Bridging the Gap Between the Obesity & Eating Disorders Fields: A Q&A

Leah Schumacher, PhD, Katherine Balantekin, PhD, RD, Ellen Pasquale, BS, Stephanie Manasse, PhD, Jacqueline Hayes, PhD; Obesity and Eating Disorders SIG

Obesity and eating disorders are both highly prevalent and can affect many aspects of health and wellbeing. Both also often involve difficulties with or impact eating and physical activity, weight, and body image. Despite these similarities, work in these areas is often siloed, and efforts to advance research or clinical care in one arena is sometimes perceived as at odds with advancing the other.

The Obesity and Eating Disorders (OED) SIG interviewed Rachel W. Goode, PhD, MPH, Assistant Professor, University of North Carolina at Chapel Hill; Michele D. Levine, PhD, Professor of Psychiatry, Psychology and Obstetrics, Gynecology & Reproductive Sciences and Director of the Western Psychiatric Hospital’s Clinical Psychology Internship & T32 Postdoctoral Clinical Research Training Program for Psychologists; and Marian Tanofsky-Kraff, PhD, Professor, Uniformed Services University—all of whom work at the intersection of obesity and eating disorders—to hear their perspectives on this gap and potential ways forward.

What do you think are the main downsides of this gap from a research, clinical, educational, or policy perspective?

Goode: We fight with each other, when our efforts would be better spent joining together to create solutions on a systemic level. The people we serve are in the middle. Though some desire to lose weight to fit a cultural standard of beauty, others are facing some very real health challenges where maintaining or losing 5-10% of their body weight would make a significant difference.

Levine: One of the downsides is the missed opportunity to reach those outside of our eating/weight disciplines. Despite the myriad benefits of social media, the sharing of short bits of information denies us the opportunity to fully listen to the grains of truth in both sides. It might also deny us the chance to reach people who are reading different literatures all together and may really benefit from our collective understanding of some of the factors that drive health and mental health. 

Tanofsky-Kraff: Progress in all of these domains is being, at best, slowed and, at worst, halted. People in larger bodies with or without eating disorders are bearing the brunt of this gap. In addition, because those with extreme views have the loudest voices, there is a lot of misinformation that is spread, which only hurts the public and those in most need of help.

How has your work tried to close this gap and promote collaboration between fields?

Goode: In my lab, we are still working to design treatments to prevent/treat disordered eating and to treat obesity. We have seen early promise that both can be done at the same time. We are prioritizing building our future programs in conjunction with communities.

Levine: Research in my group focuses on the health of birthing peoples from pregnancy through the first postpartum year. It’s our goal not to pathologize the many changes in eating, weight and shape that occur during the perinatal period. I also attempt to continue to learn with trainees about issues related to weight stigma and to center the voices of the groups we focus on in research, including those who have historically been underrepresented. 

Tanofsky-Kraff: My work has never focused on only obesity or only eating disorders and my collaborators range from people in both fields, so I think unwittingly or not, I have tried to close this gap a bit. Over the past few years, I have explicitly tried to engage with people whose views are different from my own. I think this is where my belief has emerged that we are all really in support of the same goal to reduce weight-based stigma and improve the health and well-being of those with either eating disorders, high weight concerns, or both.

From your perspective, what needs to happen in the field to bridge this gap? What can SBM members do?

Goode: I think we need to spend more time hearing the stories of those in larger bodies, particular those with multiple marginalized identities, and be willing to co-create a new approach with them to determine what interventions would be the most helpful to develop.

Levine: As trite as it sounds, more of this kind of dialogue is helpful. I also imagine that additional policy briefs and other readily sharable information sheets may help us reach people working outside of the eating disorder or obesity fields.

Tanofsky-Kraff: Be open-minded and curious! Try to avoid echo chambers. If you differ in opinion with another researcher or practitioner, encourage face-to-face conversations and avoid online hostility. Some of my deepest learning comes from discussions with colleagues with whom I initially disagreed. For patient care, recognize that every person's experience is different and no two people are exactly alike. Provide education and autonomy for your clients.

To learn more or to get involved in bridging the gap, please consider joining the OED SIG or check out some obesity- and eating disorder-related sessions at the upcoming meeting in Philadelphia!