Not One More

by: Tonya Foreman, MD, Carolina House
February 06, 2023
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Not One More | Carolina House

For the past sixteen years, I have worked with eating disorder patients in residential and inpatient settings. These are some of the things I have seen and never want to see again:

  • A teenager who had to attend their brother’s wedding via zoom because they were in residential treatment for their eating disorder.
  • A woman who would only sit on the floor because she did not feel worthy of sitting on furniture.
  • A mother who had never eaten birthday cake with her children.
  • A patient who wore clothing in the shower so they would not see their body.
  • A piece of art painted by a patient who died from their eating disorder.

Not. One. More.

We can all join in the fight against eating disorders.

  • Systemic change is needed to improve access to treatment. People who do not have health insurance or who are underinsured often have nowhere to turn for treatment. People who live in larger bodies are particularly vulnerable to discrimination and barriers to care.
  • Educational efforts are needed, including for health care professionals. Patients are turned away from emergency departments every day because the clinicians there have not been taught how to identify and treat eating disorders and because few resources for treatment exist.
  • Teachers, coaches, and school administrators need training to help them interact effectively with young people so they do not unwittingly foster eating disorders.
  • The fashion industry needs to be held accountable to represent diverse body sizes and shapes. Companies that only sell straight size clothing should be called out.
  • Social media influencers who promote body neutrality need to be supported.

The changes that are needed to fight eating disorders do not all have to occur at societal or systemic levels. We can have powerful effects in everyday interactions. For example:

  • Tell a child they are strong and powerful, rather than telling them that they are pretty.
  • Order cheesecake in a restaurant without announcing that because you went to the gym today, you have “earned” dessert.
  • Do not ever comment on somebody’s weight loss or weight gain.
  • Smile for a selfie and do not hide your body behind a pillow or another person. Stand up proudly.
  • Do not allow a parent, a partner, or a friend to tell you that your worth has anything to do with the size or shape of your body.

Whether the actions you take to fight eating disorders occur in legislative chambers, in a dance studio, or in a dressing room as you help your child find an outfit for a dance, your actions matter. Every step against eating disorders is a step toward a world in which Not One More person has to hate their body or be afraid of food.

Dr. Tonya Foreman graduated from the University of Kentucky College of Medicine. She did an adult psychiatry residency at Vanderbilt University, a child and adolescent psychiatry fellowship at the University of Florida, and a forensic psychiatry fellowship at Yale University. She has been on the medical school faculties at Tulane University, University of Louisville, Indiana University, and is currently a Professor of Clinical Psychiatry at the University of North Carolina at Chapel Hill. She has won numerous awards including the Ginsburg Fellowship from the Group for the Advancement of Psychiatry and the Rappeport Fellowship from the American Academy of Psychiatry and the Law. For more information about Carolina House, please visit:

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