Jessica M. described her pursuit of food in terms of a junkie itching for a fix, an alcoholic lusting for a drink.
“I was out of control,” said the 34-year-old Chicago speech therapist who asked that her full name be withheld in keeping with the custom of the 12-step program where she found help.
“I was either eating or thinking about eating. I would sit on the couch with the shades pulled and with boxes and bags of food, and I would eat.
“I was always thinking about how I was going to get away from people so that I could eat or how I was not going to eat this or that, who was going to see me.”
The subterfuge included trips to “sleazy restaurants” in out-of-the-way locations where nobody would recognize her.
“I would eat in front of other people,” she said. “But never the way I ate when I was alone. I didn’t sit at the table like a lady.
“I would throw food away, saying, ‘I’m not going to eat any more of that.’ And then I’d go back and get it out of the garbage.”
Jessica went on her first diet at age 11, and from that point she grew heavier and heavier. “I needed food to get through my day,” she said.
Over the years Jessica struggled to find some way to stop compulsively overeating. She tried counseling, hypnotism and even just accepting her obesity.
“I acted like everything was OK,” she said. “I looked happy, but inside, though, I hated myself.”
She eventually found help in Food Addicts in Recovery Anonymous, a program based on the 12 steps of Alcoholics Anonymous. The program helped her, she said, because in addition to fellowship and spirituality, it includes a food plan that bans flour and sugar, substances that she said trigger an addictive response in her.
“I look normal,” Jessica said. “I lost 100 pounds [five years ago]. I have a normal-size body. I live a normal life with a husband and baby. But I always have to remember I’m a food addict in recovery.”
Few health-care professionals consider food an addictive substance, given that it’s not something you can abstain from and continue to live.
The diet industry regards compulsive overeating as a willpower problem. Medical professionals also tend to look at it as a problem in self-management, although they agree there are biological, psychological and social factors that contribute to the problem.
It’s people with compulsive eating problems who tend to describe themselves as “food addicts,” and their eating goes way beyond pigging out on a big bag of potato chips occasionally.
Among other indications, it involves the inability to stop eating, obsession with eating and diets, secret eating, hiding food, feeling guilt or shame about food intake.
Some self-described food addicts remember feeling different since childhood.
“My problems with food and weight go back to age 4 or 5,” said Cheryl Miller, a Chicago woman in her 40s.
“My mom or my grandmother would make brownies and I would sneak into the kitchen [for more]. I would try to cut them in such a shape so that they didn’t know I had eaten more.
“Back then ice cream came in cubelike containers that opened on both ends. So I’d eat from the bottom in the hopes they wouldn’t know it.
“I stole money from my grandma to buy candy at the corner grocery store.”
For Miller, this sort of behavior continued into adulthood.
“As a working adult I would make excuses to go out on deliveries for the business where I worked so that I could get candy, and I would eat it in the bathroom at work so people wouldn’t know. It’s like alcoholism. The thinking is very similar.”
When Miller was told she was endangering her health, she couldn’t relate to it. “All I cared about was food,” she said.
Daniel le Grange, director of the eating disorders program at the University of Chicago Medical Center, acknowledged that patients who are binge eaters often “describe their relations to food the same way a person with an addiction disorder would.”
Le Grange said there is an academic debate about whether “binge eating” should be recognized as a separate eating disorder along with anorexia and bulimia.
With the growing recognition of binge eating as a problem, he said, “we’ve kind of annexed people with obesity within the fold of eating disorders.”
The diagnosis of extreme binge eating is the non-specific phrase “eating disorder not otherwise specified,” he added.
At the Life Enrichment Center in Lawrence, Kan., an outpatient eating disorders program, severe compulsive eating is treated as an addiction.
Emotional response
Ed Bloch, a licensed clinical social worker who co-directs the center, said he classifies compulsive overeating as either “deprivational eating,” the result of chronic dieting and chronic deprivation, or “addictive eating,” which is often an emotional response.
“It’s not a chemical addiction, but certainly food has the same or similar qualities [to drugs or alcohol] in terms of what it does to the biochemistry,” Bloch added.
