An advocacy movement that presents itself as devoted to saving lives must answer a basic question: Are its priorities organized around the patients most likely to die, or around the talking points its leaders most prefer to promote?

With regard to the eating disorder community, the public record points toward a disturbing answer.

Several AI research platforms were utilized to conduct a studied analysis. These programs concluded when measured by organizational messaging, conference programming, certification curricula, activist intensity and public visibility, the modern eating disorder hierarchy appears to be:

1. Social justice
2. Obesity and opposition to obesity medicine
3. Binge eating disorder
4. Anorexia nervosa
5. ARFID
6. Bulimia nervosa

Now let’s compare that hierarchy with mortality rates.

A comprehensive 2025 meta-analysis found that people with anorexia nervosa died at 5.21 times the expected rate of comparable members of the general population. The standardized mortality ratio for bulimia nervosa was 2.20. For binge eating disorder, it was 1.46, based on a smaller body of evidence.

A separate meta-analysis involving more than 33,000 anorexia patients reached nearly the same conclusion: an estimated mortality ratio of 5.06. Suicide accounted for approximately 21% of reported deaths. Cardiac causes accounted for another 19%.

Translated into ordinary language:

Anorexia ranks first in mortality but fourth in public priority. Bulimia ranks second in mortality but last in visibility.

That is not a minor imbalance. It is an indictment.

The Deadliest Diagnosis No Longer Sets the Agenda

Anorexia nervosa can damage the heart, brain, endocrine system, bones and nearly every major organ. It can impair insight, intensify compulsive behavior and convince desperately ill patients that the treatment required to save them is the very thing they must resist.

Yet anorexia does not determine the public identity of the eating disorder movement.

The field still acknowledges anorexia. Organizations maintain information pages. Treatment centers advertise programs. Some researchers continue to study it. But recognition is not priority.

Priority produces sustained campaigns for physician education, early diagnosis, medical stabilization, insurance reform, reliable outcome reporting and protection against premature discharge. It produces outrage when patients deteriorate inside a fragmented treatment system that cannot establish consistent standards or demonstrate long-term success.

Instead, most visible campaign movements in the eating disorder community increasingly center on identity, inclusion, body liberation, weight stigma and social justice. Those concerns may deserve attention. But they do not justify allowing the eating disorder with the greatest mortality burden to become institutionally secondary.

A field confronting one of psychiatry’s deadliest illnesses should not have to be reminded that preventing death is not merely one item on an inclusion agenda. It is the central obligation and highest priority.

The Legislative Record Confirms the Priority Shift

The legislative agenda makes the disparity unmistakable. Approximately 45% of the identifiable pending legislative proposals in the eating disorder sphere concern diet pills, weight-loss supplements, obesity treatment, or opposition to weight-focused practices. Legislators are being asked to regulate supplement sales, restrict minors’ access to diet products, expand coverage for obesity medications, and address weight-based policies.

There is no comparable legislative urgency surrounding anorexia research. Currently, there are no pending federal or state bills specifically directed toward anorexia mortality, medical stabilization, treatment effectiveness, relapse, long-term survival, or the biological consequences of starvation.

The contrast exposes the movement’s priorities. Diet pills and obesity generate repeated bills, organized campaigns, and sustained advocacy. The eating disorder carrying more than five times the expected mortality has no research bill of its own.

A movement cannot credibly claim that saving lives remains its highest obligation when it mobilizes legislators around diet products and weight terminology while failing to demand research into why anorexia patients continue to die.

The absence of anorexia research legislation is not an isolated omission. It is the legislative expression of the same hierarchy visible in conferences, certification programs, public campaigns, and organizational messaging. The subjects most compatible with the movement’s current ideology receive political action. The deadliest diagnosis receives little, if any acknowledgment at all.

Bulimia Has Been Allowed to Disappear

The treatment of bulimia nervosa provides the clearest evidence that mortality no longer drives institutional attention. Bulimia carries more than twice the expected mortality of the general population. Recurrent purging can cause severe electrolyte disturbances, cardiac arrhythmias, kidney damage, gastrointestinal injuries and increased suicide risk.

Yet bulimia occupies the bottom of the visibility ranking.

It has no dominant national campaign, no expanding certification industry, no powerful activist constituency and no comparable annual awareness infrastructure. It is commonly reduced to a general information page, an occasional recovery story or a passing reference to “bingeing and purging.”

The reason is difficult to ignore. Bulimia offers little ideological or institutional utility. It is not new enough to generate the professional excitement surrounding ARFID. It is not as closely connected to higher-weight activism as binge eating disorder. It does not support the same body-liberation narrative or social-media branding opportunities. As a result, a diagnosis carrying the second-highest demonstrated mortality among the major eating disorders has been permitted to drift toward the edge of public concern.

That is not evidence-based triage. It is institutional neglect.

Binge Eating Disorder Receives an Ideological Multiplier

Certainly, binge eating disorder deserves attention. It is prevalent, disabling and frequently underdiagnosed. Patients deserve effective care and protection from stigma. However, a mortality rate comparison does not explain why it receives greater institutional priority than anorexia or bulimia.

Its estimated mortality ratio of 1.46 is elevated but substantially lower than the estimates for anorexia and bulimia. Its institutional advantage must come from somewhere else.

BED aligns closely with the eating disorder community movement’s dominant emphasis on higher-weight patients, diet culture, weight stigma, fatphobia, intentional weight loss and opposition to conventional obesity treatment. Advocacy for BED therefore functions simultaneously as diagnosis education, social-justice messaging and resistance to weight-centered medicine.

That alignment does not make BED unimportant. It does explain why BED receives an institutional multiplier that mortality alone would not provide. The problem is not that BED receives attention. The problem is that more lethal diagnoses receive less.

Obesity Has Become More Visible Than Anorexia Mortality

Obesity is among the most intensely discussed subjects in the eating disorder community. So intensely that activists, organizations and treatment providers frequently spell it “ob*sity,” as though the medical word itself requires censorship.

Organizations publish articles declaring the term fatphobic. Treatment companies question the existence of an “obesity epidemic.” Activists challenge BMI, intentional weight loss, pediatric obesity treatment, bariatric surgery and GLP-1 medications. Conference sessions and professional discussions increasingly treat obesity medicine as a source of oppression rather than a response to a legitimate health issue. This is not peripheral commentary. It represents enormous institutional attention.

There is no dispute that weight stigma can cause harm. Larger bodied patients can be dismissed, humiliated or misdiagnosed. Body size alone cannot determine an individual’s health. None of that justifies creating a professional culture in which the word “obesity” is treated as more dangerous than the medical burden it describes.

When organizations devote greater energy to censoring the term than to confronting the deaths associated with anorexia and bulimia, the priority problem becomes impossible to dismiss.

Social Justice Has Become the Driving Force

In some context, social justice belongs in eating disorder care. Race, poverty, disability, gender, insurance barriers and unequal access can determine who receives treatment and who is abandoned.

Social justice should strengthen the effort to save lives, not displace the obligation to demonstrate that patients are suffering and dying.

New certification programs increasingly market themselves around anti-racism, cultural humility, body liberation, weight inclusivity, intersectionality, oppression and white supremacy culture. These programs seek to define what clinicians should learn, which values should govern treatment and how professional authority should be exercised. Their public emphasis reveals what they believe will attract clinicians, confer legitimacy and shape the next generation of eating disorder professionals.

The question is not whether cultural competence belongs in clinical education. The question is why anorexia mortality, medical stabilization, impaired judgment, physician training and the risk of premature death do not receive comparable prominence.

A profession allegedly dedicated to saving lives should organize education around the dangers most likely to kill patients. Cultural competence should improve the delivery of that care. It should not become the principal product while mortality prevention is reduced to another module. When a certification program can devote extensive attention to white supremacy culture while the deadliest eating disorder ranks fourth in public priority, ideology has displaced triage.

