Show Notes   What is virtual care and how can it be used in treating patients with eating disorders? What are the limitations or advantages of using virtual care in treating eating disorder patients? In this podcast episode, Kate Fisch speaks with Dr. Erin Knopf about virtual care for Eating Disorders. She discusses the benefits and challenges around virtual care and the role it plays in assisting our clients and developing more effective treatments.   MEET DR. ERIN KNOPF Dr. Knopf is dedicated to treating patients with eating disorders holistically. As a triple-boarded physician (pediatrician, adult psychiatrist, child/adolescent psychiatrist) and Certified Eating Disorder Specialist, she uses her combined training with intentionality to assess disease severity and devise comprehensive plans to address the eating disorder behaviors as well as comorbid symptoms of anxiety, depression, OCD, trauma and more. She describes herself as the “mechanic of the body” and prioritizes psychoeducation and biological education for patients and families to foster insight and achieve treatment alignment. Dr. Knopf previously worked in an IP/RES/PHP program for almost 5 years and at the onset of the COVID-19 Pandemic, she served as unit psychiatrist for ten months at the ACUTE Center for Eating Disorders. She is a member of IAEDP, AED, AACAP, APA and AAP. Visit Virtual Eating Recovery For You to find out more.   IN THIS PODCAST Will virtual care replace physical consultations? The challenges faced with treating eating disorders. Childhood obesity, diets and restrictive eating. Lab results and eating disorders.   Do you feel like delivering care virtually gets in the way of connecting with patients? “I will admit, as an extrovert, I don't think there will ever be a way to replace the beauty of in person connection. There are nuances that are missed. But ultimately, would I turn away from virtual care? Absolutely not!” Dr. Erin Knopf   When we think about virtual care, the cons might be pretty clear, but the pros just far outweigh, especially when we're talking about someone getting care versus not. . .   “It’s an opportunity to bring care to people who would never have it, it's flexible, convenient. So I think overall, the virtual care frontier is really exciting and we can only do it better with our technological advances.” Dr. Erin Knopf   What is a big challenge you are currently faced with? “Right now we are, unfortunately, private pay, which I know limits access, but that is not our end game. We are currently working on credentialing with three insurance companies.We offer discounted bundles for services. We do super bills, and we even have a single case agreement.” Dr. Erin Knopf   Eating disorders don't discriminate based on socioeconomic status. They also don't discriminate based on geographic location. It is important for all patients to have access to some level of professional care and help.   What are your thoughts on the American Academy of Pediatrics’recently issued a statement on childhood obesity? “The first part is it's still relying on BMI as the measure of obesity. It actually doesn't include in the definition any other medical considerations that people get worried about - type two diabetes, hypertension, hyperlipidemia, things like that.” Dr. Erin Knopf   The steps that follow such a statement are extremely drastic, especially when we consider its referral to children. . .   “ It just says if a child's body is 90th percentile for age match, BMI percentage, then they meet criteria for obesity and therefore should be considered for, drum roll, either weight loss surgery, like bariatric surgery, or weight loss medications.” Dr. Erin Knopf   What are your thoughts on why diets and restrictive eating are so common? “Human beings like diet culture because it helps them feel in control and powerful and capable of incredible discipline. Think of how often that's overly valued and praised.” Dr Erin Knopf   When treating somebody. What is your number one concern, medically? “Medical stability and medical fragility are the terms that I consider the most. Everyone is pretty accustomed to picturing an emaciated person who meets criteria for eating disorders and has low heart rate, low blood sugar, low body temperature. But really, only 6% of patients with eating disorders are actually underweight. All it takes is 15 pounds of weight loss in three months and your body is malnourished to some degree..” Dr Erin Knopf   How do we handle clients who have good lab results but may still have an underlying issue? “Your body is miraculous, that it is going to work for you and protect you as best it can by improving the movement of electrolytes, of improving the mobilization of energy molecules from stored tissue in order to meet your metabolic need. But eventually that will give out. And treatment should not occur when you are in the middle of crisis and your body is comping out. It needs to happen sooner than that.  So if the behaviors are there and the weight loss is there or the weight interruption for whatever way it looks is there, yeah. you meet criteria in my book, and I think it is important that we have more early recognition and prevention.” Dr Erin Knopf     The one thing that virtual care provides is access to those patients who may not have thought they were able to get treatment and thus there's motivation to get better. Especially now that virtual care has been supported nationally. Hopefully it continues to get the same support even with laws changing. Now that the Pandemic emergency actions are expiring, this does give us an opportunity to bring that expert care to corners that would never have known expert care mattered, would never have known that they actually do meet criteria for an eating disorder and deserve that expert care. So it's just such a wonderful opportunity to improve health outcomes for so many more This is a fascinating topic and Dr. Erin Knopf and is filled with valuable insights, information and examples throughout the podcast.    To read the articles or find the book mentioned in the podcast, follow the links below. RESOURCES MENTIONED AND USEFUL LINKS Visit Virtual Eating Recovery For You for more on the fantastic work that Dr. Erin Knopf is involved in.   Rate, review, and subscribe to this podcast on Apple Podcasts, Stitcher, Google Podcasts, TuneIn, and Spotify.

