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Ashley Solomon, Psy.D is a psychologist who specializes in the treatment of eating disorders, body image, trauma, and serious mental illness.

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Tag: binge eating

12 Nov

Can we treat binge eating and anorexia together?

Ideas to Consider 3 Comments by Ashley @ Nourishing the Soul

If I had a nickel for every patient with anorexia that has told me that their doctor has remarked, “I wish you could teach some of my overweight patients your tricks,” well… I’d have more nickels than I’d know what to do with.

Unfortunately, physicians aren’t the only ones who often see these two groups as opposite. Many of us think of the  underweight and overweight as existing on opposite ends of some wide spectrum: one group has an eating disorder and consumes too little, the other consumes too much. The fat can learn something from the thin, they surmise. Just don’t take it too far, of course.

In reality, people who eat too much or too little likely share space on one end of a different spectrum, with those who have a balanced relationship with food on the opposite side.

As a recent New York Times article points out, the recent inclusion of binge eating disorder (BED) in mental health’s diagnostic manual may help bridge the gap in how we think about these two groups. As we begin to recognize and understand BED, we start to see the many similarities the disorder shares with its more familiar counterparts, anorexia nervosa and bulimia nervosa.

But what happens when you treat these disorders together?

When I first started treating eating disorders, I thought it was important to have more diagnosis-specific programming. Would a larger person really want to sit in a room with someone underweight and talk about their body shame? Would someone underweight panic to face a person that they fear they will look like if they begin eating properly? Like some others in our field, I worried that the anxieties and differences in these groups would be a barrier to them really being able to benefit from treatment.

I felt that each population deserved their own specific programming that would target their specific eating issues. We could work on refeeding those who needed to regain weight and we could help those who overeat to learn how to feel comfortable eating less.

And then I learned a thing or two.

What I discovered was that the work was incredibly similar. Both groups were using food in a way that was not in line with their health, well-being, and values. They were using as a tool to manage their difficult experiences and feelings – whether they were restricting or binging wasn’t really the point.

Similarities in their personalities and struggles emerged quickly too. Both groups tended to be perfectionistic and have high standards for themselves. They both were known as caretakers and supporters to others among friends and family. In the midst of helping others, both groups tended to forget and deny their own needs. And both groups tended to be very critical of themselves and place a really high value on weight and shape.

The research tells us that those who continue to place a high value on weight tend to relapse, and I realized that lessening the power that weight wielded was the work that all of these patients needed to do.

Further, they all needed to eat. While the assumption might be that those who binge eat or are of a larger size just eat all the time, that isn’t the case. In fact, most of those I see who binge eat cycle between eating too little food and then eating a large amount. So, like the patients with anorexia, those with binge eating need to learn to eat full, satisfying meals regularly.

Perhaps most importantly, treating these two groups together allows for some really powerful work to be done and connections to be made. Having patients to come face to face with their hopes and fears allows them to discover that their is a real person on the other end of those stereotypes and assumptions. They discover that their expectations about what it means to be fat or thin are hardly the case, and they can begin to challenge their own beliefs. Sharing treatment allows us to combat weight stigma in a powerful way, and that’s an issue that we all face, regardless of size.

If you’ve been in group treatment, did you have mixed groups? Did you find it helpful or not? If you haven’t, what do you imagine the pros and cons or combining treatment might be?

20 May

How One Woman Discovered the Importance of Shared Experience

Guest Post 4 Comments by Ashley @ Nourishing the Soul

The power of shared experience and connection in the midst of shame is one of the most incredible things I’ve experienced as a person and a therapist. Lizabeth Wesely-Casella, founder of Binge Behavior and and all around amazing woman, shares how she came to recognize just how significant that experience could be. 

Shared experience is one of the most powerful life events a person can have.  Just by having endured something together, individuals have been known to overcome prejudice, overlook bitter rivalries or simply respect one another for knowing what the other person has been through.

You see it in the solemnity and sometimes tearful exchanges between military veterans or in the way a seasoned mother knows just how helpful it is to load and run the dishwasher for the new mother who is struggling to find her stride.  You see it in the way a person who has been walking around lost in their own shame breaths easier when they find someone who doesn’t tell them they are ridiculous for feeling ugly or fat or worthless, but instead shares that they too struggle with their self esteem.  Shared experience forgives, rebuilds and nurtures.

Until relatively recently in my life I didn’t get that I needed to have a shared experience in my life.  I was prideful and yet I was filled with shame, nicely cloaked as “personal strength.”

I always thought my greatest strength was being compassionate; that it was fulfilling to listen to and love others and that everyone needs that, external to me.  In my mind my problems weren’t big enough to matter and there was no need to seek compassion for myself.  I also took it to mean that by being listened to, I was taking up someone’s valuable time with my petty, self-made problems and that doing so made me selfish.

My feelings included thoughts like, “I’m larger than the ideal woman so it must be a selfish lack of control that I’m this way.”  Also, “So what if I feel shame every time I walk out of the house, come face to face with a magazine or try on clothes that were fashionably cut for a size 2 and merely expanded to my size 18 body?  How can I possibly consider these feelings worth sharing?  Who wants to hear a ‘woman of size’ complain about her size?”  And, “I must be horribly weak because even this oppressive shame can’t make me change into the shape our culture celebrates.”   I thought that if I shared those thoughts, people would see just how shallow my feelings are, were, and have been for years.

