A few weeks ago my colleague and non-diet dietitian extraordinaire Sara Upson, posted a photo on her Instagram while she was at an eating disorder conference. She was commenting about a facility advertising weight loss (they said “weight management” but in the Eating Disorder treatment world that means weight loss) being at an Eating Disorder conference. You can view the post here. Also, I encourage you to follow Sara shares a lot of great info!
After this post Sara got several responses from pretty amazing people in the eating disorder recovery field. Some people who are kind of really big deals. They were all agreeing that promoting weight loss is so harmful to our clients and culture. However, there were several people who seemed to be very confused about why these eating disorder professionals were “making such a big deal out of this.”
Normally I would dismiss this. “Don’t feed the trolls” as they say. I try to avoid most people who try to bait me into social media arguments. However, as I looked at the people commenting I felt compelled to respond. They were mostly young women who have been woefully misinformed about eating disorders and their treatment. So I thought I would clear a few things up about one specific Eating Disorder that kept surfacing in the Instagram post:
Binge Eating Disorder (BED).
This post made me think about a time eleven years ago when my, then five year old, daughter suddenly started to run a fever over the weekend. We had been through this more than once so we decided to “just treat the fever” at home because she had no other symptoms. By Sunday her fever was over 105 degrees and she rapidly developed a rash. We called the pediatrician and they told us to get her to the ER ASAP. When we arrived we were quickly quarantined (that doesn’t ever freak out two first time parents, right?) and a few hours later we were told that she had Scarlet Fever. Which is apparently still a thing and not just a way people die in the computer game Oregon Trail (if you have never played this, I am sad for your life).
What does this have to do with BED? That day I was scared to death. Absolutely frightened. I was so thankful for the team of doctors that knew exactly what they were doing, the nurses that knew just the right things to say to ease our worried minds, and the precise evidence based treatment that healed my very sick daughter.
Unfortunately people struggling with BED don’t always have this experience and they suffer for a lifetime needlessly. So here are some facts about BED that might help you:
- BED is a mental health disorder where binging presents itself as a SYMPTOM. This means there are several factors that play into binge eating that must be addressed in recovery. It is such a complex issues that “just don’t binge” is more harmful than helpful. What if we would had showed up to the ER with my daughter and they would have said “meh. It’s just a fever. Let’s just give her Tylenol and not figure out what’s really going on here!” Only addressing the bingeing behavior is the EXACT same!
- One of the most complex aspects of BED is that it is a disorder rooted in restriction. Most of my clients with BED eat a very restrictive diet- so how would prescribing more of a symptom treat the problem? This is why weight loss, or “weight management” as some people like to sneakily call it, is harmful in the treatment of BED. This would be like taking someone who has a fever and giving them more of a fever to get rid of the fever! (I think this may be something my Memaw used to do..love you Memaw!)
- BED exists in people of any body shape and size so it is a mistaken assumption that all people who have BED “need to lose weight.” IF weight loss were even a possible, desirable, and achievable goal (another discussion for another time). Plus this misunderstanding about BED leaves people who still have a real struggle thinking “maybe it’s not a big deal because I’m not a certain body size” or the opposite “if my body is larger I must have BED.” I have clients of all body sizes and shapes that struggle with BED. This would be like thinking only people with blonde hair get fevers and no one else can, if a person with brown hair has a fever-well that would just be impossible!
- Many people with BED do seek weight loss treatment, which is not the appropriate treatment for the disorder and keeps them stuck in a cycle of shame. This is treating the disorder by prescribing more of the symptoms and the real issues never get fully addressed. These people might be able to maintain a smaller body for a period of time using more restriction but inside they often have not dealt with the mechanism that drove the binging to begin with. Then when they gain back weight, because biologically that is what our bodies are designed to do, they feel like they are failures. This would be like taking my daughter who was sick with Scarlet Fever and giving her medication that has been scientifically proven to be ineffective and then convincing her that she must have done something wrong to cause the problem, because people don’t just get fevers unless they are complete and utter failures.
In my practice as an eating disorder specialist, binge eating disorder is perhaps the least understood eating disorder.There is so much confusion in our culture about BED. This confusion stops people from getting the appropriate help and that is something we must take seriously.
If you are reading this because you are struggling with BED or you are wondering if you might struggle with binge behaviors, I encourage you to seek help with a trained eating disorder treatment team. There is hope and freedom! Recovery is possible!