The Eating Disorder Recovery Podcast: Recent Episodes
Tabitha Farrar
I've not written a blog for months. I've been moving house, had little internet connection, and been generally busy, and tired. I'm glad that this past couple of weeks I had felt like I have the time and space to start writing again, so there will be blogs to come, soon.
I wanted to put something down to express my gratitude for all of you who have listened to and supported my podcast over the past three years. I didn't think that it would go anywhere, or that anyone would really listen to it. Well, you did. So thank you.
I've had such support for the podcast, that I feel extremely guilty about announcing that I will not be producing any more episodes. But, as I discovered in the last 6 months or so, feeling guilty about stopping is not a good enough reason to keep going. I'd rather than stop completely than keep it going, but only publish episodes sporadically.
Podcasts are a lot of work. Finding people to interview, scheduling interviews, and editing audio after interviews. If I am quick, an episode may take 6 hours start to finish (including scheduling etc), but many episodes take more like 10.
It is a time thing. It's not that I don't have time. I can always make time. These days, my "free" time — time to do absolutely nothing productive at all — is increasingly precious and glorious to me. I am growing less inclined to give it up. I'm more selfish about my time — unapologetically, I enjoy that I enjoy being just me, without being the 'doing stuff' me.
This 'wanting to do nothing' is actually exactly something that scared me when I had anorexia. I was scared that if I allowed myself to rest, I would always want to rest. I would forget how to be productive. My 'value' would decrease. Because when I was sick, I thought my value was in my ability to never rest, and always be productive. (Which, if you think about it, in a famine, would be about right.)
The wonderful thing about being human in a brain that doesn't have anorexia any more, doesn't perceive that resources are scarce, and therefore doesn't believe that value is in productivity, is that I have the freedom to see the real value of being human. I know that sounds incredibly deep and ridiculous, but it is true.
The other night, I was going to make this podcast. I had an hour or so. I was making my way up my back porch steps, and one of the puppies followed me up and "pawed" me on the leg, asking for attention. Years ago, when my value was in being productive, I either wouldn't have noticed him, or I would have noticed him, and gone inside anyway. These days, I'm more inclined to sit on the floor and play with the dogs because they asked than I am to go inside and start editing audio. Sometimes it is a puppy. Sometimes it is a horse. Sometimes it is a pattern that the wind has made in the snow that I need to stare at. Sometimes, very often, it is snuggling with Matt.
I never take for granted my recovered brain. A brain that allows me to see the value in happiness, and being human. Never, ever, take it for granted. I feel blessed to have known a brain in starvation mode, if only because it allows me to know the bliss of not being there.
Anyway. That's my way of saying there will be no more podcasts. Just because it is the right time to stop. I appreciate you for listening.
In this podcast Tabitha talks to Donna about her experience of bariatric surgery and eating disorder recovery
The social importance of food
Blog post: https://tabithafarrar.com/2019/09/food-is-so-much-more-than-just-nutrition-by-design/
This week, Tabitha talks to peer mentor JD Ouellette about experts by experience and peer mentoring in the eating disorder field.
JD Ouellette is a peer coach with a specialty in "Full Metal Apron" Eating Disorders Parent coaching. She is the mother of a young adult in full recovery and living a relapse-prevention lifestyle. JD works globally with families who have a loved one of any age impacted by an eating disorder on education, system navigation, boundaries to support full recovery, and interventions. Having experienced cutting edge treatment at the UC San Diego Eating Disorders Center for Treatment and Research, she understands that families who receive comprehensive psychoeducation and specific skills training can make all the difference in the outcome.
Warning: This episode may be difficult or triggering for some listeners. It involves talking about a person who recently died of anorexia.
In this podcast, Tabitha talks about a person who recently died as a result of the malnutrition associated with anorexia.
Sarah was a joyful, incredibly like-able, intelligent woman with a good sense of humour. She came to me as a client, and someone determined to recover. She was also a person who had been through 30 years of traditional treatment, but never lost hope in her ability to get well. Sarah wasn't non- compliant, she was the opposite of difficult, and she was on her way and actively in recovery when she died. Apparently, a lifetime of malnutrition had resulted in a weak heart, and it was too little too late. Sarah was truly let down by the traditional treatment model. The tragedy is that at the time of her death, she was at the best place she had been for years. Sarah didn't die in the way we stereotypically expect people with anorexia die in a IP bed rejecting food. Sarah was eating better, feeling better, and actively living her recovery when she died.
The effects of malnutrition are serious and can be long-lasting. Treatment has to prioritise unrestricted eating, and spreading the message that hunger and desire to eat can be trusted.
In this podcast, Tabitha takes to the wonderful Dr Jennifer Gaudiani about trans and non-binary individuals in eating disorder treatment.
The Gaudiani Clinic provides superb expert outpatient medical care to adolescents and adults of all sizes, shapes, and genders with eating disorders or disordered eating. The Gaudiani Clinic also offers comprehensive person-centered care to those who are recovered from an eating disorder. Through a collaborative, communicative, multi-disciplinary approach, the Clinic cares for the whole person, in the context of their values.
Under the care of Jennifer L. Gaudiani, MD, CEDS, FAED, patients receive expert medical care provided in a comfortable and highly discreet private practice setting. Dr. Gaudiani is one of the only outpatient internists in the United States who carries the Certified Eating Disorder Specialist designation and is internationally recognized as an expert in the eating disorder field. In her role as an expert outpatient medical doctor, Dr. Gaudiani can function as a patient’s primary care physician or as an expert adjunctive physician as part of a multidisciplinary team.
The Gaudiani Clinic is located in Denver, Colorado with both local and telemedicine treatment plans available.
Dr. Gaudiani also offers professional services including private and group consultation, professional webinars, and presentations.
Jen's book on Amazon: https://www.amazon.com/Sick-Enough-Jennifer-L-Gaudiani-dp-0815382456/dp/0815382456/ref=mt_paperback?_encoding=UTF8&me=&qid=1553546290
Clinic: www.gaudianiclinic.com
In this podcast Tabitha Farrar talks to Dr Cynthia Bulik about recent study that identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa.
Link to paper: https://www.nature.com/articles/s41588-019-0439-2
Dr. Bulik, a clinical psychologist, is Distinguished Professor of Eating Disorders in the Department of Psychiatry, professor of nutrition in the Gillings School of Global Public Health and founding director of the UNC Center of Excellence for Eating Disorders.
She is also professor of medical epidemiology and biostatistics at Karolinska Institutet in Stockholm, Sweden, where she spends half of her time.
Her research includes treatment, laboratory, epidemiological, twin and molecular genetic studies of eating disorders and weight regulation. She has written more than 590 scientific papers and chapters on eating disorders and is the author of Crave: Why You Binge Eat and How to Stop, The Woman in the Mirror, Midlife Eating Disorders: Your Journey to Recovery, and Binge Control: A Compact Recovery Guide.
She is a recipient of the Eating Disorders Coalition Research Award, the Academy for Eating Disorders' Leadership Award for Research, the Price Family National Eating Disorders Association Research Award and the Women’s Leadership Council Faculty-to-Faculty Mentorship Award.
Dr. Bulik is past president of the Academy for Eating Disorders, past vice-president of the Eating Disorders Coalition and past Associate Editor of the International Journal of Eating Disorders. She holds the first endowed professorship in eating disorders in the United States.
Her academic life is balanced by being happily married with three children and performing as an ice dancer and ballroom dancer.
In this podcast, Tabitha answers the question "What are your thoughts on the term Atypical Anorexia?"
Dannielle B. Grossman is a California licensed marriage and family therapist in private practice in Truckee, California. She also works by phone and FaceTime with clients throughout California.
Danielle understands that food deprivation and fear responses around eating are at the core of all eating disorders and disordered eating patterns. She helps clients to truly get it that their struggles with food are not their fault and do not mean ANYTHING negative about them. It is a powerful and empowering shift when clients can observe that their patterns with eating are simply their brainbodies doing their job to ensure survival amidst real or perceived threats to getting the food they want or need. Then, the work of therapy is getting out of this chronic threat mode with eating by developing patterns with food that are based in full nourishment, unconditional permission to eat and an ability to honor all signals of hunger. Danielle’s work is based in compassion, an understanding of trauma and survival responses and current science in the fields of weight stigma and eating disorders. truckeecounseling.com.
In this podcast, Tabitha Farrar talks to Jennifer Thomas and Kamryn Eddy about their new book on ARFID.
-Cognitive-behavioral therapy for avoidant/restrictive food intake disorder patient/family workbook (free) — https://www.cambridge.org/files/1015/4408/8646/CBT-AR_workbook_12.4.18.pdf
-Cognitive-Behavioral Therapy for Avoidant/Restrictive Food Intake Disorder: Children, Adolescents, and Adults (Cambridge University Press, 2019) — https://www.amazon.com/Cognitive-Behavioral-Therapy-Avoidant-Restrictive-Disorder/dp/1108401155/ref=sr_1_2?ie=UTF8&qid=1542036242&sr=8-2&keywords=cognitive+behavioral+therapy+for+avoidant%2Frestrictive+food+intake+disorder&dpID=41PGcm%252BEHuL&preST=_SX218_BO1,204,203,200_QL40_&dpSrc=srch
-Fudo app (free) — https://www.novosi.com/fudo
-Study on reward and flexibility in restrictive eating disorders or amenorrheic athletes (research participation opportunity for females ages 16-26 years old who have amenorrhea) —anereact@mgh.harvard.edu
-Neurobiology of ARFID study (research participation opportunity for males and females ages 10-22 years with or without avoidant/restrictive eating)— CAREstudy@partners.org
In this podcast Tabitha talks to B, a guy who totally didn't have anorexia ... but probably did! B thought of himself as a normal guy, doing normal things: obsessively tracking calories, running absurd distances, and hiding in closets to avoid being invited to lunch. After an incident involving a blog post, evolutionary biology, and a semi-anonymous e-mail exchange, he did the normal thing: he researched and wrote a guide on anorexia recovery, and then started following it. Study cited: https://www.researchgate.net/profile/Stephanie_Klenotich/publication/220016913_The_Activity-Based_Anorexia_Model/links/0a85e52d80de043a13000000.pdf "The no-nonsense guide for people who think they might have an eating disorder" is at http://nononsenseguide.net
In this podcast Tabitha Farrar talks to David Wiss about eating disorders co-occurring with substance abuse.
David Wiss, MS, RDN is the founder of Nutrition in Recovery, which specializes in: Addictions, Eating Disorders, Mental Health, Gut Health, Body Image, and General Wellness. Mr. Wiss works closely with individuals to help them revolutionize their relationship with food and has shared his expertise with numerous eating disorder and addiction facilities throughout the greater Los Angeles area. David is a published author and a nationally recognized expert in nutrition for addiction, currently working on his PhD in Public Health from UCLA. View some of his work at www.nutritioninrecovery.com
In this podcast, Tabitha Farrar talks about how eating disorder change our beliefs and values, and how recovery also changes these aspects.
Podcast dedicated to "Mary." I miss you.
In this podcast Tabitha talks to Dr Gaudiani about what happens to the muscular system when a person is in recovery from and eating disorder and/or malnutrition as a result of dietary restriction.
Jen's book on Amazon: https://www.amazon.com/Sick-Enough-Jennifer-L-Gaudiani-dp-0815382456/dp/0815382456/ref=mt_paperback?_encoding=UTF8&me=&qid=1553546290
Clinic: www.gaudianiclinic.com
In this podcast Tabitha Farrar talks to Hannah, about eating disorders and cerebral palsy.
Tabitha's note: I have worked with a number of clients with anorexia who also have cerebral palsy. The aspects of body image and body control justification that Hannah speaks of in this podcast I have witnessed in every client I have worked with who also have cerebral palsy. That's not to say it exists in all, but certainly people with disabilities are very under-represented in eating disorder treatment and advocacy.
In this podcast, Tabitha Farrar has a discussion with Shan Guisinger — author of the Adapt to Flee Famine paper — about the biological fear of eating response.
In this podcast, Tabitha talks to "S" an 11-year-old in recovery, about his recovery journey, and his desire and motivation to get well.
In this podcast, Tabitha Farrar talks to Dr Trisha Greenhaugh about the paper titled Six ‘biases’ against patients and carers in evidence-based medicine."
Link to paper: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4556220/
This week Tabitha talks to Sarah Rzemieniak, a fellow recovery coach who has recovered from an eating disorder herself. Sarah Rzemieniak previously worked as an eating disorder dietitian before recognizing that her true passion was in the coaching and counselling aspect of the work. She then became a certified eating disorder recovery coach through The Carolyn Costin Institute, where she was supervised and trained directly under Carolyn Costin, eating disorder therapist, author, and founder of Monte Nido residential treatment centers. Sarah is now an eating disorder recovery coach with The Eating Disorder Center, providing virtual recovery coaching services worldwide. She also co-leads an eating disorder support group in Victoria, BC, and has past experience serving as an eating disorder recovery mentor through MentorConnect, as well as working as a hotline staffer for The Crisis Intervention and Suicide Prevention Centre of BC. Sarah has been interviewed and has written about eating disorder recovery for Psych Central Professional, Thrive Global, The Looking Glass Foundation for Eating Disorders, The Eating Disorder Recovery Speakers Podcast and Real Health Radio. She was a featured contributing expert to the book, Thrive: Expert Tips For Coping With Depression and An Eating Disorder. And my blog is: https://sarahrzemieniak.com/blog/ Favourite books page: https://sarahrzemieniak.com/favourite-books/ Recovery coaching website: https://www.theeatingdisordercenter.com/sarah-rzemieniak-eating-disorder-recovery-coach.html
New Year 2019.
In this podcast, Tabitha talks about her own recovery, and why wanting to recover isn't enough.
In this podcast you will hear an audio recording of an account of a treatment facility from a person in recovery.
In this week's podcast, Tabitha talks to Ari Snaevarsson about bodybuilding, gyms, and his perspective on how the fitness culture influences people with eating disorders. Bio Ari Snaevarsson is a certified nutritionist* who has worked a great deal with disordered eating clients. He also works as a counselor and dietetic technician at a residential treatment center for eating disorders. Coming from a background of competitive bodybuilding, Ari has himself recovered from an eating disorder marked by severe restrict-binge cycles. Ari is devoted to helping those struggling to escape the prison of food anxiety and body hatred.
Links: My site (100 Days of Food Freedom): https://www.100doff.com/ My book (same name): http://a.co/d/di06NLF
In this podcast episode, Tabitha talks to a person in recovery about past treatment experiences, and how these led to this person being taught that unrestricted eating was a thing to avoid at all costs.
In this podcast, Tabitha talks to a person in recovery who shares some information about how treatment has made her even more confused about how to eat.
It is important that people in recovery are encouraged to listen to their bodies and eat what they want to eat.
In this podcast, Tabitha speak a little on the topic of full recovery, and what mental state and other markers may look and feel like.
In this podcast, Tabitha Farrar talks to Bridget Whitlow about weighing in recovery Bridget Whitlow, MS, LMFT is a licensed psychotherapist that provides psychotherapy for adolescent and adult individuals, couples, families, and groups. Bridget has clinical expertise in the treatment of anxiety, eating disorders, obsessive-compulsive disorder, LGBTQ, and self-criticism. To learn more about her please visit: http://www.bridgetwhitlow.com/about/
In this podcast, Tabitha talks to Dr Jennifer Gaudiani about her new book "Sick Enough."
Introduction
Part One: Not Enough Calories
- 30,000 Foot View: What happens when you starve yourself?
- Going into Hibernation
- Hormones and Bones
- The Empty Tank
- Extreme Presentations
- Starting to Eat Again
Part Two: Purging
- 30,000 foot view: What is Purging, and Why Does it Cause Medical Issues?
- What Happens to the Body Physically?
- Electrolytes and Stopping Purging
Part Three: Binge Eating Disorder and Weight Stigma
- Binge Eating Disorder (BED)
Part Four: The Unmeasurables
- Irritable Bowel Syndrome and Associated Conditions
- Postural Orthostatic Tachycardia Syndrome (POTS) and Associated Conditions
Part Five: Specific Populations (A Series of Short, Case-Based Chapters)
- Type 1 Diabetes Mellitus (DMT1) and Concurrent Eating Disorders
- Avoidant Restrictive Food Intake Disorder (ARFID)
- Orthorexia
- Elite Athletes
- Male Patients
- Gender and Sexual Minorities
- Women’s Sexual and Reproductive Health
- Older Patients
- Comorbid Substance Abuse
- Caring for the Patient Who Declines Treatment: The Spectrum from Mandated Treatment to Hospice Care
Conclusion
https://www.amazon.com/Sick-Enough-Medical-Complications-Disorders/dp/0815382456/ref=sr_1_1?ie=UTF8&qid=1537389096&sr=8-1&keywords=gaudiani
In this podcast Tabitha Farrar talks to Dr Adele LaFrance about Emotion Focused Family Therapy in eating disorder treatment.
