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March 17, 2011

Woman Vs. Food: Inside Overeaters Anonymous

woman vs. food

Photo Credit: Long Tall Sally

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Still, living on ice cream tends to leave a spiritual void. Carrie called me the next day and summarized the program: Everyone creates a food plan of their choice, and calls or e-mails someone daily with the plan. Many weigh out every meal. Most women — and 87 percent are women — permanently ban foods like bread, cake, and pizza because it's easier to take no bites than one bite. I met a woman who had happily skipped her own wedding cake.

I chose the most common food plan, 3-0-1 (three healthy meals a day, nothing in between, one day at a time), along with OA's suggested rules: Meals must happen on time (no skipping), have a distinct beginning and end (no grazing), and be healthfully caloric (no dieting). I was a little stressed about cramming my 2,200-plus daily calories into three meals, but when she called a few evenings later, Carrie suggested that I list the foods that make me feel peaceful. Not comfort foods, but the ones that make me feel good after I eat them. My list included heaping plates of stir-fry, healthy melts, and traditional dinners — vegetables, mashed potatoes, casseroles. I banned candy, frosting, and bread baskets. Sticking to this would be my abstinence.

As suggested, I also attended daily meetings, part of the beginner's 90 meetings in 90 days. The urban meetings were lighter on religion; one Tuesday in Colorado Springs, I found myself in a thinly veiled Christian prayer group. I noted that on the days I went to a meeting, I stayed on my food plan. I should've been able to do it without a meeting, but functionally, I didn't. I found it impossible not to improve from a daily hour focused on my problem.

Eating 3-0-1 kicks the legs out from under your emotional eating. You just can't do it. It also shines high wattage on your flawed coping skills. On those evenings when I still wanted to crawl through the garbage for a cupcake, it became painfully clear that I was reacting to something else, perhaps a boyfriend crisis or a stack of work. On my happy days, I had to set an alarm to remember lunch. I realized that I'd never actually eaten well-rounded, sizable meals before, and I found them rather satisfying. I suddenly understood French waistlines.

Yet many of my epiphanies had little to do with the OA structures and everything to do with the longtime members, who had an eerily encyclopedic knowledge of exactly how to manage me: One day an alcoholic overeater commented that her periodic kicks of dieting were the equivalent of being a dry drunk, white-knuckling along without addressing the underlying emotional eating. Me too. A struggling obese woman mentioned her work to get off of diet soda, my first awareness that perhaps my all-consuming seltzer habit was a little extreme. A 60-year-old doctor commented that stress and little sleep always result in a spinout, so she now knows that the battle is always fought the night before. And a bulimic 20-something announced that her root problem isn't eating but lying to herself, the "It's OK to do this because I'm having a rough day." All very true.

As I struggled to stick to my plan, I wondered whether the program even works, and was not surprised to learn that some psychologists and psychiatrists deeply question 12-step programs. Numerous, hotly debated studies indicate that 12-step programs are effective for a small minority but not the majority, and that intensive therapy is more worthwhile (though pricier). Psychologists wince at OA's nuances, like the word abstinence. "The reality is that abstinence makes sense for alcohol. It makes less sense for food," says psychologist Edward Abramson, Ph.D., author of the emotional-eating book Body Intelligence. "We make 200 eating choices per day, and none of us is going to do it perfectly. I'm not a big fan of OA. Some people get benefits from the group support, but it tends to promote black-or-white, all-or-nothing thinking, which for eating behavior is a mistake."

The overarching problem is that OA is a substance-abuse program used for overeaters. Step 8 is Made a list of all persons we have harmed, and became willing to make amends to them all. "I can't imagine that people who eat do too much damage to others. It's not like someone who is addicted to heroin," says Stanford psychiatrist Keith Humphreys. Then there's the OA ideology, which deems overeaters powerless over food and in need of God's grace to save them. Addiction psychologist Stanton Peele, Ph.D., is a longtime challenger of 12-step programs. "These groups do so well because they hit a core in the American experience — the whole getting-up-and-confessing-your-sins thing that is very strong with Protestantism," he says. "But it's not a therapy of any sort. What's the therapy? Get up and say you're powerless over something?" Peele bristles. "We essentially have a religious system in place that is not effective, which some people find deeply repugnant, and it's basically immovable."

