Battling Eating Disorders
A medical student’s cause
When Amanda Moreno Garcia, M.D. ’26, joined an eating disorder awareness club as a freshman majoring in neuroscience at the University of Pennsylvania, she did it to support a friend. “My friend had lived experience [of an eating disorder] and was really passionate about joining this club,” Moreno Garcia recalls. Then she learned the scope of the problem—by age 20, 13 percent of people in the United States develop eating disorders, which carry a 12 times greater risk of death for adolescents than any other mental illness—and what began as an act of friendship became a calling.
Ultimately, Moreno Garcia and her friend, Christina Miranda, would run the club for all four years of their undergraduate careers before, in 2021, receiving a $200,000 President’s Engagement Prize from Penn. They used the award to found the nonprofit Body Empowerment Project (BEP), a 10-week program of one-hour, after-school workshops that teach middle and high school students who choose to join to think of eating in terms of health rather than weight and to reframe their beliefs about health and wellness. College student volunteers (coordinating with nurses and school counselors) now teach the curriculum—which includes team activities, student-led discussions, and informational videos—in 13 Philadelphia-area public schools. The program is divided into five “core competencies”: self-acceptance and body positivity, redefining health and wellness, challenging diet culture, building community, and empowerment and activism.
While treatment programs—the current default approach to combating eating disorders—are expensive and produce high relapse rates, the the BEP’s relatively inexpensive prevention strategy has yielded statistically significant reductions in eating disorder symptoms for its students, according to an Institutional Review Board-approved research study of the program.
“There are so many things that influence the development of an eating disorder—biological, psychosocial, socioeconomic,” Moreno Garcia explains. “And so, we recognized that with any prevention program, we wouldn’t be able to tackle all of those things. But we thought about what tangible things we could change: students’ ideas about what beauty means, what intuitive eating looks like, and how to dissect the messages we receive from social media and society at large.”
Moreno Garcia’s impression of societal dysfunction around health in the United States began in her childhood after her family immigrated from her native Cuba to Miami when she was seven years old. As immigrants, she remembers, their access to healthcare was spotty and littered with bureaucratic hurdles. “I grew up going to free clinics and seeing my parents struggle with the medical system—with language barriers, financial barriers, insurance barriers,” she says. Her ultimate choice of a career in medicine and health activism was strongly influenced by her early memories of “traversing a healthcare system that oftentimes leaves marginalized communities out.”
That same history then guided her choice of medical school, which at first seemed yet another institution practically, if not officially, barred to outsiders. From the start, Harvard stood out for its Office of Recruitment and Multicultural Affairs (ORMA), which ran workshops dedicated to coaching pre-med minority applicants on skills like writing a personal essay or preparing for an interview. This impressed Moreno Garcia, who notes that “[Harvard] was the only med school that did that of all the ones I was applying to. I saw it right away as a supportive institution that wanted to see me thrive even before I had applied and been admitted.”
These days, her minority background helps her speak to a diverse BEP student body that often harbors misconceptions about eating disorders, including the belief that only the “thin, affluent woman” suffers from the condition. Moreno Garcia explains that it’s crucial to dismantle this stereotype in the program since one-third of its students identify as male, and the participants come from different backgrounds. “What’s unique is that we don’t come in and create separation between experiences,” Moreno Garcia says. “We hear everybody’s perspective, regardless of identity, and then discuss that.” Similarly, she emphasizes that discussions about healthy eating require confronting varied ethnic and familial traditions—she always asks students, for instance, how their family dinners growing up might affect their current beliefs about food. “I think of me growing up in my household,” she says. “There was always the expectation to finish all of the food on your plate, and something like that can really move the way somebody approaches their eating habits.”
As she enters her third year of promoting the BEP, the memories of Moreno Garcia’s own childhood still deepen her sympathy for the struggles of young people. She remembers what it was like to be a kid moving to a new country—the distress she felt because her customs, language, clothes, and manners were different. Now, she frames many of her thoughts on eating disorders in terms of the special vulnerability of today’s youth, who are exposed to relentless unhealthy messages on social media.
“Especially for this generation, everybody struggles with body image,” Moreno Garcia points out. “Kids are constantly getting these diet-culture messages: there are good foods and bad foods, and the best way to be healthy is to avoid all the bad foods, or to eat less so I can be thinner…when, in fact, we should be talking about balanced, holistic nutrition that permits eating things that make you feel good, that make you feel satisfied, but practicing moderation.”
Despite these challenges, she is optimistic about the future for herself and the program she helped create. The BEP currently trains six college chapters that, in turn, fundraise and teach their own curricula on eating disorder awareness. The program receives financial support from several other sources as well, including the Harvard Innovation Labs and external foundation grants, and has continued to grow in the two years since its inception. Moreno Garcia, who wants to practice clinical medicine upon graduation, also hopes to help extend the BEP nationally.
“In an ideal world, looking several years down the line,” Moreno Garcia says, “I would hope that this would be embedded in health curricula across the country,” and notes that the BEP’s current opt-in model can’t prevent eating disorders in broader student populations. “[Right now] most health curricula across the country in middle school and high school never discuss eating disorders, and in fact, there are a lot of health curricula that carry some of the biases that perpetuate these issues, like talking about restrictive dieting and exercising,” she says. “So there really needs to be a shift at the national level.”
Though still navigating the pressures of medical school rounds and deciding what kind of clinician she wants to be, Moreno Garcia says that “one thing I do know is that I want to stay involved in this nonprofit work forever. I think it’s the most wonderful thing that I’ve ever done.”