Binge eating

I don't have an official BED diagnosis but I certainly am an emotional eater. It will without a doubt be a lifelong struggle.

Every day I have to make the decision to eat only 3-4 times and only protein rich foods. Some days I totally fail at keeping myself on plan and graze on anything I can get my hands on all day. I don't have an answer, only that I think of VSG as a tool that will get you 60-80% to your goal weight - the rest of the way plus maintaining a normal weight for life is all a daily willpower struggle.

Thank you Mahonia. I am currently breastfeeding too and I think it contributed to my weight gain in the last year. I thought breastfeeding will help me burn calories and loose weight but the opposite happened. It makes me constantly hungry and craving sweets and unhealthy stuff. I have no control over my self. I am also an emotional eater, I eat when bored, stressed and lonely specially that Iam on a maternity leave and i spend all day at home. I find comfort in food and only food, no other interests or hobbies can take its place. I really appreciate food greatly and as many obese people feel its my main source of joy and pleasure.

Are you seeing a therapist? You've got a lot going on here that surgery won't "fix."

I thought I knew what hunger was until I started the three week liquid diet I'm on.

I didn't, my hunger was all in my head. I don't think I've felt actual physical hunger in more than a year - my stomach was always filled with something.

This is hard for me to "talk" about openly. I was diagnosed with BED three years ago (roughly two years before I had VSG). I had reached the point of bingeing 3-4 times a week. If you're suffering from BED, you know it is more than emotional overeating. My emotional overeating was regular daily type of thing, it would just happen, but I would plan for my binges. There was an element of secrecy, definite overwhelming guilt, and undeniable compulsion. I would wait for my son to be asleep in bed and I would start. I knew it was wrong/disgusting, and I knew I'd feel bad afterwards, but I often thought of it as "the one thing I did for myself". My favorite binge was pizza.. I would systematically eat at least an entire pizza-I always had two prepared (with ranch dressing or garlic butter-or both****il my stomach hurt. I would enter a mental haze that felt good? Satisfying? Guilt usually set in when I went to lay down and felt how much my stomach hurt. But I would just tell myself I wouldn't do it ever again. (I always did it again)

When I started psychotherapy I did not intend on having WLS; I was out of control and had depression/PTSD issues as well. I would tell my therapist about my binging, but we didn't really begin addressing it for over a year. (I'd had some bad experiences we worked on first). She had me record my binges--which was mortifying and illuminating. We worked on this for a long time, and are still working on it. I have not binged after VSG. I'm not yet a year out and it would have been physically impossible to this point. Have I thought of it? grr yes. I am ashamed to say I miss it. But I don't want to have that behavior any more. Hence, my continuation of therapy and dedication to finding activities that make me feel good.

The role VSG has played for me has been both major and minor. I hate to use the word "tool", but it really is such an apt description. I don't think I would be successful if it weren't for my combined use of therapy, VSG, exercise, support systems, and education. So, my point is, VSG is not a stand alone solution for BED (or anything), but it's a valuable factor in a holistic plan.

Thaank you so much for your enlightening post, I just love it as it gives me hope that may be I can do it. I will try to follow your steps hopefully I will get there.

People do not know this, however eating disorders have some of the highest lethality rates of all mental illness. Do not screw around with them. Surgery does not fix them. Surgery can exacerbate them, actually.

The chief reason surgery cannot fix an eating disorder, is that binge eating is never about food. A true medical binge occurs because it is an attempt to reestablish control after a loss of control - trauma is one of the top reasons people develop binge eating, for instance, and trauma does not go away. The effects of trauma do not disappear. They require treatment, often for years, to overcome.

All eating disorders are more like addictions to control. Again, binge eating has nothing to do with food. If it wasn't food it would be heroin, shopping, alcohol, reckless behavior, cutting, promiscuity, and so forth. Behavior never causes itself. That is, with any behavior that occurs, another cause is below the surface whether it is brain damage or neurodevelopmental disorders, trauma, depression, etc.

The reason that stimulants work for true binge eating disorder is the same reason they work with ADHD. In fact, eating disorders and ADHD occur really often together! Any clinician who says they help binge eaters because they suppress appetite has no idea what they are talking about.

Post-operatively, it is difficult to meet the psychiatric criteria of a binge, as we are restricted in how we can eat. However! Instead of overeating, both my clinical observation (and personal experience) have taught me that our binging is actually a more magnified feeling of a loss of control.

This is because binge behavior has two primary psychological features: 1) impulsivity and 2) compulsivity. Impulsivity means we act without thinking, basically. The fancy term for this is "impaired executive function." Basically, due to the loss of control, we become impulsive. Compulsivity is different - it means we feel compelled, almost urged, internally to binge. Both together mean binging can easily get out of control without assistance. Further complicating the issue, many people have food addictions. This is a totally separate issue and is not the same as having binge eating disorder. It may be disordered eating, and an addiction, but that is not necessarily the same. Also, you can even have both at once!

For these reasons above, it's vital if there is disordered eating to get an assessment from someone trained to diagnose and treat eating disorders. If ADHD is suspected, it is current good clinical practice to get a neuropsychological assessment. Many disorders mimic ADHD, and it is your right, both as a patient and a healthcare consumer, to request an ADHD assessment rather than just accepting a diagnosis. Even if it means I personally lose money I refer people out for assessment for this reason.

If ADHD is not suspected, you need a clinician familiar with BED, bulimia, and anorexia nervosa because there are still many differential diagnoses which may be at work. Most clinicians can treat eating disorders, sort of, however certain therapies are more useful for you if your eating disorder is severe.

Always seek out a fully licensed professional for eating disorder treatment. If your mental health is serious and you have private insurance, find the best professional in the area and head straight there.

Donna, this ^^^ is a GREAT post. Thanks for your good information, clear writing, and the time you took to type all that out for the OP.

So many "overeating" terms get tossed around on WLS boards -- terms like emotional eating, food addictions, binge eating, overeating, head hunger, etc. Many terms are misunderstood, and some are meaningless.

Again, thank you for this post, Donna.

Thanks also to others (above) who posted accurate and useful information.

Very best wishes to the OP. I hope you are able to have your eating issues accurately diagnosed and that you find a therapist who can help you address your issues.

Thank you so much for all the kind wishes. People here are so cooperative and I learned alot from all of you. Xx love you all

I am always happy to help. If anyone ever has trouble finding out how to get help where they live, I am also always happy to assist with that, too. Finding resources is a huge part of my job.

In general, we use a lot of mental health words weirdly in pubic discourse. Like, "that's so bipolar!" or "omg, I'm so OCD today!" The reality is that these are serious and crippling disorders, and when we do this it makes these trivial issues. Hey, I'm guilty of this too...I am trying to fix my language, but it is a very ingrained habit.

People don't really know what a binge is. It's not overeating. It's a psychological state. Even I honestly didn't have a clue until long into my education... and then I was like, oh, so that's what a binge is? Huh, maybe I have been binging! WTF didn't anyone tell me! I intentionally had a different person do my bariatric assessment, and it uncovered a lot that prior mental health care had missed.

Sadly, overeating is a component of many eating disorders, and many therapists and psychiatrists do not further screen to uncover it. A lot of us slide under the radar.

The truth is that you can be anorexic and obese, as well as having binge eating disorder or bulimia and be skinny. We get a lot of assumptions made about how we look regarding what pathology we have. While appearance is actually a big part of assessment, it also does us a disservice as patients and therapy clients who are overweight.

Of course, for all us fat, formally-fat, and crazy people, that is not remotely news to us. Part of my job is working to fix that, both for my clients, and for myself, too.