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EDeology: The People Behind Today's Eating Disorder Treatment LandscapeCan Intentional Weight Loss Be Body Positive?Perhaps the single most charged issue in eating disorder recovery is intentional weight loss. In the general population, we know based on research that the long-term success rates of intentional weight loss diets are abysmally low. In the world of eating disorder recovery, not only are the success rates low, but so many people have been deeply harmed by diet culture.For so many in this field, the very idea of intentional weight loss brings up all of the fatphobic and destructive messages they've received throughout a lifetime and a history of feeling at odds with and...2025-06-051h 15EDeology: The People Behind Today's Eating Disorder Treatment LandscapeHarm Reduction: Colluding with the Eating Disorder or Connecting with the Person Beneath It?Many traditional approaches to eating disorder treatment focus primarily on behaviors such as meal plan compliance, and strategies that aim to support and reinforce these behaviors. In higher levels of care, and some outpatient settings, the goal is to make eating disorder behaviors non-negotiable. This may be accomplished through contingency management, where access to certain privileges depends on meeting specific behavioral expectations.In this model, the eating disorder is the enemy that sabotages a person's life and medically compromises their health. Clinicians and clients are positioned as working together to challenge this enemy by reinforcing m...2025-05-291h 06EDeology: The People Behind Today's Eating Disorder Treatment LandscapeI Spent 15 Years in Overeaters Anonymous—Here’s Why I LeftFood addiction: does it exist or not? Is it helpful or harmful? Does science support it or disprove it? These questions have become so polarizing, especially in the eating disorder and substance abuse communities, where people often take a hard yes or no stance.In this podcast, we look at it differently.The fact that there are such strong, diverging opinions on this topic is the best indication that both experiences are real. There are people who are helped by the food addiction model and people who are harmed by it. Otherwise, why would so...2025-05-221h 05EDeology: The People Behind Today's Eating Disorder Treatment LandscapeUltra-Processed Food Addiction: What It Is, What It’s Not, and Why It MattersDoes food addiction exist?This question is the topic of heated debate within the eating disorder recovery community.We know that binge eating and compulsive overeating can share some characteristics with substance use disorders, such as loss of control, repeated unsuccessful attempts to quit, and continued use despite negative consequences.However, the question is whether this loss of control around food is the body’s response to food restriction, as is often the case with chronic dieting and binge eating disorder, or the result of disinhibition, similar to patterns seen in substance use di...2025-05-151h 19EDeology: The People Behind Today's Eating Disorder Treatment LandscapeMeeting What's in the Room: Dietician Trained in Internal Family Systems and Somatic ExperiencingIn the West, medical treatment tends to be highly specialized. In eating disorder recovery, dietitians are typically responsible for specifying and monitoring clients' food intake. Therapists are responsible for helping clients build coping skills and navigate their internal worlds. Psychiatrists or nurse practitioners are responsible for prescribing psychiatric medication and monitoring medical risk. And so on...However, human beings are not easily compartmentalized. It is near impossible to change physical health behaviors without navigating a person's emotional reality, and vice versa.In this episode, Tracy Brown talks about meeting what's in the room with clients...2025-05-151h 07EDeology: The People Behind Today's Eating Disorder Treatment LandscapeGLP-1s: The Good, the Bad, and the UglyGLP-1s, such as Ozempic, Wegovy, and Mounjaro, are a class of medications originally developed to treat type 2 diabetes. More recently, they've become a hot topic in the mainstream for their weight loss effects. A quick Google search brought up the following headlines:“Weight loss is finally easy with a prescription to GLP-1 medication” “Join 100,000+ patients and transform your health, body, and life”.“A natural approach to medicine”Media and marketing promote these medications as the key to finally feeling at home in your body.Eating disorder recovery profe...2025-05-021h 06EDeology: The People Behind Today's Eating Disorder Treatment LandscapeEvidence Based Treatment is Flexible and Compassionate: DBT and FBT for Eating DisordersThe 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-Based Treatment (FBT), sometimes referenced as the gold standard for treating eating disorders, is a manualized treatment that gives parents the responsibility for restoring their child's weight and managing eatin...2025-04-281h 13EDeology: The People Behind Today's Eating Disorder Treatment LandscapeTherapists have boundaries too: A conversation about treatment contracts and ultimatumsWhat 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 behaviors can, and sometimes must, be mitigated in outpatient settings, especially for those with treatment trauma.In this episode, we explore the flip side: the im...2025-04-1758 minEDeology: The People Behind Today's Eating Disorder Treatment LandscapeYour eating disorder is not your enemy: Understanding embodied recoveryWhat 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 response to societal pressures, or a biological susceptibility triggered by food restriction. Is an eating disorder about food and body image or some deeper biopsychosocial dynamic? How we...2025-04-101h 10EDeology: The People Behind Today's Eating Disorder Treatment LandscapeThe Reality of Living with Dissociative Identity DisorderIf 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 mental health system without a clear