Bulimia & Food Addiction

Food addiction begins with physical craving, evolves into mental obsession, and, ultimately, becomes a whole life of spiritual illness. It is also a physical disease of chemical dependency upon one or more foods or on volumes of food in general.

Bulimia is a psychological illness, a mental-emotional problem usually rooted in unresolved trauma from before the earliest incident of purging.

It is fairly straight forward to know if you are bulimic. Do you binge and purge?

Do you keep doing this after you decided to stop? More specifically, do you physically vomit food that you have eaten when you are not sick? Or do you use pills, ipecac, laxatives or diuretics to try to take off weight? Or do you exercise excessively – sometimes to the point of hurting yourself – to try and control weight? Do you use highly restrictive dieting over and over again? These are the most common physical symptoms of bulimia. If you are not sure if you are bulimic, you can ask a doctor or eating disorder specialist for a diagnosis.

How does a bulimic know if they suffer from food addiction?

One simple indication is if they were obsessing about and/or bingeing out of control on commonly addictive foods before they started purging. The “food drug” to which people most often become addicted is sugar in one of its myriad forms. The second most common “food drug” is flour and other refined carbohydrates which metabolize quickly into simple sugars. Further addictive food substances may include: chocolate, excess fat, wheat, artificial sweeteners, salt, caffeine and a large volume of any food.

Sometimes addiction to volume is simply another form of sugar addiction, but there is also a separate process in which people do not have the normal bio-chemical sensation of satiation.

If someone was binge-eating before they became bulimic, it is usually clear that this is a primary mental-emotional complication of bulimia nervosa. But is this binge-eating due to psychological problems? Or is it the beginning of chemical dependency? Or is it both?

This is sometimes less easy to discern. One possible indication of food addiction is that there are symptoms of detoxification when specific binge foods are completely eliminated. If the person has food cravings soon after abstaining and wants to eat to deal with the cravings, this is an even stronger sign of addiction to that particular food.

Not all bulimics are food addicted, but, for the many who are, understanding and treating their chemical dependency on food is essential to long term recovery from bulimia. Abstinence and recovery helps develop better emotional skills and enables healing of primary trauma.

If you do not want to abstain from all binge foods completely, there is another way of seeing if you are food addicted. When you try to eat all foods in moderation and find that you still want to binge even when you work at dealing with underlying feelings, this could be because you are also chemically dependent on food. It will take some time to be sure about this, of course, for it can take months or years of intensive work to develop strong emotional skills and work through all unresolved trauma.

One test: have you been doing therapy for a year or more for your eating disorder and are you still bingeing and purging? If so, it might be useful to look more seriously at food addiction, because you may not just be medicating feelings; you may also be biochemically addicted.

Treating Food Addiction

To treat food addiction, it is important to begin by detoxifying from all binge foods and eliminate the physical cravings for them. This means abstaining from all trigger foods completely. You can identify the foods you are addicted to and get support for detoxification exactly like other food addicts, though the bulimic often commits to abstaining from purging as well as specific foods. The Twelve Step fellowships (such as Overeaters Anonymous and Food Addicts Anonymous) are excellent support programs for this process. ACORN workshops are designed to help those who need additional professional help.

We have a number of people working in ACORN who are bulimic and have spent a year – sometimes several years – in therapy for their eating disorders. These bulimics said that although they had been helped in dealing with their feelings, their eating was still out of control. Often their therapist had said that they “should” be able to eat in moderation or that the rigor of committing food to a sponsor every day and weighing and measuring was “too rigid.” However, when they tried treating themselves as if they were addicted, their cravings diminished. They were better able to deal with difficult feelings, and they came to see that they had a food addiction.

There is a lot of misunderstanding about food addiction – even in the medical community. It is not taught at all in many medical schools or graduate programs for dieticians and the differences between bulimia and food addiction are seldom clarified for counselors and therapists.

Questions for Bulimics to Ask

Do I ever think of purging without bingeing first?

If you always plan on bingeing – especially if the binge is on addictive foods – before you purge, then the primary problem may be the food, and the underlying problem may well be chemical dependency. Food addiction is a primary disease, just like addiction to alcohol or drugs. If someone is drinking out of control and depressed, the alcoholic must begin by putting down the drink and accepting that he or she is an alcoholic. If one is medicating feelings with pot or some prescription medication, the drug addict must first put down the drug. For most, there is usually much more emotional and spiritual work to do, but this is not possible while still self-medicating with an addictive substance. It is the same with food addiction.

Another basic question helps you see the difference: Would you suggest to an alcoholic or drug addict that they work on underlying therapeutic issues while they are still using alcohol, cocaine, or some other drug of choice? Well, some foods have exactly the same opiates as in these more socially identified addictive drugs.