“Terminal Anorexia” Exposed the Entire Hierarchy

The “Terminal Anorexia” controversy should have forced the field to confront its priorities. Anorexia, the eating disorder with the highest established mortality was the sole diagnosis selected for a proposal under which certain patients might be declared terminal and where legally available, qualify for medical aid in dying. Critics warned that prognosis could not be determined reliably, starvation could impair judgment and a terminal label could convert inadequate treatment into a death sentence.

That proposal should have generated immediate institutional mobilization. Organizations that rapidly condemn stigmatizing language should have mobilized against declaring anorexia patients beyond recovery. Certification programs should have convened emergency discussions. Advocates committed to disability justice, healthcare equity and protection from institutional abandonment should have demanded proof before any malnourished patient was classified as terminal.

That movement wide mobilization did not occur. Silence was the order of the day.

The contrast is devastating. Parts of the field treated the spelling of obesity as an urgent moral issue while remaining publicly silent when the deadliest eating disorder was offered as a basis for medically facilitated death.

That is misplaced priority carried to its final, fatal conclusion.

The Usual Defense Fails

The predictable defense is that public health priorities cannot be based solely on mortality.

Although that may be technically true it is also both reductive and evasive.

Mortality is not the only legitimate measure of public health importance. Prevalence, disability, delayed diagnosis, unequal access, discrimination, and long-term impairment all deserve attention. But acknowledging those considerations does not permit mortality to become an afterthought. When one diagnosis carries more than five times the expected risk of death, and another more than twice the expected risk, those facts alone should exert decisive influence over institutional priorities. A movement may weigh many forms of harm, but it cannot credibly claim to be organized around saving lives while consistently assigning greater visibility, funding, advocacy, and professional attention to issues carrying substantially less immediate lethal risk. Mortality always imposes a minimum level of urgency.

Organizations cannot evade responsibility by treating their priorities as accidental. Institutions reveal their priorities through allocation. Conference agendas, certification curricula, public campaigns, grants, legislative initiatives, staffing decisions, and fundraising appeals all reflect deliberate institutional choices. When the same subjects repeatedly receive the most prominent platforms, the greatest rhetorical urgency, and the strongest organizational support, while mortality prevention, physician education, medical stabilization, insurance reform, and treatment accountability remain comparatively neglected, the resulting hierarchy is not incidental. And matters of integrity and transparency must then be questioned and explored.

The answer to those questions may lie in the ideological culture of the organizations themselves. When boards, executives, policy officers, conference speakers, educational programs, and campaigns repeatedly reflect the same social justice framework, institutional homogeneity becomes relevant. A movement lacking meaningful dissent can mistake agreement within its own leadership circle for agreement among patients, families, clinicians, and the broader public.

It is the product of judgment, and the institutions making those judgments are responsible for what they elevate and what they leave behind. When institutions repeatedly choose social justice branding, obesity language controversies and weight stigma messaging over physician education, medical stabilization, mortality reporting, insurance reform and enforceable treatment standards, they are not expanding the mission.

They are replacing it.

The Verdict

The mortality evidence exposes a movement whose public priorities are no longer organized primarily around lethality.

Anorexia is first in mortality and fourth in visibility. Bulimia is second in mortality and sixth in visibility. Binge eating disorder receives greater institutional energy despite a lower demonstrated mortality ratio. Obesity commands enormous attention, but much of that attention is directed toward delegitimizing the diagnosis and opposing its treatment. Social justice has risen above every clinical condition as the movement’s dominant public identity.

That hierarchy cannot be defended as clinical triage.

It reflects ideological priority, activist pressure, branding opportunity and institutional self-interest more closely than it reflects the risk that patients will die. A serious eating disorder movement should be capable of broadening representation without obscuring mortality, opposing discrimination without denying disease and practicing cultural humility without surrendering medical judgment.

The present eating disorder hierarchy does the opposite.

When organizations turn obesity into a forbidden word but cannot turn anorexia mortality into a defining national campaign, they have revealed their priorities. When bulimia carries more than twice the expected mortality and remains the least visible major diagnosis, they have revealed them again. When certification programs institutionalize ideology while mortality prevention lacks comparable prominence, the conclusion becomes unavoidable and inescapable.

This is not merely a movement with misplaced priorities. It is a movement that has constructed a hierarchy in which ideological usefulness outranks mortality, institutional branding outranks medical danger, and the patients facing the greatest risk of death receive the least sustained urgency. The consequence is not a rhetorical imbalance or an academic disagreement. It is institutional abandonment.

When an eating disorder community gives greater priority to the issues identified as the most convenient to promote rather than to the patients most likely to die, it has forfeited any credible claim that saving lives remains its highest obligation.

Eating Disorder Hope (“EDHope”) began as an independently operated educational website. Over time, it built credibility by publishing information about eating disorders and recovery, maintaining treatment directories and state and city provider pages, offering screening resources, and helping families identify possible sources of care.

That history gave the website something a new treatment company could not create overnight. That is, public trust, extensive searchable content, established Google visibility, and access to families actively looking for help.

Ownership and control of that platform changed in June 2026.

On June 30, Within Health announced that Hopeful Media, LLC, the operator of EDHope and The Bulimia Project, had become part of the Within Health organization. EDHope’s owner is now identified as Hopeful Media, LLC which is a wholly owned subsidiary of Within Health Group, Inc. Within Health is the brand name. Within Health Group, Inc. is the full corporate name identified by EDHope. The word “Within” by itself, has no particular significance.

Within Health is a for profit virtual eating disorder treatment company. EDHope, the educational website that spent years earning the public’s confidence is now owned and controlled by one of the virtual businesses competing for eating disorder patients.

The acquisition did not simply give Within Health another place to advertise. It gave the company access to families before they select a provider, before they understand the available levels of care, or before they recognize that the information presented to them might be shaped by a commercial interest which has only been in business since 2021. And does not see patients face-to-face.

From Education to Patient Acquisition

EDHope openly and notoriously continues to portray itself as an independent resource connecting families with treatment providers without favoring any particular program. Yet the contact number prominently advertised on its website routes callers directly to Within Health, the virtual treatment company that owns and controls EDHope.

That relationship is not disclosed beside the number in clear, prominent language. A visitor must instead notice and click the italicized phrase “*About Our Number,” which appears in small print beneath the telephone number. Those three words are inconspicuous on the page. Other hyperlinks are underlined, displayed in contrasting colors, or otherwise formatted to attract attention. The ownership related disclosure is not.

This ownership related disclosure is also hidden on another part of the EDHope’s homepage. EDHope merely states it is, “powered by Within.” Not owned, but powered by. Not Within Health. Just Within. Apparently, Within Health cannot even be completely transparent about its ownership of EDHope.

Only after the visitor opens the pop up does EDHope acknowledge the routing arrangement. Even then, the disclosure emphasizes that EDHope does not receive a commission based on the provider ultimately selected. That statement may sound reassuring, but it sidesteps the central financial conflict.

Within Health has no reason to pay a referral commission to its own corporate affiliate. When an EDHope caller enters treatment with Within Health, the economic benefit does not take the form of a commission. It arrives as treatment revenue generated by the patient’s admission.

The absence of a commission therefore does not eliminate the conflict. It merely describes the corporate arrangement in terms that obscure how the money is actually made.

Consider also more often than not, the person coming to the EDHope website is a frightened parent whose child may be suffering from a serious eating disorder and who is urgently trying to understand the illness, compare treatment options, and find help. EDHope expressly addresses families and loved ones, acknowledges that the treatment process can feel overwhelming, and invites visitors who do not know where to begin to call its advertised number. In those circumstances, a reasonable parent is likely to rely upon the website’s repeated assurances that EDHope is an independent, unbiased guide … and not stop to examine footer disclaimers, open inconspicuous hyperlinks, or trace the corporate ownership of Hopeful Media, LLC.

These companies do not publicly report how many calls become Within Health assessments, how many result in admissions, or how frequently callers are referred to competing inpatient, residential, or partial hospitalization programs. Without those figures, the public cannot determine whether the hotline functions as a neutral navigation service or as an admissions pipeline built upon the credibility EDHope developed before Within Health took control.

