug and stopped it. I had stopped before and the binge eating worsened, but this time, that’s not what happened. My eating was unaffected. Physically, I felt better off the drug, so I stayed off. There are plenty of risks associated with Topamax and it’s not a cure-all. Actually, for most people, it doesn’t work and causes more harm than good. Other side effects include tingling in toes and fingers, eye problems, confusion, and it can affect sleep. Any of these drugs can affect your ability to drive. Be careful!

13) Seeing a nutritionist. This can be helpful for many people. Find one that understands eating disorders or who was a sufferer her/himself. Also, I personally found that those who had only traditional “food pyramid” training didn’t really know about many of the problems I was dealing with. Be careful whom you select. Unfortunately, most people are given no alternatives and they are stuck seeing the one they are assigned to. Some nutritionists aren’t trained in eating disorders but in diabetes and weight loss. I found that those folks weren’t helpful at all except when I had weight to lose. Many charge ridiculous fees. I’ve seen $300 a session and upward.  Most insurance won’t cover nutritionists.

14) meal plans. A meal plan might help to get someone in a routine or disciplined if that’s what they need, or teach them to eat properly. No, these didn’t help with binge eating, but some folks find them helpful. Be aware that following a meal plan can cause “rigidity” in one’s eating and this is a problem, too.

15) Exercise. This is usually a good idea anyway.  I found that moving my body when I could made me feel better. I didn’t have a problem with overexercising for the most part. Twice I did overexercise, and was sorry when my knee gave out!  But for the most part I haven’t had a problem with exercise addiction.  I truly believe that these “eating disorders specialists” who insist a person stop exercising are full of it! Unless it’s medically dangerous to exercise, or do a particular exercise, I think to force someone to stop is cruel. Each person needs to find their own particular type of exercise that suits them. Do you like walking your dog? Do you work better in a team or alone? Do you enjoy gardening and working outdoors? Does your job include physical activity? Mopping floors and vacuuming are also exercise.  Waiting on tables or delivering materials on foot will keep you physically active.  Do you use some form of exercise in your commute, if you work or go to school? Do you like the structure of an exercise class?  What about dancing?  If you hate exercising, you probably have been trying the types of exercise that aren’t a good fit for you. Try something new. Be daring. If you smoke, you will find that you are quickly motivated to quit!  It was back in the 1980’s that Jane Fonda wrote about how exercising helped her eating disorder. Many complained that her methods didn’t apply to them. So invent your own.

16) Not eating at all. This I did, or I ate hardly anything at all. I don’t recommend this because I nearly died in the process. I have heard that fasting can be helpful but probably it will worsen the situation in almost all cases. Especially if you are already underweight.

17) Chinese medicine, namely, acupuncture – yes, do try acupuncture. This is rarely explored and standard medical practitioners will tell you it’s hogwash. But it isn’t. It really works! If you find the right acupuncturist you will be amazed. Acupuncture helps with pain and sleep especially. I have heard that statistically, acupuncture has an excellent success rate for people with eating disorders. But finding the right acupuncturist is essential. It must be a good match. Sadly, many people don’t have a huge selection in their geographical area. And many won’t even give it a try. It’s not all needles! Many offer a sliding scale.

18) Various vitamin therapies. This will definitely be helpful for many people. Sadly, most folks assume vitamins do nothing or have very little effect. Or they are told scare tactics and they don’t even bother trying. You may be binge eating due to a vitamin or mineral deficiency. Some deficiencies don’t show up on a blood test. Some people find that they need unusually high doses of certain vitamins and they never find out for years.  I hear that there are specialists in this such as naturopaths and if you find a good one, take their advice!  I myself have tried various B vitamins, fish oil (which isn’t a vitamin but an oil), and others. Chronic dieting will cause deficiencies. I have heard Thiamine, zinc, Riboflavin, and others are helpful. Be careful, though, because overdosing on vitamins is possible! I’d say, “Ask your doctor,” but medical training doesn’t include this and chances are, your doctor will just shrug and say, “I don’t know. It can’t hurt” and little else. Integrative medicine practitioners, including MD’s, are more qualified in this area. Also, be careful mixing anything with any pills you take.