What is interoceptive awareness and can it play a role in the development of eating disorders? What is interoceptive exposure and how can it be used in the treatment of eating disorders? In this podcast episode, Kate Fisch speaks with Dr. Melanie Smith about interoceptive exposure and awareness. She discusses how interoceptive exposure can help assist our clients and develop more effective treatments. MEET DR. MELANIE SMITH Melanie Smith, PhD, LMHC, CEDS-S, is the Director of Training for The Renfrew Center. In this role, she provides ongoing training, supervision and consultation to clinicians across disciplines for the purpose of continually assessing and improving competence in the treatment of eating disorders. Dr. Smith is co-author of The Renfrew Unified Treatment for Eating Disorders and Comorbidity Therapist Guide and Workbook (Oxford University Press), is a Certified Eating Disorders Specialist and Approved Supervisor, and is a Certified Therapist & Trainer for the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP).  Visit Melanie Smith to find out more.   IN THIS PODCAST What is interoception? What is interoceptive awareness? How can we use interoceptive exposure to help clients? The brain and body image.   Where do we start in terms of interoception? “Let’s start with interoception in and of itself. This is just our body’s internal perception, so our bodily senses of what is happening inside our body.” Dr. Melanie Smith Our clients are always looking for as many tools as they can to treat their eating disorder clients. It is important for us, as therapists, to understand all the factors that can influence eating disorders… “When we think about eating disorder application; our ability to sense if I'm hungry, if I'm full, if my stomach doesn't feel good; all of that is what we're talking about when we're talking about interoception.” Dr. Melanie Smith   What then is interoceptive awareness? “Interoceptive awareness is the level to which we are consciously aware of the things happening inside our bodies.” Dr. Melanie Smith   It is important to understand what level of interoceptive awareness a client has and how they react to what is happening inside the body, because most of us, most of the time, shouldn’t be (or aren’t) noticing things such as our heart beating or ourselves breathing. “Heightened levels of interoceptive awareness also results in heightened anxiety about what is happening inside our body. So we might start to overthink it or overinterpret what it means.” Dr. Melanie Smith   How can we use interoceptive exposure to help clients?   “The ultimate goal with interoceptive exposure is to intentionally evoke those same unpleasant, uncomfortable sensations. So, we're going to allow ourselves to experience that emotion, allow it to rise, BUT allow it to fall and learn that this is actually something we can tolerate.” Dr. Melanie Smith   Interoceptive exposure seems to align with other methods and skills that we already understand as therapists or clinicians. If we were to think about Mentalizing, Acceptance and Commitment Therapy or Dialectic Behavioral Therapy. “Those same principles are absolutely at work here, which is why I would suggest it as a wonderful adjunctive that could nicely coincide with any of those treatment approaches.” Dr. Melanie Smith   When was this developed and is there any current research into the method?   “The first places you'll see it in the literature as a proposed intervention, from an experimental standpoint, was back in the late 80s, maybe early 90s. But I think in the 80s specifically, it was proposed as a Cognitive behavioral exposure-based intervention for panic disorders.” “There's also a lot of really interesting evidence out there and people doing more trials with this with individuals with PTSD because when you think about trauma response and the way that trauma is held within the body, and that bodily reaction, you're not going to talk someone out of that. There have been really successful applications with other chronic illnesses and chronic pain.” Dr Melanie Smith   When talking to a family or talking to a client and trying to explain what is happening to us or to your brain start by explaining; You have your brain which is the organ which Neurologists take care of, and then you have your mind which is a little bit less tangible and it's what us therapists take care of. One of the issues that we have is that our civilization, which is backed by our minds, has actually evolved faster than our brains have so our brains get activated by perceived threat and still think tigers are chasing us. It's still our brain, that primitive Caveman Limbic system, deep in the depths of our primitive brain that is not aware that it's not a tiger. That's that overinterpretation of threat. When our brain is not aware that it is not a tiger. So it is still dropping all of those neurochemicals associated with running for your life. Now our minds are thinking; “there's not a tiger - so why is my heart beating this fast?”. My heart's beating that fast because my brain told it to because it thinks I'm running from a tiger.  There's something about that idea of separating the brain from the mind that really helps people understand that they're not defective. They're not doing something wrong, or their loved one isn't doing something wrong or isn't broken. In fact, you're the opposite of broken. Your brain is working magnificently, it's doing exactly what it's designed to do. Now our mind needs to override that brain part and that feels like such a good starting point.   “Those teaching examples and metaphors I think are so brilliant. I literally start with that one, usually the tiger. That's one of my teaching examples.” Dr. Melanie Smith   Let’s talk about what this all looks like in a therapy room and any examples you may have. “All of the education kind of stuff we just talked about, you have to bring in the room with a client using language that is appropriate developmentally and, again, relationally; like it's not a science class but we are teaching them about science.” Dr Melanie Smith   It is clear that introspective exposure is a tool that therapists and clinicians can incorporate, but as a method of treatment, this is not something you're going to start off with. We need to get past certain stages in therapy and have foundational blocks before we move onto using interoceptive exposure with clients. This is a fascinating topic and Dr. Melanie Smith provides valuable insights, information and examples throughout the podcast. To read the article or find the book mentioned in the podcast, follow the links below.   RESOURCES MENTIONED AND USEFUL LINKS Visit National Library of Medicine to read the article mentioned in the podcast. Visit this  Amazon Link to get the book mentioned in the podcast.   Rate, review, and subscribe to this podcast on Apple Podcasts, Stitcher, Google Podcasts, TuneIn, and Spotify.

