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Section 6
Binge Eating as a Result of Anxiety

Question 6 | Test | Table of Contents

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In the last section, we discussed three concepts of interpersonal relationships.  These three concepts of interpersonal relationships included:  early childhood development; as a means to please; and secrecy.

In this section, we will examine three aspects of binging as a result of anxiety. These three aspects of binging as a result of anxiety include:  generalized anxiety; fortune telling; and source identification.

In my experience, many clients with bulimia have reported feelings of anxiety as one of the main causes of their binging and purging. To relieve their stress and their anxious feelings, many clients will indulge in their favorite forbidden foods which inevitably leads to a binge. Also, the feelings of anxiety can weaken a client’s will power and their sense of discipline, making the onset of a binge even more unavoidable.

3 Aspects of Binging Resulting from Anxiety

♦ Aspect #1 - Generalized Anxiety
The first aspect of binging as a result of anxiety is generalized anxiety.  Several research studies have indicated that clients who experience anxiety but are unable to identify the source of the anxiety are at a much higher risk for overeating.

The inability to control one’s anxious feelings increases the severity of the anxiety and in order to assert control over the unease, clients will resort to food which has a mild stabilizing effect. Feeling full can have a calming effect on client’s nerves, but if the client has been diagnosed with bulimia, he or she could become very susceptible to a binging episode, resulting in even more anxiety about weight gain.

Lisa, age 25, had already become a successful and highly paid business associate with a multi-million dollar corporation.  She had become accustomed to a high class lifestyle and prided herself on being able to dissociate herself from the blue-collar background she had originated from.  Lisa stated, "I know anxiety is my big trigger for my binging, so I try to avoid it at all costs!  But last weekend, I went to my sister’s wedding and as soon as I got home, I began to eat all the cookies in the cupboard!  Then the bread went and I made some pasta for myself and ate all of that!" 

I stated to Lisa, "The encounter with your sister and the rest of your family may have recalled some slightly painful memories from your childhood.  However, at the time, you didn’t know that.  Because you couldn’t pinpoint the direct cause of your anxiety, you needed to eat."  Think of your Lisa.  Does he or she binge after an onset of generalized anxiety?

♦ Aspect #2 - Fortune Telling
The second aspect of binging as a result of anxiety is fortune telling.  Fortune telling, as you know, is the type of distorted thinking that takes the form of predicting that some type of disaster is imminent.  Because the client cannot readily control what has not yet happened, he or she will begin to feel acute anxiety. Also, when a client begins to catastrophize the future, he or she will undoubtedly focus on the worst case scenario. Obviously, this only exacerbates the situation. 

Valerie, age 17, was a chronic catastrophizer. Ironically, most of her anxiety resulted from a fear of binging, and thus this fear resulted in comfort binging.  She stated, "I had an interview for a big college scholarship, and so I was really nervous already. But it wasn’t the possibility that I may fail horribly at the interview, it was the idea that I might come home and eat my weight in snacks that got me worried!  I didn’t want to gain weight before I went to college because this might ruin my chances of making friends. So what do I do?  I eat 100 pounds of oreos!  Not even kidding! So then I had to be interviewed bloated and in pain. I didn’t even have time to purge!" 

♦ Cognitive Behavior Therapy Technique:  Distractions
To help clients like Valerie cope with their fears and anxieties, I asked that they try the "Distractions" CBT exercise. Because Valerie’s binge eating resulted from her catastrophizing, I suggested that she come up with activities that would distract her from her anxiety.  Instead of trying to avoid the urge to binge itself, Valerie was anticipating the urge and removing its root cause.

Her list of distractions included:  reading my favorite book; knitting my sweater; finishing up my photo album.  Think of your Valerie.  What activities could he or she do to distract him or her from anxiety and binge eating?

♦ Aspect #3 - Source Identification
In addition to generalized anxiety and fortune telling, the third aspect of binging as a result of anxiety is source identification. Because clients like Lisa experience even more acute anxiety when they cannot directly identify the source of their worries, I find it helpful to give them the tools they need to accurately analyze their feelings. I asked Lisa to think about the last time she was anxious and binged. I asked her to identify the antecedent, that is the event that triggered the anxiety, the thoughts that resulted from the event, and the emotion resulting from those thoughts. For Lisa, the antecedent was her sister’s wedding. 

The Thoughts that Accompanied the Antecedent included the following:

  1. If I’m not careful, I’ll gain weight or screw up at work.  I could lose everything and end up like my sister and her friends
  2. I’m really a fat, poor kid, not a slender, successful business woman.
  3. I shouldn’t be so uncomfortable around my sister’s friends.

And the emotion that accompanied these thoughts was, of course, anxiety.  I have found that this also works for other emotions in addition to anxiety, such as depression and loneliness.  Think of your client with bulimia.  Could he or she benefit from the "Source Identification" exercise?

In this section, we discussed three aspects of binging as a result of anxiety.  These three aspects of binging as a result of anxiety included:  generalized anxiety; fortune telling; and source identification.

In the next section, we will examine three connections of anger to eating in clients who binge and purge.  These three connections of anger to eating include:  overt anger; suppressed anger; and illogical thinking.

Peer-Reviewed Journal Article References:
Cotter, E. W., & Kelly, N. R. (2018). Stressrelated eating, mindfulness, and obesity. Health Psychology, 37(6), 516–525.

Levinson, C. A., Zerwas, S., Calebs, B., Forbush, K., Kordy, H., Watson, H., Hofmeier, S., Levine, M., Crosby, R. D., Peat, C., Runfola, C. D., Zimmer, B., Moesner, M., Marcus, M. D., & Bulik, C. M. (2017). The core symptoms of bulimia nervosa, anxiety, and depression: A network analysis.Journal of Abnormal Psychology, 126(3), 340–354. 

Luo, X., Nuttall, A. K., Locke, K. D., & Hopwood, C. J. (2018). Dynamic longitudinal relations between binge eating symptoms and severity and style of interpersonal problems. Journal of Abnormal Psychology, 127(1), 30–42.

Maxwell, H., Tasca, G. A., Gick, M., Ritchie, K., Balfour, L., & Bissada, H. (2012). The impact of attachment anxiety on interpersonal complementarity in early group therapy interactions among women with binge eating disorder. Group Dynamics: Theory, Research, and Practice, 16(4), 255–271.

Radin, R. M., Epel, E. S., Daubenmier, J., Moran, P., Schleicher, S., Kristeller, J., Hecht, F. M., & Mason, A. E. (2020). Do stress eating or compulsive eating influence metabolic health in a mindfulnessbased weight loss intervention? Health Psychology, 39(2), 147–158. 

Tasca, G., Balfour, L., Ritchie, K., & Bissada, H. (2007). Change in attachment anxiety is associated with improved depression among women with binge eating disorder. Psychotherapy: Theory, Research, Practice, Training, 44(4), 423–433.

What are three aspects
of binging as a result of anxiety? To select and enter your answer go to Test.

Section 7
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