Introduction

Binge Breaker! Stop Out-of-Control Eating and Lose Weight
by Dr. Peter M. Miller

It's 2:00 A.M. Is a carton of ice cream calling your name?

If you find yourself eating more than you know is healthy-perhaps while standing over the sink in the middle of the night-you may be suffering from Binge Eating Disorder, which affects nearly half of all overweight Americans. You are not suffering from bulimia; binging simply means you're eating more food than feels comfortable. We all do it. But its demoralizing and distressing effects are most felt by yo-yo dieters. The problem is not a lack of motivation or determination, but self-sabotaging eating patterns. Now, one of America's most trusted and well-known weight-loss specialists, Dr. Peter Miller reveals the 6-step program that has already helped thousands of dieters conquer binge eating and lose weight permanently. Discover:

• The psychological and biological reasons why you binge
  
  
• Ways to eliminate the "all-or-nothing" syndrome, where one cookie equals a box, or one bite of ice cream becomes a carton
  
  
• How to eat and enjoy "forbidden" foods in moderation and eliminate "shameful" acts of eating
  
  
• Breakthrough techniques of "mindfulness"-the key to overcoming binge eating permanently
  
  
• Behavior strategies, flexible eating plans, and a moderate exercise program that can change your life and free you from your dependency on overeating.

If you believe you are a binge eater, you no longer have to suffer in silence. You are not alone!

Anne, a 35-year-old graphic designer, learned as a child to keep negative feelings to herself. Instead, she would eat when she felt angry, resentful, and depressed. As an overweight adult, she went on one diet after another and lost weight, but inevitably binged and gained it back.

Alex, 35, saw foods as either "acceptable" or "forbidden." As a result, he was either starving himself on liquid diets or binge eating. One cookie became a binge because he'd been "bad," and guilt and self-blame caused him to lose confidence in his ability to get back in control.

Elizabeth, 50, had spent her life pleasing others. She had grown up as "the good girl," always trying to please her perfectionist parents. As an adult, people took advantage of her nature to the point that she was feeling used and abused but couldn't do anything about it-except binge.

The strategies in this book showed these people and many others how to eat sensibly and end their self-destructive cycles. You too can be a... Binge Breaker!™

Beyond Overeating

After spending most of her adult life unsuccessfully trying to lose weight, Janet finally found a diet that gave her hope. After a month of dieting, she had lost 12 pounds and her spirits were high.

Then, at 4:15 Tuesday afternoon, self-restraint came to a screeching halt. Janet was home alone feeling bored, tense, and restless. Her day had been stressful and hectic. Her husband was out of town on business and would not be home that evening. She felt very hungry, strongly craving something sweet.

She just had to eat something. To keep dietary damage to a minimum she fixed herself an English muffin with nothing on it. She finished it quickly, experiencing little satisfaction. She fixed another, but this time smothered it with strawberry jam. She ate rapidly, feeling driven to eat more. Rummaging around the kitchen, Janet found an opened package of Oreo cookies that her daughter had brought into the house. The package was still about three-quarters full. Almost without thinking she turned on the television, sat down, and proceeded to eat one cookie after another until the package was empty. As she was eating, Janet felt that she was unable to control what or how much she was eating. She felt uncomfortably full.

When the impact of what she had done finally hit her, she experienced an extreme feeling of self-disgust, anger, and guilt. She later described her thoughts and feelings to me in this way:

I felt totally defeated. I began thinking, "Now I've really blown it. Stupid! Stupid! Stupid! I'll never do it. This happens every time I try to lose weight. What is wrong with me? Who cares anyway? It doesn't really matter. Nothing matters. I'll never be able to lose weight. Things will never change. I'll always be fat."

With that, Janet gave up. She had planned to eat a low-fat, low-calorie frozen meal for dinner but instead she picked up the telephone and ordered a medium pepperoni pizza with extra cheese to be delivered. After she ate the pizza, her mood became even more negative. She felt embarrassed, depressed, and hopeless. She stopped dieting and exercising and over the next three weeks gained back all the weight she had lost.

If Janet's experience sounds familiar, you may be suffering from a newly described eating syndrome known as binge-eating disorder, an eating problem that keeps thousands of women and men from successfully losing weight and keeping it off. Recent studies have shown there is a subgroup of overweight individuals who have a serious problem with persistent out-of-control eating. Successful dieting is not possible unless this basic eating problem is overcome.

The Dieter's Downfall

Even with the best diets available, you may find it difficult to lose weight and impossible to keep it off once the weight is lost. I found this out with the dietary program that I prescribe in my book The New Hilton Head Metabolism Diet. Over a million and a half overweight people have followed this popular plan with the majority doing very well. However, some readers complained to me that their temptation to binge eat was too great to allow them to follow low-fat, low-calorie menus consistently.

