The Dude Therapist

What if the diet you started to feel better about your body is the same thing that's quietly damaging your relationship with it? This week, Eli interviews Dr. Brad Smith, a board-certified psychiatrist and Chief Medical Officer at Accanto Health, the parent organization of the Emily Program, for an open and clinically informed conversation on eating disorders, diet culture, and the hidden dangers of wellness trends. With over 14 years of experience in eating disorder treatment, Dr. Smith has witnessed how a simple desire to "be healthier" can subtly evolve into something harmful. Eli and Dr. Smith discuss why eating disorders almost never stem from bad intentions and how the line between "disordered eating" and a clinical diagnosis is often more blurred than most realize. They explore how social media has amplified body image issues and dive into the controversy surrounding GLP-1 medications like Ozempic and Wegovy within the eating disorder field. From keto and intermittent fasting to MLM programs like Optavia, they scrutinize popular diet trends, addressing the lasting harm caused by approaches like The Biggest Loser model of weight loss, which a recent Netflix documentary sheds light on. Dr. Smith also explains the neuroscience behind body dysmorphia, why malnourished brains struggle with therapy, and how well-meaning doctors and coaches can unintentionally trigger eating disorders in patients aiming to improve their health. The conversation concludes with a reflection on a common yet problematic remark: complimenting someone's weight loss with "you look so good," and why such comments can have unintended consequences. If you've ever criticized your body in the mirror, turned a diet into an obsession, or questioned whether your GLP-1 prescription is helping or harming, this episode is for you. Topics Covered: How eating disorders begin—and why they're rarely about vanity The blurry line between disordered eating and clinical eating disorders Social media's impact on body image distortion The debate surrounding GLP-1 medications (Ozempic, Wegovy, Mounjaro) Fad diets: keto, intermittent fasting, and MLM programs like Optavia The Biggest Loser and Netflix's exposé on weight-loss reality TV The neuroscience of body dysmorphia How malnourishment impairs therapy and recovery The presence of diet culture in healthcare as well as social media Links between eating disorders, anxiety, depression, and substance use And more About Dr. Brad Smith: Dr. Brad Smith is a board-certified psychiatrist and the Chief Medical Officer at Accanto Health, the parent organization of the Emily Program, one of the nation's leading eating disorder treatment providers. With over 14 years of expertise in eating disorders, he brings both clinical insight and deep empathy to discussions about recovery, treatment, and the systemic factors contributing to the prevalence of eating disorders. Links and Resources  🏥 Accanto Health : https://accanto.com/ 🎗️ The Emily Program : https://emilyprogram.com/ 📘 Anti-Diet by Christy Harrison: https://www.christyharrison.com/antidietbook 📘 The Wellness Trap by Christy Harrison: https://www.christyharrison.com/thewellnesstrap  📺 The Biggest Loser (2024), Netflix Connect with Eli & The Dude Therapist 📖 From I Do to We Do by Eli Weinstein: https://www.eliweinsteinlcsw.com/book 🌐 EliWeinsteinLCSW.com : https://www.eliweinsteinlcsw.com/  📱 Instagram: @eliweinstein_lcsw : https://www.instagram.com/eliweinstein_lcsw  🎙️ Podcast Instagram: @thedudetherapist : https://www.instagram.com/thedudetherapist 0:00 - Intro: Diet Culture & Well-Meaning Habits That Backfire 0:49 - Meet Dr. Brad Smith: Psychiatrist & CMO of Accanto Health 9:03 - What Is an Eating Disorder & How Does It Start? 15:52 - GLP-1 Medications (Ozempic/Wegovy) & Eating Disorder Risk 18:33 - Who Is Most Susceptible to Developing an Eating Disorder? 25:33 - Disordered Eating vs. Eating Disorders: Where's the Line? 27:49 - "Wow, You Look So Good" — Why Complimenting Weight Loss Is Harmful 33:00 - The Hard Truth: Eating Disorders Have One of the Highest Mortality Rates Learn more about your ad choices. Visit megaphone.fm/adchoices