EDeology: The People Behind Today's Eating Disorder Treatment Landscape

The most fundamental question in treating eating disorders is “What works?” Eating disorders are so painful and can be so fatal; we want to use the treatment that has the best chance of giving our clients their lives back. We live in a time when empirical observation can be used to answer this question as more and more research studies examine the effectiveness of various interventions.  Family-Ba...

What happens when someone with a high acuity eating disorder needs more support than can be provided in outpatient settings, but refuses a higher level of care? Considering the high mortality rate of eating disorders, this question can quite literally be a matter of life and death. In a previous episode on harm reduction, we discussed the value of meeting clients where they’re at and how high-risk...

What is an eating disorder? We know it can involve symptoms such as food restriction, binge eating, or purging behaviors. But what underlies these behaviors? What causes an eating disorder, and how do we treat it? These are questions that do not have a universal, clear-cut answer.  Is an eating disorder a coping strategy developed in response to trauma, an attempt for control, a cry for help, a re...

If you’ve had a client who has been through multiple treatments, tried countless medications, received diagnosis after diagnosis—bipolar disorder, borderline personality disorder, depression, eating disorder—leaving their treatment team confused and unable to find a path that sticks, it might be dissociative identity disorder (DID). Many people with DID go years, even decades, cycling through the...

Does weight affect health? For many years, the scientific and medical communities assumed the answer to this question as an obvious yes. After all, studies show correlations between higher BMI (body mass index) and various medical conditions, one of which—PCOS—is the topic of today’s episode. When we look at studies showing a correlation between weight and PCOS or other medical conditions, two key...

There’s a stereotype that eating disorders are a young woman’s illness. Many treatment centers cater primarily to young people, and even adult treatment centers often have a predominantly young adult population. As a result of this, when someone experiences an eating disorder in midlife or later, they may face not only the challenges and stigma of the diagnosis but also a sense of isolation, feeli...

Periodically, I come across social media posts or comments questioning the legitimacy of work by a non-credentialed author, healer, or influencer. These questions stem from the fact that, as mental health becomes increasingly recognized as its own discipline, standards are developed to monitor and legitimize it. Academic degrees and clinical licensure help ensure credibility, ethical standards, an...

As we learn and grow, we also begin to recognize the inadequacies of what we once believed. For healthcare professionals, this realization comes with the added weight of knowing that our past lack of knowledge may have hurt the people we worked with and cared for.  In the eating disorder recovery field, there is an increasing movement away from restrictive dieting as research emerges showing that...

Eating disorders can be deadly. They have some of the highest mortality rates among mental illnesses, both as a direct result of medical complications and the increased risk of suicide. Because of this, clients with severe symptoms often require continuous support and medical monitoring that can only be provided in higher levels of care. Active suicidality and severe malnutrition can warrant hospi...

Does food choice affect mood, energy level, and quality of life? Are some foods healthier than others? Do whole foods, processed foods, and ultra-processed foods impact the body differently? What constitutes a healthy diet—if such a thing even exists? In the eating disorder recovery community, these questions have become highly charged and controversial. Many professionals in the field, having see...

Dissociative identity disorder (DID) is a condition in which an individual's personality fractures in response to extreme trauma. It is often portrayed in its most extreme and obvious iterations and is thought to be so rare that a clinician is unlikely to encounter it throughout their career. Because it has been designated to the realm of niche expertise, very few clinicians recognize DID when the...

In eating disorder treatment settings, meal plan compliance is often used as the objective measure of safety and recovery, which then determines readiness to step down to lower levels of care. It follows that meal plan non-compliance is assumed to be a form of treatment resistance. The reality, however, is that meal plan non-compliance is not always a sign of resistance but can also indicate a mis...

Traditional medical and dietetic rhetoric around the relationship between food, weight, and health emphasizes correlations between BMI range and medical conditions. However, it often fails to consider how these correlations are interpreted and how they subsequently impact individual patients and society. In this episode, Laura Cohen shares her personal journey as a former registered dietitian trai...

In this episode, I explain what this podcast is, why I created it, and how future episodes will be structured. The eating disorder professional world has become so politically and ideologically charged.  Issues related to food, health, body image, disordered eating, and the impact of these on marginalized communities spark heated debate among ED treatment clinicians and researchers. Many of us hav...