IEDE Courses
Eating Disorder Education for:
therapists, dietitians, medical providers, & coaches
$180 per course
IEDE courses à la carte | Pay as you go for IEDS Certification | Online and self-paced learning
IEDE offers each of the 10 courses that comprise the IEDS Certification training à la carte.
You are welcome to purchase courses individually to reduce financial strain, and pay as you go while you complete each course, while working toward the IEDS Certification.
Not interested in the full IEDS Certification?
You can pick and choose which of the courses that interest you, and receive your instant downloadable CE certificates as you pass each course exam.
See the full agenda for each course below.
Eating Disorder Courses
1. Introduction to Eating Disorder Treatment, Eating Disorder Recovery, & Relapse Prevention
CE Credit Hours: 3
2. Diagnostic Overview & Assessment of Eating Disorders
CE Credit Hours: 4
3. Nutrition Therapy in Eating Disorder Treatment, part 1
CE Credit Hours: 5
4. Nutrition Therapy in Eating Disorder Treatment, part 2
CE Credit Hours: 3
5. Eating Disorder Treatment Modalities
CE Credit Hours: 7
6. Trauma-Informed Eating Disorder Treatment Modalities & Skills
CE Credit Hours: 5
7. Body Image & Dysmorphia in Eating Disorder Treatment
CE Credit Hours: 3
8. Compulsive Exercise in Eating Disorders
CE Credit Hours: 3
9. Bias and Intersectionality in Eating Disorder Treatment
CE Credit Hours: 6
10. Person of the Therapist & The Eating Disorder Treatment Team
CE Credit Hours: 2
What you’ll get
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All courses are available for individual purchase for you to design your own training program, unique to your needs and level of experience.
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Evidence-based, antiracist, and inclusive education to practice ED treatment safely and confidently. Become trauma-informed or improve your trauma-informed care.
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At-your-own pace, fully online training program.
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10 individual courses you can select individually (41 hours in total learning) packed with education and skills to use with clients now
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Printable PDF Manual that goes along with each individual course with all the specifics, handouts, notes, and more.
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Brief assessments, quizzes, and engaging activities are included throughout each course to help you retain knowledge and to bring the content to life.
What’s Inside Each Course
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Familiarize with the program, meet the makers.
Introductory Foundations of Eating Disorder Treatment 10
Ethics in Eating Disorder Treatment 10
Cultural Diversity & Competency in Eating Disorder Treatment 11
Adverse Childhood Experiences (ACEs) Questionnaire 15
White Supremacy Culture Can Impact Eating Disorder Development and Recovery 23
WSC Characteristics to be Aware of 23
General Warning Signs of Eating Disorders 26
Psychological Warning Signs of Eating Disorders 26
Physical Warning Signs of Eating Disorders 26
Behavioral Signs of Eating Disorders 27
9 Truths About Eating Disorders 28
Nine More Truths about Eating Disorders: Weight and Weight Stigma 31
Eating Disorder General Facts 31
Factors That Influence the Development and Maintenance of Eating Disorders 32
Emotional Neglect and Disruption in Primary Caregiving Relationships 33
General Concepts & Skills for Eating Disorder Treatment 35
Core Clinical Targets and Context 35
1) Impaired insight (denial of illness) 35
2) Ambivalence and identity/self-evaluation 35
3) Belonging, rejection sensitivity, and social context 35
Why the Eating Disorder “works” and “helps” (functional analysis) 36
“Roles” the Eating Disorder Occupies 37
Conditions that Enable Behavior Change 37
Therapeutic alliance and trust: 37
