Board Certification Chaos: How Disunity and Private Equity Diluted the Community

Few areas of mental health care illustrate dysfunction as clearly as the eating disorder board certification industry.

What began decades ago as a grassroots movement of passionate clinicians, dietitians, and advocates has metastasized into a labyrinth of overlapping credentials, proprietary “certifications,” and glossy corporate training programs.

Today, the United States alone boasts well over one hundred distinct eating disorder related certifications. This is more than that which exist for all other major psychiatric conditions … combined. For schizophrenia, there are fewer than a dozen. For depression, arguably the world’s most common mental illness, maybe two dozen. For autism, a total of ten programs. For eating disorders?

This is a table listing eating disorder related certifications:

The eating-disorder field, serving a far smaller patient population, is drowning in certificates, credentials, and branded “specialist” designations. And more are seemingly arriving every month.

This glut is not a sign of progress. To the contrary. It is the predictable outcome of a profession with no unified standards, no central accrediting authority, no ethical oversight, and an increasingly privatized treatment economy driven less by patient outcomes than by returns on investment and profiteering perpetrated by individuals and their egos.

The Great Credential Free-for-All

Unlike psychiatry or psychology fields with centralized boards and accreditation bodies, the eating disorder community has no single regulatory anchor. Instead, numerous competing organizations (IAEDP, AED, NEDA, ANAD, APT, and others) define “competence” differently and seldom recognize each other’s credentials.

The result is a credential arms race. Clinicians seeking legitimacy often accumulate multiple certifications, not because each adds new expertise, but because no one can agree which ones actually matter. Every theoretical school, CBT-E, DBT, FBT, ACT, somatic, trauma-informed, HAES®, intuitive eating, and more has spawned its own “certifying institute.”

With no governing framework, anyone can create a credential. And many have. Do you want to include social justice and political issues? Blame White Supremacy Culture? Blame the white man for all mental health issues? Create a certification program which does not include any information on ethics, or state-of-the-art medical and biological treatment? No involvement of diverse persons in creating a certification program? Extensively utilize information that is well known and has been in the community for many years? Sure! Why not? Who is going to say you cannot?

When Certification Becomes a Branding Exercise

This fragmentation might have remained a benign inconvenience if not for a second, more corrosive force: monetizing eating disorder certification through the rise of private equity.

Over the last decade, investment firms have used their monopoly power to control the narrative and then, consolidated the treatment landscape. In doing so, they squeezed the very life out of the field one dollar at a time. Large PE-backed treatment centers now own a majority of residential and intensive outpatient programs in the United States. And yet, at least one CEO of private equity owned treatment center testified in a sworn affidavit that the private equity owners prioritized profit over patient care. And patient care was compromised.

Private equity’s influence reshaped everything, from staffing ratios to program philosophy, but nowhere is the shift more visible than in education and credentialing. Under investor ownership, training is no longer an act of professional stewardship; it’s a marketing opportunity. Corporate chains launch internal “training academies” that sell branded certifications to staff and outside clinicians. Certification has become the new advertising … a low-cost, high-margin product that projects authority and generates revenue.

The loans to the investors are not simply going to pay themselves. Additional streams of revenue must be found to meet the financial demands.

Disunity as a Business Model

Eating Disorder organizations have failed to coordinate standards because fragmentation serves their financial interests. Each group has its own alleged proprietary curriculum, fees, and renewal dues. Collaboration would mean shared intelligence, information, revenue and control. Research and data would be collaboratively shared. For the first time the term, “evidence-based” would have substantive merit instead of simply being a vacuous catch phrase without any real meaning, without definition and without regulation.

Private equity masterfully exploits this vacuum. Without a single regulating body to enforce quality benchmarks, PE-backed centers can market themselves as the “gold standard” simply by aligning with whichever certification best fits their brand narrative. Or better yet, simply create your own standard of demonstrating expertise. No matter how many patients are abused, groped, or treated as if they were mere grist ground down by the mill of greed and incompetence, any treatment center can claim they are the “gold standard.”

Since they are privately owned, they can operate in the shadow of secrecy with information, which at best may be shared with their fellow PE owned overlords at quarterly meetings. Meetings which are conducted clandestinely, never to be disclosed to the families which need the highest level of care.

The Human Cost of Credential Inflation

For patients and families, the consequences are not academic, they’re life-altering. A parent searching for specialized care for a child with anorexia may encounter a clinician advertising six or more “certifications,” yet none of those credentials guarantee the provider has completed supervised ED training, worked within a multidisciplinary team, or met any validated competency benchmarks.

This blurring of standards enables underqualified practitioners to enter the field under the guise of expertise. Genuine experts are forced to buy legitimacy through redundant credentials simply to remain competitive in a marketplace driven by SEO and optics rather than outcomes.

The Wellness Economy and the Collapse of Accountability

The eating disorder arena overlaps with the $5 trillion wellness industry, which thrives on micro-credentialing. Nonclinical players, nutrition coaches, yoga instructors, and social media influencers alike obtain “eating disorder informed” certifications online, sometimes in less than a weekend.

Education has been replaced by branding. Evidence based care is replaced by radical social justice brain washing. If a person is offended by society, they need only slap an inflammatory label on the issue and not worry about its nuances. Congratulations! You have just become certified as an “Inclusive” board certified expert. The result is a field saturated with worthless credentials but starved for accountability.

Questions which should be asked are not being asked. For example, what new information does your certification program provide that was not already public knowledge in the community? Did, and does, your certification program include research professionals, medical doctors, dietitians, mental health experts, or even any men on its advisory board? Did you collaborate with any organizations or treatment centers when you were creating your program? What specialized knowledge does your organization have which other organizations do not possess? Do you have any agendas outside of providing necessary care for families suffering from eating disorders? How is your certification program going to lower the appalling mortality rate of eating disorders? Objectively speaking, how and why is your certification program an improvement over that which is already in the public domain?

Without substantive answers to these questions, professionals are left with a meaningless diploma … and simply more innocuous initials to put after your preferred pronouns.

A Perfect Storm of Profit and Disunity

Disunity and privatization feed each other. Lack of collaboration creates a vacuum; private equity monetizes it. The proliferation of proprietary programs generates revenue and brand differentiation but erodes professional credibility. Without regulation, there is no penalty for low standards, only rewards for market dominance.

The tragedy is that eating-disorder professionals entered this field to help patients including those most often marginalized by healthcare systems and diet culture. Yet through disunity and commodification, the field has allowed itself to become a marketplace rather than a discipline. Every new certification minted without oversight or accountability is another crack in the foundation of public trust.

Until collaboration replaces competition, and professionalism and the priority of patients triumph over profit, the eating disorder treatment industry will remain a cautionary tale: proof that when market logic outruns moral logic, vapid expertise becomes just another product for sale.

Nine Years Beyond the Darkest Night: Grief, Truth, and Hope for Greater Tomorrows

On October 30, 2016, my beloved daughter Morgan died after battling eating disorders for seven (7) long years. She was 23 years old when she was taken. At the moment of her death, when a daddy hears those dark words, “She’s gone” though he may not know it at the time, the better part of him is also ripped away.

Morgan was brilliant, kind, and fiercely determined to get well. She thought of others, often before her own needs. Her own words, “I can seem to help everyone else … I just can’t help myself” is her legacy. And yet, those very words still haunt her daddy every day.

When those words and the reality of a loss no parent should ever have to suffer are combined with the state of the eating disorder community today, you realize that there will be many more of our loved ones condemned to share the same fate which took my daughter… unless a seismic change is forthcoming.

A System Without a Compass

Even at that time, the system that claimed to know how to help Morgan had no map, no unity, and tragically, no accountability. Nearly a decade later, the eating disorder community is in even greater disarray. There are still no generally accepted treatment guidelines … no consensus on what works, no uniform standards for care, no consistency from one program to another and no accountability nor consequences. If you send your child for treatment, what happens next depends less on science and more on which center you happen to find, and what ideology dominates that space.

The Vanishing of Science and the Rise of Ideology

The dire crisis in the community has worsened as grant funding for research dries up. Federal and private funders have largely turned their attention to other mental health priorities, leaving eating disorder research chronically underfunded. Few new studies are being published, and the next generation of researchers is dwindling. Research professionals and medical clinicians on the front lines rarely collaborate. In this vacuum, ideological movements have filled the void … often louder, more absolutist, more absurd and less accountable to data or outcomes.

