In the latest installment of his blog, Dr. Weiner discusses how binge eating disorder is now included as an official diagnosis in the DSM-5. Read an excerpt of the blog post below, or click here to view the article in its entirety at huffingtonpost.com.
Binge eating disorder (BED) is perhaps one of the most widely misunderstood mental disorders despite the fact that it affects as many as 3.5 percent of American women and 2 percent of American men. This illness, which is characterized by compulsive, out-of-control episodes of eating followed by shame, guilt and depression has long been underdiagnosed or misdiagnosed as a mental health issue, due in large part to BED’s classification as only a provisional eating disorder diagnosis in the Diagnostic and Statistical Manual (DSM).
However, this serious mental illness, which can significantly impact quality of life and is often accompanied by serious medical and psychiatric conditions, will be included as an official diagnosis in the fifth edition of the manual that mental health professionals use to diagnose and treat mental disorders, due out this month. This important change to the DSM — the first significant update to the eating disorders section of the manual in almost 20 years — will clearly define diagnostic criteria for BED and validate the illness as a treatable behavior pattern.
Previously, clinicians that observed the symptoms of BED in their patients had to assign a diagnosis of eating disorder not otherwise specified (EDNOS), a “catch-all diagnosis” referring to abnormal eating without all the symptoms needed to be diagnosed with anorexia nervosa or bulimia nervosa. For example, a person with EDNOS may binge eat and purge afterwards, but does so with less frequency or intensity than the criteria outlines for a diagnosis of bulimia. The new classification of BED in the latest edition of the DSM confirms that binge eating is a separate issue people struggle with, and validates destructive eating behaviors and patterns of thinking that professionals in the healthcare community have seen become increasingly prevalent.
It is clear that the inclusion of BED as an official diagnosis in the DSM-5 provides important validation and definition to an illness that impacts the health and quality of life of so many men, women and children. However, it remains to be seen how the official designation of BED as an eating disorder diagnosis will impact access to care for the patients and families that need it, particularly with regard to insurance coverage for specialized BED treatment.
The issue of insurance coverage for BED treatment has to do with mental health parity laws. Mental health parity laws mandate that coverage for treatment of biologically based mental illnesses is no less extensive than the coverage provided for any other physical illness. However, parity laws vary by state and often differ with regard to the specific parity requirements for eating disorders; in other words, what conditions are considered “equal” and qualify for coverage. In fact, while more and more state mental health parity laws require that insurers cover treatment for anorexia and bulimia as well as several common psychiatric conditions (including depression, anxiety and bipolar disorder), EDNOS — the umbrella, “catch-all diagnosis” previously used to diagnose BED — has not traditionally been included on the parity law list of conditions to be covered.
In the latest installment of his blog, Dr. Weiner discusses how the use of values is an effective way to address anxiety in eating disordered patients. Read an excerpt of the blog post below, or click here to view the article in its entirety at huffingtonpost.com.
The Role of Values in Eating Disorders Treatment
The women, men and children struggling with eating disorders have world-class anxiety, and they use their eating-disordered thoughts and behaviors to manage their anxiety. As a result, addressing anxiety is key to effective intervention and sustainable recovery.
The treatment community has found that an effective way to address anxiety in eating disordered patients is through the use of values. When we talk about values, we’re not only identifying what patients value, but evaluating whether their eating disorder is helping them work toward the things that are important to them, or if it’s actually keeping them from living their values and achieving their goals. Unfortunately, it’s usually the latter outcome, which presents an opportunity for eating disorders treatment professionals to help demonstrate a path for recovery that aligns with the things in life that these patients hold dear.
A thought leader on the role of values in eating disorders treatment is Emmett R. Bishop, Jr., MD, FAED, CEDS, medical director of adult services at Eating Recovery Center. Below, he answers common questions around the use of values-based anxiety management in eating disorders recovery.
How do values assist in anxiety management?
Oftentimes, individuals use destructive thoughts or behaviors to self-soothe and “escape” painful thoughts, feelings or experiences. Values-based anxiety management is when we work with anxious patients to identify what they value in life and help them see how their values can trump their anxiety. It’s all about understanding that there are things that they value more in life — family or intimate relationships, education, professional success, honesty, spirituality and the like — than escaping their anxiety.
How does values-based anxiety management help people with eating disorders?