Personal growth and self-efficacy: 37
Functional understanding of behaviors: 38
Reduce isolation; increase corrective experiences: 38
Family/partner support and unresolved grief/trauma: 38
Values and goals > ED symptom functions: 38
What is Weight Inclusivity and What is HAES®? 42
Original ASDAH HAES® Concepts: 43
History of Weight Inclusivity 44
Weight Centric Modalities Can Contribute to Eating Disorders 47
How do we collaborate with doctors who follow a conventional medical model? 50
Weight-inclusivity and Eating Disorder Treatment 51
A Critical Comparison to Traditional Treatment Paradigms 52
Grounding in Liberatory Frameworks 52
Critical Engagement with Weight Science 53
Competence in Caring for Fat Bodies 53
Non-Oppressive Tools for Healing 53
The Science of Weight Inclusivity 55
Weight-Inclusive Approaches to Nutrition and Dietetics: A Needed Paradigm Shift (Levinson, 2024) 59
Weight Change over the Lifespan 60
The BMI associated with the lowest mortality increases with age. 63
Does social class predict diet quality? 72
Introduction to Eating Disorder Recovery 76
The Addiction Model is Contraindicated in Eating Disorders 76
The Recovery Model is Central 77
Recovery Phases: A Perspective on Eating Disorder Recovery 77
2. Continued Need for Eating Disorder Behaviors Despite Distress 77
3. Decreasing Reliance and Habits of the ED: Insight and Skill Building 78
4. Identity Shift and Relapse Resilience 78
Supporting Research & Evidence 79
Stages of Recovery: A Perspective on Eating Disorder Recovery 79
Conceptualizing Eating Disorder Recovery 82
Foundational Tenets of ED Recovery 82
2. Individuality in Recovery 82
3. Internal and External Factors 83
4. Systemic Oppression Shapes Trajectories 83
Recovery Domains to Attend to in Treatment 83
2. Psychosocial Functioning 84
4. Identity beyond the Eating Disorder 84
External and Systemic Factors Affecting Recovery 84
External / Proximal (direct, day-to-day) 84
Systemic / Structural (context, policy, culture) 85
Characteristics Common in Recovery 85
Translating Framework Into Practice 86
Recovery Concepts: A Brief Introduction 86
Embodiment: Coming Home to One’s Body 87
Mindfulness and the Present Moment 87
Reconnecting with Pleasure and the Lived Body (vs. Self-Objectification) 87
Stillness, Tolerance, and Interoceptive Trust 88
From External Rules to Internal Guidance 88
A Working Definition of “Recovered” 89
RD–Specific Recovery Concepts 89
Physiological Restoration and Metabolic Recovery 89
Sufficient Energy Availability and Intake Patterns 90
Normalized Eating Behaviors and Cognition 91
Body Acceptance and Identity 91
The “Invisible” Metric: Cognitive Bandwidth 91
Therapist–Specific Recovery Concepts 92
Cognitive and Identity Expansion 92
Emotion, Insight, and Behavior 92
Family of Origin (FOO), Trauma, and Core Beliefs 92
Meaning, Presence, and Somatic Connection 93
Understanding ED Urges and Rituals 93
More Notable Recovery Concepts & Goals 93
Normalizing Lapses and Relapses 94
The Core Links (what to map) in Behavior Chains 95
A 10-Minute in Session Script: Behavior Chain Mapping 96
Transdiagnostic Relapse Prevention 97
Common High-Risk Relapse Contexts 97
Eating Disorder Specific Relapse Risks: Acuity 98
Habit-Focused Relapse Prevention in Anorexia Nervosa (AN) 98
Clinician Tools & Examples to Use Now 99
Core Components of an ED Relapse Prevention Plan 100
Anticipation Stage Expanded: Planning for the Future 101
Statistics on Prevalence, Relapse, and Recovery 101
Who is being missed (treatment gap and preventable mortality) 101
Weight status during/after illness 102
Migration/crossover among diagnoses 102
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What are Eating Disorders? 3
General Risk and Mortality 3
Eating Disorder Diagnoses 5
Anorexia Nervosa & Subtypes 5
Types of Anorexia Nervosa 8
Anorexia Athletica 8
Atypical Anorexia Nervosa 8
Restrictive Type Anorexia Nervosa 8
Binge-purge Type Anorexia Nervosa 9
Orthorexia Nervosa 9
Bulimia Nervosa 10
Types of Bulimia Nervosa 11
