Blair Burnette is a second-year assistant professor in the clinical science area of the Department of Psychology at Michigan State University. She earned her PhD at Virginia Commonwealth University in Richmond, Virginia, did her clinical internship in West Virginia, and then completed her postdoc at the University of Minnesota in epidemiology and community health before coming to Michigan State.
Interview
Could you tell us about your current research?
The overarching thing I say to people is that I study the social, cultural, and environmental influences that shape how we eat and feel about our bodies. I am especially interested in applied research. That means we use our research findings to inform the development of better prevention and treatment interventions. More specific areas of my research involve intuitive eating, a multidimensional framework of eating and body image that has ten principles. Intuitive eating emphasizes eating according to your hunger and fullness cues, body respect, emotion regulation, and mindful movement. It’s an anti-diet framework that’s founded on self-compassion and tuning into your own needs. It goes against the paradigm of dieting and focusing on weight loss. I study what makes intuitive eating possible and what makes it harder, especially looking at social, cultural, and environmental factors, such as food insecurity or socioeconomic status. Then, I do intervention research, especially looking at intuitive eating as a secondary prevention. This involves helping people who already have some risk factors for disordered eating and seeing if teaching them intuitive eating can help reduce the risk of those symptoms escalating into an eating disorder. We’re doing some intervention development right now in the lab in this area of research. I do work on trying to make eating disorder treatment better and more accessible. We’re developing some novel digital interventions for eating disorders, and we’re using community engagement as part of that. We have a community advisory board on one of our projects that is helping us develop these interventions. I also do a lot of work around weight stigma, especially as it shows up in medical settings and how it affects patients in the healthcare system. My work also extends to food insecurity, both related and unrelated to disordered eating. In a project my colleague and I are working on, we’re looking at the effect of universal free school meals policiesand whether they reduce disparities for children across different identity factors.
Could you talk to us about your path and what drew you specifically to this area of research?
My interest in body image and eating has always been there. As a girl growing up in the 90s and early 2000s, it was the age of Britney Spears and Christina Aguilera. There was this emphasis on having a flat stomach and all those things, and I remember, even at that time, feeling that it was so damaging. It’s so harmful that we’re so focused on the appearance and size of someone’s body. I didn’t understand why the emphasis was there and not on health or well-being. I was always really fired up about that as a teenager and didn’t know exactly what I was going to do with it. But then, when I went to college, I was lucky enough to have advisors who were eating disorder prevention experts, so I got to work with them. I ultimately decided to get my PhD. When I was in my doctoral program, I noticed that we treated body image and eating issues differently depending on what someone’s shape or size was, or what their symptoms were. So, for someone who’s in a thin body or someone who’s engaging in restrictive eating, we tend to prescribe a treatment that would emphasize food flexibility, reintroducing previously feared foods, and appreciating and accepting their body. Whereas someone in a larger body or someone who’s engaging in binge eating, they’re much more likely to be funneled into standard weight loss treatment where they’re told to restrict their calories, to cut foods out, and follow rigid exercise routines. These different approaches didn’t make sense to me because we know that diagnostic crossover is really common. If you treat one specific symptom, it’s probably not going to be adequate because people may cross over into another symptom, and we know that the highest rates of disordered eating are actually in people with larger bodies. If you’re just funneling them toward weight loss treatment, you’re totally ignoring the disordered eating that’s happening. Intuitive eating became really interesting to me because I saw it as a viable trans-diagnostic approach. Could intuitive eating address the spectrum of disordered eating behaviors across body shape and size? Is it a more inclusive and trans-diagnostic framework? That’s why I started doing work on that – to solve that problem. That’s where my focus grew. Additionally, during my doctoral training, especially my clinical internship, I became very passionate about weight stigma because I saw firsthand how harmful it was to my clients. especially in medical settings.
What contributions do you hope to make with your research?
I’m realistic in knowing that my singular program of research is probably not going to dramatically shape the field in and of itself, but I hope my work lends to making eating disorder treatment more accessible and more effective. Our existing eating disorder treatments are not very effective. They fail a lot of people. I hope my work helps inform how we can make treatment more accessible, effective, and inclusive. I also hope that my work is a small part of making this world an easier place to have a body and eat, because I feel like almost everyone – whether you have clinically significant levels of body image concerns or disordered eating – have a contentious relationship with eating and their body. Very few people feel totally at peace with their bodies and totally chill about eating. I think that’s rare, and I don’t think we should accept that as the norm. If my work helps to make the world a place where we don’t have to accept that norm and where people are allowed to feel at home in their bodies and not fight with it all the time, that would be amazing. And, of course, I hope that with the knowledge gained we can start to make meaningful reductions in the number of people who deal with disordered eating and eating disorders, because we have not seen any reduction in recent decades. We’ve only seen an increase, especially since COVID. We need to reverse that trend for sure.
