Brain Over Binge (26 page)

Anyone—with or without a history of an eating disorder—who chooses to diet for health reasons should be aware of the role their survival instincts will play. Acting on survival instincts by binge eating or simply overeating will, at best, sabotage the diet and, at worst, lead to the habit of binge eating. But being aware of the survival instincts and knowing how to deal with urges to binge allows the dieter to go forth with the weight loss plan, without worrying that binge eating will hamper progress. Urges should disappear quickly as healthier, less-excessive eating habits become the norm.

33
: Low Self-Esteem

J
ust as I didn't have to improve my body image to be free of binge eating, I didn't have to improve my self-esteem, either. As far back as I can remember, I've never had the greatest self-esteem. As a child, I didn't have too much confidence, I often doubted and underestimated my abilities in sports and academics, and I didn't usually feel confident in my ability to socialize and make friends. Achievements and compliments from others could boost my feelings of self-worth for a little while, but my esteem never seemed very strong from within. My low self-esteem didn't hold me back too much, however, and it often served as a source of self-motivation for me. It was as though I always had to prove to myself that I could accomplish things. It wasn't until I entered therapy that I viewed my low self-esteem as a big problem, even a hypothetical cause of my eating disorder.

When I was caught up in the cycle of binge eating and purging, my already shaky self-esteem plummeted. It was difficult to think any positive thoughts about myself when I couldn't even do a seemingly simple thing: stop eating thousands of calories at a time.
What kind of stupid, foolish person does this?
I thought.

I felt out of control, and there was simply no way I could talk myself into believing I was a worthwhile person while caught up in that cycle. Even if I could have managed to love myself unconditionally while bulimic, as my therapists encouraged me to do, it wouldn't have magically taken away my urges to binge. My low self-esteem was indeed a concern—it probably has been a concern my whole life, and I still don't feel great about myself—but my feelings of inadequacy, past or present, were never the cause of my binge eating.

THE ROLE OF SELF-ESTEEM IN BINGE EATING: A VULNERABILITY AND A RESULT

It is true that women who have low self-esteem are more likely to develop eating disorders than those with a healthy self-esteem, leading some experts to believe that low self-esteem is the root cause of eating disorders,
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or at least a necessary prerequisite.
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There is no doubt that eating disorders and self-esteem are strongly related; however, just because low self-esteem is a "common trait of people with eating disorders,"
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that does not mean it causes eating disorders or that curing low self-esteem will cure eating disorders.

I believe low self-esteem has only an indirect link to eating disorders. Women and girls with low self-esteem are more susceptible to eating disorders primarily because they are more susceptible to dieting and, in turn, more likely to take their diets too far. If a girl feels inadequate, she may turn to dieting as a solution,
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whereas a woman with a healthy self-esteem has less reason to want to diet. In other words, people who feel okay about themselves are not easily influenced by society's pressures to look one way or another.
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In this way, low self-esteem only makes someone prone to dieting, and this dieting can bring about the eating disorder in certain situations.
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When I began restricting calories in high school, I didn't consciously think,
I need to diet to feel better about myself,
but increasing my self-esteem could have been a subconscious motivation. However, once my dieting escalated and led to binge eating, whatever had caused me to diet in the first place—low self-esteem, poor body image, perfectionism, and so on—didn't matter anymore. Solving any of the problems that may have caused me to diet, as I often tried to do in therapy, did nothing to rid me of my binge-created brain-wiring problem.

When I finally stopped acting on my urges, I found that my self-esteem significantly improved. Giving up my habit gave me a great boost of confidence, took away my shame, and gave me back my freedom. I finally had confidence that I could control my own behavior and trust myself. Nonetheless, I still lacked self-esteem in other areas. I am still very shy, I still lack confidence in social situations, I often doubt my ability to achieve goals. But, just like before my eating disorder, I don't view my low self-esteem as a huge problem. It doesn't stop me from doing things I want to do, even if there is sometimes an annoying, self-depreciating voice in my head.

