20 Years, 20 Leaders: Jennifer L. Gaudiani, MD

Jennifer L. Gaudiani

“I believe that when individuals can tell me their stories and share their expertise about themselves, then I can share my medical knowledge and together we can create a plan of care that honors the patient’s unique goals and values.”

Our connection to the experiences of those who came before helps to define the present and future of medicine. The Foundation is celebrating 20 years by joining in conversation with 20 women leaders in all aspects of medicine to understand their stories and how their experiences will shape the next generation.

Jennifer L. Gaudiani, MD, is founder and Medical Director of the Gaudiani Clinic in Denver, a Certified Eating Disorder Specialist (CEDS), and Fellow in the Academy for Eating Disorders (FAED). She is the author of Sick Enough: A Guide to the Medical Complications of Eating Disorders, and has served as an Associate Professor of Medicine at the University of Colorado School of Medicine and Medical Director of the ACUTE Center for Eating Disorders at Denver Health.

Here’s what we learned from Dr. Gaudiani:

Why did you choose to go into medicine or your related field?

I’m the daughter of a cardiac surgeon and I spent my entire childhood (pre-HIPAA) rounding with my dad and watching him see patients in his office. It was like growing up in a foreign country and having the benefit of learning a language natively. I always knew I wanted to be a doctor.

In medical school, I almost chose ob-gyn but realized towards the end of my third year that I’m truly the classic nerdy internist who loves being involved in every aspect of care and has an insatiable interest in how problems interconnect. By a lucky accident, I had the opportunity early in my Hospitalist career to help grow and run the nation’s top inpatient medical stabilization unit dedicated to adults whose anorexia nervosa has gotten too severe to receive care anywhere else. Alongside a brilliant multidisciplinary team, I helped these wonderful patients stabilize sufficiently to proceed to intensive eating disorder programs.

After eight years, I left my hospital to found my own outpatient clinic which serves the outpatient medical needs of people with eating disorders and disordered eating of all genders, ages, and body shapes and sizes from around the country using a telemedicine platform. I am passionate about caring for people with eating disorders and have particularly embraced the important social justice aspects of this field. 

What’s your core philosophy?

Having been an English major in college, I deeply enjoy the process of hearing a patient’s narrative in order to understand them as a whole person. I believe that when individuals can tell me their stories and share their expertise about themselves, then I can share my medical knowledge and together we can create a plan of care that honors the patient’s unique goals and values. I try to resist assumptive, hierarchal relationships with my patients in favor of a collaborative approach that requires creativity and patience. I am an enthusiastic and supportive person. 

What motivates you?

Patients with eating disorders, as well as individuals in larger bodies with or without eating disorders, are often harmed by the current medical system. Doctors aren’t taught much (if anything) about eating disorders and we live in a society rife with size stigma. As a result, many of my patients have been invisible in the medical system or have been harmed by its embrace of diet culture. I’m passionate about bringing information about the medical complications of eating disorders to my patients, to validate their lived experience and to help them move forward in recovery. 

How do you motivate others?

On a dyadic level, I try to help motivate my patients by reminding them what they say they want in life, which is usually unachievable in the context of having an eating disorder. On a broader level, I love speaking to audiences of therapists and dietitians (and sometimes physicians) about the medical complications of eating disorders and how we can use this knowledge base to break through denial of disease and improve outcomes. I also blog and share short video posts to help inform and inspire people. In 2018, I published my first book, Sick Enough: A Guide to the Medical Complications of Eating Disorders (Routledge), and my hope is that this allows good science and compassionate care to be adopted by more individuals than I’ll ever get to interact with personally.

What challenges have you had to overcome?

While acknowledging my many privileges, it has been a challenge as a physician to start my own private practice and a type of clinic that is unique in the country, so I don’t have the benefit of following someone else’s successes and failures. Doctors are often on the more anxious, harm-avoidant, path-dependent side of temperament, and I am for sure! That made leaving my prior, stable job more fearsome, and it has made all of the decisions and uncertainties scarier. While I have lots of experience as an attending/teaching physician, I don’t have much management experience. All these things have been good and difficult. I feel incredibly grateful to have had support from my team, family, and friends as I have developed my clinic. 

Humans fail. Please share a time when you failed and what you did next to move forward.

