The DBT Solution for Emotional Eating: A Proven Program to Break the Cycle of Bingeing and Out-of-Control Eating

by Debra L. Safer

Eating can be a source of great pleasure--or deep distress. If you've picked up this book, chances are you're looking for tools to transform your relationship with food. Grounded in dialectical behavior therapy (DBT), this motivating guide offers a powerful pathway to change. Drs. Debra L. Safer, Sarah Adler, and Philip C. Masson have translated their proven, state-of-the-art treatment into a compassionate self-help resource for anyone struggling with bingeing and other types of "stress eating." You will learn to:

*Identify your emotional triggers.
*Cope with painful or uncomfortable feelings in new and healthier ways.
*Gain awareness of urges and cravings without acting on them.
*Break free from self-judgment and other traps.
*Practice specially tailored mindfulness techniques.
*Make meaningful behavior changes, one doable step at a time.

Vivid examples and stories help you build each DBT skill. Carefully crafted practical tools (you can download and print additional copies as needed) let you track your progress and fit the program to your own needs. Finally, freedom from out-of-control eating--and a happier future--are in sight.

Mental health professionals, see also the related treatment manual, Dialectical Behavior Therapy for Binge Eating and Bulimia, by Debra L. Safer, Christy F. Telch, and Eunice Y. Chen.

Genres: Self Help, Nonfiction, Health, Psychology, Food, Mental Health

278 pages, Kindle Edition

Published January 1, 2018

Reviews

[Schizanthus Nerd · Rating 4 out of 5]

So, I received notification of my ARC of this book mid chocolate binge. (Hello, universe? Was there something you wanted to tell me? 🤪)

This was an interesting first read for the year. While I don’t make New Year’s resolutions I am always ready to learn ways of doing life better. Eating disorders and I go way back. I’d tell you we’ve been acquainted for over 25 years, but that’s impossible because I’m not that old! Having managed fairly well in this aspect of my life for several years I fell fairly spectacularly into a vat of chocolate around March last year and I’m not sure if anyone’s seen me since. (Hello, Cadbury, my frenemy! 👋)

This book has a title that’s as much a mouthful as your last binge - The DBT® Solution for Emotional Eating: A Proven Program to Break the Cycle of Bingeing and Out-of-Control Eating, and for those unfamiliar with psych-speak, DBT is Dialectical Behaviour Therapy. DBT helps people manage difficult emotions without hitting their own personal self-destruct button. How does it do this? It gives you tools, broken down into three categories:
* Mindfulness
* Emotion Regulation
* Distress Tolerance.

The perfectionist in me initially freaked about the concept of dialectical thinking, whereby you can hold two opposing points of view at the same time, i.e., I can know I need to change a behaviour and I can also accept myself for who I am at the moment. What??? I don’t get to be all judgy-judgy about myself because I failed at something one of the times I attempted it? If I don’t punish myself enough, then how will I ever move on?! Scarier still, dialectical thinking “allows success and failure to coexist” (38%), so there’s no need to beat yourself up. You can simply acknowledge your mistake, learn from it and continue moving towards your goal. 😱

If you are serious about making this change in your life, know that this program requires a commitment from you but let’s face it, it took a commitment for you to choose to self-destruct by [insert your food-drug of choice here] in the first place, and you deserve to set aside the time it will take to make a positive change in your life.

There are 13 chapters and it’s recommended that you work through these, by yourself or with a therapist or supportive friend, at a rate of a chapter a week. Along with the reading you are expected to complete homework related to the chapter you’ve just read and build gradually on the skills you learn throughout the program. You’ll have an opportunity to discover why you binge in the first place, what your triggers are, and which tools work best for you to manage the urge to binge.

As I received an ARC of this book I read it straight through but I plan to work through the book again at a slower pace with pen and paper in hand. Even though I haven’t completed all of the assignments and taken the time needed to give this program a fair go, there are already elements that I know I will be introducing into my life and others I’ll be building on. I can also envisage how useful DBT would be to help manage other behaviours such as overspending (but I need that book!).

