Episode 16 - Diets No More
Binge Eating Disorder is grossly underdiagnosed and can leave dramatical devastation in its wake. So how do you find your way in a culture that makes it so difficult for us to rise above diets, shame-based choices, and self-hatred?
We sit down with Andy McLoughlin and talk about his lifelong journey to shed the darkness of his disorder and embrace a fulfilling life.
Ellie Pike: The world of eating disorders is incredibly varied. From anorexia to over-exercising, to intense binging, humans have developed dozens of ways to negatively cope with food. Not only that, but it's the cutting edge of modern medicine, one where we are constantly finding new definitions to help us tackle long-standing problems. Of all [00:00:30] of the known eating disorders, binge eating disorder is one of the hardest to hide, yet one of the newest to be diagnosed. It only became an official disorder in 2010 and because of that can be grossly misunderstood.
The amazing news about having a diagnosis is that there's now hope. There's finally an opportunity to shed shame and anger. There's the chance to break free from a culture that explains the disorder as laziness, or a lack of willpower. There's the option to live life freely [00:01:00] and fully. Today's podcast gives us a window into just how transformative that hope can be. We'll be following Andy.
Andy: I am 34 years old. I live in Philadelphia, Pennsylvania. I'm an alumni of Chicago's ERC BETR program. I was there two years ago for about three months. I've been in recovery since.
Ellie: We'll walk together over three decades of struggling with a disorder that he didn't even realize he had. We'll go from innocent [00:01:30] childhood quirks, all the way up to being physically incapacitated due to the disorder and then onward to a future where he's found the freedom to be himself. Hearing Andy's story is a reminder for me of the human capacity to heal.
He rose from a never-ending string of failed diets and self-hatred to a place of love, acceptance, and even an end to binging behaviors all through discovering the elusive diagnosis of binge eating disorder. You're listening to Mental Note Podcast. I'm Ellie Pike. [00:02:00]
Andy has an incredible presence. His smile is big and you can hear the warmth in his voice as we talk. Meeting him now, it's difficult to realize he suffered for 30 years with an undiagnosed disorder that took over his life, finances, and emotions. [00:02:30] The journey begins in early elementary school.
Andy: I was a pretty normal kid, grew up in the mountains just north of Philly. As a young child, I had two older brothers, I still have two older brothers.
Ellie: [laughs] That's a good point.
Andy: Yes. I was a normal kid. I liked playing outside, liked building forts in the woods, playing sports with the neighborhood kids. The older I got, the more kind of leading this towards the eating disorder story. [00:03:00] Around kindergarten, first grade, I became recognizably heavier than most kids my age and my two older brothers, so it's where the "something was not right" part came into my life from my parents perspective, from my own perspective.
I remember realizing that going shopping in department stores, I was a size husky. I don't know if they still have that size, but back then, [00:03:30] having your set young boy was in the husky session. Not as cool choices of clothing. My brothers' got the cool little race car shirts and stuff and I got the lame primary colors.
Ellie: Like the plain T's.
Andy: Yes. There was a little bit of like, that's the first time I remember realizing that I was different and I was different to a negative side. One day, my first-grade teacher actually observed me eating a pencil [00:04:00] in class. Odd thing to say and not something a lot of people can relate to, but I think it's important for me to tell my story because of how obviously odd it is, not normal at all.
Ellie: Can you tell me a little bit about what that was like for you? Were you consciously doing it?
Andy: I don't remember a lot of emotions surrounding it, all I remember is the need to, and it sounds almost laughable looking back because of how short-lived it was [00:04:30] and how, again, obviously not normal it is, but I just remember the need to-- the craving that I had to do this, eat these pencils.
Ellie: At about the same time, Andy's size began to rapidly grow, prompting his parents to talk with doctors, dentists, and teachers about what might be fueling the odd behavior and weight gain. [00:05:00] Yet, time and time again, nobody thought Andy needed help. They simply chalked it up to a quirky personality or weak will. Left unchecked, his disorder began to blossom.
Andy: Around that time in second grade, I was being allowed to be home alone for the first time for an hour here or there. I remember my mom would go get her hair done after school at my neighbor's house who did hair, and I would wait till she left [00:05:30] and I'd watch her out the front window, go to my neighbor's house, walk into the salon door, and then boom, I hit the kitchen. I'd peruse the kitchen, and I did it in a very intelligent sneaky way where I would eat what I could that wouldn't be noticed, so a variety of things. That just goes to tell you, it wasn't like I was craving one specific thing. All I was craving was the act of eating.
