Ilene Fishman

A Chat with Ilene Fishman, Part 1: On wellness and society

Recently we sat with Ilene V. Fishman, LCSW, ACSW, FAED (Fellow of the Academy of Eating Disorders). In part, we wanted to discuss her book The Deeper Fix: For your Growth and Empowerment, and we also wanted to catch up with a dear friend of and provider or clinical supervision for Galen Hope. We are excited that Ilene has agreed to share some of her wisdom with us and allowed us to share it with you.

In this first segment, we discussed Ilene’s journey to being becoming an ED provider.

“I was very, very passionate about getting myself well and very, very passionate about helping my patients get well. And in all of my professional work, whether it’s direct contact with patients, or clients, whether it’s when I was also a founder of the National Eating Disorders Association and spent many years on the board (I was on the Board of the American Anorexia Bulimia Association before, and then we founded NEDA), I really was very fortunate to come into the field of eating disorders, sort of at the ground level, and that was just again very, very, good fortune that I feel very blessed about.  I’ve always been passionate, and still am, about good treatment and about what it takes for people to get well.”

What does it take for people to get well?

This idea, getting well (as opposed to simply getting better) is central to the work we do at Galen Hope. We have discussed it specifically in our blog, and pressed Ilene on the question of what, in her estimation, it takes for someone to get well.

“You have to heal people’s relationship with themselves. And there’s a toxic relationship with self, and we need to be able to identify how that works and how the eating disorder is an outgrowth of that, or tied to that toxic or unhealthy painful relationship with self. 

Because when you think about eating disorders, they in some ways go against nature, right? It’s very, very painful and people are hurting themselves. Yet they feel compelled to do that, and whether they don’t feel they deserve more or that’s their best self, or you know it’s complicated, right? This stuff is very, very complicated. 

But the bottom line is something that I think about all the time in people that I work with; it’s self-esteem and the relationship itself.”

Barriers to wellness: Society and eating disorders

As Ilene suggested, the relationship with self is a vital aspect of ED treatment, but so is the relationship with society. Those who work in our field recognize that there has been a significant glorification of extreme fitness and extreme dieting and extreme exercise that supports anorexia. We also recognize that the outgrowth of this orthorexic culture that has developed, and has become that much more magnified over the last couple decades, has rendered a very complex relationship with disordered thinking.

We asked Ilene her thoughts on shame and on the intersections of society and eating disorders:

“Our society has this rhetoric about control. And that the more people are in control of themselves, the better we are, the more superior we are, the harder we drive ourselves and further, we’re in control. And anorexia seems to represent that, whereas bulimia and binge eating disorder don’t, right? They feel like out of control, and out of control feels shameful. That feels weak. Anorexia restriction is strong, right? Eating clean, healthy, blah blah blah, exercising in what I call extreme tyrannical ways. 

But you know, that’s like superior whereas, not doing that is inferior. 

I think one of the biggest, most important changes in the eating disorder world, that I’m so happy about, is that people are talking about how toxic diet culture is, and about health at every size, and that you know, we’re learning that.  What we defined even as “unhealthy,” “overeating,” or whatever, isn’t true, and one-size-fits-all stuff isn’t true.”

Shifting narratives in the field

We’ve, as a field, moved away from thinking that eating disorders impact only the “poor little rich girl,” or the teenage white cisgender female, or that eating disorders are only anorexia nervosa. And we see that trauma, marginalization, and a lot of other intersecting social determinants of health can impact eating disorders, and we see them in LGBTQIA folks and trans and non-binary folks. We see them in people of all races and ethnicities.

We asked Ilene to reflect a little bit about the work it takes, having been in the field from the ground up, to shift people’s perspectives? How do we address misinformation, or attitudes like “I can’t have an eating disorder. I’m a guy,”

“That’s another, I would say, huge positive change in the field. You know, when I came into the field, it was a rich white girl illness, or at least a white girl illness, or a somewhat privileged white girl illness. The addition of atypical anorexia as a valid and legitimate diagnosis Is really important because anorexia lives in larger bodies, not just skinny, underweight bodies. And we now know, of course, that men are completely impacted by eating disorders, and disordered eating, and all the toxic messages that men get too. Right, so women get it, but certainly men get it too in their ways.

All the other, like you said, LGBTQ and BIPOC folks, we’re all learning so much. And eating disorders are so prevalent in many other cultures and groups of people. Which makes so much sense ’cause it’s about relationship with self. It’s about feeling uncomfortable in oneself and one’s body and one’s person in the world, and that makes sense that a lot of people who have been oppressed, and have felt less than, are going to be at war with their bodies.”


Built on the principles of assertive community treatment, Galen Hope is an eating disorder and mental health treatment center offering individualized treatment options that include Intensive Outpatient (IOP), supported housing, and Partial Hospitalization Programs (PHP). As a “Community of Integrated Wellness,” we pride ourselves in fostering a thoughtful and meaningful care experience that can guide our clients on their road to recovery and increased quality of life, regardless of diagnosis. Galen Hope currently offers separate, age-specific programming for adolescents ages 12-17 and adults 18 and up, of all genders.

To learn more, or to join our community for integrated wellness, please contact us today.

Belong. Heal. Grow.

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