Parts and More Parts and IFS

Many professionals have explained and elaborated on the theories, called Internal Family Systems (IFS), of Dr. Richard Schwartz. It’s all about the “parts” — or inner beings — that inhabit psychologically troubled people. In what is perhaps a vain attempt to understand why these childhood-obesity-related teachings have caught on in such a big way, we consult yet another explainer, this time, writer Tess Brieva.

Overall, there seems to be a consensus that the various parts all aim to do the same job in different ways. That main task is to help the patient figure out, “Why am I doing this to myself?” Or perhaps, “Why are we doing this to ourselves?” Bottom line is, they all, in their unique ways, struggle to ultimately blend together into a single, healthy being.

One problem is, some of the parts are misguided, and every effort they make to avoid causing pain to the “exile” parts will only cause new problems. A “firefighter,” for instance, being an emergency first responder, might recommend an obvious cure that will distract and comfort the human host quickly, but alas, only temporarily. Brieva writes,

A binge-eating part might believe it’s helping by offering temporary comfort from emotional pain, while a restrictive eating part may believe it’s creating safety through control.

Then — just like small children when Mommy and Daddy fight — the “exile” parts experience even more fear, loneliness, shame, separation, and other negative emotions. Their problems are compounded, and another cycle of attempted compensation begins.

“It’s above my pay grade”

This author characterizes the “manager” parts as proactive, and anxious to avoid such obstacles as, for instance, painful emotions. Sadly, those efforts to dodge suffering only generate more problems, like, for instance, unreasonable rules and unachievable standards. It all gets to be just one big dysfunctional merry-go-round, with every part clueless about how to make the darn thing grind to a halt so everybody can get a grip.

Apparently, the basic goal of Internal Family Systems is to rope all those confused yet earnestly striving inner beings onto the “same page.” Or at least, singing from the same hymnal. Brieva explains what stands in the way of that peaceful resolution:

In eating disorders, managers and firefighters are usually polarized, creating inner conflict and a sense of confusion, turmoil, or stagnation. Protector parts in these extreme roles often lead to yo-yo dieting, restrict-binge cycles, and other unstable patterns.

Nobody wants to live with a bunch of different voices yammering away inside their head, and IFS makes a valiant effort to carve a new path to a better way. As the author explains,

IFS encourages individuals to explore the underlying intentions of their parts and uncover the deeper wounds driving those behaviors. Healing becomes possible when all parts are welcomed, listened to, and guided by the Self toward new ways of being.

Then, she clarifies that listening to and understanding the different internal parts, and their various plans for correcting the situation, does not imply approval. The therapist “does not necessarily condone or support this behavior,” because obviously some of the protective plans made by firefighters and managers are anti-social, self-harming, or otherwise counterproductive.

While the intentions are good, the methods may just cause more trouble, and this is what all the inner parts, it is hoped, will understand, and then figure out more effective methods for their healing process. It’s like a club where some members misbehave, but nobody gets kicked out, because the goal is to convert them into team members, who will then help to bring those other slackers into line.

Your responses and feedback are welcome!

Source: “Internal Family Systems and Eating Disorders: A Compassionate Approach to Recovery,” BalancedAwakening.com, undated
Image by kirill_makes_pics/Pixabay

WHO Releases First Global Guidelines on Weight-Loss Medicines

The World Health Organization (WHO) has issued its first-ever guideline on a new generation of weight-loss medications — a major move that could reshape global obesity treatment as rates continue to climb.

The recommendations center on GLP-1 therapies, a fast-growing class of drugs that includes liraglutide, semaglutide, and tirzepatide. WHO’s new guidance offers conditional recommendations on how these medicines can be used safely and effectively as part of long-term obesity care.

A growing global crisis

Obesity now affects more than one billion people worldwide, contributing to an estimated 3.7 million deaths in 2024. Without stronger action, the WHO warns the number of people living with obesity could double by 2030. This surge poses enormous challenges for healthcare systems and could result in $3 trillion in annual economic losses.

Given WHO’s role as the world’s leading public health authority, the new guideline is expected to influence national policies, insurance decisions, and clinical practices at a time when demand for effective weight-loss treatments is exploding.

WHO Director-General Tedros Adhanom Ghebreyesus commented:

Obesity is a major global health challenge. Our new guidance recognises that obesity is a chronic disease that can be treated with comprehensive and lifelong care. While medication alone won’t solve this global health crisis, GLP-1 therapies can help millions overcome obesity and reduce its associated harms.

Obesity recognized as a complex and chronic condition

The WHO stresses that obesity is not simply due to poor lifestyle choices. Instead, it is a complex chronic disease shaped by genetics, biological factors, environment, and social conditions.