Over the past 10 years behavioral scientists have begun an intense investigation of people whose periodic out-of-control eating goes beyond simple overeating. The finding of these studies is that as many as 30 percent of people who seek help for weight loss treatment suffer from what has now officially been diagnosed as binge-eating disorder-often referred to by its initials, BED. This syndrome is characterized by periodic episodes of compulsive overeating, or out-of-control eating, that severely hampers attempts at successful weight control.

Binge eaters overindulge when they are alone and they typically feel disgusted, depressed, and embarrassed afterward. They eat large amounts of food even when they are not physically hungry. This eating is much more rapid than usual and continues until the binge eater is uncomfortably full. If you have binge-eating disorder it will keep you from losing weight. While many people with this problem can lose some weight in the short term, it is almost impossible for them to keep the weight from returning. Because of their binge eating they often gain their weight back quite rapidly.

The Extent of the Problem

Early information on binge-eating disorder came from large field studies conducted in the early 1990s by Dr. Robert Spitzer and his colleagues at Columbia University. This research group found that while binge-eating disorder is relatively uncommon in the general public (about 2.5 percent), it is very prevalent among overweight individuals seeking help to lose weight.

Prevalence rates increase with the complexity of the problem. For example, about 16 percent of those attending commercial weight-loss programs such as Weight Watchers meet the criteria for binge-eating disorder. More intensive, comprehensive programs conducted by universities, hospitals, and medical schools are found to have a prevalence of 30 percent. Approximately 70 percent of members of Overeaters Anonymous, a self-help group for overweight compulsive eaters, show characteristics of this disorder. Binge-eating disorder is found in men and women of all ages. It is slightly more common in women than men with about a 3-to-2 female-to-male ratio. Its prevalence is similar in various ethnic groups.

Is Binge-Eating Disorder Simply Overeating?

Binge-eating disorder is not just eating too much from time to time. This happens to almost everyone. People with binge-eating disorder feel driven to eat, as if they cannot stop themselves. During the eating episode they experience a strong sense of being unable to control their behavior. They also feel great psychological distress over this problem but don't know what to do about it. Binge eating is not simply a matter of being weak-willed because physical hunger is rarely involved.

Is Binge-Eating Disorder a Form of Bulimia?

Just as binge-eating disorder does not describe simple overindulgence of food, neither does it represent an eating disorder as serious as bulimia or anorexia. Bulimia, or more correctly bulimia nervosa, is a severe eating disorder that occurs in young women of normal weight. Not only do bulimics overeat but the most important aspect of their diagnosis is that after overeating they engage in purging (forcing themselves to vomit by sticking a finger down their throat), fasting, or excessive laxative use to compensate for their overeating. They do this, in part, because they have a severe body image disturbance that gives them a morbid fear of gaining weight.

In contrast, while people with binge-eating disorder feel upset and guilty after they overeat, they do not usually purge, fast, or use laxatives to excess. In addition, unlike the normal-weight bulimics, people with binge-eating disorder are overweight. Bulimia is primarily a disease of young women while binge-eating disorder affects men and women of all ages.

Anorexia nervosa is a separate eating disorder that involves a total refusal to eat rather than binge eating. However, all of these problems involve a self-concept that is too much related to body image and not focused enough on internal qualities of character.

The main fact for you to know is that binge-eating disorder is much less severe and complex than bulimia or anorexia even though it is far more widespread. It is also easier to treat, and the success rates with appropriate treatments are high.

There Is Hope!

While we continue to learn about the problem of binge-eating disorder, we now know enough to help anyone with this syndrome. The most important questions in your mind right now may be, "Do I have binge-eating disorder?" and, more important, "If I do have it, what can I do about it?"

In the following chapters, I will explain exactly what this problem involves and give you a test to see if you suffer from it. Once we have this information, I will outline a step-by-step program that can help you.

It is possible to overcome binge-eating disorder and free yourself from your dependence on food. Traditional weight-reducing diets will not help because they do not address your binge-eating problem. You've probably already discovered this by repeated failures on diets. What you need is the special behavioral, emotional, and dietary program that I will outline for you.

If you have a binge-eating problem you may be suffering in silence, feeling so embarrassed that you don't know where to turn. I want you to know that you are not alone. Binge eating is a common problem among chronic dieters. Unfortunately, binge-eating disorder not only undermines your attempts at weight loss, but also causes you a great deal of suffering and emotional distress.

There is hope. You can overcome this terribly frustrating problem and free yourself from the power of food. Once you accomplish this goal, you will stop feeling guilty, start losing weight, and regain control of your life.

© 1999 by Peter M. Miller

About the Author

Peter M. Miller, Ph.D., founded the Hilton Head Health Institute on Hilton Head Island, South Carolina, in 1976. Dr. Miller received a bachelor of arts degree from the University of Maryland and a doctorate in clinical psychology from the University of South Caroline. He holds a faculty appointment in the Department of Health Promotion and Education at the University of South Carolina. He is the author of 11 books, 70 research articles, and is editor in chief of the scientific journal Addictive Behaviors. Dr. Miller's work has been profiled on television as well as in national magazines.