1. INTRODUCTION
Doctors don’t hesitate to send their patients with alcohol problems to Alcoholics Anonymous. Why do so few send their patients with eating problems to a similar group? During my 13 years as a psychotherapist, I have referred many of my clients to a twelve-step group such as Food Addicts Anonymous or Overeaters Anonymous. I have found that many of my clients who have anxiety and depression also have eating issues. What follows is a summary of my experience. Any twelve-step group has not approved this blog entry.
2. WHAT ARE TWELVE STEP GROUPS?
Twelve Step groups are self help groups based on the same principles as Alcoholics Anonymous. They are free – self-supporting – which means they pass a basket at meetings to pay for rent, etc. But no one is obliged to pay.
The twelve steps are a set of emotional or psychological steps that are taken that help you recover from your addiction. For example, the first step is admitting you have a problem. The second step is in believing that a power greater than yourself can help you with that problem. Even though there are no professionals, the groups work well because people who recover stick around. Experienced members report that their lives are better when they attend. And they risk relapse if they don’t go to meetings and continue to help others to recover.
3. BENEFITS AND PROBLEMS:
I will first outline the benefits of 12 step groups. I will address the problems or difficulties next.
PROS
There are many advantages to 12 step groups. They are free; they are in almost every small town and urban centre. For example, about 6,500 Overeaters Anonymous groups meet each week in over 75 countries. There are approximately 54,000 members worldwide. There are hundreds of Food Addicts Anonymous meetings in the United States. Both groups have many telephone and internet meetings per week. For quick reference, see below for Food Addicts Anonymous meetings in Toronto alone. In 2010, Alcoholics Anonymous reported over 2 million members worldwide and over 115,000 groups.
In O.A. and F.A.A. I hear people say, “I lost 90 lb. and I kept it off for 20 years.” Or, “I lost 20 lb. or 60 lb. and I kept it off for 5 years.” Other weight loss programs help you lose the weight, but most people put all that weight back on at some point, usually within a year. Twelve step groups seem to have the best track record for long-term weight loss and recovery.
Other advantages are: You are in charge of your recovery; you decide what you need to work on; you progress at your own pace. Twelve step groups help to heal shame and isolation. You are no longer alone; other people have done what you have done with food. The excellent formats and guidelines for group conduct make it a safe place. For example, there is a rule of “no cross talk,” which means people do not interrupt, comment upon, or refer to someone else’s sharing. You do not need to share, but when you are ready, sharing without interruption, in a safe place, helps you to find your voice. (A.A. is the exception to this rule. AA’s often interrupt and give each other feedback.) And lastly, many sponsors (experienced members) are available for phone calls every day. You do not have to wait for an appointment with your therapist. You can call someone in the group at any time (within reason) whenever you have food cravings or when you want to talk about a problem.
The twelve steps help you to deal with the thoughts, emotions and behaviors that fuel your addiction. They give you tools to deal with all your life problems. In my opinion, they are the best form of free therapy.
CONS
Many helping professionals have difficulty with 12 step groups. Some don’t like the spirituality. Also the language is negative; there is talk about “powerlessness,” “insanity” and “character defects.” In addition the language is old (1930’s), Christian, and masculine. The abstinence model is also problematic for some; harm reduction is a more popular approach for many professionals. Some have referred a client to 12 step and saw their client have a bad experience with a difficult group member. I have also heard of professionals who discouraged 12 step groups, thinking that their clients become dependent on the program and don’t develop enough of their own autonomy.
All of these concerns are worth discussing. Twelve step groups aren’t for everyone. But when they work, they really work wonders. So, in my opinion, it is best to refer all your clients with food addictions to a 12 step group. If it works, it’s great. If it doesn’t, try something else. I would like to take each of these concerns one by one.