Exercise Bulimia 11
Diabulimia 12
Binge Eating Disorder 13
ARFID - Avoidant Restrictive Food Intake Disorder 14
OSFED - Other Specified Feeding or Eating Disorder 15
UFED - Unspecified Feeding or Eating Disorder 16
Rumination Disorder 17
Pica 18
Night Eating Syndrome 19
Purging Disorder 21
Severe and Enduring Eating Disorders (SEED) 22
Common Co-occurring Diagnoses 27
Obsessive-Compulsive Disorder (OCD) 27
Obsessive-Compulsive Personality Disorder (OCPD) 27
Borderline Personality Disorder (BPD) 28
Generalized Anxiety Disorder (GAD) 28
Major Depressive Disorder (MDD) 29
Substance Use Disorder (SUD) 29
Post Traumatic Stress Disorder 29
General Risk Factors for Eating Disorders 30
Identifying Functionality of EDs in Treatment 31
Eating Disorders in Boys and Men 32
General Facts about Men & Boys Eating Disorders from Academy for Eating Disorders (AED) 32
Understanding and Addressing Eating Disorders in Boys and Men 36
Understanding Differences in Eating Disorders Among Men and Women 37
Summary of Eating Disorders in Boys & Men 39
LGBTQIA+ Considerations for Eating Disorders Treatment 39
“Body Mass Index Requirements for Gender-Affirming Surgeries Are Not Empirically Based” 39
“Understanding the Nutritional Needs of Transgender and Gender-Nonconforming Students at a Large Public Midwestern University” 41
“Higher Rates of Lifetime Traumas and Current PTSD Among Sexual and Gender Minority Individuals in Residential Eating Disorder Treatment” 43
“Eating Disorders and Disordered Eating Behaviors in the LGBT Population: A Review of the Literature” 45
Trans and Nonbinary Experiences of Conformity, Coping, and Connection in Atypical Anorexia 47
“Transgender and Other Gender Diverse Adolescents with Eating Disorders Requiring Medical Stabilization” 49
Neurobiology & Eating Disorders 52
Medical Aspects of Eating Disorder Treatment 55
When To Worry? 56
Eating Disorder Treatment Guidelines 58
“Atypical” Anorexia Nervosa (Gaudiani, 2018) 59
Special Medical Considerations (Gaudiani, 2018) 60
ED Treatment Considerations (Medical Perspective) 62
Gastroenterology 63
Obstetrics and Gynecology 65
Psychiatry 65
Pediatrics 66
Sports Medicine 66
Extreme Presentations - Eating Disorders 66
Eating Disorder Behaviors: Symptoms & Indications 71
Further Medical Considerations Regarding Eating Disorders 74
Resources 82
Levels of Care: ED Traditional Treatment 83
Outpatient Level of Care 83
Intensive Outpatient Programs (IOP) 84
Partial Hospitalization Programs (PHP) 88
Residential Level of Care 91
Inpatient Hospitalization 94
Importance of Stepping Down Through Each Level of Care
Caution! Traditional Eating Disorder Treatment May Not Be For Everyone
Potential Barriers for Vulnerable Populations Seeking HLOC
Assessment 100
Assessment Items
Eating Disorder Examination Questionnaire (EDE-Q 6.0)
References 104
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Nutrition Counseling Introduction 3
Common Misconceptions Dietitians May Have About Nutrition Therapy 3
Activity 4
Countertransference 5
Scope of Practice: Dietitians 6
Parent/Caretaker Involvement Support 12
Tips on Dealing with Parenting Challenges 13
Education for Parents & Supports 13
Determining Appropriate Level of Care (LOC) for RDs 14
Nutrition Therapy Across Levels of Care 17
Nutrition Assessment 18
Introductory Questions 19
History Taking 19
Current Behaviors and Attitudes 19
Eating Attitudes Test 20
Physical & Medical Assessment 20
Lab Work 22
Recommended Lab Assessments for Eating Disorders 22
Recommended Lab Assessments for Symptomatic and Malnourished Clients 23
Symptoms of Malnourishment 25
Physical symptoms 25
Psychological Symptoms 25
In-depth Analysis of Eating Disorder Behaviors 26
Anthropometrics: Weight History 27
Step-by-Step Guide: Nutrition Therapy 28
Initial Work 28
First sessions 29
Second Session 30
Functions of Macronutrients – Biochemistry 101 31
Carbohydrates 31
Fats 32
Protein 32
Vegetables 32
β-carotene 34
Folate 34
Vitamin C 34
Vitamin K 35
