How to Use “Managing Binges.”

The attached optional participant handouts, Managing Binges, may be given to selected participants during an individual In-Person visit or may be used to support a discussion during a group class.  

It is very important to keep in mind that periods of overeating or emotional eating do not constitute a diagnosis of binge eating disorder.  Also, highly structured behavioral weight loss programs with reasonable weight loss goals, such as the DPP Lifestyle Balance Program, have been shown to help individuals with binge eating problems normalize their eating patterns.  If you have ongoing concerns regarding the clinical severity of a participant’s binge behavior, call the Lifestyle Resource Core and/or consult your local behavioral scientist.

Also attached is “Binge Eating in Obesity,” a chapter from Binge Eating: Nature, Assessment and Treatment (edited by Fairburn, CG and Wilson, GT, 1993, Guilford Press).  This is for your professional reference (not for participants).

Note:  An excellent book for participants is Overcoming Binge Eating (1995, Guilford Press) by Dr. Christopher Fairburn, a well-known international authority and researcher on eating disorders.  If you recommend the book to a participant, make it clear that some of the book may not follow the DPP goals exactly but it stresses the behavioral skills (e.g., self-monitoring and problem solving) that are key aspects of the Lifestyle Balance Program.

Managing Binges

A binge is when you eat much more food than usual and feel a sense of being out of control or feel that you have lost control of your eating.

The first step to managing binges is to self-monitor.  Record exactly what you eat and drink, including binges, as soon as possible after you eat.  Leave nothing out.  Also record anything that affects your eating (e.g., feelings and situations).  Use your records to answer the following questions.

Describe a recent binge:  

C	Where were you?  What was the time of day?  

C	How were you feeling?  

C	What happened before the binge?  

C	During it?  

C	Afterwards?

Review some other binges.  How were they the same?  Different?

There are three basic ways to manage binges:  try to prevent the binge, get back on track as soon as possible, and learn from the binge.

Try to Prevent the Binge 

1.	Don’t let yourself get too hungry.  Plan three meals and two or three snacks, no more than 3-4 hours apart.  Do not skip meals and snacks.  Stay at your DPP fat/calorie goals.  
		I will eat meals and snacks at these times:

2.	Watch for any warning signs that a binge might occur.  For example, certain feelings or situations may place you at risk for a binge. 
		I will look for these warning signs of a binge:

3.	Plan to do something not related to food as soon as you notice any warning signs of a binge. 

 Keep a list of things on a small card.  Carry it with you.  Take the list out as soon as you feel the urge to binge, and work through it one by one.  Include on your list:
C	Things you enjoy doing.  Visiting a friend.  Listening to music.  Taking a shower or bath.
C	Physical activity.  Taking a brisk walk, hiking on a favorite trail, or going for a bike ride will lift your spirits.  It will also get you out of the kitchen.
C	Talking to someone about your feelings.

I plan to do the following things when I notice any warning signs of a binge:

                                                                                                

4.	When you feel the urge to binge, wait at least 10 minutes.  Set a timer.  Then get busy doing something distracting on your list.  After 10-30 minutes, the urge to binge may pass. 

Get Back on Track As Soon As You Can

1.	After a binge, talk back to negative thoughts with positive thoughts.  Don’t let guilt overtake you.  That can make matters worse.  

For example, you might be thinking, “I’ve blown it.  I might as well keep on eating.”  Stop this thought.  Replace it with something like, “I’m not a failure.  I can get back on track again.”  

		Negative thoughts I might have 

                                          

                                          
Positive thoughts

	                                            

                                          
2.	Focus on all the positive changes you’ve made.  Make a list of how you have changed since joining the Lifestyle Balance program.  List things you can do now that you couldn’t do before.  

Positive changes I have made:

                                                                                             	    

      
3.	Return to your fat and calorie goals right away.  Start with a clean slate.  Do not try to starve yourself as a form of punishment.   

Learn from the Binge	

The best way to learn from a binge is to use problem solving. 

Describe the problem in detail.    Be specific. 

What led up to the binge?  What were the early warning signals?  What situation or foods put you at risk?  How did you try to prevent the binge?  What went wrong?  Were you able to get back on track as soon as possible?  If not, what got in the way?

                                                                                         

Find the action chain.

Links	Brainstorm your options.

Options	

		

		

		

Pick one option.  Weigh the pros and cons.  Choose one that is very likely to work and that you can do.

Make a positive action plan.	

I will:                                                                      

When?                                                                     

I will do this first:                                                       

Roadblocks that might come up:	I will handle them by:

                                                  	   	                                           

I will do this to make my success more likely:

How can we help you?

 
5.	Try it.  See how it goes.  Did it work?  If not, what went wrong?  Problem solve again.