• Dr Susan Baxter

Clean to binge

I was honoured to be featured in ‘Fitness Life’ magazine as an invited author of the following (published 2013).

There’s currently a lot of hype about the concept of ‘clean eating’. But what does this really mean, and is it genuinely the ‘healthy option’ it is cracked up to be or a recipe for disaster in the longer term? Susan Baxter sheds a light on the matter….

“Clean foods are those that have a mum or come from the ground or from a tree” – Bella Falconi.

One of the main challenges with ‘clean eating’ is that there is no specific and objective definition of what exactly it means to ‘eat clean’. Different advocates have their own variations on what the term entails, whilst critics deride it by asking if it means that food has been properly sterilised for human consumption.

The common denominator in all descriptions of clean eating is to follow a diet where the foods are derived from whole sources, as close to their natural state as possible. That means no added sugar, generally little or no added ingredients on the nutrition list, and minimal packaging. These foods are called ‘clean’ or ‘healthy’ or ‘good’; while the alternatives, such as junk or processed foods, are deemed ‘unclean’.

Whilst many diets and eating habits come and go, the real question that needs to be considered is whether the ‘new’ diet is any healthier than your current (or any alternative) diet. Also ask yourself whether foods you are excluding cause harm, such as weight gain, compromise bodily function, or can lead to malnourishment.

Despite the current fear mongering surrounding foods containing sugar, fat, and salt (which are each complex issues in their own right), the real concern should be on who is eating the particular item of food, and in which quantity (think portion control). Such an approach would not rule out any food item completely, but rather limit the amount of sugar-laden foods that you’re able to eat (since these generally have fewer nutrients in them) to maintain your body weight. In other words, a moderation approach rather than an elimination approach seems preferable, provided you have no food allergies or sensitivities (in which case you may need to cut our gluten, sugar or dairy products, depending on the allergy).

The benefit of a clean eating approach is that foods derived from wholefood sources tend to be less calorie dense, and that limiting your sugar intake will reduce blood sugar spikes that may cause you to experience hunger pangs. For both of these reasons the propensity to overeat is much lower.

In addition, there are more nutrients and fibre in wholefoods, meaning that clean eating should reduce the risk of being ‘malnourished’. Fibre has also been shown to reduce the amount of calories consumed during the day by as much as 10 percent, which again reduces likelihood of overeating.

Okay, so these factors indicate that clean eating is essentially the healthier option, right? Well, not quite, as there are a number of mechanisms by which it can lead to unhealthy behaviours. These include: the psychological factors surrounding restricting one’s diet; biological responses to eating junk food (or, more to the point, stopping eating such foods); social and psychological factors surrounding dieting; and of course hunger.

Each of these factors has been associated with a phenomenon known as binge eating or compulsive eating, in other words comsuming food beyond the needs of hunger and achieving satiety. The compulsive eating described in this article focuses on short-term binges surrounding restriction for dieting; it is not intended to address more serious eating disorders or help diagnose such disorders.

If you or someone you know is suffering from such concerns please seek professional help. For resources and help on eating disorders, go to www.feast-ed.org, or phone the hotlines http://www.ed.org.nz/ or 0800 2 EDANZ. And then there’s http://www.aroundthedinnertable.org offers a 24 hour on-line forum for practical ideas, help and support.)

Scientific evidence from the USA on people following clean eating has shown a small but statistically significant association with binge eating. Binge eating is not just harmful to a person’s weight management intentions, but can also have ‘knock-on’ effects that can harm a person psychologically. These include increased anxiety to make up for the ‘unhealthy eating’ during bingeing, and physiological effects on hunger and satiety hormones, both of which can lead to another binge episode.

These mechanisms work on the intrinsic need to eat, which is regulated by the feeling of hunger. When following any restrictive diet the extra focus and obsessing on food can cause hunger. In clean eating, hunger can be a mechanism to drive binge eating since the foods (as mentioned above) tend to be lower in calorie density and therefore potentially (and unintentionally) cause people to under eat. Consequently they might end up bingeing, particularly when the further physiological effects of hunger set in, such as involuntary shaking.

Although ‘the shakes’ might be the result of hunger associated with low blood sugar levels, scientific research also shows that many of the ‘high- incentive’ (‘junk’) foods that people crave during bingeing (in order to release energy quickly) activate the same pathways within the brain that are activated by drug use! For instance, dairy and cheese stimulates the opioid pathways, and many high sugar items stimulate endocannibinoid pathways: such that are stimulated by morphine and cannabis use. These release a sense of euphoria and have mind and mood altering effects- you can see why removing such items might pose cravings.

Junk food stimulates the release of dopamine, a neurotransmitter that makes you experience pleasure. The problem is, as the body enjoys this ‘hit’, it craves another. The body is also very adaptable to the stimulus, in a way not unlike the training effect of exercise. In a similar fashion, the brain will require more of the junk food to release the same amount of dopamine. As a result, the body begins to crave this junk food hit more frequently. This is how and why the cravings (and worst case scenario addiction) occur.

Given such ‘addiction’, by eliminating the foods that previously triggered these pathways, the person on a clean diet can experience similar withdrawal effects as a drug addict: moodiness, irritability; even headaches and ‘the shakes’. It is these effects that can cause a person to seek out a junk food hit and cause them to binge.