Militant factions within the “body liberation” movement now control far too much of the public conversation in the community. They label professionals, clinicians and even families in a gross, inflammatory manner. Anyone who speaks about weight restoration or malnutrition is labeled as “fatphobic.” White Supremacy Culture. Invasive species. Utilizing every “ism” word possible. Complex medical and psychiatric illnesses are reframed as political identity issues. The result? A silencing of nuance and a dangerous confusion between eating disorder treatment and radical social activism. Inflammatory labeling has become the substitute for reasoned professional, collaborative communication. And our loved ones suffer.

Private Equity and the Hollowing Out of Care

At the same time, private equity–owned treatment centers, once the great hope for scaling access, are collapsing under the weight of their own failed business models. Many have failed outright or are surviving only by slashing costs: laying off medical doctors who served as full time employees, replacing them with part time independent contractors and inexperienced working staff. Running skeletal programs that cannot provide the continuous, multidisciplinary care our loved ones require. The result is a race to the bottom: more marketing, fewer doctors, more “coaches,” less medicine. No accountability nor consequences.

Families are left navigating glossy websites and sales teams instead of evidence-based programs. If a family wishes to speak with the medical director of a program before entrusting their child to that program … good luck. Insurance denials come faster than ever. Inpatient stays are shorter. Step-down programs are often nonexistent.

When Morgan was fighting for her life, I wondered whether the lack of care was a failure of coordination. I no longer wonder. It has never been clearer that it was and continues to be, a failure of values.

A Community in Financial and Moral Crisis

The largest eating disorder nonprofit organizations, long believed to be the moral anchors of the community, are collapsing financially some losing more than $200,000 per year. Echo chamber thinking and associated conduct have replaced outreach to professionals who respectfully disagree with their view. Where at one time, these organizations were led by persons of vision, true giants of the community, now with very few exceptions, they are led by boards who shrink away from transparency, oversight and responsibility. These organizations host conferences and awareness campaigns, but their impact is negligible at best and failing at worst.

Their messaging has grown vacuous and timid, shaped more by the politics of social media than the needs of our loved ones. Once they were advocates for treatment access and medical rigor; now too often, they stand meekly on the sidelines … mere bystanders to the on-going carnage.

The Human Cost

The price paid for the wholesale failure of the community is measured by the dearest blood possible … the lives of our loved ones. The mortality rate for eating disorders, already the highest among psychiatric illnesses [apart from opioid addiction] has worsened. Suicide and medical complications are climbing. The promise that “recovery is possible” rings increasingly hollow to families who can’t even get a proper diagnosis, let alone a full course of the highest quality medical and mental health care. Which results in:

Behind every number is a person, a victim. Behind every person is a family like mine, standing outside a treatment center, a hospital, a counselor’s office, desperately holding on to the only thing they can … that is, the fading hope that this time will be different.

Where Do We Go From Here?

Families are entitled to transparency. Accountability. Honesty. From our doctors, clinicians, and counselors. Families should demand nothing less. But, to accomplish this reality, we not only need an evolution of thought and wisdom … we require a bold reckoning. The eating disorder community must reclaim science, ethics, and accountability. The community can only provide those necessary qualities by demanding:

The adoption of national treatment guidelines grounded in evidence, not ideology.
Federal, state and philanthropic investment in clinical research and longitudinal outcomes.
Oversight of private treatment companies that market medical care that is not forthcoming as it sheds experienced medical practitioners and licensed staff.
Strong, bold, new leadership in nonprofit organizations that prioritize patients over politics.
Measured inclusion of all reasonable, rational, intelligent viewpoints and persons.

But these steps require a courage of conviction… conviction which is sorely lacking.

Not just Morgan, but all those who have died from eating disorders cannot die in vain. But until we admit that this system and community are broken, until we expose the silence, the failures, the charlatans, thed fraud and the fear … we will keep losing more daughters, more sons, more loved ones, more years of life.

The eating disorder community once promised healing. Today, it must fight simply to survive. For survive it must. But in an evolved, intelligent, collaborative manner.

The very lives of our loved ones depend upon it.

EQUITABLE MENTAL HEALTH CARE AWAITS

Two of the more troubling topics confronting mental health communities are: (1). Lack of Minority Representation in the Mental Health Workforce and (2). Limited Accessibility of Mental Health Care in Minority Communities.

We will be focusing on exploring real world, workable solutions instead of using inflammatory labels, pointing fingers and embracing the litany of “isms” being cavalierly thrown around.

Any solution necessarily begins with starting and having open, collaborative conversations. While recognizing that a start is just that … a start and not a solution. And yet, from that start perhaps seeds are planted from which bold, forward-thinking initiatives grow which could ultimately result in a better world.

Increasing Minority Representation in the Mental Health Workforce

No one disputes that minority representation in the mental health workforce is grossly lacking. So, let’s address some of the issues which produced this inequity and explore possible solutions.

1. Financial Pathway Support

Problem: The cost and duration of training (graduate degrees, licensure) are major barriers for minority students.

Possible Solutions:

Targeted scholarships and loan repayment programs for minority students in psychology, psychiatry, counseling, and social work (e.g., HRSA’s Behavioral Health Workforce Loan Repayment Program could be expanded or localized).
Paid internships and residencies in community-based organizations serving minority populations.
Employer-based tuition reimbursement tied to post-graduation service commitments in underserved areas.

2. Pipeline Programs (High School → Graduate School)

Problem: Minority students are underrepresented early in the pipeline.

Possible Solutions:

Create “Grow Your Own” mental health workforce programs in high schools and community colleges — exposure to mental health careers, mentorship, and clinical shadowing.
Partner with HBCUs, HSIs, and Tribal Colleges to create joint degree or accelerated pathways into counseling, psychology, and psychiatric nursing.
Establish bridge programs for paraprofessionals (e.g., caseworkers or peer specialists) to obtain advanced clinical credentials.

3. Licensure and Training Reform

Problem: Licensure barriers disproportionately impact minority and bilingual professionals.

Possible Solutions:

Reciprocity agreements among states to ease cross-state licensing for clinicians serving telehealth clients.
Allow supervised hours to include culturally competent community-based or telehealth work, not just traditional clinical settings.
Bilingual competency credits or pathways for professionals providing care in multiple languages.

4. Mentorship and Professional Networks

Problem: Isolation and lack of role models lead to attrition.

Possible Solutions:

Fund minority mentorship programs through professional associations (e.g., APA, NASW, NBCC).
Develop online professional communities for peer support and continuing education focused on serving minority communities.

There are no “zero sum game” arguments. No white people must step aside. No looking backward as to what was previously done wrong. No obsessing on the past.

Simply a possible roadmap to start discussions to increase minority mental health providers.

This is going to become even more important in the future as research scientists increasingly discover additional biological links between the brain and mental health issues. We could be at the genesis of a bold new frontier regarding how mental health issues are studied, researched and treated. We need all persons to be involved in this process.

With this reality facing us, how do we increase accessibility of mental health care?

Increasing Accessibility of Mental Health Care to Minority Communities

Mental health care providers, resources and treatment centers must become more available and accessible in minority communities. Let’s explore how we can start to address this issue.

1. Community-Based and Culturally Anchored Services

Problem: Mainstream clinical settings in minority communities are few and far between and when they do exist, can feel unwelcoming or irrelevant.

Possible Solutions:

Fund community-based organizations, churches, and cultural centers to offer embedded mental health services (e.g., co-located clinics).
Recruit faith leaders, barbers, and cultural ambassadors as mental health liaisons trained in Mental Health First Aid or peer support.
Support mobile crisis units staffed with culturally and linguistically matched professionals.

2. Telehealth Expansion and Equity

Problem: Digital divides and lack of culturally competent telehealth platforms persist.

Possible Solutions:

Subsidize broadband and devices for patients in rural or low-income minority areas.
Require telehealth platforms to support multilingual access and easy interfaces.
Train clinicians in telehealth cultural competence (e.g., cross-cultural communication online).

3. Insurance and Reimbursement Reform

Problem: Minority-serving clinics often cannot sustain services due to poor reimbursement rates.

Possible Solutions:

Equal reimbursement for behavioral health and physical health under parity laws (and enforce it). [This requirement is already provided by federal law. Insurance companies have found ways to avoid or get around this requirement. These loopholes must be closed by legislative bodies.]
Expand Medicaid coverage for peer support specialists and community health workers.
Incentivize integrated care models (behavioral + primary care) in federally qualified health centers (FQHCs) and minority-owned practices.

