Communication between physicians and patients with suspected or diagnosed binge eating disorder.
BACKGROUND
Physician-patient conversations were examined to identify barriers to effective discussions about binge eating disorder (BED) arising from discrepancies in how physicians and patients communicate about BED.


METHODS
Conversations between suspected or diagnosed BED patients (n = 38) and psychiatrists (n = 11) were recorded and the transcripts were reviewed for BED-related lexical terms using automated conversation analysis software. Researchers disambiguated multivalent terms and combined similar terms.


RESULTS
The results showed that psychiatrists evaluated some diagnostic criteria (e.g., the absence of compensatory behavior) but not others (e.g., eating more rapidly than normal), focused more on symptoms in relation to weight and generally discussed weight-related issues more often than did patients, and asked about the type of food consumed more often than the diagnostic criterion related to the quantity of food consumed. In contrast, patients used terminology that attempted to clarify the relationships between feelings, coping strategies, and compulsion to binge eat when discussing binge eating episodes.


CONCLUSIONS
These findings suggest that educational materials promoting more effective physician-patient dialogues regarding eating behaviors in general, and BED specifically, may be beneficial. Conversations should highlight the BED diagnostic criteria, assessment of patients' emotions and sense of lack of control, and relationships between body weight and BED.
a 1 Department of Psychiatry and Institute for Women's Health, Virginia Commonwealth University , Richmond, VA 23219, USA.
Susan G
SG
Kornstein
Paul E
PE
Keck
Barry K
BK
Herman
Rebecca M
RM
Puhl
Denise E
DE
Wilfley
Ilyse D
ID
DiMarco
D000328:Adult; D056912:Binge-Eating Disorder / Q000175:diagnosis / Q000523:psychology; D002032:Bulimia / Q000523:psychology; D003144:Communication Barriers; D003192:Compulsive Behavior / Q000175:diagnosis / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004644:Emotions / Q000502:physiology*; D005260:Female; D063427:Food Quality; D006801:Humans; D007406:Interview, Psychological / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000523:psychology*; D010817:Physician-Patient Relations; D011570:Psychiatry; D000068356:Self-Control; D009626:Terminology as Topic
Binge eating disorder; conversation; evaluation gaps; patient; psychiatrist