Ellie: Then you were also trying to hide it.
Andy: And trying to hide it. I would run to the window every couple of minutes, and [00:06:00] the entire time. How long does it take for someone to get their hair done? An hour?
Andy: I'd keep running back and forth and I'd keep switching from one thing to another.
Ellie: Do you remember any reason why you wanted to eat, or any like triggering, or instigating events for when you wanted to eat?
Andy: I don't. I think, and this goes throughout my whole life even into my depths of real binge eating disorder a couple of years ago is, any emotion, good, bad, happy, sad. I could be angry and the answer [00:06:30] was this, food. I could be celebrating and the answer was this food. It was just always my answer to any emotion or lack of emotion.
Ellie: One of the reasons that binge eating behavior has become so habitual is that binging engages a double dose of reward centers for the brain. Not only does it temporarily relieve anxiety through the act of overeating, but it can also provide a feeling of euphoria. [00:07:00]
Andy: My identity in social situations as a child became that of the funny fat guy, and it was an option that-- It was the only option I saw because I always had a great personality. I always was able to make people laugh, and that was always, and still is even now in recovery, I enjoy using it much more, but it was always my safety blanket. I slid into this persona, this identity at the time again, I was okay with it. [00:07:30] I was like, "Yes, this is me. I'm not the coolest guy in school, but he's my best friend. I'm funny, and I make him laugh every day, so let's do it."
When I got to high school, it was again, like dating scene was flat-lined for me pretty much throughout high school, but I kept trying in small ways, and that was football for me was, what are big guys supposed to do that's socially good, and that was play football.
Ellie: Through football, laughs, and family, [00:08:00] Andy was able to get by with this disorder with few major incidents. Once he got out on his own at college, the disorder's voice took center stage.
Andy: College was the first time I realized that I was not like everybody else pretty significantly, not I wouldn't say I like sat there said to myself, "Jeez, something's wrong with me," but it's the first time I started hiding my food habits from my peers.
Ellie: Oh, interesting. [00:08:30] Before, it was just from your family.
Andy: Sure. People, the family that were there to care for me, and worried about me, and whatnot, and this is freshman year of college. My parents moved me into my dorm room and the roommate, my freshman-year roommate, wasn't there for a couple of nights for whatever reason. The first few nights, I was on my own. My parents left, and within 45 minutes, I was on the phone with the food delivery place ordering three people's worth of food, because it was like [00:09:00] I had just been set free. Something. Now I know my binge eating disorder had just been given a free pass.
Ellie: And no one was watching.
Andy: A summers' job full of bank account money and take-out menus all over the dorm, and I closed my door and I ordered all those food. I just sat there for the first night of college. There's so many different things that I could have done on the first night of college, but that's what I did. Did I sit there and say, "Oh something's wrong with me," no, but, [00:09:30] especially now looking back, that was the birth of my eating disorder's control.
Ellie: Control over you?
Ellie: Despite the disorder's newfound strength, Andy discovered a real talent for the hospitality industry while in college and decided to build his career in restaurants and hotels, a risky place for someone prone to overeating.
Andy: Anyway, if anybody's familiar with the hotel or restaurant industry, [00:10:00] the culture surrounding the restaurant business is extremely, how should I put this, party-centric. You work, you party, and you sleep in, and then you work again.
Ellie: Right, and it's a lot of late nights.
Andy: It's a lot of late nights, it's a lot of, I don't want to say peer pressure because it's not something I really resisted when I was in it, but it was, I guess, that group mentality. When the [00:10:30] entire restaurant is like, "Are we going out after this?" Yes, of course, we are and we're going to rage.
Ellie: It's going to get crazy.
Andy: Then we're going to go to bed and we'll sit back here at 11:00 AM tomorrow.
Ellie: How did you keep up with that?
Andy: I don't know looking back. I got progressively unhealthier. After five, six years in the restaurant business, right out of high school I went into it, and then let's say, 26, 27, 28 [00:11:00] until then was all of that. There was work, party, sleep, repeat. If I had to cut part of that out it was sleep, it wasn't party. By the time I'm 26, 27, 28, I am again, heavier than I've ever been, heavier than just the funny fat kid. I am now the guy that gets stared up by children in grocery stores. I was angry at the world. [00:11:30] I felt that I walked into a room and I could see on everybody's faces what they saw.
Ellie: You felt like you were being the center of attention?