Eating-disordered individuals manage their anxiety with an eating disorder, be it anorexia, bulimia, binge eating disorder or eating disorder not otherwise specified (EDNOS). They’d much rather find an escape mechanism — such as eating disordered behaviors — than deal with their anxiety. However, managing anxiety with an eating disorder keeps anxiety between patients and what they value.
To understand the role of values in eating disorders treatment, it’s important to acknowledge a few key characteristics about the minds of patients struggling with these illnesses. In general, they display traits of anxiety, rigidity and inability to see “the big picture.” And it’s these traits that maintain eating disorders and keep patients from identifying and living their values. Because traits don’t change, we have to help patients manage the traits that they cannot readily eliminate and “play the hand they’ve been dealt.” From a biological perspective, eating-disordered patients have starving brains with significantly less activity in the prefrontal cortex, the part of the brain that allows them to see the “big picture.” Additionally, intense anxiety from the amygdala — the emotional brain — further inhibits the prefrontal cortex, making it difficult for eating-disordered individuals to maintain a self-observing stance and think critically about how they’re living out their values, particularly when thinking about sensitive topics like food and body size.
Eating disorders are phobic disorders; therefore, we have to challenge the phobia and support patients in confronting their fears. To do so, we must find something they value more than their eating disorder, something that’s so important to them that it overrides this anxiety. Because eating disorders patients generally have low self-directedness, values identification gives patients something to direct their lives towards.
In the latest installment of his blog, Dr. Weiner discusses how friends and family can help their loved ones in recovery. Read an excerpt of the blog post below, or click here to view the article in its entirety at huffingtonpost.com.
Protecting Eating Disorders Recovery During The Holiday, Season Part 2: Advice for Friends and Family
In my last post, I outlined several strategies that those in recovery from an eating disorder can draw on during the holiday season to protect their ongoing recovery. Family and friends can be additional champions to support a behavior-free holiday season, and a supportive network is essential to navigating this often hectic time of year. However, despite the best of intentions, loved ones can sometimes inadvertently cause stress and anxiety in their efforts to spend quality time together and carry on their long-standing traditions.
The advice below seeks to help friends and family understand the unique needs of someone recovering from an eating disorder and be a champion for sustainable recovery during the holiday season.
1. Take it easy. As much as you want to re-engage your loved one into all of your holiday traditions, ease into the holiday season by focusing on activities that don’t involve food, such as putting up decorations or sending cards.
2. Be mindful of the needs of your loved one during holiday gatherings. Eating-disordered patients and individuals in recovery are often “people-pleasers,” and will hide their anxiety in an effort to meet the emotional needs of friends and family. If your friend or family member doesn’t feel as though they can attend an event, support them in this decision even if you feel disappointed. If your loved one is willing and able to attend a holiday gathering, support them if they need to “escape” for some fresh air to keep their emotions in check, and be willing to leave early if the festivities begin to feel overwhelming. It may be helpful to agree on a signal or sign that your loved one can use when he or she needs your help to change the subject during a conversation with a nosy neighbor or a tipsy relative, or when he or she needs to take a moment away to regroup.
3. Plan ahead. Provide as much information as possible to your friend or loved one regarding holiday activities — where, when, what types of food will be available and whether alcohol will be served. Information and preparation can help patients in recovery plan ahead, practice flexibility and avoid situations that might trigger an eating disorders relapse.
4. Consider scheduling family therapy sessions when family members are together. Family relationships can play an important role in eating disorders recovery. Ask your loved one if it would be appropriate to invite relevant family members to participate in therapy sessions when they’re in town for the holidays. Families with members scattered across the country can make use of holiday vacations spent together to address important issues, or use therapy sessions to learn how to help the entire family navigate the holidays while supporting your loved one’s recovery.
5. Make your loved one’s eating disorders recovery a priority. Altering holiday traditions in the short term can significantly impact your family member or friend’s wellbeing in the long term. Changing traditions or creating new traditions to meet the needs of your loved one in recovery can feel disappointing and scary, but remind yourself that eating disorders recovery is fragile and that you have the power to help protect it.
Eating disorders are complex illnesses, and in spite of abundant love, support and understanding from friends, families and colleagues, relapse can happen. In many cases, outpatient care — appointments with a therapist, psychiatrist or dietitian or participation in an intensive outpatient program (IOP) a few days each week — can address the recurring thoughts or behaviors. In some cases, however, a higher level of care may be the recommendation of an eating disorders professional to restore medical, psychological and sociocultural health.