- The Spirituality
You do not have to believe in God in order to join or in order to recover. Atheists and Agnostics have come to 12 step groups and have found recovery there. Twelve Step Groups offer a spiritual program, but it is not related to any denomination or religion. You can be Hindu, Buddhist, and Moslem, Jewish, Christian, Wiccan, Atheist, Agnostic or anything else. You can make up your own religion. Also the only requirement for membership is a desire to stop eating compulsively. There are no other requirements. Even the twelve steps are only suggested, not required. The second step is, that we “Came to believe that a power greater than ourselves [can help us.]” You can define that power any way that you want. The strength and support of the group can be your higher power. Your inner “Higher Self” can be your higher power. And you can relate to your higher power in any way that is right for you. You don’t need to define your higher power to begin your healing in a 12 step group. Learn what you can from the 12 step group. Ask others what helped them recover. Take the suggestions you like and leave the rest.
- The language is negative – powerlessness – insanity – character defects
- The language is masculine, Christian, and old-fashioned
These are both true. However, I have seen such amazing success from my clients working the 12 steps; they have shown strong, positive changes, not only in their addiction, but also in their moods, their behavior and their whole way of life. They have done this by using the concepts in the 12 steps, but translating the language to suit them. For example, some change He to She and God to Higher Power or Great Spirit or Goddess, or whatever words work for them. Language does not have to be a barrier.
- Abstinence model
This is a valid concern. If your client’s goal is not abstinence, then it may be better to refer them to a counselor, clinic or treatment centre that specializes in food addiction and allows for a harm reduction model. However, I have noticed that people who are not willing to give up sugar and flour struggle more with their cravings. Your client may benefit from some education about food addictions. (See Dr. Tarman’s workshop and web site.)
- No professionals
I was also concerned about the lack of professional leadership when I first heard about 12 step groups. The F.A.A. food plan follows sound nutritional guidelines. In O.A. all members are encouraged to consult a nutritionist or health care practitioner about their food plan. In meetings, the group format is written out in detail, so the chairperson has only to read the script for the meeting to flow smoothly. And the twelve traditions guide twelve step members towards behaviors that promote group harmony.
- People in the program who are judgmental or inappropriate in their behavior towards your client.
Of course there may be bad experiences in any group, and difficult group members. Help your client to avoid or speak up to people who are problematic. Help them to surround themselves with people who show good recovery and can help them.
- Do people get addicted to 12 steps and lose their own autonomy?
Twelve Step groups talk about how electricity gives us power – power to heat our homes, cook our food, build our cars and wash our clothes. It is a power most of us would rather not do without. People in 12 step groups say that they feel the same way about their groups. Group membership gives them the power to live healthy, fulfilling, joy-filled lives, free from addiction. They are dependent on the 12-step group the same way we are all dependent on electricity. And they don’t want to be without either. They say that without their group meetings, they eventually fall back into their addiction and into self-sabotage or hurting others. With the group, they have more choices to live happy, healthy lives. Some people say, “My life is better than I ever dared dream.” “I have more power, more autonomy, and more choices, when I work the 12 step program and live the 12 step way of life.”
4. When to refer:
When your client says their eating behaviors feel like an addiction.
When their goal is abstinence.
When they say they feel powerless over their eating behaviors.
When they say they are not put off by the spiritual part of the program, or are desperate enough to put up with the spiritual language in order to recover.
When they are okay with going to a group.
Do refer anorexics and bulimics. Many go to O.A. and F. A. A. and find recovery there.
5. When not to refer:
When they say it’s not an addiction.
When they say they think they can stop on their own.
When they are very uncomfortable with the spirituality.
When they want a “harm-reduction” model, instead of abstinence.
i.e. Don’t refer someone to F.A.A. when they do not want to give up sugar and flour. If they don’t want to stop binging, don’t refer them to O.A. O.A. does allow for more flexible food plans, but there is an emphasis on abstaining from over-eating and binging. Most, but not all, sponsors in O.A. encourage people to abstain from their binge foods.
When they are very uncomfortable in groups.
When they want an individual counselor or treatment centre instead.
I often encourage my clients to explore all three – a treatment centre, a counselor specializing in food addiction, and a 12 step a group to see what works. If their addiction is severe, then I tell them my perception is that they have a severe addiction and that I recommend a treatment centre followed by a 12 step group to prevent relapse.
Pat Guillet M.S.W.
