March 22, 2016

Tea Time with Robyn - Binge Eating Disorder: Should I Get Treatment? A Chat with Julie Friedman


Robyn: Hi everyone and welcome to Tea Time with Robyn (Me.) I am here with Dr. Julie Friedman, and she is the VP of our Binge Eating Treatment and Recovery Program. Hello, Dr. Friedman.

Dr. Friedman: Hello… I love Denver. Hi.

Robyn: I’m so grateful to have you here because I’ve been getting a lot of questions about binge eating disorder (BED) and I’m not so sure yet, that people look at it as an eating disorder.

Dr. Friedman: Right.

Robyn: And so it’s kind of like, “anorexia and bulimia are eating disorders, and they are worth treating. But I just have overeating.  I just have BED”… It’s almost like they are uncomfortable to claim even that.

Dr. Friedman: Right, right, right. Or to claim it as an eating disorder.

Robyn: Yes, exactly!

Dr. Friedman: You know, many of our patients really feel like they are just bad dieters. You know, that they lack willpower, or they lack motivation—and that couldn’t be further from the truth. And so I think first of all, we know statistically, less than half of people who struggle with BED will even seek eating disorder treatment. So, many of these patients are just going from diet to diet to diet, not even recognizing what they have.

We also know that BED is as chronic and as stable as others eating disorders—if not more. And it’s also risky. Emotionally, we know that it’s associated with things like depression, anxiety and substance abuse disorders. So it’s not just the weight gain.

Robyn: What do you say to those people who just think if they could just lose twenty or fifty or one hundred pounds (whatever the weight is) then life would be better?

Dr. Friedman: Well the first thing we would say is that dieting would actually make your eating disorder worse. We know that when people are struggling with BED, and they try to either calorie restrict or just have what we call a lot of dietary restraints.  So things like the Paleo diet, “I’m never going to eat refined sugar.” “I’m never going to eat refined carbohydrates.”

Robyn: It’s kind of like an alcoholic saying, “I’m never going to drink, like spirits.” Or “I’m never going to drink wine,” you know?

Dr. Friedman: Yes. Exactly. That yes, we need to give you more structure certainly around your food intake.  We need help you with skills to manage the urges you might have to binge, but you still need to eat. And you still need to eat in a way that doesn’t make you feel deprived. And so I think actually dieting can exacerbate binge eating which just increases somebodies weight.  So exactly what they set out to do with calorie restriction they are getting the opposite effect.

Robyn: So what would you say to people that are watching that are struggling with BED and don’t know whether to attempt to seek treatment or not, what would you say to them?

Dr. Friedman: I would say that BED has many components. So not only do you need specialized eating disorder treatment—and listen general therapy is wonderful.  It’s great to know why you do what you do.  But if somebody isn’t addressing the eating disorder behavior specifically, you are not going to get very far. And so, I would say if somebody is struggling with BED you need specialized eating disorder treatment. You need multi-disciplinary treatment; we need to have a dietician working with you. An individual clinician, often a family clinician, group therapy. Medical components as well; having a medical doctor and psychiatry.

So I would say that most people under-treat their BED, but not only do we need adequate treatment, but we need specialized treatment for an eating disorder.

Robyn: Thank you so much, Julie. Thank you. You have helped so many people today.

Dr. Friedman: I sure hope so!

Robyn: That’s all we have time for today. Remember if you have a question you want me to find answers to, email me at teatime@eatingrecoverycenter.com and together we will find the answers over a cup of tea.

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