In the latest installment of his blog, Dr. Weiner discusses the incidence of eating disorder comorbidities. Read an excerpt of the blog post below, or click here to view the article in its entirety at huffingtonpost.com.
I often remind the readers of this blog that eating disorders are complex illnesses with physical, psychological and sociocultural roots and implications. Yet another reason supporting this complexity is the elevated incidence of eating disorder comorbidities. In other words, other psychiatric and medical conditions often present alongside anorexia nervosa, bulimia nervosa and binge eating disorder. In many cases, the two diagnoses are intertwined in some way, with one illness having contributed to the development of the other condition.
Common eating disorder comorbidities include:
Depression and anxiety. Disordered eating behaviors like restricting intake, purging or food rituals can serve as powerful stress relievers for those suffering with anxiety and depression. Research suggests that roughly two-thirds of patients admitted to eating disorders treatment programs will also meet diagnostic criteria for depression and/or anxiety. For half of these patients, the depression and anxiety predated the onset of the eating disorder, indicating that the mood disorder may have been the first illness to occur. Additionally, there has been found to be a higher incidence of major depression in first-degree relatives of people with eating disorders.
Obsessive-compulsive disorder (OCD). Eating disorders symptoms can often mirror OCD symptoms. Rigidity, compulsivity and the creation of elaborate rituals around food and exercise often display in both diagnoses. In fact, 40 percent of patients seeking eating disorders treatment will meet diagnostic criteria for OCD.
Bipolar disorder. Seen most commonly alongside bulimia, bipolar disorder shares several key symptoms with bulimia, including weight issues and impulsivity. Researchers have also found a correlation between the severity of an individual’s bipolar symptoms and the likelihood they will develop disordered eating behaviors.
Substance abuse. Abuse of drugs and alcohol offers a mechanism for those suffering from eating disorders to numb their pain and anxiety. The use of substances that decrease or suppress appetite in an effort to manage weight tends to be an anorexia comorbidity, while the abuse of substances with no effect on appetite or weight tends to be a bulimia comorbidity. Research suggests that 25 percent of individuals entering treatment for eating disorders will meet criteria for substance abuse problems, as well as a higher incidence of substance abuse in first-degree relatives of people with eating disorders.
Medical comorbidities. In addition to these psychiatric comorbidities, certain medical conditions commonly occur alongside eating disorders. Bone disease, cardiac complications, gastrointestinal distress and various other organ problems can emerge as co-occurring complications associated with starvation and purging. Diabetes has also become a common eating disorder comorbidity, so much so that the media — and some members of the medical community — have adopted the term “diabulimia,” which refers to the deliberate manipulation of insulin to help diabetics lose weight or maintain a desired weight.
Understanding how comorbid conditions are intertwined with an eating disorder and treating both the eating disorder and co-occurring illness are critical to lasting recovery. It also highlights the important role of both medical and psychiatric physicians in the treatment process. Comprehensive eating disorders treatment should involve a collection of extensive information regarding past diagnoses and medications, as well as psychiatric and medical screenings upon admission. This information helps the treatment team craft an individualized treatment plan for each patient that recognizes the eating disorder and other diagnoses. However, when comorbidities are present, the initial objective of treatment is psychiatric and medical stabilization, which must be achieved before patients can meaningfully engage in the therapeutic recovery process.
 Blinder, Cumella & Sanathara, “Psychiatric comorbidities of female inpatients with eating disorders.” Psychosom Med. 2006 May-Jun;68(3):454-62.
 Mazzeo SE, Bulik CM. “Environmental and genetic risk factors for eating disorders: what the clinician needs to know.” Child Adolesc Psychiatric Clin N Am 2008; 18: 67-82.
 Blinder, Cumella & Sanathara, “The Importance of Addressing OCD and Other Anxiety Disorders Symptoms in the Treatment of Eating Disorders.” 2006.
 Baek, J. H., Park, D. Y., Choi, J., Kim, J. S., Choi, J. S., Ha, K., Hong, K. S. (2011). “Differences between bipolar I and bipolar II in clinical features, comorbidity, and family history.” Journal of Affective Disorders, 131, 59-67.
 Kaye, W., and Wisniewski, L. 1996. “Vulnerability to Substance Abuse in Eating Disorders.” NIDA.159, 269-311.
