The future of eating disorders
Psychiatrist Jennifer Derenne specializes in eating disorders.
Most eating disorders begin in adolescence, but they can appear much earlier – or later – in life, too. To begin healing, Derenne works with an interdisciplinary team to first stabilize and renourish her patients and uses evidence-based psychotherapy that incorporates strong family involvement. Recent clinical studies are exploring the use of psychedelics to open new avenues for treating these notoriously hard-to-treat illnesses. Eating disorders are a life-threatening medical condition, Derenne asserts, telling host Russ Altman that “food is the best medicine” on this episode of Stanford Engineering’s The Future of Everything podcast.
Transcript
[00:00:00] Russ Altman: This is Stanford Engineering's The Future of Everything, and I'm your host, Russ Altman. I thought it would be good to revisit the original intent of this show. In 2017 when we started, we wanted to create a forum to dive into and discuss the motivations and the research that my colleagues do across the campus in science, technology, engineering, medicine, and other topics. Stanford University and all universities, for the most part, have a long history of doing important work that impacts the world, and it's a joy to share with you how this work is motivated by humans who are working hard to create a better future for everybody. In that spirit, I hope you will walk away from every episode with a deeper understanding of the work that's in progress here, and that you'll share it with your friends, family, neighbors, coworkers as well.
[00:00:48] Jennifer Derenne: Unfortunately, I'm seeing some kids who really prefer to use ChatGPT or similar platforms as their primary source of therapy, so they can actually type in a question and they'll get a response, and often there are some compelling and useful things that will come out, but there aren't the guardrails that you would have with a human therapist.
[00:01:17] Russ Altman: This is Stanford Engineering's The Future of Everything podcast, and I'm your host, Russ Altman. If you like what you hear, follow the show. We think your future self will thank you. Today, Jennifer Derenne will tell us that for disorders like anorexia nervosa, and others, a combination of behavioral therapy and some really interesting new medications, ones that you might not expect, may be useful for helping to treat these very difficult diseases. It's the future of eating disorders. Today we are continuing our new feature, the Future In a Minute. At the end of my conversation with Jennifer, I will ask her some quick questions and she'll give me some quick answers. That'll be at the end. Before we get started, please remember to follow the show. Again, your future self will thank you for all that you're about to learn.
[00:02:09] Adolescence is a difficult time for everybody. It's a time when your body is changing, where your social network changes a lot, and friends become way more important. And you're beginning to evolve and become independent and looking towards leaving the family nest. Unfortunately, for some people, adolescence can also bring eating disorders. These are diseases where eating becomes pathological and compromises function. That is to say the physiological function, the health of the individual, physical health, as well as their ability to function in school, at home, and in social groups. These are terrible diseases that are very difficult to treat. But Jennifer Derenne is a professor of psychiatry and behavioral sciences at Stanford University, and she's an expert at adolescent psychiatry and eating disorders, among other areas. We're gonna talk to her about what the status of these diseases are in our society, whether AI and social media have helped or hurt, and what are the new promising treatments that are coming down the pike?
[00:03:11] Jennifer, to start out, how did you decide to focus much of your work on eating disorders?
[00:03:16] Jennifer Derenne: It's a great question. Um, I went to medical school thinking I was gonna be a pediatrician. Uh, psychiatry was not actually on my radar at all. Um, and then when I was doing my rotations, I realized that I actually really enjoyed talking with kids about what was going on for them. And, um, within psychiatry eating disorders have the reputation for being the most challenging of the diagnoses to work with, and I love a challenge. Um, they're an incredibly rewarding patient population to work with.
[00:03:44] Russ Altman: So can you tell me, uh, for people who don't think about eating disorders all the time, can you kind of give a landscape of the types of things we're talking about? Um, what, what, what are the diseases, um, what are the challenges in treating them?