I've learned that everyone, with or without a history of an eating disorder, has days when their self-esteem is low or times when they feel worthless. In other words, feelings of inadequacy aren't specific to eating disorders. I realize that for others, feelings of inadequacy are probably more fleeting than they are for me, and I'm certainly not saying that a low self-esteem is normal. What I am saying is that a lower-than-normal self-esteem doesn't have to impede recovery.

AN ONGOING STRUGGLE

I'll never stop trying to improve this personality flaw, as I tried to improve it in therapy. The difference now is that my recovery doesn't hinge on how good or bad I feel about myself, because my recovery is over. I'm glad I didn't wait until I developed good self-esteem to stop binge eating, because if I had, I might still be bingeing. Developing a healthy self-esteem might be a lifelong journey for me, but recovery from bulimia, luckily, was not. Sometimes my sense of self-worth feels fixed, immovable—very unlike the temporary formation and extinction of my eating disorder in my brain.

Throughout my life, I can recall others—my parents, family members, friends, teachers, and coaches—trying to help me see that I was actually very good at some things and that I was a likeable person; but I always seemed insistent, even then, on believing that I wasn't quite enough. I know I have the capacity to change, but sometimes I wonder if my sense of self-worth is so ingrained—based in my genetics and biological makeup, and possibly my upbringing—that all the self-affirmation in the world isn't going to fully change it. To repeat: my recovery isn't an example of the butterfly tale.

Today, I frequently read parenting books, and I often find a recurring theme: each child is born with a basic nature, and genes have a strong influence on temperament and personality.
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I believe this is the case with many of my traits—low self-esteem included—that my therapists seemed to interpret as fatal flaws that caused my eating disorder. These less-desirable personality characteristics are simply part of my makeup; and even if I can't make them all go away, I can work to make the best of those characteristics, just as I can help my kids make the best of their inborn strengths and weaknesses. More importantly, regardless of my traits and temperament, I can always control my actions.

A basic tenet I encounter in nearly every child-rearing book I've picked up is this: a child must be taught to act appropriately despite how he/she is feeling. Even in young children, "[t]emperament and strong emotions are not an excuse for inappropriate actions."
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This doesn't mean that I should disregard my children's feelings or avoid teaching them healthy ways to deal with those feelings, but it does mean that it's my responsibility to teach them to control their behavior. Despite anger, I must teach them never to hit; despite a strong desire for another child's toy, I must teach them never to take things from others. It is the same with me. Even if I sometimes feel poorly about myself, I must never diet restrictively; and even if a strong desire to binge arises one day, I must never binge.

34
: "Coping"

P
eople have been trying to learn how to cope with life since the dawn of time. Some people seek religion, some seek therapy, some read self-improvement books, some exercise, some meditate, some pray, some find relief in art or music, some seek the comfort of friends. There is really no wrong way to cope, as long as the solution you choose is not harming you or anyone else.

The false assumption that my binge eating was a coping mechanism formed the basis of my therapy and most traditional therapies. Since my therapists believed I was binge eating in order to cope with emotions and problems, an important goal in my therapy was to find and practice healthy ways to cope. In therapy, I was told that once I found and implemented healthy coping, I wouldn't want to binge eat anymore; but until I did this, I would continue
needing
to binge.

As I've said before: not only was this approach ineffective; it gave me plenty of excuses to binge. Finding healthy ways to cope was a worthwhile life goal, but it wasn't necessary for complete recovery from bulimia. When I believed that my binge eating helped me cope with life, I was much less likely to resist the urges. When I believed I had to learn to cope well with every problem and every emotion to avoid binge eating, recovery seemed nearly unattainable.

Learning to cope with my life and recovering from bulimia turned out to be two separate endeavors. When I stopped binge eating, I stopped binge eating—that was it. There was nothing special I had to do to cope with life after bulimia, just as there was nothing special I needed to do to cope with life before bulimia. I didn't have an inherent deficiency in coping with life; I was no different from anyone else who struggles to deal with life the best way they can. Sometimes I cope well, sometimes I don't; but this has no bearing on my recovery.