Some of the tools I’ll be incorporating into my life include:
* Diaphragmatic breathing - I already do this but need to do it more frequently
* Observing - being in the moment without letting myself get all judgy-judgy about my feelings or trying to control what’s happening. This feels like it will take about ... forever to accomplish, but you’ve got to start somewhere!
* Urge surfing - “Research shows that intense urges not only do not last forever, but typically last about 20 minutes.” (58%) Just knowing that the feeling of forever has a time limit gives me more confidence.
* Crisis Survival Skills - distraction skills and self-soothing (think grounding) skills.

I got caught up in the examples of homework answers given throughout the book, particularly Kat’s story as her responses feature more than the others. Like any good soap opera fan, I’m left ‘unfinished’ by Kat’s story. Did she and her husband Tom ever attend therapy together? Are they still together? Does Tom still bring home macaroons from his workplace? I wanted to hear Tom’s perspectives on the examples Kat gave as well. Guess I’m more of a busybody than I realised!

The PLEASE acronym didn’t work for me at all. Basically, there are six environmental/lifestyle factors discussed. The first five are:
* “Treat PhysicaL illness
* Balance your Eating
* Avoid mood-altering substances
* Balance your Sleep
* Get Exercise.” (66%)

Number six is:
* Building Mastery.

I have no problem with any of the lifestyle factors listed but to try to get people to remember them by listing five as a poor attempt at an acronym and then popping number six in at the end only added up to me remembering this was the section in the book where I shook my head and wondered about the editing process.

I personally found some of the repetition in this book frustrating. I personally found some of the repetition in this book frustrating and I understood why it was used. See? Dialectical thinking! 😊 If not for the repetition then the points wouldn’t have been reinforced and I most likely wouldn’t remember what I learned by about this time tomorrow. My brain just tends to glaze over when information is repeated, regardless of the intention. That’s my problem though, not this book’s.

Favourite sentence: “Observing offers you a calming center into which you can step to watch and maintain awareness without getting caught up in the storm.” (43%)

I received a copy of this book from NetGalley (thank you so much to NetGalley and Guilford Publications, Inc. for the opportunity) in exchange for honest feedback.

[Stephanie · Rating 5 out of 5]

ome years ago, I was the foster parent to a teenager whose adolescence had been filled with abuse by various people, including her father, brother, and even the man who played Santa Claus. Finally, some 25+ years after she left our home, she began working with therapists to deal with the consequences of her upbringing. To this day, she still is wandering in the wilderness of therapy, doing a lot of therapist-shopping and -hopping, and I am still fascinated by the possibilities for treatment and the various options available. In the past year she has begun working with a therapist who specializes in DBT. Because of this and because her issues have manifested in behaviors that include out of control eating I was particularly pleased to receive an advance copy of the new book, The DBT Solution for Emotional Eating, from Guilford Publications and NetGalley in exchange for my honest review.

Dr. Debra Safer is a Professor in the Department of Psychiatry and Behavioral Sciences at Stanford University Medical Center. After she attended medical school at the University of California, San Francisco she had a residency in psychiatry at Stanford where she worked closely with W. Stewart Agras, MD, and his eating disorders research team. In February 2017, her textbook, Dialectical Behavior Therapy for Binge Eating and Bulimia was released. She wrote this along with three other professionals. This new book, which is scheduled for release in January 2018, was written in conjunction with two other doctors and clearly designed for a general audience.

I admit to having had some confusion between dialectical behavior therapy and cognitive behavior therapy (CBT). One outstanding thing about this book is the clear way it explains DBT: “This DBT program for binge eating focuses on the relationship between your feelings and your urges to use food…” And that there are “…three modules or categories of DBT skills: mindfulness emotion regulation and distress tolerance…Central to DBT is that individuals turn to food to self-soothe, numb and avoid emotional discomfort because food “works” temporarily…” And the BFD for me:” Dialectical thinking involves holding two seemingly contradictory viewpoints at the same time by recognizing that there is always more than one way to view a situation more than one way to solve a problem…”and most of all “Don’t confuse dialectical thinking with rationalizing a binge.”…accepting yourself does not require that you approve of where you are or like it.”

