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Gustavo Tolosa: Binge Eating What is it and how to treat it by Dr Lisle, Evolutionary Psychologist
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if binge eating is a called a disorder an illness or a condition or how is it called yeah i mean [Music] i don't know that you people can use names and to describe things and you could call it a binge eating disorder um that that's okay by me i i feel like the problem is is that a lot of times when that happens it it starts to it starts to categorize something as if this is an affliction that you have um and and then then we've got some sort of medicalized cure or plan for it the uh so i've known that i think uh i think i've known that that certain kinds of of psychopharmacological agents have been used to quote treat binge eating disorder um this starts to go down to a direction that that i think is uh counterproductive so uh binge eating binge eating is something that that uh if we break it down brick by brick uh it it makes perfect logical sense uh why it exists and the uh and then from there we can derive some sensible ideas about how to try to unwind it okay okay all right um one question that comes up a lot and um honestly i have not had a uh a clear answer i still don't know well maybe i don't know if there is an answer but uh well there's always an answer um is it binge eating um purely physical is purely something physical or is it related to some other needs or unresolved issues in our past or in our present life how do you see yeah very good question no it's not related to anything this is a uh what what binge eating is is it's the me let me sort of back this up before i brought up more completely and that is that that all behavior all of it every single behavior that you ever see out of any animal is is the result of the the brain uh computing a cost-benefit analysis and so the when when a person binge eats it's because their brain is calculating cost-benefit analysis so you might say well it's a binge so they would appear to be overeating and then a good question would be well why would they be overeating and the answer is why people overeat is almost always the result of the benefit of the food that they're eating uh being judged as spectacularly high because as they eat more food they are getting evidence of the cost and the cost is a distended stomach and a feeling of discomfort and even pain upon uh more more eating so the question is why on earth would the organism continue to eat what benefit could they be seeking that would be worth the cost and the answer is that the benefit is spectacular because it's super normal stimuli it's the same reason to ask why does the the person who's drinking alcohol and has an alcohol problem take their fourth shot of whiskey after the first three and the answer is the cost benefit is is stoking the dopamine pathway in a way that it doesn't in a normal person and as a result the the person is in trouble okay so the super normal stimuli it's just like for example if you have a dog or a cat and you've got one of these little laser lights and you just run them all over the room chasing that laser light there's something about that laser light that is clearly a super normal stimuli for these animals and so the um the the reason why a person is binging don't think of it as a binge think of it as one bite at a time because that's actually the behavior that's taking place in principle there's no such thing as a binge that's a category of a bunch of separate actions so when we break it down it's like okay there's that bite there's that bite well every time you take the bite the you are deciding you aren't deciding in a conscious fashion this is what we call the adaptive unconscious is telling you this is the right thing to do the benefit outweighs the cost so the person is monitoring the distension is discovered in their stomach while they take another chunk of chocolate okay and and why are they doing that all the way to the point of feeling absolutely ill because the the food that they're eating is super normal okay just show me somebody that binges uh to the point of feeling sick on apples or carrots uh such individuals exist but they're exceedingly rare okay so i would say 99.5 percent of all binge eating is directly attributable to the hyper stimulating aspects of supernormal stimuli so what i'm telling you is that 99 and a half percent of all binge eating would disappear off the face of the earth if there wasn't a natural food okay so that's interesting so before we before we uh analyze any reasons and try to get into people's psychology or try to think through what we're going to do to quote control or stop somebody's binge eating the first thing we need to say is well would there even be a binge eating problem if there wasn't any super normal stimuli on the earth and the answer is no there wouldn't be anything that remotely resembles binge eating and so as a result of that it's like okay so now we get down to what the problem is and the problem is is that we've got super normal stimuli okay so super normal stimuli being the root cause of almost all binge eating we now we now have to realize okay that that is where the root of the problem needs to be addressed so now it's like well where are you getting the food you know how are you buying it you know and and what are your plans for eating because remember the the reason why people eat is that they're hungry so their brain is running a cost-benefit analysis on whether or not they should continue to shine their shoes or continue to talk to their kid or whether they should eat okay so you eat when the cost-benefit analysis of the eating makes sense if you turn and you you've activated the hunger drive and it has become the most important uh thing for you to do in the next 15 minutes is to eat so you've actually directed yourself to where the food is um where you know what is the food that's the biggest question that there is and if the food is a bunch of fritos and coca-cola and we've got a binge eater we've got a problem right so that's the that's the center of that problem uh gustavo is what but what about i actually i have met in person um but i've also received many emails and comments