Another obstacle is that following a wholefood diet can be difficult to accommodate when eating out, which may lead a person following an extremely strict regime to become socially isolated and obsess about food even more. Such constant obsessing or thinking about food can also increase the risk of binge eating.

One piece of advice I’d like to give anyone who has experienced short-term binge eating is to think about the underlying causes of what might have driven this urge? For some it can be a fear of success (perhaps associated with lots of extra attention?). Or perhaps you feel low or even lonely, and you are hoping that food will fill this void (albeit subconsciously).

Restriction itself can also be a problem, since the focus on food causes you to think about food a lot; or perhaps you need a little extra guidance from a nutritionist about choosing the correct food regimen for you, with enough food for your calorie needs.

Whilst the evidence shows an association between clean eating, dietary restriction and binge eating episodes, it is important to recognise that the evidence does not show that clean eating directly causes binge eating per se. Is is rather that, during such restricted dieting, some people may become obsessed with food and are more pre-disposed to binge eating because of it.

To conclude, as with most things, I’d like to stress the importance of ‘moderation’, and also suggests an alternative solution: to make small and sustainable changes long term without eliminating anything. If you have an issue controlling your weight, it is more important to consult a nutritionist than to embark upon a squeaky clean (or fad) diet for that matter.

Undertaking a structured programme of exercise, coupled with a simple diet based on a reduced calorie intake (and not elimination) is a guaranteed route to weight loss and maintenance success, and will also foster a healthier relationship with food. Habits are formed over a lifetime and consistency pays off, so set a sustainable goal and follow the eight ‘Steps for eating right success’.

Steps for ‘eating right’ success

  1. Seek advice of a professional to ensure that you are meeting your individual energy demands and goals, and set a date or series of milestones as a goal.

  2. Ask yourself the purpose of your new eating regime: knowing the ‘why’ behind your big change can help ‘keep you honest’ when you remind yourself of your motivation for this change.

  3. Use planned ‘treat meals/cheat meals’ at regular intervals as these provide you with a welcome psychological break from the confines of strict dieting.

  4. Do not feel guilty if you ‘slip up’. You are only human and eating is an intrinsic part of living; eating should not be grounds for constant anxiety as guilt can be counterproductive and actually encourage bingeing.

  5. Take small steps at a time, and make yourself accountable. Choose one extra change to make to your diet each week, and either tell people what you are planning or write down what you intend to do. As the saying goes: failing to plan is a plan to fail!

  6. Keeping a food diary is also important in changing and monitoring your eating behaviours.

  7. Experiment by finding out what works best for you, given your lifestyle, preferences and daily routine. Afterr all, different strokes for different folks!

  8. Learn to love yourself as you are and don’t focus merely on ‘the change’. Many people tell themselves “they will be happy when… “ don’t! Choose to be happy now and that the changes you’d like to make may enhance your life in the long term.

Sam’s story

“Competitors, clean eaters, strict dieters or those who consider themselves ‘health advocates’ can often fall into the trap and vicious cycle of binge eating, most commonly brought on by an unhealthy relationship with food. I have been one of them and still struggle to this day.

After suffering from anorexia for four years, I plummeted into a dangerous cycle of binge eating for about two years. Then I decided to compete because I thought that it would ‘solve my food problems’, but it only created more issues for me.

It’s such a fine line – how much is too much? Should I be kinder to myself? But if I’m kind to myself, will I just justify that it’s okay to binge? I used to find myself asking these questions. Food was like my best friend, my comfort; it was my escape leaving me mindlessly numb as I ate to no return. I would get addicted to the process, so it became a weekly or even three-day habitual cycle.”

‘’ How have I broken out of this?

  1. By holding myself accountable. By putting my hand up and acknowledging that I am the only one responsible for what I put in my mouth, I can no longer lay blame on to external sources.

  2. I started writing a daily journal. You don’t have to publish this or post it publicly, just write it for you. On a piece of paper in bed at night, on your phone or on your laptop at work – whenever you feel the need to vent. Being honest with yourself is the most liberating feeling, and by writing it out I found it has helped me clarify the problem and allow me to make better decisions as to how to combat the triggers.

  3. FIND YOUR TRIGGER. Don’t skip around it. Get uncomfortable, the ‘binge’ side of you is going to hate it – but if you want to be free of these chains you need to find the source of the problem. For me, it’s removing all the food I would binge on out of the house, even if it wasn’t my food I’d throw it out. It CANNOT be here.

  4. Listen to your body. Literally. Don’t just pretend to listen to it, but after you eat a clean meal; LISTEN to how your body responds – how does it feel? It feels nourished, it feels clean, it feels like a well oiled machine right? That’s how it should feel! Not over indulged and full of crap!

  5. The old trick of moderation. This is probably the hardest one to learn; as we ALL have different goals, different metabolism’s and it can be a fine line to what’s okay and what’s not – but essentially, YOU define what is ‘okay’.. make your own rules, but make them specific and reasonable so you can follow them! Make allowances, Learn to respect the treats your body desires and feed it accordingly.”

All in all, it takes ONE big step to choose to START making yourself accountable. You’re going to fall down, you’re going to maybe binge again, you’re going to slip in the mud; but it’s okay. As long as your being honest to yourself and forgiving yourself, it’s okay.

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drsuz@drsuzsquad.com

Highett, Victoria, Australia

©2020 by Dr Susan Baxter

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