What do you hope people who participate in your research studies can get out of these studies? Do you have anything you’d like to share with people who are thinking about participating in a mental health research study?
I think there are silos between the communities affected and the people who study them. A lot of the time, there are barriers between these groups. This is especially true in eating disorders, where people with eating disorders have been viewed as not credible and not able to speak about their disorder because they’re too sick or their mind is too warped by the disorder. Their voices have been excluded from research in the past, so I think that has limited our understanding of many things. For instance, in our community advisory board right now, I want them to know that their voices matter and will shape the research that we do and the treatments that we develop. I think their voices are so crucial for doing better science. We make so many assumptions as researchers; if we do a survey study and we see an association between two variables, it’s up to us to determine what that means and interpret it for the scientific community. I just think we need to be asking the communities we’re studying what our findings mean and what our treatments lack. I hope that people who participate in my research feel like their voice matters and that they are changing the treatment and prevention landscape for eating disorders and are contributing to those overarching aims of better treatment, more accessible treatment, and fewer people who deal with these issues.
Why do you think that inclusivity is important to mental health research?
Regarding inclusivity, I think what’s happened in the eating disorder literature,is not different from other areas. What’s interesting is for a really, really long time, eating disorders were viewed as only affecting young, thin, upper-class, cisgender white women. For that reason, our understanding of how eating disorders show up, what their symptoms are, how to treat them, the risk factors, it’s all built around that group of people. Our measures were developed almost entirely on samples of that group. We call it the “golden girl myth” or the “swag stereotype” as the focus was on the skinny white affluent girls. Because we were so narrow in our focus for so many decades, it’s trickled down across everything. 90 percent of participants in eating disorder treatment trials are women, and 80 percent are white, making up the overwhelming majority. All our measures and how we conceptualize eating disorders were developed on this group, so it’s affected everything. It’s affected how we measure eating disorders, how we treat them, and how we prevent them. Because of that, we’ve missed a lot. This is a glaring problem because groups who do not fit that stereotype are actually at heightened risk. For example, LGBTQ youth and adults are at much higher risk for disordered eating, eating disorders, and body image concerns. We know so much less about how those issues show up in those folks. What are the factors that increase risk? What are protective? What are the factors we need to address in treatment? We really don’t know. I think inclusivity, especially involving the affected community in our research, is so important because we are underserving so many people in our field when we have that narrow focus. It’s kind of sad because our eating disorder treatments, even in the best-case scenarios, are still just not that effective, even for that group of white women.
Do you have any advice for people who are looking to pursue a career in research?
I think a lot of people aren’t sure if they like research or don’t know if they want to do research. I think it’s so important for young people who are just getting started, or people who are early in their careers or education to know that research can look so many ways. You may be involved in one lab or one study and not really enjoy it, but there are so many reasons why that could be the case. It could be the topic that you’re studying. It could be the methodology. Some people do wet labs, and they’re doing experiments on rats. Some people do fMRI or EEG research or eye tracking. Some people do intervention development. Some people do survey research. In our lab, we do a lot of qualitative and mixed-methods research. We do a lot of interviews, treatment development, and randomized trials. I would encourage people to get experience with different topics and especially different types of research because it may be that you enjoy some types of research, but just not all of them. I would also say a career in research can be really challenging. There are a lot of pressures and demands and competing priorities. In my opinion, the way to be able to navigate that and handle all that pressure and not be overwhelmed is to research something you care deeply about. I think there are plenty of things that you can study, but when you have a passion for it, you want to make a difference and see a change, it is easier to navigate all of those pressures. Passion makes it worth it. The work just feels meaningful, and it gives back to you. So, study something you’re really passionate or curious about, or that you find interesting and fun. I think it might be tempting for some people early in their career to try to study whatever seems trendy or what is going to get the most funding, but I think you need to really care about it to have the best outcomes.
Outside of research, what do you enjoy doing in your free time?
In my free time, I spend a lot of time moving my body. I run, cycle, and do yoga. I also have three animals, so at the beginning and end of the day – it’s the best way to start and end my day – I snuggle up on the couch with those three cuties. I also play music. I’m a singer-songwriter, so I do that when I’m not too drained from work.