Why You Can't Stop Eating w/ Sarah Dosanjh @The_Binge_Eating_Therapist

Introduction

Liv: Today I’m speaking with Sarah Dosanjh, psychotherapist and author of the book, I Can't Stop Eating. After recovering from binge eating disorder, she’s gone on to help others do the same by running therapy groups and communities, co-hosting the Life After Diets podcast, and creating videos on how to recover from binge eating via her YouTube channel, The Binge Eating Therapist. Welcome, Sarah! I'm so excited to be talking with you today!

Sarah: Hi, Liv! I'm really glad to be here, thanks for inviting me.

Liv: I always love hearing my guest's stories about what brought them to where they are and what inspired them to do the work they do. What inspired you to become The Binge Eating Therapist?

What inspired you to become The Binge Eating Therapist?

Sarah: I feel like many other professionals in the recovery space have a similar story in that I struggled with it myself. I was struggling with binge eating for over a decade, and through my recovery, decided I wanted to go on to help others. Though, I was still struggling with binge eating when I trained to become a therapist. Some people think, "Oh, I recovered from binge eating and then I decided to be a therapist." I was so lost when I was in my binge eating, I felt like life was passing me by. I think I was looking for meaning and purpose, so I decided to train as a therapist. I didn't know I was going to specialize in binge eating. Maybe in the back of my head, but it wasn't necessarily my intention. I was a bit nervous to work with food and disordered eating, actually, but once I started, it was where I wanted to be. 

Liv: I love that so, so much, and totally reminds me of one of my favorite phrases: "Your mess will become your message.” When I started trying to help others, I was still struggling, as well. I think when we know first-hand how hard it feels for others struggling with the same thing, we have this desire and yearning to help. You can truly feel their pain points. So it's so beautiful how you've turned your struggle into inspiring others! I've listened to almost all your podcast episodes, watched all your YouTube videos, and the value you give is so radically different from what I see in many other kinds of binge eating content. That's the content we need and it tells others that they’re not broken. I really, really, admire you! With all that said, how do you believe labels and diet culture influence binge eating and played into your own struggles?

How do labels and diet culture influence binge eating?

Sarah: So somewhat controversially - I know you're Liv Label Free - but labels can be helpful. You talk about this as well, to be fair. It's quite common that I'll get a message from somebody who has been struggling with it for years and only just realized it's a thing. When you hear others using the term “binge eating” and you resonate with that, there's a relief. So labels are a way of trying to categorize, which can be problematic when we oversimplify, but it can also really create a community where we find people that understand what we're going through. And then diet culture teaches us not to trust our bodies, that we are supposed to be always working on our bodies, making them better, making them smaller, or leaner, or more toned. All of that just leads to a sense of not feeling good enough. For those who've never struggled with body image, on the surface it can seem like a superficial, shallow concern. But when we peel back the layers, it comes back to being associated with approval, belonging, and safety. I don't think many things in life are superficial when you look underneath... But, you know, I'm a therapist, I'm always looking for deeper meaning! But surrounding diet culture is the sense that we're not supposed to trust our bodies. We're supposed to somehow figure out, with our Thinking Minds, what we should be eating. And anytime we have urges or desires for something different or more, there's all this judgment that comes in. That's the other part of diet culture, the moralization of food. When your self-esteem hooks onto that, it leads to, "Oh, I eat 'bad foods,' that means I'm ‘bad’'" And so part of my work and my recovery was separating that. Some people go into recovery and their binge eating just stops, but for the first year or two of recovery I still had sporadic bingeing. I had to take the morality out of it and go, "It's okay if I occasionally binge, I just want to understand it."And not, “It's okay” as in I don't care, because sometimes people will swing to, "I'm fed up with beating myself up, so I'm just going to pretend it's not happening." The polarized thinking around disordered eating actually has a middle ground of, "I binged again, I don't feel comfortable about that, I feel disappointed, but I'm okay.” You might have binged and that might not feel okay, but you’re okay, so no matter what you do, it doesn't impact how you feel about yourself. It’s an opportunity to reflect on what was going on and what might have triggered the binge. Because people will either panic and try and control, or they'll pretend it didn't happen and move on. That's the black-and-white response to a binge. There's a middle ground of acceptance, and that is a lot of the work that I did and the work I do with my clients and community. 

