Big Ideas In Eating Disorders

Scott Griffiths, PhD is a body image and physical appearance researcher at the University of Melbourne. He leads the Physical Appearance Research Team as an NHMRC Senior Research Fellow. Roisin McNaney, PhD, a cross-disciplinary digital health researcher directing CSIRO's Next Generation of Graduates program in AI and Mental Health. They are combining their expertise to explore whether social media -  particularly TikTok's -  can be repurposed for eating disorder screening. Their work transforms the discussion on social media and mental health.
Drs. Griffiths and McNaney have contributed a chapter to Big Ideas In Eating Disorders (Weissman & Pike, editors) that is tremendously thought provoking and forward looking. They share highlights from their research that is built on a bold and visionary question about the use of social media. Their work comes amid growing efforts in Australia to restrict social media access for vulnerable youth, including the Online Safety Amendment banning under-16s from social media. Scott and Roisin are exploring whether an opportunity exists to use social media to actually improve mental health rather than only restrict access. They want to genuinely understand and address the underlying risks these platforms pose AND exploit their potential for good.
Their central insight flips a common concern on its head. Rather than treating recommendation algorithms purely as a threat, they see the rich, passively generated data these platforms already produce as an untapped opportunity — one that could enable personalized eating disorder screening at a scale and precision current methods can't match. Join us to hear more about their big idea, and you can read the full chapter in the Big Ideas In Eating Disorders (Weissman & Pike, editors).

Stuart B. Murray, PsyD, PhD, is the Franklin Mint Professor in the Department of Psychiatry and Biobehavioral Sciences at UCLA, where he serves as Director of the Eating Disorders Program and Director of the Translational Research in Eating Disorders Laboratory. His lab is dedicated to elucidating the mechanisms of symptom remission in eating disorders, developing novel treatment interventions, and advancing the recognition and treatment of male eating disorders. Professor Murray joins us for this third episode in our Big Ideas in Eating Disorders series featuring contributing authors to the book that Dr. Ruth Weissman and I co-edited. His chapter co-author, Jason Nagata, MD, MSc, is Associate Professor of Pediatrics at the University of California, San Francisco, where his research focuses on eating disorders and body image in boys and young men.
 
In Chapter 3 of Weissman and Pike's Big Ideas in Eating Disorders, Murray and Nagata confront a blind spot the field has carried for decades: eating disorders in boys and men. For generations, the science, the screening tools, and the treatments have been built around girls and women, leaving millions of boys and men underdiagnosed, misunderstood, or invisible altogether. Muscularity-oriented disordered eating, they argue, doesn't just look different; it demands a different lens entirely.
 
That gap has real consequences. Murray and Nagata trace how diagnostic frameworks calibrated to thinness can miss the drive for muscularity at the heart of many boys' and men's struggles, and they make the case for what it would take, from research to screening to treatment, to build a field that sees all of its patients.
 
Join us for a behind-the-scenes conversation with Stuart as he unpacks the chapter he co-authored with Jason Nagata, the science behind it, and what it means for the boys and men the field has too often overlooked.

William Sharp, PhD, directs the Pediatric Feeding Disorders Program at Emory's Marcus Autism Center, where he's also a Professor in the Division of Autism and Neurodevelopment in the Department of Pediatrics. Kathryn Peterson, PhD, BCBA-D, is a professor at Rutgers Robert Wood Johnson Medical School. Professors Sharp and Peterson join us for this second episode in our Big Ideas in Eating Disorders series that features contributing authors to the book that Dr. Ruth Weissman and I co-edited.
 
In Chapter 2 of Weissman and Pike's Big Ideas in Eating Disorders, Sharp and Peterson tackle a diagnostic puzzle hiding in plain sight. Two conditions, Pediatric Feeding Disorder and Avoidant Restrictive Food Intake Disorder, are both used to describe eating disturbances in children, and they overlap so heavily that clinicians are often left guessing which one actually fits.
 
That confusion isn't just academic. Will and Kate trace how the field ended up with two overlapping categories instead of one clear path forward, and make the case that untangling them is essential to improve treatment. Get the diagnosis wrong, they argue, and the treatment doesn't just fail. It can make things worse. 
 
Join us for a behind-the-scenes conversation with Will and Kate as they unpack the chapter, the debates that shaped it, and what it means for the kids caught in the middle.

Phillipa Hay MD, DPhil, is Chair of Mental Health, Translational Health Research Institute, Western Sydney University, Penrith South, New South Wales and the Director of Mental Health Research at Southwestern Sydney Local Health District. Dr. Hay is an academic psychiatrist who is recognised internationally for her expertise in reducing the personal and public health burden of eating disorders and obesity.
Deborah Mitchison, PhD is Associate Professor in Psychology at the Graduate School of Health at the University of Technology Sydney. Professor Mitchison also holds adjunct appointments at Western Sydney University and Macquarie University. 
Drs. Hay and Mitchison’s chapter in Big Ideas In Eating Disorders poses a big and provocative idea: What if we completely reimagined how the field classifies and diagnoses eating disorders? They argue that the current diagnostic frameworks are confusing and limited in practice, and they strongly advocate that the field will be better served by understanding the defining features of an individual’s eating disorder and the unique constellation of symptoms as experienced by the individual. In this podcast, Dr. Hay elaborates on these core ideas and what they would mean in real-world practice.

