Amy Pershing LMSW, ACSW is the Executive Director of PershingTurnerCenters, a full-spectrum outpatient center for the treatment of eating and related disorders in Annapolis, MD, and Clinical Director of the Center for Eating Disorders in Ann Arbor, MI.

Q: What are the biggest misconceptions about binge eating disorder (BED)?

A: The biggest public misconception I see is the idea that binge eating is about willpower, about a weakness of character in some way, and that somehow people should just be able to “stop.” The general understanding is still that this is “diet failure,” not an eating disorder, with a biopsychosocial etiology, deserving (and requiring) treatment on the same order as anorexia and bulimia.

The biggest clinical misconception is to focus too much on behavioral change (specifically weight loss) instead of real recovery and real healing. The clinical community is a product of our weight-biased culture, and the impact of this on treatment of BED must be addressed. The primary focus of BED treatment needs to be understanding the psychological role food plays and how to care for the body, not weight loss.

The biggest internal misconception for clients is that BED is evidence of their pathology, of craziness or weakness. I firmly believe that BED, for the vast majority of people, is an attempt at self care. To view BED as an attempt to survive, to soothe, to escape, is to meet the behavior with compassion and understanding.

Q: What are common challenges that make it tougher to overcome BED or problems with overeating?

A: From a cultural perspective, we begin to teach people to distrust and dishonor their bodies from childhood. We do not, as a society, value size or shape diversity; in fact weigh bias and stigma fundamentally underlies any eating disorder. “Thin” has to be presumed more valued for the symptoms to coalesce. We are taught to distrust our food preferences and our appetites, especially as girls, from early in life. We are taught to “exercise,” but not to play. Children learn their bodies are to be controlled, not honored. So the ability to hear cues, to really feel the positive impact of playing and eating well, typically must be relearned.

Additionally, weight and being “fat” is so completely vilified now that the idea of body wisdom is more remote than it has even been. We have a “war on obesity.” Literally now people are encouraged to be at odds with their bodies. Then, we are sold a profound “bill of goods” by the diet industry (with a 95% failure rate over 6 months), further removing us from simply listening to our needs. The current system makes recovery a veritable act of defiance. You have to be a renegade just to be in your body.

Q: How can readers work to overcome these obstacles?

A: Be a renegade! If an image makes you feel bad, reject it. If getting on the scale will change anything in that moment about how you think about yourself, don’t get on it. Allow yourself to gently talk to your body image voice. Help that part of you know the culture is stacked against you feeling content with your body, no matter its shape, but especially if you’re not thin.

So try writing your own “rules of beauty.” What is truly beautiful to you? Is it as narrow as you have been taught? Would you love your best friend less if s/he was bigger? Remember there may always be a part of us that feels “unacceptable” physically, but it will get quieter and quieter. The work is to not allow that part to be louder than your true heart.

Do you want to be taking your last breath thinking” thank god I spent all that time trying to be thinner”? So do one thing today for your physical body that is cherishing. And remember the body judge will be loud at times. But loud does not mean accurate. When you hear her, try asking what triggered her judgment. Probably some fear, insecurity, or sense of failure. See if you can find out what she really needs.

(Source: blogs.psychcentral.com)