[00:03:56] Jennifer Derenne: Yeah. Um, so, uh, gosh, we have the more traditional eating disorders that people often think about. Like Karen Carpenter was diagnosed with anorexia nervosa back in the seventies and eighties. Um, bulimia nervosa where people eat large amounts of food and then compensate by, um, purging in some way, and then binge eating disorder, uh, which is similar to bulimia, but there's no compensatory behavior. We also have a relatively new diagnosis called avoidant restrictive food intake disorder. Um, and that is seen in kids who are having trouble eating, but it's not because they wanna be thin or because they're trying to lose weight. Um, and these kids have always existed, but, uh, it only has risen the level of being an actual diagnosis in the last, um, 10 to 15 years. Um, so that's really where we're putting the majority of our effort. Uh, sometimes people say, well, what about kids who are at higher weight who live in larger bodies? We don't necessarily view that as an eating disorder unless it's of the binge eating type.
[00:04:59] Russ Altman: Good. So, um, and you, you said the word kids a couple of times and I think it is the case, and tell me if I'm wrong, that these do tend to kind of manifest, at least for the first time in, uh, at adolescence, uh, or early adulthood. So can, what are the demographics of these diseases in terms of, uh, when you're seeing them, uh, and making the first diagnoses?
[00:05:18] Jennifer Derenne: Often they present in, um, adolescence. So really the teenage years is kind of the stereotypical time, but they can really present across the lifespan. So unfortunately, I've seen kids as long as, old as 5 or 6 who've presented with real anorexia nervosa. And then we've also seen people in their 60's, 70's, even 80 years old, who present for the first time with symptoms. So it truly can present across the lifespan.
[00:05:46] Russ Altman: And so let, let's take anorexia nervosa, just as our first thing to think about. And I know people think about that and worry about that a lot. Uh, what are the symptoms and how can somebody tell if, if they or a loved one really have a, a disorder versus, I don't know it's, it's quirky eating habits.
[00:06:03] Jennifer Derenne: Yeah. Uh, I'm asked to comment on this all the time, um, because I think in some ways, sometimes disordered is a little bit normal. Um, most people have been on a diet or been concerned about their weight or shape at some point in their lives, and for a lot of people, they may for a few weeks kind of watch what they're eating. They might exercise a little bit, um, but it typically doesn't get to the point where they're not functioning across domains. So when someone is unable to attend school, they're no longer seeing their friends, they can't go to work, um, and they're in a medically dangerous place, uh, then we start to worry that this is really a diagnosis.
[00:06:41] Um, with anorexia nervosa it may be that, um, they feel like their weight is, is too high. Um, they're being very restrictive in what they're willing to eat. Um, they have a lot of weight and shape concerns, so we may all see that they are objectively underweight and in a potentially dangerous space, um, but they actually don't see that or don't feel that. Um, and so they continue to engage in these problematic behaviors, um, to the point where it can become very medically dangerous.
[00:07:15] Russ Altman: Yes. And, and you mentioned that a lot of this gets, um, manifest in, in adolescence. And of course, as you know, better than most, this is a very difficult time for, for young people, this transition from being a child to being an adult and, and many issues, um, I, as we all know, arise. Um, I'm guessing that it's hard to, um, uh, it's hard to manage these folks because in addition to having these disorders, there's so much else going on in their life. Social interactions, the changing body, separate from, from the potential disorder. There's, there's just changes in the bodies happening. So how do you approach the treatment and the communication and creating a bond with the patient?
[00:07:54] Jennifer Derenne: Oh, a hundred percent true. Um, we always joke that eating disorders are everyone's fault and no one's fault. Um, so it's not one thing. It's usually a perfect storm. Um, and a lot of it is actually first really getting a shared understanding of what it is that we are trying to treat and getting, um, the patient's buy-in as much as possible, but also family buy-in. We really want, um, families to be equal partners in the treatment process. Um, and then we really, you know, we sometimes say we have an agnostic view, that it doesn't really matter if there was one potential reason that this happened. The important thing is that we've recognized that it's a problem and we're gonna work together on solving it. So where we get change and improvements in outcomes is around changing eating behaviors, stopping exercise, stopping binging and purging, and really supporting the patient all around rather than spending unlimited amounts of time trying to get to the bottom of why this happened. We don't get people better when we focus on that.
