The Last Word on the First Bite

The Last Word on the First Bite
By Mim Collins, M.F.T., Psy.D.


An eating disorder is a symptom. It is another form of addiction

 

For the last decade, “eating disorders” treatment has been fashionable. This comment is not to minimize the severity or the danger which threatens those afflicted. Rather, it is to emphasize the fact that, like clothing styles, issues in mental health can become commodities for the marketplace, and are subject the whims of the marketers of western civilization.
For this reason alone, it is essential to keep in mind that even though the spotlight of the networking world has shone on the diseases of the 21st Century, codependency, short-term treatment and meeting the requirements of managed cared companies, victims afflicted with compulsive overeating still suffer, weight loss recidivism is still 90% and the complications of the disease can still be fatal.

As a compulsive overeater in recovery, as a psychotherapist treating the disease, and as a student of the disorder, I have watched weight loss programs come and go for many years. They don’t work; they don’t cure. We might wonder what’s missing; why haven’t we found the answer?

An eating disorder is a symptom; it is another form of addiction. It is a manifestation of, and, an acting-out of many levels of pain, distrust, and avoidance of issues far more threatening than being overweight. In 1978, Susie Orbach made a significant contribution with her book Fat is a Feminist Issue. She pointed out that overeating and being fat are two separate issues. This distinction was a starting place for developing a comprehensive view of the issues that must be addressed in working with compulsive overeaters. This view must include at least five major concepts:

Overeating as a form of substance abuse

Being overweight as a means of survival in the family system

- The dangers of being thin

An understanding of the differences among natural, emotional, and addictive hunger

- The addictive nature of overeating, the understanding of binge behavior and what is meant by “The First Bite.”

Most compulsive overeaters do not recognize natural hunger, and at times it is difficult to differentiate it from anxiety. Anxiety often foreshadows other feelings that have been repressed because these feelings were too painful to be tolerated. When these feeling begin to emerge they are squelched with food and described as hunger.

Rarely, if ever, is the stomach empty long enough to transmit the message to the brain. When “real hunger” occurs, it takes amazingly little food to satisfy it, which can be deeply disappointing for the person who seeks more from food than it can provide. Disturbing feelings are often mistaken for hunger, food is used to camouflage a feeling, which in turn, produces guilt, then depression, and the binge cycle begins once more.

The binge, once started often touches off addictive eating. Each attempt to stop the binge threatens to overwhelm the person with the intolerable feeling(s) that started the binge. Addiction has many definitions. Some say it is knowing that the behavior is destructive but engaging in it, nonetheless. Others say it is behavior that is out of control. I observe that addiction has personality all its own.

To contain the impulse to binge means not to take “The First Bite”. The first bite to a compulsive over eater is similar to the first drink to an alcoholic: “One drink is too many; a million is not enough” Distinguishing the “first bite” means becoming attuned to natural hunger, eating until naturally satisfied, which is not easy to determine and to not take that “first bite” beyond natural satisfaction.

Being overweight must be understood by the function it serves. It says something to the outside world that the overweight person may not have been able to transmit directly, such as “Stay away; I am afraid to have you come any closer to me”, or “I don’t know how to declare my boundaries.”

Each of these issues is just a piece of the complexity of overeating. It must be viewed from all these angles and more. We all know diets don’t work. What is so much more difficult to know is what the behavior covers, how to reach the underlying issues and how these issues be effectively addressed.