As 2004 winds down and I've had more successful time and experience in recovery from my binge eating disorder and morbid obesity, my thoughts and feelings about the program of Overeaters Anonymous have changed as I've changed. I'd like to share some of my insights and feelings here because I feel a need to be totally honest in the presentation of my recovery. If I am not able to be honest, this whole web site would be a sham. Please understand, I don't expect anyone to agree with me. These thoughts and feelings are strictly my own. The first point I'd like to stress is that a lot of people have found the OA program to be exactly what they were looking for. They've found the entire OA philosophy to fit perfectly with their personal recovery. I think that's both wonderful, and impressive. The following is an exploration into my current feelings and understanding based on my own observations and experiences. It may have absolutely no bearing on anyone else's recovery.

In OA, Abstinence is defined as the act of not eating compulsively

I've come to view the OA concept of abstinence, and even the use of the term, as something less than beneficial. In fact, I believe it may be as often a hindrance to recovery from Binge Eating Disorder (BED) as it is a help.

Two of the biggest impediments to recovery for people with BED are Perfectionism and All or Nothing Thinking. We feel somehow that we must "diet" perfectly, and of course, that's a set up for a most common trigger to a binge. When we lapse or deviate in any small way from our eating plan, we feel like we have failed entirely. The next step is to binge. We may tell ourselves something like, "since I've already "blown it" for the day, I might as well have one last binge and start over tomorrow. The concept of abstinence, coupled with a rigid eating plan, is almost certainly bound to exacerbate BED.

The biggest bug-a-boo for me with OA was the idea that abstinence is a black and white thing or goal--you either are or you aren't. That just kept killing me. I had to make abstinence a much more flexible and forgiving thing, because to me, life has to be flexible and forgiving. If it's not, there's precious little room for humanity and love left. I just can't be very compassionate with myself (flexible and forgiving) if I always feel like I'm on the wrong side of abstinence. I don't think I could live the rest of my life feeling like I was always just one bite away from losing my abstinence. That just scares me.

Abstinence is usually presented and discussed in terms of; if one isn't abstinent, it follows that they are not in recovery. This All or Nothing view works well for alcoholics in AA, but not for people with BED.  At least if the concept is taken literally as it's described in AA literature. A drunk person certainly isn't working toward positive healthy goals while they are inebriated, but a person in OA who is still overeating or binging certainly can be. They may be progressing on many levels even when their food isn't "perfect". Food is not a psychoactive substance. If you choose to incorporate Overeaters Anonymous into your personal recovery, please don't let the concept of abstinence become a roadblock to your progress.

Harm Reduction

For a binge eater, the process of dealing with getting over the binge eating part of the problem is probably more important than being perfectly abstinent or even losing weight. They are actually two separate but related things. There is obesity, and then there is Binge Eating Disorder. If an individual with BED didn't binge so often or was able to stop, that would add considerably to their physical and emotional well-being despite of their weight. In many if not all cases, deprivation and restriction are exactly what leads to a binge. Demanding strict abstinence of ourselves, at least early on, can easily set us up for failure and depression. It's not gentle, compassionate, or realistic to expect perfect abstinence from someone who is affected by BED, or any other compulsive overeater.

Instead of saying, I was abstinent today, why not try saying, I made health promoting food choices today. I've been choosing to eat healthy, or, I've chosen to eat to improve my health today.

Struggling to achieve abstinence can leave a person feeling chronically guilty. It may feed a sense of hopelessness when they can't seem to meet their self or peer imposed expectations. It can set up a cycle of perceived failure that can seem almost impossible to overcome. This frustration causes a great many to eventually give up on OA or turn to weight loss surgery out of desperation.

Small changes such as incrementally incorporating healthier food choices or beginning to increase physical activity are magnificent achievements. They should never be discounted because one has not achieved perfect abstinence. Each small change brings a lowering of risk factors for disease. Each small change is a step forward in recovery. If acknowledged as the wonderful accomplishments that in fact these small changes truly are, the effect is cumulative and empowering. Small positive goals achieved over time may better allow us the time to develop more constructive life skills and integrate them into our new lifestyle. This may prove substantially more effective than the All or Nothing attitude that is inherent in the usual concept of O.A. abstinence.