4. Public Awareness and Trust-Building

Problem: Stigma and mistrust are major deterrents.

Possible Solutions:

Fund anti-stigma campaigns featuring diverse community voices and lived experiences.
Partner with trusted local messengers (e.g., influencers, pastors, tribal elders).
Offer mental health literacy programs in schools and workplaces, especially in minority-majority areas.

Of course, all of this is not probable unless there is greater policy, corporate, institutional and legislative support. This support could resemble the following:

Policy and Institutional Support

Data collection and accountability: Require reporting of workforce demographics, service access, and outcomes disaggregated by race/ethnicity.
Federal and state grants: Prioritize funding for programs demonstrably improving minority recruitment and retention.
Cross-sector collaboration: Involve education, housing, and criminal justice systems in joint mental health equity initiatives.

An “Integrated Implementation Model” could be structured as follows:

Minority Mental Health Workforce Accelerator (state-level example):

Provides full scholarships and living stipends to minority students pursuing behavioral health degrees.
Requires 3–5 years of post-graduation service in designated shortage areas.
Operates mentorship and continuing education programs led by culturally competent practitioners.
Partners with community-based agencies that receive reimbursement incentives for hosting trainees.

The mental health field, particularly the eating disorder community, talks of the need to increase minority mental health providers and the necessity of having greater access to mental health care for minorities. The community is absolutely correct. But that is as far as rational discussions go.

More often than not, discussions take place in an echo chamber. The community points fingers at the patriarchy, white supremacy culture, the diet culture and apply many other inflammatory labels … and nothing is accomplished. The community is defined by the past. A failed past. Instead of embracing a bold future.

Solutions to provide mental health care for our minority population can only be found by looking to the future. A future filled with hope and unlimited possibilities.

Inflammatory Labeling = No Progress

The mental health system in the United States is inundated with inequities and is hindered by limited access to care. Universal complaints about mental health include gross underfunding of services, provider shortages, fragmented care between mental and physical health, inadequate insurance coverage and widespread stigma that creates policy and opportunity barriers for people with mental illness. No one disputes that reality.

When significant cultural issues confront us and change is demanded, generally there are two types of people.

There are those people who lead, who are people of vision. They recognize and identify the problems and then commit to explore workable, rational, obtainable, collaborative solutions. These people who will negotiate with Satan himself if it leads to more people receiving the help they so desperately need.

Then there are “the ROYS.” In Texas, that acronym stands for “Rest of Y’alls.” This constitutes the vast majority of people. Those who are content with only complaining about the problems without being willing to invest in finding a rational, reasoned, collaborative solutions. When facing those issues, they immerse themselves deeper in their tribes safely ensconced in the comfort of their echo chamber. They are satisfied with whining and applying inflammatory labels to the issues. Their egos and fears drive their lack of vision. They refuse to interact with anyone who does not agree with them.

With that backdrop, how may we presume the eating disorder advocacy/therapist community responds to the daunting issues confronting mental health in general, and eating disorders specifically?

In the past few years, I have spoken with research professionals, medical doctors, therapists and advocates about the state of the eating disorder community. All seem to be unanimous in their view that things have never been worse in the eating disorder industry and communities.

As such, it should come as no surprise that the community seems largely content to address daunting, societal mental health issues by fostering divisiveness through utilizing inflammatory labels on their websites, publications and even a purported certification program. In general, inflammatory labels are cavalierly directed toward other people in the community, but only from a person’s keyboard.

So, what is inflammatory labeling? Inflammatory labeling is just as it sounds. It is when we assign highly negative or even cruel labels to people or organizations.

Focusing on inflammatory labels instead of solutions in social justice movements, or for that matter in any context, hinders progress by reducing complex issues to oversimplified caricatures. This practice intensifies social divides, alienates potential allies, and prioritizes outrage over tangible reforms. While rhetoric is central to advocacy, the way it is framed can either drive constructive dialogue or deteriorate into unproductive polarization.

Studies on social movements have found that extreme or inflammatory rhetoric, including labeling, tends to decrease public support for a cause. This is because such tactics reduce the average person’s sense of identification with the movement, making it difficult to find common ground. Inflammatory labels simplify people into negative stereotypes, making it harder to recognize their full humanity.

This reflects the sociological concept of “labeling theory,” which posits that assigning a negative label can lead to a self-fulfilling prophecy and further entrench deviance. Labeling opponents with charged terms can create a binary “us vs. them” mentality, making it difficult to challenge ideas through reasoned debate. Instead of addressing the complexities of an issue, discourse devolves into a culture war of labels, name calling, and finger pointing all of which obscures real policy solutions.

By way of example, radical eating disorder activists casually throw out inflammatory labels like:

There are so many others: White Privilege, Whitestream Research, toxic masculinity. These inflammatory terms of derision are directed at anyone who does not agree with their viewpoints as well as the mainstream medical and mental health communities. In addition, the term “invasive species” is even being used to define or refer to the same White Supremacy Culture and people and organizations which fall under that umbrella. And that is supposed to be productive?

As for any proposed practical, realistic collaborative solutions to address the inequities in mental health care? They propose none.

A few years ago, a small group of people published a letter directed at eating disorder organizations and treatment centers. Amongst the demands made in the letter included: providing reparations to Black People, Indigenous people and People of Color, (“BIPOC”) especially queer and transgender BIPOC; hiring a transgender consultant to revise your marketing material; establishing sliding fee scales for BIPOC, transgender and gender diverse clients; redistributing wealth from the for-profit ED treatment world; providing access to Hormone Replacement Therapy.

Other radical activists equate mental health research and treatment as a zero sum game. That BiPOC, LGBTQ+, fat therapists and professionals must be centered and that there is no space for white, straight and thin people to jump in. Or that white, liberal female therapists should focus more of their attention on social justice issues and political reform in all they do.

Of course, in the unlikely event the latter ever happened, those therapists would then be labeled as White Saviors and would be publicly eviscerated in the town square ala Lindo Bacon.

There must be a way. Other than inflammatory labeling, whining and complaining, what possible solutions exist which could be explored to address some of the inequities in mental health care systems?

Inequities which include far too few medical doctors, therapists, counselors and other medical and mental health professionals who are BIPOC. Minority and BIPOC communities are far underserved. Medical school training largely ignores eating disorders and BIPOC issues. Far too few BIPOC persons receive mental health care. Access to meaningful mental health care is severely limited for BIPOC persons. Research has not included significant BIPOC participation. Mental health care can be prohibitively expensive.

These complex, daunting issues require collaborative wisdom. And when progress is made on these issues, as they surely must be, this necessarily will result in a more enlightened society. So, the question must be asked again … how are name calling, tribal mentality and inflammatory labeling going to be remotely effective in addressing these serious issues? Answer … they aren’t.

A roadmap does exist for systemic mental health reform in the U.S., prioritizing enforceable, high-impact interventions first while building toward longer-term initiatives. The roadmap assumes some federal and state collaboration, leveraging funding, licensing, audits, and measurable metrics. But it is possible. It will not be easy. It will require participation, wisdom and sacrifice from society as a whole. It will require us looking past our human frailties and being bold and forward thinking. But it is possible.

And so, we will address that roadmap next.

When Maladjusted Masquerades as Activism … Weight Stigma Awareness Suffers

Weight Stigma Awareness Week should be an opportunity to confront one of the most damaging forces in healthcare: bias against people in larger bodies. This should be a week for data, clinical rigor, and constructive collaboration. Done well, it can highlight evidence-based solutions, elevate medical leadership, and foster collaboration across disciplines. And families who are suffering are the ultimate recipients of this shared wisdom.

Next week’s agenda includes sessions that could help shape our response to stigma and patient care. For example:

Rebecka Peebles, MD, FAAP, DABOM, & Lauren Hartman, MD — “Healing Without Harm: Ending Weight Stigma in Healthcare.” Practical, evidence-based strategies for clinicians who treat real patients in real exam rooms. The goal is not slogans but practical training rooted in science.

Leslie L. Williams, MD — “Navigating Eating Disorder Risks in the Age of GLP-1 Medications: A Weight-Inclusive Clinical Approach.” With GLP-1 drugs reshaping public conversations about weight and health, the need for clear, medically sound guidance has never been greater. Families deserve facts, not fearmongering.

Abigail Pont, MD — “Anti-Fat Bias in Medical Education Through the Eyes of a Medical Trainee.” Change must begin with training. Reforming curricula to prepare physicians to treat all patients with dignity and competence is not optional — it is essential.

