

(Ellen Shuman wrote this cover story for
Cincinnati Magazine in January of 1994)
This
was more than a craving for Chips Ahoy.
Something was terribly wrong...
Yes, it's true. Oprah was as genuine in person as she appears
to be on TV. That information is for all of you who haven't run
into me in Kroger and had the chance to ask in person. It's still
hard for me to believe, but, I really did it. I went national on
two Oprah Winfrey shows with my story of thirty years of binge eating.
Before and after each taping, I questioned my decision. What would
people think of me? Then, the combined effect of the Oprah appearances
and my concurrent Channel 9 News series on binge eating disorder
resulted in more than a thousand emotion-packed calls and letters
from people requesting help. That's when I knew the personal risk
had been well worth taking.
If you've never used food to cope, to "stuff down" or
avoid feelings, I know it's hard to understand how someone could
continue to do so despite the physical consequences (excess weight
and all associated health problems) and the emotional toll (self-loathing
and worse). Then there's the social fallout, withdrawal from activities
and sometimes from friends and family because we're so terribly
ashamed of what we've done to our bodies. To tell you the truth,
it's even hard for those of us who do it to understand why we keep
doing it and why we can't stop.
We feel out of control with food. We try to keep what we're doing
a secret. (Not easy as my weight soared to 289 pounds.) We eat in
bathrooms and we thank God for the relative anonymity of drive-throughs.
We know all the most isolated parking spots in the tri-state. That's
where we do much of our eating because we wouldn't dare do it where
anyone might spot us. We hold our breath and pray for the strength
to pass a UDF without going inside. When we're not feeling numb
from the effects of our latest binge, we feel shame.
We feel deprived when we don't give in to our obsessional food thoughts,
guilty and desperate when we do. The best description of what living
with this disorder is like comes from a friend of mine. She says
it's just like a scene in a movie where an alcoholic says, "I've
got to have a drink. I've got to have a drink." And then, as
soon as he gets that drink he's okay. For many of us, it's just
like that, only with food.
Another friend told me she had enough weigh-in cards from one internationally
known diet program to wallpaper a house. I did too. Believing that
the weight is our problem, we go from commercial diet plan to commercial
diet plan. Oh, the money I spent on programs and pre-packaged diet
foods believing that if I could just get some of this weight off,
the rest of my life would straighten itself out. I'd be happy and
then I'd do all those things I wouldn't dare to do overweight.
I thought I lacked willpower. That's what well-meaning people, including
doctors and mental health professionals, told me for years. But,
I knew in my heart that there had to be more to it. I really wasn't
weak-willed or undisciplined. I had worked hard to put myself through
college. I had established myself as a credible broadcast journalist,
getting thin for every job hunt. I won a Peabody Award and then
a prestigious fellowship for mid-career journalists to Stanford
University. If I could do all that, why couldn't I stop eating?
It just didn't make any sense.
Today, it makes all the sense in the world. Through my own therapy,
research and discussions with experts in the fields of eating disorders
and obesity treatment, I've come to understand that diets don't
work for people like me. Diets treat only the symptom, which is
the weight, not the problem, which is an eating disorder.
What I have learned is this. People who eat compulsively, who use
food to repress their feelings, are usually people who have trouble
identifying, tolerating, expressing and regulating their feelings.
Research also shows we are people who have a higher rate of (or
family history of) depression, anxiety or alcohol use than those
in the general population. We make food, with its immediate reinforcement,
availability and social acceptance, our coping strategy of choice.
Why food? Because it works.
"We think the reasons that promote this kind of overeating
come from the brain." When MIT research scientist Dr. Judith
Wurtman said those words to me during an interview, I felt like
I had been waiting to hear them my entire life. How many times had
I tried to explain to a health care professional or to a diet center
pseudo-counselor about this physical discomfort, agitation or craving
that I'd get that would lead to a binge? How many times had I been
told, politely, that it was all in my head? It turns out it was
in my head. But not exactly the way those counselors meant it.
After seventeen years of studying the relationship between food,
mood and brain chemistry, Dr. Wurtman says, "People who binge
are biochemically different from the people who don't binge. And
I think this is very important in order to remove guilt from people
who do use food
as a way of handling anxiety."
Dr. Wurtman says some people actually consume sweet and starchy
foods, carbohydrates, in an attempt to self-medicate. Her research
indicates that people like me, when stressed, crave foods like sweets,
breads and potatoes because those kinds of foods lead to the production
of the brain's own calming chemical, the neurotransmitter serotonin. "Serotonin is made in the brain when carbohydrate-rich foods
are consumed." Wurtman says serotonin plays a major role in
regulating our moods. "When produced in sufficient quantity,
serotonin makes people feel less anxious, less depressed, more alert,
more emotionally stable. But, on the other hand, when it is not
available in sufficient quantities in the brain, it sets up feelings
of emotional discomfort, depressed feelings, anxiety, inability
to focus, and an irresistible craving to eat sweet and starchy foods.
So what happens is the serotonin, which is not available in enough
quantity when there is stress, is saying to the eater, eat some
carbohydrates so that more serotonin will be made and emotional
calm will be restored."
Dr. Wurtman says we binge because it works and we keep bingeing
because it's self-reinforcing. I kept turning to carbohydrates to
relieve emotional discomfort, just as someone with a chronic headache
might keep reaching for two aspirins. "These people are driven
to self-medicate with food over and over again until the underlying
emotional disturbance is resolved."
Okay. So, I was right. I wasn't bad or weak-willed. It wasn't my
fault. There was a reason I started self-medicating, zoning out
with Chips Ahoy cookies and Wonder Bread at age 4. I ate as much
as I could sneak from the bread drawer because the foods my mom
kept in the bread drawer took the edge off my chaotic homelife and
nobody ever taught me any other healthier ways to manage uncomfortable
feelings.
So now what? Blaming my parents for raising me in a dysfunctional
family wasn't doing me any good. Here comes the hard part. Although
none of this was my fault, recovery was my responsibility. And,
as is often the case with giving up a defense that has worked well,
I found the early stages of recovery sometimes more painful than
the disorder itself.
"We
feel out of control with food. We try to
keep what we're doing a secret. We eat in
bathrooms and we thank God for the
relative anonymity of drive-throughs."
Not long
after I entered an inpatient eating-disorder treatment program,
I faced the fact that I was more comfortable with my "I'm too
fat to participate in life" excuses, than I was dealing with
the emptiness that I'd been trying to fill with food all those years.
If I gave up the food and the excess weight, what would life be
like? What risks would I have to take? How vulnerable would I be?
What would I obsess about if I wasn't thinking about food all the
time? What feelings would I actually have to feel and live through?
If I got down to goal weight I might be tempted to start dating
again. Then I might get hurt and then I would just have to turn
back to the food so why take the risks to begin with, and on and
on and on.
Today, after much therapy and emotional risk, I am at peace, not
always, but more often than I ever thought possible. I no longer
live in total fear of my feelings. I've learned that even the bad
feelings pass without permanent damage, if I just let them. I'm
learning that when I'm anxious, stressed or depressed, even angry
(still the toughest one for me to deal with), I can turn to healthier
coping strategies than food for mood regulation. Today I have wonderful
friends and a great support network.
And I have a mission to help others (especially health care professionals)
understand that not every overweight person is the same. Some overweight
people do have poor eating habits, but many of us have a disorder
that won't be fixed by a 1200-calorie diet and suggestions such
as "put your fork down between bites." During a routine
office visit, a friend of mine says her doctor pointed out her weight
gain, as if she hadn't noticed, then he suggested she go buy some
of those "Lean Cuisines." "They're proportioned," he said. I'm sure he was trying to be helpful, but his lack of understanding
added greatly to my friend's feelings of pain and despair.
Today, my mission has a name. I am part of a new, multi-faceted
and much-needed treatment option in Cincinnati. With the support
of my bosses at Channel 9, I co-founded the Acoria Wellness and
Eating Disorder Treatment Programs. (Acoria is a word that Hippocrates
coined. In the psychiatric literature it means "moderation
in eating".)
Today, I'm seeing some of those same Channel 9 viewers who called
or wrote to me after the Oprah Shows take the same risks I took
and they're getting well, emotionally and physically. I can't tell
you how wonderful that is to witness!
My friend with the "Lean Cuisines" is now seeing an Acoria
psychotherapist and, at last, she's finding out why she overeats...And
she is learning alternative coping strategies for mood regulation.
Under the care of the Acoria Psychiatrist she is taking an antidepressant
that improves her serotonin level and that has greatly reduced her
need to binge. With the help of our registered dietitian she's developing
healthier eating habits. With our certified physical fitness specialist
she's working through her resistance to exercise. All of her treatment
is coordinated by a team of health care professionals who feel that
the emotional, nutritional and physical aspects of recovery must
all be addressed simultaneously and holistically.
As I sat quietly to write this article, I thought about all the
feelings I have actually felt (rather than "stuffed" down),
during the past few years of my recovery. Many of those feelings
have been exciting. Some very scary. And is often the case in life,
some have been both. Last year I experienced two sudden and unexpected
losses. A family member, who was depressed, committed suicide. My
father, who was only 64 and had not been ill, died of a heart attack.
After many strained years, he and I had just reconciled. It wasn't
fair. I was grateful that we'd finally begun to get to know each
other, but I felt cheated out of a relationship that could have
been...but now, would never be. But, I felt it all! I experienced
it all, the good and the difficult feelings, without using food
to blur the edges. And it all turned out okay.
Today, through all the highs and lows, I remain in recovery. And,
as anyone who has ever used food as their coping strategy of choice
can tell you, that's a miracle.