The distinction is especially important because Within Health only provides virtual treatment. Families calling an apparently independent resource should know whether they are receiving an objective assessment of every appropriate level of care or entering the admissions department of a virtual company selling one particular model.

A Marketplace Owned by One of Its Competitors

EDHope sells preferred directory visibility to treatment providers. Paying companies can appear above free listings, purchase premium placement, and obtain greater exposure across virtual, state, city, homepage, and other website locations.

This platform openly defines its users as a high-intent audience. In practical terms, this audience are families actively deciding where to obtain treatment and how to spend substantial amounts of money.

Competing providers are therefore being asked to purchase visibility inside a marketplace owned and manipulated by Within Health. Even after paying, no competitor can obtain the advantages Within Health already possesses through ownership of the website, access to its total audience, receipt of its treatment calls, and potential knowledge of the searches and provider pages attracting consumers.

Within Health is also identified as EDHope’s Platinum Sponsor. That description makes Within Health sound like an outside advertiser supporting an independent publication, even though its wholly owned subsidiary operates the publication.

The owner is not merely buying space inside the marketplace. The owner controls the marketplace itself.

The Owner Declares Itself Superior

EDHope’s sponsorship page describes Within Health’s treatment as “clinically superior” and “revolutionary.” Those phrases appear on a website that continues to present itself as an independent source of treatment information.

“Clinically superior” is not harmless puffery. It is a comparative medical claim suggesting that Within Health produces better clinical results than competing treatment approaches.

The advertisement does not identify the programs being compared, the outcomes measured, the patient population studied, the methodology used, or any independent research supporting the claim. Within Health may possess such evidence, but none is provided beside the assertion.

The conflict of interest and ethical questions are difficult to ignore. A virtual treatment company controls the website, appears as its highest-level sponsor, and uses the platform to declare its own services clinically superior.

Paid Placement Disguised as Distinction

EDHope uses the heading “Top Virtual Eating Disorder Centers” above a tier containing sponsored providers. Its advertising materials separately confirm that payment buys placement above free listings and that premium payment can secure top positioning.

The word “Sponsored” appears beside the paid providers, but the heading still communicates a broader message. A family may reasonably interpret “Top” to mean that the programs were selected because of superior outcomes, safety, experience, or independent clinical review. The public materials disclose no such ranking methodology. What they do establish is that money materially influences prominence.

A sponsored provider has purchased attention. A top provider is generally understood to have earned distinction. EDHope blurs that difference while placing its own corporate owner inside the preferred tier.

And the money continues to flow into the same interconnected network. Providers may purchase premium placement on EDHope, but callers using the website’s general treatment number are delivered first to Within Health. When a caller needs in-person care that Within Health cannot provide, the most obvious referral destination is Galen Hope, the South Florida treatment center founded and still led by Within Health’s own co-founder, chief executive officer, and chief medical officer, Dr. Wendy Oliver-Pyatt.

Within Health and Galen Hope do not publicly disclose whether Galen Hope receives preferential referrals, what instructions are given to admissions personnel, or how often callers are directed there rather than to unaffiliated competitors. It would strain credulity to assume that these overlapping leadership, clinical, and commercial relationships play no role in the referral process. That does not establish the answer. It does establish why the FTC should obtain the call scripts, referral logs, internal communications, financial arrangements, and admissions data necessary to find it.

Competitors Vanish While Their Names Remain

EDHope’s provider directory is not comprehensive. Major treatment organizations have been excluded from relevant searches, substantially underrepresented, or connected to pages containing little or no useful information.

Eating Recovery Center operates a large Dallas based program offering inpatient, residential, partial hospitalization, and intensive outpatient treatment. Yet EDHope’s Dallas results have prominently displayed sponsored Center for Discovery locations while failing to present ERC Dallas as a functioning local option. ED Hope nevertheless maintains an indexed page using the name “Eating Recovery Center Dallas.” But this page contains no meaningful provider name, address, telephone number, description, or treatment information.

Children’s Hospital of Plano which has a dedicated eating disorder treatment program for children and adolescents is also absent from EDHope’s Texas treatment centers.

Center for Change also had an indexed page bearing its name but no usable listing. An obsolete Veritas Collaborative page remains searchable even after that brand had been retired and consolidated under The Emily Program.

These pages may be the result of neglect, faulty migration, outdated databases, or deliberate commercial strategy. The public record does not yet establish which explanation is correct. Their practical effect is easier to identify. A consumer searching for a particular treatment provider can enter a Within Health owned website, encounter paid listings and Within Health advertising, and receive an invitation to call Within Health, while the organization originally sought is nowhere meaningfully presented.

When questionable health claims are being made and families are potentially hurt, the ramifications are serious.  As should be the consequences.

The Partner Who Understood the Internet

Within Health’s digital strategy becomes easier to understand when its leadership is examined. The company’s co-founder and president, Abhilash Patel, publicly describes himself as a digital marketer, entrepreneur, and venture investor.

His Within Health biography states that he founded Ranklab, a marketing company that worked with behavioral health operators, and co-founded Recovery Brands, the digital publisher associated with Rehabs.com and Recovery.org. Patel’s experience lies precisely at the intersection of behavioral health, internet publishing, search visibility, and patient acquisition.

That background does not prove that Patel created the empty competitor pages or directed deceptive advertising. It does establish that Within Health was co-founded by an executive who understood the commercial value of controlling the websites families encounter before choosing treatment.

EDHope is far more than a collection of educational articles. It functions as a powerful patient acquisition channel, intercepting consumers who are searching for specific eating disorder treatment programs and instead, directs them first to an EDHope controlled page. Across numerous Google searches, EDHope appears as the first organic result, often outranking the treatment provider’s own website. The following searches illustrate the pattern:

Iaedp eating disorders

AED eating disorders

Veritas eating disorders

Center for Change eating disorders

Monte Nido eating disorders

Center for Discovery eating disorders

Odyssey eating disorders

Crescent Grace eating disorders

Avalon Hills eating disorders

With those searches, and many others, the result you receive is more than likely, this:

The value of the first organic search result is not theoretical. Approximately 28% of Google users click it. That visibility gives EDHope access to consumers at the precise moment they are searching for treatment. Because Within Health operates a virtual treatment program and shares founding leadership and executive control with Galen Hope, an in person provider, EDHope functions as the front door to an affiliated treatment network. Each caller or website visitor is therefore more than a reader seeking information. That person is a prospective patient capable of generating significant treatment revenue.

The Certification Operation Completes the Network

The Within Health system now extends beyond treatment, media, and referrals. The Eating Disorders Education Institute is developing and issuing the Eating Disorders Certified Specialist (“EDCS”) designated credential.

Within Health executives and clinical leaders teach through the institute. Their instructor pages already display the EDCS credential after multiple names, even though the institute’s public materials identify September 2026 as its official launch.

A legitimate pilot program or faculty credentialing process may explain that timing. The institute has not publicly provided enough information to determine who established the standards, who independently evaluated the first recipients, or whether affiliated personnel received special pathways.

The broader conflict is more significant. A treatment network can now participate in educating clinicians, define professional standards, award credentials, and employ some of the people displaying those credentials.

Without independent governance and transparent validation, the process becomes circular. Affiliated individuals create the standards, teach the curriculum, award the credential, and then use the resulting designation to strengthen the authority of affiliated treatment services.

Peeling Back the Layers

On the surface, the organizations initially appear separate. Within Health provides virtual treatment, Hopeful Media operates websites, EDHope publishes information and directories, EDEI provides professional education and certification, and Galen Hope provides in-patient treatment services.

However, if we follow the leadership, one person connects every major component.

Dr. Wendy Oliver-Pyatt is Within Health’s co-founder, chief executive officer, and chief medical officer.

The Eating Disorders Education Institute is the public-facing educational operation of Institute for Contemporary Eating Disorder Education, LLC, a Florida for profit LLC owned and controlled by Dr. Wendy Oliver-Pyatt, its only publicly identified authorized member.