Liv: I love SO MUCH of what you just said and want to unpack it all, starting with the labels. I have a sentence in my memoir when I’m talking about my autism discovery, “But Livia, isn't autism a label?" And I go into basically what you were just saying, that labels can serve an important purpose or function. But if used in certain circumstances - like in diet culture - THEN labels can be very harmful! When someone feels restricted or limited, as if they should or shouldn't do something, it is almost always rooted in labels. But these are limiting labels like, “Whole milk is bad and this light bread is good," or, “If I binge, I am unworthy.” That creates a sense of restriction. It ties back to the idea of a middle ground. Having labels in your life, and becoming aware of which labels are helping and serving a purpose. I remember you had a post on Instagram about different types of binges and being able to identify them or becoming aware that not eating enough yesterday caused a binge today… Labeling to recognize that is SUPER helpful! You can learn from it. As you said, some people want to pretend it never happened but if you just wipe it away and don't take time to reflect on what triggered it, it'll inevitably happen again. You're not taking from this experience and applying that new knowledge to the future. So I completely agree with you on the labels and how when I say I'm Liv Label Free, it's not, “No labels, ever!” Because if I can't say I'm autistic, I will feel incomplete. That label is part of me and my personality, whereas, with something that limited me, like my eating disorder, I don't identify because it restricted me from living to my full potential. Another thing you said was, "I'm not bad for bingeing, it's okay.” A super helpful mindset for me is replacing the word "but" with the word "and." I'm trying to think of an example…

Sarah: I could offer one: "I'm feeling so disappointed that I just binged and I still recognize I'm okay." 

Liv: Yes, yes! That's a great one because when we use the word "but" we're invalidating what we said previously. And when we feel invalidated, it causes our inner rebel to come forth and be like, "Well, I can't feel this, I'm going to cover it up or numb it." I feel like that's when binge eating often comes in, which leads to that black-and-white thinking of, "Oh, I binged anyways, I might as well just keep eating because it doesn't matter." But if we can recognize it's okay and have the permission to choose to keep going or not, that's when we are in control. It's no longer this external label of “bad” or “ashamed” that continues to dig you into a deep hole of misery.

Sarah: When it comes to labeling, are you somebody who will use the phrase, “I am autistic,” or do you say, “I have autism?” Is the language around that important to you?

Liv: It is! And it's interesting because when I discovered I'm autistic three years ago, I shared a YouTube video that was called ‘How I Discovered I Have Autism,’ and I had been conditioned to use this person-first language of, "I have this," because that was super important with my eating disorder. I "had" an eating disorder, I was NOT disordered. Disentangling it from my identity was key to saying I can get rid of this. When we identify with something, we act in alignment with that identity. But then someone messaged me and said, "Livia, I really appreciate you making this video but have you considered using identity-first language? Most of the autistic community actually prefers saying 'I am autistic' because everything we do is autistic and it's not a disorder that we can just get rid of whenever we want to." That message really opened my eyes and it made so much sense! Ever since then, I started using the phrase “I am autistic” and backing it up. Everything I do is autistic, the way I think is autistic, I can only see my life through the eyes of an autistic person because that's me! When it comes to labels, it's similar to when people say, “I am gay” or “I am queer.” They don't say, “I have gayness” or “I have queerness,” right? They identify as that. Whereas if it's a label that limits you, such as an eating disorder or other illness, people don't say, “I am cancerous,” they say, “I have cancer.”

Sarah: That's really interesting because, with something like binge eating, people are wanting to not be that, so there's a separation. To say, “I'm struggling with binge eating,” rather than, “I am a binge eater,” there's a benefit. But from an identity perspective, yes, if this is part of your identity, and you want to own it as part of your identity, then yeah, it needs a person-first language. Interesting!

Liv: So a majority of my audience struggles with recognizing physical hunger cues, which often leads to binge eating or overeating or eating past fullness, and it's always, “I'm not restricting, I'm eating.” That brings me to the question: how can mental restriction lead to binge eating? I feel like this is a type of restriction that is often overlooked. 

