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The SeasonED RD is a podcast for all professionals in the field of eating disorders who want a “one-stop-shop” for the resources, the people, and the connections that matter. Whether you are newly seasoned (intern, student, or newer professional in the field) or well seasoned, this podcast is for you. Let’s learn together!
Episodes
Friday Jun 30, 2023
Abbi’s Pick - “Boundaries Do Not Equal Bitchy” [repost]
Friday Jun 30, 2023
Friday Jun 30, 2023
Alli Spotts-De Lazzer, CEDS-S LMFT is a skillful teacher here and in her book MeaningFULL about terminology and acronyms, types of therapists, types of specialties, and more.
She asks us as professionals to stop perpetuating the myth that eating disorders are about control and how setting boundaries brings the safety that is needed for true recovery.
A supervision nugget she received from Carolyn Costin about the importance of being AUTHENTIC.
And her passion for using the multidisciplinary treatment help each other “open our patients up” that brought our workshop to life – “Staying in Your Lane In The Scope of Practice Freeway”
Alli authored a great read, MeaningFULL: 23 Life-Changing Stories of Conquering Dieting, Weight, & Body Image Issues—a book of diverse stories with expert insights that can help readers to feel seen, validated, and hopeful.
Bio:
Alli Spotts-De Lazzer is a Licensed Marriage and Family Therapist, Licensed Professional Clinical Counselor, Certified Eating Disorders Specialist (CEDS), and iaedp-approved CEDS-Supervisor with a private practice in Studio City, Los Angeles. Since 2008, she's been speaking and publishing on eating disorders and mental health. A believer in service, she has co-chaired committees for the Academy for Eating Disorders and the International Association of Eating Disorders Professionals, facilitated an ongoing eating and body image support group, and created #ShakeIt for Self-Acceptance! - a series of public events that educate through fun and flash mob dance.
Inspired by both personal and professional experiences, Alli authored MeaningFULL: 23 Life-Changing Stories of Conquering Dieting, Weight, & Body Image Issues—a book of diverse stories with expert insights that can help readers to feel seen, validated, and hopeful.
Website: Therapyhelps.us
Shake-It for Self-Acceptance Flash Mob
With your host Beth Harrell
Saturday Jun 17, 2023
Kate’s Pick - BIPoC Eating Disorders with Whitney Trotter [Repost]
Saturday Jun 17, 2023
Saturday Jun 17, 2023
Whitney Trotter, MS, RDN/LDN, RN, RYT
This is a repost from last year's FIRST EVER BIPoC ED Conference. The 2nd annual is coming up soon, with early bird registration ending soon.
Topics Include:
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Eating Disorders in the Black community,
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Fat Liberation Panel
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Minority Myth in Asian American Culture and Adoption
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Antiracism training
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Religion, eating disorders and liberation
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Trans presenters
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Live panel on religion
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Ramadan in Islam and the intersection of eating disorders
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South Asians and eating Disorders
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Unsolicited Fattys
Whitney’s Seasonings:
Stay the course – if at first you don’t succeed
Volunteer to get your foot in the door of your passions (HIV and AIDS)
Always keep learning – next up Psych NP Doctorate
BIPoC Eating Disorders Conference Website
https://bipoceatingdisorders.showit.site/
Closed Captions and American Sign Language
BIO:
Whitney Trotter: (she/her) is dually licensed as a Registered Dietitian, Nurse, and yoga instructor. Whitney has over ten years of experience working as a registered dietitian serving the HIV/AIDS community, as well as working in the eating disorder field. Whitney also previously worked at a Level 1 Pediatric Trauma Center as a Pediatric emergency room nurse. In addition to working as an RDN and RN, Whitney has served as a member of her county's Rape Crisis Center. Her work at the Rape Crisis Center equipped her to co-found an anti-trafficking organization, Restore Corps, where she now provides medical training to the community focusing on human trafficking response. Whitney's career in the Eating Disorder field includes being a former Nutrition and Nursing director of a Residential, PHP, and IOP center. Whitney is also the owner/founder of Bluff City Health, a private practice specializing in bridging the gap in the eating disorder field of equitable care and social justice.