Professor Phillipa Hay is a psychiatrist and the current Chair of Mental Health at Western Sydney University in Australia, the co editor-in-chief of the Journal of Eating Disorders, and past recipient of the Lifetime Leadership Award from the Australia New Zealand Academy for Eating Disorders. Drawing on her experience from decades of teaching, research, and clinical care in eating disorders, Dr. Hay discusses the limitations of weight-based criteria in eating disorder diagnostic criteria, both in terms of limiting treatment access and in restricting our understanding of recovery.

Today we have the good fortune to hear from Dr. Kelly Klump whose contributions to the field of eating disorders are indeed invaluable. Inspired by one of her early mentors, Professor Gloria Leon, Dr. Klump has embarked on a journey of groundbreaking research that reshapes our understanding of the complex interplay between genetics, hormones, and environmental factors in the development of eating disorders. Dr. Klump’s exploration of gonadal hormones, including estrogen, progesterone, and testosterone, is steadily uncovering the relationship of hormonal fluctuations, particularly during puberty, to the onset and expression of eating disorders. Translating these findings to clinical practice has the potential to inform more effective prevention strategies and personalized interventions for individuals at risk of developing eating disorders.

In this episode, we delve into the insights of Trinity University Psychology Professor Carolyn Becker, whose insatiable curiosity and openness to explore diverse fields have been the driving forces behind her innovative and fruitful career. Recognized for her excellence in teaching and research, Professor Becker's expertise lies in implementing scientifically backed interventions in both clinical and real-world contexts. She has led innovative work focused on body image and athletes and has spearheaded groundbreaking research on eating disorders among individuals facing food insecurity, a demographic often overlooked by conventional eating disorder studies. Her work underscores the imperative to dismantle stereotypes surrounding eating disorders.

Today’s episode takes us on a global journey with Dr. Anne Becker, Maude and Lillian Presley Professor of Global Health and Social Medicine at Harvard Medical School. Although Anne never became the meteorologist she imagined in her youth, as a psychiatrist and anthropologist, she traveled far from home to launch pioneering work in Fiji focused on how culture contributes to shaping the meaning of body image and risk for eating disorders. In this episode, Anne shares how she got to Fiji, the surprising conversations, and the evolving meaning of weight in Fijian communities at different points in time. Anne shares the serendipitous circumstances that enabled her to map the impact of the arrival of American television on triggering eating disorder symptoms and rising body shape and weight concerns. Dr. Becker’s keen intellect and her delight in discovery is riveting and contagious as she shares her pioneering work, which is foundational for anyone who wants to understand culture and eating disorders.
Becker, A.E. Television, Disordered Eating, and Young Women in Fiji: Negotiating Body Image and Identity during Rapid Social Change. Cult Med Psychiatry 28, 533–559 (2004). https://doi.org/10.1007/s11013-004-10...
Becker, A.E. Body, Self, and Society: The View from Fiji, 1995.

I am delighted to be joined today by Rachel Rattenni as part of our special series focused on the proposed diagnosis “terminal anorexia nervosa.” Rachel has a graduate degree in bioethics from Columbia University and is currently pursuing a master’s in public health at Johns Hopkins University Bloomberg School of Public Health. She also serves as Rachel serves as the Program Assistant for Big Ideas In Eating Disorders. Her formal studies and work, in combination with her own lived experience with an eating disorder, inform her thoughtful and insightful comments on the risk of losing hope associated with the proposed diagnosis and the need to create more space for patients to have voice and agency in shaping their treatment goals, i.e., from the beginning and long before they meet the proposed criteria for “terminal anorexia nervosa.”

The current episode is the third of our six-part series focused on the proposed diagnosis of “terminal anorexia nervosa.” My guest is Rosiel Elwyn (they/them/she), a PhD candidate at the Thompson Institute, Australia, who is studying the neurobiology of anorexia nervosa with a focus on the role of trauma and its effects on the glutamatergic system, the gut microbiome, and interoceptive function. Rosiel has lived with anorexia nervosa since childhood and currently works as a lived experience researcher and mental health consultant on a number of projects and advisory groups in eating disorders, suicide prevention, psychosis, trauma, and trauma-informed care, with a particular interest in co-design in these areas. With heart and mind, Rosiel shares with us hard earned insights on the proposed diagnosis of “terminal anorexia nervosa” and demonstrates brilliantly the unique and essential contributions that people with lived experience bring to field of eating disorders.
Elwyn, R. A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope. J Eat Disord 11, 2 (2023).
Treem, J., Yager, J., Guadiani, J.L. AMA J Ethics. 2023;25(9):E703-709.