[00:08:56] Russ Altman: Yeah. And, and, and on the why, and I won't, I promise I won't focus on it too much, but do we have an understanding of the relative contributions of environment versus kind of genetics and kind of nature versus nurture? Is this, uh, are these diagnoses that come because of the experiences and the things that the person, uh, uh, lives through or are there innate tendencies towards this, or do we understand it?
[00:09:21] Jennifer Derenne: I think it's both and. Um, people far smarter than I am are looking at the genetics and the biologic vulnerabilities, which are definitely passed along within families. Um, but we also know that there are some temperamental factors that tend to be really consistent across the board. A lot of times our patients are very high achieving, perfectionistic, risk avoidant people pleasers. Um, and then there is the whole element of media, and particularly social media in this day and age, we're all exposed to it. We don't all develop eating disorders, but for people who are vulnerable, it can be a really important trigger. Um, and anyone who's been on any of the social media platforms knows you watch one video, the algorithm will start sending you that content over and over and over again.
[00:10:08] Russ Altman: Yeah. So since you, since you raised social media, I, I'm imagining that this is a huge part of your practice, even separate from the, from the eating disorders. And so can you tell me, um, what, what, what are you seeing in, in young adolescent people there? There's an, an informal observation from many of us, just on the street, seeing that young people are down on their phones all the time. That, that, that they, they refer to these, um, what do they call it, social media natives, where, um, the, the phones, all of this has been since they were born. They really don't remember a world without it. I'm imagining it's created, uh, I don't know if I can use the word earthquake, but some big changes in your practice. Is that true?
[00:10:48] Jennifer Derenne: A hundred percent. Um, you know, I feel like when I was a kid, um, you know, longer ago than I care to admit, I would go to school and if someone was picking on me at recess, I might decide to tell the teacher, but I might also have to try to work it out with my friends. Um, if nothing else, I was gonna have to wait till I got home to tell my mom and dad about it. Um, and so there's a lot of, um, natural need to focus on self-soothing, problem solving, working it out amongst yourselves. Um, I think when you add something like a, a smartphone to the picture, you have constant contact with people in your lives. And I wanna be really clear. I am not saying that kids should just figure it out on their own. And at the same time, if you immediately are messaging mom and dad and they're coming in to intervene, you lose some of that valuable ability to practice.
[00:11:44] And so I think people who are talking about putting, um, restrictions or limitations on, uh, smartphone use in this age range, it's not because we just wanna take it away. Um, but I think we wanna give people practice developing some of the skills that are really important. So face-to-face communication, I find that my patients struggle with. Um, I feel like phones are very often used as, um, soothing tools. And if the phone is taken away for a punishment for some reason, that can cause a very, uh, big emotional response. We've seen kids in the emergency room because someone took their phone away and they threatened suicide. Um, so it's definitely a huge part of our practice across the board right now.
[00:12:32] Russ Altman: So, so, um, related to this, I think, is I know that you have a special sub interest in, um, the transition to college or the transition out of the family, and it's really fascinating, and I'm sure all these issues kind of are, are intermixed, but tell me about, tell me about that transition because it's a big one for families. It's a big one for parents. It's obviously the biggest one, uh, many of us have vivid memories of the weeks and days around the time where we left our, our childhood home and went to some new place. Um, if, if you're lucky enough to be able to do that. Um, so, so tell me about that, that particular experience and the kinds of lessons and what you're seeing there?
[00:13:13] Jennifer Derenne: Yeah, I mean, I think in many ways the good news is that we're seeing more kids who are able to make that transition. We've gotten better at identifying mental health conditions, getting people treatment early, keeping them supported. Um, and because parents are so involved, they're providing a lot of scaffolding and support at home. I think one of the top things I see as an issue, though, is that families may not realize how much they are supporting their child, and so all of a sudden when it's time to go to college, they may assume that the kid has learned some things that we just kind of expect that you do when you're an adult. But no one's actually taught them how do you budget? How do you do laundry?
