In a companion post looking at the latest brain research on binge eating, I decipher some pretty confusing neuroscience based on a very thorough review article that Kessler et al. (2016) published earlier this year. However, while it can be important to learn about how the brain functions in order to understand binge eating, it is even more important to figure out how this information relates to changing your behavior. By understanding the neuroscience of binge eating, some clear strategies emerge that point to tactics used by many of the current, effective treatments for this problem. Below is a list of some of the most important things that we know about binge eating and how you can change for the better:
Learning to Say No
Normally the parts of the brain responsible for inhibiting behavior are busy controlling the effect of our appetite. These parts include your prefrontal cortex and anterior cingulate cortex. Lots of research has looked at the function of these areas in appetite and behavioral control, and in the case of appetite and binge eating the evidence is mounting that these more frontal parts of our brain play an important role in your efforts to exert self control. People who are prone to binge have less activity in these “frontal” parts of the brain, meaning that you are less likely to consider not eating, less likely to stop yourself from eating, find it harder to turn down food, and generally struggle more to exert self control over your food intake.
Practicing activities that require self-control can help. All sorts of activities can involve unpleasant experiences or simply require self-control. If the parts of our brain involved in self control get out of balance, this will effect more than just your eating behavior. In fact, you may struggle with several other areas of life that require motivation or self discipline. This is part of the reason why many people with eating problems don’t like to exercise or exert themselves.
For this reason a lot of modern treatments have begun to emphasize skills like meditation or the use of physical exercise. What meditation method or the type of exercise you use is not as important as what these activities force your brain to do – activate the kind of thinking that gets you doing things you don’t want to do, which in turn requires more use of the brain circuits that underlie this self-controlling, motivating kind of thought. Achieving some kind of self-realization or improving your cardiovascular health is not the point of this kind of practice. Instead, these kinds of activities train the brain to ignore competing urges and maintain a focus on behaviors that are simply hard to do. While going for a brisk walk or jog will certainly have some health effects, what really matters is that by practicing this you will become better at controlling your thoughts and urges. In essence, many activities like meditation and various types of exercise train your brain to control itself better. This is the core feature of cognitive therapy and the skills you develop when you practice will help when you need to inhibit your urge to eat.
Redirect Your Focus
People who binge are much more attentive to food cues. If you have trouble with binge eating, you probably think about food more, notice food more, and attend to food more than most other people. Like most addicts, your value system and idea of pleasure is built around your favored drug –which in this case is food. Plus, you are more likely to think about and notice specific foods that have stronger effects on your pleasure circuit. Unfortunately, these tend to be unhealthy foods with higher sugar and fat contents.
This “attentional bias” can be modified by practicing healthy eating. While this sort of practice might sound a bit obvious and self-confirming, there is a subtle point that needs to be made. Just as the mental exercise underlying difficult activities like meditation and strenuous physical activity is a way to practice self-control, practicing healthy eating gets your brain doing things in a way that promotes all sorts of beneficial changes. What matters is that you are using a strategy that redirects your mental focus from a habitual, unconscious process to one that is in your awareness and under your control. As much as you are teaching your brain to attend to healthy foods, you are at the same time teaching it to ignore the unhealthy foods that usually grab your attention. Gradually, the bias in your attention will weaken. While at the start you may not be particularly fond of a particular food, like veggies, if you seek them out and eat them more often in place of fatty or sweet foods your brain will adjust its bias and learn to pay less attention to the calorie rich foods
A very simple newer therapy method that tackles this challenge is called the Dot Probe Task. Dot Probe Tasks present people with two images. One of these images usually has a positive association, and the other usually has a neutral or negative association. In the case of eating behaviors, one image may be of a delicious chocolate donut, while the other may be of a tasty salad, or simply anything not related to food. It has subjects repeatedly choose the positive image over the negative one. In the case of binge eating, you would be required to choose the healthy food over the unhealthy one, or even a non-food cue over a food cue. Ways that you can practice this in the grocery store include focusing on the aisles that contain more healthy food choices, reading the labels on food packages, calorie counting, and so on. By changing what you attend to in the grocery store you are actually practicing a new activity using your brain and this practice will gradual help to shift your attentional bias.