Galen Hope is a privately held, for profit treatment company operated through Galen Hope Holdings, LLC. It was founded and originally owned by Dr. Oliver-Pyatt and Amy Boyers. Dr. Oliver-Pyatt is listed on the entity’s website as its CEO and Founder.

Within Health’s subsidiary, Hopeful Media, LLC controls EDHope. EDHope promotes Within Health, routes treatment calls to Within Health, and describes Within Health’s services as clinically superior. Current Within Health personnel teach through Dr. Oliver-Pyatt’s certification institute.

Patel provides the digital marketing and behavioral health publishing experience. Dr. Oliver-Pyatt supplies the medical authority, executive control, treatment operations, and certification enterprise.

Together, they sit at the center of a network syndicate capable of influencing what families read, which providers they find, whom they call, and which professionals appear qualified to treat them.

An Investigation Is No Longer Optional

This structure may ultimately prove to be aggressive but lawful vertical integration. It also may instead represent one of the most concentrated and conflicted commercial systems in the eating disorder field.

The conduct described above raises several potential violations of Section 5 of the Federal Trade Commission Act which prohibits unfair or deceptive acts or practices in commerce.

Despite its ownership by Within Health and the routing of its general treatment telephone number to Within Health, EDHope’s continued representation as an “independent and unbiased educational resource” may create a materially misleading impression about the commercial source and purpose of the information families receive.

The FTC expressly recognizes that promotional content may be deceptive when it appears to originate from an independent or impartial source, even when some underlying statements are technically accurate. Similarly, placing paying providers beneath a heading such as “Top Virtual Eating Disorder Centers” may falsely imply that prominence was earned through objective clinical evaluation rather than purchased through sponsorship.

Within Health’s description of its treatment as “clinically superior” presents an additional issue because an objective comparative health claim must be supported before publication by competent and reliable scientific evidence relevant to the precise comparison being asserted. Disclosures that the website is “powered by” Within Health, that certain listings are sponsored, or that calls are directed to Within Health will not necessarily cure these representations if the disclosures are inconspicuous, separated from the claims, or overwhelmed by the website’s broader portrayal of independence.

The FTC evaluates the entire net impression conveyed to a reasonable consumer, making the ownership relationship, paid rankings, treatment-call routing, and asserted clinical superiority appropriate subjects for investigation as possible deceptive misrepresentations, material omissions, and inadequately substantiated health advertising.

The FTC will be asked to investigate those matters as well as the claims of independence, the routing and conversion of treatment calls, the assertion of clinical superiority, the paid provider rankings, the use of competitor-name pages, the handling of consumer search and health-related data, and the relationships among Within Health, Hopeful Media, Eating Disorder Hope, Galen Hope, and the Eating Disorders Education Institute.

The central question is no longer whether each company performs some legitimate function. The question is whether those functions have been assembled into a coordinated system that converts public trust, internet visibility, professional authority, and consumer vulnerability into an unfair and unethical commercial advantage.

Families have a right to believe they are entering an independent educational resource. If instead, they are entering into a privately controlled treatment network hiding behind the reputation of a website built before that network owned it, there should be draconian consequences for this misconduct.

Dr. Oliver-Pyatt and the executives surrounding these enterprises are now on notice. The ownership records, leadership overlaps, paid rankings, comparative clinical claims, treatment-call routing, competitor-name pages, and prematurely displayed credentials have been identified and are subject to subpoena.

The remaining questions cannot be answered through carefully drafted website disclosures or assurances of editorial independence. They require the underlying call scripts, referral logs, admissions data, internal communications, credentialing records, financial relationships, and instructions given to employees who are contacted by families seeking treatment.

Presumably, the Federal Trade Commission and other appropriate agencies who may conduct investigations will be requesting those records. Perhaps only then will truthful answers be forthcoming from the syndicate of Within Health, Galen Hope, Hopeful Media, EDHop, Eating Disorders Education Institute and Dr. Wendy Oliver-Pyatt.

The eating disorder field urgently needs better professional education. Physicians, nurses, therapists, and dietitians may complete years of training without learning how to recognize malnutrition, assess medical instability, identify refeeding risk, distinguish among diagnoses, or determine when outpatient treatment has become unsafe.

The Eating Disorders Education Institute (“EDEI”) is the latest entity attempting to provide this education by claiming its program would build bridges. Instead, it merely created yet another silo pandering to a certain aspect of the eating disorder spectrum.

The EDEI was created by Chevese Turner and Dr. Wendy Oliver-Pyatt. The EDEI purportedly offers courses in assessment, medical complications, psychological treatment, nutrition, trauma, cultural awareness, weight stigma, body liberation, and social justice. It also plans to award a new Eating Disorders Certified Specialist credential known as EDCS.

The question is not whether additional education would benefit clinicians. The question is why the field needed another privately controlled, for profit credential, particularly one that places social justice and body liberation so prominently within its definition of professional competence.

An unproven credential marketed as a new standard

EDEI describes itself as a leading certification program. This despite the fact that its first public cohort is not scheduled to begin until September 2026. The credential therefore has no record of graduates, examination performance, employer acceptance, disciplinary enforcement, or improved patient outcomes.

New programs must first be required to prove themselves. They cannot credibly market anticipated success as an established accomplishment.

Even the current public materials of this “institute” (which really is not an institute at all) provide inconsistent descriptions of what candidates must complete. Different pages refer to varying numbers of courses and either eighteen or twenty-four practicum hours. Those discrepancies may be prelaunch mistakes, but they concern the essential requirements of a credential already being promoted as evidence of specialization and clinical readiness. They also evidence haste and lack of thorough professionalism.

A certification body must be able to state clearly how many courses are required, how much supervised experience candidates must obtain, what knowledge is tested, and what the designation actually certifies. The EDEI fails on these issues.

Social justice is not merely included; it is embedded

EDEI’s curriculum contains legitimate clinical subjects, including assessment, medical complications, psychological treatment, nutrition, trauma, and ethics. Topics which are covered by other programs. It would be inaccurate to describe the EDEI as nothing more than social activism.

Yet a number of core courses expressly emphasize cultural awareness, weight stigma, body liberation, social justice, and culturally responsive care. EDEI also states that weight inclusivity, anti-bias practice, cultural humility, and diverse lived experience will be integrated throughout the program.

Some of that instruction is necessary. Clinicians often miss eating disorders in people who do not appear underweight, and patients in larger bodies can suffer severe restriction, malnutrition, and medical instability. Cultural and economic barriers can also prevent people from obtaining accurate diagnoses and treatment.

The difficulty arises when broad political or philosophical concepts are treated as settled clinical competencies. Body liberation and social justice are not medical diagnoses, treatment protocols, or measurable safety standards. EDEI must clearly distinguish among replicated research, clinical guidelines, expert opinion, lived experience, and advocacy doctrine.

Lived experience can reveal mistreatment and diagnostic blind spots. But it does not carry the same evidentiary weight as validated clinical research, particularly when patients with the same diagnosis may hold sharply conflicting views about treatment.

And most importantly, instead of simply illuminating these issues, the EDEI must provide practical, rational, logical, workable, real-life solutions addressing these issues. Without solutions to embrace and implement, illumination becomes nothing more than complaining.

Certification should measure competence, not agreement

EDEI emphasizes reflective “Confirm Understanding” exercises, while its public materials provide little detail about the final examination or competency assessment. Reflection can help students examine assumptions, but it cannot by itself establish that a clinician recognizes bradycardia, electrolyte abnormalities, orthostatic instability, prolonged QTc, suicide risk, or refeeding syndrome.

Those subjects have clinically sound and clinically dangerous answers. A specialist credential must be capable of failing an applicant who does not understand them.

The reverse is equally important. A clinician who demonstrates competence in diagnosis, medical risk, nutritional rehabilitation, family involvement, and evidence-based treatment should not be penalized because the clinician questions body liberation, HAES doctrine, or a particular interpretation of social justice.

EDEI should disclose its examination blueprint, passing standard, validation process, retesting policy, and method for evaluating reflective assignments. Candidates should also receive an explicit assurance that respectful disagreement with contested social theories will not jeopardize certification.

