CogBlog – A Cognitive Psychology Blog

Can you ever imagine that you can finish eating all forty cookies, one bucket of pretzels, two packs of chips, one pot of boiled milk, one jar of nuts, half of the pomelo, and two chocolate pies just in an hour without a second of rest? And can you also imagine even after you finish all of that food, your brain still craves for food though your belly is so swollen that you are about to puke? You may think that the person who can eat all of these must be a monster. Unfortunately, that’s not necessarily the case

Kung Fu Panda ate 103 dumplings

(though you may recall the scene Kung Fu Panda ate 103 dumplings). Or you are probably going to think of those competitive eaters. They can shovel so much food into their stomach in a short period of time. However, what might surprise you is that many people, myself included, even including those skinny, ripped athletes, can finish the amount of food all at once, roughly equivalent to nine meals for an adult. And this behavior is neither normal nor beneficial for people’s mental and physical health. So, what is this uncontrollable, torturous, and unstoppable action of food-intaking? The answer is binge eating disorder (BED), which is defined as the uncontrollable consumption of a large amount of food. Then what led to the creation of “glutton”? Why can’t these people control themselves from eating normally and healthily? And what are some treatments for the abnormal cravings and intaking of food?

Before we jump into these questions, imagine a pretty woman or man in your head. Then, you might have imagined that the person would be someone who is centered with these characteristics: slim, slender, able to wear size zero clothes, low waist-to-hip ratio, thigh gap, six-packs… However, this is not a coincidence: magazines, advertisements, social media, television, and even dolls are expressing these fixed, stereotypical, and superficial beauty standards to influence body confidence and self-esteem negatively. This society is spiteful to those people who don’t meet the beauty standards and even press those “qualified” people to keep losing weight to be skinnier. And weight loss is one of the six reasons which trigger binge eating disorder. Because of the idea “the thinner, the better,” many people begin their weight loss journey. However, weight loss is always accompanied by taking pills, unhealthy dieting, or excessive workouts. And what exacerbates this unhealthy cycle is that people become extremely sensitive to their weight and body shape, which triggers the hidden BED. People who don’t know about BED may have a typical impression regarding the individuals who suffered from BED: you can just improve your self-control and then problem solved. However, that is not the case. Attention, memory, and decision-making, many different areas of the cognitive process, are involved in shaping BED patients’ behaviors. The complexity of BED needs to be known to more people in society to better help those patients from keeping suffering from BED.

To better comprehend BED, we need to learn more about how individuals experiencing weight loss view the information related to weight and body shape (it may include image with different body shapes, number on the scale, or the statistics on chest, waist, and hip). In one study, Michelle Jiang and Lenny Vartanian had participants to search for a blue triangle with three types of images presented on the screen (thin body-shaped women, overweight body-shaped women, and plants) and later asked them to do a recognition task which includes both old (presented in the previous task) and new body-related images and plants images. Though participants are asked to search for blue triangle, what researchers really cared is how their attention is captured by those irrelevant images as distractors in the background. As it turns out, people who are restrained eaters (those who concern about their body shape and try to restrict their food intake to lose weight) did a better job in recognizing those body-related images than the unrestrained eaters. Though unrestrained eaters can better recognize plant images, the difference between memory advantage for restrained eaters to recognize body shape images than plants is more profound, suggesting restrained eaters allocate more attention to process body-related images. It also shows that because of memory bias for body shape information, restrained eaters are more easily subjected to body-related stimuli which suggests that even body-related stimuli should not be paid attention to, restrained eaters are still easily captured by them. This idea brings up the attenuation model which describes attention worked as an attenuator: information above the threshold get attended to and the closer the information, the easier the information get attended to. In this context, body-related stimuli are so close to the threshold that people direct their attention to them. And with the idea of processing information with a different schema which is the general collection of information for certain event and concept (centered on the issues of weight and body shape), retrained eaters obtain a more efficient strategy to process body-related information. Thus, people who restrained their eating or went on a diet are more sensitive to body-related information. Their awareness regarding their body shape and weight are more than those of unrestrained eaters. And because of the sensitivity of the relationship between diet and weight, anxiety and fear for gaining weight by just one small bite of brownie may be raised. And because of the anxiety, they may try some more unhealthy diet and then form the binge cycle (unhealthy methods of weight loss to binge eat and back to more severe unhealthy method to loss weight).

While individuals with BED are sensitive to their weight and body image, they also try different methods to help themselves from gaining weight after eating. For most of the restrained eaters, there seems to be a valid equation kept in their mind: the less you eat, the faster you can meet your ideal body weight. So skipping meals, only eating veggies, and drinking water to make yourself feel full are the most common but the most harmful methods to lose weight. Through abnormal eating habits, people may have a stronger desire for food and then suffer binge eating later. With the social explanation in mind, cognitive psychology also provides insights into the interpretation of the relationship between the eating disorder and food craving. More recently, a lot of work was done to show that attentional bias had a significant impact on BED, explaining why patients with BED are always easily attracted by food. Florian Schmitz and colleagues designed a clarification task and spatial cueing task for participants to make identification of stimulus and fixation on the dot with food-related stimuli. In the clarification task, participants are asked to identify degraded words (include food-related words and neutral words) which are initially covered by black ink and unable to be identified. For the spatial cueing task, participants need to detect the position of a dot after seeing a cue picture which can be on the same or opposite side compared to the dot (includes food-related pictures and neutral pictures). The goal of the two experiments is to investigate the attentional bias to food-related information for BED patients. The results show that though both individuals with BED and the control group have difficulty in getting disengagement from food stimuli in the spatial cueing task (but more prominently for the BED group), individuals with BED can detect food stimuli faster than control participants in the clarification task, suggesting that a higher vigilance on food stimuli is possessed by individuals with BED and supporting the idea that attentional bias is linked to the easiness of food stimuli detection. Therefore, patients with BED can’t help themselves from thinking of food and eating because they are more easily captured by food stimuli in the environment, which triggers the desire to eat food. With this mind, for most of the BED patients, food-related information is like exogenous cue which is the stimulus that captures people’s attention immediately and notice them automatically. Thus, as food serves as the exogenous cue captured BED patients’ attention immediately, they become more aware of the existence of food which leads to the constancy of thinking about food.