The AA model

I love the Twelve Steps. They helped save my life. They've been a catalyst for my personal, spiritual, and emotional growth and they helped me stay clean and sober for over 20 years so far. However, I have serious questions about just how well they fit binge eating disorder as a main framework for recovery. The parallels between alcoholism and compulsive overeating are obvious, but they are also superficial. When I first came to OA, I took for granted that the AA model was perfectly suited for OA. There's no denying that it works well for many people. It is also clear that it does not work for many people.

When Rosanne S., the founder of Overeaters Anonymous, heard about the remarkable success of the Alcoholics Anonymous program^[1] she understandably wanted some of that success for herself and other compulsive overeaters. She could see that alcoholism and compulsive overeating had many elements in common. So, logically enough, she took the AA mold, and poured the problem of compulsive overeating into it to create OA. She in effect, made her disease fit their solution. It was not and is not necessarily a perfect fit.

The Addiction Model

One of the most important gifts to society made by the pioneers of Alcoholics Anonymous was the concept that addiction to alcohol was a disease. Prior to that society considered it a moral failing. AA's described an alcoholic as having a physical allergy to alcohol. They rightly maintained that alcoholism is a progressive illness that can never be eliminated. They found that the only workable 'cure' was that it be managed through a lifelong program of strict abstinence from all alcohol which could then keep the disease in remission. Once an alcoholic, always an alcoholic.

I don't believe the logic that says once a compulsive overeater, always a compulsive overeater holds up. An alcoholic can never drink successfully again. A bender is always just one drink away for them. I don't think many sane people would argue with that. I've never met a recovering alcoholic who could return to social drinking without rapidly becoming a slave to the bottle again. The old saying that one drink is too many and a thousand is never enough, holds true. However, many former bingers and overeaters who, having changed their relationship to food, can and do eat the occasional sweet treat or indulge in a fast food meal once in awhile. Two of the largest scientific studies, The National Weight Control Registry^[2] and The Nurses Health Study^[3] clearly demonstrate this.

Food, simply is not technically an addictive substance. Alcohol, of course, is. The idea that compulsive overeating and binge eating disorder can never really be cured but can only be kept in remission by perfect abstinence does not appear to be accurate.

Something that helped me to start thinking in terms of eating disorder instead of addiction was to ask myself: Is a person who is struggling with bulimia or anorexia an addict? Binge eating disorder is the same as bulimia, but purging isn't a significant part of the picture. Nearly all of our current scientific knowledge about eating disorders came about long after OA was formed. But the addiction / abstinence model still fits with alcohol and AA perfectly. The formation of AA went almost hand in hand with science's growing understanding of alcoholism. That didn't happen with OA.

Additionally, some of the components of true addiction are missing from the substance, food. Food is not a psychoactive substance. It may alter moods to some extent when huge amounts of calories are consumed, but that is different from being chemically psychoactive. It's pretty hard to imagine a person eating themselves into an acute state of psychosis, but that's exactly what drinking too much alcohol does. It is essentially, toxic to the brain.

One of the main components of an addictive substance is that of increasing tolerance. That is, the more you use over time, the less effect it has. This phenomena causes the addict or alcoholic to physically require ever increasing amounts of a substance to achieve the same level of intoxication. The common foods associated with addiction by members of OA, such as sugar and white flour, simply don't have this defining characteristic.

Around 1987, The DSM III-R (Diagnostic and Statistical Manual of Mental Disorders, revised edition, American Psychiatric Association.) was updated to reflect concerns that the term "substance abuse" was being misused. They began using the term, "psychoactive substance abuse" specifically to remove food from the range of disorders described.

The traditional concept of addiction has been watered down gradually over the last few decades to include just about any compulsive or repetitive behavior. In many cases, simple habits get tossed into the brew along with problems that amount to nothing more than a series of bad choices or a lack of good coping skills. I don't mean to diminish compulsive overeating and binge eating disorder as issues. They are serious and often progress to be life threatening medical conditions. When let untreated they can be deadly.

