Beyond the Stereotypes: Identifying and Treating Eating Disorders in Adults

In this episode of Medicine 3.0, Dr. Catherine Isaac sits down with Dr. Rebecca Berens, a board-certified family medicine physician and founder of Vita Family Medicine in Houston, Texas, to explore a topic that is often misunderstood and underdiagnosed in clinical practice: adult eating disorders.

While eating disorders are typically associated with adolescence, they are increasingly present—and frequently missed—among adults. Dr. Berens brings a unique perspective to this discussion, blending her clinical expertise with personal lived experience and a deeply weight-inclusive approach to care.

Reframing What We Think We Know

As Dr. Berens explains, most clinicians and patients still carry outdated stereotypes of what an eating disorder "looks like." These misconceptions often lead to missed diagnoses, delayed treatment, and harm caused by well-intentioned but misinformed care.

Among the key takeaways:

• Many individuals with anorexia are not underweight
• Binge eating disorder is the most common eating disorder in the U.S.
• Disordered eating is widespread, normalized, and often undetected in primary care settings

Disordered Eating vs. Eating Disorders

One of the central themes in this episode is the distinction between disordered eating and diagnosable eating disorders. Disordered eating often exists on a spectrum and may not meet strict DSM-5 criteria, but still carries serious physical and psychological consequences. This includes chronic dieting, food avoidance, excessive “clean eating,” or rigid fasting practices that disrupt daily life.

Dr. Berens shares simple screening tools like the SCOFF questionnaire to help clinicians identify high-risk behaviors and initiate conversations that are compassionate, non-judgmental, and clinically useful.

Medical Complications and Misdiagnosis

Eating disorders don’t just affect mental health—they can compromise multiple body systems. Dr. Berens details how restrictive eating patterns, binge cycles, and purging behaviors can lead to:

• Osteopenia and osteoporosis
• Sarcopenia (muscle loss)
• Amenorrhea and hormone disruption
• Bradycardia and orthostatic hypotension
• GI symptoms frequently misdiagnosed as IBS

She also emphasizes how many common conditions, including ADHD and PCOS, intersect with eating disorders in ways that are frequently overlooked.

Creating Safe, Weight-Inclusive Care

The episode challenges providers to move away from weight-centric care and toward a more individualized, evidence-based model. Dr. Berens outlines how to:

• Avoid re-traumatizing patients through weight-based messaging
• Shift clinical conversations toward health behaviors, not body size
• Build trust with patients who may have avoided care due to weight stigma

Recommended Resources

Dr. Berens shares helpful tools for clinicians and patients alike, including:

• National Alliance for Eating Disorders: allianceforeatingdisorders.com
• Association for Size and Weight Inclusive Health: aswimh.org
• Christy Harrison’s Podcast & Books: Food Psych and The Wellness Trap
• Harvard Implicit Bias Tests (Weight IAT): implicit.harvard.edu

For providers interested in CME, Dr. Berens recommends offerings from Eating Recovery Center and the Academy of Eating Disorders.

Episode Timestamps

• 00:01 – Introduction and Dr. Berens’ background
• 02:45 – How personal experience shaped her clinical approach
• 04:40 – Disordered eating vs. eating disorders
• 07:00 – Overview of the “big four” eating disorders and ARFID
• 10:53 – The SCOFF questionnaire and screening tools
• 12:45 – Medical complications: GI, cardiovascular, hormonal, and bone health
• 16:11 – IBS vs. disordered eating: the hidden connection
• 19:50 – Prevalence of eating disorders in adults
• 22:07 – Binge eating vs. binge/restrict cycle
• 24:44 – Common comorbidities: anxiety, ADHD, PCOS
• 28:43 – When to test bone density in at-risk patients
• 33:59 – The role and risks of body composition scans
• 40:10 – How to avoid triggering patients in clinical care
• 46:49 – Treatment strategies and levels of care for adults
• 49:29 – Resources for clinicians and patients

Subscribe to Medicine 3.0 for more in-depth conversations at the intersection of evidence-based care, preventative medicine, and whole-person health.

‍

Buffalo Chicken Loaded Sweet Potato

A simple, high-protein meal made for busy days.

If you're looking for something fast, flavorful, and packed with protein—this Buffalo Chicken Loaded Sweet Potato is your answer. With minimal ingredients and almost no hands-on time, it's the kind of recipe you can throw together with pantry and fridge staples. Perfect for a weeknight dinner, quick lunch, or even meal prep.

