Thursday, 8 February 2007

Binge Eating

Some of my clients train extremely effectively, working hard and diligently. They follow personalised nutritional plans and train consistently. However, every now and again they go "off the rails". Often this is the result of binge eating and the resulting negative spiral.

Generally, a binge once in a while has little or no effect on training goals. It may even help occasionally. The problem is the related negative cognitive spiral that often accompanies binging and the duration of the binge cycle.

Ideally, if a client binges, even if the binge is prolonged, my advice is to forget about it, continue to train, and return to the usual nutritional plan, which generally involves eating six to seven meals a day at roughly three hourly intervals. Under no circumstances should they skip meals or try to juggle calories to balance out a binge episode.

The problem with the negative cognition is that it is usually a response to certain eating rules: some foods are identified as bad, and if I eat those foods I may consider myself "fat", "lazy", "useless", "a failure". What follows next is a "what the hell" attitude and further bouts of binging.

In a desperate bid to take control the individual will often resort to a strict diet and will set themselves dietary rules which are virtually impossible to maintain. Once the rules are broken (and they will be) the negative cognition kicks in and the binging starts again. Another factor here is the hunger caused by the semi-starvation diet which physiologically primes us for the next binge.

There are some self help approaches that may be of benefit for those who do not have a Cognitive Behaviour Therapist (preferably one trained in the CBT-Enhanced method for eating disorders).

The first principal is to increase metacognitive awareness, which basically means "thinking about thinking". Over time, through discussion with others, reflection, or better, recording what is eaten, when, and what the accompanying mood and thoughts are, we can start to recognise the characteristic automatic negative thoughts.

A useful analogy is that of the DVD player. In various situations we relate to others and our environment on a virtually automatic basis. For each of this situations (and our relationship with food is one of them) it is as if we have inserted a particular DVD. The thoughts are not ourselves - many of us identify with our thoughts and feelings, both of which have a large degree of autonomy. Once we recognise that the "eating disorder" DVD is running we can take steps to eject it (for example: challenging negative thoughts and offering more realistic alternatives; diversion - exercise, socialising, cinema etc- or working on some of the structures that hold this negative thinking pattern in place - low mood, anxiety, low self-esteem, boredom etc.

This kind of work is ongoing and reaps benefits in accordance with the commitment put into the self-help techniques.

Statistically, however, the most effective approach for reducing binge eating is to regulate eating, to eat small meals at roughly three hourly intervals and to avoid skipping meals. Once this approach is combined with your training goals (i.e. high protein, low GI, adequate nutrition) you have a highly effective defense against binging, and if you do binge you have an immediate strategy: just get on with the eating plan you were following with no self-recrimination.

There is no need to commence "driven" exercise regimens or to increase the frequency and duration of your workouts. Just keep on as normal, train hard and effectively, eat at regular intervals, and don't worry about slipping up: just think of the extra stored glycogen you can draw upon for your next training session!

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