Clinical Round Table 9 - Dismantling Fatphobia: A Roundtable on Integrating Fat Liberation in CBT Interventions for Eating Disorders

Individuals living in larger bodies face a disproportionate risk of adverse mental health outcomes, including eating disorders. Weight stigma or fatphobia, defined as the pervasive denigration of higher-weight/larger-bodied individuals based on body size or perceived weight, is a critical factor in these health disparities. Likewise, the internalization of weight stigmatizing messages serves as a robust mediator between experiences of weight stigma and eating disorders. Current evidence-based interventions, including cognitive behavioral therapy (CBT), have been developed to mitigate the detrimental effects of weight stigma; however, such interventions often lack a foundational framework of fat liberation. Instead, while acknowledging the detrimental effects of weight stigma, CBT interventions frequently maintain a deficit-based perspective by concurrently advocating for weight loss, an approach fundamentally antithetical to effective eating disorder treatment in fat individuals. Expert panelists in this clinical roundtable will discuss how weight stigma research can inform a paradigm shift toward fat liberation in CBT interventions for eating disorders, with the goal of fostering more inclusive eating disorder care. Two panelists and experts in weight stigma will discuss how research can inform CBT interventions aimed at reducing the psychological effects of weight stigma in a way that integrates principles of acceptance and respect for clients of diverse body sizes. Our third panelist will build on this discussion based on her experience adapting eating disorder interventions for marginalized populations by providing guidance on how to utilize CBT skills to foster a sense of body appreciation, body functionality, and weight stigma resistance. Finally, our fourth panelist will provide insights based on her involvement in fat activism on how clinicians can provide affirmative CBT interventions for clients in larger bodies. Our co-moderators will facilitate this discussion by drawing on lived experiences related to facing weight stigma, as well as their programs of research broadly focused on developing and delivering identity-affirmative, CBT interventions for eating disorders.