Otherwise, EDCS risks becoming a measure of ideological alignment and not clinical education.

Why was another credential necessary?

EDEI is not entering an empty field. iaedp already administers the Certified Eating Disorder Specialist credential, or CEDS, which requires eating disorder specific clinical experience, consultation, education, examination, and professional references.

Iaedp’s governance, financial incentives, and former membership and symposium requirements remain legitimate subjects of criticism. Those problems do not erase the fact that CEDS is an established credential with published experience requirements.

The Inclusive Eating Disorder Specialist credential, or IEDS, also recently entered the market. That program heavily emphasizes weight inclusive, trauma informed, antiracist, HAES aligned, and social justice-based education. It mentions White Supremacy Culture or WSC approximately 175 times in one module alone. It has seemingly cornered the market on social justice drum banging.

EDEI therefore does not apparently duplicate an established clinical credential. It also duplicates much of the ideological territory already claimed by IEDS.

So, what does EDCS teach or measure that CEDS and IEDS do not? Does it explore newer biologically based treatment regimens like rTMS? Does it explore the manner in which social media platforms cause harm and what can be done to minimize exposure to dangerous on-line content? Does it explore the exploding access to AI platforms and their influence on patients? Does it explore revolutionary brain implants?

What patient harm resulted from the absence of a third designation which needed to be addressed? Did Ms. Turner and Dr. Oliver-Pyatt attempt to improve, supplement, or collaborate with either existing program? Could EDEI’s courses have become an advanced concentration within an established credential? Why didn’t the ecosystem finally come together, place families first and collaborate on this important topic? This would have resulted in the production and acceptance of one, all-encompassing, strong, wide-ranging certification program which would have been authoritative, respected and the cornerstone of a stronger, collaborative community

It is reasonable to presume that EDEI will not publicly answer those questions. For that matter, will anyone else in the community?

Without a formal gap analysis or evidence of failed collaboration, EDEI appears to follow a familiar pattern within the eating disorder ecosystem: leaders identify self-perceived deficiencies in an existing organization and respond by creating another organization they can control.

A field that teaches collaboration while practicing fragmentation

Eating disorder care depends on collaboration among medicine, psychiatry, psychology, nutrition, nursing, patients, and families. A failure to communicate across those disciplines places patients in danger.

However, at the institutional level, the field repeatedly models the opposite conduct. Iaedp has CEDS. Inclusive Eating Disorder Education has IEDS. EDEI is introducing EDCS and its own consultant pathway. With no oversight and no federal or state agency which can impose accountability and consequences, silo mentality has become the inevitable result. The cost for this short sightedness is measured in human lives taken.

Each organization controls its curriculum, eligibility requirements, assessments, instructors, directories, badges, renewal fees, and professional network. No independent national body determines whether the credentials are equivalent, complementary, redundant, or incompatible. This proliferation does not create a common understanding of eating disorders. It allows clinicians to select the credential that most closely reflects their existing beliefs.

Patients and families are then left to decipher the difference between CEDS, EDCS, and IEDS. The similarity between CEDS and EDCS is especially troubling because the same four letters are merely rearranged, increasing the possibility of confusion among patients, employers, referral sources, and insurers.

Collaboration forces competing disciplines and philosophies to confront their blind spots. Separate institutions populated by generally aligned faculty can reinforce confidence without producing a more complete understanding.

The resulting fragmentation also weakens advocacy. Legislators, medical schools, licensing boards, and healthcare systems need a defensible statement of what every professional should know about eating disorders. A field divided among competing credentials and ideological definitions cannot provide that baseline with authority.

Instead of financing another badge, the ecosystem should be developing a common national competency framework that can inform medical education, graduate training, licensing requirements, and continuing education.

Closing the conversation compounds the problem

Ms. Turner and other social advocates have blocked people who disagree with them on social media. This is very troubling since it results in substantive questions being excluded from discussions used to promote professional education. Blocking critics removes contrary views from the conversation visible to followers and can create an artificial appearance of consensus. Blocking opposing points of view is not progress. To the contrary.

The question must be posed, why should a “president” of an organization which is supposed to be operating for the good of families suffering from eating disorders block anyone? How does that serve the interests of the community? As “president” of EDEI, Ms. Turner’s first and highest obligation is to the eating community at large. That includes ALL the community. Which leads to consideration of a broader issue. And that is whether that exclusion extends to clinicians, families, researchers, and advocates who question EDEI’s ideology, standards, or need for another credential. How far is she prepared to go?

A certification body should welcome rigorous examination. Scientific disagreement is not harassment, and clinical questioning is not exclusion.

EDEI could answer all concerns through transparency. Before awarding EDCS, it should publish one definitive set of course and practicum requirements, specify how much eating disorder specific experience candidates need, disclose its testing and disciplinary procedures, and explain how its founding instructors received the credential before the public launch.

The EDEI should also publish a comparison showing what EDCS adds to CEDS and IEDS, identify any attempts at collaboration, and explain why another separately controlled credential was necessary. Candidates should be told that reflective work will be judged by reasoning and evidence rather than ideological agreement.

Most importantly, EDEI should consider whether its curriculum could contribute to an independently administered national standard rather than another proprietary system. Different organizations could continue offering specialized instruction while sharing one minimum definition of eating disorder competence.

EDEI is introducing an untested designation with inconsistent public requirements, uncertain independent validation, substantial overlap with existing programs, and an unusually prominent social justice orientation. At the same time, the field continues to lack a common standard that patients, employers, medical schools, and policymakers can understand.

EDEI’s slogan is “Building Bridges, Changing Lives.” A bridge should connect existing institutions and bodies of knowledge. It should not merely lead to another separately controlled credential.

If it does not do that, EDEI is not any type of bridge.  It is simply another silo.

Alsana represents its Chief Medical Officer, Dr. Jay Joglekar, as a “leader in the eating recovery industry” who oversaw five residential, partial hospitalization and intensive outpatient programs in the Washington, D.C. region. Alsana also claims that he works with its clinical and admissions teams and “reviews each client’s pre-admission medical assessments.”

These representations are intended to convey expertise, vigilance and safety. Families deciding whether to entrust a medically compromised loved one to Alsana are expected to believe that an experienced eating disorder physician personally evaluates every prospective patient before admission.

The public record provides no reasonable basis for that belief.

A Specialist Who Exists Only in Alsana’s Biography

Alsana does not identify any of the five programs Dr. Joglekar supposedly oversaw. It names no employer, treatment center, location, period of service or formal position. The company offers no description of his responsibilities and does not even establish that the programs treated eating disorders.

That omission is glaring. Treatment programs have names, licensed facilities have addresses, and physicians who lead residential, PHP and IOP programs ordinarily leave an identifiable professional record. Yet Alsana’s entire basis for calling Dr. Joglekar an eating recovery industry leader appears to be a sentence Alsana wrote about its own employee.

Independent records describe a very different professional background. Dr. Joglekar’s Privia profile identifies him as an internal medicine physician in Winchester, Virginia who graduated from the University of West Indies Medical School. It discusses internal medicine, integrative medicine, electronic medical records and earlier work involving a clinical trial for head and neck cancer. It contains no reference to anorexia nervosa, bulimia nervosa, ARFID, medical stabilization, refeeding complications or leadership of an eating disorder program.

His Virginia Board of Medicine profile also identifies internal medicine as his area of practice. According to the most recent updates, he reported practicing internal medicine at Internal Medicine Consultants in Winchester from Monday through Friday. His profile lists no eating disorder facility, behavioral health appointment, academic position or specialized role involving eating disorders.

Public searches have identified no article written by Dr. Joglekar about eating disorders, no professional presentation, no eating disorder research project and no federal research award in the field. There is no publicly visible affiliation with the Academy for Eating Disorders nor iaedp, no documented role with NEDA and no disclosed eating disorder credential or certification.

A physician does not need to write articles, receive federal grants or join professional organizations to provide competent care. But Alsana is not merely stating that Dr. Joglekar is a licensed internist. It is presenting him as a leader in a specialized field while identifying no employment, training, clinical experience, scholarship or professional involvement that supports that description.

