Suman Ambwani received her PhD in psychology from Texas A&M University and completed her clinical psychology internship at the Medical University of South Carolina. She is an Associate Professor of Psychology at Dickinson College, where she teaches courses on psychopathology, research design and analysis, and eating disorders. She also serves as the Principal Investigator for the Clinical Assessment and Research (CARE) lab. Her scholarship examines factors associated with the development and maintenance of eating disorders, particularly cultural features (such as fat-shaming environments and pseudoscientific diet fads) and difficulties with interpersonal relationships. Dr. Ambwani is also currently involved with two clinical trials investigating technology-based guided self-help interventions for anorexia nervosa and strategies for caregivers to best support their loved ones with eating disorders.
In honor of National Eating Disorders Week (Feb 25-Mar 3) we sought to learn more about Dr. Ambwani and her work. Read on below to hear about her interest in eating disorders, her mentors, and what she hopes attendees will take away from her March 3 presentation in Baltimore.
Q: How did you become interested in the field of eating disorders research and the factors that contribute to them?
A: I must admit that I originally began investigating body image as a junior in college as a strategic decision – I wanted to work with a faculty member whom I greatly admired, and I knew that this topic fell under her area of expertise. That initial research led to a senior honors thesis examining relationships among gender, body image and experiences in romantic relationships. Delving into this area of study sparked more questions and helped me to understand the urgency of examining the complex, multifaceted factors associated with the development and maintenance of eating disorders.
Q: What is the CARE Lab at Dickinson and what kinds of current research are you doing? What makes your research innovative?
A: The CARE Lab focuses on understanding sociocultural and interpersonal factors that play a role in the development and maintenance of eating disorders. We hope that furthering our understanding of these factors will inform preventative efforts and facilitate more effective interventions for patients and their loved ones. Our research targets several theorized risk factors for disordered eating, including, “fat talk,” disrupted perceptions of social interactions, personality characteristics, negative mood, and difficulties in interpersonal relationships. We have used this work to inform guided self-help interventions for individuals with anorexia nervosa, and are presently collaborating on two clinical trials using these approaches in the UK. Recently, we have also begun investigating systemic factors, such as anti-fat bias and pseudoscientific dietary fads, to better understand how these could be targeted to prevent eating disorders on a broader scale and thus improve population health.
Q: You recently took some time away from teaching at Dickinson College to serve as a visiting scientist with the Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) at Harvard’s School of Public Health. Can you tell us more about STRIPED and the work you did while you were there?
A: About two years ago, I read an article by the director of STRIPED, Dr. S. Bryn Austin, in which she advocated for policy translation work as a macro-environmental lever to prevent eating disorders. I was inspired by her call for action, in which she said “Bluntly stated, if we keep doing more of the same over the next 30 years of research, we will continue to earn only the same type of small-scale victories with little promise of substantial impact on population health.” I decided that I wanted to shift focus from individual-level factors to learn more about opportunities to target systemic factors to prevent eating disorders. STRIPED was my top choice for a research partnership given their leadership in this arena. During my time with STRIPED, I had the opportunity to be involved with several different research projects, such as projects on “clean eating,” social media, anti-weight discrimination legislation, and dietary weight loss supplements. I was also able to assist with training and dissemination efforts, such as a training program for primary care providers on screening and referral for eating disorders, and a workshop on developing online courses about eating disorders and other public health concerns. Finally, as STRIPED is currently assisting with three bills for the MA State Legislature (all targeting eating disorder risk factors), I was also able to learn about the procedures for policy translation work.
Q: You’re headed to Baltimore to present When Pseudoscience Becomes Trendy: An Exploration of Clean Eating, False Health Claims and Eating Disorder Risk. Why is this an especially relevant topic for our current culture?
A: Whether you peruse a magazine while checking-out of the grocery store, review your Instagram feed, or simply read the news, you are likely to be confronted with information about “clean” diet fads and their “miraculous” health benefits. But although “clean eating” is frequently touted in the popular press and in social media, there is very little scientific research on this dietary strategy. What does it even mean to “eat clean”? What kinds of claims are made about the benefits of “clean eating”? Could there be any risks associated with this dietary strategy? For instance, given the well-established link between dieting and increased risk for disordered eating, could following dietary fads like “clean eating” also confer increased risk for eating disorders?
Q: What makes something pseudoscience versus actual science? What are some of the biggest sources or promoters of pseudoscience?
A: Pseudoscience is when something masquerades as science but does not actually follow the stringent principles of the scientific method. For instance, Gwyneth Paltrow’s company, Goop, was recently charged with making unsubstantiated health claims about their rose quartz vaginal eggs and essential oils (claiming that they balanced hormones and prevented depression). As another example, someone might claim that a “clean diet” can cure cancer, but the only evidence that they can provide in support of this claim is unsystematic, or poorly measured, or non-replicable. Several websites make unsupported, non-evidence-based claims about “clean eating,” and close scrutiny often reveals a lack of nutritional expertise among the authors (many identify as “wellness gurus” or offer similarly ambiguous credentials).
Q: What are some examples of systemic factors that might contribute to the development or maintenance of eating disorders?
A: There are many systemic factors that could contribute to eating disorders. For instance, our cultural preoccupation with thinness and stigmatizing attitudes toward fatness create an environment where it is simply not ok to live in a larger body. As another example, our diet, weight-loss, and fashion industries shape unrealistic standards of beauty and fail to represent the real diversity of human bodies. Alternately, relatively low awareness and misinformation about eating disorders may contribute to failures in detection and thereby maintain eating disorder symptoms. Similarly, lack of access to appropriate care could be considered another systemic factor that serves to maintain illness symptoms.
Q: Who are some of your academic, clinical or advocacy role models? Any favorite books you think people could benefit from reading on the topics of eating disorder recovery, prevention or diet myth-busting?
A: I greatly admire Dr. S. Bryn Austin and her team at STRIPED for their dedication to preventing eating disorders. Dr. Austin is a wise and prolific scholar, a thoughtful mentor and leader, and a passionate advocate for policy change to improve public health. Those who wish to bridge the gap between science and policy to address eating disorder prevention and social justice should follow the work of STRIPED and consider contributing to support their efforts.
I also greatly admire the work of Professor Janet Treasure, an extraordinary clinician and researcher at King’s College London. Her scholarship has fundamentally shifted our understanding of brain processes, social relationships, and treatment approaches for eating disorders. Professor Treasure’s work is especially novel because it highlights patient and caregiver voices in developing treatments for eating disorders. In terms of recommended readings, I highly recommend the following:
- Skills-based caring for a loved one with an eating disorder: The New Maudsley Method by Janet Treasure, Grainne Smith, and Anna Crane
- Fat shame: Stigma and the fat body in American culture by Amy Farrell
Q: In addition to mental health providers and folks in the fitness and nutrition fields, who else do you think could benefit from attending your talk on March 3?
A: I think young people – older adolescents and young adults – could benefit from the talk. They could learn about the risks of these dietary fads and share the information with their peers.
Q: What do you hope attendees take away from your presentation?
A: I hope that they understand the research on dieting as a risk factor for eating disorders and the harmful impact of embracing pseudoscientific dietary fads (even those marketed as health-promoting strategies). I also hope that they start to think about how we can make a change in our culture, in our policies, and how doing so could serve to reduce eating disorder risk on a broader, population level.
Q: Where can our readers go to follow along with the great work you’re doing?
Many thanks to Dr. Ambwani for her time and effort in answering our questions! Join us for her free presentation on March 3 in Baltimore. RSVP here.