The best way for you to tell if you are addicted to food is to treat yourself as if you are food addicted for six months to a year.

  1. First, look at your own eating experience and identify foods and eating behaviors to which you may be addicted.
  2. Second, get the support – from peers and or professionals – to eliminate those foods entirely and to make abstinence the number one priority in your life.
  3. Third, continue to work on any difficult feelings, irrational thoughts and deeper spiritual issues that pull you back to the food.

If you are able to stay abstinent – or, if you make substantial improvement in dealing with food – it’s likely that you are food addicted. If you are not, you are still making progress.

Slip Inventory Explanation: Steps to a Slip Inventory

A “food slip” begins with a spiritual disconnection (from being in “fit spiritual condition”); followed by emotional disconnection (trying to be the “director” and control events); and then the obsession (false craving) with food, which leads to addictive eating.

Recognizing that a slip begins long before the food is eaten, this tool will help you identify what happened at each stage, so that you can learn to back out of relapse. Of course, if you don’t do your 12 Step work, the food slips will continue to happen until you are in full relapse. This is not a program of slip inventories! If you are in full relapse, you need to do First Step writing.

It’s important to do this within the first 24/48 hours of the slip. Otherwise, details that are already difficult to recall will disappear entirely into the food addict’s thinking. The longer you wait, the more blurry the details become. This is part of a food addict’s “strange mental blank spots.” It’s easier to slip into denial when we don’t remember what we were thinking and how we felt.

  1. Select lined paper and write on every third line. You will be putting in other details later. Write a story of what happened leading up to your slip, starting at least four hours before it happened.
  2. Write about the slip as if you were holding a movie camera on yourself. Your actions, thoughts and feelings should be included, right up to “and then I ate…”
  3. Identify where the “emotional relapse” happened. When did you get angry, start obsessing, try to control a situation, feel overwhelmed by fear. Write the feelings on the empty lines. You may need another food addict to help you with this.
  4. What were the lies you told yourself so that you could eat? “It’s only one bite.” “I’ll start tomorrow.” “It’s my last chance to eat something yummy.” “Oh, screw it; I’m going to have what I want.”
  5. After that, identify the spiritual disconnection. Did you have a connection to your Higher Power that morning? How long ago did you lose it? That’s when your slip really began.
  6. Read this inventory to two other abstinent food addicts, in addition to your sponsor. You need abstinent people to help you through the blank spots and denial. People that are still in the food are not clear enough to help you.
  7. Write out your plan for how to address the situation the next time it happens (AND IT WILL.)
  8. Finally, what is the spiritual lesson in your slip?

© Phil Werdell & AEH 2008

The Process of Abstinence is Surrender

The initial surrender necessary for recovery from food addiction is to accept completely that you are a food addict. This means that you have a progressive disease that is physical, mental-emotional and spiritual in nature. Because it is a disease of the mind, there are times when you cannot trust your own thinking, so you need to rely on a Power beyond yourself. What does this look like specifically?

Physically

Physically, it means – A surrender of one’s specific binge foods, i.e.foods to which you are addicted. If one is addicted to volume, surrender to weighing and measuring or to some other external form of portion control.

This is most commonly done by surrendering to a food plan. A food plan defines the general content of abstinence. Food addicts need to be specific about what it means to be abstinent. What foods can you eat? What foods can you not eat? How much do you eat? How do you determine nutritional balance? It is common for food addicts who are new to recovery or are having difficulty getting abstinent to make this decision with someone who understands food addiction. If this person is not medically trained, it is also important to consult with a doctor, dietitian, or other health professional.

It also may mean to surrender to more structure and support until you are able to be food abstinent and stay abstinent. This might mean physically being in meetings, physically eating with other recovering food addicts, even staying with other abstinent food addicts 24/7. It might also mean putting oneself in a professionally-led recovery group, workshop, or in-patient treatment.

Mentally

Mentally it means – Surrendering to not making decisions about your food by yourself. Since most food addicts are not able to do this alone, it is common to make day-to-day decisions with a food sponsor. In the 12-Step fellowships, this is called committing your food to a sponsor. It also means accepting direction and support to surrender your food specifically one day a time.