Links to resources:
www.emotionfocusedfamilytherapy.org www.mentalhealthfoundations.ca/resources
http://www.mentalhealthfoundations.ca/ed-parent-webinar https://www.edcatalogue.com/emotion-focused-family-therapy-eating-disorders/
In this podcast, Tabitha Farrar talks about emotional eating, and why it isn't really a thing
In this podcast Tabitha Farrar explains why she believes that neural rewiring is a crucial and often not understood aspect of achieving full recovery from a long-term restrictive eating disorder such as anorexia nervosa, bulimia nervosa, binge eating disorder.
In this week's podcast, Tabitha talks Sophia — a person currrently in recovery — about medical use of cannabis in recovery from anorexia.
This weeks podcast is a conversation with Aimee Becker on recovery, connection, and advocacy
Aimee Becker is the Chief Operating Officer of the Gaudiani Clinic. She spent 10 years dedicating herself to developing the infrastructure for Monte Nido & Affiliates. Inspired to join the field through her own recovery, Aimee joined Carolyn Costin when Monte Nido was only a six bed residential facility, as the Program Coordinator. Progressing to Director of Operations and then Chief Compliance Officer, Aimee oversaw Monte Nido & Affiliates’ expansion into six states. In addition to her strong commitment to superb programmatic and operational functioning, Aimee developed a deep engagement with the therapeutic values and processes inherent to the world of eating disorder treatment. Through years of leading groups on gender and sexuality at Monte Nido, Aimee further developed her fundamental belief in client-centered goals, a narrative approach to therapy, and the idea that the person is not the problem, the problem is the problem. She is developing training on queer competency for eating disorder professionals, highlighting non-binary constructs of gender and sexuality and non-assumptive models of therapeutic engagement.
Links and resources:
TFFED - http://www.transfolxfightingeds.org/
Elizabeth Cooper - Queer Body Love Series
Gender Wisdom Self-Test for Therapists : (S. Baker & W. Basil, 2017)
Fiona Willer, AdvAPD, is the author of 'The Non-Diet Approach Guidebook for Dietitians', and co-author of 'The Non-Diet Approach Guidebook for Psychologists and Counsellors'. Her business, Health, Not Diets, provides online and face-to-face training and workshops for health professionals in the non-diet approach. Fiona's background includes clinical dietetics, private practice and university lecturing in nutrition and dietetics. She is currently conducting PhD research into HAES ® use in dietetics. As an advocacy leader in this field, she represented Australia in contributing to the HAES graduate curriculum for the Association for Size Diversity and Health (ASDAH), and has been an invited speaker at DAA, SDA, ANZAED, DC events and presented at a variety of academic conferences Fiona is a proud member of the DAA, current Vice-President International of ASDAH, and executive member of HAES Australia. Find her online at FionaWiller.com, UnpackingWeightScience.com, and HealthNotDiets.com.
Relevant links: Unpacking Weight Science: www.UnpackingWeightScience.com Health Not Diets (resources for health professionals in the Non-Diet Approach): www.healthnotdiets.com Twitter and Instagram: @FionaWiller Facebook: HealthNotDiets
Deb Burgard, PhD, FAED* is a psychologist and activist from the San Francisco Bay Area specializing in concerns about body image, eating, weight stigma, and relationships. She is also one of the founders of the Health at Every Size(r) model, the original BodyPositive.com website, and the Show Me the Data listserv, building communities where people can find each other and the resources to resist weight stigma, especially in medical and psychological treatment. Her activism includes working with healthcare providers to integrate an understanding of the social determinants of health and creating interventions that address structural oppression and support stigma resistance. She can be found at conferences sparking impromptu dance parties in the pool. Fellow, Academy for Eating Disorders Links: Poodle Science video https://www.youtube.com/watch?v=H89QQfXtc-k Review of HAES lit paper: https://www.hindawi.com/journals/jobe/2014/983495/
www.sizediversityandhealth.org The Association for Size Diversity and Health. "What Is Wrong with the War on Obesity?" http://journals.sagepub.com/doi/full/10.1177/2158244018772888
This week I talk to June Alexander, who was in her fifties when she fully recovered from long-term anorexia.
June's personal bio:
I love sharing my writing passion by helping people with eating disorder experience to tell their stories. I believe everyone has a story to tell and the way it is told makes all the difference. When you have had, or have an illness, the story creation process can help you to see that your life counts because it involves being an observer as well as participant of your experiences. I offer guidance and mentoring in achieving these outcomes. Following a long newspaper career as reporter, sub-editor and editor, I wrote my memoir, which explores the effect of developing restrictive anorexia nervosa at age 11, and how this severe illness shaped my life. This led to a further nine books on eating disorders and a PhD in Creative Writing, focusing on the therapeutic value of non-fiction writing in recovery. I run group workshops and work privately with individuals to record their narratives. I aim to and inspire hope at every age through story-telling. My website, The Diary Healer , which includes a weekly blog, delves more deeply into this aspect of my work. I offer a wealth of insight and wisdom and know what it means to experience and heal from an eating disorder and other traumas. My story-telling work has achieved global recognition, winning the Academy for Eating Disorders’ 2016 Meehan-Hartley Advocacy Award for public service and advocacy in the eating disorder field. I serve on national and international organisations in the mental health field and my mantra is ”there is hope at every age”. I live in Australia and am the proud mother of four children and grandmother to five children, and share my home with Norah Cat.
Rebecca Scritchfield is a registered dietitian nutritionist, certified exercise physiologist, author of the book Body Kindness, and host of the Body Kindness podcast. Through her weight-inclusive counseling practice, she helps people make peace with food, find the joy in exercise, and create a better life with workable goals that fit individual interests. Central to all her work, Rebecca aims to develop self-compassion in place of shame by rejecting the rules of diet culture and the pervasive myth that to achieve better health one must lose weight.
Using her Body Kindness philosophy, Rebecca mentors registered dietitians and supports women from around the world in collaborative, online learning spaces free from unhelpful diet chatter and negative body talk.
Rebecca has influenced millions through her writing, podcast, and appearances in over 100 media outlets including NBC Nightly News, CNN, the TODAY show, the Washington Post, O Magazine, Self, Real Simple, Health, Yoga Journal, and many others. She lives in Washington, D.C., where she was recently recognized as one of ten “Supermom” entrepreneurs in the Nation’s Capital.
LINKS:
Postpartum Body Image Research Study: Body Kindness Reader Survey with option for free Body Kindness e-book
https://www.bodykindnessbook.com/research/
Free Body Kindness E-Course, Book Chapter
https://www.bodykindnessbook.com/get-started/
Articles:
Whole 30
https://health.usnews.com/health-news/blogs/eat-run/articles/2018-05-18/this-nutritionists-manifesto-against-the-whole30-will-shake-your-view-of-healthy-eating
Take Fat Shaming Out of Fitness Culture https://www.washingtonpost.com/lifestyle/wellness/why-we-need-to-take-fat-shaming-out-of-fitness-culture/2018/03/08/728365ac-1e31-11e8-9de1-147dd2df3829_story.html
Why Fear of Sugar May Be More Toxic Than Sugar Itself
https://www.self.com/story/why-fear-of-sugar-addiction-may-be-more-toxic-than-sugar-is
In this podcast I talk about my personal highlights from the ICED conference presentation that I was part this year with Rebecka Peeples, Rachel Millner and Therese Waterhaus.
Rebecka Peebles
Rebecka Peebles, MD, is an Adolescent Medicine Specialist and Co-director of the Eating Disorder Assessment and Treatment Program at Children's Hospital of Philadelphia.
Dr. Peebles is an assistant professor in the Division of Adolescent Medicine at The Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine.
Prior to joining CHOP, she was an instructor at Stanford University School of Medicine's Division of Adolescent Medicine, Department of Pediatrics, and was primarily involved with the Eating Disorders Program and the Center for Healthy Weight at the Lucile Packard Children’s Hospital.
Dr. Peebles’ research interests focus on the health outcomes of disordered eating in adolescents of diverse weight ranges, and how the Internet can be used as a vector to both help and harm young people as they try to approach a healthy weight. Her most recent work has been funded by the American Heart Association.
Rachel Milner
Dr. Millner is a licensed psychologist in the state of Pennsylvania. She graduated from the California School of Professional Psychology (now Alliant International University) in San Diego and completed an APA (American Psychological Association) approved internship at the University of Buffalo. Dr. Millner completed her post-doctoral training at the University of Pennsylvania in Philadelphia, PA.
Dr. Millner is a member of the American Psychological Association, the Pennsylvania Psychological Association, the Philadelphia Society of Clinical Psychologists and the Lower Bucks Chamber of Commerce.
In addition to her private practice, Dr. Millner has taught at the University of Pennsylvania and is currently teaching at Gwynedd Mercy College.
Dr. Millner's website: http://www.rachelmillner.com/aboutus.php
Therese Waterhaus
Therese has been a Registered Dietitian for nearly 30 years, she completed her doctoral degree in nutrition biochemistry, studying vitamin D and bone metabolism. She has been in private practice for over 9 years and has been involved in the eating disorder community for over 15 years. Her goal is to bring to the local community the most recent information about eating disorders.
Therese's website: http://www.willamettenutritionsource.com/
Personal story time!
Not everyone who is suffering from long-term malnutrition turns to stealing, but I think it is a lot more prevalent than most people assume it is. It makes sense why a brain that believes resources are scarce would feel the need to take without giving anything away.
In this podcast, I talk about my personal experience with kleptomania.
Link to YouTube video on anorexia and hoarding here: https://www.youtube.com/watch?v=CDxPWT_TuV4&t=2s
Link to Blog post on anorexia and hoarding here: http://tabithafarrar.com/2018/05/brain-malnutrition-hoarding/
In this podcast, Tabitha talks to Drake, who is in recovery from an eating disorder and wanted to share some hope.
In this podcast Tabitha talks to a person in recovery about her struggles with diabulimia.
link to the BBC diabulimia documentary mentioned:
https://youtu.be/tSLjM6cZaTo The Eating Disorder Recovery Podcast
Recovery Stories: The Dangers of Diabulimia
Tabitha: Hello there, welcome to this weeks podcast. This week I'm going to be talking to somebody who would like to remain anonymous. We are talking about her experience with diabulimia. Diabulimia is a type of eating disorder, that happens when a person has type one diabetes and then they start to use eating disorder behaviours or insulin control to control their weight. We start this conversation by my anonymous friend telling us a little bit about herself.
Anon: I was diagnosed as type 1 diabetic when I was 9. A week before my 10th birthday. Then due to some treatment I received for the eating disorder when I was 12, I had quite a few other medical tests and things done because my diabetic control was so good because the lack of food, I didn't need a lot of insulin, I wasn't having very low or very high blood sugar levels and as a result of those tests they found out I had actually had quite an unusual form of diabetes called MODY which is, I think it's categorised more akin to type 2 diabetes but it's treated in the same way as type 1 and it's quite unusual.
So for all intents and purposes I'm treated in the same way as a type 1 diabetic and I guess my eating disorder history is that I developed plain vanilla classic anorexia when I was 12 and then the anorexia really spiralled when I was going on 13 at which point in about 6 months I'd lost about a third of my body weight and I was towards the lower end of the healthy BMI scale as it was. I became very very unwell and was on the verge of being sectioned by CAMS, the Child and Adolescent Mental Health Service in the UK. I remember sitting in my bed at home on the evening after my parents had taken me home from the outpatient hospital and brought me this bowl of cereal, bran flakes or something, but they brought me this bowl of cereal and they said, my mum was there saying you have to eat this you have to eat this. I don't know what it was but I was so distressed and so upset that I just ate it.
And that started a three month period of what you refer to as feast eating. So I ate and I ate and I ate for 3 months and I ate no diabetic friendly foods at all. All cakes and chocolate and all of the things I'd been restricting and one of the things that the medical team had tried to get me to drink when I was underweight and I'd feigned drinking and poured away and done all the usual anorexic guise getting out of eating were these things called Scandishakes. They are basically like these meal replacement shakes. But they are actually really nice ones in terms of they are just full of sugar basically. So they just taste like McDonald's milkshakes so they are really quite enjoyable but when I started having those initially my blood sugar just went absolutely off the scale because I hadn't been having them before and so the medical team just assumed well those are fine for people with diabetes. But when I actually started drinking them, the sugars went off the scale and I didn't put on any weight. So I was eating a huge volume of food, a lot of calories, really a lot of food and I wasn't putting on an ounce. And at one point I was actually losing weight despite being extremely underweight.
I suppose that was the first experience I'd have of what's referred to as Diabulimia which for any listeners who aren't aware, Diabulimia refers to when predominantly type 1 diabetic patients do not take insulin which is something they need to take to break down carbohydrates and sugars. They don't take their insulin because they know if they don't take it they can eat whatever they like, which if they are restricting is probably high fat, high carb, high sugar food and not put on any weight at all and in some cases lose weight. So that was my experience, it was completely in inadvertent at first and at that point I assumed that my brain was being nourished to some extent because I didn't put 2 and 2 together and think this is nice, I'm going to carry on doing this.
I took the insulin, I got things under control again and it was all a bit up and down anyway because of the types of foods I was having to eat at that point to get to weight restoration. But when my BMI reached I think it was 18 the medical profession thought she's out of the woods, she's clearly put on this weight, she's fine and at that point, my parents were scared by the amount that I was eating as well because they didn't understand what was going on, they didn't think I had an eating disorder at that point. So they were very much OK great, so you can stop all of the eating now, you don't have to eat so much food, you can just go back to normal, eating normal foods and normal potions and go back to caring your diabetes and what's healthy for that.
Because at that point I was in no way mentally recovered, nowhere close, I hadn't received any psychological support at that point because I was hell bent on not getting any mental help at that point and my parents, because I'd assured them being in the eating disorder mindset, I'm fine, I've got this under control they didn't compel me to go and get treatment and to be quite honest with you the only treatment that was offered to me was an inpatient facility that was 100s of miles away, I think it was in Scotland. It was 100s of miles away from them anyway and that was the last thing they wanted. They were really so concerned for me to then be whisked off away to the other side of the country wasn't something that they were keen to do at all.
So I reassured them and I was going back to this regular quote pattern of eating with what I now realise was very much quasi recover and then I suppose at that point it was a conscious effort to pursue, for a lack of a better word, the diabulimia. So I would be craving all the high sugar, I don't like the term junk food, but processed foods and I'd be craving them and I didn't feel able to give myself permission to have those foods and take my insulin at the same time. It went in dribs and drabs.
I did that for a couple of years and then after that time I just worked out that it felt so rubbish to abuse the diabetes in that way because I don't know what the experience is like for anyone with an eating disorder particularly anorexia without diabetes because that hasn't been my experience because it set in at 9 and I developed the eating disorder at 12 so I only ever had an eating disorder with the diabetes but I can not convey how weak and tired and how horrendous it feels to have low blood sugars and then how tired and just faint and unwell I felt when my blood sugars were high as well. When the blood sugars were low and I was very much in the anorexia stage there was this immense fear of having to eat in order to bring the blood sugars up again because I was taking next to no insulin but there was this huge fear of if my blood sugars go to low and I could go into the coma I'm going to have to eat something that wasn't planned for.
Looking back on at, that is hugely scary because I would, and I think as well that the issue I had was that I was getting a lot of positive reinforcement from my diabetic team until my weight became a concern I was getting a lot of positive reinforcement because my blood sugar control was exemplary because I wasn't eating, I was having next to no insulin and my blood sugar control was excellent and so from their prospective I was the model diabetic patient which definitely plays into my plain vanilla anorexia type personality or susceptibility. Because I'm very type a, perfectionist want to please people. From a purely physical perspective if I don't eat my blood sugars go extremely low because I have to take a certain amount of insulin my body doesn't produce that and so I need take long acting and short acting insulin several times a day.