Ignoring Your Appetite
If you are a binge eater, much of your reward system – the circuit in the brain that helps you learn to get the things you want and avoid the things that are unpleasant – is focused on getting pleasure from the simple act of craving itself. Your brain is stuck on thinking about food. You think about it all the time, just like a drug addict thinks about drugs all the time, or an alcoholic thinks about drinking all the time. In other words, the act of thinking about food becomes just as important a source of pleasure as the actual act of eating.
In a healthy person, this wanting and liking activity in the brain is more evenly distributed among other important activities like being with the people we love, exercising, working, etc. – all of which get us indirect and direct rewards. The issue is not that we crave things – craving is natural and when directed at the right things, it is healthy and vital to our survival. However, without realizing it our behavior can start to focus cravings on areas that are not good for us, which can leave us feeling as though we have no control over the process.
Response prevention involves learning to ignore our wants and carry on with our activities. Mindfulness is a popular therapy method that is a form of response prevention that targets thinking itself. It encourages you to remain in the moment, rather than get caught up in your automatic, default thoughts (which are probably all about food). Just as someone with a fear of open spaces must expose themselves to what they least want to, and try to remain calm and carry on, binge eaters need to practice carrying on as though they were not hungry or wanting to binge. Mindfulness strategies are effective because they do not focus on trying to stop unwanted thoughts or make a person feel guilty for having them, but instead teach us to redirect our attention to something simple and practical that we are doing in the here and now. This is very different from efforts to simply “stop the thoughts”. When you become more mindful of what you are actually doing in the present moment, you are activating brain circuits that are associated with executive functioning – the “just do it” parts of your brain. When our executive functioning is active, the circuits underlying your more automatic, habitual default thinking are turned off, making it easier to ignore your urges.
Keep in mind that the reverse of this process is also true. If you focus on your cravings and exercise your habitual, default thinking, this tends to turn off your executive thinking circuits, making it harder to concentrate, exercise good judgment, and get important things done. So while it may seem like a harmless pleasure to fantasize about your next delicious treat, this is actually exercising an imbalance in your brain circuits that gets stronger with practice.
Rebalance Your Reward Circuit
Bingeing is associated with less enjoyment of normal portions or healthy food types. If someone has been practicing binge eating for long enough, it takes more food, and more junky types of food (sugary, fatty) to satisfy hunger and feel good. This means you feel the need to eat more even though you may not be hungry – it simply takes more food to get the same “bang for your buck”. This is partly an effect of binge eating, since too much of even a good thing wears out our ability to enjoy the food because our brain adjusts its response when there is so much available. Like the addict who needs more and more drug or alcohol to get their fix, people who binge need more and more food to get the same effect. So eating more only makes the problem worse.
To combat this, you actually need to practice eating less rich and sweet food in order to increase your enjoyment of these foods. So long as you are flooding your brain with signals that you have lots of sugary, fatty foods in your system, your reward circuit will remain desensitized to their effects and you will require more to feel satisfied. Instead, focus on other rewards, and practice things that will help you cultivate your appetite for things other than food. The effects of many typical rewards may have become rusty but can be quickly activated and give you more pleasure than you might expect. Most addictions are like this – we are drawn to the very thing we have too much of, partly because our brain has been fooled into thinking it needs more to survive. In the process we have diverted our energy and focus away from all the other potential rewards in life and without regular reinforcement have lost interest in them.
Changing Your Behavior Rewires Your Brain
Hopefully as you have read through this tip sheet you can see that there is more to changing your appetite than simply trying to argue with your urges or convince yourself to like carrot sticks. Real change comes from the practice of specific behaviors. In the case of binge eating, the practice may have little to do with food, and instead is merely a way of getting your brain to use circuits that tap into your self-control, motivation, and other more executive functions that typically are used to get stuff done in life. Rewiring your brain in this manner is not easy or quick, but it is effective and rewarding if you keep at it.
Kessler, R.M., Hutson, P.H., Herman, B.K., Potenza, M.N. (2016). The neurobiological basis of binge-eating disorder. Neurosci Biobeh Rev. 63, 223-38.
Volkow, N.D., Wang, G-J., Fowler, J.S., Tomasi, D., & Baler, R. (2012). Food and drug reward: overlapping circuits in human obesity and addiction. Philos Trans R Soc Lond B Biol Neurosci. 363(1507), 3191-200. Doi: 10.1098/rstb.2008.0107.
Voon, V. (2015). Cognitive biases in binge eating disorder: the hijacking of decision making. CNS Spectrums. 20, 566-73.
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