How can mental restriction lead to binge eating?

Sarah: So imagine you were going to give a big presentation tomorrow in front of 300 people. You could be thinking about that and feel nervous, getting butterflies in your stomach. Your biology is responding to anticipation, because you're not in that moment yet, and it can be the same with food. If you're saying to yourself, “I'm going to restrict, I'm going to cut out these foods," in effect, your biology responds in anticipation of famine. The primal parts of our brain and body are always eavesdropping on our thoughts to figure out what's happening. There have been times when I've been in conflict with myself about eating a particular food, and the more I'm in conflict, the more the desire for that food increases. Then there were occasions when I started giving myself permission and was able to realize I don't actually want this food right now. That was shocking to me! I just thought my switches were all broken, that I was just in an obsessive cycle with food and it was always going to be this way. I just wanted food too much, there was something wrong with me, and I had no self-control. So I think that's a big part of how to honor the fact that mental hunger is still hunger. When we think about food or anticipate eating, our bodies produce ghrelin. So even thinking about food can trigger physical hunger, those signals to eat, which can be incredibly confusing when you feel like you've eaten a lot. I also think the brain knows how much you've eaten over a long time. It's monitoring that, you can't fool it. You can fool the stomach for a little bit by filling yourself up on more voluminous lower-calorie foods, but the brain knows. What often happens, particularly with people struggling with compulsive eating, is if they don't feel hungry, they don't want to eat because they're worried that they're going to be out of control. They feel like they have been so many times before when overeating that they need to make the most out of when they're not hungry. So I see that a lot with delayed eating, trying to eat a lot less throughout the day, then have a substantial dinner and saying, "I'm hungry and don't know why because I feel full.” We're not looking at the overall picture. We have to look at the physical first and do our best to ensure we’re eating enough. And then we're looking at what are we anticipating? What's the judgment? Permission is scary for people because they think if they let themselves eat, they’ll just eat everything. The permission is also learning you're not saying “no” to food. When you're questioning whether to have something, the answer isn't “yes” or “no,” the answer is “now” or “not now.” There are very few occasions where there's ONE opportunity to have this food. Sometimes that will happen and you might have food just because it's the only chance, but most of the time there's another opportunity. If you're not giving yourself permission in a moment of tussle with food, it feels like now or never, and that's going to trigger more problems.

Liv: Yes, yes! That's biological, in the most primal part of our brain. Like, if it's now or never, well… Now, right? Because otherwise, we fear famine. That goes back to our body knowing what we've eaten in the long term. If your brain has this primal fear of, "We don't trust you, this is not safe, we don't know when there's going to be abundant food,” as soon as you get abundant food, your brain says, "We don't know when this is going to be there again," and it eats the whole pack of cookies or tub of ice cream because it's providing a safety cushion for future famine. Something my clients say, and I'm sure this is something that happens with yours, as well, is, “But logically, I KNOW there's no famine. I know I can buy as many tubs of Ben and Jerry's as I want.” And this has to do with that primal part of our brain that's being activated. When our brain stem perceives food scarcity, it's not going to communicate with the logical part of our brain because it's not the logical mechanisms that are activated. It's the same when someone is very, very malnourished and they're just not eating enough food, their brain stem is almost in hyperarousal mode over their logical thinking brain. That's why logical thinking often goes out the window, the primal part of your brain is like, "We need to ensure survival RIGHT NOW and if that's eating all the food, that's what we're going to do!" So I think it's really, really important to recognize what you said, that it's either now or later. That's such a crucial shift to make because you're telling yourself it's always going to be there and you don't have to feel that there's another famine around the corner. To prevent that fear response, you need to prove to your body and mind it's safe. Of course, there are many strategies to help with that, which both of us work on. What are some examples of mental restriction? So that people can get some insight into ways they might be restricting that they might not even be aware of. 

What are some examples of mental restriction?

