Summer to Kirsten means one thing: Ice cream, and lots of it.
It's true that she only thinks about ice cream now, and not nearly as often as she used to.
But Kirsten has eaten plenty of ice cream. "I couldn't go out with my friends and eat one ice cream," says the 22-year-old senior at a Baltimore college. "I'd have maybe five," but not with her friends. When Kirsten ate in quantity, she did so in private, maybe while driving around in her car, she says.
Kirsten says she's a compulsive eater, a binge eater. But she's 40 pounds thinner than she was two years ago and no longer avoiding life through food -- thanks, she says, to Overeaters Anonymous (OA).
Stories like Kirsten's will be heard repeatedly this weekend as more than 2,000 members of OA gather in Baltimore for their annual World Service Convention at the Hyatt Regency Hotel. The convention's workshops are open to the public.
OA is a recovery program for compulsive overeaters who "share experiences, strength and hope," says Rozanne, the California woman who founded the group in 1960 with a few friends. (Because it is an anonymous organization, members do not share last names.)
Based on the principles of Alcoholics Anonymous, the overeaters' organization adheres to the "just for today" theory and Twelve Steps that enable compulsive overeaters "to live without the need for excess food," according to an OA brochure.
The program is conducted through free group meetings, where members of the group talk about "what we were like, what happened and what we are like now," says Rozanne. The group rotates meeting leaders and occasionally invites outside speakers.
There are no scales, diets, food plans or medical recommendations. But there is recognition of a "power greater than ourselves," although OA is not a religious organization, its members stress. There is also an admission that "we were powerless over food -- that our lives had become unmanageable" -- the first of the Twelve Steps.
Compulsive eating is "a pattern of eating behavior where a person experiences a loss of control," says Dr. Harry Brandt, director of the Mercy Center for Eating Disorders at Mercy Medical Center. Compulsive eating can take several forms: bingeing; bulimia (bingeing and purging through induced vomiting or use of laxatives), and grazing, or eating continually.
It's also eating "for reasons that have nothing to do with nourishing the body," Rozanne says. "A lot of us eat to stuff our feelings down." Those feeling aren't always bad, either: Overeaters eat in joy, too, she says.
"The eating disorders are manifestations of underlying conflicts," says Dr. Brandt, who treats eating disorders through inpatient and outpatient care at Mercy. "There's something underneath, driving that [abnormal eating behavior]."
Those forces may be physical, emotional, psycho-social or a combination of these, he says.
"Often there's a self-esteem problem," adds Dr. Lawrence Cheskin, director of the Johns Hopkins Weight Management Center at Francis Scott Key Medical Center. Or a person is continuing, almost unconsciously, patterns of behavior established in childhood, prompted perhaps by "the clean-plate club" or "starving children" somewhere. Overeating is also a reaction to stress.
Whatever the forces, they must be reckoned with if a person is to overcome overeating. "Losing weight doesn't necessarily solve the problem," he says.
For this reason, programs such as those at Mercy and Johns Hopkins combine weight-loss strategies, nutrition counseling, therapy, support groups and sometimes medication. Some people in these program also attend groups such as OA.
"There are some people it seems to be very helpful for," says Dr. Brandt, adding that he takes issue with some tactics -- such as avoiding categories of food -- and theories of the organization.
To reverse a pattern of overeating, he says, a person needs to establish "normal" eating habits, begin psychological counseling and take medication, when appropriate. Often these treatments occur simultaneously.
"No one specific program is a panacea for eating disorders," Dr. Brandt says. He adds that anyone with an eating disorder should be examined by a doctor before beginning a treatment program.
Although OA is patterned after AA -- Rozanne says she went to AA meetings for years to learn the techniques -- there is one big difference. Overeaters cannot abstain biologically from food the way alcoholics can abstain from alcohol.
Whether food is, in fact, an addiction is controversial; that food causes many people physical and emotional problems is not. Dr. Brandt says he thinks eating disorders are increasing as our society continues to emphasize thinness, while promoting high-fat and high-calorie foods, especially fast food.
Members of OA do practice "abstinence," which to them means giving up old eating behaviors, Kirsten says. She eats three meals a day, avoids snacks and alcohol, and does not eat sugar or white flour.