For many years self-esteem was seen to be the key to psychological health. More recently, however, researchers have identified several downsides to the pursuit of self-esteem such as narcissism, ego-defensiveness, social comparisons, and the contingency and instability of self-worth. Research suggests that self-compassion is a healthier way of relating to oneself, offering the benefits of self-esteem without its downsides. Self-compassion involves treating ourselves kindly, like we would a close friend we cared about. Rather than making global evaluations of ourselves as “good” or “bad,” self-compassion involves generating kindness toward ourselves as imperfect humans, and learning to be present with the inevitable struggles of life with greater ease. It motivates us to make needed changes in our lives not because we’re worthless or inadequate, but because we care about ourselves and want to lessen our suffering. This talk will present theory and research on self-compassion, which a burgeoning empirical literature has shown to be powerfully associated with psychological wellbeing. It will distinguish self-compassion from self-esteem, and discuss research indicating that self-compassion is a more powerful and effective motivational tool than self-criticism. A brief self-compassion practice will also be taught that can be used in daily life.
What if my patient gets fat? Confronting Weight Bias and Treating Eating Disorders in Higher Weight Patients.
This presentation addresses diagnostic and treatment considerations for higher-weight patients with eating disorders. Beginning with an overview of weight bias, presenters will discuss weight bias in medical care and the eating disorder field. Next, presenters will introduce eating disorders across the weight spectrum, focusing on atypical anorexia. Data from a recent study of atypical anorexia will be discussed regarding demographic characteristics and clinical presentation, including eating disorder severity scores, weight suppression, and treatment delay. Additional qualitative findings regarding treatment experiences are discussed. Following this, presenters will introduce binge eating disorder, and address issues of diagnosis and treatment, including addressing internalized weight bias and potential iatrogenic aspects of treatment. Finally, presenters will end with a discussion of treatment considerations when treating higher weight folks with eating disorders, including the significance of diagnosis and transdiagnostic approaches, addressing internalized weight stigma in the clinical context, and the importance of intersectional approaches.
Identify three ways clinician weight bias can negatively impact clinical care for individuals in larger bodies with eating disorders.
Explain five clinical considerations in treatment of higher-weight eating disorders and discuss ethical responses to these considerations.
Describe the clinical presentation of individuals with atypical anorexia and identify three important disparities these individuals may experience compared to their thinner peers.
Learn three ways a weight-inclusive approach can enhance the treatment of eating disordered individuals.
Food Insecurity and Eating Disorders: Creating Accessible Treatment Options
The methods used to diagnose and treat eating disorders were derived from research that did not differentiate between food secure and insecure eating disorder patients. Although these treatment methods are appropriate for many people, it is harmful for providers to overlook how these approaches naturally create blind spots in treatment for individuals from different socioeconomic classes. Laura Watson is a registered dietitian that treats eating disorders in food insecure individuals from various marginalized communities in North Carolina. Kimberly Singh is a dietetic intern who has worked with refugee communities in the Southeast and food insecure families in The South Bronx. Their combined experiences have taught them that famine, food access, and societal oppression shape how patients heal their relationships with food. Ms. Watson and Ms. Singh will explain how nuanced differences in messages, goals, and barriers influence eating disorder treatment and recovery for individuals with food insecurity.
Identify food insecurity in eating disorder patients and examine the ways in which food insecurity is impacting patients’ recovery
Understand the role of food insecurity on health, dietary behaviors, and eating disorders as demonstrated in research, case studies, and lived experiences
Establish goals in recovery that are patient0centered in regards to food security status and cultural identity
Learn methods to identify and minimize cultural barriers to help those with food insecurity and eating disorders
Learn how to increase access to food and recovery for all
Day 2: March 2
Out of the Stuck: Using ACT and Therapeutic Strategies to Create Change
Eating disorders are genetically predisposed MIND disorders that are reinforced by cultural beliefs, personal values and environmental influences to cement eating disorder beliefs, behaviors and identities. Treatment and recovery require the team, family and client to challenge the thoughts, values and behaviors that precipitate and perpetuate the eating disorder. Learn the importance of nutritionists using ACT principles and other cognitive treatment strategies to assist clients in shifting their MINDS, thoughts, values, actions and culture from judgement to acceptance, worthlessness to worthiness, image to essence, powerless to powerful and restriction to nourishment. ACT and CBT thinking skills are aimed at negative thinking patterns and behaviors, which impact the sufferers’ relationship with their food, body and others. A variety of concrete thinking skills including before and after thinking, minimizing, labeling, accounting, buffering, distancing and transferring of thoughts will be offered for practitioners to bring back to their practices.
Participants will have a better understanding of how ACT theory can impact nutrition therapy and nutrition strategies for eating disorder treatment.