understanding of what’s really happening. In a previous episode with Annie Goldsmith, we discussed how DID is far more common—and less dramatic—than how it's often portrayed. In this episode, Monica Ostroff takes...2025-04-031h 05EDeology: The People Behind Today's Eating Disorder Treatment LandscapeWeight loss didn’t cure my PCOSDoes 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 questions arise:1. Does weight cause the condition, or is there a third variable that influences both weight retention and the condition?2. Are the treatment recommendations based...2025-03-311h 06EDeology: The People Behind Today's Eating Disorder Treatment LandscapeEating Disorders Happen in Mid-Life TooThere’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, feeling as though others in their age group don’t share their struggle. The reality, however, is that eating disorders can affect people of any age. In this episode, Betsy B...2025-03-201h 00EDeology: The People Behind Today's Eating Disorder Treatment LandscapeCoaching, Spirituality, & Alternative Paths to HealingPeriodically, 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, and accountability. Scientific study moves therapy from the subjective experience of the practitioner to empirical observations of an intervention’s effectiveness. Seeking mental health treatment puts a person in the vulnerable position of sharing their most raw and painful experiences with a stranger. Al...2025-03-1358 minEDeology: The People Behind Today's Eating Disorder Treatment LandscapeI want to help people not have to suffer in the way I did: A Dietitian's Journey from Restrictive Dieting to Intuitive EatingAs 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 restrictive diets are unsustainable and often damaging. For a dietitian, the challenge of making this shift is often twofold: both personal and professional. How does a person navigate a shift that i...2025-03-0656 minEDeology: The People Behind Today's Eating Disorder Treatment LandscapeUsing harm reduction to treat suicidality and high-risk behaviorsEating 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 hospitalization, sometimes involuntary hospitalization.But what happens when patients have experienced treatment trauma in higher levels of care? This question is especially painful in light of stories of abuse emerging from some of the larger treatment...2025-03-031h 12EDeology: The People Behind Today's Eating Disorder Treatment LandscapeDoes food choice affect health and well-being?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 seen firsthand the harm caused by restrictive weight loss diets, adopt an "all foods fit" approach, emphasizing that any and all foods can provide nutrients and fuel for the body. Others argue that ignoring th...2025-02-201h 11EDeology: The People Behind Today's Eating Disorder Treatment LandscapeDissociative Identity Disorder is more common than we were taughtDissociative 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 they do encounter it. As a result, people with comorbid dissociative and eating disorders may cycle through treatment centers without receiving appropriate care.In this episode, registered dietitian Annie Goldsmith shares how she...2025-02-131h 04EDeology: The People Behind Today's Eating Disorder Treatment LandscapeNot all meal plan non-compliance signals treatment resistance: Accommodating autism in eating disorder treatment
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 mismatch between the meal plan and the unique characteristics of the person prescribed it.
In this episode, registered dietitian, Brenna Veles, discusses how traditional eating disorder recovery...2025-02-0651 minEDeology: The People Behind Today's Eating Disorder Treatment LandscapeWhat I wish weight loss providers understood: An ex-dietician's journey from a diet to anti-diet approach to wellnessTraditional 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 trained in a weight-centric environment and parent of a loved one with an eating disorder who was harmed by many of the messages she was taught would promote health and well-being.Laura serves as a lead family mentor with Equip, which provides evidence-based...2025-01-3046 minEDeology: The People Behind Today's Eating Disorder Treatment LandscapeCan a clinician treat disordered eating while themself in active recovery?Can a clinician treat eating disorders while themselves in active recovery? Many of us in the eating disorder recovery field have our own lived experience. It follows that, just like for our clients, recovery is often nonlinear, clinicians are no exception.
What happens when a clinician experiences a relapse? Can they still be trusted to effectively treat clients whose symptoms, in some ways, mirror their own? Will they be triggered by their clients' symptoms?
In this episode, psychotherapist Lucie Waldman shares her experience grappling with these questions and the conclusions she has reached.2025-01-2753 minEDeology: The People Behind Today's Eating Disorder Treatment LandscapeIntroduction to EDeologyIn 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 have personal recovery experience and care deeply about these issues. We've experienced the harm caused by dominant narratives firsthand and want to make a change.
EDeology is a space for d...2025-01-0718 min
Neshamos.org Podcast: Stories of Hope and HealingSoul Substance (feat. Elka Cubacub)Elka (Malamud) Cubacub is a yoga teacher and Psychology student born and bred in Chicago, where she currently resides with her husband and daughter.
For years, Elka struggled with Bulimia/Binge Eating Disorder that first began when she attended seminary in Israel. As she struggled with restrictive eating habits and bingeing compulsions, she began to understand that at the root of her unhealthy behaviors were underlying emotions and a sense of disconnect. What followed were years of ups and downs as she delved deeper into her inner self, weathered bouts of depression and disordered eating, and began the journey toward...2021-02-011h 12