[00:13:53] How do you make an appointment? How do you fill a prescription? And if you have someone who struggles with depression or anxiety or ADHD, um, that all can be triggered in the context of this big life change. And so I have seen kids who have, you know, crashed and burned a little bit with the transition. And so my dream is for every family to really think about, okay, we are making the plans to go to college. We're gonna think ahead of time about what do we actually need for there to be in place? And then what are our contingency plans if something doesn't go well? And then how do we give the kids some independence and practice while they're still at home so that transition isn't so scary.
[00:14:38] Russ Altman: I love, I love that idea. So it, it implies that we don't do this a month or two before saying goodbye for college. This might be something in sophomore year, junior year say, okay, we're headed towards this event. Let's like do some planning for it.
[00:14:51] Jennifer Derenne: A hundred percent. And even small things like if you are waking your, your child up every morning to get to school, that is wonderful. It's a very caring parental thing to do. And if they don't ever experience the natural consequence of sleeping through their alarm, not making it to school, not being on time for their test and maybe getting a bad grade because of it, they're never gonna be able to learn from that and develop, uh, skills and strategies to make sure it doesn't happen again.
[00:15:22] Russ Altman: Yeah. Really interesting. I have to just comment that, uh, when I went to college, I took a train to college and I said goodbye to my parents, I got to the campus, and the first person I met turned out to be my partner and wife for the next 40, 45 years. And so that, that transition took one hour. I mean, there was a lot that had to happen, but like when you look back on it, it was bye mom and dad. Hello partner. Um, and wow. I think lucky, luckily. Um, um, okay.
[00:15:51] So I wanted to talk a little bit about, um, treatments. Treatments, uh, and and, and I think this will go even into our next segment, but, um, as you make these diagnoses, um, and as you have these, um, young people, in many cases, who are struggling and they're struggling with many things, um, is there a hierarchy of treatments? How should we think about the treatment for these disorders for, and I can imagine, you know, therapy type treatments, maybe medications, maybe other things that you wanna tell us about? Where are we for, for treating these uh, disorders?
[00:16:22] Jennifer Derenne: Yeah. Um, so right now really it's a team approach and it's multidisciplinary. Um, first off, we need to make sure people are medically stable, so, uh, I am lucky enough to work collaboratively with adolescent medicine physicians, um, who kind of share that piece.
[00:16:38] Russ Altman: Um, it's scary. Sorry to interrupt, but it's scary to, to even think, like, of course you would wanna make sure that they're medically stable and it's, it's, it's kind of shocking because of course there might be, it may get to the point where their, their health is in jeopardy, and then you have to manage both the, um, the psychiatric and the physical manifestations and, and I'm sure that's very hard. I mean, thank you for just mentioning that so we can all remember how serious these things can get.
[00:17:06] Jennifer Derenne: Yeah. I mean, the bulk of my time actually is on a medical stabilization unit where we take care of kids who have gotten medically unstable for some reason. So it definitely happens. Um, and then food is your best medicine. So nutrition, renourishment, that is by far the most important part of this whole process. And a lot of times kids will say, you're just focused on the food. This is so boring. I don't like this. I wanna talk about my feelings and my emotions, and I would love to talk about that stuff. But not until you're out of danger. And so we are working on increasing nutrition, regulating and normalizing eating patterns.
[00:17:45] And then, um, focusing on getting rid of other eating disorder behaviors. And so we tend to work with the medical provider, a dietician who often consults with the parents around what is the appropriate amount of food that this person needs to recover from their eating disorder. A therapist who specializes in eating disorder, and sometimes someone can play more than one role. So you might have a psychiatrist who is also the therapist. Um, the evidence-based treatments, there's not a ton of them.
[00:18:14] Uh, eating disorders are, are tough to treat because a lot of times, um, the individual actually doesn't think there's a problem. They don't wanna change. Um, and so actually treatment with someone who is still an adolescent is often a little bit easier because you have the parent involvement and the parents are the ones making the decision. And that actually contributes to improved outcomes over time.