These are the conversations that deserve attention, funding, and follow-through. They are the ones that have the potential to save lives.

But here lies the danger: while some leaders are advancing medicine, others are actively working to undermine it. Instead of fostering collaboration, maladjusted activists reject it. Instead of engaging with science, maladjusted activists ignore and dismiss it. Instead of building trust between patients and the medical community, maladjusted activists sow division, reject science, reject collaboration, and replace patient-centered work with grievance theater.

The weapons they use are fatuous ideology and vacuous grievances void of real substance and merit. This leaves patients and families caught in the crossfire.

This is the dark side of the ledger: militant, maladjusted, angry activists, wallowing in such internal pain, who reject collaboration, denigrate clinicians, and weaponize grievance for influence. This sadly is not theoretical.

It played out in 2021 at the Legacy of Hope Summit — a convening of some of the field’s foremost experts intended to build consensus and advance patient-centered solutions. Instead of joining that work, some radical activists not only opposed it, both before and after, but they tried to burn it down.

The most vocal critic was Chevese Underhill Turner, co-host of Weight Stigma Awareness Week, who also serves on the Board of Advisors of Within Health and is “Queen of the Ashes.”

Regarding the Legacy of Hope, Turner wrote:

“The entire ED community is getting ‘upskirted’ by certain men and we cannot put our own FOMO aside long enough to see it. Instead, we attend these men’s meetings and give them power to continue their gaslighting and lack of any willingness to see the intersections affecting our field. I’d love for other women to join me (and a few others) in being difficult when it comes to these people.”

This was not a critique grounded in evidence. It was not a call for better data or stronger collaboration. It was a deliberate attempt to sabotage a convening of experts — through crude language, ad hominem attacks, and an open invitation to disrupt and destroy.

Turner’s misguided viewpoints do not end there. On various podcasts and in social media, Turner has attacked clinicians, mocks evidence, and replaces medicine and science with grievance politics.

Her own words make it clear:

“It bothered me that all the air was taken by a white perspective.”

“My heart is in the higher weight community, whether a person has an eating disorder or not.”

“I believe bodies are political.”

“Everything is political.”

“I came out of the womb as a political beast.”

“When I hear “marketing” in the context of ED services to marginalized communities I hear white folks not learning from colonization and slavery. We need to stand down.”

“We must also be centering and supporting BiPOC, LGBTQ+, fat therapists and professionals. This is no space for white, straight and thin folks to jump in.”

“When we constantly protect the feelings of those who are oppressing then we never actually get to the work needed to undo the oppression.”

Turner, in writing stated that she supported and was working toward the following: “ … providing reparations to Black People, Indigenous people and People of Color, (“BIPOC”) especially queer and transgender BIPOC; hiring a transgender consultant to revise your marketing material; establishing sliding fee scales for BIPOC, transgender and gender diverse clients; redistributing wealth from the for-profit ED treatment world; embracing and incorporating non-western treatment practices; providing access to Hormone Replacement Therapy.”

These extremist radical views come from ignorance and distrust of the medical community. In Turner’s own words:

“The DSM [Diagnostic and Statistical Manual of Mental Disorders], it is what it is … it’s not great.”

“Those of us who have done the work around our internalized biases no longer trust the medical establishment to actually help us.”

“That has only grown into a place where we are now. Body Positivity Movement. We don’t want to be judged on our looks and our size. The medical community said, ‘Ok. We’re going to judge you on your health.’”

“Most of the country is at a higher BMI, but when you begin to talk about people above a 35 who are visually fat, the oppression increases — plenty of data on that. People in the 50, 60 etc (superfat) range experience even more oppression. These are the folks who are publicly chastised and harmed continuously by the medical profession. Oh, the stories I could tell. Public health in this country is getting it so wrong and there is a better way, but we need to be willing to actually listen to those being harmed.”

“There may be some things with eating disorders that are brain issues … I don’t know.”

Turner’s harmful, illogical, extreme points of view do not constitute insight – they are ignorance masquerading in cartoon regalia, strutting as wisdom. They demonstrate contempt for medical science disguised as activism, reckless to the point of sabotage. And yet, somehow, they earn you the golden ticket to co-host Weight Stigma Awareness Week. Turner’s very presence doesn’t elevate the cause; it cheapens it, hollowing the message until nothing credible remains.

In the past, Turner redirected organizational platforms away from patient-centered care and toward political crusades. As a former officer of NEDA, one of the largest eating disorder organizations in the country, she proudly declared, “We won’t be deterred in our social justice work.” Under her “leadership,” donors were encouraged to contribute to the Minnesota Freedom Fund — an organization later revealed to have posted bail for accused murderers, rapists, and other violent offenders.

Ask yourself: who benefits from public disruption? Certainly not patients. Nor families. Nor clinicians attempting to balance complex risks and benefits. Disruption for its own sake only produces a cacophony of racket instead of clarity. It produces division where we need partnership and collaboration.

And yet, Turner is annually trotted out as a co-host of Weight Stigma Awareness Week even though her message never changes. She is still handed the microphone. Still made co-host. Still rewarded.

Turner’s destructive, insidious pattern is consistent and consequential. When so called leaders prioritize ideological purity tests over rigorous science, they do more than dispute ideas — they undermine care. When organizational platforms are repurposed for partisan causes, and donors are steered toward politically charged funds with questionable implications, the field’s credibility erodes. When individuals who oppose expert collaboration are nonetheless rewarded with boards, speaking invitations, and opportunity, the message is clear: rhetoric is encouraged; results are irrelevant. And yet, that is the reality in the eating disorder community.

In any other professional community, such conduct would bring harsh consequences. Suspension. Banishment. In the eating disorder world, it brings greater influence and opportunity. But it does not have to be that way.

The way forward is clear but it requires courage and resolve:

Elevate science-first voices. Medical experts who ground their work in data and clinical care should be at the center of not just this week, but every week and this field.
Insist on collaboration. Medicine is not the enemy. Progress depends on partnership between clinicians, researchers, and advocates willing to engage constructively.
Enforce accountability. Organizations must set standards of conduct. Those who undermine collaboration with reckless rhetoric cannot continue to hold leadership roles.
Protect patient-centered care. Eating disorder treatment should not be a platform for partisan politics. The focus must remain on evidence-based approaches that save lives.

Patients deserve better than empty slogans. Families deserve better than spectacle and disruption. The eating disorder community deserves leaders who are accountable, collaborative, and grounded in science.

Weight Stigma Awareness Week should not be a stage for any one person’s hate filled ideology. It should be a platform for medical and science based workable solutions.

The choices confronting us are simple.

Evidence based treatment over drama and dysfunction.

Clinicians and researchers who do the hard work of translating evidence into care over charlatans who sell social justice snake oil.

Collaboration over spectacle.

Accountability over impunity.

Lives are at stake. Families are desperate for solutions grounded in competent, humane care. Patients cannot wait for ideology to sort itself out. If we allow disruption to replace discourse, we become complicit in the harm that follows.

And the escalating mortality rate.

When Social Justice Therapists Go Too Far …

Since prolific anti-semitism directed toward Jewish therapists by non-Jewish therapists is an appalling reality, it was predictable that the assassination of Charlie Kirk would reveal the worst in humanity … including of course, eating disorder therapists and family liaisons. More’s the pity.

When a loved one has an eating disorder, families are already living in a war zone. Every meal feels like a battlefield. Every doctor’s appointment feels like judgment day. And when parents turn to therapy, they are not looking for ideology, slogans, or someone’s Twitter feed come to life. They are looking for life saving help.

Eating disorders don’t care about politics. They don’t care about hashtags. Eating disorders only care about shutting down organs, hijacking minds, and killing people. But too many therapists, treatment centers, and professional organizations are importing America’s divisiveness into treatment. The result? Families are left paralyzed, distracted, and betrayed.

More and more therapists and family liaisons are peddling something else: politics disguised as treatment. Some wave the flag of “Free Palestine” with militant zeal. And yet, most could not even remotely explain the complex nuances of Middle East politics going back thousands of years. When the phrase, “From the River to the Sea,” is spewed forth with all the hatred and horror which exists within the soul, many therapists and activists cannot even identify which river or which sea is being referred to, let alone identify the dark significance of that phrase.