In practice, the most common way of surrendering with a sponsor works like this:

  1. Write down your food before you eat it. This means you let go of or surrender spontaneity regarding food. You have to plan ahead. There is a slogan that goes with this principle, “Failing to plan is planning to fail.”
  2. Read what you wrote to your sponsor. This means you give up or surrender self-sufficiency and making decisions about your food alone. It means you give your word regarding your food. The slogan is, “Commit what you eat, and eat what you commit. Nothing more, nothing less.”
  3. Don’t change your commitment (unless there is a health emergency). This means let go of or surrender grazing or snacking between meals. It means let go of or surrender making decisions about food impulsively.
  4. Afterwards, be rigorously honest with your sponsor. This means let go of or surrender of your self-sufficiency and pride. If you are abstinent, say to your sponsor that you are. If you are not abstinent, i.e., made changes, eaten something you didn’t commit to eat, skipped a meal or forgot to eat something, be rigorously honest about how you are not abstinent and develop a surrender plan for the next day. The principle is again summarized in a fellowship slogan, “You are as sick as your secrets.”

This practice of rigorously surrendering one’s food daily with a fellow recovering addict may sometimes seem drastic, but it also seems to be what works for most of the thousands of food addicts who have found abstinence and recovery in the various food 12-Step fellowships. A common response about committing one’s food and/or weighing and measuring is as follows: “No, while I sometimes don’t want to do it, I no longer see it as a burden. It gives me a freedom regarding my food and my life that I never had before.”

Spiritually

Spiritually, it means – Surrender your food and your will to the care of a Power greater than yourself. This usually means surrendering to the practice of making conscious contact with God (as you understand God). This might be as simple as praying for help with your abstinence and life each morning, and saying” Thank You” at the end of the day. It might mean taking time each day for spiritual reading and/or silent meditation.

For someone having trouble with the God idea or with having a personal relationship, it means surrendering to work through the Twelve Steps rigorously from beginning to end (or some other effective spiritual practice).This is best done with a sponsor – or in a group. The bottom line is to have an effective spiritual awakening; a change in personality that enables us to live soberly without using food addictively.

Finally, the ultimate spiritual act for a food addict is surrendering to regularly helping another food addict. This is at once the most practical way to stay food abstinent when all other things do not work and the best way to assure there will continue to be a spiritual community to help you if and when you need it. In the end, often in spite of themselves, abstinence is a way of life for food addicts in that they surrender to being with and serving God.

There are, of course, as many ways of looking at surrendering one’s food as there are paths to God. This is just one that works for many food addicts. Thank God.

© Phil Werdell, M.A.

Practical Reasons for Weighing and Measuring Your Food

While every food addict does not need to weigh and measure their food, there are some very compelling reasons for doing so:

  1. Weighing and measuring simplifies portion control. There is no question of how much of each food to eat.
  2. For the food addict who is weighing and measuring, it is always clear exactly what surrender means.
  3. If the amount of food in your plan has the amount of calories to be your ideal weight, you will eventually reach it and maintain this weight.
  4. For those who sometimes – or always – have a distorted concept of food volume, weighing and measuring is like wearing glasses with the corrected prescription.
  5. Weighing and measuring is a gentler and a much less expensive alternative to intestinal bypass surgery.
  6. For volume addicts – who almost always want more food – weighing and measuring assures that you are getting enough to eat.
  7. Weighing and measuring eliminates the need for all the head talk about “how much is enough today?”
  8. Being committed to weighing and measuring assures that you know there is one important way you are remembering that you are a food addict.
  9. No one gets hurt– including the food addict – by a practice of weighing and measuring.
  10. When a food addict weighs and measures in public, there is always the chance another food addict will be helped by seeing and talking about this practice.

© Phil Werdell 2010

Diet vs. Food Plan

Why Use the term Food Plan?

Since most of us have been unable to eat or diet like normal eaters, we choose not to use the word “diet”. To us, diets mean something we can follow by reason and will power alone. We have come to accept that we cannot manage our food by self-control alone. Willpower failed us utterly, so we surrender to our powerlessness over food. The purpose of the food plan is to make this surrender more specific.

Few compulsive eaters chose a food plan because this is always the way they want to eat the rest of their life. Rather, we chose to surrender to a specific food plan because we have admitted we are powerless over food. There is real choice in deciding to use a food plan and what specific plan to use, but the first and most important decision is choosing to use a food plan – and practice surrendering to it – that works for the specific ways we are addicted to food.

Most abstinent food addicts have an abundance of choice regarding what they eat. There are over two hundred different foods in most grocery stores, and only a handful are foods most of us find addictive. However, there is no choice about which food plans or principle will work and which will not. If you are addicted to a specific food, for example, it is not likely you will be able to include this food in your plan and have an abstinence that works.

Most compulsive eaters would like to be able to eat everything they want, exactly the way that they want, and suffer no consequences. Most of us would like to eat like normal eaters, but this choice is simply not available to us if we also want recovery. There is no such thing as surrendered food abstinence without giving up foods and ways of eating that your disease has long been wanting dearly.

