Beyond the Plate: Exploring the Intersection Between Nutrition and Mental Health at The Emily Program with Jackson Knox

Hello everyone! My name is Jackson Knox, and I am a senior at the University of North Carolina at Chapel Hill majoring in neuroscience with minors in chemistry and food studies from Rutherfordton, NC. This semester, I have had the opportunity to serve as a Gil Intern at The Emily Program, an eating disorder treatment center in Durham, North Carolina. As a clinical therapy intern, I work directly with patients navigating the complex challenges of eating disorder recovery. From supporting patients during meals to participating in cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and individual, group, and family therapy sessions, I have gained an appreciation for the interdisciplinary approach required to treat these complex conditions. However, one of the most meaningful lessons I have learned is that eating disorders extend far beyond food. They are serious, potentially life-threatening conditions that affect nearly every aspect of an individual's physical and psychological well-being. My experience at The Emily Program has challenged me to look beyond the visible manifestations of disease and consider the complex biological, psychological, and social factors that influence a patient's health and recovery.

Where My Interest in Nutrition Began

My interest in nutrition and its relationship with health began long before I considered pursuing a career in medicine. At 11 years old, I was diagnosed with Crohn's disease, a chronic inflammatory condition affecting the gastrointestinal tract. Throughout my childhood, I became familiar with gastroenterology appointments, medications, flare-ups, and conversations about the relationship between diet and disease. These experiences introduced me to the importance of nutrition in managing chronic illness and shaped my understanding of how closely our daily lives are intertwined with our health.

Growing up in a rural, medically underserved community in western North Carolina further shaped my perspective. I became increasingly aware that access to nutritious food and healthcare is not equally distributed, and that these disparities can profoundly influence health outcomes. This understanding inspired me to pursue a minor in food studies and explore the broader social and structural factors that influence nutrition. Through coursework at the UNC Gillings School of Global Public Health, I have developed a deeper understanding of food insecurity, nutritional disparities, and the role of food systems in shaping health. Outside the classroom, volunteering with UNC's Flourish program at the Student Health Action Coalition (SHAC) has allowed me to help provide fresh, nutritious food to patients facing barriers to food access.

Together, these experiences have reinforced a belief that continues to guide my interests in medicine: nutrition is not simply a matter of individual choice, but an essential component of health shaped by biological, social, and environmental circumstances.

Understanding the Connection Between the Brain and Body

While my personal experiences sparked my interest in nutrition, studying neuroscience introduced me to another dimension of human health: the remarkable complexity of the brain. During my freshman year, Introduction to Neuroscience opened my eyes to how much remains unknown about the organ responsible for our thoughts, emotions, behaviors, and perceptions. I became fascinated by the opportunity to explore questions that scientists are still working to answer, particularly those concerning the relationship between the brain and the rest of the body. This curiosity led me to join Dr. Scott Williams' laboratory, where I conducted research under the mentorship of Dr. Kendall Lough. Our work explores the gut-brain axis, focusing on how sensory information from the gastrointestinal tract is communicated to the nervous system. Through investigating the role of brain-derived neurotrophic factor (BDNF) in the development of gut-brain connections, I have gained experience in scientific research while developing a deeper appreciation for the intricate communication between our physical and neurological systems.

My understanding of this relationship has also developed through my work as a medical scribe with the Adult Consultation-Liaison Psychiatry service at UNC Hospitals. In this role, I have observed how psychiatric conditions can complicate the treatment of physical illness and how medical conditions can influence psychological well-being. I have witnessed the importance of addressing depression, anxiety, motivation, sleep, and other psychiatric symptoms as part of a patient's broader medical recovery.

These experiences have demonstrated that physical and mental health cannot always be understood or treated independently. Rather, they are deeply interconnected, requiring clinicians to consider the whole person rather than an isolated diagnosis.

Beyond the Plate: My Experience at The Emily Program

My interests in nutrition, neuroscience, and mental health ultimately led me to The Emily Program, where these fields intersect in ways I had previously only explored through coursework, research, and clinical observation. Eating disorders illustrate just how deeply connected our physical and psychological health can be. Although nutrition is central to treatment, recovery involves much more than restoring adequate food intake. It requires addressing the thoughts, emotions, behaviors, and experiences that shape an individual's relationship with food and their body. As a clinical therapy intern, I have the opportunity to observe and participate in multiple aspects of this process. I regularly attend therapy sessions, facilitate conversations with patients, provide support during meals, and learn from an interdisciplinary team of healthcare professionals, especially my supervisor, Emily Dolegowksi. Each of these experiences has helped me better understand the challenges patients encounter throughout recovery and the importance of individualized, compassionate care.

One particularly meaningful aspect of my internship has been spending time on the Center of Excellence unit, which is the only residential and inpatient treatment center for adults with avoidant/restrictive food intake disorder (ARFID) in the U.S. Unlike eating disorders commonly associated with concerns about body image or weight, ARFID can involve sensory sensitivities, fear of adverse consequences from eating, or limited interest in food. Learning about this condition has challenged some of my previous assumptions about eating disorders and reinforced the importance of recognizing the diverse ways these conditions can present.

Through my experiences at The Emily Program, I have developed a newfound appreciation for the severity and complexity of eating disorders. Behaviors that may appear straightforward from an outside perspective can reflect deeply rooted psychological distress, sensory challenges, and other factors that require patience, understanding, and specialized treatment. Perhaps most importantly, I have come to recognize that recovery is not simply about changing what someone eats. It is about helping individuals rebuild their relationship with food, regain confidence, and develop the tools necessary to reclaim their lives.

Looking Beyond the Diagnosis

As I prepare for a future career in medicine, my experience at The Emily Program has strengthened my understanding of what it means to provide comprehensive, patient-centered care. My journey began with an interest in how nutrition affects physical health, expanded into studying communication between the gut and brain, and has now brought me into a clinical environment where the relationship between mental and physical health is central to treatment. I have learned that effective care requires more than understanding disease mechanisms or identifying appropriate interventions. It also requires listening to patients, recognizing the challenges they face beyond their diagnoses, and appreciating the many factors that influence their ability to recover.

I am incredibly grateful to The Emily Program, my clinical supervisors—Emily Dolegowski and Jennifer Castro, and the UNC Gil Internship Program for providing an opportunity to explore these interests in a meaningful clinical setting. The knowledge and perspectives I have gained will continue to influence how I approach medicine, regardless of the specialty I ultimately pursue. My greatest takeaway is that treating disease and caring for a person are not always the same thing. Meaningful healthcare requires both.