Andy: I was judged and I was a victim. I didn't know what was going on. All that frustration did was make me go deeper into that party, work, repeat thing until 28, 29 years old, I'm [00:12:00] well over 500 pounds almost 600. I'm unable to be a chef or a restaurant manager because I can't be on my feet more than 45 minutes. My hips every day are on flames, I sleep sitting up because if I lay down I can't breathe.
Instead of listening to the people, even the people that are enablers around me at this point in the restaurant business, even the ones that are sitting at the bar with me [00:12:30] and staying up till 04:00 with me are saying, "Dude, what's going on? You got to do something." I have pictures from that this time that I look at me and I see two slits where my eyes were with a yellow discoloration around them, and I always smiled because I was always good at that, but very little else of any meaningful substance. At this point in time, I cut off [00:13:00] those people. I worked poorly, and then I went home and binged, and then I went to bed. I did that for another two years.
Ellie: Tell me, you mentioned that people have seen you after a binge, and it was a euphoric type of feeling. I think that's an important [00:13:30] thing to talk about because there's a reason behind these behaviors even if it wasn't always conscious. There was a reward, what was it about that euphoric feeling or what did it feel like?
Andy: It's a numbing sensation. After a binge, your brain works a lot like drugs, dopamine's released, and a sense of euphoria comes about you. Anyone who's ever done any kind of substance can relate. It's just like there's nothing in [00:14:00] the world that's wrong. I'm going to sit here and be comfy, and I'm going to relax and maybe watch a movie, and then that goes away in like 20 minutes. Now, you just feel like, "I can't move, I'm too heavy to sit up, so I'll just lay here." Then you start going over and over in your head, "Why did I just do that again? I can't afford it financially, I can't afford it physically. It wasn't that great anyway. What am I doing with myself?"
That's when the shame spiral [00:14:30] kicks in and you turn into this-- After the euphoria it's terrible. It's like you just can't wait until there's room in your stomach to do another binge.
Ellie: Because you feel the shame that you want to get rid of again?
Ellie: So it's a cycle?
Andy: It's definitely a cycle. It's a snowballing cycle. It gets bigger and worse and more frequent and more costly, and just in every way.
Ellie: It did become costly to you. You-
Andy: I did the math once in the last year of my binge eating behaviors, and I stopped at about $35,000 just on binging. That was only through three quarters of the year. Just estimating.
Ellie: Wow. What's that like to say?
Andy: Terrible. [00:15:30] In that period of time between 25 to 28, I had three or four different personal trainers, more than a half dozen gym memberships that just sat there, but then you want to talk about monthly weight loss clubs, the big one, in particular, I probably put the owner's children through college. Years' worth of monthly memberships. Fad diets, shake systems, I tried pretty much everything shy of [00:16:00] the eat only cabbage for two months thing.
Ellie: It was all about controlling what you ate and losing weight. That's a message that was around you?
Andy: It was all about losing weight regardless. The personal trainers would say it's 80% exercise, 20% food. Then you have plans like Weight Watchers or the monthly weight loss clubs that said, "I didn't work out and I lost this." I didn't know what was going on. I had [00:16:30] no factual data at all that was accurate to me. All I knew is what the society was throwing at me and the concern that my loved ones were sharing with me, and the dread that was rolling with inside of me.
Ellie: I know for a lot of people the message they end up getting then is like, "Well, you don't have enough willpower to make it happen. You need to just do this more." Did you ever feel that way?
Andy: The word willpower is, I don't know that I hate [00:17:00] any word more than willpower. As someone who has lived a lot of their life seeing people around them do things and act in ways that are seemingly easy to them and come second nature, and for me, I couldn't ever develop these plans or develop this routine. The word willpower was thrown at me so many times in my life. I don't think it's even a real thing. [00:17:30] There's willingness coming to something with an open mind and the ability to try and listen and process, but willpower is not a real thing to me. I don't like willpower at all.
Ellie: To dive more into why [00:18:00] cases like Andy's go undiagnosed, I sat down with Dr. Jennifer Ashton, physician, author, nutritionist, and chief medical correspondent for ABC News. How has the medical community contributed to the stigmatization of binge eating disorder?
Dr. Jennifer Ashton: Well, I think two things. Number one, in the world of medicine we're really, I think, intrinsically programmed to want to make a diagnosis. [00:18:30] I often say to my patients, and I've said this on national television as well, I also think in medicine, it's just as important sometimes to know what something isn't as it is to know what it is. I think when you talk about why so many people with binge eating disorder have a massive delayed diagnosis or are misdiagnosed, it's because the healthcare provider oftentimes is in such a hurry, often for good reason, [00:19:00] we want to help the person, so we want to make a diagnosis.