In my mind, these thoughts of mine didn’t merit sharing.  There was nothing wrong with other people feeling this way, but in my mind I had no right to these feelings.  I had (thankfully, have) a healthy husband and dog, I clearly wasn’t starving, I had a safe home…  I was bitching about the little stuff.  Well that “little stuff,” it really hurt me inside and by not sharing it, I only added to that hurt and piled the shame on higher.

Then came the day where the need to share broke me.

It wasn’t planned, it wasn’t even the right forum, but it happened in all of its vulnerability and power and tears and snot and… compassion.  I was speaking to a group and was given a really heartfelt compliment which I struggled to gracefully accept and that breached the walls.  I could no longer hold in my pain, my shame, my fury at being unable to cover it with my social mask any longer and it all came out in an unstoppable flood of admitting my feelings.

Now, as luck would have it, I was among compassionate people.  It’s wasn’t a group therapy scenario and these weren’t people I would interact in this manner ever again; however, the experience prepared me to seek out the right venue for sharing my feelings.  It showed me that I’m not the only person can listen without judging; who needs to give compassion in order to get it and it also showed me that the “little stuff” feelings are more common than I thought.  I had a shared experience in thinking about myself the ways that I did and I was not alone in being ashamed for feeling those feelings – I was not alone in that group.

When I finally found the right place for me to discuss my struggles with my body image and my binge eating disorder (after finding out that those were the struggles that I was having in the first place), I found that by sharing I was getting and giving a free pass of sorts.  I was present with people who had checked their judgmental selves at the door (or the Login page) and for us as participants, no topic or feeling was to go un-honored.  We each needed to know that our feelings were like the feelings others had and in knowing that, those feelings become less burdensome on us as individuals.  They became less troubling and far less powerful.

Those people that I have shared experiences with, they are part of my pack.  I will protect them and support them and I know that they will do the same for me.  We may not have met otherwise, we may not have otherwise enjoyed each others’ company, but in knowing the struggles we share, knowing them bone deep, we respect and stand for one another.

Shared experience means that you know from your own life what I’m dealing with in mine.  Can I count on you to value all that “little stuff” that I question about myself?  Can you trust enough in yourself to ask the same of others?  If sharing my own story has helped encourage you in any way, then that “little stuff” just became a little more valuable.

Lizabeth Wesely-Casella

Lizabeth Wesely-Casella is and advocate for people with binge and impulse control disorders.  She is the Founder of BingeBehavior.com and she uses her experiences with binge eating, binge drinking and trichotillomania to support others through writing and speaking.  Stay current with the latest information and join the forums at www.BingeBehavior.com or follow on twitter at @BingeBehavior.

19 Jan

What To Do the Morning After a Binge {On the Move…}

Guest Post 4 Comments by Ashley @ Nourishing the Soul

 

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I am honored to have written a post for the fabulous site, HealthyGirl.org. Sunny Sea Gold, author of Food: The Good Girl’s Drug and tireless advocate for those struggling with food issues, was kind enough to have me share my thoughts on a tough one – what to do once you’ve engaged in a binge. Here’s a bit of that post:

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Your eyelids reluctantly lift from their resting place as the harsh light washes over you, signaling it’s time to rise from this intoxicating slumber. You’d like to pull the warm comforter back over your head and disappear into the abyss of ignorance – the place where you can forget the shame of last night.

But your body won’t let you forget. You feel the distinctively sharp pains deep in your belly; you still feel the food sitting high and heavy. Your mind spins in circles, looping in and out of the names that last night held such beauty and power, but now elicit a feeling of disappointment. Oreo and Oscar Meyer and Special K and Hostess. Those bastards – letting you down once again.

You promised yourself this wouldn’t happen again, you wouldn’t let food leave you feeling bent and broken in the morning. But here you are – alone, frightened of the voraciousness of your hunger, and desperate to get out of this cycle.

Handling the day after a binge episode is most certainly not for the faint of heart; it is one of the most difficult challenges that we face in overcoming emotional overeating and binge eating. When all we want to do is hide under the covers is the precise moment at which what we need to do is call on all of our reserves and prepare for battle. We are no longer just fighting against the temptations of trigger foods, but also against the insidious voices that try to undermine our recovery….

Learn the tips and read more here

16 Dec

Five for Friday :: Binge Eating Edition

Five for Friday No Comments by Ashley @ Nourishing the Soul

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I’m getting super excited to head to Philadelphia in March for the Binge Eating Disorder Association National Conference. (You should join us!) I’m starting to organize my thoughts and plan out the two talks that I will be taking part in. One is on the how social media can be part of the recovery process from binge eating, and the other is about whether binge eating is an addictive process and what the answer might mean for treatment. Fun stuff, right?!

Since BEDA and binge eating has been on my mind a lot lately – and, fortunately, on the minds of many of those working on the newest edition of the diagnostic manual for mental health (BED will soon be officially recognized!) – I’m focusing this week’s Five for Friday on this insidious issue. With almost 3% of the population experiencing this disorder at some point in their lifetime (that’s over nine million people!), we cannot continue to ignore the suffering that it creates for individuals, families, and even communities.

These amazing writers have covered the topic eloquently, so take a few moments to learn more:

 

Do you have a post to share on binge eating? Include it below!

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