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• Groups help in fight against bulimia 

 
Jeri S. of Orcutt had been using food as a source of comfort since she was a child. At 3 or 4 years old, she already felt different from other people.

“I considered food my best friend,” said Jeri, who declined to use her last name. “When I was frightened or worried, I found that overeating calmed me.”

Doctors prescribed diets for her, which she couldn't follow, in elementary school. As a teen she was sent to what she calls a “fat farm,” where she lost 25 pounds in two weeks. The weight never stayed off.

As an adult, Jeri watched her mother die from diabetes-related complications. That's when Jeri became desperate.

“I could see me going the same way,” Jeri said. “I could see me giving up on life, not being able to control what went into my mouth.”

She tried going to different doctors, therapists, other “fat farms,” diets, herbs, shots and pills to lose weight. None of them worked.

Five years ago, she joined Overeaters Anonymous, a 12-step support group based on the same principles of Alcoholics Anonymous. She's lost 45 pounds in that time, and has kept it off.

What is it?

Francie White, owner of Central Coast Intensive Outpatient Program, a clinic for eating disorders, defines binge eating as eating a relatively large amount of food in a way that feels out of control, followed by deep sense of self-loathing and guilt. Not everyone who occasionally eats for comfort is a binge eater.

“We all overeat sometimes, we all comfort eat sometimes,” White said. “(But) in eating disorders, it feels like emotional overeating is controlling you.”

Bulimia involves binge eating as well as purging, although to confuse the issue, there are two types of bulimia: “purging” or “non-purging.”

In both types, bulimics use “inappropriate compensatory behavior” to make up for the mistake of bingeing by getting rid of the calories in some way and to relieve their feelings of shame. “Purging” involves the use of vomiting, laxatives, or diuretics, while “non-purging” bulimia involves compulsive exercising or restricting food.

Helping others

Marlena Tanner, pictured July 3, has recovered from bulimia and now works at the Central Coast Intensive Outpatient Program eating disorders clinic. //Len Wood/Staff

Marlena Tanner, registered dietitian at Central Coast IOP, uses her own experience as a former bulimia patient to help her patients at the clinic.

Like Jeri, she grew up with a feeling of not fitting in, and was sensitive to the emotions and problems around her.

“I was really overwhelmed, so I turned to food,” Tanner said.

Around age 14, she started restricting her food intake, which is common among the patients she sees today. She started bingeing again two years later. She felt like a “failed anorexic.”

“Restricting gave me a sense of security, control (and) quiet in a chaotic environment,” Tanner said.

Why do it?

Binge eating has two possible causes, Francie White said, and patients can have one or both.

One cause of binge eating is seeking emotional comfort, White said.

“Overeating certain foods gives some people a sense of comfort, numbness, or an ability to disassociate from painful feelings, and another (person) a sense of safety,” White said. “They're using food to control their emotions, much like someone would use alcohol or drugs. ”

Binge eaters may be genetically susceptible to using food as a substance to soothe themselves, according to White.

Jeri S. discovered, through her Overeaters Anonymous meetings, that food wasn't the solution to life's problems. She discovered that her overeating wasn't a lack of willpower, but an ineffective method of coping.

“The problem as we see it in OA is that we have an addiction,” Jeri said. “If the problem is that you are dependent on food to solve life's problems, then being on a diet, no matter how good it is, isn't going to provide what you're searching for.”

The second cause is what White calls “deprivation-driven eating,” which results from restricting a set of foods or calories for any reason, such as going on a diet or not having access to enough food. In the case of voluntary deprivation, a feeling of rebellion can “add fuel to the fire of bingeing,” White said. This can be especially true for adolescents.

“If you restrict something, you're going to be obsessed with it in a matter of time, especially if you're restricting it for image-related reasons,” White said. “Deep down, I think that the subconscious will not put up with starvation for Š a conditional love.”

Purging, said White, is a response to the shame of bingeing, and becomes an addiction in its own right when bulimics associate it with releasing stress.

Cultural factors

White said overeating can be a way to “stop the world” in a culture that emphasizes accomplishment over simply being human.

“Western culture values continual accomplishment, ‘doing doing doing doing.' And we're way out of balance between ... being versus doing,” White said. “Add a difficult childhood, add the pressures of just getting into college, (and) people are getting eating disorders just from that. The pressure is so intense.”

Terry White, marriage and family therapist and clinical director of Central Coast IOP, said people may subconsciously use obesity as an expression of defiance toward the impossible cultural ideals of thinness and beauty.