These militant therapists and family liaisons sneer that the death of Charlie Kirk, a conservative commentator was deserved, and in their ignorance and room temperature IQs, slap “ism” labels on him and then rejoice that his life was tragically cut short. These providers and activists are intentionally obliterating the line between activism and care. Families should take this as the clearest possible warning sign: walk away. As fast as you possibly can. Do not trust those people or their organizations.

It is bad enough that families seeking help often find therapy rooms that sound more like activist seminars than clinical spaces. Instead of guidance on food and recovery, they get:

“Diet culture is colonialism.”
“Anorexia is a symptom of white supremacy.”
“Thin privilege is the real disease.”

These are not treatment strategies. They are slogans, ripped from Twitter and recycled in therapy sessions. When families should be hearing about family-based treatment (FBT), CBT-E, or medical stabilization, they’re handed culture-war scripts that do nothing but fracture trust.

Eating disorders thrive on chaos and division. They feed on families who are fractured, therapists who are distracted, and organizations that are broken. Every minute spent arguing over slogans is a minute not spent on saving a life. Every resource squandered on activism is a resource stolen from recovery.

Therapy is supposed to be a sanctuary from the chaos of the outside world. It is supposed to be a space where pain is met with compassion, not political litmus tests. Injecting social justice battles into that space doesn’t just distract — it actively harms.

Here’s how:

It replaces healing with indoctrination. Patients and families arrive desperate for answers about food, weight, fear, and survival. Instead, they may be handed lectures about geopolitics, race, or privilege. The family’s suffering becomes a prop for the therapist’s personal crusade. That is gross exploitation, not care.

It breeds division when unity is essential. Eating disorders tear families apart. Recovery depends on pulling together. A therapist who filters everything through activism risks turning family members against each other based on political or cultural identity. That kind of manufactured division is gasoline on the fire.

It signals contempt for dissent. A therapist who proudly mocks the death of someone they dislike politically is broadcasting one thing: if you disagree with me, I do not respect you. How could any family trust such a provider to respect their child, their family bond, or their values? Trust collapses before therapy even begins.

It encourages rigidity instead of curiosity. The most effective therapists know they don’t have all the answers. They ask, they listen, they adapt. But the activist-therapist thrives on certainty: oppressors vs. oppressed, good vs. evil, us vs. them. That rigidity suffocates the flexibility patients desperately need for recovery.

It undermines professional ethics. The ethical codes of every counseling profession warn against imposing personal beliefs on clients. Therapists who cannot resist bringing their political militancy into the room have already failed the most basic test of professionalism.

Let’s be clear: cultural awareness and respect for diversity are good things. But respect is not the same as ideology. Sensitivity is not the same as indoctrination. Families need therapists who can meet them where they are, not therapists who drag them into battles they never signed up to fight.

Eating disorders are the second most lethal mental health illness, outpaced only by opioid addiction. This is life-or-death work. Families should demand nothing less than evidence-based treatment, humility, and compassion. When a therapist instead advertises their political rage as part of their practice, they are showing you what matters most to them — and it isn’t your child’s recovery.

The therapy room should be sacrosanct and must never be allowed to become another front line in America’s political battles. Families: if your loved one’s treatment starts to look like activism instead of medicine, get out. Your child’s survival depends on science, unity, and clarity — not the noise of a broken country bleeding into a broken field.

THE VICTIMS … THEIR FACES

I was recently advised that articles about IAEDP and Acadia were getting redundant.

So, why continue ?

Regarding Acadia, the answer is quite simple. Because its systemic corruption continues seemingly unabated and its vapid denials and inane posturing have reached an absurd level.

But before going into the most recent damning New York Times investigative article on Acadia, let’s look into the eyes of some of their victims:

Christopher Gardner

Five year old Christopher was left for 8 hours in a transport van at a West Memphis, Arkansas daycare facility owned by Acadia. Workers tried to cover up their gross negligence by signing documents showing that Christopher was taken inside the West Memphis day care center, even though he remained on the van. At least one media outlet reported the temperature in that van rose as high as 141 degrees. Christopher died in that van.

Deborah Cobbs

In May 2024, 20-year-old Deborah Cobbs, died after she threw herself down a staircase. At Timberline Knolls. Police reports indicate that she attempted to run away from the campus twice that very day. Which makes it quite curious as to why she was not being closely supervised.

Tiley McQuern

In January 2023, Tiley McQuern, 50, was found dead in her bed at Timberline Knolls after swallowing too many pills.

Those are just three of the many Acadia victims. Look at their faces. Never forget their faces. Because the faces in those photos are all that is left for their loved ones.

On April 22, 2025, the New York Times published an article about Acadia’s now shuttered and infamous facility, Timberline Knolls. It is entitled, “Suicides and Rape at a Prized Mental Health Center. Timberline Knolls, a mental health center owned by Acadia Healthcare, skimped on staff. Then came a series of tragedies.”

Although behind the New York Times paywall, the good people at the Salt Lake Tribune published the article in its entirety here:

https://www.sltrib.com/news/nation-world/2025/04/22/timberline-knolls-owned-by-acadia/

Some of the statements in the article include:

“But dangerous conditions persisted for years at Timberline Knolls, an investigation by The New York Times found, in part because of pressure to enroll more patients without hiring enough employees.”

“Two former residents sued Timberline Knolls last year, claiming that an aide had raped them. Acadia had hired the aide despite a criminal record that included domestic violence and gun charges.” [emphasis added]

“Another resident — a child who was a ward of the state — nearly died after she overdosed on medication that had been left out in a common area, according to former staff members. And two other women died by suicide after being left unsupervised, a rare occurrence at mental health facilities.”

“We were extremely understaffed,” said Cecilia Del Angel, who worked as a behavioral health aide at Timberline Knolls until last July. Several other former employees echoed that sentiment. The patient deaths, Ms. Del Angel said, were “entirely preventable.”

“Illinois regulators had not looked into the suicides. A spokesman for the state’s health department said it did not regulate Timberline Knolls, and the state’s Division of Substance Use Prevention and Recovery had not visited the property since 2019.”

“The problems at Timberline Knolls were part of a nationwide pattern of lapses at Acadia, one of the country’s largest for-profit providers of mental health services, with more than 260 facilities in 39 states, The Times found.”

“Acadia has closed facilities over the past decade after reports of sexual abuse. More than a dozen patients reported sexual assaults at an Acadia psychiatric facility in Utah. At a youth treatment center in New Mexico, patients claimed that staff had sex with them and pushed them to participate in “fight clubs.” And in Michigan, three women said they had been sexually abused by a supervisor at a youth treatment center.”

“In the summer of 2018, patients complained to Timberline Knolls employees that a therapist, Michael Jacksa, had sexually abused them on Timberline’s campus. The facility waited more than three weeks to call the police, doing so only after the patients complained to the state’s substance abuse agency, court records show.”

“Timberline’s leader at the time, Sari Abromovich, said an Acadia executive had told her not to alert the authorities, according to a deposition she gave in a lawsuit later filed by one of the women who was raped.”

“Ms. Abromovich, who was fired in 2018, said she was under daily pressure from corporate managers to fill beds and keep expenses low by skimping on staff.”

“Patient enrollment fell with the news of Mr. Jacksa’s arrest. In the ensuing years, Acadia pressured staff to find new ways to fill beds, according to eight former employees, who spoke on the condition that The Times not publish their names because they still work in the mental health industry.”

“Staff struggled to prevent patients from fighting, harming themselves and escaping the facility. In 2020, the Lemont police were called to Timberline Knolls 222 times, police said. By 2023, that number had soared to 519. No one else in Lemont made more emergency calls.”

“In a brief telephone call with The Times, Eiliana Silva, the director of J.P.’s [rape victim] residential unit, acknowledged that she had heard concerns from staff about Mr. Hampton [the rapist/employee] but said she could not properly supervise him because she was one of only two directors overseeing five lodges. As soon as she heard about J.P.’s complaint, she said, she relayed it to Timberline Knolls’ leadership.”

“At the time Timberline Knolls’ leadership heard the accusations against Mr. Hampton, the staff was still reeling from three other disasters.”

“In January 2023, Tiley McQuern, 50, was found dead in her bed after swallowing too many pills. A staff member told police that although employees were supposed to check on patients, those checks were “not thorough,” police records show.”

“Seven months later, a child, who had been placed at Timberline Knolls by the state’s child welfare agency, was rushed to the hospital after overdosing on medication that a staff member had left in a common area.”

