Binge Eaters Brace for the Holidays

From the WebMD Archives

Nov. 26, 1999 (Atlanta) -- For binge eaters, the bewitching season has begun. It is a time of year when the days are regularly punctuated with opportunities to indulge, along with psychological pressures to do so. Little wonder that some feel more anxiety than anticipation about entering the holiday season.

"This is kind of a tough period for folks," says Rick Kilmer, PhD, program director of the Atlanta Center for Eating Disorders. "There are lots of foods not encountered at other times of the year ... and they go back home where lots of old eating habits and issues are. It even happens in people who clean up their lives. Yeah, this is a challenging one for people with food issues."

The challenge is, of course, to stay on an even keel in waters filled with tempting food. Binge eating -- sometimes characterized as "compulsive overeating" -- is a disorder similar to bulimia, but with one key difference: there is no purge involved. What binge eaters take in they hold in. And the amounts can be enormous. A binge might include a dozen doughnuts, a quart of ice cream, a box of cookies, or a huge plate of pasta. "It really can get quite extreme," says Anne Becker, MD, PhD, director of research at the Harvard Eating Disorders Center in Boston.

And yet for most of the day a binge eater might eat nothing. "They tend to be meal-skippers, or they eat something immediately gratifying," Becker says. "Of course what happens is oftentimes by the time people get home they are ravenous -- and get what we call a 'trigger'". That is, something that will set off a binge.

And the holiday season, unfortunately, is a minefield of triggers. From the trays of cookies to the irregular meal times to the plain, old-fashioned stress of putting up with certain family members, it's a time of year when people with eating disorders are set up to fail, Becker says.

Not that they have to. Psychologists who treat binge eaters tell WebMD that there are a variety of ways these patients can keep the overeating in check. "We try to teach people to relax and enjoy the food without bingeing on it," says Patricia Kelly, RD, MS, co-founder of the New Realities Eating Disorders Recovery Center in Toronto. Kelly says part of relaxing around 'holiday' foods is realizing they can be prepared and eaten at any time of the year, so there's no need to gorge.

Binge eaters also ought to keep things in perspective if they slip, says Elizabeth Carll, PhD, a therapist in Huntington Center in New York. "As long as the rest of their days are normal a party shouldn't throw them off track," she says. "The reality is one particular binge is not connected to another."

Carll also advises letting a bit of the steam out of this 'special' time of year. "Many people look at it as a totally different kind of time," she says. "Put it in the context of life as usual with a few parties in between." That way, she says, some healthy routines will more likely continue through the holidays, including regular exercise.

But avoid getting too rundown, advises Anne Kearney-Cooke, PhD, director of the Cincinnati Psychotherapy Institute "We know when people are fatigued or deprived they know the right choice but don't make it," she says. With binge eaters that might translate into choosing a food trigger rather than eating a reasonable meal.

And speaking of that, the most consistent piece of advice the experts have for binge eaters is to eat regular meals.

Still, some indulgence at this time of year is probably to be expected. "It isn't etched in stone that people have to do badly over this time," says Leslie Bonci, MPH, RD, director of sports medicine nutrition at the University of Pittsburgh Medical Center in Pennsylvania. "But I never expect my patients to lose weight over [the holidays]," she says.