19) other things you find in a health food store or online – I have found fish oil helps with depression. I either take fish oil or eat fish regularly. I don’t suffer from depression anymore. I had high blood pressure from one of the pills I had to take. I used CoQ10 (I think that’s what it’s called) for a while, and it did bring my blood pressure down after nothing else worked. I tried chromium picolinate and it didn’t have any effect at all. I tried other trendy stuff (some ridiculously expensive) which did nothing. I tried 5-htp which did indeed help binge eating. It really worked!  Don’t mix it with psych meds, especially antidepressants. Also, don’t stay on it for long periods. This goes for l-tryptophan and other single amino acids as well. I have heard l-tryptophan helps some people with sleep. Melotonin also. But neither of these did anything for me. Some swear by l-glutamine.  I tried it and it did nothing for me.  I found that pine nut oil was  immensely helpful, but it can be expensive. Actually, other oils will do just as well, and have a similar effect, even olive oil, nuts, and seeds.  Please don’t use unhealthy oils to prevent binge eating. I doubt they will be helpful. Don’t use anything you are allergic to. If you are allergic to tree nuts, stay away from oils from tree nuts, or oil blends that may contain tree nut products.

20) caffeine. Believe it or not, caffeine is amazingly helpful to me. For some, stopping caffeine will in fact cure them of binge eating. I find that for me, it’s quite the opposite. Caffeine does indeed stop binge eating for me.  Caffeine can be habit forming so use common sense. I have never taken uppers such as Ritalin, and don’t want to do those drugs. A simple cup of coffee or pure unprocessed cacao can be amazing. Some swear by green tea but I cannot stand the taste. I wouldn’t recommend caffeine for everyone, only those who are certain they won’t overdo it. Don’t use caffeine if it interferes with sleep. Also, be aware of that caffeine will give you a lift for a while, then suddenly bottom out, just like sugar. Don’t use it like a diet pill.

21) Keeping a food journal. I would recommend this so long as it doesn’t cause obsession over record-keeping. Do it for yourself, not for someone else. It’s your body. Notice which foods cause what.

22) Getting rid of the scale. I tried that. Those were the years I became overweight, gaining over 100 pounds. Not knowing my weight was certainly not helpful. I believe I am adult enough by now, and I should know my body, including what it weighs and looks like. I don’t believe in the use of deception, ever, nor hiding facts.

23) Not eating “trigger foods.” I have found this helpful. However, don’t assume your trigger foods are junk food or sugar. I found that dairy makes me binge. I am still exploring this. If you see a naturopath or doctor who has awareness of these issues, you may find that you have food sensitivities that you never knew about. Eliminating these foods may solve the problem entirely. You won’t know till you try. At one point, ANY food, anything I tried to eat would set me off. But I got past that. Don’t keep known trigger foods lying around. After a while, you may be able to reintroduce them. Or maybe not.

24) Grocery shopping. This can be a pitfall. I found that if I went to certain stores, I’d be overwhelmed by the pretty packages, bright lighting, muzak, and “sales.”  I found that the marketing alone was overwhelming, and even frightening. You may need to avoid such places for a while.

25) Getting away abusive or oppressive situations. This is an absolute must. If you are being abused or oppressed, please leave the situation. Sometimes, it takes stepping back and seeing your life for what it is to realize exactly what the oppression is.

24) Honesty – be honest with others and yourself. It’s a good idea overall to tell the truth.  Only lie if you absolutely must for survival’s sake. If someone is threatening you or abusing you, you may need to hide the truth just to save yourself, or even lie. Let this be temporary. The exception. If you are around good people, you don’t need to lie anymore, but this doesn’t mean you have to reveal everything you think and feel. Use common sense.

25) Forced weigh-ins. These aren’t treatment and did nothing for me. I can’t believe the doctor charged my insurance just to weigh me. I was threatened repeatedly over my weight. I would say that forced weigh-ins are harmful to most people. Instead, weigh yourself at home and if challenged over it, be honest. If you have a doctor who refuses to trust you, find another doctor. Relationships should be based on trust. Go ahead, let the doctor weigh you occasionally. Keep ’em happy. But refuse regular forced weigh-ins. They won’t make you better.

26) tube feeding. I found tube feeding to be degrading. I also found it physically painful. During the time I was tube fed, I farted nonstop. It was physically painful to eat.  The similarities between tube insertion and rape are striking. Especially if you have a “We’ll call security if you don’t” threat. Avoid being too influenced by immature patients who use the tube as status symbol. Eat instead. Remind yourself that you are saving your own life.  You are in the driver’s seat. That, in fact, feels decent. Tube feeding, if not done properly, can cause medical complications such as refeeding syndrome, which is often fatal.