Consisting of 5 new episodes, season 2 of the Eating Recovery Academy Podcast is about to drop! Click here to listen to the official Trailer   From the second week of November 2023 the episodes will become available. The guests are amazing in their fields and we cover some fascinating and insightful topics surrounding eating disorder treatments. Be on the lookout for the first episode - you won't want to miss it! Make sure you're following Eating Recovery Academy on any of the platforms below, and that your notifications are on. Apple Spotify Google Deezer Stitcher

What are clinical resources? What clinical resources are available to therapists? How important are clinical resources in assisting with the treatment of eating disorders? In this podcast episode, Kate Fisch speaks with Lara Effland about clinical resources. She discusses the role that clinical resources play in assisting therapists with the treatment of eating disorders.   Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

What does the brain have to do with eating disorders? Does the brain influence eating disorders? Can neuroscience help us treat eating disorders? In this podcast episode, I speak with Melinda Karth about neuroscience and how studying the brain can help lead us to both educate our clients and also be able to pick more effective treatments. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

What is music therapy? How does music therapy affect the brain? How can therapists incorporate music therapy into eating disorder treatment? In this episode I speak with Dr Annie Hedder Heiderscheit about music therapy as a supplemental intervention for eating disorder treatment and the current research on this form of therapy. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

Can psychedelics be used to help treat eating disorders? How do psychedelics interact with the mind and body? How can psychedelics, when used correctly, help a person to make significant changes in their lives? In this podcast episode, I speak with Dr. Natalie Gukasyan about psychedelics, eating disorders, and the current research on new forms of treatment. We discuss what psychedelics are and how they can be used, in the appropriate settings, to change behavioral patterns.  Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

Can psychodrama be used to treat eating disorders? How can positive experiences help change someone’s brain for the better after trauma? Why is psychodrama an effective and powerful regulation tool that clients can use to heal trauma? In this podcast episode, I interview Karen Carnabucci about psychodrama. We discuss its origins and modern-day applications as well as how clinicians can use psychodrama to help patients self-regulate.  Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