Potassium 35
Calcium 35
Magnesium 35
Iron 36
Socioeconomic Status (SES) 36
Third Session 36
Treatment Planning Goals 37
Myth Busting and Nutrition Education 38
Carbohydrate and Sugar Myths: 45
Cholesterol and Fat intake myths 45
Hypertension and Sodium Intake: 47
Restriction Myths 48
Inflammation and Intake 48
Serving Sizes 49
Exercise Myths 49
Addressing Family Attitudes Around Food and Body 50
Middle Work 52
Later Work 54
Medical Considerations in Nutrition Therapy 55
Harm Reduction in Nutrition Therapy 60
Specific Skills: Harm Reduction for RDs 61
Weight Restoration 70
Weight Cycling Impacts 71
HAES® & Nutrition Therapy (from https://asdah.org) 71
Dietetics School vs Weight Inclusivity 72
Activity 74
Meal planning 74
Teaching Exchanges to Clients: 78
When Meal Plans Are Appropriate 78
Special Diet Considerations: Vegan, Vegetarian, Religious Diets 79
Considerations for Medical Diets 79
Supplements & Other Recommended Medications 80
Integration of Intuitive Eating 81
Exercise 85
Medical Considerations 85
Quesnel, Cooper, Fernandez-Del-Valle, Reilly, & Calogero (2023) explore in-depth these consequences: 85
Dysfunctional Exercise in Eating Disorders 94
Bariatric Surgery 98
References and Resources 100
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Introduction 2
Early Eating Experiences 2
Satter Model of Eating Competence 3
Normal Eating Readiness 4
How do you know when a client is ready for intuitive eating? 4
Intuitive Eating Principles & ED Diagnosis Specifics 5
Foundational Introduction to Normal Eating 8
Key features 8
Intuitive Eating Outcomes 9
Initial Sessions 9
First Session 10
Second Session 12
Common Diet Rules 13
Third Session 17
Fourth Session 18
Stocking: Tool for Intuitive Eating 18
Client Activities: Intuitive Eating Skill Building 19
Principles of Intuitive Eating (Tribole & Resch, 2020) 20
Initial Work in Nutrition Counseling for Intuitive Eating 20
1. Reject Diet Culture (Tribole & Resch, 2020) 20
Research Supporting Intuitive Eating 21
2. Make Peace with Food (Tribole & Resch, 2020) 28
3. Challenge the Food Police (Tribole & Resch, 2020) 29
4. Honor Your Hunger (Tribole & Resch, 2020) 31
Hunger/Fullness Scale 33
Research 33
Middle Work in NutritionTherapy for Intuitive Eating 34
5. Feel Your Fullness (Tribole & Resch, 2020) 34
6. Discover the Satisfaction Factor (Tribole & Resch, 2020) 35
7. Cope with Your Emotions with Kindness (Tribole & Resch, 2020) 36
8. Respect Your Body (Tribole & Resch, 2020) 42
Later Work in Nutrition Therapy for Intuitive Eating - If Appropriate 44
9. Movement - Feel the Difference (Tribole & Resch, 2020) 44
Adequate Activity Mindsets 45
10. Honor Your Health - Gentle Nutrition (Tribole & Resch, 2020) 47
What is Healthism? 47
Learn More 49
References 49
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Introduction to Therapy Modalities for Eating Disorders (EDs) 4
Fundamentals in Eating Disorder Treatment 5
The Therapeutic Alliance in Eating Disorder Treatment 6
References 9
Identity & Eating Disorder Recovery: An Introductory Overview 10
Treatment Interventions for Identity Reclamation & Reconstruction 11
References 15
Ambivalence in Eating Disorders: Introduction, Overview, & Clinical Interventions 15
Treatment Interventions for Ambivalence 16
References 17
Dissociation In Eating Disorders 18
References 20
Developing Emotional Competency in Eating Disorder Recovery 20
References 29
Autonomy 29
References 32
Dialectical Behavior Therapy (DBT) 33
Core Principles of DBT 34
Techniques & Skills 35
DBT for Eating Disorders 38
Examples of how the approach may be integrated into clinical practice: 40
Case Study: Using DBT to Treat Bulimia Nervosa 41
Contraindications & Limitations of DBT for Eating Disorders 42
Learn More 43
References 44
Radically Open Dialectical Behavior Therapy (RO-DBT) 45
Basic Concepts and Assumptions of RO-DBT 45
RO-DBT versus DBT 47
RO-DBT & Eating Disorders 47
Theory of Change 48
The Primary Mechanism of Change: Social Signaling 49