[00:18:39] Russ Altman: And, and I, it's, it's a difficult question to ask, but do we have to do, or do we have in our toolkit at least, like directly observing the therapies to make sure that this, the, that the patient is eating the food. I mean, I can imagine, you know, I can just imagine being a, being a teenager who might not be happy about where they are. Might think that the problem is not as big a problem as everybody else thinks. And then there's the issue of are they actually, um, doing the things that are being prescribed? And, and I can imagine that that's a deeply connected with their trust in the team and their willingness to continue the therapy. So how, tell me about that.
[00:19:13] Jennifer Derenne: Yeah, it's a great, great question. Um, it's true and you know, we, I think sometimes people think these kids are manipulative or sneaky. It's not them, it's the disorder, um, which can be really desperate in this situation and wants to do whatever it can to stay in power. Um, and so we deploy parents to be the first line. They are observing. They are supervising. And um, with time, as the person is doing better, we start to give them more independence. Um, and the proof is in the pudding, right?
[00:19:45] If they're not actually eating at lunch, if they are not doing what they need to be doing, if they're sneaking in exercise when they haven't been cleared to do it, they're gonna be medically unstable at their doctor's appointment. They're gonna end up right back on my hospital unit. Um, and obviously I hate to see that, but that's the safety net. That's how we keep people safe and contained in situations like this.
[00:20:07] Russ Altman: This is The Future of Everything with Russ Altman. We'll have more with Jennifer Derenne next. Welcome back to The Future of Everything. I'm Russ Altman and I'm speaking with Jennifer Derenne from Stanford University. In the last segment, we discussed the basics of eating disorders, some of their symptoms, and why they're so dangerous. We talked a little bit about social media and a little bit about the behavioral therapies that are used to try to help patients get better. In this segment, I want to ask Jennifer two things. I want to ask her about AI and its influence on psychological and psychiatric health of adolescents in general, and specifically for eating disorders. And I also wanna find out about some amazing new medications that are coming around and how promising they look and how they might work.
[00:21:03] Uh, Jennifer, in this segment I wanted to ask about AI, 'cause like, why not. Every, it's on everybody's minds. We, we have these chat bots now. Uh, they also fuel social media, which we already discussed a little bit, but I wanna just ask in your practice, are you seeing AI coming up as an issue, and is it a good thing, a bad thing, or is it a mix?
[00:21:23] Jennifer Derenne: Uh, it's the question of the hour. Um, as I think with anything, I would say it's probably a mix. Um, the negatives are, uh, that unfortunately I'm seeing some kids who really prefer to use ChatGPT or similar platforms as their primary source of therapy. So they can actually type in a question and, uh, and they'll get a response and often there are some compelling and useful things that will come out, um, but there aren't the guardrails that you would have with a human therapist. So unfortunately we've also seen kids who type in questions like, I'm on an inpatient medical stabilization unit. How can I, um, cheat? Or, uh, lose weight while I'm here without my team knowing, and they will get a response, some ideas.
[00:22:15] Um, and the worst possible scenario, there have been some widely publicized cases of teens who've actually asked these search engines, you know, I wanna kill myself and what's the best way to do it? Uh, and that is a huge bummer. Um, I think with the appropriate guardrails, there's a lot of promise to make these interventions, uh, really supportive and helpful. I love that people are more open to therapy and if there's anything we can do to reduce stigma and increase availability, great. Um, but we need to, we do need to be able to respond when there are those red flags.
[00:22:51] Russ Altman: Yeah. I mean, oh my goodness. The headline of what you just said, which is that some of the, these young people or some of these patients, in general, might prefer the, the, uh, the, the LLM, the large language model, the ChatGPT like tool, um, might prefer that as their therapist. That's like a, that's a, I think, I, I can use the word shocking. And, uh, and the, and so how do you process this as a therapist who's trained and who like knows what you're talking about? Um, have you, have you sat down with, with, with kids and with the LLM and is, is there any kind of showing them do's and don'ts or pros and cons, or how do you even address this as, 'cause they say, well, you're just being competitive. Like you, you just are jealous that ChatGPT is so good at helping me. I mean, how do you even begin to address these issues in your therapies?
[00:23:43] Jennifer Derenne: Yeah, I mean, I think the best thing to do is to actually talk about it openly. I would much rather know that kids are doing it, um, so that we can talk about like where are the areas where you could get into trouble? Or um, where you really do need to have a human being involved when you're asking these kinds of questions.
