I’ve been sitting on this blog for several weeks, but I decided to finally post it. My instinct is not to talk about bingeing (b/ping in general, but particularly the bingeing aspect), because to me it’s the most shameful part of my eating disorder. I know I’m not alone in this though, and I hope that the more I address it the less ashamed people will feel about confronting this behavior.
The article “Investigating the Reinforcing Value of Binge Anticipation” talks about binge eating in terms of alleviating negative emotions. A person apparently binge eats in the context of these emotions and through negative reinforcement the binge eating behavior alleviates this negative affect. When I first read this, I kind of disagreed. In the worst of my eating disorder, I binged/purged in the context of any emotion. I sought to numb myself completely but I was also physically starving, so I relied on the constant b/ping behavior to distract from the never-ending hunger. I was either severely restricting or bingeing on large quantities of food and then purging until completely empty (or well, as empty as was possible for me). That was in the worst of my disorder though. When I’m not as physically starving, I do notice the urge to binge is related more to negative emotions and anxiety.
I also noticed right away that the article focused no attention on the role of purging, which makes me wonder if their generalizations apply more to individuals who binge eat without purging, rather than those with bulimia or anorexia- b/p type. For me (and I’m sure others), bingeing is always paired with purging, and purging almost always follows true binges, not regular eating. This is why I usually refer to the entire behavior as “binge/purging” or “b/ping,” because those two behaviors are always linked for me.
That said, the article then goes on to talk about the unique role of binge anticipation, which is rarely, if ever, discussed in the literature. Ah, binge planning… so many memories of scrambling to write down all the foods I was craving in the moment and hoping they’d be the same foods I craved hours later when I actually got the chance to binge. Clearly for most people, bingeing directly following negative emotions is not always possible. You may be at school, at work, or simply unable to obtain the food necessary for the binge until a later time. This is where binge anticipation comes into play. Researchers hypothesized that often this binge anticipation phase may serve the same purpose as the binge itself, in terms of alleviating negative affect. This may explain why so often I’d be in heaven while planning my perfect binge only to be sadly disappointed when the actual binge failed to live up to expectation (or when the streneous purging part ruined it all).
The article talks about a recent pilot study that examined the brain activation of women with bulimia using an MRI scanner. The experimenters used a mood induction technique to place the subjects in a negative mood. They then measured the subjects’ brain activity when they were asked to plan a binge versus when they were asked to pick out furniture for a fictional apartment. They found a large drop in amygdala activation when the women were planning a binge, but almost no change in amygdala activation when picking out furniture. The pattern of amygdala-related change observed when the subjects were planning a binge has been associated with a decrease in negative affect. They also noticed an increase in activation of the caudate, which may indicate positive reinforcement and “appetitive reward.” In other words, this data suggests that the decrease in negative emotion that has been long associated with bingeing happens (also? instead?) during the binge planning stage. Another study they mention involving the anticipation and actual consumption of a milkshake suggest that this reduction in negative affect is solely associated with the planning, and not the eating itself. However, I think there are too many variables not accounted for to make this conclusion, including the role of purging and level of physical hunger before the binge.
The authors go on to suggest more mood induction, ecological momentary assessment (i.e., rating moods in the moment using some kind of mobile device), and longitudinal brain imaging studies of binge anticipation. I would add that studies should be done with a variety of diagnoses that involve bingeing (binge-eating disorder, bulimia, and anorexia- b/p type).
So the answer is simple then? Just do all the fun planning and skip out on the actual binge (and purge). Negative emotions sill reduced! Problem solved! Haha, right. Up next, how to actually apply these brainy findings to real life…