The Unsung Addiction: Compulsive Eating

Elizabeth Zelvin

Every year on January 1, millions of Americans resolve to diet and lose weight. Each year, by January 15 or February 1 or some other date, most of those millions have broken their New Year’s resolution. They tell themselves they need more will power. Others succeed in eating less and more healthily, reach what dieters call goal weight, and within a short time go back to eating the way they did before. They vow not to gain back the weight lost, but they do, because they cannot sustain a moderate way of eating.

Why don’t diets work for so many people? Why do so many return again and again to a practice that has always failed for them? An addiction model of compulsive overeating and related eating disorders, such as bulimia, provides a more convincing explanation than individual weakness. Addictions are compulsive behaviors that start by providing such benefits as immediate pleasure and relief from uncomfortable emotions, follow a progressive course, are characterized by the psychological defense of increasing denial, and end up with the addict unable to stop, although the compulsive act or substance may cause severe adverse consequences in every area of life: health, relationships, and the ability to lead a normal productive life.

Not every compulsive overeater is obese. But obesity is one cause of the intense shame that sufferers from eating disorders experience. Obesity is considered comical in our culture. It is always open season on fat people, who are subject to jokes about a condition they can’t help that would be considered unacceptable if applied to, say, racial minorities. Among survivors of sexual abuse, fat becomes a way to hide out from unwanted attention and their own sexuality. Such survivors are especially vulnerable to agonizing shame.

Bulimics, whose compulsive behaviors include both binge eating and purging behaviors such as deliberately induced vomiting, compulsive laxative use, chewing and spitting out food instead of ingesting it, and excessive exercise, are prisoners of the intense pressure on people in our culture to look slim and fit, whatever the cost. And the costs of bulimia can be extreme: consequences can range from severe dental problems to vocal cord nodes to throat or esophageal cancer.

Diet clubs that focus on achieving a particular amount of weight loss through self-control and a depriving way of eating fail to understand the compulsive nature of addiction. Deprivation leads to resentment and rage and eventually, another cycle of bingeing or compulsive purging. The idea of a diet as deprivation encourages the dieter to give up completely after a single transgression. It might work a lot better to design a way of eating that the compulsive eater is actually satisfied with and encourage an attitude of gentleness and acceptance of imperfection in carrying it out. The simple but profound notion of “one day at a time” that works so well with recovering alcoholics can also work for compulsive eaters. To a food addict, the prospect of life without, say, chocolate is a nightmare, just like the prospect of life without booze to an alcoholic. But for someone who can’t have one without eating the whole box, maybe not having any today is possible.

Why I Don't Make New Year's Resolutions

Elizabeth Zelvin

The addictions field is probably the only area of mental health in which mainstream professionals as well as patients or clients routinely talk about the spiritual aspect of recovery. Spiritual, not religious, as treatment practitioners and members of 12-step programs will tell you. When I first entered the field 25 years ago, I didn’t get it. Now I get it, and I’ve discovered that certain spiritual principles provide a way to live my life with a lot less agita than I learned at my mother’s knee.

Either a book called Adult Children of Jewish Parents or one on marrying a nice Jewish boy whose title I can’t remember—I gave both to my daughter-in-law when she and my son got engaged—includes advice on “how to worry” (along with “how to interrupt”—I was happy to learn we do it because we’re interested). I was raised to worry, indeed to believe that if I failed to worry, I wasn’t doing my job. When I became a shrink, I learned that the clinical term is projection: looking down the tunnel of life ahead of you and seeing, not the light, but some disaster that makes you (if you’re Jewish) moan, “Oy vey!”

We can’t predict the future: not you, not me, not even my mother. Nor can we control it. So projection is futile. This may seem shocking, but in fact, it’s good news. The future can give you heartburn. Furthermore, the future is overwhelming. No wonder we stare at it and moan, “Oy vey.”

The solution? Forget the future. Sure, you’ve got to make plans sometimes. But there’s a big difference between planning and projecting. The 12-step programs have a slogan that simplifies life enormously: “One day at a time.” The King James version of the Bible expresses it a little differently: “Sufficient unto the day is the evil thereof.” Same thing, right?

Millions of Americans, to use an excellent example, start the New Year by resolving to go on a diet. They vow to lose the weight they gained over the holidays and keep it off this time. What happens to that resolution by the time New Year’s Eve rolls around again? For most, it has long since crumbled. Dieting means deprivation, and deprivation arouses craving. Some say the hell with it by the middle of January. Some hang on until bathing suit season, buy the bikini, and promptly reward themselves by turning back to ice cream and cookies and all things fried and beautiful. And at the year’s end, they make another resolution.

So I don’t make New Year’s resolutions. On January 1, 2008 I opened my eyes and asked myself, “What shall I do today?” On January 2, I did the same. And so it goes. Nobody does one day at a time perfectly, by the way. Coming anywhere near it takes a lifetime of spiritual practice. But as a way of biting off manageable chunks of life, it sure beats ending each once-promising year with a sense of failure. So what will I do tomorrow? I have no idea. It’s still today.