Can’t Horseback Ride Because of Your Size? That Might Just Be a Load of “Horse Shit.”

Horseback riding when fat [Image description: back of a fat person with long flowing blonde hair and a purple shirt, riding a horse]

By Carolyn Comas, LCSW, CEDS-S, Clinical Supervisor Navigating the world in a fat body can be frustrating and may feel disheartening. There are, unfortunately, some activities and spaces that do not accommodate people in large bodies. When someone in a big body encounters spaces that do not accommodate their larger body, it’s common to conclude …

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Can CBT for Eating Disorders Be HAES®-aligned?

CBT plus HAES for Eating Disorders [Image description: large bodied gender neutral person seated and facing a therapist whose back is to the camera]

Cognitive-Behavioral Therapy is the most effective approach for treating adults with eating disorders, including bulimia nervosa and binge eating disorder. The most recent and commonly taught and implemented version is an “enhanced” protocol, CBT-E (Fairburn, Christopher G., 2008). Unfortunately, Cognitive Behavioral Therapy (CBT) for eating disorders is not always employed in a weight neutral way, …

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How Diet Culture Can Harm Your Recovery from ARFID

ARFID Diet Culture

by Carolyn Comas, LCSW, CEDS-S People diagnosed with Avoidant Restrictive Food Intake Disorder (ARFID) struggle with consuming adequate nutritional intake due to either 1) fear of aversive consequences (i.e choking), 2) low interest in food altogether, or 3) sensory sensitivity to food textures, smells, or appearance. Usually, people with ARFID do not report refraining from …

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How a Health at Every Size(R) (HAES) Approach Can Help With Eating Disorder Recovery

Health at Every Size and Eating Disorder [Image description: black larger bodied woman eating a donut]

Eating disorders are not only about body image. Nor have they only recently arisen in response to societal pressures to be thin. In fact, eating disorders date back to at least the 13th and 14th centuries, when it was documented that women were fasting to demonstrate religious devotion. However, today eating disorders do occur in …

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Teen Eating Disorder Recovery Group

Teen Eating Disorder Recovery Group open to teens 13 to 18 in California over zoom

  As we have written elsewhere, we believe Family-Based Treatment (FBT) is a complete treatment for teens with eating disorders. Most teens will not need (or want) additional therapy. The one area where we think teens could use a little more support is in developing a strong anti-diet stance to stand up to weight stigma …

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What Parents of Teens with Eating Disorders Need to Understand About Diet Culture

What Parents Need to Know About Diet Culture

  Many parents experience guilt when their teen is diagnosed with an eating disorder. Nearly every parent can point to a time they themselves dieted, opted not to have a dessert they really wanted, expressed a preference toward thinness, or discouraged their child from keeping eating. You may have done things to try to keep …

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How We Set Recovery Weights

Recovery Weight [Image description: doctor scale] How we set recovery weights in eating disorder treatment

If you have an eating disorder, or your child has one, there is a good chance that weight gain will be an essential part of the recovery process. This is true not just for people in objectively small bodies, but also for people in larger bodies who are diagnosed with Atypical Anorexia, a weight-biased diagnostic …

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When Eating Disorder Providers Are Steeped in Diet Culture

When Eating Disorder Providers are Steeped in Diet Culture

“People are concerned about the fact that I’m a therapist and have an eating disorder, and I’m like, ‘You’re concerned about me? I’m concerned about our entire fucking field.’” — Shira Rose, FoodPsych with Christy Harrison This quote has generated a lot of reactions. In this podcast, Shira—who lives in a larger body when she …

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When You Have Adapted a Health At Every Size Approach and Your Family is Still Stuck in Diet Culture

When You Have Adapted a Health At Every Size Approach and Your Family is Still Stuck in Diet Culture

For many of my patients who have firmly joined the anti-diet camp and embraced a Health at Every Size® (HAES) approach to health, dealing with family members entrenched in diet culture can be a minefield that is tough to navigate. Let me say that I get it! I also have friends and family members who …

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