Do
You Have a
Binge-Eating Disorder?
The first step on the road
to recovery is seeking help
The official diagnosis of Binge Eating Disorder is new. This proposed
criteria for diagnosis will be included in the next edition of the
manual that psychiatrists and insurance companies use to determine
the need for treatment.

Research
criteria for
Binge Eating Disorder
A. Recurrent episodes of binge eating, an episode being characterized
by both of the following:
-
eating,
in a discrete period of time (e.g., within a 2 hour period) an
amount of food that is definitely larger than most people would
eat during a similar period of time under similar circumstances
-
a
sense of lack of control during the episodes (e.g., a feeling
that one cannot stop eating or control what or how much one is
eating.)
B. The
binge-eating episodes are associated with three(or more) of the
following:
-
eating
much more rapidly than normal
-
eating
until feeling uncomfortably full
-
eating
large amounts of food when not feeling physically hungry
-
eating
alone because of being embarrassed by how
much one is eating
-
feeling
disgusted with oneself, depressed or very guilty after overeating.
C. Marked
distress regarding binge eating is present.
D. The binge eating occurs, on average, at least twice a week for
six months.
E. The binge eating is not associated with the regular use of inappropriate
compensatory behaviors to prevent weight gain, behaviors that are
characteristic of bulimia nervosa or anorexia
(e.g.;
self-induced vomiting, use of laxatives, fasting, diuretics, excessive
exercise)
Ellen Shuman was a Peabody Award winner and special projects reporter
with Channel 9 News.
For
more information call (513) 321-4242
or email A WEIGH OUT.

Learn More About Binge Eating Disorder in
Ending The Cycle of Emotional Eating and Therapy
Services for Binge Eating Disorder

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