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It is important not to make food, and the behaviours around it, the central issue in recovery from an eating disorder. Abstinence from compulsive overeating, starving, vomiting and purging is only the first step and not the ultimate goal in itself. The whole purpose of recovery from addictive disease is to be able to rid ourselves of emotional obsessions and their damaging physical consequences. Simply changing an obsession for doing something into an obsession for not doing something (for example going from bingeing into starving or vice versa) is no improvement. The correct treatment for both is to follow these guidelines for abstinence - in order to relieve the physical consequences of addictive behaviour - and then work the Twelve Step programme in order to facilitate long-term emotional and psychological health. Many people come into Twelve Step recovery programmes after years of disordered eating patterns. These guidelines are an attempt to answer some of their questions on how to be physically abstinent from using food addictively.
The basic issues of abstinence in an eating disorder are simple and straightforward, just as simple as for alcohol or drugs: put down the addictive substances and behaviours, then experience and deal appropriately with the feelings that arise and learn to cope with the various realities of life.
These guidelines are useful for patients in early recovery when we may have little or no concept of how to fuel their bodies healthily. They are a framework - not a diet or strict regime - around which we =build a long-term, well-balanced and healthy way of eating.
The Twelve Step principle concerning addictive substances is one of total abstinence. We are powerless over mood-altering foods (sugar and other refined carbohydrates) and we need to be totally abstinent from them, just as alcoholics avoid alcohol entirely. Food of some kind is essential for life but refined carbohydrates are not. Nor is alcohol. Compulsive overeaters often make out that they have a particularly challenging time because they confront food every day - but they are wrong: alcoholics have to drink something every day in order to stay alive, just as sufferers from eating disorders have to eat. However, alcoholics do not have to drink mood-altering drinks (anything that contains alcohol) and, correspondingly, eating disorder sufferers do not have to eat specific foods that have a mood-altering effect, nor do they have to involve themselves in mood-altering behaviours around food. Abstinence is possible just as straightforwardly for people with eating disorders as it is for alcoholics.
We have to have a clear definition of our abstinence. We need to avoid those food substances - the refined carbohydrates (sugar and white flour) - that are more likely to lead us back to using food obsessively or compulsively Behavioural abstinence involves having three regular meals daily with nothing to eat in between. Chewing stimulates the appetite centre of the brain. Once stimulated, it remains "turned on" for about twenty minutes. Grazing between meals can therefore result in a constant feeling of hunger or expectation of food. For the same reason it is possible still to feel hungry after a vast, but rapid, binge.
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