People often have questions about mental health issues and aren’t sure how to get the answers. Here, Dr. Roger answers questions about issues that matter to you.
It is important to know that we don't do therapy here, or give medical help or specific psychological advice (e.g. should I break up with my boyfriend?).This is a forum where people can ask freely whatever question they have about mental health.
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Q: I have a problem with food, i binge eat and then go on crash diets or sometimes purge. I dotn think that i have an eating disorder.. but i need some help on how to control my food habits and live healthier. Please help me and give me some tips on what i can do? Thanks.

Binge eating

A: Binge eating is a problem that seems to be growing over time. A recent study found that Binge-Eating Disorder is now more prevalent than both anorexia and bulimia. However, I should also mention that Binge-Eating Disorder is not technically an official disorder yet, but that's another issue.

The problem you described involved binge eating, followed by periods of extreme dieting and occasional purging. This is a pattern of behaviour that is typical in Bulimia, and occasionally with Anorexia. The essential features of Bulimia are (1) problems with binge eating, which is (2) followed by extreme efforts to get rid of the calories that were ingested during the binge. Anorexia Nervosa is similar to Bulimia in that the person is very concerned with body image. However, the typical pattern in Anorexia is self-starvation which leads to an unhealthy, below-average weight. There can be binge-eating in Anorexia as well.

In terms of defining what a binge is, the core feature is not really the amount of food eaten (although it is usually more than what most people would eat), but feeling as though you've lost control and cannot stop eating. One of the more common reasons for why people binge eat is to regulate emotions. When a person has negative thoughts or feelings (e.g., they are self-critical; feel sad or angry) and feel as though they cannot control these experiences on their own, they sometimes turn to other substances to help them. Some people drink alcohol, others do drugs -- some people are even addicted to shopping! However, for many people, eating is the most effective and fastest way to feel better. Unfortunately, you only feel worse in the long run. Furthermore, the purging that is sometimes used to get rid of the calories after a binge is not really that effective (some estimates are that only 50% of calories are lost through vomiting), and can lead to physical health problems (e.g., damage to teeth; problems with electrolytes and your heart).

Thus, there are 3 problems that need to be addressed in a healthier way: (1) better emotion regulation, (2) improved body image, and (3) a better, healthier way to eat. For better emotion regulation, I recommend seeing a professional if you feel it is really causing you problems. For improving your body image, you have to realize that this is partly determined by thinking biases. Many women in our Western culture are largely influenced by the popular media (e.g., TV; magazines; Perez Hilton), which either shows an inaccurate portrayal of how women should look (e.g., you only ever see women with professional make-up jobs; airbrushing in magazines), or places a lot of emphasis (often critical) on appearance (e.g., it is common for magazines and internet writers to mock celebrities for their flaws). It is hard for many women to not try and fix their flaws to be more likeable. The problem is that everyone has physical imperfection, which is rarely revealed in popular media in an accepting way. There are many aspects to this issue -- too many to discuss here. The point is that improving your body image does not always start with your body, but your head.

Finally, in terms of losing weight, there is only one approach I know of that leads to sustained weight loss over time. The key word is SUSTAINED. I used to work in an obesity clinic in Calgary, Alberta, where psychologists worked with people trying to lose weight. What I learned there is that losing weight is sometimes not so hard, it is keeping weight within an acceptable range for an extended period of time that is the most difficult part. The best way I know of doing that is through healthy eating and moderate exercise. Losing weight slowly while you make healthy eating and exercise a part of your daily routine is the best approach I know of. Please keep in mind that I am not a dietician, but I have worked with a few, who tended to follow the same approach.

I also recommend you read "Mindless Eating" by Brian Wansink. An excellent book on eating and weight loss.

I hope you found this information helpful.

Dr. Roger