Open Letter to Overeaters Anonymous

In August of 2010 Overeaters Anonymous celebrated its Golden Anniversary at its world convention in Los Angeles. As someone who has treated compulsive overeaters for more than three decades, I was privileged to be an invited guest to join in the celebration. As a point of reference my professional relationship with OA dates back to my earlier years in practice as I began to refer many of my patients to the local OA groups in my area. Doing so left me indebted to the courageous members of this fellowship who taught me so much more about this disease than I could have ever imagined. Since that time, Overeaters Anonymous has been a virtually indispensable support for those who have come to our facility seeking treatment. As a point of reference, here’s a little history of my experiences.
Before delving into my history with OA, I’d like to put forth a brief editorial comment at the outset. That is, I have long believed Overeaters Anonymous not only serves as a program of ongoing recovery for those suffering with compulsive overeating but also for those struggling with similar eating disorders. More specifically, I have continued to witness the success of countless people working the same 12-Steps, adopted from Alcoholics Anonymous, in OA. Many of my patients, past and present, suffering with bulimia, binge eating disorder, and related eating disorders have found refuge and recovery at the meetings and among the fellowship OA offers. Truth be told, I believe OA holds a place for anyone wishing to refrain from a compulsive or addictive relationship with food.
I finished my training as a clinical psychologist in 1979, passed my boards, and began a practice specializing in the treatment of eating disorders. As part of my graduate work I had been engaged with various research projects examining the regulation of eating and body weight. You could say I became an expert on what made laboratory rats and mice overeat and become overweight. You’d be surprised to learn humans and rodents are a lot alike when it comes to being predisposed to abnormal eating.. Anyway, over the course of the next several years I graduated to treating people with varying types of eating disorders, most notably compulsive overeating, bulimia, and what is now termed binge eating disorder. What I discovered over time was simply that weight was but the symptom and the disease was really an addictive relationship with food and/or dieting. I say this because I began to see people at the university’s clinic who were not overweight yet clearly ate compulsively. Most of these compensated for their overeating by either “making themselves sick” and getting rid of the food, over exercising, or alternating between periods of copious overeating followed by restricting, aka dieting. Of course, the majority of folks coming to our program suffered with varying degrees of obesity, the symptom most identify with compulsive overeating. Despite this, I soon concluded the more appropriate measure of the problem lies with the physical, emotional, and spiritual consequences and not the number on a bathroom scale. In effect, compulsive overeaters had more in common with their alcoholic and drug addicted brethren that most realize. There was more to this than a “weight problem.” In fact, today we see any number of AA and NA members who are compulsive overeaters who attend OA meetings as part of their ongoing recovery programs.
Not so different than the misguided beliefs about alcoholism in years past, the professional community is currently divided as to how to view, let alone treat compulsive overeating and related eating disorders*. If we distill the basic essence of the division, it would come down to those who view the compulsive eater as suffering with a psychiatric illness coupled with a lack of discipline and those seeing it as an addictive disease. Historically however, there has always been a small group of researchers, physicians, and healthcare professionals who have held steadfast to the addiction thesis. I’m pleased to report this minority group of professionals is multiplying and gaining momentum. Fact is, recent advances with brain mapping technology such as MRI imaging have clearly identified specific chemical responses in the brain that differentiate the compulsive overeater from his “non-addict” peers. The evidence has taken speculation and theory to the level of scientific fact. Personally, this has only served to validate those of us supporting OA through the years – namely compulsive overeating deserves to be recognized the same way we’ve come to understand and treat alcoholism and drug addiction.
It’s been my experience active participation in a 12-Step program such as OA is indispensible to the ongoing success of anyone wishing to recover from compulsive overeating or a similar eating disorder. Although not intended as a substitute for professional treatment when called for, OA affords the best opportunity to gain and keep a foothold in recovery. For purposes of making this point, I’d like to add a quote from the American Society of Addiction Medicine as it defines the disease of addiction. One can substitute the phrase compulsive overeating to clearly see that the proverbial shoe fits.
“Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in the individual pursuing reward and/or relief by substance use and other behaviors. The addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished recognition of significant problems with one’s behaviors and interpersonal relationships. Like other chronic diseases, addiction involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.” -American Society Of Addiction Medicine, 2012 –
Just about anyone who has attended a support group such as OA for any reasonable period of time will likely hear “their story” told by another member. The effect of one person’s experiences shared with a fellow having the same experiences is, to quote a related program, “unparalleled.” Once the initial layer of the onion is peeled away, namely the “but I’m different than these people,” the stage is set for identification rather than comparison. The question then becomes, “so what do I have in common with everyone here?” “Maybe I’m not alone or so different.” From that point forward, the focus begins to center more on the solution – “what do I need to do to recover?” The “magic” of OA seems to then become clear - a combination of people having a common purpose and seeing others working a set of suggested steps lending testimony to the promise of recovery.
It is my sincere hope the fellowship will continue to grow and its members serve as a beacon of light to show the way to those who have yet to find OA. It’s a spiritual axiom a group of people with a common history and purpose can do as a group what could not otherwise be achieved by the individual. In that sense OA offers what no professional or single person can match – hope by example.

Marty Lerner,Ph.D.
March 4th, 2013