on videos of people that are that follow a whole food plant-based way of eating and they binge on potatoes that they really i couldn't believe it but it really was this person would just could eat potatoes and sweet potatoes yeah and they can binge on what we would call health food right what about that yeah first of all when you talk to those people carefully the amount of food that they're eating is not really that extraordinary okay so they're they're not eating 3 000 calories the way that somebody's eating 3 000 calories of crackers bread chocolate and um you know candy okay or uh cookies okay so ice cream so those kinds of things are so concentrated it's very possible for a binge eater to eat 6 000 calories of food right whereas people that are quote binging on potatoes they're not eating six thousand calories of food they maybe they eat a thousand calories maybe they eat three pounds of potatoes and they feel way distended now um what's happening there what can stokes and binge eating and those are yeah uh with that there's there's different different aspects of this that can be useful one of the problems is very often uh binge eaters are determined to control their weight so this is a you know a derivative of anxiety about gaining weight and as a result of that a lot of binge eaters basically display a very high degree of conscientiousness and self-control where they will essentially grind their teeth and draw down their glycogen reserves during the day so they will get they will get very hungry okay so then now that they're very hungry they've got nothing in their stomach they may have very little in their small intestine uh they are uh they're they they are having a concavish type situation in their stomach which they actually like because it relieves them uh over the the fear that they are fat um and then then however they eventually will eat now a classic example of the binge eating fiasco is that they don't they're not really preparing very well to eat so that what they wind up getting into is super normal stimuli the quickest easiest thing and then they start grabbing for that and now we wind up with a legitimate binge eating episode um however there there are there would be people who have even one more notch of extraordinary self-discipline where they actually have healthy food around okay so um and in those cases those people might well be able to binge ie knock down a thousand calories or potatoes uh to the point where they are physically uncomfortable now one of the things that that caused that was having a situation where they were extremely hungry okay so uh one of the most valuable things that that i have instituted uh with binge eating is to have people scheduled to eat save five meals a day so those five meals a meal doesn't have to be that big uh it can be you know a modest bowl of oatmeal in the morning but what that does is that it it essentially makes sure that we don't drain off all of our glycogen stores in our liver and that we don't wind up ravenously hungry and then two or three hours later we eat another 300 calories and then three or four hours later we eat another 300 cupboards and then three or four hours later you know we eat another 300 calories and then at night we eat 500 or 600 calories but we were never ravenously hungry okay so that is a that is a way to really settle down uh binge eating binge eaters a lot of times are also they they can be very you know obsessed and thinking a lot about food um and so if they've got enough conscientiousness we can organize what those five meals are gonna be and so they can be very stereotyped in what it is that they're doing and uh in in doing that we can settle this thing down to where it is that they um that they never get super hungry and therefore they never wind up with a panicky like situation where they're cramming food now there's another aspect of this and that is that oftentimes this unusual type of binge eating that would take place in the whole plant foods world with apples or or potatoes or something like this the occasion occasionally what is wise is to actually increase the calorie density of those people's diets sometimes they are in that trap because there is not actually enough calorie density in the diet in order to reach satiety by the time they've eaten a pound and a half of food a pound and a half of food is a lot of food and the normal stretch receptor satiety mechanisms in the stomach would be quite happy uh with a pound and a half of food or a pound of food those are those are not small amounts um a person a fairly large eater would be eating five pounds of food a day that's quite a lot of food so a pound and a half in a meal would be a lot but if the meal is very low calorie density um let's suppose it's the equivalent of a fruit salad or something that or potatoes which are low calorie density you could eat a pound and a half of food and i've only eaten about 500 calories if you only do that a couple of times a day you are only eating about a thousand calories and then what's happening is you're in trouble and you're actually under eating which you kind of like because that keeps your stomach thin and empty and so as a result what happens is that when you finally hit hit the food 500 calories does not actually suffice the system so now we eat you know we cram more food in even though it's uncomfortable we haven't really significantly overeaten what we've done is we've just pushed a thousand calories of low calorie density food into the system it can feel disgusting uh for people that are binge eaters on this kind of dimension they can be so sensitive to the fact their stomach is now sort of unnaturally pooched out and they are have a great deal of anxiety about their stomach in terms of their uh their appearance so it looks fat even though all it is is it's a bunch of potatoes in your stomach and as a result that can be pretty demoralizing and pretty upsetting so that's why uh one of the things uh i have a person that i uh refer a lot of binge eating to her name is justina friese uh she's in germany she's a young lady who battled this for 15 years and then has come up with a series of excellent excellent exercises and solutions to help others uh justina will encourage people to eat