Eating Disorders Recovery Conference with Dr. David Garner

Written by HealthyPlace.com Staff Writer

online conference transcript

Bob M is the moderator.

BEGINNING

Bob M: Good evening everyone. I want to welcome everybody here tonight for our Eating Disorders Recovery Conference. Everyday, I get emails from those of you with eating disorders talking about how difficult it is to recover from them. You talk about trying, you talk about getting therapy and relapsing and I want you to know that is not that unusual. Recovering from eating disorders can be a long, difficult and trying process. Our guest tonight, is one of the top researchers of eating disorders in the country and we'll be discussing why it's so hard and what you need to know to make your recovery longer lasting and more effective. Our guest is Dr. David Garner, Ph.D. Dr. Garner is the Director of the Toledo Center for Eating Disorders. He has published over 140 scientific articles and book chapters, and has co-authored or co-edited 6 books on eating disorders. He is a Founding Member of the Academy for Eating Disorders, a scientific consultant for the National Screening Program for Eating Disorders and a member of the Editorial Board of the International Journal of Eating Disorders. Good evening Dr. Garner and welcome to the Concerned Counseling website. I'd like to start with the question: Why is it so difficult for people with eating disorders to make a full and lasting recovery?

Dr. Garner: Thank you for the introduction. This is a difficult question since there are many reasons for failure to recover; however, most significant is the conflict about weight and weight gain.

Bob M: And what is that conflict?

Dr. Garner: Most people with eating disorders suffer from the "anorexic wish"- the wish to recover but not gain weight. This leads to continued attempts to suppress body weight which leads to increased urges to eat. The key to breaking the cycle is becoming a strong "anti-dieter" - a real problem for those who fear weight gain.

Bob M: Before we get into how to accomplish that, I want to also have you touch on the other reasons for failure to recover.

Dr. Garner: Sometimes the eating disorder is a comment on dysfunctional family international patterns and as long as the patterns continue to exist, recovery is difficult. For instance, the problems in recovery may relate to a trauma, such as sexual abuse, and until this issue is dealt with, recovery is impeded.

Bob M: So is that one of the reasons for failure to recover from an eating disorder...that the issues that led up to it haven't been dealt with completely?

Dr. Garner: That is correct. Another one is that the simple wish to maintain a low weight is in conflict with the biological realities related to the person's set point for body weight and this is simply not accepted and the person continues to diet. This may seem like a straight forward issue, but for women in our society, it is very difficult to accept a body weight higher than one would like.

Bob M: Is it possible then to effectively work through your eating disorder while at the same time dealing with the abuse, or other issues, that may have lead up to it? Or to be really effective, should one work through the other issues before tackling the eating disorder?

Dr. Garner: The order of dealing with the issues varies. Usually, one needs to work on both at the same time. In all cases, it is impossible to make headway on the psychological front while continuing to engage in symptoms. Bingeing and vomiting b/v and strict dieting alter your perceptions so much that it is impossible to work on other issues.

Bob M: At the beginning of the conference, I mentioned that those who have relapses along the way, should not feel alone. What does the research say about the number of people who try and recover and have a relapse...and what are the average number of relapses a person experiences?

Dr. Garner: The percent of people with bulimia who recover at a 7 year follow-up is about 70% with another 15% making significant progress. With anorexia nervosa (AN), there is less research and the treatment phase is longer, but 60-70% of patients recover with treatment from a high quality eating disorders treatment facility. Many patients recover after quite a number of relapses.

Bob M: What is the best form of treatment when it comes to making a significant or lasting recovery?

Dr. Garner: The best studied treatment for both Anorexia and Bulimia is cognitive behavioral treatment (talk and behavioral modification therapy). However, for patients under 18, family therapy must be part of whatever treatment is offered.

Bob M: We get many questions here Dr. Garner from folks who want to know, is hospitalization the most effective way to deal with an eating disorder, followed by intensive outpatient therapy or can you just get therapy on a weekly basis?

Dr. Garner: I do not think that hospitalization is necessary or desirable for most patients- intensive outpatient treatment or day hospitalization has replaced inpatient treatment for the most part. Most bulimic patients benefit from outpatient therapy and severe eating disorders usually require something more than weekly, outpatient therapy.

Bob M: Here are some audience questions:

Rhys: How does one become a strong anti-dieter and not gain weight? It seems like an oxymoron.

Dr. Garner: It is, that is why most people decide on some level to opt for trying to continue to suppress their weight. Modest weight gain may occur even in treatment for bulimia.