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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
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
![The Perfect Marriage of Medicine and Psychology [Medical Series]](https://pbcdn1.podbean.com/imglogo/ep-logo/pbblog11197775/episode_89-DennisGibson-SRD_300x300.jpg){kind=logo}
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
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
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
Friday Mar 17, 2023
Friday Mar 17, 2023
"I wish I would have known there was another way to help people heal"
Her nuggets for us as professionals today include:
- How she knew she had eating problems but was missed by a therapist who said she was ok because she wasn’t throwing up and “looked ok”
- How she wants everyone to know that restrictive eating to lose weight can cause infertility
- How important it is to surround ourselves regularly with other professionals
- Addressing the criticism that Intuitive Eating (IE) can’t be used for eating disorders, (see also Christy Harrison’s Food Psych podcast recording with Elyse about using IE for eating disorders).
Finally, her new journal is coming out, with a book signing THIS weekend if you are near LA or looking for a good reason to visit, and although this journal and the IE program is for consumers, this is a call to all professionals to do our own work through practicing IE in our own lives.
Book signing - Saturday, June 12th at 12:30 The link to sign up is: https://bit.ly/3wTQgv1
ASDAH Health Sheets - https://haeshealthsheets.com/the-health-sheet-library/
Elyse Resch, MS, RDN, CEDRD-S, Fiaedp, FADA, FAND, is a nutrition therapist in private practice in Beverly Hills, California, with thirty-nine years of experience, specializing in eating disorders, Intuitive Eating, and Health at Every Size. She is the co-author of Intuitive Eating, now in its 4th edition, the Intuitive Eating Workbook, and The Intuitive Eating Card Deck—50 Bite-Sized Ways to Make Peace with Food (upcoming, 2021). Elyse is also the author of The Intuitive Eating Workbook for Teens and The Intuitive Eating Journal—Your Guided Journey for Nourishing a Healthy Relationship with Food (upcoming, 2021), and a chapter contributor to The Handbook of Positive Body Image and Embodiment. She has published journal articles, print articles, and blog posts. Elyse does regular speaking engagements, podcasts, and extensive media interviews. Her work has been profiled on NPR, CNN, KABC, NBC, KTTV, Los Angeles Times, AP Press, KFI Radio, The New York Times, USA Today, and The Huffington Post, among others. Elyse is nationally known for her work in helping patients break free from diet culture through the Intuitive Eating process. Her philosophy embraces the goal of developing body liberation, with the belief that all bodies deserve dignity, and reconnecting with one’s internal wisdom about eating. She supervises and trains health professionals, is a Certified Eating Disorder Registered Dietitian and Supervisor, a Fellow of the International Association of Eating Disorder Professionals, and a Fellow of the Academy of Nutrition and Dietetics.
With your host Beth Harrell
Friday Mar 10, 2023
Friday Mar 10, 2023
Meghan Foley, RD, CEDRD-S
Meghan shares her style when working with clients at the highest level of care for eating disorders.
“Being a dietitian in this field is the best of both worlds.”
Statements like “This isn’t going to get easier until you just do it” and “We have to feed you through this” help us know our decisions as RDs won’t be popular but can immobilize and heal.
Third voice here is Janice Baker – link to her episode
Lean on other RDs in clinical settings
Monthly supervision with Dr Mehler
IBW is such an antiquated thing – pt at 120% based on conventional wisdom is actually 70%
Those with AAN are still at risk for bradycardia, SMA syndrome, nausea vomiting, pain with eating, refeeding syndrome
Please remember, Sweets are ok, including for those with diabetes.
Testing for allergies is important to confirm the need to remove certain foods from the diet and to create the food heirarchy.
Webinar March 23rd, 2023- Journey to the levels of care
https://www.acute.org/journey-through-levels-care-acute-mccallum
Meghan’s Seasonings:
*Dr. Mehler’s Book (link)
*Dietitians need to stay together and help each other
*Hold a boundary with sharing things like calories and weight numbers
*There’s always room to fix a rupture
*This isn’t going to get easier until you just do it
*We have to feed you through this
Bio:
Meghan Foley, RD, CEDRD-S, is the Clinical Nutrition Manager for ACUTE, where she has become an expert in using medical nutrition therapy to help treat severe eating disorders.
As Clinical Nutrition Manager for ACUTE, Meghan continues to cover a clinical caseload as part of her job responsibilities. Her years at ACUTE have allowed her the opportunity to become an expert in using medical nutrition therapy to help treat severe eating disorders, work on research projects with Dr. Philip Mehler and other members of the multidisciplinary team and assist in the continued growth and expansion of ACUTE. Additionally, she has earned iaedp’s prestigious CEDRD-S credential, which confirms Foley’s extensive experience as a nutrition therapist, her commitment to stay abreast of current developments in the field through Continuing Education, and compliance with iaedp’s stated Ethical Principles.
Tour of ACUTE https://www.youtube.com/watch?app=desktop&v=A_X7L_PKjM0
With your host Beth Harrell
Saturday Mar 04, 2023
Saturday Mar 04, 2023
Dr. Phillip Mehler, MD, CEDS
Eating disorders are mind-body Illnesses and are curable.
“Remember, I’m a medical provider not a mental health provider”, however, medical providers can help reduce shame
You can no longer applaud any weight loss – medical complications are happening at all sizes.
This field is burgeoning – there are new opportunities, new research, and new findings all the time.
Dr. Mehler’s Seasonings:
It takes several bites of the apple – never give up hope
Professional alignments – expect much from each other and share resources.