Participants will be able to explain and demonstrate several corrective ACT and CBT thinking tools and creative strategies that promote positive thoughts and feelings which in turn elicit positive actions and facilitate change, growth and a healthier sense of self.
Participants will be able to challenge repetitive and compulsive eating patterns with their clients by utilizing ACT and CBT dialogs to elicit and demonstrate a positive change in food and eating behaviors.
Psychiatric Medications: Uses and Implications for ED Recovery and Optimizing RD/PsyD Teamwork
Eating Disorders rarely exist alone; often, they are co-occurring with other mental disorders. Many mental health disorders can cause disturbances in appetite, produce negative thoughts, result in maladaptive behaviors and rituals, interfere with sleep, and isolate an individual for their support system – all of which can result in treatment non-compliance with the therapist and dietitian and even resulting in personal, professional, and academic distress.
It is important for patients with eating disorders to see a psychiatrist that understands eating disorder pathology to help communicate with the team about medications. Most importantly, focusing on medications that can increase or decrease weight gain through appetite signaling, pros/cons of starting or stopping medications, and how RD’s can effectively support the patient with nourishing their bodies when medications are interfering with appetite signaling or are altering body weight. Additionally, understanding these mechanisms and understanding the psychosocial stressors of the eating disorder can help minimize polypharmacy.
Develop a broad understanding of a psychiatrist’s training to give broader context to the necessity of a psychiatrist on the treatment team.
Understand the importance of an outpatient team for eating disorders and the psychiatrists’ role of increasing communication within the team.
Have an understanding of when medications are required and when they are not.
Be able to identify classes of psychotropic medications, their uses, and how they may effect eating disorder treatment.
Changing our MENtality – Perspectives of Missed Diagnosis and Under-Recognized Eating Disorders in Male Athletes
This presentation is intended to initiate conversation in the assessment and treatment of males with eating disorders specifically male athletes.During Becca’s time working in the NFL and collegiate athletics she saw a gap in identification of disordered eating and who was encouraged to seek help. This presentation will share case study examples of how conventional treatment may miss the mark in support and effective treatment of male athletes with body dysmorphia and eating disorders.
Be able to recognize how male athlete may differ in their presentation of eating disorder symptoms and behaviors
Distinguish how treatment goals and outcomes may differ for the male versus female athlete.
Recognize current efforts for awareness and where males may still be excluded in assessment questionnaires, current literature and social media campaigns.
The Be Body Positive Model: A Whole-Person Approach to Eating Disorders Recovery and Prevention
Connie Sobczak, Author and creator of The Body Positive
The five Competencies of the Be Body Positive Model offer a holistic approach to well being because they touch on the core elements of what it is to be a human being. With Reclaim Health, we access our mind; with Practice Intuitive Self-Care, we connect with our bodies; with Cultivate Self-Love, we move into our hearts; with Declare Your Own Authentic Beauty, we open to our souls; and with Build Community, we address the deep need human beings have for connection with others. In this webinar, you will be introduced to this model that not only reconnects people with their bodies, but also with their deep purpose and value in a way that is truly healing.
Describe three practical applications of the Be Body Positive Model in a clinical setting.
Demonstrate relevant Be Body Positive Competencies to use in promoting resiliency against poor body image in clients.
Experience the power of our Model to enhance your relationship with your own body, improve your self-care, and prevent professional burnout.
Day 3: March 3
The Wonder Years: Advocating for Protective Care for Adolescent Girls
In our fatphobic environment, the increase in body fat that characterizes normal adolescent female growth is often pathologized by parents, healthcare providers, and other trusted adults. When normal growth is targeted as problematic, iatrogenic interventions may be imposed, increasing risk for eating disorders and lasting body image disturbance. This presentation will explore normal female adolescent growth in detail, including rapid weight gain and body fat percentage increase, empowering professionals to advocate for appropriate, informed, and protective care for young girls. We will also discuss deviations from normal growth and when concern by parents and providers is warranted.
Discuss the evidence that dieting messages and cultural environmental messages contribute to eating pathology and weight dysregulation in adolescents.
Conduct a complete assessment of growth information and determine if weight is dysregulated or if growth appears normal.
Describe appropriate and inappropriate nutrition intervention when weight dysregulation is present in the adolescent patient.
Using the Dietitian in Family Based Treatments for Adolescent Eating Disorders
Nutrition therapy plays an integral role in the treatment of eating disorders (ED). Research continues to show family based treatment (FBT) approaches for ED, indicating positive outcomes for adolescents; yet utilization of registered dietitians (RD) have not been studied or formally included in practice parameters. With familiarity in behavioral and medical consequences of malnutrition, the RD represents a valuable role in the support of parent empowerment. This presentation will discuss integration of an ED RD into an FBT-informed model. Topics will address: division of labor, scope of practice, collaboration, and levels of care (LOC). High acuity case examples will be used to illustrate how an ED RD is utilized in treatment goals in order to strengthen patient recovery outcomes.