There were many other things that resonated with me: “…for their whole lives they’ve been told that they’re “too sensitive”…” and “Hedonic eating …involves an increased appetite drive or preoccupation with highly desirable food even without physical hunger…”

Finally, “Another valuable way to use dialectical thinking involves accepting who you are at this moment while at the same time accepting that you want to change….you are accepting yourself exactly as you are in this moment so you can change…what can be changed is the way you react to your distress and difficult emotions.” POWERFUL STUFF !!

I think this book is terrific. It is extremely straightforward well organized, and readable. It includes very specific skills and strategies for managing emotions without turning to food…and it has such a supportive tone reminding the reader constantly that they are where they are and it isn’t the end of the world if they do binge…but there are ways to work on modifying this behavior. Very highly recommended for anyone who knows the struggles with food and weight management and who wants to be healthy, with a healthy approach to food and nutrition. Five enthusiastic stars. And I hope my former “daughter” will benefit from DBT!

[Lorena · Rating 5 out of 5]

I don't have binge eating disorder, but I do have a problem with emotional eating and I have been known to fall into a trance in front of the TV or computer and eat far more than I intended, so I was grateful for the opportunity to review an advanced reader copy of this book.

The authors first wrote a therapists' manual based on their research on the effectiveness of DBT in helping patients with disordered eating. Then they developed this self-help version for anyone wanting to learn the DBT skills on their own. This version was tested with patients to ensure its effectiveness. If you're someone who likes to see the research, all of the studies that the program was based on are cited and described in the appendix.

I really liked the way this book was written. It was easy to understand, with lots of examples from representative patients. There's a lot of repetition because the authors subscribe to the "Tell them what you're going to tell them, then tell them, then tell them what you told them" school of thought, and they also keep reminding you to renew your commitment to the program and keep practicing the skills. I think that really works in this case though. The repetition and review is helpful when learning new skills, especially when there's likely to be a lot of emotional resistance.

The program described in this book does require a major commitment. You can't just read through the book in a couple hours and expect your life to change. The book is 13 chapters with lots of exercises, and the authors suggest that you complete one chapter per week so that you have enough time to complete the exercises and practice the new skills in the areas of mindfulness, emotion regulation, and distress tolerance.

I'm finding these skills and exercises very helpful in reducing episodes of emotional eating, but also in many other areas of my life. DBT is helpful in reducing all sorts of problematic behaviors that we engage in because of emotional distress or in an attempt to avoid our problems (e.g., compulsive shopping, overworking, fighting with loved ones). This is touched on in the book.

Because of all of the exercises in the book, it would be easiest to complete this program working from a hard copy of the book that you are willing to write in. However, The Guilford Press has made the most important forms available to download from their website. A determined reader should be able to make a Kindle version work; it's just going to require a little more effort and perhaps a bit of creative problem solving at times.

I was provided an ARC through Net Galley that I volunteered to review. Because I have not seen the final published version, I cannot comment on the final editing and formatting.

[Annette Fuller · Rating 5 out of 5]

Wow is this a cool book. It’s rare that I read a self-help book that has prescribed exercises and a “program” to follow and I actually do them. But this one? Wow.

Every chapter is full of amazing information and helpful anecdotes and useful homework exercises. I worked my way through half of the book/program, and then hit an emotional wall with it and took a few months off. Then I came back and read the second half (only doing the written exercises, not continuing the weekly tracking and the behavior chain worksheets), and I still got SO MUCH out of this.

I’ll be repeating the program again in the future, absolutely. The skills you learn in it are so damn *helpful*. For so many situations, not just food-related ones.

Intuitive eating and NO MORE DIETS are the way to go. Science is totally clear on that. And this program is the only thing I’ve encountered so far that actually gives you the real emotional and mental skills that you’ll need to be *successful* at changing your relationship with food.

