Binge-Eating, Part II
Note: In Part I of this series on Binge-Eating focused on ways to manage the urge to binge-eat by distinguishing between appetite and hunger. With Part II we’ll talk about how to avoid or get rid of binge-eating all together by developing a game plan and identifying Behavior Chains. In Part III we’ll pull all the pieces together from Part I and II by reviewing how behavior modification techniques can help using an example in Part III.
When clients, who struggle with binge eating, know a troublesome “high risk” situation is coming up, eg, vacation, family event, deadline at work, I ask them to walk through a game plan with me. We start by talking about the situation and the challenges. Then I’ll ask what is the preferred or best outcome? Choices include either avoiding an old behavior or maybe having the flexibility of in-the-moment management. For example, maybe your travels include meals with your favorite binge foods - do you avoid the meals or plan to enjoy them with in-the-moment management.
If their choice is to avoid the old behavior, we spend time discussing if this is realistic. We’ll talk about the level of support the client is expecting, the amount of control in the situation that would allow for success (see Binge-Eating Part I more information), etc. We spend much time imagining worst case scenarios- because in spite of much pre-planning, often there will be many surprises that can derail the best laid plans. The goal is to give clients practice and time to think about strategies so they can easily pivot in real time if other high risk situations come up.
If the client chooses the strategy of flexibility with in-the-moment-management, then time is spent talking about how to manage the behavior to create the least amount of work to get back to their overall game plan. If any of the above sounds like a lot of work, it is. Not only are you trying to create and maintain new behaviors but, as I mentioned, you are also getting ready to pivot in real time in case there are unexpected curve balls. These curve balls can create the feeling of being ambushed in spite of your thoughtful game plan; often with the sensation of being out of control.
So where to start to untangle all of this? We start with something psychologists call “Behavior Chains” ( see Notes below for more background). This is the notion that nothing “just happens”. There is always a series of behaviors or steps that have to take place beforehand (think of the musician who spends 20 yrs touring before having a big hit and is considered an overnight star as their popularity spikes - finally). Binge-eating often seems to sneak up on us, but it is no exception to this concept. I’ve found behavior chains are the best tool to prevent binge-eating and other unwanted behaviors like not making it to the gym. But it is the method that will require the most homework about yourself and how to design and manage your game plan. To identify the behavior/steps that take you to the place of binge-eating (or any other unwanted behavior), start by re-tracing the events that create these moments. Where did the food come from? How big is the container? Did any specific feelings send me in search of extra food? Stress? Sadness? Did I miss a meal? In Part III, I’ll use an example I’ve wrestled with over the years – binge-eating a bag of cookies, to further explain how to “work” behavior chains. As you’ll see from just the few questions above, identifying behavior chains can take a long time to unravel. But the reward is being able to change the outcome and/or avoid the situation altogether . Part III will go into more detail about untangling your chain(s), using things as familiar as that old standby, behavior modification. Come – bring your scariest binge and let’s make it a kitten instead of a lion.
Reflection –
As you may have already guessed; I’m going to suggest you try your hand at mapping out a couple of behavior chains using problem situations for you. Start with an easy one where you have the most control over the steps, maybe your 3:00 pm run to the vending machine for something sweet. Then work up to a more complex scenario-maybe one that involves a visit to your family over a weekend or holiday (one where you may not have as much control over your environment). It can be helpful to talk with a trusted friend, counselor or dietitian about the chain of behaviors. There is something about saying the steps out loud that often helps to unhook us from the emotional aspects of confronting a path. Also, sometimes it is easier for others to help come up with ideas, especially in difficult situations.