modest amounts of higher calorie density foods along with their low calorie dense you know wet carbohydrate along with duplicious carbohydrate if you do that then you don't have to put so much food in the stomach in order to start reaching satiety and if we do that at regular intervals where we're not getting ravenously hungry then the person's uh eating life can level out and so you can hit a sort of a stereotype group where we're doing very similar things day to day uh and we can leave behind this sort of really disruptive unusual cycle those are those are for our healthy eaters for our unhealthy eaters we have to tell you you have to plan to have healthy food around multiple times a day and we've got to eat it before you starve yourself into a rage at which point then we go start grounding for the richest food in the environment and then we wind up with a three or four or five thousand calorie pound bench so these are these are the tools that we use and we have to be patient and we have to use little mental gymnastics uh and tricks and get people to take run experiments but there is a way out of this mess there is a way out and like you said you have to be patient it's not something that overnight uh will disappear or am i wrong right this is uh this is why i have people uh work with justina uh because justine is used to taking people across a sequence that that may last a couple of months uh where they need support uh where we tweak the sort of tweak the system uh and and run little miniature experiments and learn as we go what will work for you so uh if you go to my website at esteemeddynamics.com you'll see uh not only jen and i which we talk about everything uh with people but justine is specifically a binge eating specialist and that's that's uh we like to direct people to her because she's very patient and very good at working with that problem okay all right and i'm just typing it here for people to see it your website is uh steamdynamics.com okay let me see uh yeah okay and um so dr live just to to be clear you when you have a patient with uh binge eating you really don't you don't dwell then on emotional uh issues or okay now this is a now now people may be puzzled because remember there's a what's driving a lot of this pattern not everyone but what's driving a lot of this pattern is a is essentially a restriction and then explosion oscillation and the restriction in other words the determination to not eat is a is an eating eating disorder process and then people want to uh try to figure out what what was the cause of the eating disorder process and the cause of the eating disorder process is uh generally a hyperconscientious female who's worried about her appearance so the uh and and then we say well where did that come from and the answer is um an interface between a highly conscientious sensitive personality and the modern world as a young as a young woman uh starts to simply you know as she's eating the satiety on the food of her environment she starts to get fat as a teenager and a lot of times i can't tell you how many of these women will tell me that they weren't even really thinking about it until somebody mentioned it you know so you know so grandma said on my 14th birthday wow you're starting to get fat and amazingly enough that kid might not have ever even been thinking about it because they were reasonably normal weight they might have been very slightly overweight but they weren't really taking any feedback from peers and they were liked and accepted and everything was fine and then suddenly they find out that they've got a highly interested party and a trustworthy party giving them honest feedback that could also be you know somebody else that is just not anybody that you know but because they make the comment you believe it it's kind of like well if a stranger says that my shoes are terrible then they really must be terrible but my friends aren't telling me well you know stranger makes some comment uh i've had i've had women who young women who uh what stoked it was their father commenting about some other girl and about how you know lisa's getting chubby these days suddenly suddenly the daughter realizes well maybe he would say to me but i'm his kid so he's not saying it and so one way or the other those are not the moments that cause the problem those moments are inevitable it is inevitable that that hyperconscientious nervous system given the fact that it's in a little young female body that is in trouble uh vis-a-vis the modern environment of the modern food supply it's going to get chubby that personality and that fact are on a collision course that are inevitable so people will point out like well gee if your dad just hadn't said that you didn't feel that pressure oh you are going to feel that pressure from somewhere okay that that so the the people can trace back the moment where their little anorexia or bulimia or binge eating you know restriction oscillation cycle uh began but they but it was an inevitable situation like it was gonna happen your first year of college you know i mean sometime that personality and this situation we're going to meet okay so what i'm telling you is that the underlying there's an underlying uh personality structure that makes this basically inevitable uh it's going to be the very high conscientious sort of sensitive individuals this is they're they're going to want to get control over their body shape and morphology and other people will go on a little diet now and then but they won't do anything like this so this takes uh this takes a ferociousness a competitiveness in this domain that is only sitting in 10 of of the world's personalities so and so that's what happens and then once we have that problem um you know most people will work their way out of it sort of naturally because they don't have that that badly the people that we run into have been at it uh justina was at it for 15 years from probably her 12th birthday to 27th so the uh so most people uh if they get a hold of this this is quite an odyssey uh and some people struggle with their whole lives so this is uh we're here to try to help them understand that that they're with that you know number one there's nothing weird about this psychologically at all the uh that