This year’s #NEDAWARENESS theme is Come as You Are: Hindsight is 2020 has got me thinking a lot about what I/We have learned as a community about the treatment of eating disorders. I’ve been involved in the treatment of eating disorders for a relatively short period of time compared to many of my colleagues. Over the past years, I have worked in a variety of settings and each one has been an important learning experience. Throughout all of this, I and the community have continued to grow and learn. In my own journey, I’ve settled into a solid place of understanding of Health at Every Size® (HAES), and Body Trust® and their essential role in helping people heal from their eating disorder. As that learning has become more grounded, I’m thankful to have found a home at Center for Discovery, a company who is willing to invest in the hard work of embracing HAES® and what it means to do it. I’ve also gladly seen a shift in the treatment world too with more folks open to learning about these paradigms and the movements grow each year. Progress has been made, but there is still much to do and in keeping with this year’s theme here are some thoughts about what I’ve learned and hopes for where both Center for Discovery and the rest of the treatment world can move towards.

● Weight stigma is a topic that must be addressed in all aspects of treatment. We need to challenge our weight bias and fat phobia from every direction. As clinicians and leaders, we need to see that unless we unlearn our bias, we will do harm. In the past, treatment has not been a safe place for all body sizes and we need to work on changing that by providing training to staff and listening to the experiences of those we have done harm to.

● HAES® is an essential tool to help move folks along in their recovery. This philosophy embraces the idea of size diversity and uses a social justice mindset to help us consider how fat acceptance can all of us heal from eating disorders. Fat acceptance is essential not just for us to be more comfortable in our bodies but helps us challenge the weight bias we have inherently learned in a diet-obsessed culture.

● Professionals come to this work for many reasons, some of which include our own personal history with eating disorders. As a community, how can we make space for this reality and know that at some point, we might slip and struggle with food and body issues? We must challenge the shame and judgment that comes when this happens and instead, create safe spaces for our friends and colleagues to share their struggles and find space for healing.

● There are more and more voices coming forward, sharing their stories of eating disorders. Slowly, we are seeing a more diverse narrative around who struggles with this issue, but we need to continue to make more space for more folks to share their story and get treatment.

● We can change. I’ve seen it, in just the small amount of time I’ve been in this field, I’ve seen a shift of learning and understanding. It might take time, but we need to be open to change and willing to be creative about what we are doing as treatment centers and how it’s affecting our clients. I hope that we continue to make space for change and be willing to sit with the hard questions and answers that come when we do.

I’m thankful to be at a place like Center for Discovery, surrounded by colleagues who are willing to ask hard questions and for leadership to be willing to listen. Moving to a HAES® model takes time but it is something we are committed to doing because it’s the right thing to do. My hope is that as I look back on this post in the years to come, there are new sets of questions and thoughts to consider because the ones I’ve listed above have been around a long time and it’s time to address them in a meaningful way and move our profession and treatment forward because what we want most is, help folks heal from their eating disorder.

Aaron Flores is a registered dietitian nutritionist based out of Los Angeles, California. With over 10 years of experience, Aaron has worked with eating disorders in a variety of settings. A large part of his career was spent working at the VA Greater Los AngelesHealthcare System where he helped develop and launch one of the first Binge eating disorder programs to help Veterans struggling with this disorder. Since leaving the VA, Aaron has continued to work in the eating disorder community helping run groups and providing individual counseling to adolescents and adults. He currently works part-time at Center for Discovery as the Health at Every Size® Director and part-time in his private practice in Calabasas, CA. He is a Certified Body Trust® provider, and his main areas of focus are Intuitive Eating and Health at Every Size®. In his work, Aaron helps individuals learn how to make peace with food and develop body-positive behaviors. His work has been featured during Weight Stigma Awareness Week, in blogs for the National Eating Disorder Information Centre and National Eating Disorder Association. Aaron is a frequent speaker and has presented at the 2016 and 2017 Binge eating disorder Awareness Annual Conference, the 2018 and 2019 International Conference on Eating Disorders and the 2018 Association for Size Diversity and Health Conference. Along with his work with eating disorders, he also is a co-host of the podcast, Dietitians Unplugged.