It’s been more than a week since I’ve returned from the International Academy of Eating Disorders annual conference (though returned is really a silly word as it was only 12 miles from my house this year), and I’m finally able to sit down and gather my thoughts about it. If you’ve never been, even if you’re not a clinician, I highly recommend. There is a lot of advocacy and research there and many things to learn. Next year it’s going to be in Prague! I certainly won’t be able to go, but I was psyched to have an opportunity to go this year as it was in San Francisco. With two littles at home, big travel is hard.
There were a few main themes ICED 2016 (International Conference of Eating Disorders) that were floating around:
Eating disorder research and treatment vs. obesity research and treatment. Wow. There was serious, serious controversy there. This is because obesity researchers as well as state funded grants (think NIH) are still using ideas such as food restriction, caloric restriction and BMI to measure recovery. All eating disorder clinicians and researchers have evidence that all of this, dietary restriction, BMI, “weight management” and dieting all lead to disordered eating patterns. Obesity researchers believe that obesity has to be treated because it leads to heart disease, Type II diabetes, etc. But Eating Disorder researchers and clinicians (and me too!) believe that when you focus on the obesity as the health problem, you are doing a disservice to the patient – you should be focusing on health and treating the specific disease. “Treating Obesity” continually leads to failure. Obesity isn’t a disease, but heart disease is.
Next off we discussed ADVOCACY a whole lot. People often think of eating disorders as a white woman’s disease, but the truth is that EDs hit not just white women, but women AND MEN across all races. In fact, Latina women have a higher incidence of eating disorders than white women. But most people of color or folks who aren’t cisgender tend to shy away from treatment – for many reasons. It’s not accessible (affordable), it’s not relatable- treatment is geared toward one gender and one race, and it’s stigmatized and unsupported by family and community. For instance, many years ago I had a client who, despite the fact that she had a horrific case of bulimia, her family would not support her treatment because they said it was a “white women’s disease.” She did come in for treatment and got great support from our treatment center and the treatment community but not from her family or her own community. This is not an uncommon situation. The fact that she came in for treatment is really fantastic, but most people don’t. The conference spoke a lot about getting it out there that EDs strike everyone everywhere and nobody should be ashamed to try and get help. And, as a community of ED professionals- we have to provide more help in different and more accessible ways. So lots to do there. And a note, if you are a human being who is not a white woman and you are suffering from an ED- please do reach out (you can even reply to this post) and I’ll point you in the right direction for treatment- thanks to this conference I have some really great resources now.
I met some of my heros of Eating Disorders, like Deb Burgard – and I was really seriously starstruck and took a selfie with her- it was more exciting to me than meeting say Johnny Depp (but honestly that would excite me too). If you don’t know about Deb, please click her name above and check out her work. She is a brilliant Psychologist, speaker and advocate for size diversity and Health at Every Size. I also got to meet Lizabeth Wesely-Casella from Bingebehavior.com – (have you read that blog? It’s awesome). And that was really exciting as well. Such amazing people do this work – it’s good work, and it’s hard work.
Body Positivity – A lot of people ask me why as a a clinician treating Eating Disorders I advocate for Health at Every Size and why it’s important. The answer is easy- almost every eating disorder started with a diet. If we can eradicate people being told that they are not good enough and they need to diet, we can deeply change the internalized messages that dieting is the only way out – we then allow people to live in bodies that were meant for them. Those bodies might be big or they might be small- but what we want them to focus on is their true health. True health isn’t about getting on a scale to measure your health. It’s about giving your body what it needs- good healthy food and good healthy movement (where you can), but of course movement and exercise can be difficult for those in larger bodies because of the social stigma. So it’s all very challenging and there needs to be a lot more kindness and acceptance out there. And the obesity paradox actually says that people in the “overweight” BMI category live longer and are healthier. So there you go. There’s no good science around these debates yet.
Body Image – The body image part was interesting. I talked to a lot of different experts on it. The consensus is really that body image is deeply ingrained and that we should be working on prevention more than anything else. The body project is a good example of that kind of early intervention.
I went to a ton of neuropsych panels that were fascinating, but I’ll metabolize them into a different and accessible post soon enough.
Eating disorders are notoriously difficult to both treat and understand, but people are working really hard to make it happen and to find help for those suffering. Fortunately many people have gotten to the other side of their EDs and recovery is possible. If you need help, please reach out, you can reply to this post, email me directly or go directly to NEDA or call 800-931-2237.