A recent mindbodygreen article stresses that:

What makes this announcement meaningful isn’t only the endorsement of medication; it’s the explicit recognition embedded within it.

The WHO is formally acknowledging obesity as a chronic, relapsing disease requiring comprehensive, lifelong medical management. Not a character flaw. Not a willpower deficit. A complex metabolic condition deserving the same comprehensive, lifelong care we afford any other chronic illness.

Obesity increases the risk of heart disease, type 2 diabetes, and several cancers, and it can also worsen outcomes for infectious diseases. For many individuals, long-term weight loss is extremely difficult without medical assistance.

GLP-1 therapies help by mimicking a natural hormone that regulates appetite, blood sugar, and digestion. These medications can trigger meaningful weight loss and significant health improvements.

WHO added GLP-1 therapies to its Essential Medicines List in 2025 for high-risk diabetes patients, and the new guideline now recommends long-term use for adults with obesity, except during pregnancy.

However, the guidance remains conditional because of limited long-term safety data, questions around maintaining weight loss after stopping treatment, high cost, and concerns about unequal access across regions.

Medication isn’t enough

A major theme throughout the guideline is that GLP-1 drugs cannot serve as a standalone solution. mindbody green chimes in:

The WHO’s new guidelines recommend these medications for long-term obesity management in adults (excluding pregnant women), but with a critical caveat: they must be combined with what the document calls “intensive behavioural interventions,” structured, ongoing programs involving nutrition counseling, physical activity support, and behavioral health services…

This integrated approach (pharmaceutical intervention plus foundational lifestyle medicine) represents the future of metabolic health. GLP-1 therapies can be powerful catalysts for change, but they work best when layered into a broader foundation of movement, nutrition, sleep, stress management, and community support.

WHO also highlights the broader need for systems-level action. Creating healthier food environments and early intervention programs requires cooperation between governments, healthcare providers, and industry, not just individual effort.

Ensuring access, affordability, and safety

Demand for GLP-1 medicines already far outpaces supply. Even with expanded manufacturing, the WHO estimates fewer than 10% of eligible people will have access by 2030. Without careful planning, this scarcity risks widening existing health inequities. To counter this, the WHO urges governments to consider pooled procurement, fair pricing strategies, and voluntary licensing agreements.

Another emerging issue is the rise of fake or substandard GLP-1 products, driven by global shortages. WHO stresses the importance of regulated supply chains, proper prescribing, and strong oversight to ensure patient safety.

WHO plans to update the recommendations as new research becomes available, and in 2026, the organization will work with global partners to prioritize access for people most at risk.

Your responses and feedback are welcome!

Source: “GLP-1 Medications Just Got WHO’s Backing — Here’s The Part You Can’t Ignore,” mindbodygreen.com, 12/1/25
Source: “WHO backs wider use of weight-loss medicines, calling obesity a chronic disease,” UN.org, 12/1/25
Source: “WHO issues global guideline on the use of GLP-1 medicines in treating obesity,” WHO.int, 12/1/25
Image by Karola G/Pexels

The Problematic Core of Internal Family Systems

Obviously, aspects of Internal Family Systems (IFS) might prove elusive or difficult to grasp. Why are patients with eating disorders said to be exceptionally difficult to treat? Why do so many sources mention the particular suitability of IFS to treat eating disorders? And yet, why do some experts consider it an unsafe form of psychotherapy?

If the popular Internal Family Systems philosophy is quite possibly dangerous, or even simply misguided, inconsequential, or otherwise unworthy of attention, why devote so many words to it? Because it cannot be ignored. The number of adherents and practitioners is startling. This may be because, despite sounding perhaps unlikely, some of the basic notions are either familiar enough to be comfortable with, or unfamiliar enough to be intriguing.

Although the tenets are controversial, they are by no means original. For example, we noted how, several decades ago, the popularity of a particular book was able to dramatically increase public awareness of multiple personality disorder. Once the existence of a new malady is confirmed, the day inevitably comes when the public will “take that ball and run with it,” as the saying goes.

Age of Aquarius

Along came the Sixties, when huge numbers of young (and not-young) Americans tuned in to ancient ideas, and turned on to new ones. Our society has entertained some interesting notions and practices. Although Richard C. Schwartz did not suggest this, a case could even be made that the additional inner beings he posited might originate from previous existences.

Each “part” is like you, because they all are you, and yet each brings to the table its own concerns, talents, and traumas. Over thousands of years, millions of humans have accepted the concept of reincarnation. It would not be difficult to interpret those voices as echoes from one’s own successive physical presences on Earth.

