Eating Disorders - Getting the Help You Need

Bob M: Good evening everyone. We are ready to start tonight's conference. I hope everyone had a pleasant holiday. Our first conference of the year, tonight, is "Breaking Free From Your Eating Disorder--Getting the Help You Need". We are always trying to focus on doing positive things and offering things to help with recovery. Our guest is Jonathan Rader, Ph.D. Dr. Rader is the Chief Executive and Clinical Director for Rader Programs, one of the nations leading providers of inpatient, daycare, and outpatient eating disorder services. He has worked in the field of eating disorders for over 17 years. His work has been documented in eating disorder journals. Good evening Dr. Rader and welcome to the Concerned Counseling website. Before we get underway with tonight's topic, could you please tell us a bit more about your expertise and the Rader Centers and where they are located?

Dr. Rader: We, at Rader Programs have been treating anorexia, bulimia, and compulsive overeating since 1979 and we currently have two locations, one in Tulsa, Oklahoma and one in Los Angeles, California.

Bob M: I'm going to assume that most people here know if they, or someone they know, has an eating disorder. The question is: how do you know that it's really time to get professional help?

Dr. Rader: That is a good question, Bob. A person really needs to look at the amount of dysfunction the eating disorder has caused in all areas of their life; physical, emotional, social, family, and work.

Bob M: One of the big questions we always get is what kind of treatment should you get. Outpatient, inpatient, or just see a therapist once a week or so. Can you explain the criteria one should use to evaluate that issue?

Dr. Rader: Unfortunately there is not a simple answer to that question. We, at Rader Programs, try to treat the patient with the least restrictive environment; but since eating disorders affect all aspects of an individual's life, the most effective treatments have included the use of a multi-disciplinary treatment team. It is important not to ignore the nutritional, exercise, and physical components of the eating disorder.

Bob M: If you are just joining us, welcome. Our guest is Dr. Jonathan Rader, of the Rader Programs. Our topic is: "Breaking Free From Your Eating Disorder--Getting the Help You Need". Here are a few audience questions Dr. Rader:

Shanna: After you have recovered (symptom free) and you still get the feelings to purge, what are some good ways to get past the feelings?

Dr. Rader: At Rader, we look at eating disorders as an ongoing recovery process . Even though you may no longer be in the throes of your disordered eating, feelings may still come up around eating disorder issues. It is okay to have these feelings and to realize that you did not develop your eating disorder overnight nor will all of the feelings disappear overnight.

Bob M: Is it possible to prevent a relapse, and if so, how?

Dr. Rader: Sometimes relapse can be part of eating disorder recovery. We often say it is important to never be too hungry, angry, lonely, or tired. ( HALT).

Winkerbean: What do you recommend for getting through denial, even after having completed outpatient treatment and still being in denial?

Dr. Rader: We use a process called our First Step. It gives an individual the opportunity to look how their life has become unmanageable because of the eating disorder. The person writes down the first remembrances of their eating disorder up until the present time. Family members and friends are also good at pointing out the dysfunction the eating disorder has caused.

Bob M: I know that various treatment centers have their own focus, or way to recovery. Some offer 12 step programs, others behavioral therapy. How does one determine what would be best for them?

Dr. Rader: According to the APA (American Psychological Association), eating disorder treatment programs must have a multi-disciplinary treatment team and process. It must be able to address the medical, psychological, nutritional, and behavioral issues associated with having an eating disorder. I would recommend not only going with a treatment center that you feel comfortable with, but one that also has a medical doctor, registered dietician, family counselors, and individual counselors.

Bob M: Here are some more audience questions:

Katiebee: My daughter is bulimic. Now she is gaining so much weight. I'm worried.

Bob M: So what's a parent to do in this situation? and really any situation where they are concerned about their child or relative, but that person is in denial or doesn't want help?

Dr. Rader: Weight fluctuations are common in eating disorders. It is important for both of you to get in contact with an eating disorder professional as eating disorders are a family disorder.

Bob M: One of the most difficult things though is actually getting the person to accept the idea of treatment. Can you give us some insights on how to accomplish that?

Dr. Rader: It is important for the person to look at how the eating disorder has affected their life. If they can look at how their lives could possibly improve for the better, they may be willing to accept the idea of intervention.

Marion: Dr. Radar, what about a situation where the ED sufferer is ready and willing to begin her recovery process, but the parents are in denial, and basically tell her to smarten up and 'be normal'?

Dr. Rader: If it's possible to get the parents alone without the child, you may be able to deal with their feelings of being responsible for the eating disorder, which they are not. Parents who are reticent to let their children seek treatment often feel guilty and responsible for their child's eating disorder.

Bob M: Our guest is Dr. Rader. We are talking about recovering from your eating disorder. Dr. Rader is a psychologist and CEO of the Rader Programs (Treatment Centers) in California and Oklahoma. They offer in-patient and out- patient treatment. 

Angel: I'm 31 years old have had anorexia for 16 years. Is there hope for me? Can I overcome this or will I have this the rest of my life?

Dr. Rader: Yes, there is definitely hope for you. If you want recovery it is there for the taking. We have seen many patients in your situation come to the other side of this devastating disorder. It won't be easy, but if you want to overcome your eating disorder, you'll need professional help and support.

Bob M: Which eating disorder is easier to overcome, anorexia or bulimia? and why?

Dr. Rader: Both are extremely difficult. People used to believe that anorexia and bulimia were mutually exclusive disorders. It is now known that many individuals bounce between both disorders. Neither should be taken lightly as eating disorders have the highest death rate among psychiatric disorders with 10% succumbing to death.

