“Eating disorders tend to make people’s lives smaller. If you’re spending 50% plus of your day thinking exclusively about what your body looks like, you deserve a bigger life than that.”
This comment comes from Dr. Margaret Funk from Melrose Center who specializes in treating people with eating disorders. Dr. Funk was the guest on the episode of the Off the Charts podcast that discusses eating disorders, what’s changed over time and how treatment can help people live a full life.
Listen to the episode or read on for highlights from the conversation.
8 takeaways from a conversation with an eating disorder doctor
During the podcast, Dr. Funk touches on many aspects of eating disorders. Here are eight important highlights.
1. Eating disorders don’t just affect white women
Eating disorders affect people of all ages, genders and socioeconomic statuses, but the messages in our culture seldom make this clear.
“There still is this misconception that eating disorders are an affluent white woman’s disease, which is absolutely not accurate,” says Dr. Funk.
She believes this may stem from the fact that, historically, well-to-do white people were the ones who had the best access to eating disorder treatment. But now that treatment is more widely available, conversations about eating disorders are starting to change.
“One of the positive things that we’ve seen, are so many more diverse voices in the eating disorder community talking about their experiences,” she says.
Still, she notes that “there continues to be a stigma for individuals who are male presenting to get treatment for an eating disorder.”
2. A person’s unique growth curve should be celebrated
Doctors and clinicians play a role in how people view their bodies. Dr. Funk says that at Melrose Center, “I have a lot of kids who come in and say, ‘My doctor said they were worried about my weight.’”
Thinking back to her time as a family medicine doctor, there are things she would have done differently. One of these is spending more time talking about normal growth patterns, especially with patients who were uncomfortable with the size or shape of their body.
“I wish that I would have taken more time to emphasize, ‘Look at how amazingly your body is growing and following this curve. It’s selected just for you,’” she says.
3. If you’re a parent, your behaviors affect your child’s body image
Dr. Funk says, “I wish that I could tell all parents that the first time their kid is going to start to think about their body is often when you make a comment about your body.” And for the kids in our lives, “they look up to the amazing things that we’re doing, but they also look up to the things that we say.”
So when you talk about gaining a few pounds or wonder if your pants look good on you, Dr. Funk says that your kids may also start to think, “Well, maybe I should be thinking that way.”
4. Our culture often praises disordered eating
“There’s a lot in our culture that will sometimes present disordered eating behaviors as being something positive,” says Dr. Funk. These can include juice cleanses, intermittent fasting, excluding entire food groups and the obsessive pursuit of clean eating (orthorexia). In addition, related behaviors such as compulsive exercise are also often seen as healthy and fitness-forward.
“And when people get kind of too enmeshed in that, they don’t even realize that what they’re doing is disordered,” she says. In fact, people are liable to defend their behaviors as healthy.
In these situations, Dr. Funk likes to ask questions such as “Is it impacting your physical health?” and “How is it impacting you mentally and how much of your day are you spending thinking about this stuff?”
5. GLP-1s are affecting the availability of “body neutral” content
“One thing that I think has been really challenging is the explosion of GLP-1 usage,” says Dr. Funk.
GLP-1s are prescription hormone drugs that help regulate appetite, digestion and blood sugar. While they were first used for managing type 2 diabetes, they are increasingly being prescribed for weight loss.
While these medications provide meaningful health benefits, GLP-1s have also changed the conversation about what healthy looks like. In short, the cultural spotlight has shifted toward weight loss and transformation stories and away from body-neutral content.
“A lot of people who used to be in the body positive or body neutral space online, suddenly their content is all shifting to weight loss … or not talking about body neutrality anymore,” she says.
Plus, social media platforms prioritize trending topics. And since GLP 1s generate high engagement, weight loss content is amplified, while body neutral creators struggle to maintain visibility. This has left a sizeable gap in the resources, community and support for body neutrality and Health at Every Size®. And Dr. Funk says these changes can make someone feel less secure or supported in how they feel about their body.
6. All foods fit in a balanced diet
For healthy nutrition, Dr. Funk positions variety as the ultimate goal. “Instead of talking about junk foods or bad foods or putting foods on a hierarchy, I will try to talk to [patients] about variety in their diet, about getting all of your food groups.”
According to Dr. Funk, all foods can have a place in a balanced diet. So, her message to patients is, “Let’s make sure you’re giving your body everything that it needs and not just some of what it needs.”
7. When treating eating disorders, it’s “nutrition before cognition”
Research shows it’s hard to learn new habits around food and body until your body is renourished, says Dr. Funk. That’s why the first step in treating eating disorders is restoring weight and nourishment. This applies to everyone, regardless of size or shape.
In the past, treatment looked different for people in larger bodies. Doctors would stabilize weight but not fully restore it. “Unfortunately, what they found is people had really poor recovery rates when we went that direction,” Dr. Funk explains.
Why does renourishment matter so much? When you have an eating disorder, your brain adapts to starvation or chaotic eating. It rewires itself to prioritize control, avoidance or compulsive reward seeking, making behaviors feel automatic and hard to break. This is sometimes called “survival brain.”
Dr. Funk describes what a brain in survival mode can be like for people with an eating disorder. “It gets really perseverative about food and says, ‘Hey, you should keep going. And in fact, I’m going to add this rule and that rule. If you don’t follow them, life’s going to get worse. But if you do, everything’s going to be okay.’”
The good news? “We find that a lot of that intrusive quality or that perseverative quality tends to get much better when the body is renourished,” she says.
8. Eating disorder treatment takes a team
Eating disorders are complex conditions that require expert care for the body, mind and emotions. That’s why treatment works best when there’s a team of eating disorder specialists.
A team can work together to understand the causes and impact of the eating disorder, and to develop a personalized plan that addresses all the thoughts, behaviors and health challenges that come with an eating disorder. In most cases, this team includes a medical expert, dietitian and therapist.
Dr. Funk’s role as the medical expert is to care for a person’s body during eating disorder treatment. “I always talk to the families, saying my role is to make sure that your body is safe to be doing this work at home, to keep evaluating for appropriate level of care.”
“The dietitian is to help you and your family learn what is an amount of nutrition that [your] body needs, and that’s going to be very different as you go through treatment,” she says.
“The therapist really is to get at the foundation of why these decisions are being made,” she says. For example, therapists help people to recognize thoughts caused by the eating disorder and what to do when they’re happening.
Find more information about eating disorders
Eating disorders are complex mental health conditions that can affect anyone of any age and any gender. So it’s good to be aware of eating disorder symptoms and the available treatments.
A great source for up-to-date information is the Melrose Heals podcast. Each episode focuses on topics important to people, families and communities impacted by eating disorders, such as body image and navigating eating disorders during the holidays. There are also plenty of recovery stories to provide inspiration and encouragement.
If you think you or a loved one has an eating disorder, call Melrose Center at 952-993-4100 to schedule an initial assessment.