Ingredients

Here’s what you’ll need to make one serving:

• 1 medium sweet potato
• 1 cooked chicken breast, shredded
• 1–2 tablespoons buffalo sauce (adjust to your spice preference)
• 2–3 tablespoons plain nonfat Greek yogurt
• Garlic powder, salt, pepper, and parsley
• Feta cheese (or your favorite cheese)
• Optional: chopped green onions for garnish

Instructions

1. Bake the sweet potato
Wrap the sweet potato in foil and roast at 400°F for 40–60 minutes, or until fork-tender. (You can microwave it in a pinch, but the oven gives a better texture and flavor.)

2. Prep the chicken
While the sweet potato is roasting, shred your cooked chicken breast. Mix it with buffalo sauce, Greek yogurt, and a sprinkle of garlic powder, salt, and pepper. Stir to combine.

3. Load it up
Once the sweet potato is cooked, slice it open lengthwise and fluff the inside with a fork. Pile on the buffalo chicken mixture, then top with crumbled feta, fresh parsley, and green onions if you have them.

Why You’ll Love It

• High in protein
• Minimal ingredients
• Comforting with a healthy twist
• Easy to double for meal prep

Pair it with a side salad or steamed greens for a balanced, satisfying meal.

Ready in under an hour with only a few minutes of hands-on time—this is comfort food, simplified.

#EasyDinner #HighProteinMeal #BuffaloChicken #HealthyComfortFood #MealPrepMadeSimple #BionicHealth #RealFoodRealLife

‍

When in Doubt, Make a Bowl

Let’s be real—trying to cook a new recipe every night can feel like a full-time job. It’s time-consuming, expensive, and honestly, not always sustainable when life gets busy. That’s why when I’m short on time or energy, I stick to my go-to strategy: I make a bowl.

Instead of reinventing the wheel each week, I focus on batch prepping a few core ingredients—a couple of proteins, some carbohydrates, and a mix of veggies and sides. With those basics ready to go, I can mix and match ingredients into quick, well-rounded meals that are both nourishing and satisfying.

One of the easiest proteins to prep and build around? Chicken breast. Here's how to bake it:

First, prep your chicken:

For each of these, bake boneless, skinless chicken breasts at 400°F for 25 minutes with a little olive oil, salt, and pepper. You can shred it, slice it, or cube it depending on the dish.

Then comes the flavor. Here are 5 ideas:

• Balsamic Veggie-Packed Bowl:
  
  • Chicken breast
  • Roasted vegetables: broccoli, onion, brussel sprouts, and zucchini. Season with salt, pepper, and Italian seasoning, and roast at 375 for 20 minutes.
  • Top with fresh edamame and balsamic glaze
  • Serve over your choice of base.

• Chicken Fajita Bowl:
  
  • Chicken breast
  • Roasted or sautéed bell pepper and onions with fajita seasoning
  • Top with salsa, black beans, cheese, fresh avocado, and nonfat plain Greek yogurt.
  • Serve over your choice of base.

• Buffalo Chicken Bowl:
  
  • Shredded chicken breast
  • Buffalo sauce
  • Nonfat plain Greek yogurt
  • Lime juice, salt, and pepper
  • Mix all ingredients, top with chopped green onions. Optionally, add fresh coleslaw on top, like this one.
  • Serve over your choice of base.

• Mediterranean Lemon Feta Bowl:
  
  • Chicken breast
  • Tomato and cucumber salad (chopped tomato, cucumber, red onion, olive oil, red wine vinegar, salt and pepper, fresh herbs)
  • Feta cheese
  • Squeeze of lemon
  • Dollop of hummus
  • Serve over your choice of base.

• Chicken Salad Bowl:
  
  • Shredded chicken breast
  • Nonfat plain Greek yogurt and dijon mustard
  • Lemon juice
  • Chopped celery, bell pepper, red onion, and grapes
  • Sliced almonds
  • Parsley, dill, salt and pepper.
  • Mix together all ingredients and serve over your choice of base.

For your base, here are some options to choose from. Find what works best for you and your family!

• Roasted sweet potato
• Russet or baby potatoes
• White or brown rice
• Cauliflower rice
• Quinoa or lentils
• Leafy greens for a salad-style bowl

Why do these bowls offer a great option for a quick and easy meal to use your batch prepped ingredients?

• Flexible – Adapt to what you have in your fridge
• Efficient – Prep once, eat many ways
• Balanced – Easily incorporate protein, fiber, and healthy fats. These are a great way to introduce vegetables in a more unique and flavorful way!
• ‍Satisfying – Endless flavor combinations

Which bowl will you try first?