“Then, in May 2024, another resident, 20-year-old Deborah Cobbs, threw herself down a staircase while no one was supervising her and died. She had tried to escape Timberline twice that day, police records show. Ms. Cobbs had also told several people that she was feeling suicidal, according to former employees who worked there at the time.”

So, what was Acadia’s response to this legion of corruption and harm to those entrusted to their care?

“Tim Blair, a spokesman for Acadia, said in a statement that the company had a zero-tolerance policy for behavior that could put staff or patients in danger. “We reject any notion that we put profits over patients,” he said, adding that “complaints and incidents are investigated and addressed.”

“Mr. Blair denied that Timberline Knolls had dangerous conditions and said it had adequate staffing levels.”

Another unidentified Acadia spokesperson said, “The recent New York Times story about Timberline Knolls, a closed Acadia facility, includes material inaccuracies and cherry-picks and conflates historical incidents to paint a false and inaccurate picture of the safety and quality of the care our facilities provide.”

Acadia’s corruption is vast. A report by the National Disability Rights Network detailed allegations of inappropriate physical restraints, sexual abuse, and emotional abuse at for-profit treatment centers, citing examples at Acadia facilities including an incident where a 9-year-old was injected with antihistamines as punishment at an Acadia facility in Montana.

In March 2025, three adolescents filed a lawsuit against Detroit Behavioral Institute, LLC and its owner, Acadia. The plaintiffs allege widespread sexual, physical, and psychological abuse inflicted on dozens of children. In fact, more than 35 people have come forward after they were reportedly abused as children at the Detroit Behavioral Institute between 2005-2022. The lawsuit alleges that the children were groomed, sexually assaulted and those that spoke out were retaliated against.

Naturally, Acadia closed the facility in 2022.

https://www.clickondetroit.com/news/local/2025/03/11/trapped-in-a-jail-of-horrors-juvenile-detroit-facility-accused-of-abuse-cover-ups/

Acadia’s response to that lawsuit? “The well-being of all patients is of the utmost importance to Acadia Healthcare and its affiliated facilities. We take these allegations seriously. While we can’t comment on specific allegations and patient situations due to privacy regulations, the picture being painted of Acadia and the quality of care provided by our facilities is inaccurate. We intend to defend this case vigorously.”

It is enlightening that Acadia’s public response to both the Timberline Knolls scandals and the horrific allegations against Acadia’s Detroit facility utilize almost identical language … “the picture being painted of Acadia and the quality of care provided by our facilities is inaccurate.

In addition, the same day the New York Times published its story, Acadia released its own statement entitled, “Setting the Record Straight: Acadia is A Leader in Quality, Safe Behavioral Healthcare.”

That statement can be found here:

https://quality.acadiahealthcare.com/setting-the-record-straight-acadias-a-leader-in-quality-safe-behavioral-healthcare/

It should come as no surprise that Acadia once again uses its old stand by line, “Regrettably, a recent media report cherry picked and conflated historical incidents at a closed Acadia facility to paint a false and inaccurate picture of the safety and quality of the care our facilities provide.”

So apparently, medication overdoses causing death while under the watchful eyes of Acadia, two suicides in the facility within a year, a minor taken to a local hospital because of a drug overdose, numerous young women being sexually assaulted and raped, five hundred nineteen (519) 9-1-1 calls within one year all fall into the category of “false and inaccurate picture of the safety and quality of the care our facilities provide.”

So, painting an inaccurate picture? Like this?

Or is the painting inaccurate because it does not nearly portray the numerous additional instances of abuse, misconduct and neglect perpetrated by Acadia?

It seems as if Acadia anticipates these lawsuits and issues the same trite defensive language dripping in lawyer ick. For Acadia, it is merely the cost of doing business with our loved ones being nothing more than corporate commodities.

Acadia’s profiteering at the expense of its patients results in the dirtiest kind of money. And yet, our eating disorder organizations continue to close their eyes and continue to accept Acadia’s dirty money. In February, it was iaedp at its annual symposium.

Next month in San Antonio, it is AED’s turn to turn a blind eye and accept Acadia’s dirty money. In doing so, AED arguably becomes complicit in the following odious, reprehensible acts perpetrated by Acadia and its feckless employees:

Multiple rapes in their treatment facilities located in a number of states;
Multiple sexual assaults in their treatment facilities located in a number of states;
Multiple attempted suicides in their treatment facilities located in a number of states;
Multiple successful suicides in their treatment facilities located in a number of states;
Having your lack of oversight result in the death of a 5 year old child left under your care;
Acadia’s officers and Board of Directors engaged in a scheme to defraud and mislead investors concerning patient care, staffing levels and legal compliance issues;
Acadia and its employees submitting false claims for payment to Medicare, Medicaid and TRICARE for inpatient behavioral health services that were not reasonable nor medically necessary;

There are many other woeful, reprehensible, unethical, illegal and criminal acts being perpetrated by this rogue organization. But even all of this is not enough to make eating disorder organizations take notice, stand up, and say enough, no more, no longer will we permit you to abuse the most helpless, vulnerable people in society. We refuse to be part of your misconduct.

Instead, like a common street walker, these organizations stand by with their hand extended willing to participate in any act no matter how vile, demeaning or degrading for its 30 pieces of silver.

MEDICALLY INDUCED COMA FOR ANOREXIA?

There are numerous quotes about being in a “coma” scattered throughout Hollywood movies.

“Paralyzes him, puts him in a coma, then keeps him alive. Now what the hell is that?

Alien

“Her heart. Can you give her something? – She’ll go into a coma.”

Exorcist

“Unless they’re completely supplied with lysine by us, they slip into a coma and die.”

Jurassic Park

“He’s in a coma. – Then bring him out of it. I want to talk. Now, doctor.”

Green Hornet

“When he arrived here, he was very ill, in a coma, not likely to live. And yet in a matter of ten days, his body is fully recovered.”

36^th Chamber of Shaolin

“We don’t know what the hell to do at this point. So, let’s put her in a medically induced coma and tube feed until she gains 20 pounds. That should fix things right up!”

The Marx Brothers in Medical School [Ok, not a real movie.]

Apparently, in the UK, a recent Telegraph investigation revealed that NHS hospitals authorized at least six young women with anorexia to be placed into comas in order to restore their weight.

https://www.dailymail.co.uk/news/article-14503651/Anorexic-girls-coma-NHS-hospitals-force-feed.html

Doctors attempt to argue that this hair-brained plan … err, I mean, that intervention is necessary to prevent death. However, reputable professionals and specialists caution it is a high-risk intervention with no medical precedent and that safer, evidence-based alternatives exist.

Before jumping into this fray, I should note that about three years ago when a previously untested and untried end of life option which shall not be named (thank you Harry Potter) [but, it rhymes with “Perminal Plannoplexia!]

was brought into the public consciousness, I went full blown nuclear from day one, filed ethics and board complaints and was considered (by some) very ugly in published articles.

Well, I learned my lesson. This time I am going to be more measured. More reasoned. More compassionate. Kinder, Gentler …

Before we delve into this latest Marx Brothers like Clown Show, let’s review the numerous criticisms of NHS hospitals in the UK.

A health ombudsman in the UK made the following remarks about the treatment of eating disorders in NHS facilities:

“Urgent action is needed to prevent people dying from eating disorders, the parliamentary and health service ombudsman for England has warned, as he said those affected are being “repeatedly failed”.

“The NHS needs a “complete culture change” in how it approaches the condition, while ministers must make it a “key priority.”

“Little progress has been made since the publication of a devastating report in 2017, which highlighted “serious failings” in eating disorder services.”

“Lives continue to be lost because of “the lack of parity between child and adult services”, and “poor coordination” between NHS staff involved in treating patients. There remain issues with the training of medical professionals.”

“Eating disorders are enormously complex, and those on the frontline treating people have a tremendously difficult job to do. This [is] not helped by a lack of a sense of urgency to address the scale of the problem. Clinicians need better support to do their job of protecting patients.”

“It is heartbreaking to see repeated mistakes and tragedies happening again and again. We need to see a complete culture change within the NHS, where there is a willingness to learn from mistakes.”

“The government also needs to fulfil its promise to treat eating disorders as a key priority so that we can see meaningful change in this area and make sure patients receive the quality of care they deserve.”

Tom Quinn, the director of external affairs at Beat, an eating disorders charity, said it was “appalling” that vulnerable patients were not getting the treatment that they desperately need.

NHS figures evidence the number of children being treated for eating disorders more than doubled from 5,240 in 2016-17 to 11,800 in 2022-23.

