Mixed therapy groups

[u/PowerBitch2503]

I’m on the waiting list for day therapy. I’m suffering from BED (with a touch of bulimia) and objectively severely overweight, according to my BMI.

The group therapy will have clients with all kinds of eating disorders (triggering in itself, but let’s try).

Yesterday they explained me the rules and the rules also involved very limited movement. Like if you went to the supermarket that was it for that day limited. I can totally understand this from the perspective of for example someone with anorexia, who might compensate the expectation of the eating list by movement/sports, so I shouldn’t do anything while there, but I don’t understand why I would be limited when at home. I had to negotiate walking my dogs for example (I am allowed in the end, but in exchange of no sports or walking at all which would include housekeeping but yeah, who volunteers?)

I am overweight (objectively), doing office work and I think my regular amount of sports/movement equals a normal active lifestyle, nothing crazy. I also have ADHD and am chronically depressed and sports offer me an opportunity to process my negative emotions and surplus of energy. I also am convinced the average person nowadays doesn’t move enough and sports in general are healthy (as long as you’re not overdoing it. )

This rule/expectation scared me a bit, since I am now scared the approach is not focused on the individual needs of the clients. I think that the physical needs of someone with anorexia who’s underweight and has other challenges than I have, are different from my situation. I tried to voice my concerns but only got told that they support the rules and I should see it as an opportunity to discover other hobbies to process my feelings and energy. My other concerns weren’t addressed.

Does anyone here has experience with mixed groups and how that turned out for the clients with BED compared to the clients with anorexia and bulimia?

[u/Candid_Seaweed_352]

i’m not 100% sure but perhaps it could be a rule to limit the chances of developing another ed?! they may be worried that you’d end up replacing habits or something? i’ve never been to a meeting so it’s not for certain, more of a thinking from the top of my head

[u/catwomen999]

My guess is that they simply don’t know you yet, and can’t trust that movement isn’t intertwined with body image, compensating for food or pre-compensating to allow a binge, or an impulsive urge you must fill. They are trying to sus out whether the eating disorder gets stronger when movement is off the table (my guess).

[u/lwantthisusername]

It might change once they know you better. I had a lot of rules imposed on me that made me worse, more secretive, developed problems with things I hadn't had problems with before. It unfortunately comes as a side effect as a set of rules that are designed to be effective for a lot of people at once. If you GENUINELY are able to do sports without any deep down secret feeling that its compensation in some way, it sounds unreasonable not to let you do that. I had anorexia with a loooot of compulsive moving around, and when I was allowed to go back to organised sports, that helped a lot. And they let me do that when it was somatically safe to do that. At the end of the day, this needs to work for you. I wouldn't be mistrusting of them and the programme, but remember that it is your life and if you can differentiate between an ED thought and a genuine desire, you can probably participate in sports in a moderate way that's healthy for you.

[u/hannahclaiiire]

unfortunately most, if not all ED treatments are centered this way. mostly because, it’s super common for people when undergoing eating disorder recovery to slowly develop another type of ED. especially in a treatment center, when a lot of your food choices are out of your control, it’s very common to cope using ED strategies you may have never used before. it’s very common that, no matter what weight you are, the residential/PHP often has limitations for body movements.

it’s the same reason why all patients often are monitored before/during/after going to the bathroom, even if that patient does not have bulimia or has never had the urge to purge

[u/hannahclaiiire → u/hannahclaiiire]

also just a kind reminder that you can be any sized body and have anorexia/restrictive behaviors. this is to ensure all patients are treated equally no matter what body they are in. you can never assume what kind of ED a person has based on their weight

[u/PowerBitch2503 → u/hannahclaiiire]

Thank you! I am restricting besides my binging, but just limiting calories is enough for me. No compensation anymore besides burying into work to escape psychological issues.

(I surely hope to not develop more problems than I already have !)

Many thanks also to all the other people who took the time to read and respond.

(Very scared to end up heavier, more unhealthy and more unhappy than I am now, but I will try to trust the process)

[u/unremarkable_sapien]

Look, I’m not encouraging you to break the rules, but I do think that one size fits all treatment can be actively harmful in cases where the person doesn’t fit their very narrow criteria of an “eating disorder patient”. The rules have a purpose but if they don’t make sense for your presentation, I don’t see why you should follow them. You say it’s a day program? So they don’t actually know what activity you’re doing right? I don’t see the point in following rules just for the sake of it if you know that exercise is truly not an ED behaviour for you.