Constant craving

Overeating is all-consuming, highly addictive and much misunderstood. Charlotte Cripps reports on one woman's battle with an eating disorder that is the dietary equivalent of drug addiction

The moment Amanda Swann realised her overeating was out of hand was just over four years ago. She had been stashing carrier bags full of food, sweets, biscuits and wrappings in her car. She felt ashamed and confused by her overeating and was trying to keep it secret from her friends. Before starting her day as a healthcare professional, she would have already eaten six chocolate bars and two or three Danish pastries. She would continue eating throughout the day – more sweets, biscuits and cakes. These binges were periodically interspersed with attempts at control, when Amanda Swann, 42, would go on yet another diet.

The moment Amanda Swann realised her overeating was out of hand was just over four years ago. She had been stashing carrier bags full of food, sweets, biscuits and wrappings in her car. She felt ashamed and confused by her overeating and was trying to keep it secret from her friends. Before starting her day as a healthcare professional, she would have already eaten six chocolate bars and two or three Danish pastries. She would continue eating throughout the day – more sweets, biscuits and cakes. These binges were periodically interspersed with attempts at control, when Amanda Swann, 42, would go on yet another diet.

But one day, before sitting her exams for a Masters degree while also working full-time, she found herself ruthlessly stuffing herself in McDonald's, and started wondering what she was doing. "I suddenly saw how my overeating had progressed," she says. "I couldn't stop. It was very frightening." Now at the height of her overeating, she had stopped even attempting to diet and was putting on weight fast. She felt loneliness, isolation and self-disgust. It was then that she reached for the phone, rather than the fridge, and called a local self-help group.

Before this, she was an attractive woman of normal weight, and a high achiever. Having worked in the health profession, Amanda knew all about sensible eating, but was unable to apply it to herself. As a child, she remembers wondering how her best friend could keep some of her Easter egg, while she could not. But although her life didn't completely fall apart, it never crossed her mind that her overeating would get so out of control. "The whole thing baffled me," she says. "That an everyday substance – food – takes on such a power. It wasn't like I was mainlining heroin, it was just food – and yet food got me to the point where I just could not stop eating. It was as simple as that. I had food everywhere. It was in my dressing gown, it was by the bed, it was in my desk drawers at work, I hid it in my coat pocket. It was as though no amount of academic success, work achievement, material comfort or understanding relationships – nothing could really influence the fact that I felt locked into this pattern of overeating."

Overeating is the poor relation of addiction. Few people understand it. Most people, if they've heard of it at all, think it is the same thing as obesity. These days, most people are well informed, courtesy of various celebrity confessionals, about the world of addictions – drugs, alcohol, sex, shopping and gambling, as well as anorexia and bulimia. But overeating is little heard of and little understood, although many of us may remember Geri Halliwell's confession of bingeing on a chocolate cake fished out of a rubbish bin – classic overeater's behaviour. "It is fascinating that doctors do finally acknowledge anorexia and bulimia, but not compulsive overeating," says Dr Robert Lefever, who runs The Promis Recovery Centre, which offers treatment for addictive or compulsive disorders. "They do acknowledge massive obesity, but they are so reluctant to acknowledge that any eating disorder can be an emotional problem. They see anorexia as being a psychiatric problem, bulimia as rather pathetic and stupid, and compulsive overeating as plain greed, especially if you don't look huge, which many overeaters don't – because they use diet, exercise, even vomiting and laxatives to keep the weight off." Although there are overlaps between bulimia and overeating, bulimics tend to make themselves vomit after the smallest amount of food, whereas overeaters can binge compulsively without necessarily vomiting.

For someone like Amanda, who spent 20 years trying to control her food problems, overeating is little different from being a drug addict, says Dr Lefever. "It is a genetic defect of neurotransmission systems in the mood centres of the brain. That's why they do it. They discover – as other people discover alcohol or cocaine – the mood-altering properties of sugar and white flour. So they binge, and binge and binge. Partly this is because the process of bingeing in itself is mood-altering, but also because initially they binge on the refined carbohydrates. When you refine sugar, it becomes a drug."

