by Cynthia Bulik, PhD (en español haga clic aquí)

Mariana, could you start by telling us a little bit about you. Where were you born and where were you living before you came to UNC?

I was born on January 13, 1991 in Mexico City and both of my parents are doctors. They met during their specialization training—my father is a cardiologist and my mother is a psychiatrist—they met while they were working in Emergency Psychiatry. I lived in Mexico City for my first 5 years and afterwards we moved to Pachuca, a small city near the capitol where my father was from, when they offered him a job in the hospital. My younger brother,  who is also a psychologist, was born there. I lived in Pachuca until I was 25 when I started to work in a clinic in another state and afterwards, I moved to Mexico City.

What and where did you study in Mexico?

I received my degree in psychology at the University La Salle Pachuca, and later received my Masters in biomedical science and health at the Autonomous University in the state of Hidalgo. My thesis project was an intervention about parenting and eating behavior for mothers with school-aged children, During my Masters I was a visiting scholar at the University of Guelph in Canada.

At the end of my Masters, I started working at the Hospital of the Americas, a public hospital in Ecatepec, in the State of México, where I also started my clinical practice. I completed my doctorate at the National Autonomous University in Mexico. My thesis project was a multidisciplinary online intervention for patients with binge-eating disorder. During my doctorate, I completed a visiting scholarship at the University of Barcelona, Spain where I learned about prevention programs and body image in children and adolescents.

Cindy and Mariana

Please share a little bit about your clinical experience with eating disorders in Mexico.

After my Masters, I started working in a public hospital where along with a psychiatrist and dietitian, I treated children and adolescents with diverse psychopathology including eating disorders, anxiety, depression, suicidality, and bullying, among others. I was also in charge of workshops for parents who were supporting their children’s treatment. Every day, I treated between 8 and 10 patients, which was quite exhausting. The hospital had a model of multidisciplinary care and my focus there was primarily cognitive-behavioral.

Also, during my doctorate, I developed an online intervention for patients with binge-eating disorder who had co-=occurring depression or anxiety.

In my private practice, I saw patients with anorexia nervosa, bulimia nervosa, binge-eating disorder, anxiety, and depression.

Tell us about your research on eating disorders in Mexico.

My areas of investigation are primarily parental feeding practices with children, treatment, intervention, eating behaviors and disorders, body image, and emotional regulation. I have published articles about instrument validation, systematic reviews, evaluation of treatments, and predictive models in psychology. In Mexico, I am the research coordinator at the Eating Disorders Clinic at the Los Angeles Hospital. I served on thesis committees of undergraduate and graduate students at the Autonomous University of Hidalgo and I review articles for the Mexican Journal of Eating Disorders.

I am currently part of the National Researchers System, which is a recognition granted to scientists in Mexico through peer evaluation. It consists of receiving the appointment of National Researcher. This distinction symbolizes the quality and prestige of the scientific contributions that each researcher has in their field.

What motivated you to want to come to UNC to do a post-doc at CEED?

I wanted to extend myself and broaden my expectations, so I sought to go to other countries to learn more about research in my field. During my doctoral studies, I learned a great deal from my mentor, Dr. Rosalia Vázquez. I learned to always read critically, to write manuscripts, to analyze data, and above all, to interpret data. I thought that what I had learned was enough, but one of the people who motivated me to continue and do a postdoctoral program abroad was my husband.

So, I looked for a researcher whom I greatly admired, and Cindy (Bulik) came to mind. I had been reading her work for a long time, and I thought it was a good idea to write to her and see what would happen. I was afraid and nervous because I thought she wouldn’t consider me for a position. But being here has exceeded my expectations. Being with such a globally recognized research group is a challenge, and it has been difficult, but also something wonderful.

What are some of the most important questions in eating disorders that you think are important to address in research?

• “Are characteristics related to diversity such as being transgender, gay, or lesbian associated with a higher risk of eating disorders and body image distortion?
• Why, despite attempts to standardize treatments for each eating disorder, is it difficult to replicate them in diverse populations? In this case, should an evidence-based protocol be used or should treatment be adjusted to the context and the individual?
• Is there an increased risk of an eating disorder during pregnancy?
• How to address gender diversity in eating disorder treatments?
• Why do only some people suffer from eating disorders despite everyone being exposed to sociocultural influences and pressures for thinness? Is it genetics?
• Will new medications like Ozempic be beneficial or, on the contrary, another risk factor especially for patients with binge-eating disorder?
• What factors influence some patients to have long-term recovery while others have more relapses?
• Do stressful life events increase the severity of binge-eating disorder?
• Can a brief intervention model for eating disorders like in the United States be adapted to Latin America, especially in Mexico?
• What would it take to attract more men to eating disorder studies and make them aware that these are not disorders exclusive to women?
• Is OCD mostly associated with ARFID in men?”