“It can increase serotonin levels [in the brain]; it can increase endorphins. It can reduce anxiety and deal with depression. A psychological and physiological need results.”
More typically, Brad Saks, a clinical psychologist at Northwestern Memorial Hospital’s Wellness Center, calls food “psychologically addicting,” rather than physically addicting. He said people with severe overeating problems tend to get into a cycle.
Typically, Saks said, overeaters “would feel bad or something bad would happen in their life that makes them feel anxious or lonely. They turn to food as a way of making themselves feel better, to either decrease anxiety or decrease fatigue, for instance.”
For someone trying to lose weight, the good feelings are short-lived, followed by guilt for indulging. The self-blaming then leads to another cycle of eating.
“I always did feel like a druggie at my worst,” said Jessica Strange, 32, of Lawrence. “The drive for food is almost addictive. When you’re really in there, it just doesn’t feel like you have much control over it.
“Just like a druggie will self-destruct on the quest for a high, I felt I was doing the same thing.”
Strange has run the gamut of eating disorders. At 15, she started out restricting her food intake, but then found that impossible to continue.
“I think I was predisposed to emotional eating,” she said. “When I was dealing with a lot of emotion and anxiety, I always turned to food. Then I would feel immediate overwhelming regret and I turned to purging. I was bulimic for years. I finally I broke the binge-purge cycle, but then I was just a compulsive eater. I didn’t purge.”
`You can’t just stop’
Strange said she had counseling on and off over the years. After the births of her two children, she spiraled downward again.
“I was out of control around food. It was this awful feeling that I couldn’t control it and the realization I had been doing it for half my life.”
She found help through the Life Enrichment Center. What was different there, she said, is that she learned about options.
“You can’t just stop something like [compulsive eating],” she said. “You have to have something else to fill its place before you can give it up.”
Exploring creativity through drawing and sketching was part of her therapy. She said art “opened my mind to other possibilities and took the focus off eating and weight.”
While she wasn’t morbidly obese at 5 feet 4 inches and 175 pounds, she was overweight and has lost about 40 pounds.
She still overeats sometimes, she said, “but instead of feeling like a victim, I just see it for what it is, a bump in the road, and I keep on moving forward. I don’t spiral into this self-hatred and loathing. I no longer have this dark kind of despair around it.
“Food meant way too much to me. I would do stupid things to get what I thought I wanted to eat.”
Now she said she wouldn’t dream of bundling up her kids at 9 in the evening just to go out to buy cookies.
In addition to regular therapy, Bloch, of the Life Enrichment Center, uses a support/educational program, the Eating Disorders and Education Network (EDEN) Process that was developed by three Michigan women based on their own struggles with eating disorders.
The program is available online for a $12 monthly membership fee. It involves virtual workbooks and discussion groups. It is designed to end isolation, but it is skill-based and more structured than the usual 12-step group, according to co-founder Alice Grisham.
It is also available on a community level, so far through groups in Lawrence, Kan., Hawaii, San Francisco, Orlando, Minneapolis and Durango, Colo. The groups are led by a facilitator, either a therapist or recovered individual, and include a dietitian. Bloch uses EDEN because it provides an adjunct to therapy, a way to teach coping skills, and it makes outpatient therapy “more viable.”
“Insurance companies don’t pay for intensive outpatient treatment for eating disorders,” he said. “They only pay for regular therapy.”
Cheryl Miller, who said she would binge until she passed out, got treatment for her eating disorder at 30. She went from her highest weight of about 280 pounds to around 170. She believes there’s a double standard when it comes to obesity versus anorexia and bulimia.
“The sad part about growing up obese is that there is a stigma that is not there with anorexia,” she said. “Anorexia is seen as [life-threatening]. But I could have died. I was suicidal. I would sit in the bathtub and think about cutting my wrists over my lack of control over the obesity.”
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On the Web
Check out these Web sites for more information about food addiction and eating disorders:
– Food Addicts in Recovery Anonymous (FA)
www.foodaddicts.org
– Overeaters Anonymous (OA)
www.oa.org
– EDEN Process
edenprocess.com