“The cultural wisdom is this emphasis on achievement toward being thin,” Terry White said. “So part of the communication of someone who is being defiant and being obese is an expression of defiance toward those kinds of cultural values Š The judgment that people have about heavy people is they're weak, they have no willpower, that sort of thing. So there's a bit of irony there.”

Overeating can also create a literal “layer of armor” around someone who's experienced trauma, said Terry White, and social expectations of women as docile and perfectly beautiful are “demoralizing.”

Treatment

Treatment for binge eating includes integrating small amounts of “forbidden foods” to the diet to help with satiety and to counter deprivation-driven overeating, said Francie White.

To treat emotional eating, staff teach self-soothing techniques, such as meditating, reading and writing in a journal, and address bigger life issues such as a lack of fulfillment.

“It can be as deep as really taking risks in life to have much more fulfillment,” Francie White said. “Telling your husband you're going out with the girls, taking an art class, (or) setting boundaries with people.”

Group therapy helps “de-shame” the illness. Treatment also includes a medical evaluation, and nutritional services from a dietitian who specializes in eating disorders.

At Overeaters Anonymous, members admit they are powerless over food, decide to turn their will and lives over to the care of a higher power who can restore them to mental and physical health, do a moral inventory of themselves, pray for the ability to know God's will and the power to carry it out, and carry the messages of the “Twelve Steps” to other compulsive overeaters.

“I've just found that it's the answer for me,” Jeri S. said of the group.

Tanner said she looks at what bulimics are symbolically bingeing on and purging. Bingeing on food may be a way of making up for a lack of spiritual or emotional nourishment. Purging may be a way to release anger or other undesirable feelings. When bulimics check into the Central Coast IOP, they don't have to stop purging right away.

It can take an average of seven years for bulimics to recover fully, Tanner said, though that doesn't mean it takes seven years for them to stop purging. It took her about that length of time to recover, and the result was well worth it.

“My life is so beautiful today, it really is,” Tanner said. “I trust my body today. I'm comfortable in my skin. I can express my desires, I allow myself to feel my feelings. I live life on life's terms without trying to control every outcome. Bottom line, I'm at peace.”

Symptoms:

* Constant concern about food and weight, or having rules about “good foods” or “bad foods”
* Dental erosion
* Scarring on the backs of the hands
* Irregular menstrual periods
* Decreased sexual interest
* Depressed mood
* Sore throats
* Abdominal pain

- Source: The National Alliance on Mental Illness, www.nami.org

Medical effects: Here are some of the medical effects of binge eating and bulimia:

* Passing out, seizures and death
* Erosion of the tooth enamel
* Hair loss
* Cold intolerance
* Fatigue
* Sleep disturbance
* Esophageal reflux
* Poor concentration
* Irregular or no menstruation
* Heart irregularities
* Passing out, seizures or death due to potassium loss
* Most of the effects of binge eating are similar to the effects of obesity, including an increased risk of:
* Diabetes
* High cholesterol
* Muscular-skeletal problems.

- Sources: Terry White, marriage and family therapist and clinical director of Central Coast IOP, and Francie White, registered dietitian and owner of Central Coast IOP

What parents can do to help:

* Don't count calories, for either yourself or your child.
* Don't obsess about a child's weight.
* Make wise food choices, but don't make an issue of sweets.
* Eat when you're hungry and stop when you're full.
* Don't be critical of a child's body. Healthy bodies wax and wane during development.
* Don't model obsessive behavior such as making weight spreadsheets.
* Seek a registered dietitian when children become interested in dietary practices new to them, including vegetarianism.
* Don't view fat as the enemy. Healthy fats in a balanced diet help with satiety.
* Don't ignore family dysfunctions. Seek health in your relationships and parenting style.
* Keep communication open with children, but don't force family cohesiveness during advancing developmental stages like adolescence. Learn how to set healthy limits and adjust parenting strategies.
* Have fun, don't work too hard, and model the acceptance of mistakes.

- Source: Terry White, marriage and family therapist and clinical director of Central Coast IOP

CONTACTS:

Overeaters Anonymous meets at 9:30 a.m. Saturdays at Bethel Lutheran Church, 624 E. Camino Colegio in Santa Maria. For information, call 937-8269 or 714-3742.

If you think someone you know may have an eating disorder, the staff at Central Coast IOP can assess where they are on the eating spectrum. Call 688-5057 and ask for Kristina Bengton.

Editor's note: “Jeri S's” last name is being withheld to protect her privacy.

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