The cumulative absence cannot be dismissed as an incomplete résumé. Alsana supplies the conclusion while omitting every fact that could establish its truth. That is not transparency. It is credentialing by assertion.

Internal Medicine Is Not Eating Disorder Expertise

Dr. Joglekar may be a capable internist. Internal medicine training is relevant to cardiac abnormalities, electrolyte disturbances, dehydration, kidney function, endocrine complications and medication interactions. None of that, however, establishes specialized competence in evaluating patients entering a higher level of care for an eating disorder.

Such an admission is not a routine medical clearance. Patients can appear outwardly stable while facing serious cardiac, metabolic and psychiatric danger. Laboratory results may appear deceptively normal, current weight may conceal rapid deterioration, and a single set of vital signs may fail to reveal fluid manipulation, purging or the cumulative effects of severe restriction.

A meaningful review requires the physician to integrate weight trajectory, blood pressure, pulse, orthostatic changes, laboratory findings, EKG results, medications, purging, restriction, compulsive exercise, psychiatric instability and refeeding risk. The physician must also determine whether the proposed facility can safely manage the patient or whether acute medical hospitalization is required.

Nothing publicly available establishes that Dr. Joglekar has experience making those decisions in eating disorder patients. His general medical background may qualify him to read laboratory results and identify familiar abnormalities. But Alsana has shown no factual basis for portraying him as an authority on the complex and frequently deceptive medical presentation of patients entering residential treatment, PHP or IOP.

Without specialized experience, his review would necessarily depend heavily on the work of Alsana’s nurses and admissions personnel, the company’s standardized protocols and the information selected for his consideration. That is not the independent medical safeguard families are led to believe they are receiving. It is a corporate admissions process carrying a physician’s name.

What Does “Reviews Each Client” Actually Mean?

Alsana’s use of the word “reviews” conceals more than it reveals. The term could mean that Dr. Joglekar personally examines every original record, independently interprets the medical findings, evaluates the patient’s stability and determines whether the proposed placement is safe. It could just as easily describe a process in which a nurse summarizes the file, identifies selected abnormalities and obtains an electronic approval from the physician.

Those processes are not remotely equivalent. A checklist is not an individualized medical evaluation, a nursing summary is not an independent physician analysis, and an electronic signoff does not establish that the physician considered the complete clinical picture.

Alsana nevertheless uses one ambiguous word to create the impression that every prospective patient receives direct scrutiny from its highest-ranking physician. That impression reassures frightened families, strengthens confidence in the company’s admissions process and makes Alsana appear more medically rigorous than the available evidence supports.

The scale of the representation makes it even more doubtful. Alsana does not disclose its annual admission volume, but even modest assumptions reveal the physician time required for genuine individual reviews. At 750 admissions, a twenty (20) minute review would require approximately 250 hours each year; a thirty (30) minute review would require 375 hours. At 1,000 admissions, the commitment would rise to between approximately 333 and 500 hours annually.

Those figures exclude time spent obtaining missing records, requesting repeat testing, consulting with clinicians, documenting conclusions and performing Dr. Joglekar’s other duties as Chief Medical Officer. They must also be reconciled with his reported Monday through Friday internal medicine practice in which he represents to the Virginia Medical Board he devotes 100% of his time.

It is physically possible for a physician to open hundreds of electronic files. That does not mean he personally performs a substantive medical analysis of every patient, nor does it establish that he possesses the specialized experience necessary to make those reviews reliable. The more plausible inference is that Alsana’s admissions and nursing personnel perform the underlying work, with selected cases referred for some form of physician approval.

Alsana then converts that internal process into a sweeping public assurance that Dr. Joglekar reviews every prospective patient. In doing so, the company borrows the authority of his title while leaving the substance of his involvement carefully undefined.

Medical Authority Manufactured to Drive Admissions

Alsana took an internal medicine physician with no publicly documented eating disorder background and transformed him into a “leader in the eating recovery industry.” It then used his title to create the impression that every prospective patient receives individualized scrutiny from an experienced eating disorder medical authority.

The arrangement inverts the clinical hierarchy. Alsana’s frontline contract physicians and psychiatrists provide the actual patient care, (even if only virtually) and many possess direct eating disorder experience that is absent from Dr. Joglekar’s public professional record. Nevertheless, Alsana placed him at the apex of its medical structure without identifying the training, clinical history or specialized qualifications that would justify elevating his judgment above theirs. Clinicians with demonstrated experience therefore operate beneath a Chief Medical Officer whose claimed authority in the field can be traced only to Alsana’s promotional biography.

This is not merely inflated executive marketing. Alsana uses an unsubstantiated claim of specialized medical authority to reassure families deciding where to place medically compromised loved ones. By portraying Dr. Joglekar as an eating disorder leader and implying that he personally scrutinizes every admission, the company creates the appearance of a medical safeguard that the available evidence does not establish.

Physician authority has commercial value. It inspires trust, reduces fear and helps convert frightened families into admissions. Alsana wrapped that authority around a physician whose documented career is in internal medicine and whose supposed eating disorder leadership cannot be independently traced.

The white coat is real, but the specialized authority Alsana constructed around it is manufactured. And that manufactured authority is being used to sell treatment to families confronting a potentially fatal illness.

Alsana did not arrive in Birmingham as an innocent treatment provider suddenly confronted by an unpredictable act. It arrived carrying a corporate history of lax oversight, inadequate supervision, disputed treatment practices, warnings from former executives and unresolved patient safety failures at its facilities in Missouri. By the time a patient was sexually assaulted at its Birmingham residential program on July 26, 2025, Alsana had already been told, repeatedly and from multiple directions, what happens when growth, census and operational convenience overtake clinical judgment.

The assault was not the beginning of the story. It was the consequence.

Alsana may attempt to deflect and allege the attack was the unforeseen misconduct of one patient. However, evidence indicates that Alsana employees knew the offending patient had engaged in prior acts of public masturbation, sexually intrusive conduct, physical boundary violations and an escalating fixation on other vulnerable patients. Another former patient reported that the same individual sexually assaulted her and that management failed to act despite numerous prior reports. The eventual victim then warned staff directly, asked to be separated from the patient and explained that something was seriously wrong. Alsana left them together. After the sexual assault, the offending patient reportedly still remained in the program for a short period of time. Despite repeated warnings.

Reports indicate the offending patient was a private pay patient. Whether financial considerations influenced that decision is a question regulators and discovery will answer.

That sequence is the center of ongoing issues involving Alsana. Alsana sold safety, received warnings, yet failed to comply with its own safeguards and retained a patient whose conduct it was either unable or unwilling to manage. Once those facts are placed inside the company’s history, the July 2025 assault stops looking like an aberration.

Instead, it is the predictable result of the corporate system Alsana created.

The False Assurance of Safety

Residential eating disorder treatment is not housing with therapy added. Patients enter because they require an environment more structured and protective than the one they are leaving. The provider controls admissions, staffing, supervision, medical oversight, patient separation, behavioral intervention and discharge. Families entrust vulnerable loved ones because the company represents that it possesses the judgment and resources necessary to keep their loved ones safe.

Alsana continues to make precisely that representation. Its website promises a “safe, supportive space” and describes its residential program as providing structured care and support twenty-four hours a day, seven days a week. It created a marketing campaign emphasizing “Everyone deserves flowers.” The contrast is striking. While the company promoted “Everyone deserves flowers,” the allegations concerning staffing shortages, inadequate supervision, delayed intervention, and failures to protect vulnerable patients are especially troubling.

The Birmingham evidence indicates that when protection was actually required, another patient had to leave the victim during the assault and search for the only direct care employee available.

Alsana’s own staffing ratio was allegedly one direct care employee for every six patients. Seven patients were present that evening, including a patient whose known conduct demanded greater observation rather than the bare minimum. The same staffing deficiency allegedly appeared during a later physical altercation, when the sole direct care employee again had to leave the scene to obtain assistance. That repetition suggests an operating practice, not a solitary scheduling mistake.