What is refeeding syndrome? Why is it dangerous? How can therapists work with their client’s physicians to reduce and treat refeeding syndrome? In this podcast episode, I interview Christina Tursi about refeeding syndrome. We discuss what it is, how it can affect you, and the approaches to treatment that one might take. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

What is the relationship between mindfulness and resilience? Can you use awareness to combat mindless habits? Is mindful eating the remedy to diet culture? In this podcast episode, I interview Andrea Lieberstein about the importance of mindfulness and how it can allow us to take conscious control of our thoughts and habits.  Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

Why is it near-impossible for clients to receive treatment for eating disorders? How can therapists be aware of exclusivity in treatment? Did you know that therapists are equipped to treat eating disorders? In this podcast episode, I interview Rebecca Eyre about the challenges involved in finding eating disorder treatment. We discuss some of the misconceptions around who needs treatment, and how therapists can help. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

How do body image issues compound the struggles of eating disorders? Can you repurpose your social media to be a place of goodness instead of critique? Is Barbie the real culprit in young women’s bodily dissatisfaction? In this podcast episode, I speak with Dr. Beth Blodgett Salafia about the relationship between self-esteem and disordered eating. We discuss how social media has affected our body image, and how parents can promote body positivity in their children. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

What is the connection between “flight or fight” and “rest and digest”? Does gut health influence brain health? How do eating disorders impact gut health? In this podcast episode, I speak about gut health with Lauren Alcorn. We consider the various ways eating habits affect brain function, and how therapists and dieticians can practice sensitivity towards both the mental and physical symptoms of disordered eating. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

How can you deal with a client’s ambivalence around their eating disorder? What are some basic motivational interviewing techniques? How does a combination of CBT and DBT enable your clients to feel empowered? In this podcast episode, I speak about ambivalence around eating disorders. I show how motivational interviewing techniques can help clients realize that eating disorders lead to less control. I also discuss the supportive role that CBT and DBT can play. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

Are your clients unsure as to whether they have an eating disorder or not? Can people have mixed emotions about eating disorders? How can therapists help address ambivalence in their clients? In this podcast episode, Kate Fisch speaks about ambivalence in client decision-making. She discusses how patients can demonstrate ambivalence, how it relates to eating disorders, and how reflection can help address it.  Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

Can eating disorders be a result of gastrointestinal dysfunction? How can dieticians help their clients who have sensitive or disordered digestive systems? Why is maintaining a regular eating pattern helpful for treatment? In this podcast episode, I interview Erin Hurst about the relationship between a sensitive gut and disordered eating. We discuss some of the symptoms of gastrointestinal dysfunction, and how to work with a dietician to support patient recovery. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

Why is it important for clients in eating recovery to know how their brain works? How do you work in unison with your “caveman” brain? Why is eating more food the answer to reducing binges? In this podcast episode, I discuss how your brain responds to disordered eating. I analyze why it is that restricting calories often leads to bingeing, and discuss how changing your eating habits to be more regular can help you break the binge-eating cycle.  Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

How can working with a dietician be a beneficial relationship for therapists who treat eating disorders? What is the role of the dietician in the treatment process? What is a dietician’s definition of a “healthy diet”? In this podcast episode, Lauren Rieker and I discuss the benefits of working with a dietician to assist in treating disordered eating. We talk about how the dietician, patient, and therapist can work as a team, and how a dietician can motivate patients into developing a healthy relationship with food. Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

Why should you bring a dietician into treatment with a client? Which point in this cycle is the “easiest” place to start treating the client? What is the relationship between the brain and the mind when it comes to binging and purging? In this podcast episode, I discuss how the body responds to the restrict, binge, purge cycle, and why this makes it so difficult to break. I explain what techniques therapists can use to help patients exit the cycle, and which aspect of their patients' mindsets to focus on.  Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com

What is the relationship between the physiological and psychological aspects of the restrict, binge, and purge cycle? How do the brain and mind work against one another when a client is caught in a binge? What is the “recommitment” to the restriction? In this podcast episode, I discuss the Restrict, Binge, Purge Cycle. I explain how each of these factors builds into the cycle, and why clients may seek solace from one by moving to the other.  Thanks for listening! I'd love to connect with you over on Instagram and Facebook SIGN UP FOR MY FREE EMAIL COURSE: Click here SHOW NOTES AND RESOURCES: Click here WEBSITE: www.eatingrecoveryacademy.com