all we have is a high conscientious personality meeting a bizarre uh evolutionarily novel problem you have to understand that that uh [Music] it would be the same thing gustavo as a gambling addict running into las vegas there is no gambling addict in stone age there is no gambling in the stone age there's people that have higher risk tolerance for certain things and they may take on a wild boar when they shouldn't every now and then but the point is is that that there's no gambling addiction self-destructive process in the stone age there just it isn't um if you hunt one too many days and don't do enough gathering you start to get hungry and now you're like uh oh i better pick some berries and dig for some potatoes you don't really have a choice and so the gambling is is self-limited by your environmental opportunities for gambling modern environment you throw that person into las vegas and we have a disaster you have something that looks like a disease or a mental disease and where does it come from no it didn't come from anywhere it is a it's a natural characteristic of of human nature that now is meeting a totally bizarre environmental uh situation and resulting in something that is is extremely disturbing and a painful experience and a disaster in some ways for some people uh same thing with alcoholism there's no there's no nothing wrong with the person who's an alcoholic there is a there is a uh a hyper activation to the dopamine to dopamine from the alcohol chemical so an alcoholic does not have the same experience as i would or you would to a glass of wine they their their relative the relative dopamine hit is greater and so therefore it's inherently more attractive so in the same way women because it's almost always women not always but it's almost always women that we're talking about with these quote eating disorders and it's because you have you know three things triangulating uh highly conscientious personalities the pleasure trap inside the culture and and therefore as a result what's also sitting in the culture that would never be in the culture is a disgust over bodies that are fat there there no such thing would exist in the stone age if a woman's body is getting fat it's this you know fascinating um amazing process of pregnancy of which they you know they revere so no this is a this is a novel uh problem and therefore it requires an interesting well thought out solution uh which is to you know break down the problem and try to essentially pull the person back back to their stone age environment where this rich food isn't around and get them back to nibbling at more times during the day which is exactly what your ancestors did they did not gorge and fast and gorge and fast and gorge and fast that is not how they do it they will eat larger meals at the end of the day after all this work has been done but they will be nibbling throughout the day and as you nibble throughout the day you don't wind up with the ravenous hunger uh that then is part of an oscillation gorge cycle of you know restriction restriction and gorging that's a setup particularly for some people for binge eating right right and and i think that what's important to highlight here because i i this is something that i heard people talk about that that there's nothing really wrong with the person that's psychologically or emotionally or um because they feel so bad that there's something wrong with them and you you did mention something about that and uh yes yeah that's the that's the whole plot theme to the pleasure trap so what i'm trying to explain to people is that these addictive processes are not because there's some underlying uh childhood or otherwise disturbed feature of your psychology um you can feel like it because there can be a um there's an additional twist to um to this problem in other words it's not all as straightforward as i'm saying there's there's an additional layer of of intrigue and that is a um there's an additional problem that i call the ego trap and that is that when you expect yourself to be able to solve a problem or others expect that you should be able to solve a problem if you also suspect that you cannot solve it then you are embarrassed that you have the problem and that you uh you that you will not take normal stepping stone efforts to fix it instead you will display to the world and to yourself that you're not even trying so this is a this is what i would call kicking over the table like no i'm not even going to do it no i don't want to do it we've all been there except maybe alan goldham might not have been there so there's a few freaks of nature that somehow have not experienced this but this is a widespread normal phenomenon uh in human life that will come up currently and probably most of us could go back and encircle 20 incidents in our lives easily uh where we we it was worthwhile to try to do something but we were afraid that we would fall short of expectations and therefore we didn't do it and then we pretended like we didn't want to um as a young man that uh probably what circles around that is going up to a girl at the high school dance and asking her to dance so you would like to ask her to dance that you think that that um that you that she may well reject you but you want to pretend to your friends like you know like hey i could probably be accepted and so but so you're in this bind where your friends might think that you would be successful but you think that you might fail and therefore the right thing to do is to not try and just pretend like you don't care okay so that that set of circumstances uh will very often unveil itself in the course of human life and you can imagine uh but it's periodic it happens from time to time uh when this situation comes up like can you give a reading into the class of your poem or something all kinds of times that this uh this potential set of circumstances will arise usually not overly destructively but you can imagine a situation with an addictive like process where other people that don't have the addictive process are looking at you and saying hey you could do this just freaking put down the bottle and that's because they don't have the intuition of what it's like to live inside your nervous system you can imagine a