This is where the marketing representation becomes deceptive.

Alsana advertised a controlled residential environment while staffing below its own ratio and retaining a patient whose behavior exceeded the facility’s ability to supervise. The company did not merely fail to prevent every conceivable act of misconduct. It failed to provide the protection it had promised after the specific danger was already known.

And yet, warning signs were present.

The Birmingham facility did not operate outside Alsana’s institutional history. Alsana was intertwined with Castlewood Treatment Center, whose Missouri operations generated years of controversy involving treatment practices, patient safety, supervision and institutional response. In 2022, admissions were halted at the St. Louis programs after allegations of inappropriate conduct involving direct care employees and a patient became public. This was only a few months after Alsana’s Birmingham operations opened.

In June 2022, Alsana’s former leaders also identified the corporate force driving these failures. Former CEO Jennifer Steiner testified under oath that she became concerned about Alsana’s decision to maximize growth and revenue and was then terminated and sued after refusing to support board decisions she believed would jeopardize patient care. Her exact words were: “Specifically, I became concerned with the direction of the company and what I considered to be Alsana’s decision to maximize growth and revenue above all else. When I refused to go along with certain decisions of Alsana’s Board, including decisions that I believed would jeopardize patient care, I was terminated.” 

Former Chief Clinical Officer Nicole Siegfried described growth and revenue being prioritized to the detriment of patient care, training, staff retention and culture. Other senior clinical leaders gave similar accounts.

Alsana’s former highest-ranking officers supplied more than reputational discomfort. They gave notice that weak supervision, boundary violations and an opaque response to patient complaints could cause serious harm. The Birmingham allegations involve those same categories: known inappropriate conduct, inadequate staffing, delayed intervention, fragmented authority and institutional secrecy after the event.

Alsana’s lack of transparency on its operation’s many failings extend to its very ownership.

Who owns this place?

In late 2016, The Riverside Company acquired Alsana. Press releases and social media announcements were plentiful.

These facts make it all the more perplexing when in August 2025, The Riverside Company divested itself of Alsana. There was no announcement. There were no press releases. None could be found. No buyer is identified. Alsana, whatever it is at this point, likewise failed to publicly disclose whether the transfer was an ordinary sale, a recapitalization, a lender-controlled transaction or a management acquisition.

New entities subsequently appeared. Alsana Parent Holdings, LLC, Alsana Holdings, LLC, Alsana Management, LLC, Alsana East LLC, Alsana West NorCal LLC and Alsana West – SoCal LLC. Most if not all of these entities were organized in Delaware and registered in the State of California.

However, what is curious is that none of these entities are listed with the Alabama Secretary of State and as such, are not authorized to conduct business in that state. What is also curious is that none of these entities are registered with the Alabama Department of Mental Health as a certified provider or are listed by the Alabama Department of Public Health Bureau of Health Provider Standards as a licensed facility operator.

The National Plan and Provider Enumeration System (“NPPES”) is a database managed by the Centers for Medicare & Medicaid Services (CMS) that assigns unique 10-digit National Provider Identifiers (NPIs) to healthcare providers and organizations in the United States. NPI records list Alsana Parent Holdings LLC as the parent organization for newly enumerated Alsana provider entities, including Alsana East LLC at the Birmingham address.

So, Alsana and whoever its owner and overlord is, publicly represented itself in a federal provider registry as connected to an Alabama psychiatric residential treatment facility and mental health clinic at 5101 Cyrus Circle in Birmingham. But, the Alabama Secretary of State, ADMH, and ADPH do not list them as authorized entities. Which to families seeking care and treatment should be very concerning.

Patients and regulators are entitled to know who oversee operations, appoints the board, controls staffing budgets, selects medical leadership and assumes responsibility for the liabilities inherited from Missouri and Birmingham.

Rather than provide any answers, Alsana expanded its virtual treatment program to include up to 40 states in early 2026. This should not be surprising since at least some of Alsana’s independent contractor medical doctors appeared only virtually in Birmingham. You entrust your loved one to a brick-and-mortar residential treatment center. And the medical doctor overseeing your child’s care is a mere face on a laptop monitor.  

On the other hand, Alsana did launch its “Soul Hearted” rebranding campaign, promising that patients and the eating disorder field “deserve flowers.” The campaign presented a “new beginning” without acknowledging the company’s history, former executive warnings, unresolved ownership questions or allegations of patient harm.

The flowers are not harmless silliness. They are reputation laundering through emotional imagery. Alsana is asking the public to experience the company as compassionate while withholding information necessary to judge whether it is safe.

Alsana Was Offered an Honorable Way Out

Before administrative complaints or litigation, Alsana and the responsible parties received an extensive pre-suit brochure. It explained the prior warnings, the assault, the alleged cover-up, the staffing failures, Missouri history, former executive testimony, ownership questions and physician licensure concerns.

The proposal gave Alsana a professional way to resolve the victim’s private claims. It did not demand the concealment of patient safety information, withdrawal of regulatory reports or silence concerning matters within the jurisdiction of government agencies. The victim expressly preserved her right to communicate truthfully with licensing and patient safety authorities.

Alsana could have compensated the victim, confronted the evidence and begun demonstrating that accountability would finally replace concealment. Attorneys appointed through its directors and officers insurance coverage initially engaged in discussions. They then stopped responding substantively.

Silence was their choice. But silence does not erase the evidence or prevent the next stage.

First the Regulators. Then the Courthouse.

Administrative complaints will now be filed with the Alabama Department of Mental Health, the Alabama Board of Medical Examiners and any other licensing authorities possessing jurisdiction. Those complaints will address staffing, incident reporting, patient retention, ownership disclosures, physician credentialing, telemedicine practices and whether present patients remain exposed to the same institutional failures.

Civil litigation will follow the administrative complaints. Discovery will obtain the prior reports, staffing records, private pay revenue, internal communications, Missouri investigations, Riverside’s exit, the new holding companies and every decision that left a known sexual safety risk in the residential population.

Alsana was warned in Missouri. Its former executives warned the board. Patients warned the Birmingham staff. The victim asked for protection. After the assault, Alsana was offered an honorable opportunity to resolve her private claims without buying silence from the public or the regulators.

Instead, Alsana chose concealment, flowers and silence.

Not a statistic.

But people.

101,132 is the number of people who will have died from eating disorders between October 30, 2016, at 11:31 p.m. and October 30, 2026, at 11:31 p.m.

101,132 people.

Enough to overflow Darrell K Royal–Texas Memorial Stadium at the University of Texas.

Enough to fill Bryant-Denny Stadium at the University of Alabama and still leave people outside the gates.

Enough to come within a few hundred seats of filling Neyland Stadium at the University of Tennessee.

Or leave those stadiums empty, devoid of all life. Devoid of all souls.

101,132 is roughly the population of Boca Raton, Florida. It is the size of New Bedford, Massachusetts. It is Albany, New York. It is Wichita Falls, Texas.

An entire city.

Families. Bedrooms. Birthday candles. School pictures. Text messages that were never answered. Mothers who still listen for footsteps. Fathers who still calculate time by the minute their child died.

My daughter Morgan died from anorexia on October 30, 2016 at 11:31 o’clock p.m.

Ten years later, using the eating disorder mortality rate this field itself has reported, more than 101,000 people will have died in the ten years after that dark night.

During that decade, the eating disorder ecosystem celebrated itself. It held conferences. Issued statements. Sold treatment. Protected brands. Promoted awareness. Fought over ideology and turf. Guarded reputations. Raised paltry sums of money. Published slogans.

And the deaths kept coming.

One every 52 minutes.

Not because no one knew.

Not because the danger was hidden.

Not because families failed to love hard enough.

But because an entire system learned how to live within the crisis without solving it.

That is the indictment.

In eating disorder care, “highest acuity” is not a casual descriptor. It is a clinical alarm. It signals patients whose medical stability is fragile, whose psychiatric risk is elevated, and whose margin for error is dangerously thin. A margin for error so thin that the wrong setting can become catastrophic.