Since even my half-assed emotional-walls-restricted attempts at doing this program, I’ve noticed that the way I interact with food and hunger has totally shifted. I am so much more conscious of when I am actually hungry vs. when I am feeling some kind of emotional hunger (or just thirsty, let’s be real with our dehydrated selves). There are countless times where I’ve been able to choose not to eat, when I am feeling the impulse to binge or eat mindlessly. That’s invaluable.

A short disclaimer that I’m also in therapy and working with a therapist who is trained in mindfulness, CBT, and EMDR, which has been an amazing supplement to the DBT methods in this book (the mindfulness being the most helpful of her modalities for addressing my food issues). So YMMV, and extra support is amazing, though not mandatory to still get *so much* out of this book/program.

If you’re tired of diets, if you know that your relationship with food is more emotional than nutrition-motivated, if you want to develop skills that will last the rest of your life to help shift the way you eat, this is the book for you. (Plus the DBT skills seriously help in any and every other life situation. I can’t begin to guess how many times I’ve used these in all kinds of situations, because it’s just an everyday thing now.)

Do yourself the favor of getting this book. And if you pause halfway through like I did, make sure you pick it back up again at some point, because the most useful skills were in the second half. :D

[Tracey Pate · Rating 5 out of 5]

This is a great book to use if you struggle with any type of comfort eating, emotional eating, or binge eating issues. You can use this as a self-help book on your own or with the guidance of a therapist. There are many useful coping skill tools detailed in this book such as the techniques of dialectical thinking and radical acceptance. As a long-term comfort eater with binge eating tendencies I found this book extremely helpful and instrumental in changing my habits that were negatively impacting with my mental and physical health. Highly recommend.

[KT · Rating 2 out of 5]

If you have already been struggling with eating for some time and have researched theories and skills for coping, then this book may not offer any useful information. If you are interested in some theories about being mindful and haven’t already explored them, this book may be helpful for you.

The first 100 pages are incredibly basic if you are already very self aware. In these pages the authors review basic models of binge eating and teach the reader how to be aware of their triggers, actions, etc. the authors do cover several concepts which do not appear to be as widely known (I, at least, had not heard of them).

Unfortunately, at various points throughout the book the authors fail to fully explain what we, as the readers working through the workbook, are supposed to do. At times, rather than explaining the exercises we are supposed to be completing the authors only explain examples of performing those exercises. While this may give you a general sense of what the exercise may entail, it does not give you a clear understanding of what it is you are supposed to be doing.

The authors also often confuse various concepts by defining them one way and then, in later chapters, saying something is fundamental to their definition which was not previously mentioned. Alongside this, the initial definitions of concepts are often long, rambling, and unclear.

Furthermore, despite the authors addressing the issue of weight loss in the beginning of the book and making a point to mention that the book is not about weight loss, they confuse the concept of binge eating and being overweight throughout the book. They often ask you to imagine various things such as “the pros of stopping binge eating” and their examples include such items as “I would have more energy” which is would happen if you lost weight, not if you stopped binge eating.

The theories and statements made by the authors also tend to be less specific and less validated than one would expect. Rather than delving into the details surrounding the theories and discoveries relating to binge eating, the authors make generalizations such as stating that “the rewarding properties of food are “visible” in the brain. In a similar fashion, they state a multitude of psychological facts throughout the book such as “how intensely we feel emotions[…] is hard-wired or biological” without providing any evidence or references to peer-reviewed publications. There are several theories still unproven in the field of psychology and while the authors are experts in the field, it is important to note that they likely agree with some theories and not others. Therefore, it it’s important to have references when facts are stated so that readers can understand if the authors are stating empirically backed factual truths or one of several currently accepted theories.

Several of these theories presented in the book are truly offensive. The authors seem to operate under the assumption that those with eating problems grew up in invalidating environments and learned not to persevere. They suggest that some people binge because, rather than learning to “value [their] ability to persist despite lack of immediate rewards” they learned to give up. This idea that people who struggle with their eating simply don’t know how to persist or persevere is consistent throughout the book. Moreover, some theories on coping within the book seem to imply that binge eaters focus on how unfair life is and complain about that rather than focusing on their goals. The authors also present the theory that those who cope with their emotions through food refuse to accept reality, specifically the reality that pain is a part of the human experience.