Application in Therapy 50
Treatment Protocols and Delivery 51
Treatment Strategies 52
Specific Skills & Concepts in RO-DBT 53
Mindfulness 53
Radical Openness 54
Behavioral Activation 56
Cognitive Flexibility & Dialectical Thinking 57
Skills Training 58
Applying RO-DBT to the Treatment of EDs 59
Last Notes on Providing RO-DBT with Clients 60
Learn More 60
References 61
Acceptance and Commitment Therapy (ACT) 61
Foundational Premises: ACT 61
Treatment Strategies - Techniques, Principles, Style 63
Six Core Strategies of ACT 64
How to integrate into clinical practice (Harris, 2009): 69
ACT and Eating Disorders 69
Case Study 71
Contraindications & Limitations for ACT 72
Learn More 72
References 72
Emotion Focused Therapy (EFT) 74
Overview of the EFT Philosophy & Model 75
Emphasis on Emotional Awareness 76
EFT & Eating Disorder Treatment 76
Primary Emotions 77
Secondary Emotions 78
Transformation of Emotions & Clinical Interventions 79
EFT and Attachment in Eating Disorder Recovery 81
Attachment Styles and Their Impact 81
More Therapeutic Interventions Involving Attachment in EFT 85
Contraindications and Limitations of EFT 88
Learn More 88
References 88
Exposure and Response Prevention (ERP) in the Treatment of Eating Disorders 91
Obsessive Compulsive Disorder and Eating Disorders 92
Overview of Exposure and Response Prevention (ERP) Therapy 93
Components of ERP (Foa et al., 2012; Becker et al., 2020) 94
The Function of Exposure Therapy in ED treatment 95
ERP in Clinical Practice 95
Step 1: Assessment 95
Step 2: Hierarchy 97
Step 3: First Exposure (critical step) 98
Step 4: Repeated, gradual progression through hierarchy 99
Food and Eating Exposures 100
Body Image Exposures 100
Mirror Exposures 101
Cue Exposure for Binge Eating 102
Exposure Work with Avoidant/Restrictive Food Intake Disorder 103
Limitations of Applying CBT and Exposure work to ARFID 104
Contraindications and Limitations of Exposure Therapy for EDs 105
References 106
Motivational Interviewing 107
Overview of Philosophy and Theory of Change 108
Integration and Treatment Strategies 109
Techniques: Motivational Interviewing 110
Contraindications & Limitations 112
Where To Learn More 113
References 113
Harm Reduction 114
Key Aspects of Harm Reduction in Eating Disorder Treatment 115
Six Key Principles of Harm Reduction In Healthcare Settings 117
1. Humanism 118
2. Pragmatism 118
3. Individualism 118
4. Autonomy 119
5. Incrementalism 120
6. Accountability without Termination 120
Treatment Strategies 121
Tips: How to Integrate Harm Reduction into Clinical Practice 121
Readiness for Change 122
Client Autonomy & Clinician Bias 124
Eating Disorder Behavior Monitoring 124
Case Study 126
Where to Learn More 127
Contraindications & Limitations 127
References 127
Cognitive Behavioral Therapy (CBT) 128
CBT Treatment 129
Phase One 129
Phase Two 129
Phase Three 129
Dysfunctional Thinking Patterns: Examples 130
ABC Monitoring 130
Phase Four 131
Case Study 132
Contraindications and Limitations 132
Where to Learn More 132
References 133
Family Based Treatment (FBT) 133
Five tenets of FBT 134
FBT Treatment Involves Three Phases 134
1. Phase 1: Psychoeducation and weight restoration 134
2. Phase 2: Returning control to the adolescent 134
3. Phase 3: Consolidation and relapse prevention 134
6 Stages of Growth of Family Members Regarding the Eating Disorder 135
The Debate About FBT 135
Pros: 136
Cons: 136
Learn More 137
References 137
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Introduction 2
Acknowledgements 3
Internal Family Systems (IFS) 3
Key Principles 4
Implementing IFS 5
The 6 Fs of working with Protectors: 6
Unburdening: 7
IFS & Eating Disorders - Case Example 8
Considerations & Limitations 12
Learn more: 13
References 13
Eye Movement Desensitization & Reprocessing (EMDR) Therapy 13
Overview of EMDR 14
Research 15
Eight-Phase Protocol: An Overview 16
Three-Pronged Approach & Dual-Attention 16
Digging Deeper: Basic Protocol 16
Clinical Themes 19
EMDR-ED Protocol 19