You can have more than one thing going on at a time, it's not about just having one diagnosis. I think that until we as healthcare professionals get more open-minded, we will continue to misdiagnose many things especially in the world of eating disorders.
Ellie: Right, and most patients, I think struggling with binge eating disorder can be really secret about their behaviors [00:19:30] and they feel so much shame about their behaviors. Is that something that you commonly see?
Dr. Ashton: It is, absolutely. Not just with binge eating disorder and eating disorders in general, but with any kind of weight issue which could be being severely underweight. I think that there is, unfortunately, a lot of stigma that's doing harm to those patients and those people. I think that in this day and age, [00:20:00] there can't be shame in that game.
I think that in our culture if you're on crutches or you're on a wheelchair or you have an amputation or a prosthesis, that's something we can see so we're a lot more comfortable saying, "Oh, you have a physical limitation, I can see it." With mental health, with eating disorders, with psychiatric disorders, with psychological problems, we can't oftentimes see that [00:20:30] and so as a society I think we tend to take it less seriously or think that it's really just a fluffy problem.
I say to my patients all the time to help them overcome that shame, if you had high blood pressure you would treat it, right? If you had diabetes you would treat it, right? This is no different. If you have binge eating disorder it should be treated.
Ellie: What's the one thing that you wish medical providers just knew so that they could diagnose [00:21:00] more accurately?
Dr. Ashton: A lot of times the healthcare provider will just address that one symptom but what's causing the symptom is what really needs to be addressed. I can fix someone's irregular bleeding very easily. If it's a polycystic ovarian syndrome or an infection or a fibroid, my fix is really going to be a bandaid on the problem. Whether [00:21:30] it's a GYN problem like irregular bleeding or a binge eating disorder like what Andy went through, the issue is taking a micro view at the patient's initial symptom and then backing way up so that you get a macro view of the global problem and what is really at the root cause of it. Until you get at the root cause of any medical problem, you're only going to be putting a bandaid on it.
Ellie: What was [00:22:00] Andy's root problem? Well, as he rounded the corner into his 30s, he still wasn't sure but something had shifted and he was finally ready to at least start digging into his struggles.
Andy: I quit my job, I had to move home to Philly and live with my parents at 30 years old. I was broke which is why that money thing hurts so much. I was making good money, I was running a very successful restaurant and nothing to show for it. I'm as single as they come, as single as single could be at the time, and at that point is [00:22:30] when I got this, I don't know that you can call it gumption, it was like what else am I going to do but try other ways?
I heard about this 12-step program for overeaters and I started going there and that at 30 is truly where I heard the word binge eating disorder before. I saw people in the room with me that had, all walks of life, all ages, all sizes and shapes, and colors, and [00:23:00] the one thing we all had in common was that frustration. I could see and hear in their stories and see on their faces the same angst that I felt every day. I started like, "All right, maybe this is something." The more I went, I went to that program for about two years, and then after following up with the research there, I decided I was at a point based on what I've discovered, that I need some professional help.
I go online looking for professional help and it's not easy to find legitimate professional help.
Ellie: I'm sure you also found lots of weight loss, lots of diet programs.
Andy: I found many many, I won't mention the specific names but I still get emails and calls to this day and we're talking over two years later. I got like there's a there was a pause there where I got a little discouraged like this place wasn't real, this promised land was [00:24:00] not an actual thing but then, it's actually funny, I found one that accepted in health insurance and it was a ranch or something somewhere, but they were being closed down by their whatever company owned them.
I'd made an appointment to get an assessment and then when I found out they were closing and I asked Lee I was like, "Look, do you know anywhere that you'd recommend?" She was like, "Absolutely, Eating Recovery Center." [00:24:30] That was the next call I made the next day. I called someone in Denver and they're like, "You know, you could certainly come here but there's a new binge eating disorder program in Chicago that's probably more of a good fit for you." That's what I ended up doing, I ended up going through what's called core at the time but it's now definitely the established BETR program BETR, Binge Eating [00:25:00] Treatment and Recovery.
In Chicago February of 2016, the scariest and best day of my life, it was the 22nd of that month and that's where everything just started, that's why I'm here today.
Ellie: Andy's treatment opened an entirely new way of being to him, one where he no longer feels the need to rely on binges to help him through life. He explains how that process happened. What was treatment like for you?