If my blood sugars go too low, I become shaky, faint can not function when I've had they are called hypos, or hypoglycaemia which I know that a lot of people with anorexia deal with anyway, but I think with diabetic people it is just amplified because alongside the anorexia they are also dealing with this chronic health condition and so extremely weak, to the extent that if I was trying to get food when I had a very low blood sugar I would have to hold on to the work surfaces and things in order to not fall over, just to get some food. I actually am very fortunate in that I feel unwell whereas I know that for a lot of diabetic people sometimes they don't and it's just case of one minute they are walking around and then then next minute they are out cold on the floor.
From the other end of the spectrum when the blood sugars were high and I weren't to take insulin then, I become extremely tired, extremely thirsty, unable to sleep through the night, because I will be drinking so much I needed to get up to use the bathroom. And I suppose the invisible signs if you like, that can't be seen when the blood sugars are high, that's when things like damage to the retina occur so blindness and because of the circulatory issues can lead to amputations in fingers and toes are quite common.
T: I didn't know about the blindness.
A: Oh yes, that's very common and diabetic people have to have retina screenings every year to check to photograph the retina to see if there are any signs of diabetic retinopathy. That is quite a common side effect of mismanaged diabetes, inadvertently. But obviously with diabulimia if someone is doing that in such an extreme level then that can be accelerated quite substantially so people that are quite young can lose their sight.
T: Did you know at the time that that was a risk?
A: Yes, I did and I can honestly say I didn't think about it at the time. On a logical level, I knew what all the risks were because other risks like kidney damage, damage to organs are really serious and in some cases organ transplantation. But to me, because the anorexia was so strong, at that point none of it mattered. It was, I want to be thin and I don't want to eat more than I'm eating now. And if I do eat then I can't take insulin and that's just the way it is.
T: I know that when I had active anorexia sometimes I think it's part of that not knowing how sick you are or how risky things are but you can sort of know that something's a risk and do it anyway. You feel that you're special and it won't happen to you.
A: Yeah sure and I think as well with me, I was pulled up on it by my medical team because I was so underweight but diabulimia can happen, like anorexia in someone at any shape, any size body. So someone doesn't have to be massively underweight and because mismanagement of diabetes can happen quite innocently as it's quite a difficult condition to manage. The management of it differs hugely between individuals so it can quite easily slip under the radar of medical professionals, unless someone actually comes out and asks for help which as you say, if someone is so hell bent on restricting then that may never happen.
T: So what helped you to understand that you couldn't continue to do what you were doing?
A: Honestly I think the only thing that got me out of the diabulimia was kind of moving into Othorexia. Which is horrendous, but I got into this mindset of, I feel really bad when I eat all this junk food because I'm not taking my insulin so I equated that with, if I eat all this processed food it doesn't matter if I take my insulin or not it's definitely the food and so I can eat as much as I like provided it's healthy.
And then that went down a whole other rabbit hole so the diabulimia became kind of irrelevant at that stage because I'd found this other way of restricting and so that wasn't really required any more. It's only when I looked back on it and I'd managed to get myself to a point enough physical recovery to think, I don't want to do any of those things that I can see, there wasn't any conscious effort on my part to think, oh I'm really scared of the potential of going blind, or losing my foot or something, there wasn't nearly that rational, it was very much like, this is the way to go because look at all these people in Instagram or whatever that are eating clean and this is why I should be doing.
T: But many people do that, most of us cycle through every type of fad diet or stage and you do something maybe for a year or so and it gets tired and you look for something else that's going to help you feel safe, but allow you to change what you're doing. S it sounds likes that move to othorexia was a way that helped you feel safe but it enabled you to change to do something different which isn't ideal either.
A: No, far from it.
T: OK, so anything else that you think is relevant on the Diabulimia?
A: Having a quick look at that documentary that I mentioned to you which is the BBC 3 Diabulimia, it's called something like The Worlds Deadliest Eating Disorder, but they quoted a study which said that 60% of type 1 diabetic women have experienced an eating disorder by the time they are 25 so I think it's extremely common and I also think it's extremely difficult to not only diagnose but get help because I know people who are clinically very underweight, they should meet the threshold of inpatient treatment just as an eating disorder stand alone illness but nobody inpatient facility will take them because they are diabetic. They don't have the diabetes knowledge and they don't know how to adapt the standard meal plan that they give to everyone and everyone has to eat the same.
T: Right, so they say there is a risk that they can't take on.
A: Yes, absolutely
T: So what do you think needs to happen in the treatment field in order to be able to serve what sounds like quite a high percentage of people with type 1 diabetes who also have an eating disorder or be using that to control their weight. So what do you think in your experience could have been offered and what do you think could have helped you maybe earlier on?
A: I think that the first step with anything is awareness because at the time that I was suffered with diabulimia it wasn't a thing. It wasn't recognised particularity and I think that a lot of women and men too. There haven't been any stats on it but I'm sure men as well deal with the same issue and young boys as well.
Just to raise it as an issue and really monitor them closely in terms of every diabetic child, adolescent and adult even, should have regular diabetic appointments. Their average glucose level, their HBA1C level which is their average blood sugar taken over I think 3 or 6 months will show if they've had high blood sugar levels for that period so that will kind of give away if they've been abusing or taking their insulin or not.
Raising awareness among the diabetic consultants that this is a thing and then interdisciplinary discussions so have the diabetic dietitians work with the eating disorder dietitians and help people manage things in a way that isn't obsessive because I know with me, asking me to count carbs was not helpful because saying you can have X number of carbohydrate portions a day for this insulin wasn't helpful. So maybe just taking a more relaxed to it, saying you're taking this amount of insulin at the moment and you did this amount of insulin with this meal, so how were your blood sugars after that? Oh OK so maybe you need a bit more insulin if it was high or OK maybe that was a bit too much insulin so maybe we need to dial it down a bit. Don't go into this carb counting thing.
T: Yep don't play into things that eating disorders really like to do. So I like what you said the interdisciplinary things there. It seems like it's a no brainer that it should happen anyway if somebody has diabetes and they also have an eating disorder that people work together but I guess maybe it's probably even harder in the US than it is in the UK because at least in the UK you have the NHS and I did find when I lived in the UK, things were more interwoven on the NHS because it;s one organisation trying to work together whereas in the USA it does feel more difficult that doctors don't talk to each other and aren't necessarily working in t he same organisation even.
A: I agree, I think as well each NHS trust in the UK will have a segregated area, each trust will have a diabetic dietitian and an eating disorder dietitian and so it should in theory be possible for them to liaise. But I don't know why that doesn't, I guess because it's not picked up on.
T: Right, the importance isn't understood is it? I guess a lot of people who maybe are diabetic specialists are not an eating disorder specialist, so it's just not on their radar that people can use being a type 1 diabetic to control their weight. As much as it should be. To me it seems really obvious but my head is in eating disorder world, so it would do, I guess maybe if you were not in eating disorder world especially if you work in a health system that is obsessed with what they call the obesity crisis then maybe that is also a factor that plays into it.
A: Absolutely. I definitely agree with that, particularly with something like diabetes because what I've experienced a lot, just among the general population there is a lot of confusion between type 1 and type 2 diabetes. If you say your diabetic they just assume you are type 2 diabetic and they don't really understand what type 1 diabetes is. I think what's also tied up in diabetic dietitians in particular is this whole weigh management paradigm when they get a patient their objective is to get them to get their insulin levels under control primarily through dieting behaviours. It can be difficult when as you say, when people aren't really acquainted with the eating disorder world as it were that they don't understand why someone wouldn't take their insulin if it makes them feel really bad.
T: Do you think there was anything anyone could have done or said that would have helped you out? Because I know that we may have family members listening to this and it's a really tricky subject. Like you said you were pretty resistant to hep and support initially just wondering what your thoughts are if you can think back if anybody could have said something that might have helped you?
A: You have to reach a certain point of just being sick and tired of it and wanting help. I think if someone is in that frame of mind that they don't feel like they can give themselves permission and just go ahead and in the early stages of recovery, eat all the food. Just giving someone the permission to do that because that's all I wanted when I went to see dietitians. There's nothing that they could have taught me about nutrition or about diabetes management that I didn't know already. I was obsessed and so I think all I wanted was somebody to give me the permission and say you know what? If you want to eat 5 boxes of Krispy Kremes you can go for it and we will help you manage the insulin with that.
T: So a big thank you to my anonymous friend there. Some of you might be wondering how she's actually doing so I asked her and she said in terms of where I am with my recovery, I have recovered fully from diabulimia and have been fully recovered for 10 years and I am in the later stages of recovery from both anorexia and othorexia. Mentally I feel as if I am very close to being fully recovered.
I also asked her if there was anything that she would say with somebody with type 1 diabetes who was also dealing with an eating disorder and she said the thing she would tell them would be to reach out for support. Please tell someone, family, a friend and eating disorder therapist or anyone on the diabetes treatment team preferably someone who ascribes to a HAES model. Taking that first step asking for help can be terrifying but you reach out and the amount of support and love you could be shown would surpass any expectation you have.
Diabulimia is a lethal illness and addition to all the long term complications of an eating disorder it has all of the long term side effects of poorly managed diabetes such as amputation, blindness and organ damage and failure. This is no joke and anyone struggling deserves a life so much better than they currently have, they are worthy of recovery. Never underestimate the courage and the strength you have just living with diabetes every day it's a real achievement just living with it. A life doesn't need to be made harder by introducing an eating disorder into the mix, not that an eating disorder is a choice. If they feel unable to give themselves permission to seek help, I am giving it to them now. Go and get help so that you can live a wonderful, free life. You so deserve it.
Thank you for listening to this weeks podcast, if you have a recovery story to share or if you have something you think you would like to hear covered in this podcast, please email me at info@tabithafarrar.com or you can tweet me it's @love_fat_ Cheers and until next time cheerio.
In this podcast Tabitha talks to the wonderful Dr Gaudiani about the important and often misunderstood topic of edema.
In this podcast we cover:
- pitting edema
- dangers of long-term edema
- triggering aspects of edema
- edema and purging
- medications for edema if long-term
- edema in the abcess of purging
- the importance of specialised advice
The Gaudiani Clinic provides superb expert outpatient medical care to adolescents and adults of all sizes, shapes, and genders with eating disorders or disordered eating. The Gaudiani Clinic also offers comprehensive person-centered care to those who are recovered from an eating disorder. Through a collaborative, communicative, multi-disciplinary approach, the Clinic cares for the whole person, in the context of their values.
Under the care of Jennifer L. Gaudiani, MD, CEDS, FAED, patients receive expert medical care provided in a comfortable and highly discreet private practice setting. Dr. Gaudiani is one of the only outpatient internists in the United States who carries the Certified Eating Disorder Specialist designation and is internationally recognized as an expert in the eating disorder field. In her role as an expert outpatient medical doctor, Dr. Gaudiani can function as a patient’s primary care physician or as an expert adjunctive physician as part of a multidisciplinary team.
The Gaudiani Clinic is located in Denver, Colorado with both local and telemedicine treatment plans available.
Dr. Gaudiani also offers professional services including private and group consultation, professional webinars, and presentations.
For more information about the Gaudiani Clinic, please visit www.gaudianiclinic.com, call 720.515.2140.
In this podcast Tabitha talks to Sarah Thompson about her recovery, and her journey into body positivity. We also discuss:
- Being queer and having an eating disorder
- Weight stigma in eating disorder treatment
- The Be Nourished retreat and certification
- Recovery in an environment that encourages restriction and weight loss
Sarah Thompson is an eating disorder recovery coach, certified Body Trust® advocate, consultant and speaker. As a recovery coach, she supports you on your eating disorder, disordered eating, and/or body image recovery journey. This includes if you want to ditch dieting. She supports you in healing your relationship with food and body in the ways that you want, at the pace that you want. Sarah will hold space for hope in your healing even if you can't imagine it yet. Sarah has a particular interest in the intersection of gender, sexuality, size, and eating disorders. For info about working with me, the group I mentioned, and my blog: www.resilientfatgoddess.com For the retreat I did: https://benourished.org/events-classes/ For the certification I did: https://benourished.org/trainings-post/body-trust-provider-certification-program/
Facebook: https://www.facebook.com/resilientfatgoddxss/ Instagram: https://www.instagram.com/resilientfatgoddess/
In this podcast Tabitha chats to Dr Colleen Reichmann about her recovery, health at every size, body diversity, and advoacy and activism.
Dr. Colleen Reichmann is a licensed clinical psychologist, practicing in Williamsburg, VA. She works in her private practice, Wildflower Therapy, and is a staff psychologist at the College of William and Mary. She is recovered from an eating disorder, and this experience sparked her passion for spreading knowledge and awareness that recovery is possible. She is now an eating disorders specialist, and has worked at various treatment facilities including University Medical Center of Princeton at Plainsboro Center for Eating Disorder Care, and The Center for Eating Disorders at Sheppard Pratt. She is an advocate for feminism, body liberation, fat acceptance, and health at every size. She writes about body image and eating disorders for morelove.org, Project Heal, The Mighty, Recovery Warriors, and more. Website: www.colleenreichmann.com instagram: @drcolleenreichmann facebook: https://www.facebook.com/drcolleenreichmann/
In this podcast Tabitha Farrar talks to Jerica Berge about a new study illistrating how diet talk and encouragement to diet can be passed down through generations
Parent Encouragement to Diet From Adolescence Into Adulthood May Cause Intergenerational Harm Study: http://www.practiceupdate.com/content/parent-encouragement-to-diet-from-adolescence-into-adulthood-may-cause-intergenerational-harm/65474
- In this longitudinal study 556 adolescents were surveyed when in school and again after 15 years in adulthood and/or parenthood to evaluate the association between parental encouragement to diet in adolescence and health outcomes in adult life. Significant association was observed between parent encouragement to diet in adolescence and an increased risk of overweight or obesity, dieting, binge eating, unhealthy weight control behaviors, and lower body satisfaction in adulthood. In addition, the authors noted an intergenerational transmission of encouragement to diet in the home environment.
- Clinicians should inform parents about the potentially harmful and enduring outcomes associated with encouraging their children to diet.
Jerica M. Berge, Ph.D., MPH, LMFT, CFLE is an Associate Professor in the Department of Family Medicine and Community Health at the University of Minnesota Medical School. Dr. Berge is both a behavioral medicine clinician and researcher. Dr. Berge is a licensed mental health therapist and supervisor who specializes in integrated care and community-based partnerships to address family health issues. She has developed and evaluated several family-focused models of care within family medicine clinics including, group prenatal care for high risk pregnant mothers, integrated care clinic, and childhood obesity prevention and treatment interventions via well-child visits. Dr. Berge is one of the most cited authors on family dynamics and childhood health with over 100 publications and book chapters and 300 presentations. She has an impressive funding trajectory including K12, R21, R03, R56, and R01 grants from the National Institutes of Health.
In this podcast, Tabitha chats to Kayla Kotecki about her path to recovery, and the story behind damnthediets.com.
We talk about:
- unrestricted eating
- diet culture
- obcessive and complusive exercise
- bikini contest culture
- social pressures to lose weight and exercise
- extreme hunger
Learn more about Kayla here:
http://damnthediets.com/
In this podcast I talk about the skill of being able to force feed yourself as an adult in recovery from anorexia.
In the process of making yourself eat food you are afraid of you achieve both nutritional rehabiliation and neural rewiring goals. You train your brain that these foods are not a threat to you, and you eat the types of food that your body really needs in order to get out of malnutrition.
When you are faced with food that you are not used to eating, or in larger quantites that you usually allow yourself to eat, you go into your sympathetic nervous system -- that's the fight or flight one. Food doesn't taste that good when you are stressed about it! But, if you continue to force yourself to eat, your brain learns that the food is not a threat, and in time, you remain calm when eating. This is what leads to the neural rewiring of your brain that these foods are not a threat to you.
In this podcast, Tabitha Farrar talks to an adult in recovery from anorexia who has young children. We talk about things children pick up on, dealing with children when you are going through recovery stress, and ways of talking to young children about eating disorders.
In this podcast Tabitha talks to the fabulous Carrie Arnold about the problems associated with setting target weight too long:
Topics covered:
-
Body diversity
-
What happens in patients minds when target weight are set too low
-
Anorexia in larger bodies
-
Overshoot vs. recovery weight
About Carrie Arnold
Carrie Arnold is an award winning blogger, freelance science writer, and author living in Virginia. She writes on a variety of topics from microbiology to evolution. Carrie is in recovery from anorexia, and is very active in the eating disorder community as an advocate for better research and treatments.
Carrie’s Webiste
Decoding Anorexia
Support this podcast via Patreon! You can support this podcast and ensure the continuation of it by pledging a patreon donation here: https://www.patreon.com/Eating_Disorder_Recovery_Podcast
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Cheers!