Alongside this, the authors fall into the classic mistake of assuming those with eating disorders aren’t aware that it’s important to do certain things like have a healthy diet, get sleep, get exercise, build positive experiences via activities such as vacationing, etc. They spend time explaining how these practices are important while failing to recognize that most of them are the result of privileges related to time, money, or health.

The authors also specifically mention that some of the techniques have been adapted from programs “found to be effective for reducing pain in individuals suffering from chronic pain syndromes”. As anyone with a chronic illness can likely attest, this is incredibly telling of the mindset of the authors and the stance they take towards mental and physical illnesses.

Perhaps the section that most exemplifies the overarching issues of the book however, is when the authors ask the reader to practice “urge surfing”. The authors say to just experience the urge to eat without giving in and eating as though they do not realize that anyone capable of doing this would not have picked up this book. The authors offer no strategies or tactics to help “surf the urge” and tell the reader to just do it. Just get through the urge. Period.

Overall, the book offers some useful skills for those who haven’t looked into the psychology of eating disorders or coping. However, it is consistently offensive, out of touch, and thoroughly disappointing.

[Kelli · Rating 4 out of 5]

I struggle with my eating, and this was a great resource for how to fix it. I highly recommend doing the homework and exercises because that can only strengthen the practice.

[Dianna · Rating 4 out of 5]

I’ve read many books targeted on the subject of emotional eating, I was one of those people who wouldn’t understand or believed that people can eat when they feel stressed, hurt or anxious. It took me a long time to accept this paradigm and I’ve read many articles and science books about it. It is a fact that people binge eat when they feel stressed, they binge because the feeling of stress doesn’t subsides.
This book presents a study made by Drs. Debra L. Safer, Sarah Adler, and Philip C. Masson on the many sides of binge eating, the book has incorporated diaries, exercises and examples of real patients. It really hits home. The book speaks on so many levels, you can totally relate to it, it’s easy to read and it gives you some shock value like if you want to quit binge eating you HAVE TO LET GO OF SELF CONTROL and the fact that binge eating has your mind going foggy which makes you unaware of POSITIVITY. Wow right? I do recommend it to anyone struggling, and from reading other books on the same subject – this one was by far superior.

[Valerie Perez · Rating 5 out of 5]

Psychologist recommended

As a psychologist, I value DBT as a theoretical orientation for so many reasons (e.g. it validating, gives us more productive and healthy alternatives to detrimental behaviors we tend to cope with, as well new ways to conceptualize/understand what we are experiencing). This book does an amazing job, for both clients and clinicians, at tackling emotional eating in a way that is both individualized and general enough for everyone to resonate with. I have recommended it to both friends and clients.

[Sheri · Rating 5 out of 5]

This book has been a life saver. It has changed the way I deal with my emotions and with the way I look at food. I plan on re-reading this book again this year to reinforce the tools that helped me release my long pattern of leaning on food to deal with my emotions.

I highly recommend this book.

[Brooke Banks · Rating 5 out of 5]

Amazing. Really changed how I think about eating and food and how I approach both. Love all the examples used, it made it easier to fill out mine. Though I just want one woman to leave her awful cheating husband....

I had to read this quickly because I borrowed it from the library but I took copious notes and will buy my own when I can.

[Michele Paiva · Rating 4 out of 5]

Good but repetitive of other books of same topic

[Sue · Rating 3 out of 5]

Good info but didn't follow it to the end. May come back to it sometime.

[lqmzjjx · Rating 5 out of 5]

中文版译名《告别情绪性进食的dbt方法》五星好评。一本优秀的书。对我很有帮助，感谢作者和译者。

[Vivian · Rating 4 out of 5]

These are the most useful points discussed:
-do dialectical thinking -> don't feel like you have to restart everything just because you missed a goal once, be wary of the mindset of perfection; keep working, no need to restart
-be aware that your childhood affects so many aspects in your adulthood and are what you carry along with you
-identify what you are feeling before executing the action