Oh my gosh, I’ve failed so many times that I have a hard time picking one time to share! I feel like each week I fail in little or larger ways several times, and I try to feel it enough to learn the lesson and make improvements, while not taking it to heart so hard that I am frozen in place. I think my classic setup for failures is when I get too busy and try to go too fast. I tend then to get “checklisty” to get through the tasks before me, and sometimes I’ll reply to a patient’s email too hastily, or I’ll assume something is only my responsibility when in fact there are other professionals who need to be looped in before an answer is offered. I try to identify days when I’ll be most vulnerable to this problem and then try to remind myself, “Slow down.” 

Who was your most important mentor(s) and why?

I have a community of unbelievably wise, generous, experienced, kind, vulnerable, insightful, and luscious friends in the field of eating disorders who are my collective mentors. They range from 10-25 years older than I am, and by amazing grace they took me under their wings a few years ago and have offered encouragement, support, and love. Women who mentor women hold a special place in my heart, and I try to pay it forward similarly whenever I can. Also, my best friend (an amazing psychologist) and I take long walks whenever our weekend schedules allow, and this time together helps me process all topics and roles from professional, to wife, to mom, which keeps me steady and grounded. 

What’s the most important lesson you’ve learned?

I have learned that self-care is a discipline, not a luxury, and that I need certain breaks and recharges or I’m unable to do my work or enjoy my life. I wish I could say yes all the time, and satisfy all expectations, but I cannot. I have to set boundaries and recharge in ways that are meaningful to me (usually involving some combination of home-cooked food, nature, cuddles with my kids, travel, musical theater, reading as many fantasy books as possible, and going on walks). 

How do you define success and how do you measure up to your own definition?

I don’t have one prescriptive or bright-line definition of success. I found a new guiding principal that helped me stay true to my values. The old adage “to those to whom much is given, much is expected,” has for many years been a tough one for me. I know I was given a lot, and accordingly I expect a lot of myself. How do I reconcile these expectations with my need to set boundaries? I struggled to understand how I could set boundaries without feeling I was reneging on a responsibility to do everything possible to show my gratitude for this career I love and for the joys in my life. However, I reframed the adage. I’ll dedicate myself to the giving of my energies congruent with my values. That means I can’t leave 80 percent of myself at work and bring home a shell to my husband and daughters. They tie for first in what’s most important to me. Many women in the world don’t get to make decisions about where they give their time and energies. Because I can, I vow that I’ll be mindful about this. 

What do you see in store for the future of medicine and the related fields?

Medicine has to find a way to be accessible to all. It also has to change such that doctors don’t burn out and feel disenchanted, disempowered, and empty. I’m not sure how these wildly important goals will be accomplished, but they are truly necessary. 

What advice would you give to the next generation of women in medicine and the medical sciences?

Don’t believe the dominant narrative that when you go into medicine, you have to give up everything. I had been dating my boyfriend for two years when I started medical school, and everyone told me the relationship was likely doomed. We’ve been together for 23 years now and married for 16 years this summer.

I have long counseled young women going into medicine not to put their lives on hold as they go through medical training. Continue to foster the traits and activities that make you feel most like yourself. I just barely passed the first two years of medical school because I wasn’t a strong science student, and it wasn’t until my third year of med school, when I started seeing patients, that I felt I came into my own. What helped me to do this was having continued to grow as a whole person. Fiercely defending the right to remain a whole person allowed me to be brave and start my own clinic and help patients in a unique way. It’s not about perfection in any given moment, it’s about staying true to one’s values and taking the long perspective. 

The Backstory on Dr. Gaudiani

She completed her undergraduate degree at Harvard, her medical degree at Boston University School of Medicine, and her internal medicine residency and chief residency at Yale, where she won numerous clinical awards. Dr. Gaudiani moved to Denver in 2007, choosing Colorado with her husband because of its emphasis on the outdoors, the incorporation of nature into daily life, and the importance of family activity time in fostering work-life balance. 

Dr. Gaudiani has lectured nationally and internationally and is widely published in scientific literature and blogs. She is a current member of the editorial board of the International Journal of Eating Disorders and the Academy for Eating Disorders Medical Care Standards Committee and is a former board member of IAEDP (International Association of Eating Disorder Professionals).