December 8, 2014

Affirmation after affirmation and I'm still trying to feel better. Some days I feel so strong, but today I do not.

How am I supposed to look in the mirror and see beauty when I look in the faces of others and see disgust? Do I really see the disgust of others or am I seeing a reflection of my own.

Sometimes it's more than stress that sends me spiraling into binging. Sometimes it's the need to forget or escape things...a night of self-medicating. 

I tell myself that food will never hurt me, but it does and I let it. I'm just as accepting of the pain binging bring as I've been of abusive behaviors toward me. I take it all in thinking that taking it makes me stronger. I'm not getting stronger, I'm just becoming more numb.

For the past few nights I have giving into binging. I can't even say what is the reason. I couldn't stop...no matter what I tried. To be completely honest I didn't really try. I simply complied to it's wishes. I ate without measure and did not care. I slept with ease then woke to nausea. Typical scenario, only this time I didn't let it stop me from eating as I should. I hold up well in the light of day, but by night the urges return and I binge again. I've been cycling for the past 3 nights. Even if at that time I wanted to stop I knew I'd lose this fight.

Dear God, please help me get through tonight without binging. I feel the cravings so strong. I need the strength to fight the inner voice that constantly points out the wrongs.

It's 2:14am and I'm no where near sleep. Will I be more productive or will I just eat?

Perhaps another cup of tea or something to read to dull the negativity and the need...

Assessing the Development of My NES and Other Eating Issues

I’ve been spending more time talking to people about eating disorders. It’s been a freeing experience to talk about my NES and listening to others share stories about their eating issues. I was intrigued to find that there are different feelings associated with binging. Reading about the studies of different eating disorders is not the same as speaking to actual people and hashing out the small details. What’s most interesting is hearing how the binging experience makes them feel. I’m most interested in what emotions they have leading up to the binge, during the binge, after the binge. I’m also curious if the binge is planned or if it’s spontaneous.

Listening to others helps me to think about my relationship with food. I discovered that I have several levels of experiences with binging and food intake in general. From what I can tell, the way I binge depends on the level of stress and perhaps the origin of the stressors and triggers as well. There is a good portion that appears to be a more of a habit. Much like the formation of habitual and/or ritualistic behaviors associated with the development of addiction. It started off as a relatively benign act (or so it seemed) and then it grew into somewhat of a separate entity. The behaviors took on a life of their own and my mind simply adapted. I would even go so far as to say it’s like having an alter ego, being one way by day and another by night.

Eating at night was a way to release tension and to relax. I also loved the challenge of acquiring food for my night time feeds. I guess you could call it was the thrill of the hunt if you consider chiseling off pieces of frozen cake in the middle of the night hunting.  I would feel triumphant as if having conquered the giant and reaping the spoils. A sense of calm would come over me. Not quite euphoric, but close enough.

I have always associated feelings of euphoria with mouthing. It started with me sucking my toes to comfort myself and quickly escalated into increased mouthing and sometimes consumption of inedible objects. So I guess it’s no surprise to you that I’m diagnosed with PICA as well. As a young child, my biggest craving was bath soap. Ivory soap was the soap of choice. I loved the creamy saltiness of it. I didn’t much like taking baths growing up. Don’t ask me why, I’m really not sure. It just seemed that I could be doing so much more with my time. Eating soap made bathing more enjoyable. I looked forward to it. My mom would run the bath water for me. I’d get in and let the bar of soap float in the water for a few minutes. The soap would soften and then I would begin to eat. Always starting at the corners and slowly working my way towards the center. I never ate the entire bar in one night. It usually took me at least 3 to 4 nights depending. I don’t eat soap anymore and have not for many years; however, I do still have the occasional craving.

Food consumption or the shift of the meaning of food consumption started around the age of 4 or 5 years old. Changes in body mass were more prevalent. It seems that I was developing a pattern of gaining at least 10 to 13 pounds a year. By the time I was 10 I weighed just over 100 pounds. This is the pivotal point that marks the beginning of food deprivation and how that deprivation further locked me into a vicious cycle of cutting meal size by day and having an increased need for comfort by night. As the need for night time comfort increased I became bolder about acquiring the foods I needed. I would almost stop at nothing. Like a drug addict I’d steal money to make food purchases after school. Once home I’d find obscure places to stash my food, always careful to keep the evidence of my eating undetected. That’s why my unnatural weight gain was such a mystery to my parents.

