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Risks and Rewards: A Discussion of Challenges and Changes Affecting the Eating Disorder Industry

sunset in Arizona desert | Kari Anderson eating disorder counseling & coaching

Risks and Rewards: A Discussion of Challenges and Changes Affecting the Eating Disorder Industry

The summary statement of my recent attendance at the Symposium for the International Association of Eating Disorder Professionals (iaedp) is to keep an open mind and heart to change. A conference theme of connection will continue to be necessary as our world, the eating disorder industry, and the iaedp organization itself faces changes in the future. A division into safe camps of belief protects our ideals but are limiting to those who could benefit from new ways of solving chronic problems. 

GLP-1RA Medications

Timely and provocative presentations included discussions of the GLP-1RA medications taking the media by storm – especially after the Oprah “infomercial” recently aired. Although this is a novel drug for metabolic health, with it comes a weight loss frenzy, which amplifies weight stigma and increases risk for eating disorders. It’s complicated but worth giving it our attention. 

The neurobiological implications are impressive for mental and physical health of those plagued with metabolic and inflammatory risk factors (although long-term studies are not available for obvious reasons). There is also evidence that individuals with hedonic “hot spots,” troubled with food noise in the brain (unrelenting cravings), are being helped with this new drug after cognitive behavioral interventions have failed. 

At the same time, the anorexic side effects on appetite move individuals farther away from a mindful relationship with food. Rapid weight loss threatens the very skeletal muscle needed for metabolic health, hence a circular discussion continues. 

Ultra-Processed Foods in the Eating Disorder Industry

Another lively discussion surrounded a well-researched presentation on Ultra Processed Foods (UPF) and the vulnerability that some phenotypes of loss of control eating disorders have toward these foods. Dr. David Wiss of Wise Mind Nutrition suggests the “all foods fit” model is a blind spot in our industry, especially for clients who have repeatedly struggled with the “one size fits” all treatment model. 

The most vulnerable of our population is the socioeconomic disadvantaged, marginalized, and traumatized. These individuals fall prey to the “big Food and big Pharma” tag team. I was especially struck by “the chicken or the egg” discussion regarding which came first: the reward dysfunction causing food to be too rewarding or the dieting to control the cravings. The industry’s rebuttal to the food addiction model has always been blamed on restriction – the idea that restriction causes food insecurity and a counter action of cravings. Considering my personal memoir, it was both.  

This dialectic stance may be helpful when working with our vulnerable population with eating disorders. There are many truths. We are vulnerable to ultra processed foods and our metabolic health is being compromised, AND we are plagued with weight stigma, fat bias, and food fear obsessions that lead the vulnerable into eating disorders. There is a place for a harm reduction model for those individuals who are hypersensitive to reward, AND there is a place for pharmacological interventions for those needing metabolic healing. Our place, then, is to be open and connected to the greater role of healer and to mitigate risk, not holding too tightly to our own beliefs. 

The Importance of Organizational Change

Lastly, this is a time for organizational change. I’ve been involved with the iaedp Foundation for thirty-four years and have watched it grow into a true international organization. The vision of certification was realized, and those individuals with eating disorders and their families can now locate truly specialized resources in their time of need. 

Of course, iaedp has not been without controversy. Longtime executive director Bonnie Harken was targeted in a relentless legal suit and stepped down into retirement during this Symposium. The Board of Directors announced their dedication to organization rehabilitation and change. As with every ecocycle, in all growth and maturity, we must enter a time of pruning in order to ensure renewal. Shall we do the same?



Visit my website to learn more about my counseling, consulting, and coaching services as well as my current courses and recent Safe and Sound Protocol certification. 



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