In this podcast Tabitha talks to Elisa Oras about recovery.
Topics covered include:
-
Anorexia in people in larger bodies
-
Bulimia, and binge/purge subtypes
-
Feast eating in recovery
-
Eating lots of food!
-
Non-traditional recovery routes
-
The important of listening to your body and allowing yourself to eat and rest.
If you would like to learn more about Elisa:
Youtube: https://www.youtube.com/channel/UCxWY-0as5iyX36Uy7gPLyBg
Website: http://followtheintuition.com/
Book: http://followtheintuition.com/book/
Instagram: https://www.instagram.com/followtheintuition/
Support this podcast via Patreon! You can support this podcast and ensure the continuation of it by pledging a patreon donation here: https://www.patreon.com/Eating_Disorder_Recovery_Podcast
We want your feedback on these podcasts! Please take a second to fill out this survey with feedback so we can make these podcasts even better:
https://www.surveymonkey.co.uk/r/BSQ7BBM
Subscribe to these podcasts in iTunes: https://itunes.apple.com/us/podcast/eating-disorder-recovery-podcast/id1138563928?mt=2
In this episode, I talk to "Simon's Cat" a woman in recovery from anorexia. She shares her story about going back home to live with her parents for 3 months in order to start her recovery and get though the thoughest parts of the refeeding process.
Support this podcast via Patreon! You can support this podcast and ensure the continuation of it by pledging a patreon donation here: https://www.patreon.com/Eating_Disorder_Recovery_Podcast
We want your feedback on these podcasts! Please take a second to fill out this survey with feedback so we can make these podcasts even better:
https://www.surveymonkey.co.uk/r/BSQ7BBM
Subscribe to these podcasts in iTunes: https://itunes.apple.com/us/podcast/eating-disorder-recovery-podcast/id1138563928?mt=2
In this episode, Tabitha talks to the wonderful Rachel Millner about fat-phobia in schools:
- BMI report cards
- School dinner policing
- Health at Every Size
- Body Diversity
- Fat-phobia
- How to trust kids to eat
Here is a list of useful books from Rachel
Ellyn Satter- Any of her books
Amanda’s Big Dream by Judith Matz
Body Respect by Linda Bacon and Lucy Aphramor (this is a more general book-not specific to kids, but gives a really good foundation of Health at Every Size®
Shapesville by Andy Mills
Your Body is Awesome by Sigrun Danielsdottir
Kathy Kater’s “health bodies” curriculum
Born to Eat by Wendy Jo Peterson
How to Be Comfortable in Your own Feathers by Julia Cook
Todd Parr- has several books
https://www.amightygirl.com/
In this podcast, Dr Jennifer Gaudiani talks about your bones, and what the effects of malnutrition caused by a restrictive eating disorder such as anorexia, can be on your bone health.
- How malnutrition affects your bones
- Bone density
- Osteoporosis
- Osteopenia
- The various treatment options
About The Gaudiani Clinic The Gaudiani Clinic provides superb expert outpatient medical care to adolescents and adults of all sizes, shapes, and genders with eating disorders or disordered eating. The Gaudiani Clinic also offers comprehensive person-centered care to those who are recovered from an eating disorder. Through a collaborative, communicative, multi-disciplinary approach, the Clinic cares for the whole person, in the context of their values.
Under the care of Jennifer L. Gaudiani, MD, CEDS, FAED, patients receive expert medical care provided in a comfortable and highly discreet private practice setting. Dr. Gaudiani is one of the only outpatient internists in the United States who carries the Certified Eating Disorder Specialist designation and is internationally recognized as an expert in the eating disorder field. In her role as an expert outpatient medical doctor, Dr. Gaudiani can function as a patient’s primary care physician or as an expert adjunctive physician as part of a multidisciplinary team.
The Gaudiani Clinic is located in Denver, Colorado with both local and telemedicine treatment plans available.
Dr. Gaudiani also offers professional services including private and group consultation, professional webinars, and presentations.
For more information about the Gaudiani Clinic, please visit www.gaudianiclinic.com, call 720.515.2140.
Support this podcast via Patreon! You can support this podcast and ensure the continuation of it by pledging a patreon donation here: https://www.patreon.com/Eating_Disorder_Recovery_Podcast
We want your feedback on these podcasts! Please take a second to fill out this survey with feedback so we can make these podcasts even better:
https://www.surveymonkey.co.uk/r/BSQ7BBM
Subscribe to these podcasts in iTunes: https://itunes.apple.com/us/podcast/eating-disorder-recovery-podcast/id1138563928?mt=2
In this podcast Tabitha talks to Dr Laura Hill about motivation to change in anorexia recovery. But this time we're talking about motivation to change on the side of the clinician, rather than the patient.
Link to Dr Laura Hill's book,"A Brain-Based Approach to Eating Disorder Treatment" --> http://www.brainbasedeatingdisorders.org/
About Dr Laura Hill Dr. Laura Hill is the President & CEO of The Center for Balanced Living, a free standing not-for-profit organization that specializes in the education, treatment and research of eating disorders. Dr Hill is the recipient of Muskingum University Distinguished Service Award in 2014, the National Eating Disorders Association 2011 Lori Irving Award for Excellence in Eating Disorders Prevention and Awareness and was a TEDx Columbus speaker in 2012. She is an original founder of the Academy for Eating Disorders in 1993 and was Director of what is now known as The National Eating Disorder Association from 1990 to 1994.
She is the lead author of the Family Eating Disorder Manual, 2012; and has conducted research and spoken internationally over the last 35 years. She is a recipient of the national Feeding Hope award by NEDA, in collaboration with UCSD Eating Disorder and Research.
Find out more about Dr Laura Hill here: http://www.centerforbalancedliving.org/laura-hill/
Support this podcast via Patreon! You can support this podcast and ensure the continuation of it by pledging a patreon donation here: https://www.patreon.com/Eating_Disorder_Recovery_Podcast
We want your feedback on these podcasts! Please take a second to fill out this survey with feedback so we can make these podcasts even better:
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Saying goodbye to 2017, and looking back over the year and what I have learned. In this podcast I talk about what I call recovery "feast" eating, which is more commonly referred to as "binge" eating. Looking at eating a lot of food as a highly appropriate response to restriction.
Why it is normal and appropriate to eat a lot of food when you are in recovery from anorexia
Why restriciton makes us desire to eat large amounts of food
The problem with psychoanalysing eating — especially recovery eating!
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In this podcast Tabitha Farar talks to Maggie Westwater, one of the authors behind a study looking into misconceptions behind the notion of sugar addiction.
We talk about:
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Animal studies into addiction and what they can tell us about human behaviour.
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What studies into drug and other types of addiction can tell us about "sugar addiction."
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How restriction, not addiction, looks to be the driver behind binge eating behaviours.
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Artificial sweetners and how they affect the way we desire foods.
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Binge eating development and the role of restriction.
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Why "food addiction" can be a problematic use of language.
Paper we discussin in this podcast: Westwater, M.L., Fletcher, P.C. & Ziauddeen, H. Eur J Nutr (2016) 55(Suppl 2): 55. https://doi.org/10.1007/s00394-016-1229-6
Links to the study that Maggie Westwater spoke about:
Twitter handle (@STRIvE_Study) Official Health Research Authority page https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/environmental-and-metabolic-determinants-of-binge-eating-behaviour/.
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In this podcast Tabitha talks about what she refers to as "event restriction."
Event restriction is when you anticipate eating more or resting at an event or time in the future, and therefore try to create a "buffer" by restricting more or compensating more via exercise in preparation.
Event restriction never works. Most people find that is actually makes eating and resting harder, so ironically you struggle even more when you actually get to the big day. Most commonly people event restriction in preparation for Christmas and the festive season.
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In this podcast Tabitha Farrar talks to Wendy Marsman (from Woman Beyond Belief) about her experience with fundentmentalist religion and the diet culture that can exiest within some church communities.
I want to make it clear that the aim of this dicussion is not to judge religion. Rather, we are looking into how religious intent and trying to do the "right" thing by the word of God can become troublesome when eating disorders are involved.
We get into some sticky stuff in this discussion. It is not entirely comfortable to highlight the problems with religion and the opression of women. But it is important.
Wendy Marsman was raised in a strict religious home. Also, being from a fundamental religious background, she was influenced by the Biblical interpretations that women had to submit to men. A “good Christian wife” needed to be thin to please her husband. So, after she got married and had 3 children, Wendy continued to go on yo-yo diets. There were many opportunities to be part of diet groups in the church which she participated in, always aiming to be better, aiming to not be guilty of the “sin of gluttony”. Wendy has her own podcast called Women Beyond Belief Podcast where she mainly interviews women who have left religions and cults. Many women who have grown up in a religious background have been accustomed to suppression and inequality. She hopes to provide a platform for these women to have a voice.
Podcast Website: http://womenbeyondbelief.com/
YouTube Channel: https://www.youtube.com/channel/UCizIjQrmLqBSbPy0jqkEl3A
Facebook: https://www.facebook.com/WomenBeyondBelief/
Twitter: @WBBPodcast - https://twitter.com/WBBPodcast
Email: womenbeyondbelief@gmail.com
In this podcast Tabitha talks to Dr Jennifer Gaudiani from the Gaudiani Clinic in Denver about the important and interesting topic of hormones and how they are affected by restrictive eating disorders. Topics covered include:
- How malnutrition affects the endocrine system
- How nutritional rehabilitation affects the endocrine system
- The thyroid, and how it is affected by malnutrition
- Commonly mistaken diagonises
- What doctors need to know about hormones and malnutrition
- The menstrual cycle
- Sex hormones, and sex drive
About The Gaudiani Clinic The Gaudiani Clinic provides superb expert outpatient medical care to adolescents and adults of all sizes, shapes, and genders with eating disorders or disordered eating. The Gaudiani Clinic also offers comprehensive person-centered care to those who are recovered from an eating disorder. Through a collaborative, communicative, multi-disciplinary approach, the Clinic cares for the whole person, in the context of their values.
Under the care of Jennifer L. Gaudiani, MD, CEDS, FAED, patients receive expert medical care provided in a comfortable and highly discreet private practice setting. Dr. Gaudiani is one of the only outpatient internists in the United States who carries the Certified Eating Disorder Specialist designation and is internationally recognized as an expert in the eating disorder field. In her role as an expert outpatient medical doctor, Dr. Gaudiani can function as a patient’s primary care physician or as an expert adjunctive physician as part of a multidisciplinary team.
The Gaudiani Clinic is located in Denver, Colorado with both local and telemedicine reatment plans available.
Dr. Gaudiani also offers professional services including private and group consultation, professional webinars, and presentations.
For more information about the Gaudiani Clinic, please visit www.gaudianiclinic.com, call 720.515.2140.
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In this podcast Tabitha talks about orthorexia and why it is important to be able to eat all kinds of food without stress — including foods that you judge as unhealthy.
I see orthorexia as a restrictive eating disorder. The goalposts may be slightly altered, but it is still restricting certain types of food that the sufferer deems to be "unhealthy."
If you have orthorexia you may find that you feel stressed about eating things like:
- Fatty foods
- Sugar and sweets
- Salt
- Artificial colors, flavors or preservatives
- Pesticides or genetic modification
- Non-organic foods
- Animal products
- Dairy products
- Anything considered to be unhealthy
People with orthorexia often also get obsessive about foods that they consider to be "healthy". So supplements may be excessively bought and used. Organic foods, foods that are sold as "health" foods.
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People with eating disorders, parents, and doctors share what they think doctors should know about eating disorders.
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In this podcast, Tabitha talks to Dr Gaudiani on the topic of metabolism in relation to anorexia and other restrictive eating disorders.
We talk about:
- How the metabolism works
- How restriction affects the metabolism
- Mental hunger
- Physical hunger
- How to eat in recovery to boost your metabolism
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In this Podcast Tabitha talks about mental hunger. We look at:
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What mental hunger is
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What mental hunger represents
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Why responding to mental hunger is important
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Why physical hunger cues are not reliable in Anorexia recovery
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How mental hunger will naturally reduce during the refeeding process
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In this podcast Tabitha talks to Philipa Hay about recent research that looked into male autobiographies of eating disorders and recovery experiences.
Link to the full research paper --> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485468/
Study Abstract
Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion criteria were autobiographies of men who had experienced an eating disorder and sought any form of treatment for this, written in the English language, published between 1995 and 2015, and available for purchase in 2016. The search resulted in six books that were thematically analyzed. Analysis of data resulted in two broad themes (1. Positive experiences; 2. Negative experiences) with sub-themes. With regards to the first theme, factors such as concern of staff members, therapist’s expertise (in treating eating disorders in men), and a collaborative treatment approach were considered favorable for treatment. In contrast to the first theme, apathy of staff members, the authors’ own negative preconceptions, treatment providers being perceived as prioritizing financial concerns, perceived as incompetent and judgmental behavior of therapist(s), and time limitations of sessions were considered unfavorable treatment experiences. In this study, the perceived success of treatment depended on therapist’s features and the form of treatment provided. Further research examining these is indicated.
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In this podcast Tabitha answers questions about life before recovery versus life after recovery from Anorexia.
Topics covered include:
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Dining out
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Social life
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Feeling cold
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Eating with others
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In this podcast, Tabitha talks about restriction, and unrestricted eating. Restrictive eating disorders such as Anorexia are often misrepresented as total restriction and not eating. This is often not the case. Many people with Anorexia can eat seemingly "normal" amounts of food and still be operating under rules of restriction. The key is understanding that unrestricted eating is required in order to allow the brain and body to fully exit the Anorexia response.
Redefining how you think of restriction is often the key to understanding what unrestrictive eating means for you
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Tabitha talks to Dr. Jennifer Gaudiani about all things gastrointestinal in eating disorder recovery! We talk about bowel movements, irritable bowel syndrome, delayed gastric emptying, and so much more!
Medical Minute Videos: Gastroparesis: https://youtu.be/ANke8zW_Uu8 Bloating: https://youtu.be/XAMplGpuO2Q Metabolism: https://youtu.be/i27GwLaE3PQ
Blog Posts: The Unmeasurables of an Eating Disorder: http://www.gaudianiclinic.com/gaudiani-clinic-blog/2017/1/11/the-unmeasurables-of-an-eating-disorder
Cave Person Brain, Part 1: http://www.gaudianiclinic.com/gaudiani-clinic-blog/2017/7/31/cave-person-brain-part-1
Cave Person Brain, Part 2: http://www.gaudianiclinic.com/gaudiani-clinic-blog/2017/7/27/cave-person-part-2
Unzip Your Digestive Tract FromYour Emotional State: http://www.denverhealth.org/medical-services/acute-center-for-eating-disorders/acute-medical-mondays/article/unzip-your-digestive-tract-from-your-emotional-state-20328
Why Do I Swell Up?: Dehydration, Edema, and the Effects of Purging (Vomiting, Laxatives, and/or Diuretics): http://www.denverhealth.org/medical-services/acute-center-for-eating-disorders/acute-medical-mondays/article/e2809cwhy-do-i-swell-upe2809d-dehydration-edema-and-the-effects-of-purging-vomiting-laxatives-andor-diuretics-23148
How starvation works against metabolism: http://www.denverhealth.org/medical-services/acute-center-for-eating-disorders/acute-medical-mondays/article/test-article-18548
Gastroparesis: An often painful and dangerous eating disorder complication: http://www.denverhealth.org/medical-services/acute-center-for-eating-disorders/acute-medical-mondays/article/gastroparesis-an-often-painful-and-dangerous-eating-disorder-complication-18626
AED Guidelines: https://www.aedweb.org/index.php/education/eating-disorder-information/eating-disorder-information-13
In this podcast Tabitha Farrar talks to Micheal Lutter about the recently published paper titled: Novel and ultra-rare damaging variants in neuropeptide signaling are associated with disordered eating behaviors
From the paper:
Abstract
Objective Eating disorders develop through a combination of genetic vulnerability and environmental stress, however the genetic basis of this risk is unknown.
Methods To understand the genetic basis of this risk, we performed whole exome sequencing on 93 unrelated individuals with eating disorders (38 restricted-eating and 55 binge-eating) to identify novel damaging variants. Candidate genes with an excessive burden of predicted damaging variants were then prioritized based upon an unbiased, data-driven bioinformatic analysis. One top candidate pathway was empirically tested for therapeutic potential in a mouse model of binge-like eating.