Bob M: When someone comes to the Rader Programs, how long does treatment usually last, in general, and what is the regimen like?

Dr. Rader: The length of stay varies for all patients, but average length of stay is between 2 and 4 weeks. The regimen is highly structured with treatment beginning early in the morning and lasting until bedtime. Throughout the day our individual and group settings address the eating disorder and the many issues that accompany it.

Bob M: Here's why I ask. Is 2-4 weeks really a realistic time period when it comes to recovery? Can someone truly recover in that short period of time, even if they work hard at it?

Dr. Rader: No. We are not looking at having a person totally recover from their eating disorder in this short time period. What we are doing is addressing the main issues so that the individual can continue their recovery with an individual therapist or support group.

Bob M: Thank you for clarifying that because I think many people believe, you check into the eating disorder treatment center, you should be "cured", and then they have a relapse. But what you are saying is the treatment center is more like "intervention"...trying to break the habits and form new ones. But you still need intensive treatment to continue with your recovery. Am I correct in that?

Dr. Rader: Absolutely correct, Bob. I wish there was a magic cure. Unfortunately, it takes a lot of hard work to overcome an eating disorder, but we have seen thousands of patients truly gain their lives back.

Naia: I've been in recovery and therapy for nearly a year, but whenever I'm under a lot of stress (like during the recent holidays), I return to starving and excessive exercise. How can I stop those old habits?

Dr. Rader: One of the techniques our patients use during the holidays is obtaining a food buddy. This person is someone you can commit your food to prior to a difficult meal such as a family or work party. This person is also available to discuss how the meal or difficult event went. If you still have difficulty I would suggest contacting your therapist.

elizabethsm: What do you do if there isn't anyone on your area qualified to treat eating disorders and you can't afford to go somewhere?

Dr. Rader: We at Rader Programs truly believe in the effectiveness of support groups such as Overeaters Anonymous and ANAD. You can find a listing of OA and ANAD groups by finding their website-we have links to both on our website.

rndochka: I have EXTREME difficulty swallowing. It doesn't matter if it's water or popcorn. I constantly feel like I'm choking. Is this a symptom of anorexia or sexual abuse or both and what can I do about it? I'm getting dehydrated because of this problem.

Dr. Rader: It is important to first rule out a physical problem by seeing your general practitioner. If it is determined that there is nothing physically wrong, it would be recommended to explore these issues with a therapist. Many of our patients have this same symptom as a result of anxiety, sexual abuse or their eating disorder.

Bob M: I also want to explore another eating disorder that people usually don't put in that category of "eating disorders" and that's compulsive overeating. Do you have a program for that? There are many people who come to the site and want help, but don't know where to turn (after failing at many different diet programs).

Dr. Rader: Yes. We treat compulsive overeating just like any other eating disorder. It does not matter whether you are underweight or overweight. If food is being used for something other than nourishment, the person may have an eating disorder.

Debzonfire: If eating disorders patients are so "competitive" in their bid to lose weight, competitive with each other that is, why would you put them all together in a support group?

Dr. Rader: We have found that the power of a group of individuals exploring their dysfunction together can be more effective than in individual therapy. People who are exploring similar issues can often see parts of themselves in others. It is true that there is competition among some patients, but we use this as an issue to address as the same competitive issues happen every day outside of the treatment setting.

love those carbs: Are there any support groups for families and husbands of someone who has a eating disorder?

Dr. Rader: Yes. Some communities are lucky enough to have co-compulsive  Overeaters Anonymous groups. Many universities also have support groups for family members.

Tiffanie: I am wanting to become pregnant in the near future, but my gyn says I have an infertility problem we need to work with. Can this be caused by my bulimia?

Dr. Rader: The practice of eating disorders can be a cause of infertility. I would recommend always checking with your ob/gyn.

baby butterfly wings: I don't understand how it is possible to have anorexia and bulimia at the same time. Is that just a false piece of information?

Dr. Rader: People usually do not have both eating disorders at the same time although you can have anorexia with bulimic symptoms or vice versa. Also, it is common for an individual to start off with anorexia and then move into bulimia as they may be eating just to satisfy their family members and then purge secretly.

mleland: I was in a program for 7 weeks and wanted to get better, but relapsed immediately. How does your program work faster or differently?

Dr. Rader: Unfortunately, I do not know the specifics of the program you were in. I can only tell you that our multi-disciplinary approach will work if you are willing to put the effort in. Just because you relapsed does not mean that you did not benefit from the treatment. It is important that you work the tools that were given to you. BREAK

Bob M: What about medications Dr. Rader? Is there anything out there that can significantly help someone with an eating disorder?

Dr. Rader: Currently the most commonly used medications for eating disorders are Tofranil, Norpramin, and Prozac. These medications affect the release and uptake of the neurotransmitter serotonin. Some physicians are using naltrexone, a medication that blocks the natural opiods. But medication alone is not as effective without therapy.

Allison: How do eating disorders get worse over time? It seems like somehow they start off as no big deal.

Dr. Rader: Eating disorders are progressive disorders. It may seem as though they are something you can control when you first start practicing them. But like alcoholism, they can become addictive and produce a devastating cycle.

Dr. Rader: I know it's getting late. I want to thank Dr. Rader for being here tonight and for everyone in the audience who attended and those who submitted questions.

Dr. Rader: Thank you for having me as a guest speaker tonight.

Bob M: Good Night everyone.