Barr Taylor, psychiatrist who developed evidence-based interventions for eating disorders, dies at 78

Craig Barr Taylor, MD, professor emeritus of psychiatry and behavioral sciences, known for identifying risk factors for anxiety and eating disorders and developing evidence-based interventions for a variety of mental health conditions, died Nov. 30 from complications following a heart attack. He was 78.

Taylor, who went by Barr, was a standout mentor whose kindness, generosity, quirky good humor and lifelong curiosity served as a north star for generations of mentees.

“Barr Taylor’s wide-ranging contributions to our understanding of mental disorders, especially in the prevention of and early intervention for eating disorders, has bettered the lives of countless patients,” said Lloyd Minor, MD, dean of the Stanford School of Medicine and vice president for medical affairs at Stanford University. “He continues to be an inspiration for his colleagues and trainees who, in challenging times, still ask, ‘What would Barr do?’”

Taylor was at the forefront of many developments in his field — taking a community-based, public health approach to psychiatry; emphasizing evidence-based practice guidelines; and creating digital interventions to reach more people.

“He had a can-do attitude about working in the community, which at the time was not common in psychiatric research,” said Chris Hayward, MD, professor of psychiatry and behavioral science, who, as a resident and postdoctoral fellow in the 1980s, worked with Taylor on school-based interventions to prevent psychiatric illness.

More recently, Taylor focused on low-cost, population-level online screenings and interventions for anxiety, depression and eating disorders in college students. As a result of his work, all students in Missouri’s public universities are now offered the online Healthy Body Image Program.

But Taylor rarely took the spotlight for himself, preferring to boost younger researchers.

“Barr encouraged you to meet your full potential,” said Bruce Arnow, PhD, professor of psychiatry and behavioral sciences, who was a PhD student in the early 1980s when he met Taylor, then an assistant professor and a reader on his dissertation committee.

Just a few years later, Taylor asked Arnow to co-author a textbook on anxiety — The Nature and Treatment of Anxiety Disorders, published in 1988. “At that point in my career, not very far out of my PhD, to think that I could produce something like that seemed like a big stretch,” Arnow said. “But Barr was very encouraging and supportive of my ability to do this. That was a very important experience.”

A ‘zany guy’

Taylor was born June 8, 1945, in Salt Lake City. His father was an attorney and his mother a poet and a pacifist who chose to raise her two sons as atheists over remaining in a church community that supported the Vietnam War.

Artistic and widely read, Taylor studied art history at Columbia College and was offered a scholarship to continue his studies in art history at the Uffizi Gallery in Florence — a career path his father deemed not “professional.” Instead, Taylor applied to medical school and chose the University of Utah so he could live at home, allowing him to avoid debt and to help his mother, who had polio and used a wheelchair. 

In 1968, when Taylor was in medical school, he met Suesan Westwood, an undergraduate at the University of Utah, at a friend’s house. “There’s this tousle-headed guy at the door,” she recalled. “Barr was six-one; never tucked in his shirt; wore baggy pants, and, unusual for the time, round horn-rimmed glasses.” He was delighted when he found out she was writing a paper on the D.H. Lawrence poem “Snake.” “He slid onto the couch next to me and goes through every single line of that poem — and what it said about the guilt of wanting to be a man but wanting to be a pacifist. It was great,” she said. “He was a pretty zany guy.”

Five weeks later, after running into each other a few more times at parties and peace marches, the two married in an aspen grove in Little Cottonwood Canyon south of Salt Lake City.

In 1969, as Taylor was about to begin his residency at Stanford University, he was drafted. As a conscientious objector, he was prepared to wash dishes somewhere for two years to fulfill his alternative service. But one of his medical school professors offered him the opportunity to set up a mental health program serving the Four Corners region, where Utah, Colorado, Arizona and New Mexico meet. For two years, Taylor traveled 600 miles a week, working with Native American communities to create one of the nation’s first rural mental health programs.

After his residency, he took an assistant professorship at the University of Utah College of Medicine before returning to Stanford as an assistant professor in 1977. He became full professor in 1991.

