Why do the labs remain consistent with “health” even when someone is on the brink of hospitalization due to an eating disorder? What real, sincere change can doctors make in the medical field when combating weight stigma? Can the lack of “body exposure” be an important cause behind people’s twisted self-perceptions?   In this podcast episode, Dr. Cristina Castagnini speaks about A Healthy Dose of Reality About Health, Weight, and Food with Expert Dr. Gaudiani. 

MEET Jennifer L. Gaudiani

Jennifer L. Gaudiani, MD, CEDS-S, FAED, is the Founder and Medical Director of the Gaudiani Clinic. Board Certified in Internal Medicine, she completed her undergraduate degree at Harvard, medical school at Boston University School of Medicine, and her internal medicine residency and chief residency at Yale. Dr. Gaudiani has been a leader in the eating disorders field since 2008 and served as the Medical Director at the ACUTE Center for Eating Disorders prior to founding the Gaudiani Clinic which is an outpatient medical clinic dedicated to people with eating disorders and disordered eating. The Gaudiani Clinic is licensed to practice in over 35 US states via telemedicine and offers international professional consultation and education. Dr. Gaudiani is one of a very small number of internal medicine physicians who is certified as an eating disorders expert and is the author of Sick Enough: A Guide to the Medical Complications of Eating Disorders. Connect on Facebook, Instagram, Twitter, or YouTube.


  • Weight stigma in the medical field 
  • How can doctors encourage patients to have healthy relationships with their body 
  • Carbs or no carbs?

Weight Stigma in the Medical Field

When the medical system decides who can and cannot get certain care – that might be timely surgery, that might be an appropriate diagnosis – when care is only allowed for certain people with certain body sizes and it is denied [for] people in a different set of body sizes, we know that there is a big problem. (Dr. Gaudiani)
The medical field needs to be more sophisticated and examine a person’s history and vitals before giving out judgements. They should not look at things at face-value and blatantly giving out medical opinions before doing a full scope checkout that is bias-free and performed on all body types.  Can the medical field look beyond the “useless” BMI scale and try to better understand its patients before giving out medical opinions? Because that is how real change is made. When the medical field is held more accountable.

How Can Doctors Encourage Patients to Have a Healthy Relationship with Their Body

There are times when people will go see their doctor because they wish to be in a smaller body. How can a doctor provide them with accurate knowledge without adding fuel to the weight stigma? 
But [I also try to ground] that belief in a different kind of philosophy. I believe that the idea that body image is an “individual problem” is really nonsense and I think that more and more practitioners are coming around to recognize that what we used to say was “you need to work on your body image”, [that] “you have a problem with your unique body image” and what I say to patients is “you don’t have a body image problem, you have an exposure to the world problem”. (Dr. Gaudiani)
If a patient is struggling with their body image, that is not their personal problem but that instead they have fallen prey to the vicious and constant marketing that surrounds them and has infiltrated how they see themselves.  Doctors should also be aware of body privilege, which also needs to be addressed in these conversations. This is that often more abled bodies, whiter bodies and thinner bodies often get the attention, the promotion, the partner, and the safety more often than other bodies. They do not get hassled at the doctor’s office, they are not subjected to bias and they are allowed the freedom to make choices, expressing agency, that some other bodies are not allowed as well. 
So when patients say “I want to lose weight, I want to be smaller” all I keep coming back to … is eat plenty of food to satisfaction, work with a therapist on learning your hunger and satiety cues, move your body … and whatever body emerges from those [three] activities is the body you got. So now we have to work on body acceptance, being kind, and staying safe. (Dr. Gaudiani) 

Carbs or No Carbs?

Not eating carbs and doing the keto diet is the latest fad craze on the market that has no scientific backing to ensure prolonged health.  Like with any new diet, you may see some change in the first few days or weeks, however it is not a sustainable way to live and eat because your brain, your body and your metabolism all have evolved to work on carbohydrates and when we restrict them, we can cause serious damage to our mental and physical health. 
When people think “oh gosh, I’m addicted to sugar”, that doesn’t exist. What they’re saying is “I have restricted sugar and carbs for so long that my brain has become programmed to have an obsession with thinking about them, and has lost the ability to have a sensible conversation about hunger and satiety when actually we have access to them. It feels like a binge which feels like an addiction, but it’s not, it’s just what comes with restriction. (Dr. Gaudiani) 


Dr. Jennifer L. Gaudiani – Sick Enough: A Guide to the Medical Complications of Eating Disorders  Sabrina Strings – Fearing the Black Body: The Racial Origins of Fat Phobia




I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


Did you enjoy this podcast? Feel free to comment below and share this podcast on social media! You can also leave a review of Behind The Bite on Apple Podcasts (previously) iTunes and subscribe!