Sarah: Mental restriction often shows up as rules and “shoulds.” Some might not necessarily relate to the idea of rules, but “shoulds.” One I might have felt uneasy about was how I would binge on sweet foods. It would be things like, "Well, if I had some cake or chocolate already that day, I shouldn't be having it again." Those sneaky ways it comes in. “If I'm not feeling hungry, then I shouldn't be eating,” is a big one. Because if you have disordered eating, everything is a bit dysregulated and a bit chaotic, so if you're saying you should only eat when you're hungry, quite often by the time hunger has arrived, it's too high to be properly satisfied. So you feel full, but your satiation dials are turned down. I think is the most triggering state, when you feel dysregulated around food, feeling full but like you still need more, because that stresses the brain out. So mental hunger shows up a lot in how we think and how we judge. But also, let's respect mental hunger because it is still a type of hunger. For some, food has a more emotional purpose in their life. So when we're talking about hunger, we have a hunger for food, but a lot of our needs also can show up as hunger. We might be hungry for connection, or we might be hungry for stimulation. So sometimes, if you know that you are eating enough, the question might be: What am I hungry for? Are there other needs that I'm trying to meet through food that food can't do? If they're having an urge for food that they think might be emotional as opposed to restriction based, I invite them to ask, "What is it I believe this food is going to give me?" That can be illuminating because in the moment you don't know, the moment is just fixated on the food. It feels like it's just about the food, but often there can be other things going on as well. 

Liv: That's so, so powerful, especially it being labeled in shoulds. That's why I believe restriction is rooted in labels. Saying you should or shouldn't, that's labeling your behavior! What I found through my journey of restriction and extreme hunger, and then my whole, "I'm swinging to the other side and developing a binge eating disorder!" Whenever I said I shouldn't eat something, that's when I would actually overeat. Because by saying I shouldn't do this, I’m telling my brain to worry about famine, worry about scarcity. Then when faced with the food, the brain's like, “Okay, now's our chance, let's stock up!” Now that we know some examples of mental restriction, we were talking about how mental hunger is real hunger. For a lot of people who are autistic or have ADHD, we often do not have physical hunger cues and that can make it even harder to eat because we've been conditioned by diet culture and by society that if you don't feel hungry, don't eat. Otherwise, you are "emotionally eating." And that term itself is very problematic because if food's only sole purpose was to provide us with fuel, we wouldn't have bakeshops or cookbooks, and we wouldn't have restaurants. So I think this comes back to permission; it's okay to eat and enjoy food and take pleasure from eating. It's not black-and-white, it's finding that middle ground, that colorful spectrum. If we only lived life in black-or-white, it would be so boring! I know that's so cliche, but it's true! Mental hunger is real hunger, and a reframe that I found really, really helpful was saying, "Well, mental hunger IS physical hunger, because mental hunger happens in the brain, and the brain is part of the physical body!" Even though that may sound kind of woo-woo for some people, when I started seeing it that way, it really gave me that permission to say I do have physical hunger, I just feel it in a different part of my body than others. I don't feel this growling stomach. When people describe that, I have no idea what they're talking about, but I will feel very, very obsessive about food. That's a major sign of my body communicating hunger to me. So for each individual, it's really important to figure out how your body communicates hunger. You mentioned, "Is my body hungry for food or is it hungry for some other need?” That's a HUGE part of recovery and discovery of yourself as a person! Learning the different ways in which your body communicates its different needs to you. What are some strategies that you have had success with implementing on how to feel more peaceful or safer around food? ESPECIALLY if one has unreliable physical hunger cues. 

How can one feel more peaceful around food?

Sarah: The first thing I would question there is, do you want to feel peaceful around food? I know that sounds obvious, but I think from your and my perspective, having gone through it and found a semblance of peace, we can say yes, it's totally worth it. But when you're in it? I don't know if peace would have particularly resonated with me - I wanted control. I wanted to lose weight, and I wanted to change this "unacceptable" body. So, first of all, there has to be a willingness and a desire to make friends with food. That HAS to be a priority. I remember getting to a place where I thought, “I want peace of mind more than anything else, more than weight loss, more than any of it,” because actually, I'm hoping if I get control and lose weight, that will give me peace of mind. I'm hoping that's just going to be the outcome, not realizing that perhaps it's available to me now. My brain would go, “I don't want it now, I want to change first.” So I think that's the first bit, at the individual level, whether you are in a place in which you have the desire to make that a priority. I have quite a strong rebel in me, I think a lot of people who struggle with binge eating do. 