Results An excessive burden of novel damaging variants was identified in 186 genes in the restricted-eating group and 245 genes in the binge-eating group. This list is significantly enriched (OR = 4.6, p
This week I speak to Shan Guisinger again, and this time we are talking specifically about fear in Anorexia. Fear of weight gain. Fear of eating more. How could a fear this great have possibly had an evolutionary advantage? Find out!
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Recovery from Anorexia is often a time of heightened anxiety and stress. Managing recovery while looking after a young family is a reality for many adult sufferers. In this podcast Tabitha talks to an adult in recovery, Erin, about managing recovery with young children.
About Erin:
I am 36, and have lived in Colorado my entire life. I currently live in Highlands Ranch and have two children, 11 and 6. I have been married for 15 years. I studied sociology, philosophy and women's studies in college. I have struggled with issues around food and body image since I was a preteen. My eating disorder became severe at the age of 33. I want to help people of all ages, backgrounds, and weights understand that they can indeed develop this illness and that it is a life threatening disorder that needs to be taken seriously. I hope my experience can help others know they are not alone if they are struggling to recover while also being a parent.
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In this podcast we talk about the Adapt to Flee Famine Perspective of Anorexia evolution with Shan Guisinger.
The Adapt to Flee Famine Perspective puts forward convincing evidence for the case that Anorexia is an evolved genetic response to times of famine. A migratory response that makes people with the genetic predisposition for Anorexia respond to energy deficit by wanting to exercise more and eat less.
You can find out more about Shan Guisinger here: http://www.adaptedtofamine.com/
Paper on The Adapt To Flee Famine Perspective: https://www.ncbi.nlm.nih.gov/pubmed/14599241
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Just me in this podcast! Responding to questions that I get frequently around Anorexia recovery and weight restoration. How to know when you are really weight restored? Let me tell you it is not something that you can calculate via a math equation or estimate via looking on a height/weight chart.
Weight restoration is a process of gaining weight until you are within a healthy weight range (I recommend a BMI of 22 at least) and continuing to eat without restriction until you no longer fear further weight gain. This podcast fully explains my position on that weight restoration, target weights, and weight versus mental state restoration.
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Tabitha Farrar talks to writer, speaker, and songwriter Jenni Schaefer about her recovery from Anorexia, and subsequent experiences with PTSD.
In this podcast we talk about:
- Hope and ACTION in eating disorder recovery
- Motivation to recover
- Trauma and PTSD
- Exercise and lower-level movement in eating disorders
- Recognising the symptoms of PTSD
- The importance of finding treatment suited to you as an individual
www.jennischaefer.com www.mentalnotepodcast.com www.eatingrecovery.com/Jenni
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In this podcast Tabitha Farrar talks to Dr. Rachel Millner about Anorexia and people in larger bodies. This podcast was inspired by an email from a mother of a patient who has Anorexia and is in a larger body. Topics discussed include:
- The dangers associated with energy deficit in people in larger bodies
- Problems with diagnosis and practitioner ignorance
- Weight stigma in the medical field
- Parent advocacy and strength
- Embracing weight diversity
Find out more about Dr Millner here: http://www.rachelmillner.com/ Support this podcast via Patreon! You can support this podcast and ensure the continuation of it by pledging a patreon donation here: https://www.patreon.com/Eating_Disorder_Recovery_Podcast
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Tabitha Farrar talks to Dr Graham Redgrave about the research done at Johns Hopkins looking into higher weights and a faster rate of refeeding patients with Anorexia in an inpatient hospital setting. The conversation includes:
- Refeeding intakes, traditional expectations versus new developements
- Problems with low target weights
- Relapse prevention programs
- Lower rate of relaspe for patients who reach higher BMIs in treatment
- The case for higher caloric intakes once the risk of refeeding syndrome is past
- What refeeding syndrome is, and research around this
- How and when treatment fails patients.
- Why we need to challenge the current guidelines pertraining to refeeding intakes
Link to the orginal study: https://www.ncbi.nlm.nih.gov/pubmed/25625572
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In this podcast Tabitha Farrar talks to Courtney Simpson about the work that she is doing looking at fitness tracker use amoungst people with eating disorders. We cover a lot of topics in this podcast that was originally about fitness trackers and the number of people with Anoreixa who use them to count calories and exercise.
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Tabitha Farrar talks to Hana Zickgraf about a recently published research paper titled: Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms
Link to orginal study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086050/
Study summary
Picky eaters are people who avoid many new and familiar foods because they dislike their taste, smell, texture, or appearance. When it is severe, picky eating can lead to weight loss or difficulty maintaining a healthy weight, nutritional deficiencies, dependence on supplements to get adequate nutrition or calories, or difficulty engaging in daily life because of shame, anxiety, or inconvenience. People who experience one or more of these consequences because of their picky eating can be diagnosed with Avoidant/Restrictive Food Intake Disorder (ARFID). People who restrict the amount of food they consume because they are afraid of gaining weight or being fat (and who usually engage in excessive exercise or purging behaviors to get rid of calories) are diagnosed with anorexia or bulimia when their eating leads to weight loss, nutritional problems, or interferes with life. ARFID is a new diagnosis, and in this paper, we show that 1) adults with ARFID symptoms are just as distressed, and just as likely to have symptoms of depression, anxiety, and obsessive compulsive disorder, as those with anorexia or bulimia, but that 2) adults with ARFID symptoms show very different types of eating behavior from adults with symptoms of anorexia or bulimia.
In this podcast, Tabitha Farrar talks to researcher Kathryn Coniglio about the latest study exploring the habitual aspects of Anorexia Nervosa. In the paper titled, Won't stop or can't stop? Food restriction as a habitual behavior among individuals with anorexia nervosa or atypical anorexia nervosa, the intent behind restrictive behaviours was looked at.
Link to the original paper: https://www.ncbi.nlm.nih.gov/pubmed/28388511
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Tabitha Farrar talks to Brooke Mills about pregnancy in the years after recovering from an eating disorder. We talk specifically about the effects of Bulimia behaviours on pregnancy, and the importance of establishing a solid recovery before getting pregnant.
- Morning sickness and bulimia triggers
- Sustaining recovery thoughout pregnancy
- Problems that can arise when behaviours are present during pregnancy
- Using family and friends to help in recovery
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In this podcast we hear from adults with Anorexia, parents of people with Anorexia, and dietiticans treating adults and children with Anorexia about their experiences with dietiticans in the field of eating disorders. This podcast is a mixture of Tabitha Farrar reading out notes sent in from listeners, and audio files from listeners that have been sent in.
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In this podcast, Tabitha Farrar talks to professor Cynthia Bulik about the research underpinning the genetic locus for Anorexia Nervosa. In this podcast we discuss:
- Past and present research on the genetics behind Anorexia Nervosa and other eating disorders
- Implications for treatment
- Anorexia Nervosa and OCD links
- History of Anorexia Nervosa back to the starving saints
- Importance of parents and family support in eating disorders
- Anorexia and energy deficit
- Anorexia and money
- Genetics of Anorexia Nervosa
Cynthia M. Bulik, Ph.D., FAED, is Distinguished Professor of Eating Disorders in the Department of Psychiatry in the School of Medicine at the University of North Carolina at Chapel Hill, where she is also Professor of Nutrition in the Gillings School of Global Public Health, and founding director of the UNC Center of Excellence for Eating Disorders. She is also Co-Director of the UNC Center for Psychiatric Genomics. Dr. Bulik is also professor of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden. She is passionate about translating science for the public.
Hunger is a fascinating and crucial topic in Anorexia recovery. Navigating hunger can be difficult when hunger signals are either nonexistent, sporadic, or unrelenting.
At times of under-nutrition, most people with restrictive eating disorders such as Anorexia experience a vast reduction in hunger cues — this is a very normal result of the body moving into starvation mode. When we start to eat in recovery, hunger signals can be all over the place! In this podcast, Tabitha Farrar gives some insight into hunger based on her own experience and also those of the people with whom she was worked.
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Tabitha talks to registered dietician Julie Duffy Dillon about:
- Why a fat positive approach is needed
- Eating disorder prevention
- Food is not on a dichotomy of good and bad
- Education and research on fat positive approaches
- The problem with people with eating disorders becoming nutritional advisors
- The canary in the coal mine
- The problem with nutritional science
- Polycystic Ovarian Syndrome and eating disorder
JulieDillonRD.com Facebook.com/JulieDuffyDillon Instagram @FoodPeaceDietitian My podcast Love Food: on iTunes or via my blog: http://www.juliedillonrd.com/blog/
Bio: Julie Duffy Dillon is a Registered Dietitian, Eating Disorder Specialist, and Food Behavior Expert partnering with people on their Food Peace journey. She is trained as a mental health counselor and supervises dietitians and other health professionals to help using weight inclusive and attuned eating strategies. She owns central North Carolina’s group nutrition private practice and premier source of eating disorder treatment and prevention, BirdHouse Nutrition Therapy. Julie also produces and hosts the weekly podcast, Love Food. Learn more at JulieDillonRD.com.
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In this podcast Tabitha Farrar talks to psychotherapist Carmen Cool about the origins and evolution of Health at Every Size and the power of community when it comes to eating disorder recovery.
Carman Cool’s Website: http://www.carmencool.com
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In this podcast Tabitha Farrar talks to Rachel Millner — psychotherapist about:
- How to manage recovery in a society where there is a large amount of body discontent.
- How to apply Family Based Treatment to adults in recovery from eating disorders.
- The pros and cons of people in recovery helping other people with eating disorders.
- How to keep the family dynamic “cool” when there is an eating disorder in the house.
- Fat phobia within the eating disorder community.
- The importance of a food-first approach to eating disorder recovery.
- Recovery IS POSSIBLE and there is always hope
Dr. Millner is a licensed psychologist in the state of Pennsylvania. She graduated from the California School of Professional Psychology (now Alliant International University) in San Diego and completed an APA (American Psychological Association) approved internship at the University of Buffalo.
http://www.rachelmillner.com/
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In this podcast Tabitha Farrar talks to Professor Janet Treasure about:
- The Maudsley approach to treating eating disorders with family support and how this has progressed over the years
- 35+ years of eating disorder treatment and research
- The power of community support for adults with eating disorders and caregivers/spouses/family of people with eating disorders
- Oxytocin and the importance of human interaction in recovery
- Online support for people who are unable to access other types of support
Professor Janet Treasure, OBE PhD FRCP FRCPsych has specialised in the treatment of eating disorders at the South London and Maudsley Hospital and had an academic career at King’s College, London for the majority of her career. The Unit continues to be one of the premier European academic centres for eating disorders. In their innovative approach to training and treatment they have adopted the newest technologies including iPODs, DVDs and web-based programmes as part of their interventions. Professor Treasure has spearheaded projects that introduce recovered patients and carers into the audit and development plans for clinical services and also in the delivery of training for professionals, carers and patients.
Professor Treasure was made a Professor of Psychiatry in 2000 and awarded an OBE for her work in eating disorders in 2013. Her research has led to greater understanding of, and better treatments for, anorexia and bulimia. Much of her research focusing on the development of new treatments has been carried out collaboratively with, and often inspired by patients and their families. As well as editing professional texts, Professor Treasure has written several self-help books for people with eating disorders (Schmidt & Treasure, 1993; Treasure, 1997). Guided self-help using books such as these are recommended in the NICE guidelines as a first stage of treatment.
The Maudsley Website
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Tabitha Farrar talks to Audrey Boss from the UK’s leading non-diet community Beyond Chocolate.
We talk about the history behind Beyond Chocolate’s no diet approach to health and happiness, the power of community when swimming against mainstream food and diet conceptions, and the choices that we make about our bodies.
Beyond Chocolate website: http://www.beyondchocolate.co.uk/
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In this podcast I talk to RD Aaron Flores about HAES and weight-neutral approaches to treating BED.
Aaron Flores is a registered dietitian nutritionist based out of Los Angeles, California. With nearly 10 years of experience, Aaron has worked with eating disorders in a variety of settings. A large part of his career was spent working at the VA Greater Los Angeles Healthcare System where he helped develop and launch one of the first Binge Eating Disorder programs to help Veterans struggling with this disorder. Since leaving the VA, Aaron has continued to work in the eating disorder community helping run groups and providing individual counseling to adolescents at Destinations to Recovery and with adults at La Ventana Treatment Centers. He currently works part-time at Center for Discovery and part-time in his private practice in Calabasas, CA. His main areas of focus are Intuitive Eating and Health at Every Size® and in his work, Aaron helps individuals learn how to make peace with food and develop body-positive behaviors. Aaron’s work has been featured during Weight Stigma Awareness Week, in blogs for the National Eating Disorder Information Centre and was the closing keynote speaker of the 2016 Binge Eating Disorder Awareness Annual Conference. Along with his work with eating disorders, he also is a co-host of the podcast, Dietitians Unplugged.
LINKS: www.bvmrd.com-website Facebook.com/bvmrd — Facebook Instagram.com/aaronfloresrdn – Instagram Twitter.com/@bvmrd – Twitter dietitiansunplugged.libsyn.com — Podcast
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In this podcast Tabitha Farrar talks to pediatrician Julie O’Toole. We discuss:
- Progression of the Kartini Clinic – Kartini Clinic is an internationally recognized pediatric eating disorder treatment program for boys and girls.
- Strength of outpatient setting for treating eating disorders in both children and adults.
- Importance of empowering parents to help continue treatment in the home
- Steep stepdown of IP to OP and how this can be overcome
- What the process of putting a child into a higher level of care looks like from the intake form onwards
- How attitudes towards eating disorders have changed over the last couple of decades
- The importance of a food-first approach for weight restoration
Give food a chance on Amazon
Kartiniclinic.com –> Kartnini Blog
JULIE O’TOOLE, MD, MPH CEDS Dr. Julie O’Toole is founder and Chief Medical Officer of Kartini Clinic. Dr. O’Toole is a board certified pediatrician and has been in private pediatric practice for more than two decades.
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This week Tabitha talks to Andrea LeMarre about the harmful effect of calorie counts on food packets and in restaurant chains.
- Calorie counts on labels and what this mean for people with eating disorders.
- How you can get involved and have your voice heard.
- Talking more about eating disorders in the public space.
- How seeing calorie information can utterly derail a person in recovery from an eating disorder.
Links:
Andrea LeMarre Blog
Science of Eating Disorders Blog
Tabitha’s commentary:
If you knew how much seeing calorie values displayed on food items and in restaurants affects someone with an eating disorder such as Anorexia, you’d not think it was ethical.
I’ll tell you about it. When I was trying to weight restore I wanted to eat. However, seeing a calorie value on a food would put my brain into fight-flight-freeze making it impossible to make a decision. Another thing that happens when this HPA axis response in the brain kicks off is that one can feel nauseous, short of breath, panicked and therefore trying to eat becomes not only uncomfortable but almost impossible because my throat would feel like it was closing up — it’s the same feeling you get when you are about to cry.
So yes, a full-blown fear response in public that I would have to pretend wasn’t happening which would usually result in an about-turn and leaving without eating. This was not be being a prat, it is a mental illness which means I can have a fear-response to that sort of thing on par with the type you might have if you see a rattlesnake.
That response has never gone away with full recovery. It is still there, but my fully nourished brain can dismiss it and override it in a way that it could not when I was underweight. Now it creates anger to see calorie values on food. We do not need to know the precise amount of calories or fat or anything else about our food.
Your body is not a calculator. We do not need to know what exact percentage of fat or any other nutrient in is in what we eat. The body will work it out and balance it’s own intake if we stop trying to interfere. The point is that putting calorie values on food is futile at best, but at worst causes people to artificially alter what they eat as they try to be “healthy” and all this does is create imbalance in the body which usually leads to some sort of battle between what the body wants to eat and what is actually consumed. And that’s not even going into the problems that calorie labelling elicits in a person with an eating disorder.
We need to stop messing around with the relationship humans have with food. When we push people to make decisions based on arbitrary values such as calories, we put the body and brain out of sync.
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In this podcast, Tabitha talks to Dr Lucene Wisniewski on how DBT can be implemented in treatment for eating disorders such as Bulimia Nervosa, and Binge Eating Disorder.