Applying EMDR Basic protocol to Eating Disorders 20
Contraindications & Considerations for Treatment of EDs with EMDR 24
There is Always More To Learn 26
References 26
Psychodynamic Therapy 27
Basic Assumptions of Psychodynamic Theory 27
Psychodynamic Therapy & Eating Disorder Treatment 28
Developing Insight 28
Treatment strategies 32
Case study 34
Contraindications & Limitations 36
References 36
Somatic Experiencing (SE) 37
SE Theory of Change & Philosophy 39
Treatment Strategies 39
SE & Eating Disorders Overview 40
Integration into Clinical Practice for Eating Disorders 41
Clinical Assessment 42
Example Treatment Goals 42
Treating Trauma and Eating Disorders Through the Body 43
Case Study 45
Contraindications & Limitations 49
References 49
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Introduction 2
Body Image Defined 2
Theoretical Perspectives 2
Body Image Distress or Body Shame 3
Individual and Developmental Factors 4
External and Societal Factors Contributing to Body Shame 4
White Supremacy Culture (WSC) 4
Thin-Privilege, Drive for Thinness, & Muscularity 5
Social Media/Media Literacy 5
Health-Care/Medical Community 6
Body Image in the LGBTQIA+ Community 6
Body Image in BIPOC community 7
Clinician Self-Work & Self-Reflection 7
Activity - The Clinician’s Own Body Image 7
Body Image & Eating Disorders 8
Body Image in Specific Diagnoses 9
Clinical Interventions: Body Image Spectrum, Healing Stages, & Techniques 10
Address the Functions of Body Image Distress 10
Body Image Healing Continuum 11
Body Dysmorphic Disorder 17
Body Dysmorphic Disorder (BDD) Assessment 17
Common Behaviors: 18
Related symptoms: 18
Key differences between BDD and Other diagnoses: 18
Risk Factors: 19
BDD Treatment 19
Best Practices for BDD 20
CBT-BDD: 20
CBT-BDD Treatment model with Techniques: Case Example 22
ERP for BDD: 23
ERP Case Examples: 23
Contraindications, Limitations, & Considerations 26
References 27
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Overview: Compulsive Exercise 2
Compulsive Exercise Defined 2
Exercise Dependence Defined 3
Excessive Exercise Defined 3
The Invisible Behaviors in Compulsive Exercise 4
Causes: Compulsive Exercise 4
Prevalence: Compulsive Exercise (CE) 4
Functionality of Compulsive Exercise (CE) 5
Dissociative Processes 5
Emotion Avoidance 6
Avoidance of Physiological Sensations 6
Stored, Unprocessed Trauma 7
Response to Obsessive, Intrusive, or Distressing Thoughts 7
Body Image Distress 7
Exercise as Identity 7
Inability to be Still 8
Fitness Culture 9
Diagnostic Considerations 12
Body Dysmorphic Disorder (BDD) 12
OCD/OCPD in Compulsive Exercise 12
Risks: Compulsive Exercise 14
Symptoms: Compulsive Exercise 15
CE Triggers 16
Assessment: Compulsive Exercise 16
Assessment Questions and Themes 16
CE Assessment Tool Options 17
Exercise Dependence Scale (EDS) 17
Compulsive Exercise Test (CET) 18
Treatment: Compulsive Exercise 19
A Word of Caution in Incorporating Exercise into Eating Disorder Treatment 19
A Brief History of Incorporating Exercise in Eating Disorder Treatment 21
Overview: CE Treatment Modalities 22
Psychoeducation 22
Exposure and Response Prevention 22
Cognitive Behavioral Therapy 23
Dialectical Behavior Therapy (DBT) 25
Harm Reduction 26
Safe Exercise at Every Stage (SEES) 26
Treatment Considerations for Compulsive Exercise in EDs 27
Athletes and Compulsive Exercise 30
Treatment Strategies for Athletes & CE 33
Recovery from Compulsive Exercise 36
Intuitive Movement or Intuitive Exercise 36
CE Treatment Team Roles 38
Learn More from Ragen Chastain: 39
References 39
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Objectives for Each Section 8
Racism 15
Social Impact 19
Emotional Impact 19
Political Impact 19
Historical Context 20
Foundations of the Medical and Healthcare Systems 22
Shifts Towards Recognition and Inclusivity 22
Ongoing Challenges and the Path Forward 23
Systems of Oppression 23
Colonization 24
Racism 24
Sexism 25
Classism 25
Ableism 25
Heterosexism/Homophobia 25
