Communication between physicians and patients with suspected or diagnosed binge eating disorder

Abstract

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. Conclusion. 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.

Keywords:

• Binge eating disorder
• patient
• psychiatrist
• conversation
• evaluation gaps

Acknowledgments

This work was supported by the sponsor, Shire Development LLC (Wayne, PA), and was conducted by Verilogue, Inc. (Horsham, PA). Verilogue’s role in the research included recruiting physicians to record their conversations, ensuring physician participation once recruited, collecting and maintaining submitted conversations in a database, and analyzing conversations using proprietary software and sociolinguistic methods. Shire Development LLC provided funding to Complete Healthcare Communications, Inc., (Chadds Ford, PA), for support in writing and editing this manuscript. Under the direction of the authors, Stefan Kolata, PhD, and Craig Slawecki, PhD, employees of Complete Healthcare Communications, Inc., provided writing and formatting assistance for this manuscript. An employee of Verilogue, Inc. also reviewed the manuscript for accuracy. The content of this manuscript, the ultimate interpretation, and the decision to submit for publication in Postgraduate Medicine was made by the authors independently.

Declaration of interest

This work was supported by Shire Development LLC (Wayne, PA), and was conducted by Verilogue, Inc. (Horsham, PA). Shire Development LLC provided funding to Complete Healthcare Communications, Inc. (Chadds Ford, PA), for support in writing and editing this manuscript. SG Kornstein receives research support from Forest, Pfizer, Allergan, F. Hoffmann-La Roche, and Bristol-Myers Squibb; serves as a consultant for Shire, Pfizer, Lilly, Takeda, and Allergan; and receives royalties from Guilford Press. PE Keck has been a principal/coinvestigator on research sponsored (presently or in the past year) by Alkermes, AstraZeneca, Cephalon, GlaxoSmithKline, Eli Lilly, the Marriott Foundation, NIMH, Orexigen, Pfizer, and Shire and a consultant (in the past 3 years) for Alkermes, Bristol-Myers Squibb, Forest, Merck, Otsuka, ProPhase, Sunovion, Shire, Supernus, and Teva. BK Herman is an employee of Shire and holds stock/stock options in Shire. RM Puhl serves as a consultant for Shire and Novo Nordisk. DE Wilfley receives research support from Shire and United Healthcare. ID DiMarco serves as a consultant for Shire. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

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