We see how people might be persuaded that each human contains a whole crowd of entities, all with different and important roles. Even if we are unable to prove it with science, most of us have experienced the feeling of not being ourselves, as if another driver had metaphorically taken the wheel and steered us to a bad place. Still, it is a matter for concern that large numbers of professionals have climbed on board with the multiple personality premise, a theory that is, after all, not amenable to proof.

Not uncomfortable yet?

Strong objections have been voiced regarding a corollary of IFS dogma that many experts do not accept, or at least have limited enthusiasm for. This is the idea that most early-life trauma has to do with sex. For decades, that carnal connection was mostly associated with Freud. It is not difficult to see why, even within the professional realm, it might draw negative attention.

As journalist Rachel Corbett discovered, some therapists, reviewers, and patients have embraced (maybe too enthusiastically) the apparently extensive connection between eating/food issues and early sexual trauma. Patients tend to want to please their therapists, and when multiple interior beings are proposed, are perhaps too eager to find those “parts” within themselves.

Especially when the patients or clients are minors, emphasizing this view of things can attract unfavorable attention. Regardless of how severe the problem is, or even how logically obvious it might appear that some type of sexually-oriented trauma could be the root of it, no practicing therapist wants a lawsuit involving an underage individual.

Your responses and feedback are welcome!

Source: “Internal Family Systems and Eating Disorders: A Compassionate Approach to Recovery,” BalancedAwakening.com, 12/01/25
Image by SHVETS production/Pexels

What Makes Internal Family Systems So Special?

Our look at Internal Family Systems (IFS) reveals that this treatment method is considered particularly useful and effective vis-à-vis eating disorders. Today’s post provides some hints as to why, in the minds of many, that connection has been so strongly established.

After founder Richard C. Schwartz’s career had become established at Castlewood Treatment Center, at a later point, he was joined by Frank Anderson, co-author of the IFS Skills Training Manual. Anderson is credited with enhancing the basic IFS framework by integrating “neuroscience, psychopharmacology, and advanced trauma principles, especially for dissociation and developmental trauma,” thereby extending IFS into “a neurobiologically grounded trauma specialty.”

An insufficiently examined premise?

As previously mentioned, these pioneers found that most of the early-life traumas affecting the patients were sexual in nature, and they praised Castlewood for the institution’s policies that helped clients “heal the pain that underlies their eating disorders, rather than just manage the symptoms.” However, this approval was not universal.

As journalist Rachel Corbett recently mentioned, today’s medical community tends to believe that “eating disorders are no more linked to sexual abuse than they are other types of trauma”… or, for that matter, to unrelated genetic and/or environmental factors. Additionally, Corbett’s article, published last month, dropped these bombshells:

[T]he IFS Institute will have trained 15,000 therapists in the method by the end of this year, and another 5,000 are on a waiting list.

[…] and more than 45,000 mental-health practitioners in the Psychology Today database offer it as a treatment.

[T]he practice has exploded in social media. TikTok is flooded with millions of videos mentioning IFS, including those of people role-playing and analyzing their parts…

It comes as no surprise that some obesity experts suspect that there might be worrisome and potentially dangerous elements in a field over-saturated with IFA concepts. Some traditionalists are just not buying it and don’t care who knows.

A few random websites have been consulted to try and figure out what exactly the attraction is. Are the unorthodox ideas dangerous? What about the legal implications of accepting that each person embodies a whole crowd of amateur headshrinkers?

Poet Walt Whitman famously said, “I contain multitudes.” But is that true of everyone? What would he have thought of this possible over-identification with eating-disordered patients?

One of the general complaints mentioned by Corbett is that some therapists have far too enthusiastically embraced the whole multiple personality premise, and are inexplicably over-eager to encourage patients to discover multitudes of Parts inside themselves.

One technique recommended to patients is Guided Meditation, “which helps you invite Self-energy forward and engage with your Parts calmly.” These entities, of course, include the internal manifestations of the patient-as-victim at various ages, and also one or more of the patient’s self-rescuing guardian spirits.

In order to solve, for example, an attachment to overeating, some of the interior characters express their anxieties about life in general, while other “parts” or “alters” answer them, offering hope and reassurance, as well as tactical strategies to deal with specific situations.

Treatment or cult?

We will be looking at more of the reasons why many professionals feel uneasy about IFS. For one thing, there seems to be a near-universal opinion that “patients with eating disorders are among the most difficult to treat.” Meanwhile, here are additional words from Rachel Corbett’s research into what some researchers say:

[E]ven if high-functioning patients probably won’t develop multiple selves while exploring their “parts,” and plenty find it a helpful framework, it’s too untested a practice to be considered a safe form of psychotherapy… In the wrong hands, the potential for injury is higher.