Ability to describe Family Based Treatments models, history of them, and supportive evidence in treatment outcomes.
Understanding of how FBT is used in different LOC.
Understanding of possible roles an RD can play in a collaborative team approach, and how much is within our SOP.
Awareness of differing approaches and outcomes of case examples utilizing an RD in an FBT model treating ED through changing LOC.
Confidence to ‘lean in’ and engage with other clinicians to utilize an FBT model for ED.
Obsessionality and Eating Disorders: A Team-Based Approach for Increasing Cognitive Flexibility
Research has shown that individuals with eating disorders, particularly anorexia nervosa, can struggle with cognitive rigidity and obsessionality. There are various treatment modalities and therapeutic techniques that can be used to increase cognitive flexibility, including cognitive remediation therapy (CRT). Often clients presenting with longstanding illness and obsessionality are labeled as treatment resistant, but using therapeutic techniques to increase cognitive flexibility provides an opportunity to approach treatment differently. For example, the focus in CRT is to target thinking processes versus content, thus not focusing solely on eating behaviors. This approach can increase motivation and engagement of the client, and also requires innovation and flexibility of the treatment team in order to challenge all areas of treatment–psychological and nutritional. Case studies will be utilized to explore the unique challenges of addressing obsessionality and rigidity in eating disorders and how a flexible, team based approach can be utilized.
Participants will identify ways that clinicians and dietitians can incorporate and model flexibility in treatment for eating disorders.
Participants will be able to describe the importance of addressing obsessionality and cognitive flexibility in EDs.
Participants will learn at least one practical tool or intervention that can be applied to your practice.
Day 4: March 4
Beyond Silence at the Table: Effectively using mindfulness as an intervention in the nutrition therapy setting
When the lay-public discusses the term mindful eating, they typically think about eating without distraction and eating slowly. And, in professional spheres, when dietitians attempt to draw distinctions between intuitive eating, eating competence and mindful eating, mindful eating is typically boiled down to tuning in while eating. And, while this may be an element to mindfulness intervention in the nutrition therapy setting, there is so much more to the practice of mindfulness than simply eating without distraction or tuning in while eating. This presentation will walk through the most powerful mindfulness interventions to have in the nutrition therapy setting. Mindfulness as an intervention in the nutrition therapy setting hits on the most important work a dietitian can do with a client: help them feel grounded, get attuned to their body’s needs, learn how to feel their feelings, explore embodiment and values-based living and to get comfortable with the nuance of what recovery really looks like.
Session attendees will be able to enumerate at least three empirically supported benefits of mindfulness practice.
Participants will be able to explain to their clients/patients the core concepts of mindfulness.
Participants will be equipped with mindfulness skills and practical activities to implement into sessions with clients.
Participants will be able to recognize and assess readiness for mindfulness interventions in the nutrition therapy setting.
The RAVES Model – A back pocket framework to guide the nutritional management process in eating disorders and non-diet approach
The RAVES model is an evidence informed framework that has been developed to guide the nutritional management process in both the treatment of eating disorders and when adopting the non-diet approach to weight concerns. Incorporating key nutrition principles from the eating disorder literature, the RAVES model has a twelve year history of clinical application in both the inpatient and outpatient settings. Many dietitians and other multi-disciplinary health professionals across Australia have adopted the model as nutritional tool in the clinical setting, with it’s application reported in FBT, CBT-e, and Multi-disciplinary treatment models. This presentation will outline the development of the RAVES model, its clinical application, and it’s role in helping clients develop a positive relationship with food.
An understanding of the evidence supporting the development of the RAVES model
Knowledge of the 5 key principles of the RAVES model and the benefits for each principle
Knowledge of the 3 phases of the RAVES model and the role each phase plays in establishing a positive relationship with food
The ability to use the RAVES model as a nutritional framework in clinical practice
Making the Connection: Acknowledging Differences Can Bring Greater Understanding to our Relationship to Food
Differences in cultural identity, access to food, and food preferences are an inherent part of our society. These differences play a large role in the foods we choose to eat and our relationship to food. In this presentation, you will learn about how to broach the taboo subjects related to culture, religion, gender, and ability that are critical to understanding our clients’ relationship to food. Additionally, we will discuss how to have difficult conversations that clients bring up that most dietitians don’t feel trained to discuss. Due to the complex nature of eating disorders tied to emotions and various life situations, clients often bring up topics in nutrition sessions that dietitians feel ill-equipped at handling. Not being able to respond to these leads to missed opportunities for building trust and facilitating healing with your clients.
Learn about various privileges and disparities that are critical to understanding our clients’ relationship to food.
Learn how to broach subjects and have difficult conversations with clients that dietitians often do not feel trained to discuss.
Learn how to identify and name body language that your client is displaying that will give you more insight into their emotional experiences in the moment.