Using the terms addiction or addicted to food may serve a useful purpose for some people, but I believe it is a compulsive behavior, not a true addiction. I just can't equate food to heroin and alcohol. Compulsive overeating can be thought of as an addictive behavior, but that does not mean one is actually addicted to the substance food or to one particular type of food.

I have concerns that the use of the addiction model may serve, in some instances, to defeat the hopes of people who wish to recover from binge and compulsive overeating. It tends to make the problem appear almost insurmountable. On a more superficial note, the idea that I could never again enjoy a piece of birthday cake or a slice of pizza is almost too much to bear.

Degrees of impact

Relatively few overeaters have ended up in prison or on the streets due to their illness. Eating food rarely if ever is the cause of domestic violence. Overeating rarely causes people to lose their jobs, homes, or families. Few overeaters have lived a life of crime to support their habit. Few would be driven to suffer the risk of incarceration just to keep from detoxing or going cold turkey. Overeating has rarely if ever caused anyone to wake up face down in the gutter. Overeating doesn't lead to sexual promiscuity and high risk behavior. Food simply doesn't cause these things to happen. Many alcoholics and drug addicts on the other hand, have lived that life.

Certainly binge eating and morbid obesity carries with it a horrible toll and a lot of pain, but the culture is very different and thus, the recovery has different aspects and needs. In this case I'm thinking primarily of some of the language found in the Big Book as it pertains to doing a Fourth Step inventory and perhaps making amends to those we have harmed in the Eighth and Ninth Steps. This can be done in a gentle affirming manner, but in my opinion, OA's too often try to take on the language and intensity used by their AA cousins and end up stomping on their own self-esteem in the process. In most cases this is simply unrealistic, unnecessary, and probably ineffective. The social and psychological dynamics of binge eating disorder are for the larger part, very different than those of the chemically dependant.

Unmanageability and the first step

In the early days of Alcoholics Anonymous, they were primarily dealing with "low bottom" drunks. These were people who had lost it all and were considered hopeless by society and the medical community. They had "bottomed out." The first step says, "We admitted we were powerless over alcohol — that our lives had become unmanageable."  In OA, we substitute food in place of the word alcohol.

A late stage drunk's entire life was certainly unmanageable at the point that they would end up in AA. My question is, does that idea apply to a person with a compulsive eating disorder too? Certain areas of their life may be unmanageable, but most manage other areas of their lives quite well. There is little doubt that compulsive overeating and BED may affect all areas of a person's life, for instance, if a person suffers low self-esteem or is depressed. I believe that is a very different thing than compulsive overeating and BED causing a person's whole life to be unmanageable. Part of my recovery process was discovering and embracing the parts of my life that I was managing quite well.

Powerlessness

In 12 Step recovery there is a concept called powerlessness, or, being powerless over our disease. One supposedly cannot be in recovery until they come to terms with and admit that they are powerless over their substance. Some take it to an extreme and claim to be powerless over everything. The 12 Step idea of powerlessness is not intended to mean that members are hopeless, but that they come fully to the understanding that by themselves, they cannot recover. Powerlessness in 12 Step philosophy is not intended to be a point of giving up and hopelessness, but the point of willingness to accept help—a point of true open minded humility. In effect, the point when a person actually becomes empowered to recover.

Many people that binge and overeat do so precisely because they feel or have felt powerless. They may have been subject to abuse or molestation as a child. They may have suffered from domestic violence. They may have had to endure work or home situations that feed into their feelings of powerlessness. They may be depressed. They nearly always have a fragile self-esteem. Asking those people to admit that they are powerless may, in many cases, be asking too much. It may be an emotional hurdle that's simply to high to clear.

