I recently had the privilege of attending a talk by Roxane Gay, a nationally known writer, professor, and speaker. She authored The New York Times best-selling essay collection, Bad Feminist, and most recently, the memoir Hunger.
She’s a woman who, to use her term, is “super morbidly obese” and lives in an “unruly body.” She’s gone through life with these labels given to her by physicians, culture, and nearly everyone around her.
She speaks with a level of authenticity and honesty that is rare. She speaks about her own experience in a way that truly helps one understand how very difficult it is to be significantly overweight, bringing about personal and social pain, and implications of how one reads her life.
This topic is, of course, important in our field, as binge eating disorder is the most common of all the eating disorders and, often, the least discussed in studies.
We know, however, that a significant portion of people in higher-weight bodies have a binge eating disorder. We also know that this group presents late to treatment, and often carries significant emotional issues that are related to their binge eating disorder. In addition, we know binge eating disorder can be treated through cognitive behavioral therapy.
What Roxane Gay shared with us was her life experience and the fact that going through the world the way she has caused her to suffer psychologically without any actual sense of what she should do to fix it. She talked with great precision about all of the advice she’s been given throughout her life: exercise more, eat less, eat more healthy foods. All things, of course, she knows very, very well.
Her experience with the medical field has been a very negative one. She attributes the severity of her physical and emotional problems to her doctors. She believes medical problems are worsened for obese people because physicians make them feel ashamed at visits. Therefore, people who are overweight often don’t want to go see a physician.
So, problems with diabetes, hypertension, and other issues may get less attention in overweight people compared to those who don’t have a large body size and shape. People in larger bodies are sadly less likely to seek help for their medical symptoms.
As we begin to understand eating disorders and recognize that binge eating disorder exists and, in fact, is more common than we thought, we also need to understand the amount of suffering these clients have experienced.
As a society, we often think of anorexia nervosa when we think of eating disorders. However, it is crucial that we widen our collective perspective to remember that binge eating disorder is a source of tremendous psychological and physical suffering for so many people. Their suffering is all too often overlooked. Increased awareness and understanding are important first steps toward providing effective care to those struggling with this difficult illness.
Mark Warren is the chief medical officer of The Emily Program. He is also one of the original founders of the Cleveland Center for Eating Disorders, which became The Emily Program – Cleveland in 2014. A Cleveland native, he is a graduate of the Johns Hopkins University Medical School and completed his residency at Harvard Medical School. He served as Chairman of the Department of Psychiatry at Mt. Sinai Hospital and Medical Director of University Hospital Health System’s Laurelwood Hospital. A past vice-chair for clinical affairs at the Case School of Medicine Department of Psychiatry, he continues on the Clinical Faculty of the Medical School, teaching in both the Departments of Psychiatry and Pediatrics. He is currently a faculty member and former chair of the Board of Governors at the Gestalt Institute of Cleveland. Dr. Warren is a Distinguished Fellow of the American Psychiatric Association, a two-time recipient of the Exemplary Psychiatrist Award of the national Alliance for the Mentally Ill, and a winner of the Woodruff Award. He leads the Males and Eating Disorders special interest group for the Academy of Eating Disorders.
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