Reprinted from Eating Disorders Review
May/June Volume 24, Number 3
©2013 Gürze Books
Q. One of my patients who struggles with severe binge eating recently confessed that she loves to create weird food combinations for herself (such as chocolate fudge on oatmeal with bacon chips and pretzel crumbs), but she permits herself to put these dishes together only when she’s alone because she’s too embarrassed to eat this way in front of her family and friends. Is this something I should be asking other patients about? (R.C., Cheshire, CT)
A. Creating weird “concoctions” is a reasonably common occurrence, particularly among overweight individuals and among individuals who binge eat. In a recent study of 407 college students plus 45 patients being treated for compulsive overeating or binge-eating disorders, 24.6% reported that they sometimes concocted food mixtures for themselves that they were too ashamed or embarrassed about to make in front of others. The types of mixtures ranged all over the food map, but generally included at least one high-fat ingredient. Common ingredients were cheese, flour, sugar, chocolate, and eggs. They included sweet, mixed sweet and salty, primarily salty, and condiment/savory types of mixes. Some of these concoctions, in fact, might be considered creative and serve as starting points for inventive cuisines or fad dishes, although none seem particularly health-oriented. Often individuals reported feelings of excitement and craving associated with concocting such food mixtures. Not surprisingly, after eating their concoctions 16% felt guilt and 13% reported feeling disgust. Concocting behavior was associated both with measures of binge-eating intensity and severity and with measures of dietary restraint (Int J Eat Disord. 2013; 46:213). Clinicians might want to inquire about concocting and, just as important, learn about and discuss the various anticipatory and consequent motivations and emotions their patients experience in association with these eating episodes.