Book: Eating Disorders: A comprehensive guide to medical care and complications, 4th edition
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Dr. Philip Mehler founded the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health and continues to serve as its Chief Executive Officer. He began his career at Denver Health more than 30 years ago and was formerly its Chief of Internal Medicine. He was Denver Health’s Chief Medical Officer (CMO) for 10 years until he was promoted to its Medical Director, a position he held until his retirement in 2014. He is also the Glassman Professor of Medicine at the University of Colorado School of Medicine and has conducted research into the optimal medical treatment of the most severe cases of Anorexia Nervosa and Bulimia. Dr. Mehler has authored more than 500 scientific publications, including three textbooks published by Johns Hopkins University Press and with a fourth edition slated for release later this year. Dr. Mehler was the recipient of the Academy of Eating Disorders 2012 Outstanding Clinician Award, has been recognized among the “Best Doctors in America” for the past 22 years in a row, and was voted the “Top Internal Medicine physician in Denver” multiple times by 5280 Magazine. Dr. Mehler is a member and fellow of the Eating Disorders Research Society and the Academy of Eating Disorders, as well as a member of the editorial board of the International Journal of Eating Disorders and serves as the Senior Editor of The Journal of Eating Disorders. He has lectured extensively on a national and international level as the leading medical expert on the topic of the medical complications of eating disorders.
Friday Feb 24, 2023
Friday Feb 24, 2023
Delaney Wesselink, PT, DPT, CEDS
*Sometimes just being with our patients and listening is what's needed
*This patient population is fragile - forward fold to compression fractures?
*Evidence based activity for eating disorders is discussed and isn't for everyone
*Assessing strength, balance, fall risk.
*Listen to pause and rethink common phrases we use to motivate patients
*empathy - "It's so hard to be in a brain that tells me I have to exercise for my mind to quiet down."
*What happens with over exercise and the microtears in muscle that you don’t have nutrition reserves to repair?
Delaney’s Seasonings:
*link to Michelle Laging episode
*Keep articles handy to share with patients
*Advice to newer professionals - Don't be so hard on yourself
*Sitting and talking is way more valuable than “OK great, let’s work on strength”
Articles from Delaney:
- Medical and physiological complications of exercise for individuals with an eating disorder: A narrative review
- Structural and functional changes in skeletal muscle in AN
- Soft Tissue and Bony Injuries in Yoga
- Reduced Bone Strength and Muscle Force
- Effects of exercise on bone mass
Bio:
Originally from Boise, Idaho, Delaney received her BS in Exercise Science at the University of Montana in Missoula, MT. Expanding upon her love for the mountains, she pursued her Doctorate in Physical Therapy at the University of Colorado at the Anschutz Medical Campus, and has since made Denver her home. Delaney began her career working in pediatrics with children with developmental disabilities, although she has always had a passion for inpatient rehabilitation and acute care. Delaney is an avid snowboarder, soccer player, and outdoor enthusiast. She strives to teach patients to honor their bodies through movement while creating a healthy and meaningful relationship with exercise.
https://www.denverhealth.org/services/acute-center-for-eating-disorders
With your host Beth Harrell
Friday Feb 17, 2023
Friday Feb 17, 2023
Sumner Brooks, MPH, RDN, CEDRD
Topics include:
Always remember there’s more that we don’t know. We're always making mistakes.
How many people are suffering?!? – Weight loss (or requiring kids to eat vegetables) will never be the answer to well-being and happiness.
3 keys in "How to Raise an Intuitive Eater"
- Unconditional love and support for your child’s body - emotional
- implement flexible and reliable feeding routine – technical
- Develop and use your own intuitive eating voice – body language, speaking about bodies, and why being aware is important
HOW TO NOT TO DISTURB MENTAL HEALTH WITH FOOD
Nuggets on helping resistant parents
ED RD PRO - Coming Up - September 1st Athletes, November – Family Based Treatment Informed
How to Raise an Intuitive Eater Book
Sumner's Seasonings:
- Intuitive Eating
- Supervision
- Work experiences
- Learning more about weight neutral care and weight stigma
- Vulnerability
Bio:
SUMNER BROOKS, MPH, RDN, CEDRD, is a mom and licensed registered dietitian nutritionist based in Oregon who has spent nearly 15 years working in the field of nutrition and eating disorders. Her experience includes providing nutrition therapy for adolescents and adults, public speaking, and pursuing advanced training in trauma-informed, weight-inclusive healthcare. She is also the founder of the online training platform Eating Disorder Registered Dietitians and Professionals (EDRD Pro).
With your host Beth Harrell
Saturday Feb 11, 2023
Saturday Feb 11, 2023
Em Palmerton, RD
What massage therapy and yoga taught this ED RD.
Em’s RED-S revolution
Eating disorder informed nutrition care is for all RDs
Listen in for Em’s response to Abbi’s question to clients seeking weight loss
Dietitians are well-equipped to work with ambivalence.
Social Media makes it so much harder.
Amanda Mellowspring’s episode (Cant webinar all the time)
Em’s Seasonings:
MarciRD Body image course
You don’t have to know everything.
Somatics
Bio:
Emily (Em) Palmerton is from Buffalo, NY and has been a dietitian since July 2022. She began her career as a fitness instructor and massage therapist and felt something was missing, so she returned to school to study nutrition. She currently works in private practice with the goal of becoming dually certified as a certified specialist in sports dietetics and an eating disorder specialist. Furthermore, she is a registered yoga teacher (200 hours) with hopes to include somatics in her eating disorder practice. She resides in WNY with her husband, dog, and cat, as well as keeps a pretty intense garden for all 4 months of warm weather in Buffalo.
https://www.instagram.com/fueledby_em/
With your host Beth Harrell