The annual National Eating Disorders Association (NEDA) conference was held in St Petersburg, Florida at the Renaissance Vinoy Resort and Golf Club from October 11^th – 13^th, 2012. The weather was amazing: blue skies, warm breezes, palm trees, and sailboats on the horizon. NEDA’s location choice would be considered brave, even foolish, for a conference less capable of luring people back inside. However, even before the kick-off, it was clear this year’s conference was not one to miss. Our own Dr. Cynthia Bulik presented the keynote address and set the stage for an exciting and memorable event. Her presentation, “Reflections of Reality: Eating Disorders in Diverse Populations and Across the Lifespan” focused on the importance of genetic data as a primary etiology of eating disorders. She urged listeners to help eradicate the myths placing sole blame on mothers, family, and society and to remember that, “genes are not destiny.”  She emphasized that eating disorders can affect any age, sex, or culture and only by erasing the ‘white upper-middle class teenage girl’ stereotype will we be able to effectively diagnose and tailor individual treatments for those who need it. Her energetic presentation was received enthusiastically by the audience and remained a prime topic throughout the conference.

Dr. Timothy Brewerton presented the next general session, “The Intersections of Trauma and Eating Disorders: Broadening Our Understanding for Supporting a Loved One and Improving Treatment.” Dr. Brewerton discussed how exposure to severe traumatic events can lead to PTSD and may contribute to the development of eating disorders in certain individuals with predisposing genetic factors. Avoidant and emotional coping styles can also increase these risks, and it is essential to address the trauma and PTSD for both prevention and treatment. After each general session, there were several breakout sessions from six tracks: Treatment, Family, Co-Occurring Conditions, Diversity & Special Issues, Education & Outreach, and the NEDA Organization track. With presentation descriptions ranging from “Insurance Companies are NOT the Enemy: A Collaborative Approach to Utilization Review” to “Navigating In Uncharted Waters: One Dad’s Practical Suggestions For Supporting Your Loved One In All Phases Of The Eating Disorder Journey,” it was nearly impossible to choose what to attend.  

One of my favorite sessions was “What’s Up With That?” a special feature Expert Q&A Session hosted by Dr. Douglas Bunnell, a former board president of NEDA. This dynamic session featured a panel of three leading eating disorder experts: Dr. Michael Strober, Dr. Michael Levine, and Carolyn Costin. Audience members were encouraged to ask questions by raising their hand or handing a volunteer an index card. For the super-shy audience members, Dr. Bunnell even gave out his cell phone number for those would rather text and jokingly encouraged everyone to call him day or night.

When asked to define recovery from an eating disorder, Carolyn Costin described it as, “not being willing to compromise your soul for a number. If you aren’t willing to compromise your health or betray your soul, you won’t do those behaviors.” She went on to say that she doesn’t just care about girls with eating disorders, she cares about all girls who are unhappy with their bodies but don’t get clinically diagnosed with an eating disorder. She says that every individual is so vastly unique that he or she will have his or her own jigsaw puzzle of pieces that come together to create the “perfect storm”. She mentioned that as a clinician, it is especially difficult to treat these disorders because, unlike other diseases, getting better is going to feel bad.

Dr. Strober described his experience as a clinician as a “very difficult, humbling, and long journey of discovery.” He also credited the importance of genetic and primary biologic factors as crucial in the etiology of these complex disorders. At the same time, he stressed the enormous complexity and variation of outcomes from these biologic diatheses throughout development and the subsequent need for multidisciplinary approaches to the actual clinical cases before us. Dr. Levine added that eating disorders cannot be eradicated by prevention and identification alone, and it is often surprising how many people who are considered to be at low-risk actually develop disorders. The panel agreed that proper treatment requires the broadest set of skills, as the deepest human behaviors do not necessarily submit themselves to one approach. This topic prompted a lively discussion on Drs. Strober and Johnson’s paper, “The Need for Complex Ideas in Anorexia Nervosa: Why Biology, Environment, and Psyche All Matter, Why Therapists Make Mistakes, and Why Clinical Benchmarks Are Needed for Managing Weight Correction.” The panel delved into the mysterious nature of eating disorders and the profound suffering that can accompany them. The combined experience and ideas of Drs. Strober, Levine, and Costin were an awesome and inspiring learning experience.

From the Kick-Off Dinner to the Concluding Remarks and Sunset Soirée at St. Petersburg Yacht Club, this year’s NEDA conference was a resounding success. You couldn’t ask for a better environment to learn and explore the intricacies of these complex disorders, to facilitate discussions, or to find and give support. I can’t wait to see what the 2013 conference in Washington, DC will bring!

Strober, M., Johnson, C. The Need for Complex Ideas in Anorexia Nervosa: Why Biology, Environment, and Psyche All Matter, Why Therapists Make Mistakes, and Why Clinical Benchmarks Are Needed for Managing Weight Correction. International Journal of Eating Disorders 2012;45:2 155-178.

By: Nora Luke