Andy: [00:25:30] Just like we just talked about, my whole life I never really got what was wrong with me which is frustrating because I'm someone who understands individuals almost immediately. I empathize, I have always been able to talk to strangers, I get people, I've always gotten people but I've never understood myself and that's what they did. They told me what was wrong with me and proved to me that it was an actual thing and also [00:26:00] proved to me that it's possible to recover and live as if you don't have it. Because once you follow the tools and the training and the philosophy, you really don't.
Ellie: So you were able to get your life back?
Andy: See, I wouldn't even say I got my life back, I got the life I always wanted but never had. That's what's so powerful. I'm two years post-treatment, I look and act [00:26:30] very differently but I don't physically look much different than what I did before I went in. That's why I want to tell people that it's not about that, it's about how I feel and how much I love life and love myself and literally control the trajectory of my life instead of reacting to where the binge eating disorder is taking me.
My internal model, I was terrible. I wrote a letter to [00:27:00] myself on if I failed treatment, what I would say to myself? If I didn't recover, if I quit. The things I said to myself in this letter which they didn't tell you when we were writing it that we're going to read it in front of everybody.
Ellie: Oh, wow. That's quite an exercise.
Andy: The first time ever that my internal monologue was shared with the world. That was the ugliest thing I've ever, [00:27:30] it was the most uncomfortable. I wouldn't say things that I said in this letter to myself to other people. That's- [crosstalk]
Ellie: You spoke the worst to yourself.
Andy: After you get into treatment and you dig out all this stuff and you realize, you know, some of my core beliefs in life were there, I was undeserving of what I wanted.
Ellie: Did you catch that? That was the root of the problem that Dr. Ashton had told us was so important. Andy did not believe he deserved what he wanted. [00:28:00]
Andy: You're just running a rat race at that point.
Ellie: Through realizing that, did it start to shift how you actually felt about yourself?
Andy: I guess the answer at the end of day is I didn't have a clue about myself. I was confused about myself, I didn't know what was wrong with me and now there's nothing wrong with me because I was taught about myself and learned how to live life with what I have going on. I'm no longer confused about myself. [00:28:30] If I am, I use my tools to figure it out, that's all,
Ellie: I think that your story is inspirational.
Andy: Thank you.
Ellie: I really think it takes a lot of courage to talk about eating behaviors especially binge eating, it takes a lot of courage to talk about weight and especially when you felt so judged about it. I think your story is really powerful. For anyone wondering, what does life look like for you now? I [00:29:00] know it's not like a magic one, life is perfect but how would you describe your life now?
Andy: It certainly isn't a magic wand, that would be cool. Life is, I don't want to say whatever I want it to be but that's a possibility. Life could be ugly just like it was before but I have power now that I can be [00:29:30] okay with ugly. Just because life is ugly I don't have to be ugly, I don't have to be miserable or complacent or sad or isolated or any of those things. I don't have to eat when I get an urge to eat, I don't have to isolate when I'm feeling anxious because I know how to deal with all these things. If I could give one gift to the world it would be that everybody goes to this program, [00:30:00] eating disorder, or not. It's eye-opening in a lot of ways. I think that it would help a lot of the issues that we have going on in this world.
Ellie: Understanding emotions and ourselves are critical to living well.
Andy: As a species, I've always said the human beings-- A lot of people say the opposable thumbs thing is our greatest gift, or our technology, or our intelligence. I think it's our emotional intelligence. That's where the power is, for me, especially after going through treatment and recovery, because I've [00:30:30] always been smart and logical, and I've always had opposable thumbs, but I've never had a control over my life like I do now.
Ellie: I want that to be the biggest quote of the podcast. That's just so wonderful.
Andy: This is how I feel, and that's why I say [inaudible 00:30:49].
Ellie: What I think we can take away from Andy's story is that there's hope for real long-lasting change for people battling binge eating disorder. When we shift our focus away from weight [00:31:00] loss and look for help with the underlying mental disorder that urges us to binge in the first place, we can escape self-hatred and harm, we can find peace instead of torture.
If you can identify with Andy's story, please reach out to a professional eating disorder team that knows how to treat binge eating disorder. You can call 877 411 9578 to speak with a licensed therapist and get going down the road of true recovery. You can also check out the Facebook page, Binge Eating [00:31:30] Connection, as a place of support.
Thanks for listening to our show. Mental Note is sponsored by Eating Recovery Center and Insight Behavioral Health Centers. It's produced by Sam Pike and edited and mixed by Meredith Turk and Sam Pike. I'm Ellie Pike, wishing you a loving and enjoyable summer. Till next time.
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