Lack of control and stress are the hallmarks of binge eating disorder, which drives sufferers to eat past the point of satiety and comfort and feel shame and guilt as a result, explains Russell Marx, chief science officer of the National Eating Disorders Association.
"This is not a failure of willpower," says Susan Albers, a psychologist at the Cleveland Clinic Family Health Center and author of "Eating Mindfully: How to End Mindless Eating & Enjoy a Balanced Relationship with Food." Binging is also more than emotional eating, although in both cases, someone is resorting to food to manage a need beyond hunger. "Unfortunately, a lot of these patients are sent to weight-loss programs, and that often doesn't help, and also sometimes makes it worse because you really have to understand how the emotions tie in with the symptoms that they're experiencing," Albers says.
She uses an approach to treatment based on mindfulness – helping the patient become aware of his or her emotions to ultimately accept them. Mindful eating thwarts binging because it takes the opposite behavior. "Binging is very disconnected eating ... A lot of times you're not even tasting the food," Albers says, adding that binging is a form of emotional escapism that comes in a flurry of consumption in which the patient may not even notice the stressor that started it.
Like other eating disorders, binge eating disorder has its roots in biology and temperament, Lombardi says, explaining that a family history of anxiety or depression, and a personality that is prone to perfectionism, pleasing others and high sensitivity to change and conflict, can set someone up for the disorder. It can also set into motion as a result of trauma or loss, relationships and culture. "We live in a culture that places a tremendous amount of emphasis on weight and appearance," and that can lead to "feeling pressured to look a certain way," Lombardi says.
For Turner, a big part of her healing came from making peace with a body that didn't conform to a particular stereotype of beauty. "I needed to accept that I wasn't a bad person, that there was nothing bad about me because of my size," she says. Similarly, she would learn ways to soothe herself – meditation or a trip to the spa, for example, instead of food. To do that, she had to learn to pay attention to herself and her environment and to recognize her emotions and live with them. Eventually, Albers says, the emotions always pass.