This marks the beginning of a six-part series centered around the proposed diagnosis of "Terminal Anorexia Nervosa." In this inaugural episode, I talk with Dr. Joel Yager, Professor Emeritus of Psychiatry at the University of Colorado School of Medicine. Dr. Yager, alongside co-authors Dr. Jennifer Guadiani and Alyssa Bogetz, an individual with Anorexia Nervosa who passed away before the article's publication, proposed the criteria for “Terminal Anorexia Nervosa” in the paper linked below.

With decades of experience in the eating disorder field, Dr. Yager served as the Director of the Eating Disorders Clinic at UCLA from 1981 to 1988. His contributions have earned him numerous awards, including the Lifetime Achievement Award from the National Eating Disorders Association, the Special Presidential Commendation, and the Distinguished Service Award from the American Psychiatric Association, along with a Lifetime Achievement Award from the Colorado Psychiatric Society.

Drawing from his extensive expertise, Dr. Yager articulates why he believes it is crucial for the field to grapple with and refine the proposed diagnosis of "Terminal Anorexia Nervosa." This proposal has ignited a robust conversation and debate among a diverse range of stakeholders. In the upcoming episodes, we will hear perspectives from American and European colleagues, a biomedical ethicist, and individuals with lived experiences -  all sharing their varied views on this highly controversial topic.

In this episode we hear from Dr. Bryn Austin, award-winning researcher, teacher, and mentor and Founding Director of the Strategic Training Initiative for the Prevention of Eating Disorders: A Public Health Incubator (STRIPED). Dr. Austin is Professor of Pediatrics at Harvard Medical School and Professor of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health. In this episode, she urges all of us in the field to think about risk for eating disorders from a public health and social justice perspective. She has documented that the economic cost of eating disorders is close to 65 billion USD annually - on par with severe mental illnesses like schizophrenia. She has also led research that demonstrates that prevention interventions are cost-effective. She urges scientists to get involved with policy and democracy – to engage with the world to change the world. Specifically, she makes the case that we need to pursue policy strategies to combat toxic environmental factors like social media, weight discrimination, and predatory products (like diet pills) to raise awareness and make systems changes that reduce the risk for eating disorders at a population level. After listening to Dr. Austin, your understanding of eating disorders risk and prevention will be forever transformed.

Today's episode of Big Ideas in Eating Disorders is part of a special series delving into the proposed diagnosis of "Terminal Anorexia Nervosa." I am honored to have Dr. Eric van Furth, a clinical psychologist and Professor of Eating Disorders in the Department of Psychiatry at Leiden University Medical Center, as our guest. With decades of experience in the eating disorder field, Dr. van Furth has received numerous awards and accolades, including a Leadership Award from the Academy for Eating Disorders and the Project HEAL Clinician of the Year Award.

Professor Kyle DeYoung started his university education with a focus on engineering and shifted pursuits when he decided to take a psychology elective and discovered his passion for the field. He reflects on the profound impact mentors can have in shaping our academic and professional careers and shares some really interesting ideas about the relationship of sleep and circadian rhythms to eating behaviors. Join us for this episode to learn more about a truly big idea in eating disorders.

In this episode, Dr. Pike is joined by Dr. Allan Kaplan who is University of Toronto Department of Psychiatry Professor and past Vice Dean for  Graduate and Academic Affairs in the Faculty of Medicine. Dr. Kaplan has served as President of both the Academy for Eating Disorders and the Eating Disorders Research Society. Reflecting decades of experience as a researcher, educator, and clinician, in this episode, Dr. Kaplan describes the abyss between the general public’s misunderstanding of eating disorders as volitional and self-inflicted and the reality of the experience for those with personal experience - and what the field needs to do to close this gap.

Dr. Pamela Keel is Distinguished Research Professor of Psychology at Florida State University. Dr. Keel has served as president of the Academy of Eating Disorders and the Eating Disorder Research Society and has contributed widely to the field of eating disorders. Here we discuss how Dr. Keel’s work on purging disorder stemmed from her earlier clinical work on bulimia nervosa and how our existing diagnostic system fails to describe the syndrome of purging that burdens a significant number of individuals.

Professor Yael Latzer is former Dean of the School of Social Work at the Faculty of Social Welfare and Health Sciences at Haifa University in Israel. She is also the founder and former director of the Eating Disorders Institution in the Psychiatric Division in Rambam, Health Care Campus. Dr. Latzer is also one of the founders of the Israeli Association for Eating Disorders and served for several years as its president. In this episode, Professor Latzer shares with us the innovative residential program that has been launched in Israel for women recovering from eating disorders. It is a model that can provide inspiration for eating disorder programs worldwide.

In this episode of Big Ideas In Eating Disorders, Dr. Jenny Thomas shares with us how her personal history as an aspiring ballerina put her at risk for developing an eating disorder, her good fortune in getting evidence-based therapy, and how this propelled her into becoming a pioneer in the study and treatment of ARFID.

LINKS:

https://www.massgeneral.org/assets/mgh/pdf/psychiatry/arfid%20r01%20ar%20flyer%208.18.22.pdf

https://rally.massgeneralbrigham.org/study/project_feed_arfid

Dr. Glenn Waller is a clinical psychologist and professor at the University of Sheffield, UK. He is a past-president of the Academy for Eating Disorders, and is currently president of the Eating Disorders Research Society. Dr. Waller has decades of experience as a clinical researcher evaluating and evolving cognitive behavioral treatments for individuals with eating disorders. In this episode, he challenges therapists to refrain from adopting what Paul Meehl called the “spun glass theory of mind” when treating patients. Instead he urges us to develop true therapeutic alliances that are not only compassionate, but also, brave. This episode is filled with clinical wisdom not to be missed.

Dr. Hans Hoek is clinical psychiatrist at the Eating Disorders Program in the Hague and Professor of Psychiatry at University of Groningen in the Netherlands. He also holds a faculty appointment at Columbia University in New York City. For many years, Dr. Hoek served as director of the psychiatric residency program and dean of Parnassia Psychiatric Institute, The Hague, a large mental health institute with branches across the Netherlands. He has conducted pioneering work on the epidemiology of eating disorders and has a particular interest in cultural psychiatry. In this episode of Big Ideas in Eating Disorders, Dr. Hoek shares his views on the complex and nuanced interplay of biology and environment associated with risk for developing an eating disorder.