Friday May 26, 2023
You’re The Doctor - ”Figure It Out” [Medical Series]
Friday May 26, 2023
Friday May 26, 2023
Dr. Delia Aldridge, MD, FAPA, CEDS-S
There’s not a book for psychiatrists working with eating disorders
Doctors must know about refeeding syndrome
Helping parent who says “They had a PR yesterday, why do they need to be admitted?”
Dr. Aldridge says “If this was my kid, knowing what I know now, I would be scared for their life.”
Find people in your community – therapists, dietitians, primary care docs
ER –it took 5 years to train and find ER she could trust
Co-occurring - Fertility problems, OCD, Anxiety, depression, trauma,
Medications – what are pre-existing conditions, two that are FDA approved for eating disorders,
Wellbutrin contraindications for pts with ED
Vyvanse for BED – make sure full team - CBT and RD on the team (addiction, cardiac issues)
Prozac
Dr. Aldridge's Seasonings:
- Dr Mehler’s Medical Guidelines
- APA New guidelines (but it’s not much)
- We need to infuse our brains with food, medical, psych resources
- Handout on risk of refeeding
- Here’s my cell phone, text me
- https://www.feast-ed.org/info-for-parents/
Bio:
With your host Beth Harrell
Friday May 19, 2023
REPOST - Beth’s Pick - Can’t Just Webinar All The Time
Friday May 19, 2023
Friday May 19, 2023
Amanda Mellowspring, MS,RD/N,CEDRD-S trains professionals who are seeking Approved Supervisor status for the CEDS. She shares her supervision style with us, including how she taps into the ‘it’ factor of her supervisees and stated the way she learned best is through case collaboration with therapists and medical providers and multidisciplinary webinars (even though ‘we still have to work and can’t webinar all day’ DARN!)
Amanda runs a farm with lavender and bees (and more) and answers Abbi’s reflection that supervision for eating disorders care can feel like a BEAST.
Resources highlighted by Amanda:
Anita Johnston’s Eating in the light of the moon book.
“Health Food Junkie” Dr Bratman
Bio
Amanda is a Certified Eating Disorder Registered Dietitian and Supervisor through the International Association of Eating Disorder Professionals with over 15years of experiencing leading the treatment of eating disorders at various levels of care. Amanda currently serves on the Certification Committee for IAEDP and co-authored the publication defining the Standards of Practice and Standards of Professional Performance for RDs working with eating disorders in the Journal of the Academy of Nutrition and Dietetics.
Amanda is Vice President of Nutrition Services for Monte Nido & Affiliates, overseeing nutrition programming and services for Monte Nido programs, Oliver-Pyatt Centers, and Clementine programs across the country.
With your host Beth Harrell
Friday May 12, 2023
Your Story Makes Sense to Me
Friday May 12, 2023
Friday May 12, 2023
Dr. Jennifer Gaudiani
MCAS Simplified - Mast Cell Activation Syndrome
How to listen, treat the client first, chase down the science later
It’s not “Just Your Eating Disorder”
Impact of malnutrition and stress on the body. Malnutrition and stress will fuel MCAS
Some Signs of MCAS
- Reaction to alcohol (consumed and topical like hand sanitizer)
- More fatigued than peers after being in heat
- Artificial Scents - headache, stuffy
- Reaction to artificial dyes
- Rashes – flushing, itchy
- Drippy nose after eating
- Periods are rough – intense cramps, heavy bleeding
- Chronic constipation as a kid
Plain, everyday food can activate.
Mini screener
Treatment can be simple
Elemental shakes
Trigger avoidance
OTC meds.