Doctors and charities warn limited access to community services means both children and adult patients are not able to access treatment quickly enough, which has led to many becoming so ill that they need urgent hospital care.

Ok, I think we got it.

A lack of urgency. Governmental ambivalence. Not learning from past mistakes. Repeated tragedies. Lack of support. Poor coordination. Insufficient training of professionals. Little progress addressing past serious failings. Exploding number of eating disorder patients. Limited access to care.

And the NHS’ solution is … let’s put “em in a coma!” Blimey! And Bob’s your Uncle!

Cue the Benny Hill yakety sax music …

Let’s put the patients “on ice,” tube feed them until they gain 20 pounds, have Prince Charming come along to give them “love’s first kiss to wake them up,” [No wait… Prince Charming was a creepy stalker!]. Ok, A rebellious, hoody wearing bandit named Jonathon comes along, kisses Snow Woke, she wakes up from her coma and along with his bandit friends, they storm the Bastille and live happily ever after. Back to reality now.

A medically induced coma …

Being placed in a coma and hopefully waking up with no resulting physical harm is wrought with peril. There is the increased risk of lung infection. The possibility of damaged lung tissue. Blood clots could develop in the legs possibly leading to a pulmonary embolism. Muscle breakdown and nerve damage. Possible memory loss and seizures. Weakened immune system. Dangerously low blood pressure. And of course… death.

Medically induced comas are too high risk for psychiatric treatment and are reserved for brain protection in life-threatening cases.

One can’t help but wonder if the NHS doctors in the UK first attempted rTMS. Or a ketamine regiment. Or Deep brain stimulation. Or responsive neurostimulation. The facts indicate otherwise.

In 2024, the NIHR Maudsley Biomedical Research Centre reported that it completed its first clinical trial of repetitive transcranial magnetic stimulation to the prefrontal cortex in patients with severe enduring anorexia nervosa.

Last year. The first clinical trial of rTMS… 2024.

Ketamine? Yeah… No.

On April 4, 2024, it was reported that King’s College researchers were awarded £1.45 million from the MRC Developmental Pathway Funding Scheme to run a randomised controlled feasibility trial of oral ketamine vs placebo in people with both anorexia nervosa and treatment resistant depression, marking the first time that ketamine has been used in a trial of this kind.

Last year. The first clinical trial of ketamine … 2024.

Seeing how according to the literature, rTMS and ketamine were not clinically trialed until 2024, it is very unlikely that these treatment regiments were first attempted.

And so instead, the NHS solution was to put these young women into a coma and then tube feed them. One can’t help but wonder if they first at least tried leeches or attempted to bleed the bad humours out of their blood. Trepanation? Tobacco smoke enemas?

There is certainly enough medical literature detailing the use of forward thinking medical treatment for anorexia nervosa. Were these treatments even first considered? Were they utilized? [from the UK literature, that would be highly unlikely.] I think we all know the answers to those questions.

Instead, we are left once again with the reality that universally we do not know nearly enough about eating disorders. Globally, medical providers have not found a way, nor the ability to collaborate, share knowledge, consult with professionals from different backgrounds and countries and to come to the realization that collective knowledge exceeds individual knowledge.

Which results in medieval type, untested and untried experimentation on guinea pigs. Except they aren’t guinea pigs. They are our loved ones.

Loved ones being treated by Groucho, Chico and Harpo.

We deserve better.

Hannibal Lecter, Frazier Crane, Dr. Blane … and You!

Therapists are on the front lines of mental health. They are in the trenches. They are the professionals upon whom we rely to reach down into our darkness of despair and lift us into the sunlight. To show us a bold new future filled with hope and joy. To have the strength and resiliency to not just help us fight our own internal struggle toward mental wellness, but who are able to maintain their own sanity. They must be intelligent, courageous, self-aware and in order to meet the broadest range of patients possible, they must possess an open mind regarding culture, society, life and yes … even politics.

[I understand at this point the 4 remaining therapists who may still read my missives may be pressing the block/ignore button. That’s ok. After all, we can’t have a man (or person who identifies as a man or a person who is not in our tribe) be allowed to have any type of voice which may disrupt their echo chamber!] … But as usual I digress.

Seriously, what an incredibly difficult job. As patients, we spew forth our anger, our guilt, our sorrow, the rawest of our emotions and we trust that our therapist can help guide us to the genesis of enlightenment, a path of wisdom … Or at least give us a break on their hourly fees after we have been seeing them for one year. Whichever … Whatever!

And yet, Hollywood and the television and movie industries trend toward casting doubt upon that premise. Those bastards!

So, let’s look at a few series in which therapists were prominently featured as we attempt to understand Hollywood’s seemingly negative portrayal of therapists.

First, the series “Hannibal” featured everyone’s favorite cannibal psychiatrist, Hannibal Lecter. If he wasn’t helping his patients resolve their issues, he was dining upon them… with some fava beans and good chianti.

Ok… so that may be a bad example.

There was everyone’s favorite radio psychiatrist, “Frasier” who when he wasn’t doling out McTherapy on his daily radio show, he was struggling with his own many personal issues involving family and friends. And he went through a legion of failed relationships ad infinitum.

The “Shrink New Door.” This limited series is a dark comedy starring Paul Rudd as Dr. Isaac Herschkopf – a charismatic yet manipulative therapist who exploits his relationship with patient Marty Markowitz (played by Will Ferrell). This show delves into themes of power dynamics, boundaries, and ethical dilemmas within the context of therapy while providing audiences with a unique cautionary tale about misplaced trust.

“Gypsy” was a brief series starring Naomi Watts as therapist Jean Holloway. It delved into themes surrounding boundaries, ethics, and personal relationships within the profession. Jean becomes increasingly entangled in her patients’ lives outside her office – blurring lines between professional responsibility and personal desire.

Then there is Loudermilk. A comedy about a recovering alcoholic, Sam Loudermilk, who works as a substance abuse counselor. Despite sometimes helping the people he works with, Sam’s defining characteristics are being uncaring, sarcastic, and self-centered.

A recent series, Shrinking just completed its second season on Apple TV with a third season to come. Shrinking is a comedy bundling the elements of friendship, love, kindness and dysfunctionality with an underlying theme of grief. The characters are bound together by their support and love for each other. And yet, their own struggles and dysfunctions define each character, their very existence. And give an alarming glimpse into the reality of countertransference.

Finally, there is YouTube sensation, “Dr. Blane.” Dr. Blane should best be watched instead of described:

What do those series, and numerous other series not cited have in common? They all depict counselors, therapists, those people upon whom we rely to help us, as being inherently flawed, emotionally needy and dysfunctional. A person who should be receiving therapy instead of doling it out.

Now, I did not write nor produce these series. And yet, they all portray therapists/counselors in less than a flattering light. Aren’t we justified in wondering why that is? Keep in mind this is Hollywood. The place from where the messaging seems to be, “we invented extreme, radical leftism, we hate everyone who does not agree with us, we are looney toons.” So, other than a belief that comedic dysfunctionality sells, why would the very left of the leftists portray therapists/counselors in an unflattering way?

Unless … there is a shred of truth in it.

Which brings us to the aforementioned countertransference. Therapists know that countertransference occurs when a therapist lets their own feelings shape the way they interact with or react to their client. In a therapy session, a client might remind the therapist of someone or something from their present or their past. As a result, the clinician might unconsciously treat the client in an emotionally charged or biased way.

Therapists trying to heal themselves through their patients. While inflicting their own views of cultural and societal liberalism upon those whom they are tasked to help and thereby bastardizing the therapy process.

Those therapists are fairly easy to spot. Most have social media posts replete with cut and paste posts on how all Republicans and/or President Trump are evil. He is the Anti-Christ! The world is coming to an end!

These therapists/counselors drag this pablum into the therapy room. In fact, there are counselors who openly admit they do exactly that! And to those counselors, I ask, do you honestly believe that there is space in the therapy room for your own mania? Is it ever appropriate to bring your own biased political views into a therapy session and attempt to infuse them into your patient? Especially with eating disorders where other mental health concerns are more often than not, inextricably intertwined?

Especially since there are so many complexities with eating disorders. Isn’t a counselor’s time better spent studying how and why the malnourished brain does not operate? Learning what parts of the brain are impacted? Looking at the genetic components of eating disorders? Or what you know about RTMS? Or ketamine regiments? Or Ai interactions? Or brain implants?

Your patients … our loved ones deserve the very best from you. This is not your special opportunity to heal yourself.