Shepell.fgi
Counselor
1-888-224-2053 x4508
416-654-5219 (Home Office)
Food Addicts in Anonymous Meetings in Toronto
Tuesday
Mississauga, 7pm, Eden United Church, 3051 Battleford Rd., Map, Diana F. , 905-520-5799
Toronto, 7pm, Castlefield Community Church (1/2 block west of Yonge Street, 5 blocks north of Eglinton) , 27 Castlefield , Map, Dan B. , 416-456-0110 / Diana R. , 416-857-7559
Woodbridge, 7pm, Woodbridge Pool & Memorial Arena, 5020 Hwy #7, Map, Anna R. , 416-528-2329
Wednesday
Toronto, 7pm, St. Simon the Apostle Church, 525 Bloor St. East, Map, Mel T. , 416-323-0557 / Mel T. , 416-323-0557
Thursday
Scarborough, 7pm, Grace Christian Reformed Church; Northwest corner of 401 and McCowan Road next to the CTV Station, 25 Channel Nine Court, Map, Cathy C. , 416-282-7670
Toronto, 7:30pm, MNjcc, 750 Spadina Ave, Map, Dawn A. , 416-539-8259
Saturday
Toronto , 10:30am, Castlefield Community Church, 27 Castlefield Avenue, Map, Dan B. , 416-456-0110 / Lyne M. , 416-805-6780
Toronto, 10:30am, St. Simon the Apostle Church, 525 Bloor St. East, Map, Mel T. , 416-323-0557
I have been in FA for over 13 years, struggling. It is like being in a Nazi Prison Camp. This is not a solution to my food addiction, sorry. Not so simple! Barely anyone can stand the rules and regulations…they only have 3,000 members world-wide, hardly a success. Back to the drawing board….
Thank you for posting this. I’m an ex FA-er whose health was damaged by that program.
I’m grateful people are now speaking out on FA.
I was on a starvation diet and lost weight so rapidly my hair was falling out and my muscle was being consumed by my body due to the malnutrition. This was accepted as normal within that group. Needless to say, I couldn’t sustain the expected actions, “broke” my abstinence and then was shunned and ostracized by many in that group. I was seen as a disgusting failure to be avoided as I was then considered contagious.
Thanks again for speaking up on this dangerous approach to recovery.
Here is to sober health.
Thank you both so much. I keep needing affirmation about leaving FA, because people keep questioning me about it.
I was there for 4 months and lost 50 pounds. I kept asking my sponsor for more food and she kept saying “no, just enjoy the feeling of losing the weight.” My body actually flipped from feeling starvation everyday (I cried in bed most nights because I was so hungry) to feeling full most all of the time (I went into severe restriction mode and 3 months later I still can only handle about 800 calories a day.)
What with calling my sponsor every morning, making 3 calls a day to other members, receiving calls all the time, buying and preparing the required food, going to 3 meetings a week, doing readings, etc, I did not have a life anymore.
I was also told to do things, like driving people to meetings who never even thanked me. I heard from a friend that once you reach the magic number of 90 days of abstinence, the demands on you are ridiculously high.
This is the honest truth – my phone just rang and the caller ID shows that it is my former sponsor. They don’t let you go even after you leave.
I still feel traumatized by the whole thing and very foolish for putting my physical and emotional health in their hands.
Hi Tillie
I am so sorry you had this experience. Many people who have gone to FA report similar experiences with the large number of expectations that are required in order to stay successful in the program. They leave feeling upset by the high demand of work and the intensity of calls, the ‘fascist’ like nature of the program. Even the people who stay and find the program useful will agree that it is the most rigorous of the 12 step programs.
The FA fellowship tends to maintain that this support – which you felt was overwhelming, indeed traumatizing you- is necessary to combat the insidious and persistent nature of food addiction. Ironically, I have to agree with their observation that their fellowship that has the most success in getting and maintaing the weight loss.
However, is it necessary to be so strident? So domineering? I really don’t know and hope not.
You may want to consider the other 12 step food programs ie OA, Greysheeters Anon, which have different approaches. Dont forget that the people in various groups, even countries, tend to set the tone for the delivery of their particular program, so you may find another group that is more respectful of your needs.
I hope you dont give up your attempt to achieve food sobriety and even a 12 step approach, but there simply is not that much available yet out side of this.
