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What's Eating You? Lessons in Eating Disorder Treatment & Support

What's Eating You? Lessons in Eating Disorder Treatment & Support

What’s Eating You is a new documentary/series about eating disorders on E!.  The second episode aired on Wednesday evening.  We are continuing to explore the question—are TV shows on psychological disorders like Hoarders, Intervention, What’s Eating You, etc. educational or do they run the risk of giving an incomplete picture of the disorder and treatment? 

The two individuals in this show, Kristy and Marc, had a long and painful history of bingeing and purging that was triggered very early in their teens by several factors—trauma, genetics, emotional abuse, OCD, mentally ill parent etc.  The beginning of the show focused heavily on the actual behaviors—many of them extreme—close ups of cottage cheese with hot sauce and bathroom scenes.

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Later in the show, there was a much deeper connection with these two individuals.  Rather than focusing on the surface behaviors, there was a shift onto the underlying mechanisms of the disorder—shame, difficult regulating emotion, feelings of worthlessness, guilt etc. 

Two important issues were brought to light in this episode.  The first was choosing the most appropriate kind of treatment.  The show provided treatment for a certain number of weeks.  After it was over, Marc decided to continue and do a five month intensive outpatient program (according to the show).  Viewers may not know what that means or why it is important. 

There are different levels and intensity of eating disorder treatment that depend on various factors such as how long you’ve been struggling with the disorder and how medically compromised you are.  An individual may want to change, but not be able to do so.  In this case, a more structured program is helpful.  This was likely the issue with Marc.  He had been struggling for many years, there were medical complications from bingeing/purging and laxative use and he also had Obsessive Compulsive Disorder.  He would likely benefit from a very structured and intensive program. They did not mention medication on the show, which could possibly be important for someone with OCD.

Here is a very general and basic overview of the levels of counseling:

Outpatient:  Once a week counseling appointments with a therapist, physician, nutritionist, etc. (www.edreferral.com)

Intensive Outpatient:  Approximately three hours a week of treatment, for three hours a day.  (Example, http://www.edcdenver.com/)

Partial Hospitalization:  Daily meetings for several hours a week.  A highly structured program. (Example, http://www.eatingdisorderscleveland.org/)

Residential Treatment:  A residential program, often for several weeks or months.  You live in this environment. (Example, http://www.eatingrecoverycenter.com/)

Hospitalization:  Housed within a medical facility to allow physicians to monitor vitals and medical issues.  (Example, http://www.rogershospital.org/monroe/content/eating-disorders-treatment, www.gurze.net)

Getting into the right type of treatment is important. See this chart by Academy of Eating Disorders http://www.aedweb.org/Treatment/1533.htm and the National Eating Disorders Association:  http://www.nationaleatingdisorders.org/uploads/file/toolkits/NEDA-TKP-B04-TreatmentSettingsAndCare.pdf   

The second issue is the importance of support and helping family members to understand eating disorders.  Both individuals had families with typical reactions—anger, fear, frustration, helplessness, judgment, and a desire to “just fix it.” http://www.nationaleatingdisorders.org/information-resources/family-and-friends.php

Kristy invited her husband to treatment.  There was a dramatic transformation in his understanding and ability to give support.  He always stated his love for his wife and fear of her disorder.  He thought he was being supportive.  When he learned new ways of being there for her, Kristy reached out to her husband in a vulnerable moment.  Her husband talked her through it and said helpful and encouraging statements. She walked away from her binge trigger food. Kristy’s case shows how an eating disorder can drive a wedge between you and important relationships.  They became much closer as her eating disorder faded into the background.

Inviting Marc’s father to treatment helped his father gain perspective and understanding of this disease—and it is a disease not a choice.  The father learned that when an eating disorder starts, emotional development stops.  So, if the ED starts at age 15, cognitive and emotional development is arrested at that age.  It’s difficult to expect Marc to respond at age appropriate levels. This understanding made a significant difference in their relationship and Marc’s movement toward recovery.  Marc is ultimately responsible for doing the hard work to recover.  However, it is wonderful to have someone with you on the journey.

Again, thanks to Marc and Kristy for bravely helping us learn more about eating disorders and allowing us to be part of your recovery.  Best wishes on your continued recovery.

Feel free to share your thoughts.  Are these shows helpful/educational or not?

Next week, we will meet two other individuals.  Check back to read the review of next week’s episode.

Susan Albers, Psy.D., is a licensed clinical psychologist, specializing in eating issues, weight loss, body image concerns, and mindfulness. She is the author of 50 Ways to Soothe Yourself Without Food, Eating Mindfully, Eat, Drink, and Be Mindful, and Mindful Eating 101 and is a Huffington Post blogger.  Her books have been quoted in the Wall Street Journal, O, the Oprah Magazine, Natural Health, Self Magazine and on the Dr. Oz T.V. show. Visit Albers online at www.eatingmindfully.

Susan Albers, Psy.D., is a psychologist who specializes in eating issues, weight loss, body image concerns and mindfulness. 

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