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BEDA is on board with HAES

Background
The Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association, for all intents and purposes, defines mental health issues by providing industry-standard diagnostic criteria. A new version of the DSM, the DSM-V, is due to be published in 2013. One of the major changes under consideration is adding Binge Eating Disorder as a distinct category, rather than including it under "Eating Disorder Not Otherwise Specified." This will probably raise the profile of BED and make it easier for people suffering from it to access treatment. That seems like it would be a good thing.

I don't know if we've talked about the DSM-V and BED on Big Fat Blog before. BED is more a general health issue than a fat/size acceptance issue. However, BED interacts with fatness in a few important ways.

  1. Some people assume that everyone who's fat has BED (not the case).
  2. Binge eating often causes people to gain weight.
  3. For that reason, people who have BED and their doctors often assume that the process of treating BED will trigger major and permanent weight loss. In fact, this is the main reason why some sufferers seek treatment.
  4. However, successfully treating BED does not always result in weight loss.

What is BEDA?
In anticipation of this proposed change to the DSM, an organization called the Binge Eating Disorder Association (BEDA) has emerged.

While in the past, treatment of BED has tended to focus on weight loss, BEDA seems to be taking a different approach. They are HAES-positive and are encouraging awareness of weight stigma. What does this tell us? It tells us that they're not incompetent. Although Binge Eating Disorder can arise independently as a coping mechanism, it is more commonly a response to food restriction; weight loss dieting. And guess how BED has often been treated in the past? If you said "more dieting," you'd be right. Can you imagine? Trying to treat an eating disorder with an outlook and behavior that triggers it? Obviously Health at Every Size, with its emphasis on balance and enjoyment rather than weight, is a better focus for BED treatment. HAES does not involve food restriction, which can trigger binges.

BEDA and the National Weight Stigma Awareness Week
Anyway, according to a press release from BEDA, BEDA Launches First Annual National Weight Stigma Awareness Week, subtitled The Binge Eating Disorder Association (BEDA) announced today that it will launch its first annual National Weight Stigma Awareness Week, September 26-30, 2011.


The Binge Eating Disorder Association (BEDA) announced today that it will launch its first annual National Weight Stigma Awareness Week, September 26-30, 2011. The objectives of this event are to build awareness of what weight stigma is, the harmful effects weight stigma can have on people of all ages in all environments, and what can be done to stop it.

“Whether it is children being teased and bullied in school because of their weight, adults being discriminated against in the work place, or patients being shamed in a physician’s office, weight stigma insidiously affects a variety of people.” says Chevese Turner, CEO of the Binge Eating Disorder Association. “We want to raise awareness around weight stigma and how a focus on weight rather than health and placing a higher value on “thin” can, in fact, have a negative effect on the physical and mental health of a person-of-size—especially those who have or are predisposed to eating disorders.”

As the “war on obesity” rages on and the $60 billion weight loss industry continues to grow, paradoxically, rates of obesity are not decreasing and eating disorders are rapidly increasing. Afflicting more women than breast cancer, eating disorders have the highest rate of mortality of all mental illnesses. They are complex disorders triggered by environmental factors, and studies have shown weight stigma plays a significant role. Several studies conducted by The Rudd Center for Food Policy & Obesity at Yale University have found that more frequent exposure to stigma was related to more attempts to cope with maladaptive eating practices and higher BMI.

Yes, they are talking sense. And their National Weight Stigma Awareness Week web page contains a wealth of information on weight stigma; its history, how it manifests, and the effects it has on people. Going through the pull down menu will give you a lot of general information. Perhaps the most helpful thing they've posted is this pdf file summarizing the research on weight stigma.

And, of course, if you suspect that you may be suffering from BED, they also provide a basic definition and a provider search.

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sannanina September 27th, 2011 | Link | They are HAES-positive Well,

They are HAES-positive

Well, they also say things like this:

As a result, many individuals who binge eat take in more calories than they burn for energy, and they become overweight and remain so as long as they continue to binge eat. Some individuals may attempt to overly restrict their food intake after a binge episode but this can backfire and lead to increased hunger and lead to more binge eating. Individuals with BED can get stuck in a vicious cycle of weight gain, depression, dieting, and binge eating.

And this:

Treatment for binge eating disorder targets both the elimination of binge eating and the development and maintenance of a healthy weight.

(Emphasis in both cases mine.)

I don't want to be overcritical and maybe you have more information, but while they might very well oppose weight stigma on some level (just as the Rudd Center), it sounds like they might still promote the idea of "sensible" or "moderate" restriction. It also sounds like they believe or at least tell people that people with BED lose weight once they recover and/ or that weight loss is a good indicator of treatment success in people with BED. As far as I am aware there is not a shred of data to support this (just because you might have gained weight due to overeating/ bingeing does not mean you will automatically lose some or all of it once you normalize your eating).