Ageism 25
Nativism 26
Patriarchy 26
Interaction and Compounding of Inequities: The Matrix of Domination 27
The Medical-Industrial Complex as a System of Oppression 30
An Historical Perspective 30
Modern Medical Landscape 31
Racism in Public Health 32
Pathologization of Race 33
Pathologization of Gender 34
Continued Experimentation and Mistreatment 34
The Modern Eugenics Movement 35
Impact of BMI 37
White Supremacy Culture 38
Centralization of White Norms 39
Institutional Power 39
Implicit Bias and Racial Stereotypes 39
Economic and Social Disparities 40
Resistance to Change 40
Whiteness and Body Hierarchies 41
The Valuation of Bodies Based on Looks 42
Impact of Body Hierarchies 43
Gender Non-Conforming Individuals 44
Persons with Disabilities 45
Conforming to Body Standards as a Coping Mechanism 45
Ancestral Patterns and Bodily Dissociation 47
White Supremacy as the Core Issue 49
Implications for ED Treatment 49
White Supremacy Culture By Trait 50
Perfectionism in White Supremacy Culture 52
Sense of Urgency in White Supremacy Culture 53
Defensiveness in White Supremacy Culture 55
Quantity Over Quality in White Supremacy Culture 56
Worship of the Written Word in White Supremacy Culture 58
Only One Right Way in White Supremacy Culture 59
Paternalism in White Supremacy Culture 61
Either/Or Thinking in White Supremacy Culture 62
Power Hoarding in White Supremacy Culture 64
Fear of Open Conflict in White Supremacy Culture 66
Individualism and Separateness in White Supremacy Culture 68
"I'm the Only One" in White Supremacy Culture 70
Silence in White Supremacy Culture 71
Objectivity in White Supremacy Culture 73
Right to Comfort in White Supremacy Culture 75
Progress is Bigger/More in White Supremacy Culture 77
Bias 80
Affinity Bias 82
Confirmation Bias 83
Groupthink or Conformity Bias 83
Perception Bias 84
Conscious Bias 84
Recognizing Bias in Ourselves and Our Practices 86
Shame and Stigma Sensitive Language 87
Perpetuating Shame 87
Creating Power Imbalances 87
Indicating Criminality 88
Principles for shame‐sensitive practice 89
Communal and Culturally Relevant Approaches 90
Terminology and Mind-Body-Spirit Unity 91
Actions for Inclusive Professionals 91
Intersectionality 93
Intersectionality as a Tool for Validating Experience 95
Enhances Understanding of Diverse Experiences 95
Promotes Culturally Competent Care 96
Challenges Stereotypes and Assumptions 96
Facilitates Equitable Access to Treatment 96
Supports Holistic Recovery 97
Exploring the Intersections of Identity and Bias 97
Anti-Blackness in the Context of Eating Disorders 98
Anti-blackness and the Role of Internalization and Colorism 99
Nativism and Immigration 101
Economic Changes and Disordered Eating 102
Cultural Food Whitewashing: 102
Acculturation and Eating Disorders 103
Conclusion and Charge to ED Professionals 104
Intersectionality of LGBTQIA+ and Gender Non-conforming Issues in Eating Disorders 104
Sexism and Misogyny: Impacts on Eating Disorders Recognition and Treatment 106
Sexism and Men with Eating Disorders 110
Anti-fat Bias and Size Privilege: Impacts on Eating Disorder Treatment and Prevention 111
Disabilities and Chronic Health Conditions: Navigating Barriers to Care and Support 113
Healthism: Consequences for Eating Disorder Perception and Treatment 114
Neurodivergence and Eating Disorders: Tailoring Diagnosis and Treatment 116
Ageism: Navigating Age Biases in Eating Disorder Care 118
Appearance Standards: The Role of Societal Beauty Ideals in Eating Disorders 120
WSC and Bias Compound Barriers 121
Addressing Intersectional Biases within WSC: 122
Application of Intersectionality: 124
Strategies for Incorporating Intersectionality into ED Treatment 125
Embrace Cultural Competence and Humility: 126
Develop Tailored Treatment Plans: 126
Foster Inclusive and Supportive Environments: 126
Engage in Advocacy and Community Collaboration: 126
Incorporate Intersectional Education and Training: 127
Utilize an Empowerment-Based Approach: 127