Schwartz himself told the reporter that, even after more than three decades of research and thought, his own ideas about all of this are still evolving.

Your responses and feedback are welcome!

Source: “ Internal Family Systems (IFS) Therapy,” iptrauma.org, 07/04/25
Source: “The Therapy That Can Break You,” thecut.com, 10/30/25
Image by AlisaDyson/Pixabay

The Ins and Outs of Internal Family Systems

The therapeutic modality known as Internal Family Systems (IFS) has been closely associated with, and so presumably uniquely suited for, the treatment of eating disorders that cause obesity. This preference is exemplified by the literature from a facility called Koru Spring, whose clients are “women seeking treatment for an eating disorder while presenting with co-occurring conditions including substance use disorder.”

This institution’s main areas of concern are described as anorexia, binge eating, bulimia, and Other Specified Feeding or Eating Disorders (OSFEDs). Those OSFEDs include Atypical Anorexia Nervosa, Purging Disorder, Night Eating Syndrome, and Binge Eating Disorder Not Otherwise Specified. The causes are multifarious, including elements of biology, psychology, and the environment.

Substance vs. behavioral

In the overall picture of societal desire to eliminate obesity, there are two schools of thought. One group is more comfortable with the idea of food addiction as a substance issue, while the other philosophy tends to see eating addiction as a behavior issue. (Possibly, a person could have a combination of varying degrees of both.)

IFS is described as “a system of interconnected parts, each with distinct roles.” So, this would seem to imply a tendency to favor the eating/behavior definition. Who is doing the behavior? According to founder Richard C. Schwartz, there is a central Self, and then three main categories of beings, which can each include more than one “part.” There might be, for instance, a number of Exiles in there, each one representing a separate instance of abuse suffered at a different age.

An exact quotation is provided here for a reason, and with the relevant parts emphasized:

Managers: These parts attempt to control and protect by managing daily life and avoiding emotional pain.

Exiles: These parts hold deep-seated trauma and emotional wounds, often hidden away to prevent overwhelming the individual.

Firefighters: These parts act impulsively to numb or distract from pain when exiles are triggered.

The emphasized phrases sound familiar because they describe displacement activity, something Dr. Pretlow has often discussed. The most recent mention would be right up front in the first two screens of his video “Treatment of Eating Addiction and Obesity as Displacement Activity: a Pilot Study“(as presented to the 2025 International Conference on Obesity and Chronic Diseases in Boston earlier this month.)

The inner orchestra

As always, it is interesting to see the same phenomenon interpreted or described differently by different interest groups. For instance, from a website called “Introduction to Internal Family Systems,” we learn that one treatment goal is to “unburden your wounded parts from extreme beliefs, emotions and addictions” (which undoubtedly is a skill good for anybody in this mixed-up world to acquire.) The overriding hope, however, is to learn to…

Shift from the limiting “mono-mind” paradigm into an appreciation of your marvelous, multidimensional nature.

Schwartz has been fond of describing IFS as a way to smoothly conduct one’s “inner orchestra,” saying,

The Self is the conductor, and your Parts are the musicians. With teamwork, they create a beautiful symphony!… At the heart of IFS is the Self — the calm, compassionate core of who you are. The Self isn’t just another Part; it’s your essence. Think of it as your inner CEO, mediator, or wise guide.

So, the Self is likened not only to an orchestra conductor, but to a corporate Chief Executive Officer. (Or maybe even the all-wise and always-loving parent you never had.)

The Managers, as mentioned above, are Parts in charge of maintaining safety and avoiding pain, just like the older concept of generating some displacement activity with the intention of avoiding pain; as a threatened bird might do by taking flight, or by picking nits from its feathers.

A fascinating confluence

The Parts that Schwartz christened as Firefighters play the same protective role as animal displacement activities like feeding. If a threatened creature adopts a casual, fearless attitude and begins to feed, it is just possible that the enemy could actually experience what humans call FOMO, or Fear Of Missing Out. That aggressor might be fooled into believing that some bounty is concealed in the grass, meaning that it should allow itself to be distracted from hostility, stop threatening the designated enemy, and get busy claiming its share of free food.

The inner beings Schwartz called Exiles are versions of the afflicted person, broken off and frozen in time, exactly as they were, years or decades in the past, when some outrageous wrong was done to them. They still don’t know how to escape or defend themselves, and the job of the Managers and Firefighters is to conceal and protect those wounded spirits. The object of IFS is to provide not just symptom management, but actual deep healing.