27) Being monitored while eating, or supervised meals. I think this can be helpful for some people. So long as it’s by choice and not forced. The people monitoring need to be respectful of you. If they aren’t, this monitoring can turn to abuse. Your partner can monitor you, or your parents or other family member. You may choose to eat with supportive friends. Try sharing food with others. Breaking bread together leads to meaningful relationships.  Again, if the monitoring is forced or anything like policing, this is abuse, and never helpful.  There’s a difference.

28) soup kitchens. Yes, I have heard amazing stories of people who go to soup kitchens. If you are poor you qualify. Some soup kitchens will allow anyone to eat there regardless of economic status.  Go with an open mind and heart. I tried to do this but every time I went to the soup kitchen they were one of those that had discontinued or lost funding. I know people who regularly go to soup kitchens. It’s a good exercise in taking what you are given and being thankful you are alive.

29) Grow your own, fish, or hunt. Getting close to the land is most likely a good thing. Go to an apple orchard and pick apples. Go out and find wild herbs (be careful of allergens in the process). Climb a mountain and pick wild blueberries. Don’t go hiking without carrying food and water.

30) share your food with others, even your pets. This is something I do myself and I find it helpful. I share my food with Puzzle. She eats good food, people grade food. She and I don’t eat the same, but what I can share, I do. I put it in her dish and won’t let her eat off of plates.  If it’s in her dish, she knows it’s for her. Know which foods aren’t good for your pet and don’t give them to him/her. Some pets are very sensitive. When switching your pet over to home cooked food, do so gradually. Ask your vet, too. You’ll be surprised at how much vets know about nutrition compared to how much MD’s know about human nutrition!

31) Service animals, emotional support animals, pets. Yes, yes, yes! Go for it. Animals are amazing. A service animal can remind you to eat, can help you in public situations such as grocery store shopping, and many other things.

32) Spirituality. People tend to go through phases with this. Certain times of our lives we may find spirituality helpful, often even lifesaving. Sometimes, our spiritual practices work for us, but other times, you may find you are without faith nor do spiritual practices hold much meaning for you. Allow for these variations and forgive yourself. Over time, change happens.

33) shock treatments. These didn’t help at all. They caused confusion and nearly ruined my life. Some people find them helpful but ask them again in a few weeks, and they are back to their usual depressed selves and they will tell you the treatments wore off or never really worked. They never helped my eating disorder at all.  Not recommended.

34) Lobotomy. I don’t know. I’ve never had one.

35) stomach stapling. I have never had this done and never was that overweight.  The people I know that had this are either dead or became rather ill from the surgery or its effects. It does help a person lose weight but these surgeries are done indiscriminately and the long term consequences aren’t really known. Ask around and ask people who had this done many years ago.  It isn’t recommended for binge eaters that I know of. They’re supposed to screen for various things, but often, these doctors don’t, or people get around the screening by being dishonest. I have heard horror stories about this surgery. I suppose it works out okay for some people. But ten or 20 years down the road? I have no clue.

36) Diet pills. I have heard that Meridia has been used for binge eating with some success. I have never tried it. I took that Garcinia stuff and it gave me super bad hot flashes. I had a significant raise in body temperature for a short while till I figured out what was causing the fever. I stopped these pills and never took them again. I have stayed away from diet pills mainly because financially, they were too expensive for me to bother with. The ones I tried I used for binge eating, not to lose weight. It was NOT worth it because of the side effects and cost. Most didn’t stop binge eating.

37) Prayer. This didn’t work. I tried praying that the binge eating would go away. I tried many times. No way did it work at all. If it helps you, go ahead and do it. I believe it can be very powerful. I can’t say it helped my binge eating, though.

38) Yoga and meditation. I tried a yoga class and hated it. It’s not my thing. Some love it but I don’t like exercise classes. I find them degrading. Sitting around saying Om seemed stupid to me when I could be doing other things and spending my money on more fruitful endeavors. I knew someone who chanted and she taught me how. I hear it helps some people. It’s a form of meditation. I was shocked when I realized this person was actually addicted to chanting. I realized her addiction was destroying her, and not helping her as she thought. I hope she came to her senses. I do know many people who take time out of their day to meditate. Just don’t get addicted. I don’t know how common this addiction is.

I will stop here. I have listed many of the methods I have tried over the three and a half decades I went through binge eating. I hope this is helpful.  Again, these were experimentation on myself, and your situation and experience may be different.