Sharpen® Eating Disorder Awareness & Prevention for Physicians

Sharpen® Eating Disorder Awareness & Prevention for Physicians (SEDAP-Physicians)

4 hours.

Eating disorders carry among the highest fatality rates of any mental illness, and primary care is usually where the first symptoms surface. It is also where physicians most often report that their training left them unprepared. This course is built for that moment. It prepares medical students, residents and practicing physicians to recognize eating disorder presentations across the diagnostic spectrum, screen with gold-standard instruments when symptoms are indicated, account for trauma and co-morbidity in the clinical picture, confront weight bias in their own practice, and move a patient into the right level of care with a referral the patient will accept. The curriculum is delivered through 33 documentary and peer-to-peer films, more than three and a half hours of footage, organized into seven modules: Doctors Understanding EDs, ED 201 and Treatments, ARFID and Treatment, Trauma and Eating Disorders, Doctors Ending Weight Stigma, Patient’s Bodies are Partners, and Medical Impact of EDs. Participants hear from eating disorder specialists, neuroscientists, dietitians and researchers, and from patients and families describing in their own words what helped and what did not. Included is the twenty-minute documentary Beneath the Floorboards, featuring more than twenty researchers, clinicians and individuals with lived expertise on weight bias and its effect on treatment.

Evidence base

Eating disorder prevention is the oldest work in the Sharpen® system and its deepest evidence base: twenty years of development beginning in 2006, seven research studies, four peer-reviewed publications and manuscripts, 28 conference presentations, and 87,792 people reached through live prevention trainings before any of it became digital. The curriculum was co-developed with Timothy D. Brewerton, MD, Distinguished Life Fellow of the American Psychiatric Association and Founding Fellow of the Academy for Eating Disorders, with contributions from clinicians and researchers at the UC San Diego Eating Disorders Center for Treatment and Research, the UNC Chapel Hill Center of Excellence for Eating Disorders, the UC Berkeley Department of Psychology and Harvard STRIPED.

The physician program has been evaluated twice in medical settings. In 2015 at Greenville Health System Children’s Hospital, now Prisma Health, 28 pediatricians and residents took the training across 44 course enrollments. Of the 23 who completed the evaluation, 96% said it helped them empathize with patients, understand co-morbidities and communicate with patients and parents; 91% said it assisted them in diagnosing eating disorders, which the group itself had ranked as its highest priority; and 91% rated the program Good or Excellent, with none rating it Fair or Poor (Haddad, Farrell & Hussa-Farrell, 2015). From 2023 to 2025, funded by the Spartanburg Regional Healthcare System Foundation, the course was piloted with medical students and residents at the Edward Via College of Osteopathic Medicine and Spartanburg Regional Healthcare System. Self-perceived confidence to recognize and treat eating disorders rose from 17.33 to 25.00 (p = .0002), and Anti-Fat Attitudes scores fell from 39.64 to 33.36 (p = .0049). Participants identified diagnosis and management, and hearing directly from people with lived experience, as the most valuable elements (Fadel et al., in peer review). Both institutions have since required the course as part of regular training for medical students and residents. A companion adaptation for the frontline community health workforce is in peer review at the International Journal of Medical Students (Smith et al.).

The same content has been evaluated in adjacent populations. A process evaluation of the platform with medical students was published in Cureus (Fadel et al., 2024), and a RE-AIM analysis of undergraduate and medical student use was published in the International Journal of Environmental Research and Public Health (Berreta et al., 2023). The school-based lineage of this curriculum reached educators and school professionals across 14 states; in the published evaluation of that work (n = 112), participants gained significantly on all five self-efficacy items, agreement that eating disorders are the most deadly psychiatric illness rose from 4.60 to 6.37, and understanding that dieting raises risk for both obesity and eating disorders rose from 4.66 to 6.11, all at p < .001 (Anderson et al., 2017). The films inside the course have been used as clinical training tools at more than 500 academic institutions and treatment centers, and presented at the national conferences of the National Eating Disorders Association and the International Association of Eating Disorders Professionals.

The loop closes clinically. At Prisma Health, the institution where this physician training was first evaluated in 2015, the same content is now prescribed by clinicians to pediatric eating disorder patients across all four levels of care.

Learning objectives

• Understand the prevalence and severity of eating disorders (ED) locally and nationwide
• Discuss ED risk factors and protective factors
• Identify common ED symptoms and diagnoses
• Understand weight stigma and bias
• Discuss ways to screen for ED symptoms when indicated
• Understand the impact of trauma and co-morbid diagnoses on ED development and treatment
• Identify ways that physicians can initiate and manage treatment for ED
• Identify specific steps to assist patients in getting the care they need, including referrals for medical, psychological, behavioral, and peer support as needed

References

Anderson, C. N., Holody, K. J., Flynn, M. A., & Hussa-Farrell, R. (2017). An exploratory evaluation of the feasibility, acceptability, and efficacy of the mental fitness disordered eating program in schools. Eating Disorders, 25(3), 230-245. https://doi.org/10.1080/10640266.2017.1289793

Berreta, K., Nguyen, C., Stoner, A. M., Ridgeway, L., Wilson, A., Fadel, N., & Biber, D. (2023). A RE-AIM analysis of a mental health app for undergraduate and medical students during the COVID-19 pandemic: A retrospective cross-sectional study. International Journal of Environmental Research and Public Health, 20(13), 6266. https://doi.org/10.3390/ijerph20136266

Fadel, N., Estep, C., Stoner, A., Gainey, M., Brewerton, T. D., Biber, D. D., Redden, D., & Hussa Farrell, R. (in peer review). Evaluation of an eating disorder training pilot program for medical students and residents aimed at increasing competency and decreasing weight stigma.

Fadel, N., Stoner, A., Berreta, K., et al. (2024). A process evaluation of a mobile app for medical students aimed at increasing resilience and decreasing stigma in mental health. Cureus, 16(6), e63054. https://doi.org/10.7759/cureus.63054

Haddad, G., Farrell, T., & Hussa-Farrell, R. (2015). Increasing awareness of co-morbid mental health conditions among pediatricians and pediatric residents [Program evaluation]. Greenville Health System Children’s Hospital.

Smith, H., Fadel, N., Stoner, A., Gainey, M., Brewerton, T. D., Biber, D. D., Redden, D., Farrell, T., & Hussa Farrell, R. (in peer review). Sharpening community health worker skills to combat eating disorders. International Journal of Medical Students.

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