Treatment Resistant or Systemic Failure? Reframing “Untreatable” Eating Disorders with Dr. Anita Federici

The Full of Beans Podcast

This week’s Full of Beans episode tackles one of the most critical (and controversial) topics in eating disorder care: are eating disorders really untreatable, or are we simply using the wrong tools?

We’re joined by the brilliant Dr. Anita Federici, clinical psychologist and international DBT trainer. Dr. Federici has worked with those considered “treatment-resistant” and asks an important question: is it the person who’s resistant, or is the system failing to meet their needs?

Key Takeaways

• The limitations of traditional CBT models in eating disorder care
• The importance of DBT's acceptance-based approach
• The importance of understanding trauma, neurodivergence & emotional dysregulation in recovery
• The reality of two contradictions existing: I want to recover AND I need to engage in my eating disorder.
• The danger of labels like "terminal anorexia" and "severe and enduring"
• Why the system may be treatment resistant, not the individual
• The vital role of clinicians in holding hope for their patients
• The ethical dilemma of the assisted dying bill

Timestamps:

• 04:50 – DBT vs CBT in eating disorder treatment
• 16:10 – Treatment-resistant or treatment-mismatched?
• 24:30 – The assisted dying bill: ethical concerns
• 33:00 – Who gets labelled “terminal” and why?
• 42:00 – Why hope isn’t optional, it’s essential

Trigger warning: This episode discusses eating disorders, suicidal ideation and assisted dying.

Connect with Us:

🎙️ Subscribe to the Full of Beans Podcast here

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💬 Connect with Anita on Instagram (@dranitafederici), Linkedin (dr-anita-federici-phd) or visit her website (The Centre for Psychology and Emotion Regulation).

✍🏻 Read our latest blog here

Further Resources: First Steps ED

Thank you for listening and being part of this important conversation!

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Sending positive beans your way, Han 💛