Lucene Wisniewski, PhD, FAED is a clinician, trainer and researcher whose interests center around using empirically founded treatments to inform clinical practice. Lucene, an Adjunct Assistant Professor of Psychological Sciences at Case Western Reserve University, has taught more than 150 workshops, lectures and presentations on Cognitive Behavioral and Dialectical Behavior Therapies internationally and has over 40 publications in peer reviewed journals and invited book chapters. From 2006-2014, Lucene was Clinical Director and co-founder of the Cleveland Center for Eating Disorders, a comprehensive eating disorder treatment program offering evidenced based care. She served as the Chief Clinical Integrity Officer of the Emily Program, a multi-state eating disorder program from 2014-2017. Lucene has been elected fellow, has served on the board of directors, and as the co-chair of the Borderline Personality Disorder special interest group of the Academy for Eating Disorders (AED). In 2013 the AED awarded Lucene the Outstanding Clinician Award to acknowledge her contribution to the field of eating disorder treatment. She is currently the owner and founder of Lucene Wisniewski, PhD, LLC and DBTOHIO.
www.lucenewisniewski.com
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In this podcast Tabitha talks to Kristina Saffran on the start and progression of Project Heal.
In this podcast we talk about:
- The message that recovery is possible for everyone
- The upcoming projects that Project Heal has
- The need for substantial increases in lower-level care options.
- Funding and fundraising for people who cannot afford eating disorder treatment.
Find out more about Project Heal here: http://theprojectheal.org/
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In this podcast I talk to psychotherapist and author Thom Rutledge about addition, eating disorders, and ignoring the negative inner voice.
Thom Rutledge, LCSW is a psychotherapist in Nashville, Tennessee. He is the author of several books, including Embracing Fear, The Self-Forgiveness Handbook, The Greater Possibilities, Simple Truth and is co-author (with Jenni Schaefer) of Life Without Ed. Thom has been featured on NBC’s Today Show, CNN’s Anderson Cooper, Australia’s Channel 10 and has consulted with The Dr. Phil Show. For more information about Thom’s books, workshops and availability for Skype or telephone consultations, visit www.thomrutledge.com.
Thom’s books: https://www.amazon.com/Thom-Rutledge/e/B001H6NZWG/ref=dp_byline_cont_book_1
Thom’s Nutshell Wisdom Gift Shop: www.cafepress.com/nutshells
Thom’s FREE Download Page: www.thomrutledge.com/free-downloads
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In this podcast I talk to Therese Waterhous on what registered dietician can actually do for a person with an eating disorder.
- Dietitians as case managers for eating disorders
- Eating, shopping and other food and eating related behaviors.
- Working with families when youngsters are involved
- Family dynamics and the devision of responsibility
- Meal plans and accessing nutritional need.
- When the dietitian is the only person with eating disorder training on the team
- Taking pulse or blood pressure so that they can refer information to a doctor
- Diagnostic criteria and hospitalization criteria
- Training families and support people in helping in eating disorder recovery
- Extreme hunger in Anorexia recovery and how to approach it.
In this podcast we talk about yoga, mindfulness and mediation techniques and some in-depth explanations of exactly why they are a game changer in the later stages of eating disorder recovery. We also demo a 20 second breathing exercise that listeners can try for themselves!
Chelsea Roff is the Founder and Director of Eat Breathe Thrive™, a non-profit organization that prevents and helps individuals overcome disordered eating and negative body image. An internationally recognized author, speaker, and educator, Chelsea has spent the past seven years pioneering integrative programs for people with mental health challenges.
Eat Breathe Thrive is a nonprofit organization that aims to prevent and help individuals overcome food and body image challenges. Their programs combine yoga and mindfulness-based practices to support healthy eating, emotional resilience, and body confidence. Eat Breathe Thrive operates in three dozen U.S. states and four different countries. In a few short years, the organization has helped thousands of people around the world. www.eatbreathethrive.org
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In this special podcast for Eating Disorder Awareness week, I share some stories and experiences from adults in recovery from eating disorders. Today the focus is entrenched behaviours and overcoming the identity crisis that so many people in recovery from long term eating disorders have to deal with.
Adults in recovery from eating disorders face different challenges than children and teenagers do. The idea behind AEDRA — Active Eating Disorder Recovery for Adults is that we focus on adults and the specific problems that an adult in recovery will face.
Today I read your comments and thoughts on loneliness. Anorexia and other eating disorders are incredibly isolating. But recovery brings hope. New relationships will form and old ones will heal.
Active Eating Disorder Recovery for Adults website: http://www.adulteatingdisorderrecovery.com/en/
Private adults only online support group: http://tabithafarrar.com/slack-forum/
Email Tabitha: info@tabithafarrar.com
Twitter @Love_Fat_ and @ED_MealSupport
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In this special podcast for Eating Disorder Awareness week, I share some stories and experiences from adults in recovery from eating disorders. Today the focus is entrenched behaviours and overcoming the identity crisis that so many people in recovery from long term eating disorders have to deal with.
Adults in recovery from eating disorders face different challenges than children and teenagers do. The idea behind AEDRA — Active Eating Disorder Recovery for Adults is that we focus on adults and the specific problems that an adult in recovery will face.
Active Eating Disorder Recovery for Adults website: http://www.adulteatingdisorderrecovery.com/en/
Private adults only online support group: http://tabithafarrar.com/slack-forum/
Blogs on Anorexia and Money: http://tabithafarrar.com/2016/10/anorexia-money-recovery-meant-look-relationship/
Twitter @Love_Fat_ and @ED_MealSupport
If you want to send me your thoughts on tomorrow’s topic please email me at info@tabithafarrar.com. The Topics that will be covered this week are as follows:
Mon – Work/money – financial issues due to being sick
Tue – Family – partners and children
Wed – Entrenched behaviours/ personal identity crisis after 5,10,20,30 + years of ED identity
Thur – Loneliness
Fri – Not being treated like an adult in treatment
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In this special podcast for Eating Disorder Awareness week, I share some stories and experiences from adults in recovery from eating disorders. Today the focus is relationships, sex, family and kids!
Adults in recovery from eating disorders face different challenges than children and teenagers do. The idea behind AEDRA — Active Eating Disorder Recovery for Adults is that we focus on adults and the specific problems that an adult in recovery will face.
The sex/relationships one is a big topic of conversation for adults. Lack of libido tends to lead to a dramatic fall in the desire to participate in sexual activity. Also the irritability and other disposition changes that many sufferers face as a reaction to malnutrition isn’t exactly a relationship booster. Family life can be fraught as it is, but when an eating disorder barges in it takes on a whole new level of tension.
From lack of interest in sex, to dealing with family reactions to weight loss. That is what we are talking about today.
Active Eating Disorder Recovery for Adults website: http://www.adulteatingdisorderrecovery.com/en/
Private adults only online support group: http://tabithafarrar.com/slack-forum/
Blogs on Anorexia and Money: http://tabithafarrar.com/2016/10/anorexia-money-recovery-meant-look-relationship/
Twitter @Love_Fat_ and @ED_MealSupport
If you want to send me your thoughts on tomorrow’s topic please email me at info@tabithafarrar.com. The Topics that will be covered this week are as follows:
Mon – Work/money – financial issues due to being sick
Tue – Family – partners and children
Wed – Entrenched behaviours/ personal identity crisis after 5,10,20,30 + years of ED identity
Thur – Loneliness
Fri – Not being treated like an adult in treatment
In this special podcast for Eating Disorder Awareness week, I share some stories and experiences from adults in recovery from eating disorders. Today the focus is money and work.
Adults in recovery from eating disorders face different challenges than children and teenagers do. The idea behind AEDRA — Active Eating Disorder Recovery for Adults is that we focus on adults and the specific problems that an adult in recovery will face.
The money and work one is a big topic of conversation for adults. We often have to pay for our own treatment. What do we do when we are too sick to work? Recovery is a full time job, so what about taking time out for that? And then there are the money-spending problems that many people with restrictive eating disorders have.
From spending money on putting the heating on to keep a thin and frail body warm enough, to paying thousands for treatment, to actually forking out for that piece of cake that you know you are scared to eat. It all adds up to a lot of money stress. That is what we are talking about today.
Active Eating Disorder Recovery for Adults website: http://www.adulteatingdisorderrecovery.com/en/
Private adults only online support group: http://tabithafarrar.com/slack-forum/
Blogs on Anorexia and Money: http://tabithafarrar.com/2016/10/anorexia-money-recovery-meant-look-relationship/
Twitter @Love_Fat_ and @ED_MealSupport
If you want to send me your thoughts on tomorrow’s topic please email me at info@tabithafarrar.com. The Topics that will be covered this week are as follows:
Mon – Work/money – financial issues due to being sick
Tue – Family – partners and children
Wed – Entrenched behaviours/ personal identity crisis after 5,10,20,30 + years of ED identity
Thur – Loneliness
Fri – Not being treated like an adult in treatment
In this podcast Tabitha has the pleasure of chatting with parent advocate and coach Eva Musby. We talk about:
- Nonviolent communication skills
- Exhaustion, shame, regrets, and how to deal with these normal emotions
- How kindness can heal for all parties involved
- Origins of stress for parents of people with eating disorders
- Types of stress and how eating disorder play into them
- How to really not take rebuttal, hate, and withdrawal personally
- Setting up for the long haul – as eating disorders can take years to treat
- Nurturing friendships, mindfulness, living with joy to enable you to stay in it for the long haul.
- Self compassion vs self esteem — and why you need both!
- Why you need to take time out – and how to do it!
- Action! How taking action can relieve stress for parents and caregiver.
- The importance of getting support
Links:
Eva Musby: www.evamusby.co.uk Support that Eva Musby offers parents: http://evamusby.co.uk/individual-support/
Videos offering practical and emotional tools: https://www.youtube.com/playlist?list=PLVgyQbyKQSBHUbIDLlc7t3v7bN0lmLcve
FaceBook Links
www.facebook.com/EvaMusby.Individual www.facebook.com/EvaMusby
Twitter is @evamusby
Resources mentioned in the podcast: Laura Collins’ resources about parents not causing eating disorders: https://www.youtube.com/watch?v=wE3fyQV_chI
Kristin Neff’s TED talk “The space between self-esteem and self-compassion” https://www.youtube.com/watch?v=IvtZBUSplr4 Feedback link for podcasts:
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In this podcast Tabitha talks about her experience with recovery binges when she was recovering from Anorexia. She describes how she went from restriction, into a binge-restrict cycle. More importantly, she talks about how the way out of that binge-restrict cycle is to find the restriction that is still present in your eating and eliminate it. thus allowing the body to eat freely and unlimited.
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More information on this topic in the following blog posts:
Extreme Hunger
Why You Cannot Possibly Eat Too Much In Recovery From Anorexia
Video about Recovery Eating.
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Tabitha talks to Christina Fisanick about her experience with Binge Eating Disorder.
In this podcast we talk about:
- Being honest in recovery
- Understanding that anybody can relapse
- The Anorexia recovery binges are not Binge Eating Disorder. More on this here: http://tabithafarrar.com/2017/02/recovery-binges-not-end-world/
- Important of using support in Binge Eating Disorder Recovery
- The assumptions that are made about Binge Eating Disorder
- Mindfulness and Binge Eating Disorder Recovery.
- Recovery from Binge Eating Disorder not being weight loss orientated.
- Being healthy in your own size.
Christina Fisanick Greer, Ph.D. is professor of English at California University of Pennsylvania and the author of more than 35 books. Her memoir, The Optimistic Food Addict: Recovering from Binge Eating Disorder, explores her more than 30 year battle with an eating disorder and other personal challenges. Her most recent writing has appeared on the National Eating Disorder Association’s website and on her blog, Optimistic Food Addict. She is the founder of Food Addiction Recovery, a Facebook-based support group which has nearly 9,000 members.
The Optimistic Food Addict: Recovering from Binge Eating Disorder http://amzn.to/2lA8kcM
Website: OptimisticFoodAddict.com
Other resources:
https://www.nationaleatingdisorders.org/stories-of-hope/christina-fisanick-greer-phd
Facebook/FoodAddictionRecovery
AEDRA Meal Support:
http://www.adulteatingdisorderrecovery.com/en/
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In this podcast Tabitha gets to talk to one of her favorite eating disorder experts: Laura Collins Lyster-Mensh. We discuss FEAST, eating disorder peer support forums, and how to take the sting out of an eating disorder diagnosis for the family members involved.
Laura founded FEAST, and this website is a true gift for any parent navigating the world of eating disorders. Since FEAST Laura has stayed active in the eating disorder parent community and works with treatment centers on how they can better gear services towards families from start to end.
Laura Collins Lyster-Mensh wrote the book “Eating With Your Anorexic,” which provided a blueprint for all parents struggling with the elemental challenge of parenting a child with anorexia nervosa.
In 2008, Laura became the original Executive Director of FEAST — Families Empowered and Supporting Treatment of Eating Disorders.
Laura now operates Circum Mensam. She offers her knowledge and experience in the field of eating disorders from a parent perspective to educational and advocacy organizations. Starting in 2017 Laura is also providing services for parents as well: through private consultations and Starfish Packages.
Laura Collins Lyster-Mensh now offers “Starfish Packages,” a colorful Priority Mail package filled with information and courage for parents of newly diagnosed patients. She also hosts a new podcast called NEW PLATES about how parents and treatment teams can collaborate to support eating disorder patients toward recovery, and build resilient families.
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In this podcast, Tabitha talks with former NFL player Patrick Devenny about being a man with Bulimia. We talk about the mental and physical complications that his illness brought and how these affected his life. We also talk about the role of exercise and how Patrick’s compulsion to exercise was a large part of the problem. Patrick is now on a recovery path, and while he says that there is still a way to go, he knows that the treatment that he has received from the eating disorder specialists that he has worked with has been invaluable to his recovery.
It takes incredible strength to recover from an eating disorder. It takes even more self acceptance to talk about it openly in a world where many people believe that eating disorders are a phase that teenage girls go through. Patrick is doing a fantastic service by talking about his experience with bulimia. It shows incredible strength and courage and I hope that he will lead the way so that more men can get treatment.
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In this podcast, Tabitha has a chat to Ryan Sheldon. Ryan talks about how he first discovered that he had binge eating disorder (BED), how it impacted his life and his mental health, and how he progressed through treatment.
In this podcast, we discuss:
- Binge Eating Disorder from a sufferer’s perspective
- Cultural implications of being a man with an eating disorder
- The behaviors and thought patterns associated with Binge Eating Disorder
- The importance of speaking out and seeking support
- The effects of treatment
- What recovery looks like for Ryan
About Ryan
Ryan Sheldon is founder of Confessions of a Binge Eater, a blog he created to share about his journey with Binge Eating Disorder (BED). Ryan hopes his story will help others suffering from BED overcome shame and embarrassment. In particular, Ryan provides a voice for the many men struggling eating disorders while encouraging them to get help.
Ryan used to spend his days thinking about food, planning for it, and indulging in it. For years, he justified this by calling it “emotional eating” until he realized his love affair with food was spiraling out of control. Ryan was diagnosed with Binge Eating Disorder, an illness characterized by compulsive overeating. Since then, he has made it his mission to not only overcome BED but to inspire others to do the same.
For more information on Ryan, please visit http://confessionsofabingeeater.com or email sarah@sarahrosepr.com
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Tabitha talks to Carrie Arnold on her experience on adult eating disorder recovery when Obsessive Compulsive Disorder (OCD) and Anorexia are present together. Anorexia brings its own type of OCD behaviors, however for adults in recovery who also have premorbid OCD on top of that, recovery can be even more complicated.
In this podcast we discuss:
- Premorbid OCD with Anorexia
- Contamination fears and other non-eating disorder related OCD behaviors
- Strategies to limit the disruption to recovery
- The importance of putting recovery as a priority as an adult with an eating disorder
- Later onset eating disorders
About Carrie Arnold
Carrie Arnold is an award winning blogger, freelance science writer, and author living in Virginia. She writes on a variety of topics from microbiology to evolution. Carrie is in recovery from anorexia, and is very active in the eating disorder community as an advocate for better research and treatments.
Carrie’s Webiste
Decoding Anorexia
Support this podcast via Patreon! You can support this podcast and ensure the continuation of it by pledging a patreon donation here: https://www.patreon.com/Eating_Disorder_Recovery_Podcast
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In this podcast I explain negative energy balance (energy deficit) in restrictive eating disorders. I talk about what it actually is, how it is different in a person with an eating disorder compared to a person without an eating disorder, and how if feels.
Energy deficit is important to understand as it helps us figure out why something that feels really good for us can actually be very bad for us. In order to recover, sufferers have to learn to resist the lure of negative energy balance and the soothing aspects of it. While this creates anxiety and uncomfortableness at first, it is an important aspect of recovery.
Understanding the mechanisms behind restrictive eating disorders can help us figure out what we need to do in order to overcome them.
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In this podcast I interview Tara Deliberto. Tara is the director of the new Eating Disorders Partial Hospitalization Program at New York-Presbyterian Hospital.
