
Recently, one of the creators of the Inclusive Eating Disorder Certification Program questioned how I can speak so vehemently about collaboration when I am, in that person’s view, so divisive in the eating disorder community.
That question deserves an answer because it exposes one of the field’s most persistent evasions. Many people in the eating disorder community use the word collaboration when they mean agreement, access, approval, politeness, ideological alignment, or silence. They do not mean objective testing of claims nor public disagreement nor bringing clinicians, researchers, families, former patients, regulators, and grieving parents into the same room and forcing uncomfortable facts into view.
They mean … stop making people uncomfortable.
That is not collaboration. That is compliance. It is performative. And I reject that premise.
Collaboration does not require making peace with dysfunction. Nor does it require vacuous flattering of certification programs, credential vendors, professional organizations, treatment platforms, social media advocates, or ideological factions that have all failed to produce measurable accountability in a field where our loved ones continue to die. Collaboration does not require pretending that every certificate confers expertise, every advocate with a platform has wisdom, or every institution fluent in inclusion is clinically serious.
Serious collaboration begins with reality. And reality is divisive only to those protected by illusion.
The eating disorder field has a long history of confusing tone with integrity. Raise direct questions about mortality, treatment failure, private equity, unregulated coaching, credential inflation, ideological capture, weak standards, or professional self-protection, and parts of the field suddenly discover false civility. The same people who tolerate fragmentation, silence, opaque outcomes, and avoidable harm become deeply concerned about whether the person naming the problem is pleasant enough.
That is insufferable and should not be tolerated.
Our loved ones continue to die. The body count escalates. Families are being misled. Patients are cycling through levels of care without durable recovery. Parents are paying enormous sums of money for treatment they cannot evaluate. Clinicians are practicing inside reimbursement systems that often dictate care more aggressively than science does. Militant activists are attempting to bastardize the DSM-V to fit their short-sighted understanding of eating disorders. Treatment companies market hope while withholding the outcomes data that would allow the public to judge whether that hope is justified. Certificates multiply while families struggle to distinguish education from regulation, training from authority, and branding from protection.
If exposing those realities constitutes being divisive, then the division was already there. I did not create it. I just refuse to decorate it or surrender to it.
Without common goals and objectives, there can be no collaboration. Diametrically different goals are the death of collaboration.
Collaboration is not indiscriminate. People cannot collaborate through evasion. People cannot treat bad evidence as merely another perspective. A community is not required to accept a biased certificate as a substitute for licensure, medical competence, supervision, public discipline, or enforceable patient protection. A community should not become a chorus of reassurance while mortality remains the quietest fact in the room.
The accusation that I am divisive says more about the accuser’s definition of community than it says about my commitment to collaboration. For that matter, what is this community I am allegedly dividing?
The patients? The families? Serious clinicians? Researchers? I have stood with and helped each of those groups.
The certification sector? If so, let me be precise. Certification is not regulation. A certificate may mean someone merely completed a course. It does not mean a state has granted legal authority to treat vulnerable people. It does not mean a public disciplinary body exists. It does not mean families have meaningful protection if harm occurs. In a field where the public already struggles to distinguish therapist, dietitian, physician, coach, advocate, consultant, mentor, educator, and influencer, credential inflation is not harmless. It can become structural erosion sold as progress.
The question is not whether a certification program uses the language of inclusion. The question is whether it improves clinical seriousness, patient protection, measurable outcomes, and public accountability. The question is, will it decrease the crippling mortality rate haunting eating disorders. Those questions must be asked directly.
I do not oppose inclusion. To the contrary. Access to care is an incredibly important issue which must be addressed intelligently. What I do oppose is using inclusion as a shield against scrutiny to perpetuate a close minded or radical political or social justice agenda. I will not gladly suffer anyone who attempts to use the illness that took my daughter’s life as a platform to spew forth their radical political or social justice views. That I will not forgive. Nor allow.
There is a difference between being divisive and drawing necessary lines. A field that cannot distinguish between those things is not mature enough to police itself.
That is exactly where collaboration is needed. But collaboration cannot begin with a conclusion dictated by activist commitments.
The accusation of divisiveness is efficient because it avoids the merits. It also does not answer whether the criticism is true. It does not address whether standards are weak, outcomes are hidden, research is underfunded, coaching is dangerous when it crosses into treatment, certificates confuse the public, or ideology has displaced scientific seriousness in parts of the field.
The eating disorder field does not need fewer divisions if the price of unity is silence. It needs better divisions. It needs a division between evidence and performative conduct. Between licensure and certificate marketing. Between peer support and unsupervised treatment. Between inclusion and ideological capture. Between compassion and institutional self-protection. Between families asking questions and professionals resenting those questions. Between people trying to save lives and people trying to preserve their place and social platform in the room.
A serious community does not fear those divisions. It clarifies them. It embraces them.
I am in this dysfunctional field because my daughter died. That is not a credential. It is not a claim to infallibility. It does not make every judgment correct. It does, however, make one thing impossible: I cannot pretend the stakes are lower than they are so that professionals, advocates, certification creators, treatment executives, or institutional insiders feel more comfortable. Once you are cast into a room no parent should enter and from which they cannot escape, you do not owe deference to people who think public accountability is a breach of etiquette.
So let the record be clear.
I strongly believe in collaboration. But I will not collaborate with cowardice. I will not collaborate with incompetence nor with people who use the language of harm to avoid hard questions. I will not collaborate with credentialing efforts that blur the line between education and public protection. I will not collaborate with those who mistake ideological fluency for clinical depth. I will not collaborate with institutions that protect reputation more aggressively than patients. I will not collaborate with people who believe the worst thing one can do in this field is to be disruptive.
The worst thing one can do in this field is normalize failure.
I will collaborate with anyone serious enough to put patients, families, evidence, mortality, and accountability above personal brand, institutional comfort, political fashion, professional status or profiteering. But I will not confuse collaboration with surrender. I will not soften the truth so the field can continue mistaking civility for progress. Perhaps the community should adopt similar beliefs.
If that makes me divisive, then so be it and I wear that label proudly. Because that type of division is necessary. And long overdue.