How to Focus on Heart Health in Binge Eating Recovery

February is American Heart Month.

The awareness campaign’s signature red ribbons and red dresses serve as an important reminder that heart disease remains the number-one cause of death among American men and women.

But rampant heart health messages about diet and weight loss may also inadvertently prompt disordered thinking about “good” and “bad” foods and restrictive eating, which ultimately tend to fuel food cravings and out-of-control eating.

Reducing heart disease risk in recovery

Managing co-occurring health conditions, like heart disease, can be one of the most challenging aspects of binge eating recovery.

On the one hand, you may be working on neutralizing trigger foods and including a broad spectrum of choices into your diet (deliberately incorporating “bad” foods into our meal plans is part of important exposure therapy work).

On the other hand, if you are working to manage high blood pressure, cholesterol, or blood sugar levels, eating trigger foods can feel like you are breaking the rules of a heart-smart diet.

While focusing on binge eating recovery and heart health can present a tricky balancing act, these two health goals are not mutually exclusive.

This year, instead of swearing off salty snacks and buttery pastries entirely, consider a more recovery-focused approach to heart disease prevention and management that minimizes deprivation and binge urges.

Here are my suggestions on how to do just that.

Focus on food, not weight

We often see and hear multiple weight loss messages from friends, family, and the all-but-ubiquitous diet industry. Even our physicians and health professionals spread weight loss messages frequently, usually with good intentions.

Weight loss messages can be tough to tune out, but, counter-intuitively, when we make weight loss our top priority, we tend to start engaging in the very thoughts and behaviors that prevent weight loss and may even lead to weight gain!

Diet behaviors that can lead to weight gain include:

• Under-eating during the day and then over-eating or binge eating later
• Skipping meals or losing weight rapidly, resulting in a slower metabolism over time
• Avoiding “bad” foods, only to increase cravings and compulsive eating around those forbidden foods later
• Obsessively stepping on the scale and using the numbers to justify out-of-control eating (…if we’ve lost weight, we loosen up and celebrate with a binge! If we haven’t lost weight, we want to give up and self-soothe, so we binge!)

Rather than focusing on weight loss and restriction, focus instead on what you can add.

Work on increasing intake of heart-healthy foods to your daily routine: opt for whole grains more often, include produce in more meals and snacks, and eat more plant-based protein.

Aim for moderation over elimination

Certain foods and nutrients can increase our risk for heart disease, but we don’t need to adopt an all-or-nothing relationship with those foods.

A heart-healthy diet does not have to be devoid of sodium, saturated fat, or added sugar. The challenge is to identify ways to include these foods in normalized portions and consume them occasionally versus frequently.

Unfortunately for many, this is a challenge. Most of us have heard the saying, “Enjoy everything in moderation.” For many, though, it’s hard to be mindful of how much and how often we eat something — as opposed to what may seem more simple: cutting it out altogether.

In the short term, many people truly prefer clear-cut boundaries drawn around our food. We make “Can-have” and “Can’t-have” food categories to eliminate the burden of choice and complex decision-making.

When we first start a diet, we may find it easy – even a little exciting – to automatically throw up a righteous hand in protest and say, “I’m low-carb now. No French fries with my sandwich, please. I’ll just have a side salad.”

After a while though, we start to feel deprived forgoing the fries. Sooner or later, our diet pendulum swings us to the opposite extreme, and we find ourselves eating all the French fries, all the time. Believe it or not, a heart-healthy diet can include French fries, or any other so-called “bad” foods!

Here’s how to make heart-healthy decisions in real life:

1. Order your sandwich with fries, but leave half of the fries behind the plate.
2. Get a veggie side with your sandwich instead, knowing that you can have fries later if you want them.
3. Order fries with your sandwich and eat all of them, because you enjoy them, and then move on without guilt or shame and have a lighter, more balanced meal later. See? All-or-nothing thinking is tempting, because it’s not so convoluted! But elimination diets also invariably lead to failure by setting unrealistic expectations in the first place.

Get more vitamin P

Regardless of your weight and food choices, stress can be a major risk factor for heart disease. That’s why more and more health experts are recommending regular intake of “Vitamin P”. (The “P” is for pleasure).

Eating foods we enjoy in a way that feels relaxed and pleasant actually helps improve digestion and metabolism. Conversely, research shows when we’re eating under stress – maybe because we’re in a rush, distracted by anxious thoughts, or simply choking down “healthy” foods we don’t even like – we absorb fewer nutrients from the foods we eat.

You may be eating a heart-healthy breakfast, but you’re likely not getting much out of it if you’re eating while driving in rush-hour traffic, ruminating about your boss, and resenting every spoonful of oatmeal.

So this is important to remember: chronic stress or anxiety in general, beyond just meal times, is linked to increased heart disease risk, from elevated cholesterol and triglycerides, to hypertension and weight gain.

Before you make changes to what you eat, consider how you’re eating and how you’re living, and think of ways to up your daily dosage of vitamin P.

If you’re not sure of where to begin, here are some ways to reduce your stress level and increase pleasure in your life:

• Avoid distracting or anxiety-producing environments while eating. Turn away from your phone, computer, or TV screen.
• Take the time to eat seated at a table, rather than over the sink or behind the wheel.
• Increase the ambiance at your meals. Think about how external elements like music, lighting, and table settings can promote a feeling of equanimity as you eat. Spotify “chill vibes” perhaps?
• Eat foods you enjoy. Not only is it normal to get pleasure from food, it’s essential to healthy digestion and nutrient absorption. The foods we genuinely like also tend to “hit the spot”, so we’re less likely to feel deprived and emotionally hungry after we’ve eaten.

Remember: a diet that supports both heart health and eating disorder recovery for life is one that’s balanced, moderate, flexible, and forgiving.

Talk with your registered dietitian if you’re interested in learning more about a dietary approach that supports both your emotional and physical wellbeing.