Despite the fact that Equip knew, or should have known what that phrase means, it did not treat this phrase as a warning. Instead Equip turned it into a sales pitch.

In its solicitation email sent to referral sources, Equip asked providers to transition their “highest acuity” eating disorder patients to Equip’s “acute, virtual care.” The same solicitation positioned Equip against residential treatment, partial hospitalization, and intensive outpatient care.

That was not ordinary marketing. It was a clinical capacity representation.

Equip was telling referral sources that its virtual model could handle some of the sickest eating disorder patients. Not routine outpatient cases. Not mildly symptomatic patients. The highest acuity patients.

That claim must now be judged against what Equip already knew.

Equip’s public materials describe a fully virtual program that treats medically stable patients across a wide spectrum of acuity levels, including patients who might otherwise seek residential treatment, PHP, IOP, or outpatient care. Equip also defines high acuity to include patients frequently engaged in eating disorder behaviors, moderately to severely malnourished, and at elevated risk of medical or psychiatric instability. It claims to have treated 6000 “high acuity” patients.

Those facts do not point toward casual outpatient care. They point toward the very questions Equip’s marketing appears to soften. Does the patient need PHP? Residential treatment? Inpatient stabilization? Supervised meals? Direct medical monitoring? Psychiatric hospitalization? A setting where someone can see what the illness is doing when the patient and family cannot?

Equip’s model narrows the issue to a different question … can the patient be called medically stable enough for virtual care?

That is the pressure point. Equip kept the gravity of high acuity but changed the practical effect of the phrase. Instead of warning providers to slow down and scrutinize level of care, “high acuity” became proof that Equip could handle serious cases. It became a growth category.

And yet, former employee reviews make that claim far more serious. Make no mistake, I treat most disgruntled employees’ claims with a ton of salt. Complaints about working conditions, DEI being deemphasized, officers’ vacations being mischaracterized can readily be dismissed. But consistent, substantive complaints regarding the patient population and quality of care are a different matter.

One former employee alleged that Equip admitted clients who did not belong in virtual care, made it impossible to discharge clients who needed a higher level of care, stacked therapist caseloads, fired employees who questioned the business model, and asked providers to practice outside states where they were licensed.

Another former employee alleged little to no criteria for medical clearance before admission, patients being admitted without signed consent forms, difficulty discharging patients who required higher care, and clinicians expected to practice outside their scope without adequate training or support.

Another review alleged that medically unstable patients were not discharged and that providers were required to continue seeing patients who were inappropriate for virtual care while the company moved toward volume driven metrics over clinical quality.

Other comments alleged Equip accepted patients who met criteria for Denver Acute and patients with heart rates in the 30s.

Several former employees claim that providers were pressured to practice in states where they were not licensed and asked to misrepresent information on licensing applications. They further claim that inaccurate information has been provided regarding licensing and credentialing requirements. These are not administrative oversights. They are legal and ethical violations that put providers’ licenses on the line.

Still other employees claimed that medically unstable patients were not discharged and employees were required to continue to see patients who were inappropriate for virtual care. They claim supervisory support was minimal, and the organizational focus shifted toward volume driven metrics over clinical quality. Alleged high staff turnover in multidisciplinary departments further impacted the stability of patient care.

These allegations are not background noise. They go to the center of Equip’s business model … who was admitted, who was kept, who was cleared, who was licensed, who was overloaded, and whether Equip’s public promise matched its clinical reality.

Knowledge is the crucial factor.

If leadership knew clinicians were warning about inappropriate admissions, blocked discharges, weak medical clearance, licensure problems, unsafe caseloads, and patients too sick for virtual care, then Equip’s highest acuity email is no longer simply bold marketing. It becomes a knowing misrepresentation made after due warning. Former employees claim that leadership did know.

That is the clear line between mistake and misrepresentation.

A company can be wrong. A company can overpromise. A company can launch a model that later proves unsafe. But when internal warnings exist before the public pitch is even made, the inquiry changes. The question becomes whether executives, directors, medical leaders, and compliance personnel allowed referral sources, families, insurers, and Medicaid programs to rely on a version of Equip that they knew was false.

And that is where fraud could enter the picture.

Fraud is not just a bad claim. It is a bad claim made with knowledge, reckless disregard, or deliberate blindness. In federal health care programs, that distinction can carry enormous consequences. Equip claims to accept Medicaid in four states. That is a complicating factor.

The Department of Justice states that any person who knowingly submits or causes the submission of false claims to the government can be liable for three times the government’s damages plus inflation linked penalties. The False Claims Act also reaches false records material to false claims, improper avoidance of obligations to repay the government, and conspiracy.

The Office of Inspector General for the U.S. Department of Health and Human Services (“HHS OIG”) tells physicians that it is illegal to submit Medicare or Medicaid claims they know or should know are false or fraudulent. OIG also says civil False Claims Act liability can include up to three times the program loss plus penalties per claim, that no specific intent to defraud is required, and that “knowing” includes actual knowledge, deliberate ignorance, and reckless disregard.

That means Medicaid exposure would not necessarily stop at Equip as a company.

If Medicaid paid for claims based on false or misleading representations about medical necessity, licensure, medical clearance, clinical capacity, provider supervision, or appropriate level of care, then the people who caused, approved, continued, or concealed those representations could face scrutiny. That includes high ranking officers. It includes medical directors. It includes physicians who cleared, supervised, billed, or continued patients inside a model they knew was not safe or properly supported. And persons on the board of directors.

Civil liability is only part of the risk. HHS OIG identifies the False Claims Act, Anti-Kickback Statute, Stark law, exclusion authorities, and civil monetary penalties law as major federal fraud and abuse laws affecting physicians. OIG warns that violations can result in criminal penalties, civil fines, exclusion from federal health care programs, or loss of a medical license. OIG also states that criminal penalties for submitting false claims include imprisonment and criminal fines, and that physicians have gone to prison for false health care claims.

Equip’s email cannot be dismissed as a dispute over branding.

By the time Equip asked referral sources for their “highest acuity” eating disorder patients, former employees had raised the very concerns that would make that solicitation dangerous … patients too sick for virtual care, blocked discharges to higher levels of care, weak medical clearance, unsafe caseloads, licensing problems, and a widening gap between what Equip marketed and what its clinicians could safely deliver.

That sequence changes everything.

Equip did not merely claim it could treat eating disorders virtually. It claimed clinical capacity for high acuity patients while sitting on internal warnings that some patients were being admitted, retained, or managed in ways the model could not safely support.

Families were not being asked to buy software. They were being asked to trust a clinical promise. Providers were not sending names into a neutral intake portal. They were relying on Equip’s representation that its virtual model could safely absorb serious eating disorder cases. Medicaid programs and insurers were not paying for slogans. They were paying for care that had to be medically necessary, properly supervised, lawfully provided, and appropriate for the patient’s level of risk.

That is where the alleged misconduct becomes more than marketing.

If Medicaid paid claims while Equip knew, or recklessly ignored the reality that patients were being treated in the wrong setting, cleared under inadequate medical standards, served by providers with licensing problems, or kept in virtual care despite the need for a higher level of care, the inquiry should not stop with the company’s marketing department. It should reach the officers who approved the growth strategy, the executives who received the complaints, the medical leaders who signed off on clinical practices, the compliance personnel who knew the risks, the physicians who cleared or continued patients, and the board members who had a duty to know what was happening inside the company they governed.

That is the fraud question.

Not whether Equip can point to families it helped.

Not whether virtual care can sometimes work.

Not whether the word “high acuity” can be softened by adding “medically stable.”

The question is whether Equip continued selling high acuity virtual care after it knew, or should have known, that its own clinicians were warning the model was taking patients it could not safely hold.

If leadership did not know, they epically failed. If leadership did know, the email was not an accident. It was a solicitation made after warnings. After knowledge. After acquiescence.

And once warning exists, the next referral, the next admission, the next Medicaid claim, and the next family persuaded to trust virtual care all carry a different meaning.

“Highest acuity” should have stopped the process.

Instead, Equip used it to open the funnel.