Liv: A lot of autistic people, too!

Sarah: And one of the things I rebel against is things like routine and planning. The idea of a food plan immediately felt restrictive to me, even if I got to design it. Implementing regular eating, it's important just in regulating the system. We know that ghrelin, our hunger hormone, learns our cycles of eating, so if you have breakfast, lunch, and dinner at a similar time each day, in a matter of a week or two, your ghrelin cycle matches that. You'll enjoy food more at those times of the day because your body will be producing ghrelin, which means when you eat it will be more satisfying. So where this gets problematic is people's brains have been soaked in diet culture. For me, I did CBT at one point and had to design a food plan, but looking back now, I know that wasn't enough food. I mean, breakfast was something like a small portion of bran flakes, yogurt, and a couple of egg whites to add the protein in. I wasn't being called on it at the time, but really the whole reason I was only doing that was, "Well, I need protein, but I want to keep the calories down.” That was not enough food for me. It's important to have that flexibility. Now, I don't do a specific food plan, though I know what I'm going to have for lunch and dinner, but if something happens and I desire something else or an opportunity to have something different, then I will. Many people I work with wake up in the morning having no idea what they're eating that day. Something is reassuring to the brain, knowing that food is coming but having flexibility, and having foods you enjoy that are then available to you. Because when I first found out about intuitive eating, I lived near a supermarket, so I thought, “Well, every meal, I'm just going to see what I feel like and go and get that!” And that just wasn't helpful. It didn't work for me. So planning is a big part of it but what gives us peace is the way that we talk about food and about ourselves, and that is where a lot of the work lies. The permission, the demoralization of food, recognizing and asking yourself in advance, "How do I want to react? How do I want to speak to myself when I fall short of my own expectations?" And people will go, "I don't want to fall short of my expectations, I just want to get it right." And no, assume you're going to feel out of control or you're not going to eat enough or you're going to eat too much, and you'll have difficult feelings about it. That is going to happen in recovery. So we need to anticipate those moments because when they come, the thought is, "I've gone back to square one, I was deluding myself that I could do anything different from how I am." But if we know that those moments are going to come, “I knew this was going to happen, I knew I was going to feel like this; I don't like it, it doesn't feel good, but I knew it was going to happen," we’ve changed the meaning. Recovery isn't actually about learning how to get it right with food, it's about learning how to bring yourself back in balance. It's this constant fluctuating thing, like an appetite. So the other thing with peace is to recognize that your appetite does fluctuate, especially for people with female hormones and hormonal cycles. Imagine you have a food plan and then you have a hungrier day, or a less hungry day and you're kind of forcing it down. There are some days when I'm just hungry and I just find myself wanting to eat a lot more. I don't catastrophize that anymore but it used to be really scary to me, I used to fight it. If you fight your fluctuations, you're going to end up with a rebound. 

Liv: I absolutely love that idea of flexible planning. Knowing what you're going to eat but having that FLEXIBILITY in there. Can we shout that from the rooftops!? And it is, so, so radically different from what’s said about Intuitive Eating. I have thoughts on the idea that Intuitive Eating is whatever you want, whenever you want, with no rules, nothing. For neurodivergents, it's so relevant to have a flexible plan, because we struggle with those hunger cues. In hyper-focus mode, we can go hours doing all these activities and be like, “Oh, shit, I haven't eaten for six hours!” And that's what causes that rebound effect. But when you have a plan in place, it gives a sense of trust and safety for your body to know food is coming. The plan prevents that primal brain from fearing famine. So I think that is in contrast to when people say, "Always listen to what your body wants in the moment," because it's NOT realistic. I can't do groceries three times a day for each meal, I wouldn't get anything done if I did that! I buy a variety of things that I enjoy and go from there, planning it loosely. But if I have this super, super intense craving and need a donut RIGHT NOW, I'm going to go to a bakeshop because that's what my body needs at that moment. That word: permission. Permitting your body to fluctuate and have different needs that you couldn't have predicted. I might want to croissant later this afternoon or in two days, but I'm not going to know that. Saying this is what my body needs and I have permission to honor that. Trusting my body will handle it and balance itself out is key to dimming fear of, "What if I never stop eating?” Because then you restrict, and it's that restriction that leads to giving your brain "evidence" that when you do eat you have a hard time stopping.

