6 Reasons to Skip This 12-Step
It's January and if you watch TV, read Women's (or Men's)
magazines, or overhear locker-room talk you know what that means. Just last week my husband emerged from the
gym, biting his tongue having heard a couple of guys talking about white flour
and 'bad' foods to eat and their New Year's resolutions to strike them from
their diet.
Yes, one of us bites his tongue. I, on the other
hand, feel compelled to discuss the issue further.
Why a post on OA
anyway, you ask?
Because I have been hearing tales of OA meetings, about Grey Sheet, about control and
powerlessness for years now, from clients who’d been involved with OA and
wrestled to break out of it’s grip, and from those struggling to move on. And,
because I want to point out--as I did in the Weight Watcher's post—what you
need to be cautious of if you are considering taking advantage of this program.
But first, here’s a disclaimer; I have never personally
experienced Overeaters Anonymous meetings, nor the sponsor relationship,
although I have read through their booklet several times to ensure I am taking
their information first hand as well as through the filter of its ex-members. I
am writing based on what I frequently hear in my office, from those who have
left the group, often with mixed emotions. They left, ultimately because they
realized it wasn't working for them, sometimes feeling a longing for the
camaraderie of the group, sometimes seeing their departure as their own
failure. But often recognizing that the OA approach was ultimately far from
healthy.
Overeaters Anonymous is a peer led support group based on
the 12-step model of recovery. What's 12-step, you ask? Here's a link for an
explanation:
Twelve-step programs are fabulous for helping individuals
take control when struggling with a range of addictions—such as alcohol and
drugs. But eating should not be so black and white, with columns of drug-like
foods and good food. We can compulsively overeat on anything—given the right
setting and triggers.
So what's my beef
about this 12-step program for compulsive overeating?
1. It's free. But you
get the expertise you pay for.
Guidance and support abound, by well-intentioned individuals
(called sponsors) struggling with their own compulsive overeating. And their
approach to managing food is simply avoidance. Are sweets an issue? Ban them.
Bread? Ban it. Anything white, as in white potatoes and white rice—purge them
from your diet. Admittedly not all OA members follow this rigid approach (aka Grey Sheet), which has supposedly lost
favor with the organization. Yet even in their descriptive program booklet, there’s
specific reference to avoidance of these foods.
It appears to me, from my patients’ descriptions, that
issues of control around food get transferred to control in the sponsor-member
relationship. Instructions and repeated check-ins and accountability come from
sponsors, lay people struggling with compulsive overeating themselves. They are
not trained professionals, and draw only from their specific issues and
experiences. Patients have described feeling shame and the need to be dishonest
with their sponsor, and they ultimately complain of difficulty being released
from the hold of the sponsor even after deciding to leave OA.
2. You decide what you
eat?
With Overeaters Anonymous, you can follow whatever diet you
please—it's up to you, not them! “We choose what’s appropriate and
nutritionally sound for ourselves”, they say. Sounds perfect, no? Yet this can
be dangerous, if you are misinformed as were the gym goers my husband overheard
or if your thinking is distorted from years of diet rules. If you believe that
limiting your intake to fruits and vegetables is adequate for yourself, I just
wouldn’t agree. There is a place for some reality checking with a professional!
3. We must admit we are
powerless over food?
That's their ‘step one’ so it’s no surprise that OA and I differ
philosophically here! No, I do not
believe you are powerless—although you may certainly feel powerless around food. Yes, when you have under eaten
throughout the day, you will feel out of control when food finally appears. When
you are stressed and have not yet learned alternative means to manage your
feelings other than relying on food, you will overeat. And if you feel you are
not entitled to eat—because you shouldn't
feel hungry, or if you desire something palatable but feel that you are not
entitled to eat what you enjoy simply because of your weight—surely you will
eat it compulsively and feel powerless. “Our mind/body as compulsive eaters is
different than a normal eater…” they say, and I couldn’t disagree more.
4. “Spiritual growth is
the basis for stopping and maintaining compulsive free eating.”
That’s what they say in their manual. Sure, a sense of peace
and inner calmness will help you move away from compulsive eating. But frankly,
if someone leaves a plate of home-baked brownies on your kitchen counter, even
if you’ve had a spiritual awakening, you’ll likely still eat more of those
delectable baked goods than you intended—and there’s nothing disordered about
it! Rather, it’s a pretty normal response, triggered by our senses. And if
we’re distracted at the same time, we’ll likely eat more. And if we’re hungry
at that time, we may consume them faster and in greater portions. I’m all for
spiritual growth, but you don’t need to believe in a higher being to take
control of your eating.
5. “Then we need a plan
of eating…that includes refraining from particular foods and or specific
compulsive behaviors.”
Unfortunately, restricting food intake and creating lists of
good vs. bad foods does nothing to change your long-term relationship with
food. Short term, this black and white view may seem to serve you well. But
after some time, thoughts about the forbidden foods, longing for what you miss
eating, and ultimately overeating on that which you’ve eliminated, will result.
But you may just blame yourself instead of this outrageous approach that itself
contributes to your lack of control around food. I do not endorse their
approach of identifying and then eliminating all foods that you struggle to eat
in control.
“Think of it not as deprivation but of as a positive act and
spiritual discipline…” they urge. Really?
Is this the kind of guidance that will help free you from disordered thoughts
around food and eating? I don’t think so!
6. Where do we agree?
I support OA’s interest in helping you move away from
unhealthy behaviors, including [my additions in parenthesis]:
- Eating until (uncomfortably) stuffed
- Rigidly restricting (your food intake and the foods that
give you pleasure)
- Having to clean your plate
- Hiding, and hoarding food
- Distracted eating
- Purging and restrictive dieting
“These behaviors should be stopped.” They say. And with
this, I agree. But their recommendation to follow a 3-0-1 plan to include only 3 meals with nothing in between is
simply absurd. It will neither stop your behaviors nor your preoccupation with
food and eating.
So now where can I
turn?
Support groups can be quite valuable, but I’d advise joining
one moderated by a professional in the eating disorder community. In
Massachusetts, check out medainc.org, or explore your local eating disorder
organization. Yes, compulsive overeating is an eating disorder and needs to be
address by professionals whose treatment is based not on their personal
experience, but on years of clinical expertise and guidance from evidence-based
research. Well-intentioned free guidance can cause more harm than good, as
you‘ll struggle to let go of the additional set of rules they’ve imposed.
Fair enough. But here's what struck me. At this same
pharmacy, just 2 weeks ago, they were giving out samples of Senna laxatives,
those natural-yet-lethal stimulants,
which are anything but safe, especially if taken beyond the very limited time
frame recommended. Use beyond the limited 7 days can result in dependency and
can impact potassium balance with major consequences to your heart and other
muscles. It’s not recommended in pregnancy or for nursing woman at all, nor for
kids. And they certainly aren’t helpful for weight loss, yet that hasn’t
stopped people from taking them with the hope that maybe these will get the
pounds off.