Any observations about North Carolina or Chapel Hill that you have made since you came here. Anything very different from home?

There are many differences, especially in the food. I miss our Mexican food, and  the closeness with people and family. Public transportation! In Mexico, we have the metro, buses, trolleys, taxis, pedicabs, and Uber, whereas here, there are only a few buses so it’s difficult to get around if you don’t have a car. It’s not easy to walk. But as for the good things, I love the nature, the cherry blossoms blooming, the plants, and feeling like I live in the forest. I like the university buildings and being able to go outside without fearing that someone will harm me.

*Some publications by Dr Valdez Aguilar:

Casaubon-Garcin, P.R.,Ramsay, M.,Casaubon Lemmen, M.,S., Goldbard Rochman, D., Meza Hernández O.M.O., Baptista González, H., Monroy Tenia, Z.A., Barriguete Meléndez, J.A., & Valdez-Aguilar, M. (in press) The child who does not eat well. A transcendent and constant reason for consultation in Pediatrics: validation of the feeding scale “The Montreal Children’s Hospital feeding scale” (MCH-FS) to detect eating disorders in Mexican children. Acta Pediátrica de México.

Valdez-Aguilar M.,Vázquez-Arévalo R.,& Aldaco, A.(in press). Multidisciplinary intervention in a male with binge eating disorder: a case study. Mexican Journal of Eating Disorders.

Pérez-Bustinzar, A. R., Valdez-Aguilar, M., Barriguete Chavez Peón, P. ,& Barriguete Meléndez, J.A. (2024). Validation of the short version of the Eating Attitudes Test (EAT-18) in a Mexican clinical population. RIDEP https://doi.org/10.21865/RIDEP71.1.12

Pérez, B.A.R., Valdez, A.M., Viladoms, P.A., Damm, M.W., Barriguete, M.J.A. (2024) Desarrollo y validación de un instrumento de evaluación familiar para pacientes con trastornos alimentarios. Acta Med GA; 22 (1): 27-33. https://dx.doi.org/10.35366/114590

Pérez-Bustinzar, A.R., Valdez-Aguilar,M.,& Barriguete, J.A. (2023). Validation of the questionnaire of sociocultural influences of the body aesthetic model (CIMEC-26) in the Mexican female population. Escritos de Psicología. 10.24310/escpsi.16.2.2023.1583

Valdez-Aguilar, M., Vazquez-Arevalo, R., López-Aguilar, X., RuízMartínez, A.O., Rosinska, M., & Mancilla-Díaz, J. M. (2023). Online multidisciplinary treatment of binge eating disorder in people with high weight: a case series study. Journal of Eating Disorders, 11(1), 86. https://doi.org/10.1186/s40337-023-00809-9

Pérez-Bustinzar, A.R., Valdez-Aguilar, M.,& Barriguete, J.A.(2023). Sociocultural influences on body image in patients with eating disorders: an explanatory model. Revista Psicología, Sociedad y Educación. https://doi.org/10.21071/pse.v15i2.15608

Valdez-Aguilar,M.,Vázquez-Arévalo,R.,Guzmán Saldaña, R.M.E., Figueroa-Hernández, J. A., & Rodríguez Nabor, A. (2022). Online multidisciplinary intervention for women with binge eating disorder. Psychological Therapy, 40(2), 171-195.

Valdez-Aguilar, M., Vázquez-Arévalo , R., López-Aguilar, X., & Regalado Ruíz, L. A. (2022). Validation and cut-off point of the Binge Eating Scale (BES) in Mexican population. Psychology, Society & Education, 14(3), 68- 77. https://doi.org/10.21071/psye.v14i3.14323

Valdez-Aguilar, M., Vázquez-Arévalo, R., Beas-Jara M.C., & Mancilla-Diaz, J.M. (2022). Effectiveness of psychological interventions in women with binge eating disorder: a systematic review. Mexican Journal of Eating Disorders 11 (2). https://doi.org/10.22201/fesi.20071523e.2021.2.722

Vázquez-Arevalo, R., Valdez-Aguilar, M., López-Aguilar, X., & Mancilla- Diaz, J.M. (2020). Evaluation of instruments about sociocultural influences on internalization of body ideals in the Hispanic population. Mexican Journal of Eating Disorders, 11(1).

Valdez Aguilar, M., Guzmán Saldaña, R.M.E., Salcedo Molina, T.J., & Ruiz Martínez, A.O. (2016). Psychoeducational intervention on parenting practices and eating behavior in women with school-age children. Educación y Salud Boletín Científico Instituto de Ciencias de la Salud del ICSA. 5(9).