[00:24:01] Russ Altman: How do you draw that line? Is there a way that you can say it like, 'cause you don't wanna say no, stay away from ChatGPT, it'll never be good 'cause that won't be credible. And of course there's probably some areas where they can get reasonable information. And then there are other areas where you really don't want them like going there, so to speak. So how do you summarize that to a young person who's thinking about doing all this?
[00:24:22] Jennifer Derenne: I always approach it with curiosity and a lot of neutrality. Um, so show me what sorts of things are you doing? What sorts of situations make this appealing? Um, and they'll say like, okay, I like you, but I see you, you know, once a week on Wednesday afternoons. What if I have a question on Friday night at 3:00 AM? Um, and that is a valid concern. And so ChatGPT can give or, you know, other platforms, it can actually give really useful advice. Like, how do you, um, what's a grounding exercise you can do if you're having a panic attack and you're having a really hard time calming down? Like those uses of AI I'm actually quite supportive of. Um, but when it comes down to I'm trying to cheat the system. I want to hurt myself in some way. I think anytime we're talking about a psychiatric emergency or something that's going to influence medical health in a negative way, the, in my mind, that's the very clear border.
[00:25:21] Russ Altman: Yeah. It's such a challenging situation and, wow. Um, okay. And we have a few more minutes left and I definitely wanted to get to medication. Um, and, um, what, uh, we, we, we did talk about the therapies and, uh, and then the kind of non-medical, non-pharmacological interventions. What are we using for treatments and is there anything on the horizon to be excited about?
[00:25:43] Jennifer Derenne: Yeah. Um, you know, unfortunately we don't have a ton that has a lot of robust data to support its use. Um, and so in our field, we're frequently treating the co-occurring conditions. So if someone has anorexia, let's say, and they also have depression or anxiety, or OCD or ADHD, we're using the evidence-based to treat those things. Um, but we're also taking into account the lens of the medical fragility that can happen if you are malnourished. And so sometimes there are things we need to do to monitor more closely or to have more laboratory monitoring or in person monitoring.
[00:26:21] Russ Altman: I could imagine it makes dosing even very challenging because you have to think about potential liver and kidney and other, um, dysfunctions that might change what the appropriate dose of a medication is.
[00:26:33] Jennifer Derenne: Right. And sadly, these medicines don't work as well as they could if you are not eating enough. Um, and also when you're malnourished, that actually can look a lot like depression or anxiety or ADHD. So what I said earlier remains true. Food is your best medicine. That's why we need to get the nutrition back to where it needs to be. Um, I'm really feeling hopeful and excited about some of the new things that are being looked at. Um, there are a number of studies going on right now where people are looking at things like Ketamine, MDMA, um, psilocybin to see,
[00:27:08] Russ Altman: So these are, just to be clear, these are psychedelic medications that, um, have big time, uh, kind of cognitive and, uh, sensory, um, impacts. I just, for those who don't recognize those names.
[00:27:19] Jennifer Derenne: Yes, yes. Very good to kind of center us in that. Um, and people will say that feels like a really big step. Um, but that's precisely I think why people are interested. These are illnesses that are notoriously difficult to treat people stay stuck for many, many years sometimes. Um, and I think the hope is that these psychedelic medications are going to cause, um, some openness, some decreased rigidity, um, a feeling of, uh, being more connected, being interested in and open to changing relationships. But it's not enough to just get the treatment. Um, it's paired with very, very specific and intentional psychotherapy, um, and integration sessions after to really try to cement the changes that were made. And so I'd kind of love to fast forward through this phase of research to see what are we gonna end up learning, I think.
[00:28:18] Russ Altman: So can you tell me a little bit more this, it's so fascinating. So, you know, I think some of these drugs, um, I don't know if they're, have zero indications for use, but a lot of them have very, very limited approved, uh, uses. Um, are, are we doing like microdosing, is it always inpatient or do we actually give these medications for people to try and then come into the clinic? How so, what can you tell me about how it looks like they may be useful? And I realize that this is all still under heavy investigation.
