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online conference transcript

hp-judith_asner_front.jpgJudith Asner, MSW is a bulimia treatment specialist and eating disorders coach. Ms. Asner founded one of the first outpatient eating disorders treatment programs on the east coast. She is also the sitemaster for Beat Bulimia inside the Eating Disorders Community.

Ms. Asner discusses the importance of having a strategy for recovering from bulimia and other eating disorders. She maintains that trying to recover from bulimia without a plan is extremely difficult; next to impossible. She outlines the components of an eating disorders treatment plan. Audience members questioned Ms. Asner on how to stop the binge/purge cycle, episodic binging and purging, the fact that dieting, for recovered bulimics, triggers of a relapse, and more.

David is the moderator.

The people in blue are audience members.

David: Good Morning. Welcome to and our chat conference on "Recovering From Bulimia: What You Need To Know." I'm David Roberts, the moderator. Our guest is Judith Asner, MSW. Ms. Asner is a psychotherapist who specializes in treating bulimics and those who suffer from other eating disorders. She started one of the first outpatient programs for eating disorders in 1979 on the East Coast. She is also the owner of the Beat Bulimia website here at and does life-coaching; helping people via telephone. Ms. Asner graduated from one of the top executive coaching schools in the U.S., The Hudson Institute. You can click here for a definition of bulimia. For comprehensive information on eating disorders, visit the Eating Disorders Community.

I received an note from Ms. Asner, recently, saying that a lot of the email she received came from people who stated they had tried to recover from bulimia or other eating disorders and weren't doing very well. So they decided to give up. Like there was only one way to recover and if that didn't work, than that's that. And Judi mentioned to me that from her vantage point, as a psychotherapist, she could see that many didn't even understand the basics of eating disorders recovery, much less have a strategy for recovery. So that's what we're going to be talking about this morning.

Good Morning Ms. Asner and welcome to

Judith Asner: Hello, David and guests and welcome. It's always a pleasure to be here with you, David.

Having a strategy for recovering from bulimia and other eating disorders is very important. Here's a detailed plan to recover from bulimia nervosa.David: When you talk about a strategy for recovery from bulimia, what are you saying exactly?

Judith Asner: Well, I am talking about a plan, David. Nothing proceeds without a strategy; long term and short-term goals. A plan goes this way: First, one has to have health professionals on a team. There is no way around that because bulimia nervosa is a disease. This team has to begin with an internist to cover one's physical condition and follow it. Next, a psychiatrist is needed to evaluate wheteher or not the person is suffering from a biological depression or other condition.

David: Before we get deeper into that, I want to ask this question: Is is POSSIBLE for everyone or anyone to recover from their eating disorder? Or are there some people who, no matter what they try or how hard they try, will never recover?

Judith Asner: I believe where there is a will there is a way. But statistically, there is a percentage that does not recover and remains chronic. However, I never give up on ANYONE. With bulimia, about 20 percent remain chronically bulimic.

Let us define recovery, David. A person may feel much better about themselves and still have some eating problems but have a much better sense of self and function well, but have episodic binges and purges. This is not full recovery, but it is a far sight better than being in the throws of full-blown bulimia, daily. I consider this a victory. I don't look for perfection in life. I look for some balance in a person's life. If a person falls back into bulimic patterns, I try to help them out of the downslide as fast as possible and help them get back on their feet, understand the stressors and make the next time easier. This, to me, is pretty good progress. If a person never purges again, hooray. I just hope a person can feel valuable, have a good sense of self, be kind to themselves and others, and if they slip, so be it. It's over and let's get back to living as fully as possible. If the person can go for success every day, God bless them. Hooray for them--what a victory.

David:Earlier, you mentioned that recovery begins with having a team of professionals to help you and that there was no way to effectively recover without that team. I'm assuming you are talking about needing an internist, a psychiatrist and maybe even a nutritionist. Am I right?

Judith Asner: Yes, David. Now I am not saying a person can NEVER do it alone. Let me modify that. Certainly self-help books on eating disorders, family and peer support, faith and faith-based groups, and overeaters anonymous are enormously helpful. But when there is a serious case of bulimia with underlying depression, anxiety or bipolar illness, which we call a comorbid condition or dual diagnosis, medication is necessary, monitoring of the physical condition by an internist is essential and a sound nutritional plan and exercise in the appropriate amount are important elements in the eating disorders treatment plan.

David: Judi, we have a couple of audience questions I want to get to that pertain to what we've talked about already, then we'll continue with our discussion on a "Recovery Plan for Bulimia." Here's the first question:

rcl:How do you know if you are in that 20% that are chronic and may not recover significantly and, if you are, what should you do?

Judith Asner: If you have had bulimia for say 5-10 or more years and you throw up for 3 or more times a week, go to the drawing board again. Look at what has and has not worked in the treatment before. Have you been to an inpatient facility? Have you been reevaluated for psychotrophic medications? There are many, many new medications on the market in the past years. Have you seen a psychotherapist who has worked extensively with the disorder or, in fact, had it? Have you gone to OA meetings daily? Have you hired a coach? Have you stuck to a firm nutritional plan?