DeeLeigh's picture
DeeLeigh
September 27th, 2011 | Link | I see what you mean. They

I see what you mean. Maybe they haven't completely eliminated the traditional way of thinking about BED. The "excessive restriction" thing does suggest that they think that a lesser degree of restriction is a good idea. If they think that eating without a restrictive plan = bingeing, then that's disappointing and they should know better.

It's worth noting that they don't provide a definition for "healthy weight," and it doesn't necessarily mean 20-25 BMI. In fact, there's precedent for "healthy weight" having a much broader definition, as in the Healthy Weight Network and the Healthy Weight Journal, which are actually HAES oriented. I'm not a fan of that terminology, myself. It's obviously meant to draw in people with a must-be-thin mindset in sort of a sneaky way, and I prefer more direct language. And it alienates people who are size accepting and aren't familiar with how it's being used.

sannanina September 27th, 2011 | Link | I'm not a fan of that

I'm not a fan of that terminology, myself. It's obviously meant to draw in people with a must-be-thin mindset in sort of a sneaky way, and I prefer more direct language. And it alienates people who are size accepting and aren't familiar with how it's being used.

Oh, okay, I hadn't considered that. I am wondering, however, if they might shoot themselves in the foot with that tactic. I actually am recovering from BED at this point - more specifically from cycles of BED alternating with (at times pretty severe) restriction. One of the biggest obstacles I have encountered in getting the help I need has been finding a therapist (and a doctor) who truly gets that a) it is possible for a fat person, even a fat person with BED, to restrict food intake to unhealthily low levels and b) weight loss is not necessarily a sign for recovery, nor do people with BED always lose weight when they normalize their eating. And it is exactly the therapists who agree that diets are not the answer but who then go on promoting some kind of "life-style change" (I actually had a therapist recommend Weight Watchers to me not too long ago) that have been hardest to deal with - partially because their comments are not just unhelpful, they are actually triggering eating disordered behavior. And I would bet that these therapists/ health professionals would totally nod along with everything said on that the BEDA website without ever starting to question their approach to BED and eating disorders in general. Hell, some people even manage to nod along with everything Ellyn Satter says/ writes and then go on how great their new weight management program works - and Ellyn Satter is pretty clear that normal eating does not necessarily lead to weight loss in people who were previously overeating.

(In this context it needs to be said that there are fortunately people like the Fat Nutritionist and other nutritionists, therapists, and doctors who truly get it out there - unfortunately they are few and quite hard to find.)

richie79's picture
richie79
September 27th, 2011 | Link | This new organisation's

This new organisation's position seems almost as conflicted and inconsistent as that of the Rudd Center itself (Kelly Brownell and Rebecca Puhl being its most prominent figures). On the one hand they do seem genuinely opposed to fat shaming / hatred and have produced what is possibly the most comprehensive set of resources about weight-related stigma available online. There's some really good stuff in there, including things like a gallery of non-stereotypical depictions of fat people, a media toolkit, resources for educators and more.

Yet all this is contained within a website that seems to accept and promote the standard conception of 'obesity' as a 'problem', and which avoids or deliberately downplays the relationship between this approach and the resultant reinforcement of fat sterotypes and the negative public / medical perception of fat PEOPLE which they claim to oppose. Maybe these fundamental difficulties in reconciling the two areas of research explain why the 'weight stigma' section of the Rudd Center website stands as a somewhat remote footnote to the rest of it (and indeed now seems to be being spun off to form part of an entirely distinct organisation).

Whilst treating everything they produce with caution I'm not entirely ready to write them off as a force for good, since superficially at least the sociological side of their work very much supports and accords with much of what the FA movement have been saying for years, and unlike most of the latter they do enjoy something of a media platform. Unfortunate though it be, I suspect that the fact that others in the field of 'obesity' may have more respect for research into fat stigma which emanates from another ostensibly 'anti-obesity' organisation than for similar assertions from those within the FA movement who they no doubt view as biased or 'self-justifying'.

"What is right is not always popular and what is popular is not always right" - Albert Einstein

DeeLeigh's picture
DeeLeigh
September 27th, 2011 | Link | Looks like BEDA may not be

Looks like I was mistaken about BEDA being connected to the Rudd Center. Sorry about that. I deleted this from the main post...

It seems to be associated with the Rudd Center.

The Rudd Center is not a friend to HAES. Aside from having a trendy view of food and fatness that some people would consider "healthist" and classist, they casually equate fatness with smoking, communicable diseases, and lead paint. Oh yeah.

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