[00:28:46] Jennifer Derenne: Yeah. Yeah. Um, I think where we're at right now, it's definitely not an established treatment. And a lot of these medications are illegal. Uh, this is one of my,
[00:28:54] Russ Altman: Good word, good word.
[00:28:56] Jennifer Derenne: Says, you know, um, if I don't qualify for this study, can I just go to Golden Gate Park and buy some mushrooms? Like, will that help? And she's like, yeah, I can't tell you to do that. Um, but there are parents who think it, right. So they are being very careful and intentional about the dosing. Right now, the treatment studies are for people who are 18 and older and, um, they do have to be very careful about medical stability, um, making sure that someone is not psychiatrically at imminent risk of hurting themselves or hurting someone else. So they have to, um, be stable enough to be able to participate in the treatment.
[00:29:32] Russ Altman: Yes. Are they, is it a one-off or do you get doses over a course of?
[00:29:38] Jennifer Derenne: Yeah, it's usually multiple sessions. Um, my understanding is that a lot of it is actually done outpatient over the course of several sessions with very intensive monitoring.
[00:29:47] Russ Altman: Well, this is, uh, this is exciting and an unexpected, but it, in, in an area where there haven't been great treatments for many, many years, it's kind of exciting to see that this whole new thing might be beneficial. And I'm sure they're doing the normal care in, in the, in the trials. Um, and then there'll be the whole issue of getting approvals and, you know, the many social issues will come up in terms of making these psychedelics available, but it is a very hopeful, uh, situation. Uh, well, before we finish up, I'm wondering if, uh, you're ready to move to our new segment, uh, the Future In a Minute, where I ask you some quick questions and you give me some kind of quick answers.
[00:30:24] Jennifer Derenne: Let's do it.
[00:30:25] Russ Altman: The first question is, what is one thing that gives you the most hope about the future?
[00:30:31] Jennifer Derenne: I just see people who continue to be curious and interested in learning and developing and growing. Um, people are not just crusty saying, oh, nothing's gonna change. Why bother trying?
[00:30:42] Russ Altman: What's one thing you want people to walk away from this episode remembering?
[00:30:46] Jennifer Derenne: Oh, gosh. Um, we talked about so many things. Uh, you know, I, I think just realizing that mental health providers are on your side, um, that, you know, we're not trying to tell you what to do or make life miserable for you. That we want to have, uh, informed discussion back and forth.
[00:31:02] Russ Altman: Aside from money, what's one thing you need to succeed in your work and in your research?
[00:31:07] Jennifer Derenne: Burning questions, curiosity, and a really good project manager.
[00:31:11] Russ Altman: If all goes well, what does the future look like?
[00:31:14] Jennifer Derenne: I mean, my hope is that we have more evidence-based treatments that we can offer, uh, patients and families. You know, sometimes it doesn't go as quickly as we would like, but I feel hopeful about that.
[00:31:25] Russ Altman: If you were starting over again and you needed to get your degree or certification in a different discipline, what would that be?
[00:31:31] Jennifer Derenne: I mean, I love medicine. I hope that's clear. But if I had to do something else, I think I would be a book editor. I love stories. I'm all about the human condition, why people do the things they do. Uh, and I just would love to do that in the future.
[00:31:48] Russ Altman: Thanks to Jennifer Derenne. That was the future of eating disorders. Thank you for listening to this episode. We have more than 300 old episodes in our archives. We're very proud of them 'cause they really are evergreen and many of them are just as useful and interesting as they were on the day they were recorded. So please go back to the archive and take a look at that big collection of, I think, pretty interesting conversations. Also, your ratings and reviews mean a lot to us. They help grow the community, and if you haven't yet, we'd love to hear what you think with a rating. That's a number and a review. That's some thoughts and some words, and I can tell you that our staff and I read all these comments. Thank you so much. You can connect with me on many social media, including LinkedIn, Mastodon, Bluesky, and Threads where I'm @RBAltman, or @RussBAltman. You can follow Stanford Engineering @StanfordSchoolOfEngineering or @StanfordENG.