Intersectionality, White Supremacy Culture, and Their Influence on ED Research and Public Education 127
Understanding Systemic Disparities and Inequities 130
Health Disparity 131
Health Inequity 131
Eating Disorders as a Social Justice Issue 132
Impact of Inequities and Systems of Oppression 133
Prevalence and Diagnosis 134
Disproportionate Impact on LGBT Individuals 135
Transgender Individuals and Body Modification 136
Gay Males, Binging, and Purging 136
Lesbian, Bisexual, and Mostly Heterosexual Females 136
Disparities in Treatment and Recovery 137
Disparities along Socioeconomic Status 137
Systemic Inequity and Access to Care 138
Socioeconomic Status and Healthcare Outcomes 138
Social Determinants of Health 140
Partial List of Social Determinants of Health: 142
● Economic Stability: Employment, income, expenses, debt, medical bills, and support. 142
Social Determinants as Products of Structural Racism 142
Presenting Social Determinants as Conditions to Be Challenged 143
Structural Racism as a Social Determinant of Health 144
Implications for Health Professional Education 144
Implications for ED Treatment 145
SDOH of Particular Interest to the Eating Disorders Field 146
Trauma of Racism and Oppression 146
Psychological and Physiological Impact: 147
Internalization of Racial and Cultural Standards: 147
Impact on Eating Disorder Treatment Processes 150
The Diagnostic Process 151
● Reliance on BMI 151
● Bias Regarding Who Develops EDs 151
● Cultural Differences in Assessment Responses 152
Treatment Modalities: 153
Residential Treatment 154
Communal and Culturally Relevant Approaches 156
Tools that Promote Inclusion 160
Cultural Competency Continuum 161
Application in ED Treatment 162
Understanding Cultural Diversity in ED Presentation 164
● Recognize Variability in Symptoms and Ideals: EDs manifest differently across cultures due to varying beauty ideals, food practices, and body image perceptions. Healthcare providers should familiarize themselves with the diversity of ED presentations and be aware that the "thin ideal" is not universal (Pumariega, Gustavson, Gustavson, Stone Motes, & Ayers, 1994). 164
Training and Education 164
Culturally Sensitive Assessment and Treatment Planning 164
Incorporating Cultural Practices 165
Language and Communication 165
Building Trust and Rapport 165
Advocacy and Policy 165
Understanding Cultural Diversity in ED Presentation 166
Training and Education 166
Culturally Sensitive Assessment and Treatment Planning 166
Incorporating Cultural Practices 167
Language and Communication 167
Building Trust and Rapport 167
Advocacy and Policy 167
Intersectional Feminism in Eating Disorder Treatment 168
Dismantling White Beauty Standards 170
Systemic Change and Uplifting BIPOC Providers 170
Prioritizing Resources and Referrals 171
Anti-Oppressive Supervision and Support 171
Centering Marginalized Voices 171
Health at Every Size (HAES) as a Treatment Model in Eating Disorder Care 172
HAES Principles 173
Application in ED Treatment: 173
Structural Competency 174
How to Become More Structurally Competent 176
A Call to Action for Inclusive Eating Disorder Professionals 178
References 179
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Person of the Therapist 2
Therapeutic Presence 2
Therapeutic presence defined 2
Weight Bias 4
Activity - Challenging Your Own Biases 5
Activity - Journal & Reflection Assignment: Your Body Story 5
Clinician’s Own Journey with Body and Eating Disorder Symptoms 6
Activity - Journal & Reflection Assignment 6
Research Article 7
Research Article 8
Research Article 9
Research Article 11
Research Article 12
Considerations in Eating Disorder Treatment - Levels of Care Defined and Explained 15
Research Article 15
Research Article 17
Review of Important Concepts 18
Activity - Complete the following 3 assignments 20
Activity - Contacting an Experience of Presence 21
The Eating Disorder Treatment Team 22
References 27
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