Being powerless over alcohol and drugs is one thing, but being powerless over one's eating disorder, or food as a substance, may be a very disempowering idea. In fact, realizing that I do have a choice over what I eat is at the very core of my recovery. I'm anything but powerless. I've had help, but I'm the one making the decisions about what and when I eat. I'm the only person on this earth who is responsible for my recovery. I need to feel empowered to do what I'm doing. When I hear the OA refrain that we are powerless over food, I think they've got it all wrong. Food has no power. The food isn't in or out of control, it's our behavior that is problematic.

In my experience in OA, many people get hung up over the concept of powerlessness. It is, at least at first glance, in direct opposition to concepts commonly used by many mental health professionals who specialize in the treatment of eating disorders. It may be a useful framework for some, but for others, it's a significant roadblock to self-empowerment and real recovery. The idea of being powerless may in some cases, feed the feeling that a compulsive overeater is a victim, that they are at the mercy of their disease. Empowerment may be a much more useful idea.

An Often Overlooked Concept

On page 85 of the Big Book of AA, the book that describes the program OA is modeled after, you'll find is says  “…That is the miracle of it. We are not fighting it, neither are we avoiding temptation. We feel as though we had been placed in a position of neutrality safe and protected. We have not even sworn off. Instead, the problem has been removed. It does not exist for us. We are neither cocky nor are we afraid. That is how we react so long as we keep in fit spiritual condition."

Reprinted from Alcoholics Anonymous, with permission of A.A. World Services, Inc

Overeaters Anonymous World Services is now getting ready to publish more "food plans". Diets and food plans aren't congruous with the above concepts or the basic philosophy behind the Twelve Steps and Twelve Step recovery. Food plans such as the infamous "Grey Sheet" are the epitome of controlling addictive behavior. Real recovery from compulsive overeating and binge eating disorder would be learning to let go of that sort of thing. When OA World Services legitimizes the concept of official food plans (diets), they have lost their usefulness to the fellowship and OA becomes little more than just another diet club. If you want to see my personal food plan, click here.

Conclusion

Before the summer of 2003, food, as a substance, was killing me, or rather, I was using it to slowly kill myself. Now, food is the substance that is literally saving my life and restoring my health. To me, this clearly demonstrates the inherent problem with Overeaters Anonymous. Alcohol could never be used to restore an alcoholic's health or save their life, but that dynamic is absolutely key to recovery from BED.

I no longer go to OA meetings. I haven't for a long time. I still use the Steps in my day to day life pretty much as I have for the last 20 years. That is, primarily in connection with my recovery from chemical dependency and to better handle life in general. It could be said that I am using OA, albeit unconventionally and indirectly, and I wouldn't argue with that. I believe all my previous efforts to use and live OA were and still are a valid part of my recovery experience. I can't say at this time whether my current recovery from BED, is due to my efforts in OA, or in spite of them. In the fall of 2003, I was in the process of letting go of parts of OA, including meetings, fellowship, and the concept of abstinence. This, at the same time that I was getting a firm hold of some solid recovery. The letting go process becoming an integral part of my recovery.

One of the best facets of OA for me, both online and in face to face meetings, has been the chance to tell my story. The more I tell it, the more comfortable I am with it. The more I talk about my experiences and hear other people talk about theirs, the more self-acceptance I have. It helps greatly to remove the shame and stigma that surround binge eating disorder and morbid obesity. Some groups and support lists have been too dogmatic and rigid and have demanded strict adherence to the OA line. That's one reason why I no longer go to meetings or consider myself a member. I need to talk honestly. I need to share about where I came from, what I'm going through now, and what's working for me, and it's not regular OA or the food addiction recovery model.

I believe that the OA program can be a wonderful option if one is aware of the possible limitations. My suggestion to people who wish to explore the OA option is to take what you want from the program and leave the rest. Modify it in any way that suits your purpose. Personalize the steps to fit your own recovery needs. Moderation, flexibility, and independent thinking are the key. OA is a workable framework for issues of socialization, dealing with resentments, and personal spirituality. Spirituality in this case can mean simply being part of a community, learning how to interact with your fellow human beings in a positive way, and gaining insights to the meaning of your own life. The program can be a useful tool if for no other reason than the free fellowship and support.

Love, Dave