mother with her daughter who is binging and purging or binging or or anorexia or having some uh some some uh genre of an eating crisis and the mother doesn't have the problem and the mother's like well just do this betsy just do this just be reasonable do this this this and it's not a problem it's like okay that that mom has does not have intuition that her daughter is battling something that is alien to the mom's psychology and so as a result the daughter then gets the feedback that is expected that she should be able to defeat the problem now when she knows that she has tried and cannot defeat the problem at that point there becomes added incentive to basically signal that i'm not even trying to beat the problem okay so this is uh this now feels very deep and psychological and and destructive and dark and people look um into very dark places to try to find out why it is that this process is happening um and you know freud looked all the way to the depth instinct in other words that we came from inorganic matter we're going back to inorganic matter so you know we must have a desire to kill ourselves you know all right well it's not not bad for 1925 or whenever the heck he was trying to dream this up trying to figure it out but when we look at self-destructive behavior today we can look at it through a very different lens and the lens is it must be attempting to try to solve an adaptive problem okay so it's like and so we look at gambling and we realize okay that's not a self-destructive urge that's that's an urge to try to get a spectacular deal where you know one minute of my effort is what might be worth a year of savings and there's a lure there and most of us can compute whoa that's scary and dangerous because you're also going to lose you know two weeks of your money as you take a 30 to one shot on on a roulette wheel and so most of us realize whoa i don't want to lose two weeks to my salary and hope that i make a year but you can see that someone else says well i saw somebody else do it and i you know wow and so as a result certain nervous systems are more comfortable uh with that situation well a lot of people women in particular are not comfortable um walking around with eight or ten extra pounds on their 17th birthday and they are a lot of many of them aren't uncomfortable but a whole bunch of them are like oh well my boyfriend likes me anyway what do i care i'm mad that he looks at some pretty thin waist bed but that you know oh well so in other words such as life and yeah they're not devastated over it okay but there are going to be people that are just like there's people that are going to be wasting the family fortune in las vegas that they are they are more intensely motivated uh in order to to address you know that situation uh in that case of the gambler it's an opportunity in the case of of uh restricted eating it's uh it's reducing the risk of being of being overweight and therefore embarrassed behind that and so once we find out that we are struggling with this problem and we can't control it then we have an additional layer of tragically self-destructive uh force which could be the ego drop and that's also true with with drug addiction so that is one of the things that i work with with people that are addicted to anything is that we work very carefully to make sure that when they start walking into the ego trap because they have gotten a 30-day chip or they've had some success now they can start to feel like maybe they can't do it and now they crash the car to get rid of that anxiety of the of the too high of expectations so it's it's a there's a threading of the needle when it comes to taking on these kinds of problems that is a they can be amazingly subtle and uh and that's why i can it can help to have help you know the right help can be the right help can be measurably uh useful uh wrong well-meaning help can actually be part of the problem right right dr lyle um someone asked if there is a physical um office that you have to see a patient i know that you can see patients online through your website they can book a session but do you have a place where someone can actually go no i don't know i used to i used to do this at true north but um uh it's it's it's no no longer uh when when john mcdougall quit having the in in-house mcdougall program uh so true north and the mcdougall program used to be within a mile of each other and i lived quite a long ways away so i used to uh drive there uh and then i would be able to participate in both programs but now with mcdougall now strictly virtual it's it's too too much time and energy to drive out to north so i only see people uh by phone and by zoom these days okay all right well very good well thank you for this um totally amazing and enlightening uh you know talk that you gave us about binge eating very it's a topic that um it's it's interesting i am always interested in new things that i don't know and i certainly don't know enough about this but um you make things clear too i also want i want people to know you go to my website and look up justina that will take you to her website and there's a lot of information on her website so whether you ever ever book a session with justina or not she's posted a lot of information which can be useful for people all right all right very good well thank you again and um i really appreciate it i know everybody here gestavo happy happy 58. the thing is about let me tell you how this works so you get to be 58 for about one minute and then your quote almost 59 and then when you're 59 you get to be 59 for almost one minute and then you know what happens so enjoy your youth my friend yeah yeah i know well i will i will thank you all right good good luck everybody say hi to me uh feel free people should feel free to write to me uh at my email address uh if they have questions about anything i'm always happy to give you my take what is uh what is an email address that it's got its doctor that's dr dryle yahoo.com okay all right very good all right you all have a great day of the day and great rest of the day and and same to you dr klein great thank you thanks for having me gushavo no thank you all right all right we'll see you soon bye you
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