July 21, 2025

Eating Disorders for Psychiatrists: Part 2

Show Notes

It’s Part 2 of our deep dive into eating disorders—and this time, we’re going even deeper. We kick off by unpacking our mock therapy session with Dr. Helen Liljenwall, which unexpectedly hit close to home for all of us. Then we take a sharp turn into the medical realities of starvation, including refeeding syndrome, the female athlete triad, and why your heart is always in the equation (literally).

But what happens when patients refuse to eat—and we have to decide whether they need a psychiatric hold? Who gets to say when a person with an eating disorder has lost capacity? And is “terminal anorexia” a compassionate truth—or a dangerous excuse?

If you’ve ever wondered what it really takes to treat eating disorders, this is the episode to hear. It's raw, real, and it doesn’t flinch.

Takeaways:

Refeeding syndrome isn’t just a med school concept—it’s a real, life-threatening danger in eating disorder treatment.
Psychiatric holds for anorexia raise tough ethical questions about autonomy, capacity, and what it means to save a life.
That fake therapy session? It’s not so fake when the emotional stakes are this high.
The eating disorder voice can sound like discipline—but it’s often masking deep distress.
Terminal anorexia is a controversial idea… and we don’t shy away from the controversy.