By middle school my life was split was well defined into two levels of existence. During the day I deprived myself of food and at night I would gorge myself on all kinds of sweet and salty treats. I started with cutting out breakfast. Instead I would drink a glass of juice or milk. This made my parents proud which was no easy task. My parents were seldom proud of me. So my thought process was to increase my level of deprivation so they would be even more proud and perhaps love me some day. My mom would pack a normal sized lunch for me to take to school, but would only eat a small portion of it, hoarding the rest for later. I opted to take the city bus home after school because I needed time to go to a nearby store to purchase snacks and other food items.  I’d become obsessed with my new trend. I felt it was really working for me.

My parents, glad to see me making such sacrifice towards dieting would reward me with candy and treats from our store. Funny how history repeats itself isn’t it? I would gladly take my reward and add it to my hoard. Of course, my weight gain was still a mystery. There were countless trips to various doctors and endless dieting and still no positive long term results. No matter how many pounds I was able to lose I would gain it all back…plus.

At the age of 18 my mom decided to buy into a very popular diet. She paid $600.00 for the program plus purchased their prepackaged foods weekly. The food wasn’t bad, but I was forced to document what I ate. I hated eating according to the meal plan. This was a detriment to me, because it was taking me to a very uncomfortable place...eating more during the day. My focus remained on activities of the day including limiting food intake; however the food that I continued to eat at night was no longer acknowledged. It was as if the night feeds didn't really exist even though the behaviors were still very prominent.  

I tried to make myself look forward to eating the prepackaged meals. I was sure to document what I ate and when...forced to bear witness to every morsel I place in my mouth. This was excruciating at best. I hated having to pay so much attention to eating, especially during the day. I hated how it made me feel. I wanted it to stop. I gave though to purging, but talked myself out of it. As my distain grew my ability to eat the foods dissipated. I began starving myself again eating the smallest measure of food possible.  It was starting to pay off. I lost weight and was getting a lot of attention from men. I liked that. At this point I was barely consuming any calories before 6pm. I would chew gum and smoke cigarettes to appease my need to mouth. It wasn’t long before reaching the point where I was unable to keep any food or drink down during the day. I wasn’t purging voluntarily, but I do wonder if I was experiencing some sort of psychosomatic development. I actually thought I was having a reaction to the prepackaged foods. In hindsight I now recognized that I was in full daytime Anorexia mode. The thought of consuming anything in the light of day had become unthinkable.

I managed my night time feeds by eating large quantities of lettuce. Sometimes I would consume an entire head and a half in one sitting. I’d fulfill my need for night time comfort while giving way to appease a new fear of consuming calories. This is how I was able to lose weight for a while, but even that soon ended.   

I eventually stopped losing weight. It didn’t matter how little I ate. I guess I hit a plateau. That is a common occurrence when dieting, but seemingly unrecognizable as such to me. It just drove me to pursue more deprivation. In an attempt to detox for rapid weight loss, I went on a fast only consuming small amounts of apple and water when I felt weak. I did this fast for 13 days, stopping only because my eyes were turning yellow. I stood on the scale…not one ounce lost. I had given up and slowly began to resume old eating habits, still depriving myself during the day while hoarding and planning my binge for the night.

The battled between daytime Anorexia and night Binging continued for many more years.

Where do I begin?

A few years ago I was forced to make some hard decisions about my eating disorder, Night Eating Syndrome (NES).

At present time NES is not in the DSM IV/V.

The three main components identifying NES are Morning Anorexia, Night Binging and Insomnia. There is hope for us. Binge Eating Disorder recently added to the DSM-V under (EDNOS) Eating Disorder Not Otherwise Specified has given way to the possibility of two new additions to the DSM-V, Purging Disorder and NES.

I have been ignoring NES for 25 years. Three years ago my health took a turn for the worse. It quickly became evident that I needed to change my ways or else I would surely die. So I claimed my dirty little secret, frequent night time binges, and began looking into steps I could take to make positive life changes.

First steps toward recovery:

Acknowledge having an eating disorder.
Increase awareness of my own eating patterns. Note how I feel before/during and after meal times.
Identify possible beginning of NES behaviors.
Assess feelings, emotional state and reasoning behind late night eating.
Contact Psychologist to begin work on underlying issues.

No matter if you binged last week, last night or just a few minutes ago, it's not too late to get on the road to recovery.

 

 

Related Articles:

 

Night Eating Syndrome: Should it be Included in the DSM-V 

http://www.psychotherapybrownbag.com/psychotherapy_brown_bag_a/2009/10/night-eating-syndrome-should-it-be-included-in-dsmv.html

 



Night Eating Disorder
http://www.allianceforeatingdisorders.com/night-eating-syndrome

Issues for DSM-V: Night Eating Syndrome
http://ajp.psychiatryonline.org/article.aspx?articleID=99701

What is Night Eating Syndrome?