In the latest installment of his blog, Dr. Weiner discusses why families are a key part to eating disorders recovery. Read an excerpt of the blog post below, or click here to view the article in its entirety at huffingtonpost.com.
Families Don’t Cause Eating Disorders, But Can Be Critical to Lasting Eating Disorders Recovery
Families do not cause eating disorders.
It’s true that older models of eating disorders treatment viewed families and dysfunctional family relationships as a contributing cause of these illnesses; however, the treatment community has moved away from the blaming of families toward an understanding that families aren’t a cause, but instead are critical to eating disorders recovery. In a recent address to families of men, women and children suffering from eating disorders, Dr. Ovidio Bermudez, M.D., FAAP, FSAHM, FAED, CEDS, a noted eating disorders treatment thought leader and colleague of mine at Eating Recovery Center, communicated this point by saying, “We have drifted away from shaming and blaming families and have moved toward an understanding that families are an integral part of eating disorders treatment, not only in helping an individual respond well to treatment, but also to go on to lasting recovery.”
Understand that whole families are affected by eating disorders, and everyone deserves support. Regardless of an individual’s stage in the recovery process, there are some meaningful strategies that families can employ to help support a loved one as he or she confronts and combats his or her eating disorder.
Understand the eating disorder isn’t your fault. This is so important — even at the risk of sounding redundant, I’ll say it again: Families do not cause eating disorders. You aren’t responsible for the development of this complex, devastating disorder in your loved one, so don’t blame yourself. With this realization, commit to being part of the solution and do everything in your power to support the recovery process.
Listen. Families often find eating disorders difficult to understand and even more difficult to accept. While it may sound overly simplistic, a good way to learn about the experience of your loved one is to listen to what he or she is saying. Don’t feel like you need to have all the answers or give advice. Instead, listen actively and do your best to create an environment in which your loved one can be honest with you and reach out for support.
Talk sometimes, too. While listening is important, don’t shy away from expressing yourself and your concerns about your loved one’s health. While these conversations can be uncomfortable at times and the reaction from your loved one can vary from receptive to outraged, know that secrets and things left unsaid rarely support a meaningful eating disorder recovery.
Educate yourself. Resources abound to help you learn about eating disorders, viable treatment options for your loved one and the ways in which families can support their loved ones throughout the eating disorders recovery process. The Internet can be a good place to start your research about the illness and treatment options, and can also help you to connect with other families that have experienced similar situations with eating disorders and recovery for support. For example, the National Eating Disorders Association has a robust collection of online resources for family and friends.
Participate in the eating disorders treatment process. To the extent that it’s possible and appropriate, be willing to participate in your loved one’s eating disorders treatment plan. Educational programming and family therapy for anorexia, bulimia and binge eating disorder seek to prepare parents and siblings to effectively support a loved one’s recovery following discharge from treatment. Weekly family therapy sessions will likely be part of your loved one’s programming, and can be conducted in person or by phone when proximity of the treatment center prohibits travel. Specific goals of the family contact vary, and depend largely on each patient’s unique background and struggles. Additionally, some eating disorders treatment centers offer family programming to educate, support and care for families of eating disordered patients at every stage of the recovery process.
There is nothing more difficult than watching a loved one struggle with illness, particularly an illness that takes control of the mind and body and causes extreme disturbances in an individual’s behaviors and feelings. Know that recovering from an eating disorder truly does “take a village” and that your support and participation in the treatment process can make a genuine difference in your loved one’s life and recovery.
Eating Disorders in Middle Age Bring Unique Challenges, Treatments
Emmett Bishop, MD, FAED, CEDS, Medical Director of Adult Services at Eating Recovery Center, was recently quoted in The Huffington Post discussing the health complications facing middle-aged individuals struggling with eating disorders. Read on for an excerpt of the article, or click here to read the piece in its entirety.
In an Austrian study of 475 women between 60 and 70 years old, published in the International Journal of Eating Disorders in 2006, 45 percent of the women indicated that their self-esteem depended on their shape and weight. The same study revealed that “over 60 percent [of the women] stated ‘moderate’ or ‘low’ satisfaction with weight and shape.”
This pressure to maintain youth may stem from the culture in which post 50s grew up. Dr. Blake Woodside, director of Toronto General Hospital’s in-patient eating disorder program, told the Toronto Star that the increase in midlife eating disorders can be traced to the ’60s, when ideals changed and the “thin is in” culture materialized.