(To be continued…)

Your responses and feedback are welcome!

Source: “OSFED — What To Know About Other Specified Feeding or Eating Disorders,” KoruSpring.com, undated
Source: “How Internal Family Systems (IFS) Can Transform Eating Disorder Recovery,” KoruSpring.com, 08/06/24
Source: “9th International Conference on Obesity and Chronic Diseases (ICOCD-2025),”
HealthManagement.org, undated
Source: “Introduction to Internal Family Systems,” IFS-Institute.com, undated
Source: “Internal Family Systems: Comprehensive Guide to the Model, History & Applications,”
IFSGuide.com, undated
Image by gdakaska/Pixabay

GLP-1 Medications Get a Major Price Drop As New Research Highlights Benefits for Youth

The cost of two of the most widely discussed GLP-1 medications — Wegovy and Ozempic — is about to drop significantly. Novo Nordisk, the Danish pharmaceutical company behind both drugs, announced that beginning on Monday, November 24, the cash price for each medication will fall by 30%, lowering the monthly cost from $499 to $349 for people paying out of pocket.

The new prices will take effect at 70,000 retail pharmacies across the United States, including major chains such as Walmart and Costco. These reductions apply to customers who choose to self-pay or who lack insurance coverage for GLP-1 therapies.

Dave Moore, executive vice president at Novo Nordisk, emphasized the company’s commitment to expanding access:

As pioneers of the GLP-1 class, we are committed to ensuring that real, FDA-approved Wegovy and Ozempic are affordable and accessible to those who need them. […] Our new savings offers provide immediate impact, bringing forward greater cost savings for those who are currently without coverage or choose to self-pay.

Moore also noted that the price reduction is part of a broader strategy that includes collaborating with telehealth providers, expanding insurance coverage options, and working with U.S. officials to improve affordability for people living with chronic conditions like obesity and type 2 diabetes.

Notably, the previous cash price for Wegovy aligned with the cost of a full dose of Zepbound, a direct competitor from Eli Lilly. With GLP-1 demand still at an all-time high, the price shift marks a significant move in an increasingly competitive market.

High blood pressure in children has doubled

While access to GLP-1 medications is improving, new research reveals troubling trends in children’s health. A comprehensive global review published in The Lancet Childhood & Adolescent Health found that the rate of high blood pressure in children has doubled over the past two decades.

By analyzing data from 443,914 children worldwide, researchers discovered that the prevalence of pediatric hypertension rose from 3% in 2000 to 6% in 2020, now affecting an estimated 114 million children. The authors warn that this surge “should raise alarm bells,” especially given the long-term risks high blood pressure poses for cardiovascular health.

The rise in childhood hypertension parallels other concerning trends, including earlier onset of obesity and type 2 diabetes — conditions increasingly seen in adolescents.

New study shows GLP-1s outperform metformin in adolescents

Adding to the evolving conversation around youth metabolic health, a new real-world study shows that advanced GLP-1 therapies may offer major advantages for adolescents newly diagnosed with type 2 diabetes.

The study, published in the Journal of Pediatric Endocrinology and Metabolism, compared the effectiveness of metformin, a long-standing first-line treatment, with newer GLP-1-based therapies such as semaglutide (the active ingredient in Ozempic and Wegovy) and the dual GIP/GLP-1 agonist tirzepatide (found in Zepbound and Mounjaro).

Key findings include: GLP-1 therapies provide similar glycemic control to metformin but deliver superior weight-loss benefits, which can be critical for managing early-onset type 2 diabetes.

What these developments could mean

Together, these updates paint a multifaceted picture. For one, lower GLP-1 prices may increase access for adults who have struggled with obesity or diabetes but lack adequate coverage. Second, rising childhood hypertension highlights the growing urgency of addressing youth metabolic health. Third, new GLP-1 research in adolescents suggests that more effective early interventions may soon be on the horizon.

We can only hope that as the cost of treatment falls and evidence for early, more comprehensive care grows stronger, the landscape of metabolic health is poised for rapid change across all ages.

Your responses and feedback are welcome!

Source: “Poll: 1 in 8 Adults Say They Are Currently Taking a GLP-1 Drug for Weight Loss, Diabetes or Another Condition, Even as Half Say the Drugs Are Difficult to Afford,” KFF.com, 11/14/25
Source: “GLP-1 drugs beat metformin for weight control in teens with type 2 diabetes,” News-Medical.net, 11/10/25
Image by Pavel Danilyuk/Pexels