For this month’s Tuesday’s With Tammy post, Tammy Beasley answers questions related to the treatment of Binge Eating Disorder.
How does Alsana Treatment Centers treat clients with different diagnoses within the same group therapy sessions?
Just as we customize a client’s individual therapy and treatment plan, we individualize a client’s nutritional assessment and needs. However, the clients are together at all meals and within groups as part of our philosophy to provide real world scenarios that can be challenged and addressed within a SAFE, protective environment so that the client is better prepared to handle these same issues when back home. Alsana believes that the mixed groups provide an opportunity for clients to learn how to handle emotions, challenges, and fears triggered by comparisons to another person’s own eating issues in a therapeutic, safe place – vs. being protected from these issues during treatment but harshly confronted with these same, inevitable issues in the real world where support is not available. It allows the client to practice dealing with these issues, so she/he is better prepared to face them when back home.
What if a client with binge eating disorder in residential treatment does not want to finish his or her plate of food due to feelings of fullness?
Alsana’s meal structure is based on timing and balance that is purposefully designed to stabilize metabolism and re-calibrate the body’s natural ability to determine hunger and fullness. Although the behaviors of binge eating and anorexia differ, both clients have distorted perceptions of hunger/fullness. Since each client’s meal plan is calculated FOR that individual to heal and restore, the client will be expected to complete the meal and snacks provided since perceptions of hunger and fullness are distorted as a result of the eating disorder itself at this phase of treatment. For example, a typical binge pattern is restriction during the day for multiple reasons, followed by binging in the evening, leading to inevitable return to the same pattern of day-time restriction to “make up for the prior evening’s binge”. Inevitably, this pattern will set the client up to binge yet again, fueling the same self-destructive pattern. Within this pattern, the binges are rooted in both emotional AND physical triggers, although the client is only aware of the emotional triggers and self-blames. Hunger/fullness cues are turned upside down and disconnect from the normal pattern of metabolism. The hunger/fullness cues learn to respond to a distorted pattern; therefore, a client with binge eating disorder will feel “full” especially in the early stages of treatment when eating meals and snacks based on a normal appetite-based pattern. The only way to restore and heal is to push through the distorted feelings of hunger/fullness and trust the new pattern to do its healing work.