In this podcast we discuss
- Recovery resource services such as Eating Disorder’s Partial Hospitalization Program.
- How having to eat puts us in a constant state of fearfulness.
- The difference between treating the eating disorder and treating the underlying cause.
- Why the eating disorder needs treatment first and foremost.
- Why and how eating disorders are deadly.
- Programs aimed at helping adults in recovery.
Links to the resources discussed in the podcast:
1. http://www.nyp.org/psychiatry/services/center-for-eating-disorders 2. http://taradeliberto.blogspot.com/ 3. http://www.bite-ed.com/bite-eatingdisorders-blog/ Tara Deliberto on Twitter We want your feedback!
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In this Podcast, Tabitha Farrar Speaks to Therese Waterhous on Creating a Complete Treatment Model for Eating Disorders
In this podcast we discuss:
- Myths and limitations of inpatient treatment for eating disorders
- Problems with short-sighted treatments
- How to work together to incorporate a long-term plan
- Training practitioners in up-to-date treatments for eating disorders
- Recognizing exercise as a symptom of an eating disorder and setting expectations around levels of exercise for a person in recovery with parents
- Problems arising from lack of good communication between practitioners and parents/patients.
About Therese S. Waterhous Therese S. Waterhous is a PhD/RDN, CEDRD and IAEDP (International Assn. of eating Disorders Professionals) approved supervisor, is owner of Willamette Nutrition Source, LLC, a private outpatient practice devoted to eating disorders care. Therese has formal training in basic research, clinical nutrition and multidisciplinary team treatment of severe pediatric disorders.
Therese co-authored the AND (Academy of Nutrition and Dietetics) Practice Paper on nutrition intervention in treatment of eating disorders, authored the online chapter for the AND on pediatric eating disorders and she is immediate past Director of the Sports, Cardiovascular and Wellness nutrition practice group’s eating disorder subunit as well as being a professional advisor for FEAST-ED.org. She is the credentialing chair for the Oregon IAEDP chapter, served as co-chair of the Family Based Treatment SIG, within the Academy of Eating Disorders (AED) and she currently serves on the Medical Care Standards Committee for the AED and also the Health and
Nutrition Committee for IAEDP. Therese enjoys conducing trainings for health care professionals on eating disorder research and treatment and educating the general public about eating disorders.
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In this podcast, Tabitha Farrar talk to Dr Laura Hill about the neurobiology of eating disorders such as Anorexia Nervosa. We also talk about the new treatment approach that Dr Hill is developing. In this podcast we discuss:
- The history of research and understanding about eating disorders
- The importance of involving the family in all aspects of treatment and educating support persons.
- How understanding how eating disorders affect areas of the brain can explain the behaviors demonstrated by patients
- The developments in treatment models as informed by neurobiology and patient studies
- Dr Laura Hill’s contributions to the field of the neurobiology behind eating disorders
- Treatment gaps and technologies to fill them
- Eating disorders as brain-based illnesses
- Developing compassion and understanding and applications for treatment
About Dr Laura Hill Dr. Laura Hill is the President & CEO of The Center for Balanced Living, a free standing not-for-profit organization that specializes in the education, treatment and research of eating disorders. Dr Hill is the recipient of Muskingum University Distinguished Service Award in 2014, the National Eating Disorders Association 2011 Lori Irving Award for Excellence in Eating Disorders Prevention and Awareness and was a TEDx Columbus speaker in 2012. She is an original founder of the Academy for Eating Disorders in 1993 and was Director of what is now known as The National Eating Disorder Association from 1990 to 1994.
She is the lead author of the Family Eating Disorder Manual, 2012; and has conducted research and spoken internationally over the last 35 years. She is a recipient of the national Feeding Hope award by NEDA, in collaboration with UCSD Eating Disorder and Research.
Find out more about Dr Laura Hill here: http://www.centerforbalancedliving.org/laura-hill/
Link to the recent study that we discussed:
http://jeatdisord.biomedcentral.com/articles/10.1186/s40337-016-0119-x
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In this podcast Tabs talks to Emily Troscianko about what we refer to as “overshoot” in eating disorder recovery.
In this podcast we discuss:
- Why not to stop halfway in recovery
- What exactly overshoot is in eating disorder recovery
- The importance of fat as an organ
- Why overshoot is a natural part of recovering from an eating disorder
- Why trusting the body is so crucial … but so hard!
- The greatness of life without an eating disorder
About Emily Troscianko Emily Troscianko does research on the psychological effects of reading fiction, especially as they relate to mental health. She also writes a blog about eating disorders and is coauthoring a textbook on consciousness. She suffered from anorexia between the ages of 16 and 26, and is thankful that it wasn’t longer.
http://www.troscianko.com, is where you can find out more about Emily, and her blog is at, https://www.psychologytoday.com/blog/hunger-artist.
I you are interested in learning more about “overshoot” the following resources may be of interest to you.
Overshoot Blog One
Aim to Overshoot
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In this podcast Tabitha Farrar talks about how people with eating disorders who are in active recovery can not only survive Christmas but come out feeling stronger and more in control than they were before.
Thanksgiving, family meals, Christmas and other such celebrations are hard work for a person with an eating disorder.
- How to prepare for the day without letting the eating disorder ruin it before it starts
- How to manage eating disorder thoughts leading up to Christmas
- How to stick to your guns with your recovery plan leading up to Christmas
- When to know if Christmas with family is a good idea or not.
- Understanding that recovery is a priority.
There is a blog post for this episode here.
This podcast contains actionable tips on how to manage an eating disorder leading up to Christmas.
If you are interested in either the Slack group for adults in active recovery from an eating disorder, or the group for adults helping adults in active recovery, please contact Tabitha.
In this podcast Tabitha Farrar talks to Beth Rosen, MS, RD, CDN, a Registered Dietitian promoting a non-diet approach to wellness.
- Origins of health at every size
- Dental issues in eating disorders
- Diet industry business model and how it exploits
- Overshoot in eating disorder recovery
- False truths and how they govern our eating decisions
- Dangers of diet rules
- Getting rid of the thin ideal
- How to be an activist for health at every size!
Association for Size Diversity and Health https://www.sizediversityandhealth.org/ Beth’s FaceBook group: https://www.facebook.com/groups/dietfreeliving/ Beth’s website: http://www.goodnessgraciousliving.com/blog/ HAES, diet-free living, and body positive blog posts: http://www.goodnessgraciousliving.com/blog/category/diet-free-living/ Beth’s Instagram: http://www.instagram.com/goodnessgraciousliving Beth’s Twitter: http://www.twitter.com/ggliving Linda Bacon’s book: http://www.lindabacon.org/haesbook/ We want your feedback!
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Tabitha Farrar talks to Dr. Lauren Muhlheim on the subject of compulsive exercise in eating disorders such as Anorexia. We discuss:
- Why exercise in eating disorders is a problem
- The dangers of exercising when you are underweight
- How to know if exercise is part of the eating disorder rather than a healthy pastime
- The problem of recognizing exercise as an eating disorder symptom
- Experiments in starvation in rats
- Exercise and excessive movements in children with eating disorders
- What lab experiments and observation in children can teach us about exercise as a symptom of an eating disorder
Article in Verywell on exercise written by Dr. Muhlheim
Dr. Lauren Muhlheim Dr. Lauren Mulhleim is a clinical psychologist at Eating Disorder Therapy LA who specializes in providing evidence-based cognitive behavioral psychotherapy for a variety of problems experienced by adults including eating disorders. Dr. Muhlheim regularly volunteers her time for several organizations including the Academy for Eating Disorders, the Los Angeles County Psychological Association, and Best Friends LA. She is my go-to professional and a highly valued member of the eating disorder advocacy community.
In short: Dr. Muhlheim gets eating disorders. Check out her website for more information and resources and follow her on twitter @drmuhlheim
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In this podcast I talk about the Binge/Purge Cycle In Anorexia Recovery that many of us experience. Some people find it very difficult to break this cycle once it is an established behavior. This podcast includes some practical advice on how to overcome and move through into full recovery.
In this podcast, Tabitha talks about: * Her own experience in binge eating and purging behavior * The destructiveness of the binge/purge cycle * How to overcome the binge/purge cycle * Why binge eating is common in eating disorder recovery * The importance of not restricting food or purging via exercise * Why we don’t negotiate with eating disorders
Full blog post on the binge/purge cycle in eating disorder recovery here.
Information on Tabitha Farrar can be found here
Contact Tabitha Farrar
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In this podcast I explain the crucial difference between treating the trigger vs treating the eating disorder. For any person in recovery from an eating disorder or any person who is helping a sufferer recover this is a concept that you will really have to grasp in order to decide on the most effective form of treatment.
- Triggers are separate from the eating disorder and should be treated separately
- Weight restoration should be the priority in people who are underweight
- Treating triggers is important but not as important as weight restoration
- Once weight restored trigger issues are easier to treat due to the patients increased physical and mental resources.
If you are an adult in recovery or a parent/partner of an adult in recovery please remember that I have a peer support Slack group for you to join if you are looking for more support. You can find out more here.
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In this podcast Tabitha Farrar talks about how people with eating disorders who are in active recovery can not only survive Thanksgiving but come out feeling stronger and more in control than they were before.
Thanksgiving, family meals, Christmas and other such celebrations are hard work for a person with an eating disorder.
- How to prepare for the day without letting the eating disorder ruin it before it starts
- How to manage eating disorder thoughts leading up to Thanksgiving
- How to stick to your guns with your recovery plan the morning of Thanksgiving
- How to not only get through the meal, but even enjoy it.
- How to deal with the eating disorder guilt thoughts post Thanksgiving dinner.
This podcast contains actionable tips on how to manage an eating disorder over a holiday meal.
If you are interested in either the Slack group for adults in active recovery from an eating disorder, or the group for adults helping adults in active recovery, please contact Tabitha.
Learn the dangers associated with restricting carbohydrates and other food groups for everyone but especially people in recovery from an eating disorder.
In this podcast we discuss:
- The importance of carbohydrates as brain fuel
- The importance of carbohydrates as mood boosters
- Combating the thin ideal
- The influence of society and the normalisation of disordered eating.
- Why restricting can lead to binging
- Recovered sufferers in the field of eating disorder therapy
- The problems with lack of regulation
About Caitlin Caitlin Croteau is an expert in helping her clients find body freedom. She comes with a decade of experience working in the fitness industry, nutrition field, and in health coaching. She is the founder of Finding Body Freedom, an online holistic wellness practice that provides health and nutrition coaching, intuitive eating and lifestyle programs, and retreats. She has her B.S in Health Science: Nutrition, is an RD, CPT, and RYT-200 Hour. Cait is currently attending Plymouth State University for her Master’s in Health Education and Eating Disorders. Her goal is to rid the world of dieting, help her clients quit the dieting mentality and welcome in freedom to live guilt free, and to decrease the prevalence of eating disorders worldwide.
This episode was based on the Huffington Post Article by Jennifer Rolin on reasons that you do not need to restrict carbohydrates. Read it here.
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In this podcast you will hear my conversation with Eva Musby. We talk about her experience with family-based therapy (or family-based treatment) as a mother. We also go into the key points that Eva addresses in her book and give you Getting a Person with an Eating Disorder to Eat:
- Understand the fear mechanism that is active when a person has an eating disorder. Logic and lectures will not work in this place, and Eva explains what you can use therefore.
- Compassion. Understanding how the sufferer is feeling will help you not blame them for their actions and will help you push through with family-based treatment (FBT).
- Creating an impression of utter confidence. This helps the sufferer trust that you as the parent know what you are doing and will reduce the panic and insecurity the sufferer feels. Watch: Stuck not Eating on You Tube
- Meal supporters must be on the same page. This is a key predictor of recovery — down to all decisions, not just the broad strokes.
- Become a great body language reader!
- Have a thick skin! Understand with compassion that the abuse the sufferer is dishing out is not personal.
- Self care and compassion for the caregiver. FBT is relentless! You have to be on your A game!
About Eva Musby Eva Musby is a pen name. Eva’s otherwise healthy daughter spiralled into anorexia. Eleven months in hospital restored her health, but once she was home, Eva and her family learned a lot and made fast progress.
Eva now takes the principles that she learned in helping her daughter to recover and uses them to help other parents. She has a book on helping a child recover from an eating disorder which is a fantastic resource for any parent.
Where to find more information:
Links: www.evamusby.co.uk and https://www.youtube.com/playlist?list=PLVgyQbyKQSBHUbIDLlc7t3v7bN0lmLcve www.facebook.com/EvaMusby.Individual and
www.facebook.com/EvaMusby
and twitter is @evamusby
Podcast on fear and fight or flight reaction in eating disorders
This podcast continues to discuss Family-Based Therapy for eating disorders.
In this podcast I talk to Amy Cunningham — mother of last week’s guest, Emma Cunningham. Last week we heard Emma’s story of family-based therapy from the perspective of a child who had recently been through the process. If you didn’t listen to last week’s episode you can do so here.
Amy tells us about the process of putting a child through family-based therapy. From diagnosis to close to full recovery.
In this podcast, we discuss:
- Genetics of eating disorders and how they run through families.
- Amy’s own experience with Anorexia and Bulimia.
- How Amy recognized her daughter’s eating disorder.
- Managing family-based therapy with school, work, and travel.
- Working with other family members to administer family-based therapy.
- Eating disorder advocacy and what needs to be done in order to make these illnesses better treated.
Amy now works as an advocate for family-based therapy and other aspects of eating disorder treatment and understanding. You can find out more about the advocacy part of our conversation via the following links.
International Eating Disorder Action
@IEDAction
World Eating Disorder Action Day
In this podcast I talk to Emma Cunningham about how family-based therapy saved her life. This is a very enlightening perspective from a survivor — an important listen for parents who are currently administering FBT, or contemplating it.
Emma has suffered from Anorexia, and explains how her parents worked with professionals versed in family-based therapy practices to put her in an environment where her eating disorder could not survive. In fact, not only did Emma move into a firm place of recovery from her Anorexia, but she is now an advocate for family-based therapy as an effective form of treatment. What an incredible young woman!
If you are at all on the fence about family-based therapy, don’t take it from me. You don’t even have to take it from the professionals who use it to treat eating disorder patients. Listen to this 15-year-old survivor and see what she has to say about it.
In this podcast we discuss:
- How family based therapy is difficult, but it will strengthen relationships in the long run
- Why parents should not hesitate to go into family-based therapy
- How survivors respect and are thankful to parents who help them recover
- How FBT allows sufferers to recover the fastest way, and this lets them continue with their lives without an eating disorder.
- How families can work together even when they are not all living together
- The influence of school and how to manage school during treatment.
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Eating Disorders and starting college is an important topic for many students who are in recovery from Anorexia, bulimia, or other types of eating disorders.
In this episode I talk to Florida-based eating disorder specialist Dr Sarah Ravin about eating disorders in students who are either due to go away to college, or who are already there.
About Dr. Ravin Dr Ravin specializes in treating children, teenagers, and young adults for eating disorders such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and other non-specified eating disorders. Dr Ravin also treats these populations for other psychological disorders such as anxiety and depression. She offers individual therapy as well as Family-Based Therapy (FBT) which is also known as The Maudsley Method.
Dr Ravin believes that parents are a sufferers greatest chance in recovery and works with parents to help their child reach a full recovery. She believes that a solid support system is crucial to the recovery process from an eating disorder.
In this podcast we discuss:
- How to know if it is safe to go to college or allow your child to go when an eating disorder is active.
- Leverage parents can use to make an “adult” child conform to treatment or continue recovery.
- The importance of a signed eating disorder recovery plan.
- The importance of a third party on campus to act as a verification source for the parent.
- Understanding that eating disorders make sufferers lie about their progress.
- The importance of health over education, and when to know it is time to pull a child out of school.
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In this episode I talk to Florida-based eating disorder specialist Dr Sarah Ravin about the importance of finding a therapist who uses evidence-based treatments for treating eating disorders.
About Dr. Ravin Dr Ravin specializes in treating children, teenagers, and young adults for eating disorders such as Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder and other non-specified eating disorders. Dr Ravin also treats these populations for other psychological disorders such as anxiety and depression. She offers individual therapy as well as Family-Based Therapy (FBT) which is also known as The Maudsley Method.
Dr Ravin believes that parents are a sufferers greatest chance in recovery and works with parents to help their child reach a full recovery. She believes that a solid support system is crucial to the recovery process from an eating disorder.