OUT OF PRACTICE

Since binge eating occupied my time and energy for a long time, it did seem a little odd to resume life and cope with it, without binge eating getting in the way. I had been caught up in a habit that often clouded other areas of my life and caused me to ignore the important things. I hadn't started the habit to intentionally or subconsciously distract myself, as my therapists suggested; but once I got caught up in it, there was not much time to think about other things. Distraction from life was a side effect of my bulimia.

The fact that binge eating distracted me can be explained by the brain's plasticity. Remember that the brain strengthens neural connections that are used often and weakens those that aren't. After my binge-created brain-wiring problem was well established, I began to feel consumed by my bulimia. This was because my brain
was
consumed, physically, by my habit. I was devoting more and more neurons to my problem behaviors—binge eating, thinking about food and weight gain, and overexercising—and fewer neurons to the important aspects of my life: school, my career path, my relationships, my job, my family, and my spirituality. Everything else took a backseat to my bulimia—symbolically and neurologically.

When I stopped my habit, all of a sudden, the issue of whether or not I would binge—the issue that had seemed to be the most pressing one every day for six years—simply went away. Suddenly, there were other possibilities, and I had to face the reality that I had basically squandered my college years and didn't have much of a career path. I had to face the reality that I didn't have many friends because I'd distanced myself from most people. I had to face the reality that I didn't really know who I was without the bulimia consuming me. It felt a little scary thinking about real life issues, rather than how many calories I ate in my most recent binge; but in no way did this make me want to turn back to binge eating. The discomfort I felt in thinking about real life paled in comparison to the pain I had felt while I was consumed by my habit.

The fact that I was a little uneasy thinking about real problems after my recovery was not proof that I had somehow been using food to cope. It didn't mean that I really needed to binge because I was somehow incapable of handling life. It only meant I was out of practice in living without bulimia. What's more, the discomfort I had passed very quickly. Since my brain was no longer wrapped up in my habit, I was able to devote the brain power that had once fueled my eating disorder to other goals. My real problems became less and less threatening as being binge-free became my normal way of life.

SOME TELLING QUESTIONS

I've given some thought to exactly what helped me realize that I truly didn't binge to cope. There is one question I often asked myself in one form or another when I first quit binge eating:

If I didn't have urges to binge, would I binge anyway—just to cope with life?

The answer was: of course not! It simply wouldn't make sense. The urges to binge were my problem, and I knew binge eating really didn't help me cope with anything in my life—except my urges to binge. I verified my own answer to this question when my urges to binge went away, because after that happened, the idea of binge eating as a coping mechanism was ludicrous. While I was in therapy, I often asked myself,
If I stop binge eating, how will I cope?
But once I stopped binge eating, the question became only,
How will I cope?
This is a question that everyone, not only those with bulimia or BED, has to deal with every day.

When binge eaters, myself included, ponder how they will ever "cope" without binge eating, I think what they're really wondering is:
How will I survive without the pleasure?
There was no denying the secondary benefits of my binge eating—the pleasurable taste of food, the high as I ingested those first few bites, the sugar-drunk feeling I had as my serotonin levels rose, and the immense relief from anxiety I felt when I finally satisfied my craving. In addition, binge eating often made me zone out or become numb to everything else going on around me; so that during and immediately after a binge, I often became apathetic about my fears, insecurities, responsibilities, and relationships.

I intrinsically knew that the temporary good feelings weren't worth the consequences of my bulimia—or I wouldn't have been in therapy trying to recover for all of those years. If I had thought the pleasure was worth it, I wouldn't have had any reason to want change. Even so, throughout my years of therapy, I was hesitant to give up the pleasure that binge eating brought me. To remind myself that I could indeed survive without the pleasure once I stopped binge eating, I asked myself this telling question:

If I had no urges to binge, would I binge anyway—just for pleasure?

Again, of course not! The desire for the secondary benefits disappeared with the urges to binge, and the idea of binge eating for pleasure seemed foolish. Without a craving for it, binge eating was no longer enticing; in fact, it seemed like just the opposite of pleasure. The idea of gorging myself with incredible amounts of food—for any reason—simply stopped making sense and became a disgusting prospect. In the absence of irrational urges, binge eating is not something anyone would do for pleasure or as a way to cope.