With the holidays in full swing, most of our family gatherings focus on one thing, food.
Sitting down with family and friends to gorge ourselves on the traditional ham, buttery mashed potatoes, eggnog, cookies and especially pie is a customary activity during November and December. For most of us, our tryptophan highs wear off after a few hours, and, on Nov. 23, we eat an average-sized meal of turkey leftovers.
But for some, it's not that simple.
The holidays present a unique set of challenges for Mary*, who is a compulsive overeater. Compulsive overeating and an uncontrollable obsession with food makes everyday eating a struggle, and maintaining control over this disease can be especially difficult during the holiday season when food is a major focus.
It was after her second pregnancy that Mary found her eating was getting out of control.
"I would go to Swanson's to get an ice cream cone, then drive to the next Swanson's across town and eat another ice cream," said Mary, "I would eat candy and go to fast food. I just couldn't stop eating."
Mary was always able to lose weight on diets, but never able to maintain the loss. She tried everything from Weight Watchers to fad diets where you eat nothing but grapefruit. She said she would regularly fluctuate up and down 30 pounds, but her overeating tendencies always returned and food was never far from her mind.
"My ex-husband was in a 12-step program and I would go to his meetings and stand by the cake table and eat the whole meeting," said Mary, "I couldn't focus when food was around. It was about how I was going to get it, or how I was going to not eat it."
Compulsive overeating is characterized by just these sorts of uncontrollable obsessions with food. Overeaters often change their lifestyles and behaviors based on their eating habits. Similar to behaviors you might expect from an alcoholic, they feel their lives spiral out of control every time they binge on food. A major difference between alcohol addiction and food addiction though is that we have to eat to survive, so overeaters face a daily battle with the plate in front of them.
"An alcoholic can put away the bottle, but a compulsive overeater has to tame that every meal," said Mary.
This is where Overeaters Anonymous steps in. OA is an organization created to aide in physical, emotional and spiritual recovery for those who suffer from compulsive eating.
The OA model is based on the Alcoholics Anonymous 12-step program simply replacing the word 'alcoholic' with 'overeater' and 'alcohol' with 'food.' There are about 40 members in the Bend area, said organizers.
Several times every week, in the basement of a downtown church, groups of mostly women gather together to tell their stories through OA's group sessions. They sit on folding chairs around a large table with tea and coffee. There is no cake, no cookies.
Jane, an active OA member, tells the group on a recent weekday morning that she knew from a very young age that she had a problem with food.
"One of my first memories is in Sunday school when I wanted extra graham crackers and the teacher called me a little piggy," said Jane. "That was the first time I knew I wasn't like everyone else, that I ate more."
These lifelong battles with food can culminate in isolating behaviors, depression and other emotional issues, according to studies of overeating behaviors. Along with the mental stress, overeating has major health risks including high cholesterol, diabetes and heart disease. A common perception is that these types of food issues stem from a lack of self-control, but OA understands overeating as a disease that the afflicted are powerless against.
"A normal eater will eat and get full and stop eating. People with eating disorders will eat and get full and that will trigger the binge cycle," explained Mary. "Most people know when they're full—I still don't."
Compulsive eating can often stem from stress or even childhood trauma. Frankie Mauti is a licensed dietitian at St. Charles Medical Center working with patients who have eating disorders, are emotional eaters or have a tendency to overeat. She has recommended patients to OA and has spoken at meetings.
She said there are different types of overeating. For some people, eating large portions out of habit is the source of their problem. For others, they wait until they are very hungry and then eat a lot to compensate for that starving feeling, said Mauti, who has a master's degree in counseling and is a certified diabetes educator.
"Eating for a coping tool and to deal with emotions is usually the most difficult type of overeating to change," said Mauti. "Most people who overeat emotionally have extreme guilt for eating or for being 'fat.'"
Many of the women involved in OA are dealing with emotional overeating issues and the guilt that goes along with them.
Jane knows this feeling all too well; she explained that her issues with control and wanting to please her family lead, in part, to her troubles with food.
"I was always making sure that everyone was well taken care of beyond my own needs, and also stuffing my face at the same time because I was under pressure and I wanted to control everyone else," said Jane.
Mary said stress and overwhelming emotions led her to an out-of-control lifestyle of overeating, as well.
"I would buy a box of mini-wheats and sit in front of the TV and eat them all. I would buy mini donuts and eat them all," said Mary, "It wasn't hard for me to admit I was powerless over this disease."
Stories on Overeaters Anonymous' website (oa.org) recount members binging until they were physically in pain and then purging food by vomiting, or hiding and stealing food to mask their addiction. The stories share a thread of guilt in relation to the disorder, and a gratitude to OA for helping to overcome a painful cycle of overeating.
"When you're eating you're hiding yourself, you're not being authentic," said Mary. "I had a TV in my bedroom and I would just eat in my bed. I didn't go out. I didn't date. I didn't do anything because I felt awful about myself."
Another member of OA, Lisa, put it this way at a recent meeting: "I remember sitting down at my table with a huge bowl of stuff and thinking, 'I need this, and if you lived my life you would need it, too.'"
But for many involved in OA, the sense is that people do not understand what they are living through.
"When I brought up the words food addiction outside of group, one guy turned to me and said 'that's cute,'" said Lisa.
The other women seated around the table at this group session nod and empathize, knowing that to outsiders, overeating is often joked about, not taken seriously or may even be completely invisible to even close family members.
For instance, Jane expressed fears about how she will wrestle with showing a healthy side to her family but secretly deal with the realities of her overeating behaviors.
"I could eat that piece of pie in front of everyone else and be really good," said Jane, "but then that night I might go on a sugar binge. I could eat a whole cake, or a whole box of cookies."
As I sit in this hour-long meeting, listening to stories and developing my own appreciation for the reality of this disease, I recognize a camaraderie between the women. They support each other, knowing that this holiday season, they will all sit down with a table full of food and silently struggle with their eating habits.
"There are bulimics in the group, there are anorexics in the group," said Mary. "It's not a weight loss program—it's about sanity."
*Please note we have not used real names in this story.
Tips to avoid overeating during the holiday season:
• Cook less food.
• Avoid skipping meals prior to a large holiday meal. Be sure to eat breakfast, for instance.
• Try to build a high protein snack into your diet before large meals.
• Plan your meal and what you are going to eat ahead of time.
• Bring sewing, Play Doh or something to do with your hands while everyone is still sitting at the table having seconds or thirds.
• Visualize yourself having the strength to say "no, thank you" and move on.
Sources: Franki Mauti, clinical nutrition coordinator with St. Charles Medical Center, local members of Overeaters Anonymous, and Carolyn Coker Ross, M.D.