Thank you for your email. I hope others will also respond, you have some very good points about ‘the other side’ of the recovery program, that others should hear about.
Vera
You had an unreasonable sponsor. They are not all like that! I have had many due to one being like that. Find one that is reasonable for you. There are so many in Maine where i am from that are NOT like that. Find a phone list from Maine…Particulary Westbrook Maine Monday night meetings. Blessings Melissa
Sorry for you terrible experience. I had one like that, literally passing out at work. I called the founder of FA and she said that I had to get down to a certain weight that I was in 5th grade. I told her my doctor and Weight Watchers said I could be way over that weight. She disagreed. I fortuately, found a sponsor from the line of Ann D. the other founder of FA. She is much more reasonable in he approach and allows medication at AWOL’s. I would try to find a sponsor who has what you want..similar to your personality and needs. Some are vegans, some may eat an apple if their blood sugar drops at noon. Depends on the type of sponsor.
Yes, you are right – you have to watch your sponsor. Don’t ditch the program before looking for another sponsor if it is not working for you.
Thank God I came across this review. I’m searching for a meeting place for help with my FA, this doesn’t sound like somewhere I’d like to be.
I would like to try this, am also not so fat am 74 kg, and am hight is 170 but I want have healthy body and I can control my bad habits In food, am coming soon to Toronto I hope I may get a help from you guys
Try it and keep an open mind. It works wonders to folks in Maine where I am from. Be picky. You choose the sponsor after asking around. Ask questions like, do they allow anti depressants while going to an AWOL some do and some dont. The two founders of FA split in their thinking. The hard line is very strict and won’t increase your food if you are hungary. by Cythnia. The softer line is Ann D’s line. Her line is awesome and I lost 50 pounds in 4 months starting out with carbs and fruit. You would never have those in a more strict line. I lost more weight with much more food to start than I did with starvation deporvatin mode of a strictor sponsor. My sponsor is a nurse and very reasonable. She is also taking this program seriously and this diesase will kill you if it isnt under control. I still suffer but you can suffer in program or out of program. I recommend in program with a sspnsor who does not bite your head off if you pick up the food due to Binge Eating disorder from example. Mine does not yell but accepts and says its a falling forward not a step back. Blessings Melissa
My fa experience was all so traumatic and ultimately dangerous. Fascist is a word that resonates for me–the program demanded strict adherence to guidelines that were created by individuals, and almost all having to do with what how and when you ate. Very seldom for the steps ever discussed, and never end up with the times I had gone.
OA was helpful in many ways, I unfortunately had a very traumatic experience with a sponsor. I worked with her for 2 years, and looking back realize that I had placed my a mental emotional well-being in her hands. Not surprising, and given that so much of my life experience was believing that others could fix me, but I could not change myself. And then others knew better than I did. What followed was a very traumatic descent into trigger childhood trauma, which ultimately led me to pull away from OA and begin work in earnest with professional help.
I learned through that the importance of being discerning, careful and slow in getting snow members and sharing details.
It’s hard to be safelynvulnerable without having coping skills and some sense of identity already in place to learn how to deal with difficulties and discomfort in and out of the program. I didn’t have those, which left me very vulnerable to my sponsor’s misguided and somewhat delusional attempts to live up to what she thought sponsors were supposed to be and do.
I encourage anyone, including myself, to be cautious and reflective when listening to others share and reading the literature, so that the words and concepts don’t become sources of literalism as opposed to helpful tools and support.
Hi
I am sorry that you had a dramatic experience with FA and not a great one with your OA sponsor. I don’t think you are alone.
It is true that you have to be very selective when seeking help – in the 12 step programs, there are no regulations regarding sponsors. This is the same with food coaches and even therapists (though perhaps more regulations with health care professionals). You are right, when vulnerable, it is harder to be discerning. From my experience, and I think you would agree, it is important to be cautious, and interview your helper (in whatever capacity) and always ‘trust your gut’ as far as the advice you get. I would not give up looking for support though – since doing it alone means you are confronted with the ‘fascist addict’ within! There are good / sick people everywhere, and I strongly suggest you use your intuition to find the best fit – and take your time doing it. These are tools only – and not to be taken literally, as you rightfully say.