Night eating syndrome, or NES, also "midnight hunger", is an emerging eating disorder diagnosis, which primarily characterizes an ongoing, persistent pattern of late-night binge eating.^[1][2] NES was originally described by Dr Albert Stunkard in 1955^[3] and is currently proposed for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders.^[4] The diagnosis is controversial; its validity and clinical utility have been questioned^[5] and there are currently no official diagnostic criteria. - Wikipedia.com

More information on the Characteristics of NES
http://jama.jamanetwork.com/article.aspx?articleid=191250

There are several night time eating disorders listed in varying resources. So while looking up more information you may want to check into these...

Nocturnal Hyperphagia
http://en.wikipedia.org/wiki/Kleine%E2%80%93Levin_syndrome

Nocturnal Eating Disorder
http://en.wikipedia.org/wiki/Nocturnal_sleep-related_eating_disorder

Parasomia (SRED) Sleep Related Eating Disorder (also linked to NED)
http://en.wikipedia.org/wiki/Parasomnia

EDNOS Eating Disorder Not Otherwise Specified

Exert from http://www.eatingdisordersonline.com/explain/ednos.php

According to the Diagnostic and Statistical Manual, 4th Edition there exists a category of eating disorders that do not meet the specific criteria for the two defined disorders, Anorexia Nervosa and Bulimia. When people exhibit behaviors in the spectrum of disordered eating but do not meet all the criteria for Anorexia Nervosa or Bulimia, they are given a diagnosis of an Eating Disorder Not Otherwise Specified (EDNOS). Over one-half to two-thirds of people diagnosed with eating disorders fall into the category of EDNOS. More people are diagnosed with EDNOS than Anorexia Nervosa and Bulimia combined.

Binge Eating Disorder (BED) is the only type of eating disorder under the category of EDNOS. A person meets the definition of having EDNOS if they have exhibit all the criteria for Anorexia Nervosa but have regular menstruation or a normal body weight, or if they exhibit all the criteria for Bulimia but purge less than two times per week or for a duration shorter than three months, or if only small amounts of food are purged, or if a person spits out food rather than swallowing it.

People diagnosed with EDNOS can experience the same negative psychological, social, and physical consequences as a person diagnosed with Anorexia Nervosa or Bulimia. The seriousness of their condition is no different than that for people diagnosed with specific disorders. The only difference is that the person may experience a spectrum of disordered eating behaviors and these behaviors may change over time.

Although BED is the only one of the types of eating disorders categorized under EDNOS, people who are considered to have Sub Therapeutic Anorexia Nervosa or Sub Therapeutic Bulimia are also given a diagnosis of EDNOS. To have Sub Therapeutic Anorexia Nervosa or Bulimia means that a person displays some but not all of the criteria for the full-blown condition.

Read more about EDNOS

Huffington Post
http://www.huffingtonpost.com/2013/01/04/eating-disorders-ednos-dsm-5_n_2398373.html

Wikipedia.com
http://en.wikipedia.org/wiki/Eating_disorder_not_otherwise_specified


Educate yourself

It's going to take some time before NES enters the realm of legitimized eating disorders. In the meantime you will need to education yourself on the subject and take carful not of your relationship with food.

Have your information handy when approaching medical professionals for help. NES is not commonly known or spoken off in general medicine. If your medical professional is not familiar with the term Night Eating Syndrome, you may want to try a couple of the other terms listed with exception the EDNOS which umbrellas only one eating disorder, Binge Eating in the DSM-IV/V.

My Experience

A seemingly lack of interest of the subject has been my experience with medical professionals. Though my concerns duly noted, they are still unaddressed. There is no definitive diagnosis so it is simply put into my file as a general note.

Medical professionals can be rather harsh when dealing with weight related issues. They don't understand for many, "obesity" is a band aid for internalized emotional scars. A self made barrier of protection. Obvious distain for one's heaviness and harsh words do not help the situation.

NES is very real and can be a debilitating disorder. I have lived with NES for 28 years and it has taken me until 3 years ago to figure out ways and strategies to begin helping myself.

I strongly recommend seeking council to help with this process. NES has a root and one of the ways to combat any problem is to find the root source. Having a psychologist to help you strategies your way back to a healthy relationship with food is key.

More Reading Materials about NES

Overcoming Night Eating Syndrome: A Step-By-Step Guide To Breaking The Cycle
by, Kelly C. Allison, PH.D., Albert J. Stunkard, MD, with Sara L. Their

Night Eating Syndrome
by Frederic P. Miller (Editor), Agnes F. Vandome (Editor), John McBrewster (Editor)

Night Eating Syndrome
Research, Assessment, and Treatment
Edited by Jennifer D. Lundgren, Kelly C. Allison, Albert J. Stunkard