While individuals with BED have a higher vigilance on food, high-calorie food have a stronger driving force in shaping the behavior of BED patients. Nobody can sustain the torture of the sudden change from forbidding to eat ice-cream, cookies, chips to the total low carbs, low calorie, and sugar-free eating habits. The stronger the idea of losing weight is, the more likely you crave food, especially that high-calorie food (like donuts, pizza, chocolate cake, etc.), which you cannot eat during weight loss. By conducting experiments to explore the relationship between BED and information processing for high caloric food, Jennifer Svaldi and colleagues asked participants to rate a set of pictures regarding the aspects of palatability and forbiddance. The results show that although there’s no difference in palatability between the BED group and control group (both groups rate high caloric food more palatable), individuals with BED tend to classify high caloric food as forbidden more frequently than control participants, which also implies that patients with BED consume more attention on fighting against to be attracted by high caloric food because they are so appealing and appetitive to them. This results also connect to the idea about bias which is one of the seven sins of memory. Bias describes the situation when our current mood and experiences can change our memory of a past experience. Under this context, individuals with BED have to control themselves from eating high-calorie food, so when they think about the past experience of eating high-calorie food, they may exaggerate how tasty the food is even they are not actually that tasty and appealing in the past as they thought of they were. So with the untrustworthy distorted memory on high-calorie food, the impression of being extremely tasty and savory is stored in their brain. Thus, when they binge, all different kinds of high caloric food are their first choice.

At the point when you finished all the snacks, junk food, and desserts and staring the countless food wrappers, the feelings of guilt, self-condemnation, and shame come to you immediately. You may choose to purge, engage in excessive exercise, and stop eating for the next few days. Many people without BED can’t understand this behavior.

Relieve anxiety and depression through binge eating

Even though individuals with BED know exactly the causes of overeating so much unhealthy food, they still choose to do so. They can’t stop themselves from eating until they have a stomachache, which forces them to stop. Someone may ask that they can choose to go for a walk or do something else to distract themselves, instead of choosing to keep eating. Well, the thing is not that easy. In one study, Jennifer Svaldi and colleagues had participants guess the outcome of computerized decision-making under risk game. The results show that individuals with BED tend to make more disadvantageous decisions than healthy control participants. They are more easily to adopt an unhealthy, risky strategy to reduce their anxiety and relieve their intense emotions. Because of the limited availability of cognitive resources people have, BED patients can’t inhibit all the cognitive processes which may lead to the behavior of binge eating. The inhibition of the idea about eating high-calorie food is a controlled process, which takes a large part in their limited cognitive resources. Imagine our cognitive resources as a pie chart, if you take a large chunk of resources to think about food  and body image, there’s not many resources left for decision making and other activities. Thus, BED causes distractions in their ability to make decisions even though individuals with BED know exactly what the consequences they will have after intaking so many food.

With all different levels of cognitive processes involved, the way individuals with BED tackle with the binge cycle is not simply about self-control. It’s just like telling a patient with depression to stop being depressed. Imagine being a BED

Accept yourself and love yourself!!

patient in a day, you have to constantly inhibit the idea about food and body image even though you only have a limited availability of cognitive resources. And you also need inhibitory control to regulate the stress that is brought by the negative body image and diet. However, you can’t have unlimited resources to regulate all the things at one time. So, you will end up binge eating to regulate the stress and fall into the binge cycle once again. Therefore, individuals with BED got lots in their mind that people who don’t suffer the disorder don’t know about. In sum, I encourage everyone to give more support and love to people with BED because they are extremely vulnerable and sensitive. If you also suffer from BED, please reach out to your family, friends, and psychologists who understand you and can help you get out of this disorder. Also, be nice to everyone who has a different body shape from the “mainstream” of beauty standards. Don’t ever judge people by their appearance. Please build a healthy relationship with food and body image. Let’s stop body shaming! Be confident, and you are beautiful!

References

Jiang, M. Y. W., & Vartanian, L. R. (2012). Attention and memory biases toward body-related images among restrained eaters. Body Image, 9(4), 503-509.

Schmitz, F., Naumann, E., Trentowska, M., & Svaldi, J. (2014). Attentional bias for food cues in binge eating disorder. Appetite, 80, 70-80.

Svaldi, J., Brand, M., & Tuschen-Caffier, B. (2010). Decision-making impairments in women with binge eating disorder. Appetite, 54 (1), 84-92.

Svaldi, J., Tuschen-Caffier, B., Peyk, P., & Blechert, J. (2010). Information processing of food pictures in binge eating disorder. Appetite, 55(3), 685-694.