In this podcast on how to find an eating disorder therapist, we discuss: * What is evidence- based treatment? * Why is evidence-based treatment is important for eating disorder therapy? * Why some therapists do not use evidence-based treatment. * Why non-evidence based treatment approaches can be harmful. * Questions to ask a treatment provider before you commit. * The importance of treating the most dangerous aspects of an eating disorder aggressively. * The problems associated with non-evidence based methods in both the long and short term.
You can find out more about Dr. Sarah Ravin via her webiste: http://www.drsarahravin.com
In this podcast I interview Tara Deliberto. Tara is the director of the new Eating Disorders Partial Hospitalization Program at New York-Presbyterian Hospital.
You’ll be able to hear Tara describe the dynamics of the new program in detail and explain how it came about. We also discuss why this sort of partial-hospitalization program is an essential addition to the treatment of eating disorders in adults.
As an adult with Anorexia, I personally am thrilled about this program because the state of treatment for adult sufferers of eating disorders is currently far from being up to scratch. Most of the time, the sufferer doesn’t actually recover at all in a 2 week inpatient stay. Yes, they may gain some weight, but that’s a superficial sign of recovery from an eating disorder. Full recovery means a lot more than gaining a couple of pounds.
This short of program addresses the ongoing support that is needed for people who are recovering from entrenched eating disorders.
Links to the resources discussed in the podcast:
- http://www.nyp.org/psychiatry/services/center-for-eating-disorders
- http://taradeliberto.blogspot.com/
- http://www.bite-ed.com/bite-eatingdisorders-blog/ Tara Deliberto on Twitter
In this podcast I talk to Karen Korn.
Karen is the mother of a sufferer of Anorexia, and has spent the last couple of years helping her daughter battle this deadly disease. Karen is also an anthropologist, and has some ideas about veganism and eating disorders that I think are interesting.
She’s got more of a tactful and thoughtful message than I have I think, as I just tend to bulldoze in with my “nobody who has had an eating disorder can be a vegan” approach, so her ideas might go over better for those of you who bristle at my own.
Anthropology is the study of humans. It’s also the study of human culture, and food is often a large part of our culture, isn’t it?. Regardless of religion or race, there is always a food-orientated holiday somewhere on the calendar. We go through phases as a culture over time too, not so long ago the main phase in Western culture was low fat. You all know how I feel about that one, I only dedicated my book’s title to it “Love Fat.”
While we seem to be making positive shifts towards understanding once again that fat is an important nutrient, we’ve moved on to a new phase or trend in food. All this “Clean eating” and speciality diets. Yes, veganism.
It’s an interesting discussion, we begin by talking about Karens own daughter’s experience of Anorexia and how she went about noticing the problem, to making the first steps around getting treatment.
I asked Karen to shoot me some resources to do with ethical eating, vegainsim etc. Well there is a whole huge long list from her — don’t miss the “solutions” at the bottom— enjoy!
Links http://www.beyondveg.com/index.shtml
http://naturalhygienesociety.org/diet3.html#4
http://tabithafarrar.com/2016/06/back-veganism-eating-disorders-conversation/ = LOL You’ve been in my Bookmarks for a while now
http://www.livescience.com/26278-risks-raw-vegan-diet.html
http://www.nytimes.com/roomfordebate/2012/04/17/is-veganism-good-for-everyone/meat-is-brain-food
http://www.nytimes.com/roomfordebate/2012/04/17/is-veganism-good-for-everyone
http://www.nytimes.com/roomfordebate/2012/04/17/is-veganism-good-for-everyone/a-choice-with-definite-risks
http://www.mdpi.com/2075-4698/4/2/127
Which diet is best? Vegan, Vegetarian, Paleo, WAPF, Low-Carb….?
http://www.onegreenplanet.org/lifestyle/understanding-neocarnism/
http://www.science20.com/news_articles/vegetarians_found_to_have_more_cancer_allergies_and_mental_health_disorders-133332
https://www.psychologytoday.com/blog/evolutionary-psychiatry/201211/youre-vegetarian-have-you-lost-your-mind
https://www.psychologytoday.com/blog/real-healing/201211/vegetarianism-and-eating-disorders
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466124/
https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-9-67
http://www.sciencedirect.com/science/article/pii/S0195666311006271 Study: Vegetarians Less Healthy, Lower Quality Of Life Than Meat-Eaters
http://www.naturalhealthprotocol.com/vegetarianism-and-body-chemistry.html
than-meat-lovers/#sthash.25dQeQQH.jnh7BGCi.dpbs
Why I Stopped Being Vegetarian
http://www.scientific-alliance.org/scientific-alliance-newsletter/can-vegetarians-save-world
http://www.palgrave.com/us/book/9781137554888#reviews
https://www.washingtonpost.com/lifestyle/food/vegetarian-or-omnivore-the-environmental-implications-of-diet/2014/03/10/648fdbe8-a495-11e3-a5fa-55f0c77bf39c_story.html
http://www.motherjones.com/environment/2010/07/is-vegetarian-diet-green
Why vegetarianism will not save the world
What if the whole world went vegan?
http://www.telegraph.co.uk/foodanddrink/foodanddrinknews/8012205/Eat-meat-and-save-the-planet-says-eco-warrior-and-former-vegetarian.html
Solutions:
https://en.wikipedia.org/wiki/Permaculture https://permacultureprinciples.com/ https://en.wikipedia.org/wiki/Aquaponics http://sift.ncat.org/small_scale.php http://sustainablefoodtrust.org/articles/small-scale-farming/ http://sustainableagriculture.net/publications/grassrootsguide/local-food-systems-rural-development/ http://asi.ucdavis.edu/programs/sarep/about/what-is-sustainable-agriculture http://www.regenerativedesign.org/programs/integral-permaculture-fall-2016-2017#.V7Xk3j4rJ0s
This podcast is the second part from my conversation with inspiring Eating Disorder Advocate JD Ouellette on resources available and lessons leant from parenting a child through an eating disorder.
JD’s daughter became ill with Anorexia at age 17, and Family Based Therapy was a crucial part of her recovery. In this episode, we delve more into the dangers and complications that speciality diets pose to the recovering sufferer, the role of the entire family and the importance in getting Dads involved in treatment, and so much more … including chickens!
Follow @JugglingJenn on Twitter.
Topics discussed in this podcast:
- FBT (Family Based Therapy) resources and methods
- Online help for parents and where to go to learn more
- Understanding eating disorder behaviour in your child
- How parents can prepare mentally to treat a child with an Eating Disorder.
- The role of families in Eating Disorder Treatment.
- What to look out for if you suspect your child is suffering from an eating disorder
- Vegan diets and Eating Disorders
- Dangers associated with recovered sufferers acting as Eating Disorder Therapists
- The importance of Eating Disorder Advocacy and Storytelling
Links to resources mentioned in this podcast:
FEAST
USCD Eating Disorder Center for Treatment and Research
ED Bites by Carrie Arnold
Laura Hill’s TED Talk
The Venus Fly Trap and the Land Mine: Novel Tools for Eating Disorder Treatment
Brave Girl Eating by Harriet Brown
This podcast features inspiring Eating Disorder Advocate JD Ouellette on parenting a child through an eating disorder.
We discuss resources available and lessons leant from parenting a child through an eating disorder. JD’s daughter became ill with Anorexia at age 17, and Family Based Therapy was a crucial part of her recovery.
Topics discussed in this podcast:
- FBT (Family Based Therapy) resources and methods
- Online help for parents
- Understanding eating disorder behavour
- UCSD Eating Disorder Resources
Follow @JugglingJenn on Twitter.
Links to resources mentioned in this podcast:
FEAST
USCD Eating Disorder Center for Treatment and Research
ED Bites by Carrie Arnold
Laura Hill’s TED Talk
The Venus Fly Trap and the Land Mine: Novel Tools for Eating Disorder Treatment
Brave Girl Eating by Harriet Brown
I explained in the last podcast how I used information from the FEAST website on Family-Based Therapy to kick start my own inner mealtime matron. That was probably the single biggest initiative for me in my recovery — establishing that my eating disorder was not “me”, which let to being able to foster a healthy hate of Anorexia, and develop an inner voice ordering me to eat.
But that is not the whole story. Eating disorders are dreadfully multi-faceted, so recovery tools and approaches have to be so also. In this post, I’m going to explain how I used knowledge about the parts of my brain that control fear, to overcome the fight-flight response to eating.
I explain how I used research into phobias, fear, stress, and techniques to overcome the stress fight-or-flight response to understand what was going on in my brain to cause me to have such a fear response to food.
Remember, you can subscribe to this podcast in iTunes and Google Play so that you get each episode automatically. If you have an idea for a topic you would like me to discuss, then email me or reach out on twitter. @Love_Fat_
Last week I recorded a podcast with Dr. Lauren Muhlheim on the subject of adults with eating disorders. We touch on Family -Based Therapy there. You can listen to the podcast here, and in this post I will be referencing it.
PSA: This episode contains a swear word! Listen at your own risk
About halfway through the conversation we get to talking about Family-Based Therapy (FBT) and the role that this evidence-based form of treatment that is usually used with children has in treating adult sufferers of eating disorders. Lauren asked me about my own story about using FBT to recover, and I tell a little, but I wanted to elaborate on that here.
Before I say anything more, I need to make it clear that treating ones own self for a serious mental illness is not optimal. I was desperate and I had no other resources. The whole point of advocacy in the eating disorders world is to push for resources to be available for people with eating disorders so they don’t have to self treat. That said, the principles that I applied to my own recovery can help you even if you are receiving professional treatment elsewhere — at least that my opinion. Remember, I am not a professional, I am just someone who worked out on my own how to treat my own Anorexia.
So here’s my story: I’d been suffering Anorexia for almost ten years, but I had only just began to understand that I had an eating disorder. Anorexia is particularly nefarious in they way that it disguises itself as the sufferers own thoughts and will. The nature of the disease is to not allow the sufferer to know there is a problem, but that’s another story in itself.
So, at this point I understand I have an ED, and I am starting to look for help, and all I can find are psychoanalytical approaches that tell me I must have been abused as a child, or I must absolutely hate myself, or for whatever underlying and hidden reason I am actually doing this to myself in order to gain control on my life of whatever. Bull Shit.
I knew even then that I wasn’t doing anything to myself, and I had begun to mistrust the thoughts in my head telling me not to eat and to exercise more. I had also begun to distrust the fight-or-flight response I had been having towards food for so many years. Long story short, I knew that something was up with my brain, and that whatever it was was not my doing — consciously or subconsciously.
So I start Googling eating disorders. And I come across this FEAST website that is a resource for parents of children with EDs. On that website is a forum, and I create a username and start reading. Fuck. I mean. Fuck. The stuff on that site. You’ve got parents who are terrified and watching their own children starve to death. You’ve got parents who have lost children to ED. You have parents who have successfully used Family-Based Therapy to treat a child with an ED, and you have everything in between. The anonymous nature of the forum means that this is a place where parents don’t need to hold back. They can openly grieve, rage, and unleash their frustration at their child’s illness. It’s raw.
I read a lot. Initially when I read about FBT and the process of practically force feeding children who are at risk of starving to death my own eating disorder had a fit. It told me that was cruel. But a part of me knew it wasn’t. A part of me knew it was the only thing that was going to help these children in the long run. As I continued to read about the horrific mealtime tantrums that these parents were dealing with six times a day every day I could see both sides: I was the child, but I was also the adult wanting the child to get better.
Those days reading FEAST taught me the following:
- I understood that a parent could love their child but simultaneously hate their child’s eating disorder. This planted the seed for me that the two things were separate. Much of the parent-to-parent support for parents new to Family-Based Therapy was teaching that parent that the tantrums that were directed at them every mealtime was not thier child — the tantrums were the disease. In order to not allow those tantrums to rip them apart and make them think that their own child hated them, it was crucial that they understood it was the disease talking and not the child.
TL;DR: It is okay to hate the eating disorder. The ED is not your child. You can hate the ED and still love your child. 2. You can hate your eating disorder and still love yourself. Huge. This single realisation was the biggest turning point for me. As I read the hate-rage towards EDs that the parents on this FEAST forum had I absorbed it. I recognised all those ED behaviours in my own self and I was able to HATE them. Because the forum had taught me that my ED was not me, I as at full license to hate it.
I cannot stress this enough: I had to allow myself to hate my eating disorder in order to find the energy and motivation to get rid of it. 3. Learning about how Family-Based Therapy is used to treat children I was able to take the framework and apply it to my own self. – Life stops until you eat. I would make myself sit at the table and tell myself you are not leaving until you have eaten it all. Even if it takes hours. No matter what else you had planned to do today, you don’t get to do any of it until you have eaten this meal.
Was it easy? Fuck no.
Many a time I slammed my chair back and left that table with food still on my plate, but I only got a couple of feet out of the kitchen before the “FBT voice” said: If you leave that food Anorexia has won. I hate Anorexia right, so that thought of letting it win would send me straight back to the table to eat the rest. 4. Food is medicine. FEAST drummed this into me. I think that it’s tattooed onto some part of my brain somewhere. I still think it every day for good measure. I made that my moto. I made it my mantra. I repeated it over and over to drown out the ED voice telling me to obsess over calories or exercise.
After some time, I turned that into “Fat is Medicine” in an attempt to help myself redefine my more feared nutrient in my head — and that is what lead me to the book that I wrote: Love Fat.
Not ideal. Sometimes I wonder how on earth I did that. How the fuck did I fight my own mental disorder?
But I did. Treatment from an ED professional who knows the score is optimal for recovery, as nobody should have to do it they way that I did. But my story can be used for adults who want to continue their own treatment once the initial help has been given. Know that your ED is not you. Find a healthy hate for your ED and a passion to get rid of it. Know that every single mouthful of food is a win for you. Equally know that every plate that you walk away from is a win for your ED. Be brutal with yourself if you have to do that in order not to let your ED win. Ever.
Your ED is not you. Food is medicine. Please make sure that you subscribe to The Eating Disorder Recovery podcast in iTunes to make sure that you never miss an episode.
I had the pleasure of talking to the fabulous Dr. Lauren Muhlheim over Skype today about adults with eating disorders.
Below are some of the issues that Dr. Muhlheim and I discussed. This is just the bare bones of the conversation and I recommend that you listen to the whole podcast as Dr. Muhlheim gives some incredibly valuable insight and decorates these points fantastically.
Dr. Lauren Muhlheim Dr. Lauren Mulhleim is a clinical psychologist at Eating Disorder Therapy LA who specializes in providing evidence-based cognitive behavioral psychotherapy for a variety of problems experienced by adults including eating disorders. Dr. Muhlheim regularly volunteers her time for several organizations including the Academy for Eating Disorders, the Los Angeles County Psychological Association, and Best Friends LA. She is my go-to professional and a highly valued member of the eating disorder advocacy community.
In short: Dr. Muhlheim gets eating disorders. Check out her website for more information and resources and follow her on twitter @drmuhlheim
In this podcast you will find information on: Outlining the biggest obstacles for adult sufferers when it comes to accessing treatment options.
Adult and post-menopausal onset of eating disorders.
Dynamics of family and relationships for adults with eating disorders and financial implications.
The role and potential of Family-Based Therapy.
Post inpatient treatment plans and relapse avoidance plans
Links to resources mentioned in the podcast: F.E.A.S.T – Families Empowered and Supporting Treatment of Eating Disorders — this is the website that helped me save my own life. Literally.
And here are those Dr. Muhlhiem mentioned at the end of the podcast:
ASPIRE – Adults Supporting Peers in Recovery from Eating Disorders
Recovery Warriors
NEDA
Hey there,
One thing that I really did not anticipate when I started this blog was how I would feel when readers got in touch with me. Honestly when I started I didn’t think I would have any readers, so interacting with readers couldn’t have been further from my mind.
A couple years on, I interact with readers more than I write blog posts — a lot more — and it is fabulous.
I started podcasting for work, and now that I have all the setup I want to podcast here too. I hope that you will subscribe and let me know what you think. As I say in this intro, I cannot promise how often I will publish a podcast, but I hope to do one a week. iTunes takes a couple of days to update, but before Friday you should be able to find me in the Podcast app on your phone.
This weekend I plan to record some thoughts on adult sufferers as I have been writing about that a bit recently and I have also been emailing with a number of adult sufferers. As I was an adult onset of Anorexia myself, it is a subject very close to my heart.
Thanks to all of you who have supported, inspired, and motivated me.
Stay tuned!
Podcast host: Tabitha Farrar
@Love_Fat_
Cover art with thanks to Bethany Alderson
Music credit with thanks to Accelerated Ideas