Featuring Drs. Lauren Muhlheim, Jen Averyt, and Shannon Patterson—three psychologists reshaping how we treat eating disorders through a radically inclusive new CBT workbook.

This episode of Behind the Bite, hosted by Dr. Cristina Castagnini, examines the evolution and shortcomings of traditional Cognitive Behavioral Therapy (CBT) for eating disorders, and unveils a newly developed, radically weight-inclusive CBT workbook. Joined by three expert psychologists—Dr. Lauren Muhlheim, Dr. Jen Averyt, and Dr. Shannon Patterson—the conversation provides insight into how culture, weight stigma, and inclusivity must reshape how clinicians and individuals approach eating disorder recovery.

Guest Bios:

Lauren Muhlheim, Psy.D., FAED, CEDS-C, CBTP is a psychologist, fellow of the Academy for Eating Disorders (AED), and certified eating disorder specialist (CEDS) and approved consultant for the International Association of Eating Disorder Professionals (IAEDP). Dr. Muhlheim is also a Certified Body Trust® Provider. She directs Eating Disorder Therapy LA, a group practice in Los Angeles. She is certified in FBT for adolescent eating disorders and is the author of When Your Teen Has an Eating Disorder (New Harbinger, 2019). Dr. Muhlheim has held leadership roles in several professional organizations including the AED, IAEDP, and the Los Angeles County Psychological Association. She has previously been an IAEDP core course instructor. She provides training on eating disorders to mental health providers and parents internationally. She has a website and a blog and has built a solid professional platform around weight-inclusive modified evidence-based treatments for eating disorders, specifically, CBT and FBT. Jennifer Averyt, Ph.D., ABPP (she/her) is a clinical health psychologist based in Phoenix, AZ who specializes in evidence-based, weight-inclusive treatment of eating disorders and chronic health concerns. Dr. Averyt currently works at the Phoenix VA providing training and clinical care through the Eating Disorder Program. She also offers individual therapy through her private practice, Phoenix Health Psychology, PLLC. Dr. Shannon Patterson (she/her) is a licensed psychologist based in Madison, WI, with expertise in the intersection of eating disorder treatment and psychological adjustment to chronic illness. She is the founder and owner of a private practice, offering both in-person and virtual therapy to clients nationwide. In addition to her clinical work, Shannon serves in an educational capacity at an eating disorder treatment organization, where she provides training and consultation to therapists and healthcare professionals. She also contributes to the field through her role as an ad hoc reviewer for the International Journal of Eating Disorders.  

Key Topics Discussed:

Why a New CBT Workbook?
  • Traditional CBT manuals for eating disorders are outdated, focus primarily on binge eating, and often lack inclusivity and cultural sensitivity.
  • The new workbook addresses:
    • The role of restriction across all body sizes
    • The impact of culture, diet culture, weight stigma, and medical bias
    • Social media influences and external pressures
    • Accessibility for diverse populations, including neurodivergent individuals and those facing food insecurity
Major Differences from Traditional CBT
  • Moves away from over-pathologizing individuals, instead emphasizing the influence of external factors.
  • Early and frequent inclusion of cultural influences and weight stigma in the model.
  • Updated clinical examples to reflect diverse age, gender, and socioeconomic backgrounds.
  • Removal of mandatory weekly weighing and increased flexibility with self-monitoring.
  • Greater focus on self-compassion, advocacy, and psychoeducation for both clients and clinicians.
Workbook Features
  • Modular design: Core interventions are in the book; additional resources and specialized modules are available online.
  • Suitable for self-help or guided use with a therapist—addresses the gap in access to eating disorder specialists.
  • Provides tools to assess whether a reader may have an eating disorder and offers guidance on when to seek additional professional help.
  • Emphasis on challenging food rules, encouraging regular eating, and understanding the difference between disordered eating and eating disorders.
  • Brief mention of how medical treatments (weight-loss drugs, diabetes care, post-bariatric surgery) may affect eating behaviors.
  • Focus on redefining and supporting healthy movement and exercise.
  • Includes information to help counter diet myths and unreliable nutrition information pervasive on social media.
Professional and Community Impact
  • Designed for individuals in recovery, their loved ones, and clinicians.
  • Hopes to provide much-needed inclusivity and contribute to breaking down myths and barriers in eating disorder recovery.
  • Aims to support those who haven’t felt represented or successful with traditional CBT.

Strategies for Supporting Body Image:

Address Personal, Cultural, and Systemic Influences
  • Reflect on how family, peers, healthcare settings, and media shape body image.
  • Identify the impact of "diet culture" and weight stigma, and distinguish these external pressures from personal values.
Go Beyond Traditional Cognitive Approaches
  • Incorporate updated interventions that don't only focus on changing individual thoughts, but also consider broader societal influences.
  • Avoid over-pathologizing the individual; instead, situate body image concerns within a larger context.
Use Values-Based and Justice-Based Exposure
  • Instead of only traditional exposure (like wearing a bathing suit), use values-driven and justice-oriented approaches—encouraging activities that align with personal beliefs and social change.
  • Prepare for real-world responses, including stigma or comments, and develop supportive strategies for handling them.
Practice Self-Compassion
  • Encourage compassionate self-talk and forgiveness for perceived body "failures."
  • Recognize that navigating cultural beauty standards is challenging and it's normal to experience discomfort.
Reframe and Question Distressing Terms
  • Get curious about expressions like “feeling fat”—explore what those feelings mean rather than accepting them at face value.
  • Replace judgmental or vague language with specific descriptions of discomfort or experiences.
Pre-Order The Weight-Inclusive CBT Workbook for Eating Disorders: Tools to Reject Diet Culture, Heal Body Shame, and Promote Recovery

IMPORTANT TIMECODES FROM THIS EPISODE:

  • 00:00 Introduction to Behind the Bite
  • 00:55 The Reality of Eating Disorder Treatments
  • 01:35 Meet the Experts: Dr. Lauren Muhlheim, Dr. Jen Averyt, and Dr. Shannon Patterson
  • 04:12 Revolutionizing CBT for Eating Disorders
  • 07:52 Addressing Weight Stigma and Cultural Influences
  • 13:55 Practical Applications and Future Directions
  • 20:43 Availability and Access to the Workbook
  • 35:53 Final Thoughts and Resources

Connect with Lauren, Jen and Shannon:

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Until next time, remember, we're here to break down barriers, challenge stigma, and support each other on the path to a better life.

Part of the Los Angeles Tribune Podcast Network, produced by the Tweaky Tales.

**Disclaimer:**

The content of this podcast episode is for informational and educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. The views and experiences shared by guests are their own and do not necessarily reflect those of the host or affiliated organizations. If you have any medical or mental health concerns, please consult a qualified healthcare provider. Listener discretion is advised, especially for those sensitive to topics related to body image, weight stigma, and eating disorders.