Need Medical Help for Your Eating Disorder? Get to Know Physician, Eating Disorder Specialist, and Author Dr Jennifer Gaudiani, MD
Hello all! I’m SO EXCITED about today’s blog. I’ve interviewed Dr. Jennifer Gaudiani, MD, eating disorder specialist physician, founder and medical director of Gaudiani Clinic in Denver, Colorado, and author of the amazing book Sick Enough. Getting to know Dr. Gaudiani will not only educate you on the medical issues of eating disorders, it will also let you know what services she provides, both in Denver, as well as in San Diego and elsewhere via telemedicine. She also describes the diverse patients she has helped. Enjoy!
Why did you choose to become an eating disorder specialist?
A combination of luck and personal history led me to this specialty that I love so much. When I was in medical school, my younger sister arrived at college having developed an eating disorder her senior year of high school. In addition, a dear family friend had type 1 diabetes and underused her insulin to control her weight for many years, when people didn’t even know to identify this as an eating disorder. Their collective experiences with providers and their own recovery journeys deeply impacted me as a physician.
Later, my husband and I moved to Denver in 2007, and I began working at the safety net hospital for the University of Colorado as a hospital-based internal medicine doctor. A year into my employment, I learned that this hospital housed the country’s top medical stabilization unit (ACUTE) with multidisciplinary expertise in treating adults with critical anorexia nervosa. I had the immensely fortunate opportunity to become one of the leaders of that program for the next eight years as it grew and developed. It was clear to me right away that I absolutely adored the field and my patients. I could be a general internist, thinking about how all body systems worked together and were influenced by the mind-body connection, while also establishing deep, meaningful relationships with my remarkable patients and getting to know them as whole people. Because there aren’t that many internists in the US who specialize in eating disorders, I furthermore had the opportunity to lecture nationally and internationally, teach, and write about the topic, and I found the collegiality in the field to be wonderful.
In 2016 I left ACUTE on warm terms to found my own outpatient medical clinic dedicated to people of all ages, genders, and body sizes with disordered eating and eating disorders. I wanted to support patients through all chapters of their life and recovery, not just during a two-week medical hospitalization. I also wanted to offer great medical care that would help remove physiologic barriers to recovery to a more diverse population of patients, not just the most acutely medically ill subset. I continue to learn every single day from my remarkable patients and colleagues.
What kind of treatment do you provide at the Gaudiani Clinic?
It’s so much fun! We have two physicians, and collectively we are medically licensed in over 30 states to provide ongoing telemedicine services after an initial consultation in person in Denver. I get to see an amazingly diverse group of patients, and I partner with community dietitians and therapists all over the country to form multi-disciplinary teams that don’t happen to coexist under one roof.
Besides eating disorders, what other co-occurring issues do you treat?
So far, I’ve treated patients from ages 11 to 72, of all genders, all stages in their eating disorder from first diagnosis to decades of illness, and absolutely all body types.
In the course of running this clinic, I’ve learned totally new diagnoses and clinical patterns of symptoms to watch for. Maybe even more importantly, I’ve become a passionate weight-inclusive provider, following what’s also called Health At Every Size® or HAES®. This means I utterly reject diet culture and the myriad psychological and medical harms it causes. I respect the natural diversity of body sizes, encourage patients (ideally along with an expert dietitian who’s also HAES-oriented) to eat for joy and satisfaction without restrictive behaviors, support patients in moving for joy (rather than as punishment or compensation for food) within their ability and interest, and try always to keep in mind intersectionality, social justice themes, and an awareness of my own privilege.
Here are a few examples of the types of patients I’m lucky enough to care for (no personal details being revealed!):
A 15-year-old athlete whose “healthy eating” turned into severe abdominal pain, constipation, and bloating, such that her intake fell without any intention of losing weight, and suddenly she had no period, was exhausted, anxious, and couldn’t sleep, and now lacked the ability to increase her intake because of her digestive issues.
A 27-year-old gender nonbinary individual who reduced food intake in part to get rid of a period that was gender dysphoric, who lives in a body size deemed “normal” by society but is having issues with low blood sugar and low heart rate. No one believes there’s a nutritional issue because they aren’t underweight, but in fact their anorexia is slowly taking away everything in life that’s important to them.
A 35-year old woman in recovery from an eating disorder who is experiencing episodes of passing out, shortness of breath, exhaustion, and rapid heartbeat. These symptoms have nearly bedridden her and her eating disorder thoughts escalate as she is unable to participate in any of her formerly stress-relieving physical activity. This woman also experiences fleeting rashes, joint pain, and intermittent fevers and flushing. She does intensive internet research and feels her symptoms most closely match postural orthostatic tachycardia syndrome (POTS) and mast cell activation (MCA), but she can't find a doctor who's willing to hold and treat both of those AND support her in eating disorder recovery.