Dr G’s Seasonings:
Blogs (there are FOUR on MCAS here)
Be careful for diet-y talk in Dr Google
Show up with fierce joy
Bio:
Dr. Gaudiani (she/her) is an eating disorders expert physician and the Founder and Medical Director of the Gaudiani Clinic. Board Certified in Internal Medicine, she completed her undergraduate degree at Harvard, medical school at Boston University School of Medicine, and her internal medicine residency and chief residency at Yale, where she won numerous clinical awards. Dr. Gaudiani moved to Denver in 2007, choosing Colorado with her husband because its emphasis on the outdoors, the incorporation of nature into daily life, and the importance of family activity time as it offered a great way to foster work-life balance. In 2008, she was one of the founding team members of the ACUTE Center for Eating Disorders at Denver Health. After seven great years there, she left as its Medical Director to pursue her vision of outpatient care, founding the Gaudiani Clinic. During her years at ACUTE, Dr. Gaudiani became a recognized internist for her work on the medical complications of eating disorders. Dr. Gaudiani’s book, Sick Enough: A Guide to the Medical Complications of Eating Disorders, was released via Routledge in October 2018.
With your host Beth Harrell
Saturday Apr 29, 2023
ARFID Conversations - ”Listen and Believe”
Saturday Apr 29, 2023
Saturday Apr 29, 2023
Dr. Kamila Cass, PhD, CEDS-S, (she/her/hers)
Dr. Cass tells us that our patients can FEEL when we believe them and that they need to know, so strongly, that they have a right to treatment no matter how many times they need it.
They have a right to be wrestling with their eating disordered cognitions- it's not their fault that these thoughts were there it's happening to them they didn't ask for them.
Mechanisms of ARFID (Avoidant Restrictive Food Intake Disorder)
- Fearing consequences of eating (how food will impact the way their body feels, vomiting, choking, how they will feel in their body)
- Lack of interest in eating – COVID and disruptions of waking and sleeping patterns
- Malnourished due to sensory sensitivity – unpleasant, narrow variety of food choices
They usually WANT to gain weight. Let's create a home where they feel safe and very believed. The full team is used: OT, PT, and RD in service of treating them where they need it most.
EDE-Q doesn’t work for ARFID
Why don’t clinicians BELIEVE what’s happening?
What’s happening in the brain?
ARFID – goes back to childhood, maybe infancy, maybe had a hard time eating back then.
Check out this episode of the SesaonED RD with Dr. Jenny Thomas on ARFID.
Dr. Cass’ Seasonings:
*Dr. Bulik’s research – Eating Disorders as a psycho-metabolic condition. Dr. Bulik’s episode.
*This is not just in the head, we need to believe and UNSHAME having a mental illness
*Patients can open up and do the very hard work when they are completely believed.
*Eating Disorders have little to do with poor parenting and everything to do with providing support and being an agent of change.
*Family-based treatment
*Have hope and with the same amount of courage our clients have,
*People do get better, leaning into the support of the community.
*Supervision!
Bio:
Dr. Kamila Cass, PhD, CEDS-S, completed her master’s and Ph.D. in clinical psychology at the University of Missouri-Columbia and her predoctoral psychology residency at the University of Colorado at Boulder. Dr. Cass has worked with eating disorders for many years, in several settings, including private practice, hospital programs, community clinics, and college counseling centers. Dr. Cass has also worked on a bariatric surgical team, designing the pre-surgical psychological evaluation process, and providing support to patients undergoing bariatric surgery. Dr. Cass has worked as a psychologist at the ACUTE Center for Eating Disorders and Severe Malnutrition for the past four years and is the lead developer of the ARFID Track, overseeing a multidisciplinary team of providers dedicated to providing individualized, evidence-based treatment to patients with ARFID. Dr. Cass is an Assistant Professor at the University of Colorado School of Medicine and is active in research and publishing and has been a featured speaker at national and international conferences for eating disorders.
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With your host Beth Harrell
Saturday Apr 22, 2023
You Don’t Look Anorexic
Saturday Apr 22, 2023
Saturday Apr 22, 2023
Erin Nicole Harrop, LICSW, PhD
What is it like to compare treatment received for anorexia nervosa when you're at the low end of the weight spectrum (“typical”) and then not at the lower end (“atypical”).
Dr Erin Harrop describes this experience, how they were treated and what it felt like. And then gives us professionals tips to do better.
- Believe your patient
- If you’re going to disbelieve, bring the same curiosity you would for low weight AN. Get specific, ask questions (pringles example)
- Acknowledge thin privilege and the social power differential.