Humphreys attributes any success to the positive peer pressure. "Groups give people friendship and support so you don't have to be an isolate. And you start to care about the group and what they think, and you want to succeed." He's right. Carrie was pretty and perfect, and I wanted to be in her club.

OA people talk about finding your "home meeting." I found my peers at a lunchtime meeting in midtown Manhattan, their anecdotes familiar, including meltdowns at buffets and active dodging of the date question "So what are your hobbies?" (Um, gorging? Likely while you're asleep in my bed.)

Yet I couldn't swallow the main tenants of the program. Every time someone talked about her "imperfect abstinence," I wanted to yell, "Abstinence is really not the word you're going for!" Each time we wasted 20 minutes reading a story in the book by some 60-year-old male drunk, I wanted to shout, "I think we could find something a little closer to the female eating experience!" I dropped out on day 37.

I did not, as members implied, immediately spiral into a godless world of addiction. I adopted many OA habits, beginning with "sharing," because talking about your feelings for three minutes is kind of great. You often blurt out exactly what you need to hear. Try it with a friend. I also stuck to three big meals per day, but not religiously — I prefer to eat according to my body's hunger. I could once again make eye contact with the bodega owner. I did not find God.

But the periodic cravings for an IV drip of frosting didn't disappear. What did disappear were periodic cans of frosting intended for friends' cakes — and at one point, my roommate's actual confetti cake. And then I would straighten out my act for a few months — before repeating. And so two years after my OA adventure began, I had a powwow with my journal and decided that I was — sigh — powerless over the exact same foods that have conquered me repeatedly for three decades. I would have to be a special kind of slow not to notice the pattern. And I admitted that I should try (wince) abstinence. So on October 4, 2009 — it's OA-chic to know the exact date — I banned frosting and cupcakes and candy from my life. I felt that this was extreme and cultish and unlikely to solve the underlying problems.

The first month was hellish. And then it worked. I dropped 20 pounds, and 80 percent of my crazy cravings disappeared.

I also surprised myself by shacking up with a man whose personal experience with AA makes my life look like Preschool Anonymous. He feels similarly conflicted. We almost never talk about it, but he seems to accept that his girlfriend is fruit loops about food and knows that he can buy either bread or butter but not both.

In the intervening months, I've tinkered with my food rules and figured out that they are successful not by exerting the kind of control and power that anorexics enjoy, but by simply minimizing the situations in which I predictably spin out of control. Food is everywhere, and there's freedom in not having to have a tête-à-tête with your crazy cravings on an hourly basis. This time around, I'm attempting to avoid outright bans: a dish of ice cream at a restaurant is fine, but a gallon in the freezer is not. Ditto on anything involving whipped cream. I'm still kind of a mess with Mexican tortilla baskets and am considering the options. On December 27, 2010, I admitted defeat to glazed doughnuts. I'll let you know how it goes. This is just what works for me.

I've come to see the Anonymous programs as a place you go when your problem is more problematic than 12-Step. It's a deeply flawed best option. "I'm really glad 12-Step is there because there's no doubt it saves lots of people's lives," Humphreys told me. "But I also think we need some alternatives because many people just don't like it." I would be thrilled to find a nutrition program with the same low-cost and worldwide access as OA, but structured by self-help experts. One doesn't exist.

It's been four years now, and I still periodically go to meetings. They're the only place to find dozens of urbane types who know about the bread basket. Though that problem has faded, too, because at the suggestion of someone in an early meeting, I learned the phrase, "No bread, please."

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