Binge eating is a big part of more than just binge eating disorder. Bulimia consists of binge eating prior to purging, and is also a major component of anorexia nervosa binge/purge type. We’ve tried for countless years to understand what is so reinforcing about binge eating despite the significant negative consequences. Unlike acts of addiction, eating disorder sufferers are not chemically addicted to food in the same way, not even to sugar despite what you may read in non-medical articles. But like addiction, there is a significant part of the process that does become reinforcing: anticipating and planning the binge.
When you drive by Krispe Kreme and see their “Hot Now” sign flashing its neon-red beacon and smell the dough frying in oil from 100 yards out, you get cued to want that donut. Your brain is turned on, inducing you to steer your car into the parking lot, and prompting an almost euphoric state. What you’re feeling is your brain releasing dopamine. It feels good, and you want to feel that way again and again. The reward of “wanting food” has been found to be major part of the development of an eating disorder.
Researches have collected story after story of those with bulimia where they describe feeling an urge to binge and planning through the course of the workday what they would eat, where they would eat it, and imagining how it would feel. Only upon completing the act of actually getting the food does the brain shut down that hyperactive part of itself that obsesses about the binge event to come.
Other researchers hypothesize that, like the binge itself, anticipating the binge helps to give that person a focus during the day so they don’t have to worry about other distressing areas of their life. While the binge helps to distract and numb out, the planning of the binge and accompanied anticipation also serve to distract and numb out that person. Interestingly, some studies found that anticipating the binge has a stronger chemical response in the brain than the actual binge itself.
This research suggests that treatment needs to include interrupting the binge anticipation cycle. That may include cessation of restriction behaviors, developing better coping strategies and distress tolerance tools, and improving resources that help deal with external stress that we all struggle with. We also need to research more about how the brain reacts to anticipation to better understand the role “wanting” plays in the development of an eating disorder.
By Andrew Walen, LCSW-C - Founder, Executive Director, Psychotherapist at The Body Image Therapy Center. If you would like to get in touch with Andrew please call 877-674-2843 or email firstname.lastname@example.org.