The Restrict-Binge Cycle Explained

How is Binge Eating Defined?

If you feel depressed, disgusted, guilty, or ashamed about repeated episodes of consuming large amounts of food in spite of vowing to yourself each time that it will never happen again you may be struggling with binge eating disorder (BED). Binge eating episodes typically entail eating large amounts of food in a limited amount of time, such as over a two-hour period, feeling out of control, eating rapidly, eating until uncomfortable fullness, and eating in secret. Unlike people with bulimia, those who struggle with BED don't regularly compensate for extra calories eaten by vomiting, using laxatives or exercising excessively. Most people follow-up binge eating episodes by redoubling their efforts to regain control over food via restriction of their “problematic” foods. They believe that if they just muster up enough willpower they can eliminate their binges but in reality restriction only perpetuates binging.

What is Set Point Theory?

According to the research-supported set point theory, all humans have a weight range that their body naturally maintains when they listen to their body’s innate signals of hunger and fullness instead of messing with their eating by following external food rules. While it is nearly impossible to lower the set point range, it is possible to raise it via repeated dieting attempts (Bacon, 2010, pp. 12-27). You can think of it like trying to hold your breath: because breathing is partially controlled by your somatic (voluntary) nervous system, you can choose to hold your breath for a short amount of time; however, if you hold it for too long your body will inevitably take over and your breathing will switch to autonomic (involuntary) nervous system control which will force you to gasp for air. The longer you try to hold your breath the more intense the gasp. Like breathing, eating is governed in-part by the autonomic nervous system which works in the background without any conscious thought. While you can temporarily restrict your food intake and push your weight below your set point range, at some point your body will take back control and force you to eat. The longer and more intense the restriction the more intense the rebound eating which may result in binge eating.

In fact, a large body of research reveals that 90-95% of all diets fail and that the act of restricting food only results in weight loss in the short-term and most people regain all the weight within 3-5 years, with a third ending up at a higher weight than at the start of the diet. This is the so-called “yo-yo dieting” that most of us are familiar with. Hence, restriction is often at the root of binge eating.

What are the Biological Underpinnings of the Restrict-Binge Cycle?

There are a number of biological mechanisms that underpin the restrict-binge cycle. When your body perceives that you are getting fewer calories than maintaining your set point range requires, it believes that you are in a state of starvation because your homeostasis, or internal balance, has been disrupted. This is an automatic and adaptive response, your cells can’t tell if you’re engaging in intermittent-fasting or experiencing a genuine famine due to lack of food access.

One important survival response to food restriction is slowdown of metabolism. For example, research on the metabolisms of contestants of the TV show The Biggest Loser revealed that their metabolisms slowed down significantly as a result of participating in weight control strategies during the show. The contestants would need to consume an average of 500 calories less at the conclusion of the show than before starting the show in order for their metabolism to match their baseline (Fothergill et al., 2016).

Another way the body tries to survive food restriction is by cannibalizing its own muscle tissue. You read that right, the body will convert muscle to carbohydrates in order to access energy that’s necessary for you to survive.

How Does Weight Gain Function as a Compensatory Mechanism?

The loss of both fat and lean muscle tissue causes the body to gain more weight in the form of body fat to survive. This process starts with a part of your brain called the hypothalamus which initiates the release of hormones that increase your appetite and drive to eat by making food seem tastier and more appealing. The hypothalamus can influence the kinds of food you crave, causing you to want higher-fat and more calorie-dense food because it wants you to gain energy and get back to your set point range ASAP. It can even decrease your drive to move in order to conserve energy.

The more severe the restriction the stronger and less controllable the urge to eat. If the restriction is severe enough it can result in an urgent desire to eat that often results in eating past the point of fullness. Tribole & Resch (2020), authors of the book Intuitive Eating, refer to this intense desire to eat as “primal hunger” (pp. 86-87). The longer and harder that you try to override your body’s efforts at maintaining homeostasis via food restriction the more aggressive the reaction from your hypothalamus. For example, other systems of the body may get involved, making you feel cold or sluggish, both signs that your body is slowing down your metabolism to conserve energy. Bottom line: your body is more concerned with survival than aesthetics.

Evidence-Based Therapy Can Help

If binge eating is significantly interfering with your quality of life it can be very helpful to work with a clinical psychologist who specializes in evidence-based approaches.

Therapy at Compass CBT can help you break free from the restrict-binge cycle so you can make peace with food, attune to your body, and be present in your life.

This blog was originally published on inclusivetherapists.com

Regina Lazarovich, PhD

Dr. Regina Lazarovich, PhD is a licensed Clinical Psychologist and founder of Compass CBT, serving clients across California, Florida, and New York via telehealth.

She graduated summa cum laude with a Bachelor of Science from Brooklyn College and earned her Master of Science and Doctorate in Clinical Psychology from Hofstra University.

Dr. Lazarovich has dedicated her fifteen-year career to helping individuals break free from generalized anxiety, social anxiety, panic attacks, phobias, OCD, ADHD, binge eating disorder, emotional eating, and negative body image.

Her work has spanned hospital, university counseling center, community health center, and private practice settings. Dr. Lazarovich has a comprehensive background in Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), Acceptance and Commitment Therapy (ACT), Inference-Based Cognitive Behavioral Therapy (I-CBT), Mindful Self-Compassion (MSC), and Dialectical Behavior Therapy (DBT). She approaches clients with disordered eating and body image struggles from Health at Every Size® (HAES) and Intuitive Eating perspectives.

https://www.compasscbt.com
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