Now, make no mistake, there are many incredibly intuitive, intelligent, and insightful therapists. Those who make a difference. This is not a case of Diogenes the Cynic holding a lantern wandering the Greek countryside looking for one honest man.

But … it may be in the same zip code.

AWARENESS WITHOUT ACTION EQUATES TO FAILURE

Awareness.

Have you ever wondered what comes after awareness?

In any event, once again it is Eating Disorder Awareness Week 2025. Almost all eating disorder organizations and treatment providers will be mentioning this on their social media outlets.

Some buildings will be lit in the blue and green colors adopted by NEDA. This is the St. Louis Planetarium complete with statue in the shape of what society deems an anorexic body type:

Did I just body shame a statue?

Some therapists and advocates, treatment centers and organizations will hold special “virtual” sessions highlighting their pet eating disorder interest. People self-identifying as experts will pontificate on many and varyed aspects of eating disorders. The same radical tired voices will repeat the same radical tired messages to the same radical tired crowd measuring in the tens of people.

As in year’s past, the eating disorder community will feel good about itself for the week, will pat itself on the back and then … will slink back to its customary irrelevancy in the medical and mental health fields. Next year will be rinse and repeat. Or as Herman’s Hermits once sang, “Second verse same as the first.”

However, this year is different. For a number of reasons. These reasons threaten to not just shake but could very well crumble the very foundation of the eating disorder community. Not surprisingly, these reasons and issues will not be discussed this week and the community will ignore its awareness of these issues.

These issues will not be discussed in part because the issues are just too difficult. They are uncomfortable. In addition, the firmly entrenched corruption and rot in the community will mandate that some of the issues be ignored. When for a price, even the most reprehensible predator can buy a place at the table. Regardless, the issues are incredibly serious and require serious people with serious IQs to ponder and then take rational, serious action.

Let’s review some of these serious issues.

NIH funding collapsing

On Friday, February 7, 2025, the National Institute of Health (“NIH”) announced it was pausing all grant funding pending review and placing a 15% cap on funding “indirect research costs.” Indirect costs, also known as facilities and administrative (F&A) costs, are used to cover research expenses such as equipment and facilities maintenance, IT services, and administrative support.

The freeze has impacted the funding of all continuing grants at NIH. These grants fund ongoing research, including many studies involving human subjects in clinical trials. Universities are already reacting in a manner consistent with believing that those funding grants will not be reinstated. Some universities have already frozen hiring and taken other budgetary measures. These measures include a spending freeze on travel, procurement, capital projects and events.

So, how will this impact the eating disorder community? University based eating disorder professionals are likely to have their budgets slashed making travel to conferences unlikely. This includes travel to San Antonio for the ICED conference. This could also include a reduction in membership in AED. With AED’s financial woes already being very deep, a steep decrease in membership and low attendance at its ICED event could be the death knell for that organization.

But more importantly, this issue means that there will be significantly less research conducted into our understanding of the biological and genetic aspects of eating disorders. Possible state of the art treatment requiring a research basis will not be experimented upon and implemented. “Evidence-based” will become an even greater cartoon slogan.

Which will result in the mortality rate continuing to climb.

At least we now have awareness on that issue.

Iaedp

Iaedp’s many issues and problems have been highlighted for over a year. Tax fraud. Forgery on official documents. An overall lack of transparency. Possible violations of antitrust laws regarding the certification process. I understand that attendance at the recently concluded Symposium was disappointing.

A class action lawsuit hanging over its head.

A number of chapters have dissolved.

Rumors that the 2026 Symposium will be virtual. Perhaps because of a lack of funds? After hosting an in-person conference for a number of years, a virtual conference means virtually nothing.

All of which makes iaedp’s continued survival problematic. And if iaedp does not survive, what of the certification process? Would that mean we are left with another certification process which starts out with an idiotic Indigenous Persons land use acknowledgement? Because nothing says “eating disorders and the highest quality certification process” like an Indigenous Persons Land Use Acknowledgement!

At least we have awareness on these issues now.

Residential Treatment Center issues

The great eating disorder residential treatment center experiment appears to be floundering.

Recently, Castlewood (Make no mistake, it was Castlewood all along. Alsana was merely its pasteboard mask.) closed its operations in the State of Missouri … where it all began. Now, Alsana may find itself having issues with the California Medical Board for the unauthorized practice of medicine in that state.

Acadia shuttered Timberline Knolls after numerous issues and abuse came to light.

Cielo House. Shoreline Center. Fairhaven. Evolve. All closed.

Some of the residential treatment centers which remain open seem to be exploring adopting an addiction treatment model.

Accanto Health’s CEO, Dr. Tom Britton is the former CEO of American Addiction Centers. Accanto Health owns the Emily Program. Information has been circulating that medical doctors at Accanto Health/Emily Program have been laid off or asked to take lesser roles.

Virtual treatment programs, with no independent, third-party studies supporting their efficiency have sprung up and their growing presence cannot be denied. They are less expensive to operate. Purportedly, the growing influence of virtual programs is impacting attendance at residential treatment centers.

At least we have awareness of these issues now.

Acadia Healthcare

Then, there is Acadia Healthcare. I once wondered why treatment centers and organizations were not incensed at the harm being perpetrated by Acadia. Why they did not stand up for the vulnerable and hold Acadia accountable. Of course, the answer is obvious.

They have accepted money from Acadia Healthcare. They are bought and paid for consorts for Acadia.

Since iaedp did not have enough troubles, at its recent symposium, one of its primary sponsors was Acadia Healthcare.

The National Alliance on Eating Disorders lists Acadia Healthcare as one of its “Diamond Supporters.” [its highest level]

Montecatini, McCallum Place and Carolina House are not going to stand up. They live on their knees subservient to the whims of its overlord and master, Acadia.

Acadia, knowing the eating disorder community is long on radicalism and short on common sense, embedded itself by throwing money around. It was an effective strategy. And it still is.

And to think at one time, AED would not accept money from any pharmaceutical company or health and wellness company because of concerns about conflicting interests.

Sadly, when an organization accepts dirty money, it acquiesces to whatever heinous acts are being perpetrated by the predator.

And so, we have that awareness now too!

Many other issues about which we need to be aware

Many other serious issues exist which plague the eating disorder community.

No generally accepted standards of care.

No collaboration with any medical or mental health communities to speak of.

No collaboration within the eating disorder community.

When was the last time NEDA, iaedp, AED and the other entities got together and stated, “Enough is enough. We are going to hold a joint conference. We are going to collaborate. We cannot have true progress if we remain separate and instead, we must collaborate. But, egos prevent that.

Ai is to be feared and cancelled.

Eating disorder legislative bills to increase research funding? Nope.

Then there is the beating of the drums by the Militant Fat Activists who have been allowed to poison the community with their own unique brand of craziness.

How many times have we read or heard that pediatricians, medical doctors and other medical professionals do not understand eating disorders and do not know what to look for? That lack of awareness falls on the shoulders of the eating disorder community.

The eating disorder community has had over ten (10) plus years to accomplish that! Instead? They failed. Completely. Miserably.

So, we go back to awareness? Awareness of what? Our own failures?

A focus on awareness has only resulted in failure. And this failure is measured by the lives of more children, adolescents and loved ones being taken.

The next step in awareness is … taking action. Since awareness without action is only cowardice and ignorance.

Ordinarily I would hope that at this time next year, we will be embracing Eating Disorder Action Week. But when as a community you instead embrace the known predators in the community, you have destroyed the hope which must exist within families.

So, ring in the new year. I am sure Eating Disorder Awareness Week 2026 will be the same vacuous song and dance.

The same radical tired voices will repeat the same radical tired messages to the same radical tired crowd measuring in the tens of people.

As the predators increase their profit margin, our children will continue to die.

Happy Eating Disorder Awareness Week 2025.

A DAD'S JOURNEY WITH EATING DISORDERS

Musings on Mental Health and the Eating Disorder Industry

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Tag Archives: depression

Board Certification Chaos: How Disunity and Private Equity Diluted the Community

Nine Years Beyond the Darkest Night: Grief, Truth, and Hope for Greater Tomorrows

EQUITABLE MENTAL HEALTH CARE AWAITS

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MEDICALLY INDUCED COMA FOR ANOREXIA?

Hannibal Lecter, Frazier Crane, Dr. Blane … and You!

AWARENESS WITHOUT ACTION EQUATES TO FAILURE

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