By Phil Werdell, M.A.

Normal Eater, Emotional Eater, Food Addict

NORMAL EATER, EMOTIONAL EATER, FOOD ADDICT ©
NORMAL EATER
(problems of obesity)		 EMOTIONAL EATER
(eating disorders)		 FOOD ADDICT
(chemical dependency)

The Problem is Physical:

  • Excess Weight

The Problem is Physical and Emotional:

  • Binge eating, restricting, and/or purging over feelings
  • Unresolved trauma
  • And possible weight issues (either over-or- underweight)
 The Problem is Physical and Emotional and Spiritual:

  • Abnormal response to specific foods
  • Physical craving (false starving)
  • Mental obsession (false thinking)
  • Self-will run riot (false self)
  • And often trauma and weight issues
The Solution is Physical:

  • Medically approved diet
  • Moderate exercise
  • Support for eating, exercise and lifestyle change
 The Solution is Emotional:

  • Develop skills to cope with feelings other than with restricting, purging or bingeing
  • Resolve past emotional trauma and irrational thinking (healing trauma)

. . . and Physical

  • Include solutions to the left
 The Solution is Spiritual:

  • Abstinence from binge foods and abusive eating behaviors
  • Rigorous honesty about all thoughts and feelings
  • A disciplined spiritual program, e.g. the 12 Steps

. . . and Emotional and Physical

  • Include all those applicable to the left
Using What Process?

  • Willpower
 Using What Process?

  • Moderation (along with expressing feelings)
 Using What Process?

  • Surrender, i.e., deep acceptance
© Copyright 1997 by Philip R. Werdell & Mary Foushi. Edited by A E Heald 2009

CHART EXPLANATION

NORMAL EATERS may have problems with weight (even obesity) if they do not eat the appropriate number of calories (and exercise moderately) to maintain an ideal, healthy weight. The problem for normal eaters is primarily physical: If they choose to eat a balanced diet, exercise moderately, and get support for lifestyle changes, they can lose unwanted weight (or gain weight) and keep their weight in a normal range. Basically, willpower works; just put down the fork and push away from the table.

EMOTIONAL EATERS often have similar problems with weight but find themselves powerless to follow directions to lose (or gain) weight and restore their health even when they want to. For those with diagnosable eating disorders – i.e., anorexia, bulimia or binge-eating disorder – the underlying problem is mental-emotional: It’s not what you are eating but rather what is eating you. Problem eaters use food to numb or medicate their feelings. What works for problem eaters are a moderate food and exercise plan, as well as developing skills to cope with feelings.

FOOD ADDICTS become chemically dependent on specific foods or on food in general. The way their body processes food is bio-chemically different that that of normal eaters and emotional eaters. Many food addicts are predisposed to becoming addicted to food – especially to sugar, flour, wheat, fat, salt, caffeine, and/or excess volume to any food – just as alcoholics are predisposed to being chemically dependent on alcohol and drug addicts to heroine, cocaine or prescription drugs. As the disease of addiction progresses, food addicts become powerless over physical craving and develop distortions and obsessions of the mind that keep them in denial.

SO, WHAT WORKS FOR FOOD ADDICTS?
Diets alone don’t work. Simple therapy alone does not work. What works for food addicts is surrender. Surrendering, through physical abstinence, the foods to which they are chemically dependent. Surrendering to rigorous honesty with all their thoughts and feelings about food. Surrendering to whatever structure and support is needed. Ultimately, surrendering to the process of a spiritual experience, i.e., the type of psychic change that has given relief and healing to thousands of chemically dependent individuals.

Most food addicts have weight problems – the majority are obese, though some are a normal weight or may even be dangerously underweight. Many also have unresolved emotional trauma similar to those who are diagnosed with eating disorders, e.g. anorexia, bulimia, binge-eating disorder. In short, most food addicts have problems similar to those of normal eaters and problem eaters, but for food addicts, their addiction to food must be the primary focus.

If food addicts just diet, they may lose some weight but inevitably will gain it back. If food addicts do not commit to being rigorously honest – preferably with another food addict or with a healthcare professional that understands food addiction – they may make some gains in therapy, but will eventually relapse into the food; this will make them even more anxious or depressed. To be successful in healing from food addiction, one needs to first accept that they are food addicted and then, once again, deal with this first.

Most successful, long-term recovering food addicts approach their physical abstinence and deeper internal healing as a spiritual discipline. One simple approach to this concept is to study and practice the Twelve Steps. While this clearly is not the only way – as there are an endless number of spiritual paths that will work – the Twelve Steps are a spiritual practice specifically designed for those who suffer from addiction.

© Copyright Phil Werdell and Mary Foushi, 2007