A 42-year-old man whose parents were well-meaning but very controlling with his food from a young age, leading him to sneak food and binge eat. His cycle of dieting followed by further weight gain has persisted since then, and he now lives in a larger body and has diabetes and sleep apnea. Every time he goes to a doctor, he gets sternly lectured about his weight and told to do the same restrictive behaviors that have never worked before and that make him miserable. He is ready to try something new.
A 55-year-old woman who has had anorexia nervosa for most of her life and has been in and out of treatment programs with temporary benefit but inability to sustain recovery. She’s exhausted, ill, functioning poorly, and yet there are vital parts of her life she still wants to live for. Things are starting to spiral downwards, but she cannot fathom going back to a treatment program.
How long have you been working with eating disorders overall?
Wow, it’s been about 12 years now!
What happens during a first appointment with you?
Let’s back it up to include the whole process. If someone is interested in receiving care at the clinic, they can start on our website, www.gaudianiclinic.com. There they will find tons of information about the clinic, lots of informational videos, as well as blogs and podcasts we’ve contributed to. If they wish to proceed, they can call the clinic and speak with our delightful Clinic Manager, Camille. They set a time soon thereafter to have an intake call with Aimee or Meghan, two incredible professionals who have each been in the field for over a decade. During that call, they can ask questions, share a little of their story, and if desired, get intake paperwork to fill out. The doctors review the intake paperwork quickly and reply back to the patient. If we think there’s even a sliver of a chance we can offer help, we will invite them to come for an initial consultation in Denver.
Before that consult, we’ll get releases of information and obtain prior medical records as well as have conversations with any current eating disorder team members or relevant doctors. We want to show at all times our commitment to a non-hierarchical, collegial, team approach. At the initial two-hour consultation, we do vitals (not always checking a weight!), an EKG, a full physical exam, and then have a good, long talk. I always want to learn from my patients the following key information: their goals and values (so that I’m less likely to make assumptions about what they want for themselves!), their story so I get to know them as a whole person, and their current medical issues. In the last half hour or so, I try to use the data gained beforehand and the day-of exam and conversation to synthesize a theory of what’s going on and start to develop a pathway forward. Patients may then choose to join as a member and receive ongoing care either in person or by telemedicine as often as is needed, or to use the information in the initial consultation with their home team.
Some of our patients have a primary care doctor they love at home, and some do not. We are always happy to work with existing team members including a “boots-on-the-ground” doc to support our patients when they are out of state. However, for lack of a doctor locally, we are also happy to become the primary care provider for our patients. Our incredible nurse Abby has over a decade of experience in the eating disorders field too, at all levels of care, and she’s a great resource for our patients as well, kind, funny, and super knowledgeable.
You are an author of an amazing book called “Sick Enough.” In what ways would reading the book help people with eating disorders, or family members of people with eating disorders?
Thank you! I wrote “Sick Enough: A Guide to the Medical Complications of Eating Disorders,” because I wanted more people than I’d ever have the chance to see personally benefit from my knowledge base. One of the key pillars in founding the Gaudiani Clinic was to uplift the quality of medical care for those with eating disorders across the country, and I wrote the book in order to benefit patients, their loved ones, and professionals who wanted to learn more. What I have heard from lovely folks around the country (and around the world, so cool!), is that they felt validated, inspired, determined, and educated about what happens to bodies in the context of disordered eating. Loved ones can feel equipped to speak back to medical systems that aren’t “getting it.” And people have said they like the case-based format because it makes the medical issues feel more real and connected.
What do you wish people knew about getting treatment for eating disorders?
I wish people knew that ANY eating disorder is worthy of treatment. It’s so common for people to look at images on the internet (I really recommend they don’t!) or compare themselves now to a “sicker” version of themselves from the past and decide they “aren’t sick enough” to seek help or make hard changes. The reality is that eating disorders kill, and when they don’t kill, they ruin lives. It’s impossible to be in true relationship with others when your first relationship is with your eating disorder, an abusive, harsh, irrational, jealous voice that promises safety and security but almost always delivers disconnection and misery.
What kind of services do you offer people outside of Colorado, such as in California?
Both Dr. Rosen and I are fully licensed in California. That means that as long as a patient is willing to come see one of us in Denver first, we can then do 100% of follow-up by telemedicine . . . from their home, work, or school. We collaborate with their local dietitian and therapist and any other providers they desire. We have a lot of patients in California!
How can people learn more about and contact you?
Our website is www.gaudianiclinic.com, and our number is (720) 515-2140.
Share one fun fact about you that most people don’t know.
Despite having been a Harvard English major, my absolute favorite genre of literature is young adult fantasy. I’m a total bookworm for whom reading is a top recharge method, and nothing is more satisfying than dragons, magic, and other worlds. :)
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