Wednesday, August 13, 2008

Overcoming Binge Eating by Dr. Christopher Fairburn (Pt 2)

Part 2 of Dr. Fairburn's book describes the steps one should take to deal with binge eating. He also provides blank forms for readers to copy and use, but I won't be putting them here because of copyright issues. You don't really need the form, anyway. I'm doing all my journaling right here in my blog. This is just a very general outline of the self-help section.

Step 1: Self-Monitoring & Weekly Weighing

Monitoring your food intake and related information will help you determine when a binge episode is likely to happen. Record:

the time you ate/drank

what you ate (not necessarily how much in terms of specific amounts - don't worry about writing down the calories), and include everything you put in your mouth (food and liquid), as soon as possible after eating/drinking

location - did you eat in the kitchen? sitting at your desk? the couch? table?

do you perceive the episode as excessive?

did you use laxatives or diuretics or vomit after eating?

relevant notes - record your feelings about the food/drink you just consumed, were you hungry? how did you feel?

As for weighing, pick a day and time each week and only weigh on that day. Many people with weight issues are compulsive weighers, often getting on the scale several times a day. STOP!!!

I've been doing this, for the most part. I usually track all my food, but I've started adding the other information as suggested. And I only weigh once a week anyway, so this was no big deal.

Step 2: Establish a regular eating pattern and stop using laxatives/diuretics/purging

Eat 5-6 times a day - 3 regular meals and 2-3 snacks. Try not to go more than 4 hours without eating, to keep yourself from getting too hungry. Don't skip meals and try to plan as best you can. If you're not used to eating frequently or are a regular meal-skipper, start by eating a meal you would normally miss. Every few days, add in a snack/meal until you're consistently eating 5-6 times a day.

I already do this, and have done this since I started Body For Life last year. Even when I'm off the wagon, I eat every 3-4 hours, except when I'm eating constantly. Sometimes I miss a meal or really delay one, usually when I'm upset, so this is something I can work on. Laxative and diuretics and vomiting don't apply to me.

Step 3: Find alternatives to binge eating

Actually make a list of activities you can do instead of binge. I haven't done this yet. I'll do it right now:

exercise (nothing strenuous because I have my regular exercise - probably the Wii or go for a walk)
read a book
clean my house
practice my violin/keyboard
play games with my son

The key is to find something that will take up time and make it difficult for you to eat.

Step 4: Practice problem-solving and review your progress

There are 6 steps to efficient problem solving:
Identify the problem
Specify the problem accurately
Consider as many solutions as you can
Consider the implications of each solution
Pick a solution or combo
Act on the solution

I suck at problem solving, so this is going to be a challenge for me. Usually by the time I'd get to the implications stage, I'm already stuffing my face.

Step 5: Tackling dieting and other forms of avoidance

Sadly, Dr. Fairburn suggests we may have to actually stop dieting and get the binge eating under control. If you remember from part one, there are the various pathways to binge eating and dieting is seen as a big stepping stone. He doesn't go into details of the studies he's done, but I really have to wonder how many subjects were significantly overweight and obese. Just "learning to live with" our current, overweight selves IS NOT AN OPTION for me, and he does suggest that some of us might have to do that. I would love to see some studies that deal with overweight binge eaters (who don't purge).

Regarding the avoidance of certain types of food, Dr. Fairburn suggests introducing them back into your diet, in limited quantities. I have issues with this because I try to avoid junk food, and I don't find any reason to introduce those into my diet because they have no nutritional benefit at all. I can understand introducing other foods that are commonly avoided, say nuts for example. People avoid nuts because they are high in fat, but some fat - expecially the right kind - is good for you. But really, what's the benefit of eating sugar and trans fats? I do understand learning moderation, and I guess that's his point. Even healthy version of my "bad" foods are something I try to avoid. So I suppose this is where this step applies to me.

Step 6: Preventing a relapse and dealing with other problems

Ah, the main test of this whole thing. Can we stop binge eating long term? Here, we have to have realistic expectations. I know I cannot say I will never binge again. That would be absurd! I probably will, and all I can do is keep going through the steps. Hopefully, though, going through them the first time, especially with the monitoring and problem solving steps, will help me learn when I'm likely to binge and how to better deal with it.

So how do you go through the steps? With each step, review every few days and write a weekly summary. Start with Step 1, obviously. After a couple weeks, if you feel you're doing well, move on to Step 2. After a couple weeks, move on. The time frame in the book is about 6 months for all the steps, but it really depends on what you're already doing. I know you're supposed to go step-by-step, but I was already doing half of these steps anyway, that I am trying to start off with Steps 1-3 right now. I'll reassess things in a week or two, and go from there.

3 comments:

Amanda said...

Becky,

Thank you for outlining this. I don't have time to get the book and read. I know this is my problem, and I just needed the outline. I have a problem with boredom in the afternoons, and that is my worst time. I pray I can apply these and beat bindging!

jean said...

I like your comment that Fairburn's book did not seem to be directed at the overweight. I had the same feeling. It seemed like he was always encourgaging people to eat more. I'm overweight and I already "eat more". On his method, I ate more than more. I felt self righteous eating candy and ice cream because it was all in service of yet another magical endpoint, this time being healed of binge eating. At the same time, I really hated following his recommendation of each morning figuring out the times you would eat your meals and snacks. Seemed like dieting to me. I like the approach of Jane Brody in an article you can access through the NY Times on her own binge eating. She eats three reasonable meals a day, substantial snacks when necessary, and a little something of formerly forbidden food. Of course, liking it is a little different from following it. But there you are.

Becky said...

Thanks for your comment, Jean. I'm going to have to check that article out! It sounds more reasonable than any other advice I've read.