He saw patients throughout his career, while also serving as the director of the Laboratory for the Study of Behavioral Medicine from 2000 to 2015 and director of the Anxiety Disorders Clinic from 2010 to 2015. He led the psychiatry residency program from 1995 to 2010.

Making a difference

In his nearly four decades at Stanford Medicine, Taylor studied a broad range of psychiatric conditions and their relationship to environment, biology and especially behavior.

“He felt that changing behaviors changed mindset and made for a much healthier outlook on life,” his wife said.

For example, he studied the effect of dieting behavior, body image and television viewing on obesity in adolescents; the effect of antidepressants on the survival of depressed patients after heart attack; and the effect of exercise on stress and anxiety in older adults.

“The range of his interests and his ability to bring to bear his intellectual gifts to contribute in those different areas was so impressive,” Arnow said.

Taylor loathed hierarchy and took a genuine interest in the personal aspirations and professional advancement of his mentees. As a leader, he was down-to-earth, enthusiastic, optimistic and kind. He was known for his plain sweatshirts and a signature phrase, “Right-o!” which he used to gently move a discussion along.    

He was always open to new ideas and could turn ideas into action.

“He created digital interventions in the ’90s as soon as the internet was broadly available to people,” said Smita Das, MD, PhD, clinical associate professor of psychiatry and behavioral sciences, who met Taylor as an undergraduate when she took a data-entry job in his lab. From panic disorder therapy conducted on Casio PB-1000 handheld computers to eating disorder treatment delivered through smartphone app, these digital interventions often proved to be more successful and accessible than in-person interventions.  

“Because of his influence, I decided to pursue a research career and eventually decided to also become a psychiatrist,” she said.

Taylor continued to serve as a mentor to Das when she went to graduate school and medical school at other institutions. “I’d come back over the holidays, and he was so interested in learning everything he could about what I was learning,” she said. When she was earning her master’s in public health, she told him about measurement-based care, which involved systematically tracking a patient’s progress to inform treatment.

“He was so academically driven that he did a lot of research into this,” Das said. “And the next thing I knew, he had put together the first book on how to practice evidence-based psychiatry — something that’s cool now, but ahead of its time then.” Traditionally, psychiatry relied on clinical expertise and an idea that much of psychotherapy was unquantifiable. The aim of evidence-based psychiatry is to combine clinical expertise with the latest research and practice guidelines and to measure a patient’s progress toward treatment goals.

“Wherever his interests went, he brought a strong commitment to making a difference,” Arnow said.

Fun, fish and frogs

Taylor pursued broad interests outside of medicine. He was an avid fly fisherman beginning in boyhood. He and his older brother, Brooke, took annual fishing trips to New Zealand. He painted throughout his life — with his wife while traveling, with his twin granddaughters — producing mostly watercolor landscapes, some portraits and the occasional political caricature.

He was passionate about the environment and climate change. (He once gave a grand rounds on climate change to the Department of Psychiatry and Behavioral Sciences.) In 2021, he wrote and illustrated a novella — Philius Frog Saves the World — about a reclusive, NPR-loving, opera-singing frog who sets out to find a cure for the deadly fungus decimating his kind. 

Taylor retired from Stanford in 2015 but continued his research as emeritus professor and later as a research professor at Palo Alto University. He was past-president of the Society of Behavioral Medicine and an elected member of the Norwegian Academy of Sciences and Letters.

He authored over 400 peer-reviewed publications, more than 50 book chapters, and several books for professional and lay audiences. In recent years, he published papers on virtual reality therapy for social anxiety disorder and chatbots to prevent eating disorders.

For years, he ran a heart disease prevention program with Bob Debusk, MD, cardiologist and professor emeritus of medicine, designing community-based interventions to encourage heart-healthy behavior.

In the hospital, after his heart attack — his mind still sharp but unable to speak because of a tracheostomy — Taylor scribbled on a little whiteboard: “Bob will get a laugh out of this.”

Taylor is survived by his wife, Suesan; his daughter, Megan; and twin granddaughters.