It’s not just weight stigma that influences how we feel about our bodies, racism, sexism, homophobia, transphobia.
Explain “While I try, however imperfectly, to address the effects of weight stigma, nutrition work is never neutral – always taking a side on weight and wellness.
"Cheeseburger challenge" – may feel like a dare from my dietitian
Abbi asks an important question – “How do I do this weight inclusive work and honoring my thin privilege when it feels uncomfortable?”
Ignoring discrimination is a privilege of people with privilege
Ethical care acknowledges weight stigma.
Here's a way to tee-up a weight inclusive approach...
As a nutrition provider I don't focus on weight. “I’m going to make mistakes, I’m deeply committed to giving you the BEST, most ethical, MOST proficient care that I can, and I’m gonna keep showing up and IF something happens as we’re working together that makes you feel uncomfortable, please let me know because I’m learning too. I want to do the best I can to not cause further harm.”
What NOT to say, “I’m not going to let you get fat”
AND if we make mistakes we can (and should) repair.
Part of the healing is actually treating higher weight patients like eating disorder patients.
Article discussed today:
- You Don't Look Anorexic New York Times
Erin’s Seasonings:
- Believe your client
- Come with the same curiosity about food intake and activity regardless of weight
Bio:
Dr. Erin Harrop is an Assistant Professor at the University of Denver Graduate School of Social Work. Their research, teaching, and clinical work focuses on eating disorders, weight stigma, and promoting inclusive health/mental health care for people with marginalized identities.
https://socialwork.du.edu/about/gssw-directory/erin-nicole-harrop
With your host Beth Harrell
Thursday Apr 13, 2023
The Perfect Marriage of Medicine and Psychology [Medical Series]
Thursday Apr 13, 2023
Thursday Apr 13, 2023
Dr Gibson talks about eating disorders work as the marriage of medicine and psychology.
A lot of discussion about Atypical AN and insurance.
Dr .Dennis shares that at ACUTE, teaching is happening every day, incorporating many learners on the unit: medical residents, OT, PT, ST…
Physical changes are discussed, such as the amount of muscle loss and weakness that is significant in this population.
A call to all professionals who are well-intentioned but if not adapted to EDs, are doing harm.
What is Rhabdo?
ACUTE is studying weight disruptions, weight suppression.
Interoception – ability to recognize signals from the body, plays into functional GI symptoms.
Seizures from thiamine deficiency causing complications in the brain.
Most importantly, don't be afraid to reach out and ask
Bio:
Dennis Gibson, MD, FACP, CEDS serves as the Clinical Operations Director at ACUTE. Dr. Gibson joined ACUTE in 2017 and has since dedicated his clinical efforts to the life-saving medical care of patients with extreme forms of eating disorders and severe malnutrition. He has quickly developed an expertise in the treatment of this extremely ill and underserved population, and he is actively involved in several research initiatives to help identify evidence-based treatment best practices to address the serious medical complications of eating disorders. Dr. Gibson is also an Associate Professor of Medicine at the University of Colorado School of Medicine. He completed his undergraduate degree at Albion College in Michigan and earned his medical degree at Southern Illinois University. He completed his internal medicine residency at University of South Florida, is Board certified in Internal Medicine and earned the prestigious CEDS credential from iaedp, underscoring his commitment to effective care and clinical excellence in the treatment of eating disorders.
With your host Beth Harrell
Friday Apr 07, 2023
Welcome to the ARFID PARDI
Friday Apr 07, 2023
Friday Apr 07, 2023
What is Avoidant Restrictive Food Intake Disorder?
Restriction without body image
What would cause someone to restrict food if it wasn’t to change the body?
Phenotypes described - Three types can occur in same individual
- Sensory sensitivity presentation – textures
- Trauma – vomiting, choking, pain in belly
- Lack of Interest – “I forget to eat”, don’t get hungry and get full quickly
(ARFID Plus)
What works? - Exposure therapy, Cooking therapy, sometimes speech therapy, eating at regular times, the body will come to expect that.