Whatever the cause, eating disorders can have serious side effects, including osteoporosis, heart problems and gastrointestinal issues. In a recent interview with Life Goes Strong, an online site for midlifers, Dr. Emmett Bishop, MD, FAED, CEDS — founding partner and medical director of adult services at the Eating Recovery Center — outlined some specific health issues that middle-agers with EDs may face:
Older individuals have much less resilience when it comes to physical damage from eating disorders. A lot of things can go wrong with vital organs, bone density can be impacted, dental health can suffer, and as tissues become less elastic, I’ve seen people aspirate from purging. A whole host of medical issues can arise as people abuse their bodies over time. Eating disorders are the deadliest mental illnesses and premature death is very common.
Older women also face somber statistics when it comes to EDs and death. Senior women comprise 78 percent of all deaths caused by anorexia, and the average age that women die
from the disease is 69.
Your Family Tree Can Reveal Your Risk for Eating Disorders
In the latest installment of his blog, Dr. Weiner discusses the genetic link underlying eating disorders, and explains why eating disorders, like heart disease, cancer and obesity, should be among the illnesses we look for in family medical histories. Read an excerpt of the blog post below, or click here to view the article in its entirety at huffingtonpost.com.
It’s not uncommon for individuals to consult their family trees to evaluate their predisposition to various illnesses, including heart disease, cancer and obesity. But a disease that tends to be absent from the checklist of dangerous and highly-inheritable illnesses to look for in family medical histories is eating disorders.
The link between genetics and eating disorders
Most people don’t understand the connection between genetics and eating disorders when, in fact, there is a very strong genetic component to these illnesses.* Research has found that 40 to 50 percent of the risk of developing an eating disorder is based on genetics. Anorexia nervosa, an eating disorder characterized by extreme low body weight and a refusal to consume sufficient calories to support bodily functioning, has been found to be as inheritable as bipolar disorder and schizophrenia.
Family studies have also supported the genetic link of eating disorders. Compared with the general population, a woman with a mother or sister who has anorexia is 12 times more likely to develop the disease and four times more likely to develop bulimia nervosa. Twin studies have perhaps shed the most meaningful light on the heredity of eating disorders. Among identical twins, whose genetic makeup is 100 percent the same, there is a 59 percent chance that if one twin has anorexia, the other twin will also develop an eating disorder. Among fraternal twins sharing only 50 percent of their sibling’s genes, the incidence of the illness in both twins was lower but still significant. When one twin has anorexia, there is an 11 percent chance that the other twin will also have the illness.
What exactly do you inherit when it comes to eating disorders?
While research to date has helped bring to light the connection between eating disorders and genetics, there is still much to understand, specifically what is inherited. Studies from both the Maudsley Hospital in London and the University of Pittsburgh suggest that variations in the gene for serotonin receptors may play a role in the development of eating disorders. Abnormal serotonin levels are associated with overall more negative moods and obsessions with perfectionism and exactness.**
“Eating Disorders Treatment for Children and Adolescents”
In the latest installment of his Huffington Post blog, Dr. Weiner welcomes the insights of Elizabeth Easton, PsyD, on treatment for eating disorders in children and adolescents. As Clinical Director of Child and Adolescent Services at Eating Recovery Center’s Behavioral Hospital for Children and Adolescents, Dr. Easton understands that parents seeking eating disorders treatment for their children and teens face a distinctive set of uncertainties. Read an excerpt of Dr. Easton’s insights below, or click here to read the Huffington Post article in its entirety.
How are child and adolescent eating disorders treatment different from treating eating disorders in adults?
The fundamental aspects of eating disorders treatment tend to be fairly consistent between adults and children and/or teens. Because these illnesses affect both mind and body, treatment providers will generally offer medical support, psychiatric stabilization and medication. Therapeutic support is also offered from skilled clinicians, including individual therapists, family
therapists and dietitians. However, key differences between programs designed for adults and those catering to younger patient populations pertain to the use of developmentally appropriate treatment plans and the availability of education services to help patients progress in K-12 studies during the course of treatment.
Developmentally sound care requires that the treatment team take into consideration not only the chronological age of patients, but also their developmental stage and their readiness to assume key responsibilities in the recovery process. Some patients who are either chronologically or developmentally young may require more assistance from parents regarding key
elements of the recovery process, like refeeding, weight maintenance and compliance with the post-discharge plan of care. Furthermore, seeking effective treatment for your child or teen doesn’t mean that a child or teen’s academic functioning must suffer. Unlike programs for adults, child and adolescent eating disorders treatment can involve an educational component to help patients move forward with their studies to support a seamless transition back to school following treatment.
