To help those with eating disorders, first you have to see the problem, and that’s a key focus of the eighth National Healthy Eating and Living Conference being held on Thursday-Friday, May 14-15, at the Hilton Asheville Hotel in Biltmore Park.
One of the keynote speakers, Beth Riley, says her battle with anorexia and bulimia went unnoticed by her parents and doctors for years. “No one said a word, ever,” says Riley, executive director of the Riley Center for Eating Disorders in Greenville, S.C. “I spent my 20s dealing with it until I finally got help.”
Those struggles ignited a lifelong passion for raising awareness for eating disorders, and Riley will share her expertise on what it takes to build a successful and sustainable eating disorder practice at the HEAL conference, which is sponsored by T.H.E. (Treatment, Healing, Education) Center for Disordered Eating of Western North Carolina. The conference is geared toward teaching professionals how to better treat eating disorders.
In the United States, at some time in their lives, 20 million women and 10 million men suffer from an eating disorder, including anorexia, bulimia and binge eating disorder, according to the National Eating Disorders Association. Many of these cases go unreported.
“We are not catching this illness,” Riley says. “The medical community, parents — they’re not catching it early enough.”
While studying at Stanford University, Riley began experiencing fatigue, difficulty concentrating and depression (symptoms also related to malnourishment). When a doctor recommended she eliminate yeast, dairy and sugar, she obsessed about the new diet.
“When I ate food that was not on the approved list, I would binge on it, then use compensatory behaviors such as purging and exercise,” says Riley.
Riley’s experience is still common today, says Elaine O’Barr, director of T.H.E. Center for Disordered Eating. She recounts visiting a family doctor recently and being told the office never comes across eating disorders. “There’s no way that’s possible,” O’Barr says.
In 2014, T.H.E. Center — a 501(c)3 nonprofit based at UNC Asheville that offers free services for disordered eating — served over 400 individuals in its support groups and had over 200 calls to its help line, says O’Barr.
Doctors aren’t receiving enough education about how to diagnose and treat eating disorders, as well as the severity of long-term side effects if adolescents aren’t treated aggressively, says Riley. In the last 12 months, the Riley Center sent 34 individuals to inpatient treatment.
“Most doctors have zero education in treating eating disorders,” she says.
Stomach pain is a typical complaint for someone suffering from an eating disorder, she explains. When you restrict food, the body’s metabolism slows and in turn slows the digestion process. This can manifest as chronic stomach pain, and when doctors cannot find the source of the problem, they might suggest the patient stop eating gluten, dairy or meat, she says.
Nicole Foxworth, a board-certified physician assistant specializing in family health in Hendersonville, says medical professionals are focusing a lot on obesity because they see it so frequently. She says the clinic where she works recently offered an optional lunch-and-learn on eating disorders.
At her clinic, adolescent patients coming in for a wellness check-up must complete a questionnaire about what they are eating and how they feel about it. “But not every teen comes in for a [wellness] visit,” Foxworth says. “Like anything with teenagers, they’re teenagers — they’re not the most communicative people.”
O’Barr says those who are treating eating disorders are just beginning to realize that eating disorders may not be easy to spot.
“You don’t have to look a certain way or be underweight,” she says. “Sixty percent of individuals who present with an eating disorder are normal weight or above. It’s not what you think it is.”
Eating disorders are complex and are caused by a combination of behavioral, biological, emotional, interpersonal and social factors, according to NEDA. Riley adds that some commonalities of people with eating disorders are struggling with anxiety, overachieving, avoiding risk or harm, and liking to be in control.
“If you tell them to stop eating gluten or dairy, they will take it to the extreme,” she says.
“Even though we have this facility here, when [patients] show up in my office, they are too far gone,” Riley says. “Twice a week we’re sending people far away still. We have a real crisis right now in our area. People are still waiting too long.”
Riley says she sees parents putting off help for their child because there’s no time, it’s too expensive, or it means they miss that soccer game and lose a chance at a scholarship. Unfortunately, the long-term damage of putting off treatment for an eating disorder could be irreparable, she emphasizes. The longer you restrict your body from food, the harder it is on your heart, which could lead to heart complications or heart failure, Riley says.
“Short-term discomfort will cause long-term health complications, including possible death,” Riley says.
Riley was in her mid 20s and living in Hendersonville when she sought treatment at Park Ridge Hospital. She quit her job and paid for the treatment on her own, she says.
“It did save my life,” says Riley. “That’s why I’m so committed to helping others.”
Riley has been in recovery for 26 years. She earned a master’s degree in social work from the University of South Carolina and began treating eating disorders in 1997.
She has sent clients all over the country to treatment facilities so they could receive the appropriate level of care. The expense and emotional stress of sending a child away weighs on the entire family, she says.
“Too many people sat in my office over the years and sobbed on my sofa, begging me not to send them away, but they needed to go,” Riley says.
Many times in their first year post-treatment, patients relapse. That’s when Riley realized the need for more services at home. In 2012, after consulting with colleagues across the country, she opened the Riley Center for Eating Disorders — South Carolina’s first intensive outpatient program for the treatment of eating disorders.
Along with the intensive outpatient program, which helps those needing more structure than weekly outpatient therapy and nutrition counseling, the Riley Center offers a day treatment program for those transitioning from residential treatment centers. Staff includes a certified eating disorder specialist, psychiatrist, physician, registered nurse, marriage and family therapists, registered dietitians, kitchen staff and a yoga instructor.
It has been a labor of love for Riley, who had no backers at the time and had never owned or run a business.
“It was a lot to bite off, but I was glad I did,” she says.
WHAT: HEAL Conference 2015 — the eighth National Healthy Eating and Living Conference, sponsored by the T.H.E. Center for Disordered Eating and Eating Recovery Center. The event is a workshop offering five continuing-education credit hours and an opportunity to network with fellow eating disorders treatment colleagues. Key speakers include Emmett Bishop, founding partner and medical director of outpatient services and program development at the Eating Recovery Center in Colorado, and Beth Riley, executive director of the Riley Center.
WHEN: Thursday, May 16, and Friday, May 15. Early registration and continental breakfast, 8-9 a.m. Friday.
WHERE: Hilton Asheville at Biltmore Park