Division of responsibility doesn’t match this diagnosis. Enough preferred foods first so enough calories, then slowly introduce variety.
CBT-AR – patients will report hunger simply from the act of eating. Develop a cadence of appetite.
What does CCK have to do with this?
NIMH study –Adults with ARFID 2022-2027
Dr. Thomas’ Seasonings:
Organizations
- Academy for Eating Disorders (AED, organization for professionals) — https://www.aedweb.org/home
- Feeding Matters (organization for families) — https://www.feedingmatters.org
Books about ARFID
- Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder (treatment manual)
- Picky Eater’s Recovery Book (CBT self-help book for adults)
Assessments for ARFID
- PARDI (clinical interview for ARFID; click on “supporting information” at this link for a copy of the full interview) — https://onlinelibrary.wiley.com/doi/10.1002/eat.22958
- PARDI-AR-Q (self-report screening questionnaire for ARFID) — https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00706-7
Opportunities for participation in ARFID research studies
- Neurobiological underpinnings of avoidant/restrictive food intake disorder in adults — https://rally.massgeneralbrigham.org/study/answer
Bio:
Dr. Jennifer Thomas is the Co-director of the Eating Disorders Clinical and Research Program at Massachusetts General Hospital, and an Associate Professor of Psychology in the Department of Psychiatry at Harvard Medical School. Dr. Thomas’s research focuses on avoidant/restrictive food intake disorder and other atypical eating disorders, as described in her books Almost Anorexic: Is My (or My Loved One’s) Relationship with Food a Problem?; Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults; and The Picky Eater’s Recovery Book: Overcoming Avoidant/Restrictive Food Intake Disorder. She is currently principal investigator on several studies investigating the neurobiology and treatment of avoidant/restrictive food intake disorder, funded by the U.S. National Institute of Mental Health and private foundations. She is the author or co-author of more than 160 scientific publications. She is the current President of the Academy for Eating Disorders and recently completed a 5-year term as Associate Editor for the International Journal of Eating Disorders.
With your host Beth Harrell
Friday Mar 31, 2023
Parent Relationship Can Be Such a Protective Factor
Friday Mar 31, 2023
Friday Mar 31, 2023
Scout Silverstein, (They/Them)
Happy International Transgender Visibility Day!
Today’s conversation with Scout Silverstein helps give us supportive language for our clients and their loved ones around gender affirming care.
Care notes include asking preferred pronouns and settings to use them.
Exploration vs Current/Asserted Gender.
Parents wonder if it’s a phase. Scout shares about “Regret Rates”
Look at the medical profile with care: bone density, labs, anatomy, chromosomes, menstruation, hormones
Abbi asks about body positivity, Scout proposes body neutrality and body liberation
Cognitive dissonance interventions.
The FEDUP Conference – See below for discount code, through May 1.
“Holding more possibilities”
Scout’s "Seasonings":
Minus 18.org – app to help us practice scenarios
MEDA Conference
Favorite books:
- Being mortal
- Prison by any other name
- Saving our lives
- Fiction - The Story of Edgar Sartell, by DavidWroblewski,
BIO:
Scout is a transgender and intersex queer Virgo with an educational background in health policy & public health. Within the eating disorder field, they focus on staff development training, academic research, case consultations, policy, and intervention design. They center their time outside of the eating disorder field working on legislation to protect intersex bodily autonomy, spoiling their rescue dog, and learning from the narratives of those surrounding them.
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We are proud to support the FEDUP Conference taking place in hybrid form May 25-27, 2023. The in person portion will be held in New York City at The Martinique Hotel. In the field of eating disorders, there is often a large disconnect between researchers, advocates, clinicians, and those we provide care for. This is a conference for researchers, advocates, and clinicians in the eating disorder field where all attendees are empowered to participate, share their expertise, and learn from one another so that we can incorporate approaches that work - for our patients, our communities, and ourselves. This conference is unique in that all sessions are completely participatory rather than delivered in lecture form. You can register here using the discount code "SEASONEDRD" for 30% off your registration until May 1.
With your host Beth Harrell