What should parents look for in an eating disorders treatment center or provider?
Comprehensive care from skilled experts is the most important element to look for when seeking eating disorders treatment for your child or adolescent. Eating disorders are incredibly complex illnesses, and it’s critical to identify a provider with experience treating the diseases in young patient populations and a record of successful treatment outcomes.
Another characteristic that parents should look for in a treatment provider is an educational component. By this, I mean two things. First, look for programs that make a point of educating parents and families about eating disorders and how to support the recovery of their young loved ones following discharge from treatment. Lasting eating disorders recovery for your child hinges in large part on you gaining a thorough understanding of the illness, as well as learning about and practicing effective strategies for helping to manage recovery. Secondly, treatment programs should offer a structured educational component with adequate support from licensed educators to help young patients maintain academic functioning while in treatment. Intensive eating disorders treatment can be disruptive in the life of a child or teen, and every effort should be made to support them in this area of their lives.
Read more from Dr. Easton on The Huffington Post.
Too Much of a Good Thing? What You Need to Know About Compulsive Over-Exercising
In the most recent post to his Huffington Post blog, Dr. Weiner discusses compulsive over-exercising, and explains how the behavior often occurs alongside eating disorders, as the motivations underlying the excessive physical activity often stem from food-, body- or weight-related issues. Read an excerpt of his article below, or click here to read the article in its entirety.
Exercise is good for you. This shouldn’t come as shocking news to anyone; the risks of a sedentary lifestyle are abundant and well reported, particularly as the country faces a public health crisis in which one-third of adults and 17 percent of children are obese.*
However, like most things in life, you can get too much of a good thing when it comes to exercise. Compulsive over-exercise is characterized by frequent episodes of excessive physical activity. Individuals will go to great lengths to fit exercise regimens into their schedules, even if it means skipping work, cutting school, avoiding social events with friends and family, even exercising in secret. Instead of supporting health, excessive exercise, inadequate rest and recovery time between physical activities can damage a person’s body and overall health, causing joint injuries, tendonitis, stress fractures, muscle tears, exhaustion, fainting and dehydration.
Compulsive exercise often occurs alongside eating disorders, as the motivations underlying the excessive physical activity often stem from food-, body- or weight-related issues. Many over-exercisers will do so as a result of guilt or shame from just having eaten or binged or to give themselves “permission” to eat. (The latter was recently the target of much scrutiny from the eating disorders awareness community when the idea was used humorously in a Yoplait commercial.) In fact, exercise bulimia is a subset of bulimia nervosa in which an individual is compelled to exercise at an overly excessive level in an effort to burn calories and fat. Just as individuals with bulimia purge calories through vomiting or laxative use, exercise bulimics use physical activity as their compensatory behavior. Over-exercising behaviors can also accompany anorexia nervosa when used in conjunction with severe food and calorie restriction.
In the latest installment of Dr. Weiner’s Huffington Post blog, he discusses “fat talk” and the implications of these weight-related conversations for those with a predisposition for developing an eating disorder.
Simple Words, Serious Consequences: What ‘Fat Talk’ Means
Each day, we’re on the receiving end of a barrage of messages through more and more mediums that encourage us to be thin. It’s the yogurt commercial glamorizing disordered eating thoughts or the tweet urging followers to read an article describing “good” and “bad” foods for weight loss. The underlying message might be cloaked in a word like “beautiful,” “fit” or “healthy,” but more often than not, there’s an implied association with thinness. Under this steady pressure, it’s not uncommon to internalize thin ideology, engrain it in our thought processes and behaviors around food and body image and even impress these same ideals on our loved ones.
These conversations stressing the importance of weight loss — with others or ourselves — have been coined “fat talk” by professionals in the mental health field. We’ve all done it at one point or another, muttering under your breath about your pants that used to feel much looser or asking a friend or loved one if an article of clothing makes you look fat. “Fat talk” is not always damaging — in fact, for many people, these conversations can be a catalyst for a healthier lifestyle and encourage sound eating and exercise habits. However, these seemingly harmless, offhand remarks place an emphasis on weight as a measure of worth, which can have unforeseen and sometimes devastating consequences for individuals prone to eating disorders.