For Amanda, in the end there was no pleasure left in food. It was a misery from start to finish. She felt sick before she had even started eating. Even when her bingeing was not at its height, it was the mere fact that what she was doing was compulsive that made it distressing. "It was like – oh, why couldn't I stop myself, I'm just weak-willed, greedy – that's how I would describe myself, shaming self-loathing thoughts," she says. "I didn't sit and fantasise about a wonderful cream cake – that wasn't my story. It was much more the desperation to go and get it. So I'd be watching the clock, thinking, 'I've got half an hour of this meeting left – and then I'll go to the shop.'"

What causes someone to overeat? There are three essential components to becoming an overeater, says Dr Lefever. First, a person has to have the genetic composition. "You can't make someone into a compulsive eater simply by giving him or her an emotional problem," he says. "That's why you can get two people with identical family backgrounds, and one of them has the genetic disposition and the other doesn't." Second, there must be an emotional trauma to stimulate the need for mood alteration. For example, all of a sudden a partner leaves, and the impulse to reach for the biscuits strikes. Third, there must be a susceptibility to the mood-altering properties of food. "It depends what you are exposed to," Dr Lefever says, "and what works to make you feel better."

There is no quick-fix treatment for overeating. "What we do is to help people understand the nature of their illness and prepare them to deal with it long term by going to the self-help group. Overeaters Anonymous is a 12-step programme, which is based on the same principles as Alcoholics Anonymous," Dr Lefever says. "We also work on childhood issues too, but it isn't as simple as having a bit of psychotherapy and you get over it – this isn't what happens. It's not like having appendicitis – just cut it out and throw it away. It's a chronic illness, like diabetes – you have to act and deal with it every day."

At Promis, clients with all sorts of compulsive behaviours are thrown into a group together as a way to bust through denial. "The drug addicts don't mind who is in group with them, but it goes down like a lead balloon with the alcoholics, who say the food addicts don't really have a problem. I point out that the food disorders actually have a higher mortality than alcoholism."

Now a university lecturer, Amanda has learnt to avoid her trigger foods and certain patterns that leave her vulnerable to food, like pressure and feeling overwhelmed. She never eats chocolate, sweets or biscuits. She tries to avoid sugar. But her bottom-line abstinence is that she has three meals a day and steers clear of her binge and trigger foods. "I have long periods with a healthy relationship to food, and then I'm feeling under pressure and thoughts of food creep in, but most of the time I don't have to act out on it. Sometimes I eat a bit much and the old temptation to binge comes back, but usually that's a wake-up call for me. It often means that I am experiencing difficulties with my life that I wasn't aware of and I need to deal with my feelings, rather than push it down with food and anaesthetise myself. At this point I ring a friend, talk things through and go to my support group rather than hit the fridge. Or I try writing about how I feel."

She finds it helpful to talk to others who talk about overeating with acceptance and humour. But the greatest thing, she says, is that she doesn't have those feelings of self-loathing and disgust that dogged her every move before.

Overeaters Anonymous UK national helpline 0700 078 4985

The illness that takes over body and mind

Compulsive overeating is the loss of control leading to compulsive behaviour – repeatedly searching for a mood change by using a particular food – without regard for the negative consequences.

* The main binge foods tend to be sugar and refined carbohydrates, especially wheat.

* Mentally, sufferers are totally preoccupied with food, diets or losing weight, which does not allow other thoughts to enter the mind.

* Physically, sufferers may be of normal weight (although this condition is often confused with obesity) because they may go on diets, exercise fanatically, vomit or use laxatives.

* Signs of being well on the way to having a compulsive overeating problem may include eating in secret, planning binges ahead of time, eating when not hungry, and craving to eat food other than at mealtimes.

* Part of the illness is that sufferers feel they don't have a problem; that what they are doing is normal, and that one more diet will solve the problem. That leads to the cycle of binge and diet.

* One in five suffers from a genetic oversensitivity to refined carbohydrates, which affects our insulin balance and makes us crave sugar.