Sarah: Can I comment on the listening to your body idea? Because that gets floated around a lot. “Listen to what your body wants!” I've also heard it said that bodies don't want things like donuts, the mind wants that. You know, that whole, "Are you feeding the mind or are you feeding the body?" thing. I think it's a challenging message because bodies don't have language. We have to interpret what might be going on in the body, and how do we do that? We have to use our thinking mind, which is full of diet culture messages. So it gets filtered through all these judgments when trying to listen to the body. It's an incredibly complex thing that sounds really oversimplified. It's only complex when you've got lots of competing thoughts, but when you don't, when you trust and the body-mind connection is working well - as it does in little kids - it will be simple. But we become socialized and have these thoughts and judgments. So I just want to say to anybody who's trying to do that whole listening to their body thing: It will be incredibly difficult, especially if you're still in that disordered thinking around food, even if you're just soaked in our culture, as we all are.

Liv: It reminds me again of giving yourself permission, that it's going to be difficult, and that you're still capable of learning and becoming better every day. It's difficult because that's life. Life is difficult. Life isn't easy. We always have the power to choose a new identity and to choose actions that align with who we want to be and live that life of freedom. 

Sarah: To lead off of that, I think with trying to “tune in” with what it is you might want… sometimes you just make your best guess. Sometimes you might have something and it maybe doesn't feel good in your body so you think, "Ugh, that wasn't what I needed." That's part of it. That's part of the experience. We don't have to catastrophize that. I might still have food regret, but I don't have food guilt. The analogy I use was if I went out for a walk and it rained and I didn't have my umbrella, I might regret that I didn't bring my umbrella. Maybe I could have anticipated it was going to rain, but I didn't and I just regret not having it. I don't feel guilty that I didn't check the weather forecast and didn't bring it with me. Sometimes we go out and we get wet and life moves on. Sometimes we eat something and it doesn't feel good and we think another choice might have felt better and we move on.

Liv: That reminds me of another phrase I read somewhere: "In life, we don't either win or lose, we win or we learn." And I think that's so, so tied to what you said, that it's not, “I lost, I feel guilty, I shouldn't have done this,” because where your attention goes, energy flows, right? If you're only focusing on how awful the situation is, you dig yourself deeper into that situation. But if you say it happened and it wasn't the best outcome, now you know for next time. Like checking the weather and bringing my umbrella, or if I eat five tubs of ice cream I won’t feel very good. We're all lifelong learners and I think giving ourselves permission to fuck up and make mistakes and say, "I learned from this, and I know I'm going to mess up again, but that's okay, too, it’ll be another learning experience." It’s almost a golden ticket to that sense of peace. You're never going to know exactly what's going to happen but know you're going to keep learning and have that choice to improve. Thank you so much for sharing. I'm excited for everyone to read your book, 'I Can't Stop Eating,' because I loved it so, so much! Where can people find your book, learn more about you, or get in touch if they want to?

Where can people find you?

Sarah: I'm @the_binge_eating_therapist on Instagram and YouTube and my podcast is Life After Diets. I would say my best content is on YouTube and the podcast. Instagram's great, but it's a snippet. I always have to simplify things, which is great sometimes, but then people feel frustrated because they don't know how to apply it. And my website is TheBingeEatingTherapist.com, you can message me there or look at my services. 

Liv: I'm so excited for people to learn more about you and get in touch with you because you're truly amazing and your podcast and YouTube channels are invaluable. And of course, your book is a revolutionary resource in this world that is infested with diet culture. So thank you so much, Sarah! I really enjoyed talking to you!

Sarah: Thank you, Liv.

Buy Sarah's book here!