WEBVTT - Do Only Women Suffer From Eating Disorders? feat. Matt Stranberg 0:00:00.400 --> 0:00:05.400 I won't let my body out out everything that I'm made, 0:00:05.920 --> 0:00:09.280 won't spend my life trying to change. I'm learning to 0:00:09.360 --> 0:00:13.720 love who I am. I get I'm strong, I feel free, 0:00:14.160 --> 0:00:19.600 I know who every part of me. It's beautiful and 0:00:19.640 --> 0:00:24.599 I will always out way if you feel it with 0:00:24.680 --> 0:00:27.680 your guys in the air, She'll s love to the boom. 0:00:27.800 --> 0:00:31.240 I get there, say good day and time did you 0:00:31.440 --> 0:00:36.440 and die out? So welcome back to outweigh today. I 0:00:36.440 --> 0:00:38.720 have a pretty cool guest with me. His name is 0:00:38.760 --> 0:00:42.200 Matt Strandberg, and the reason he's pretty cool is because 0:00:42.360 --> 0:00:45.000 I know him from grad school. Matt and I went 0:00:45.040 --> 0:00:49.199 to Columbia together. I believe we had the same major, right, 0:00:49.240 --> 0:00:53.280 you were nutrition and exercise physiology or just exercise physiology 0:00:53.560 --> 0:00:56.320 as well. You're both as well, right. I transitioned a 0:00:56.320 --> 0:00:58.360 little bit later, so I think I got to know 0:00:58.440 --> 0:01:01.320 you with the later part of my girl duate career. Anyway, 0:01:01.360 --> 0:01:05.120 Matt is brilliant and has always been. He's always kind 0:01:05.120 --> 0:01:07.759 of been the person in class who speaks up and 0:01:08.000 --> 0:01:10.959 says the thing that you know kind of goes against 0:01:10.959 --> 0:01:18.000 me norder, but also like very confidently will really look 0:01:18.000 --> 0:01:21.440 at the literature and come up with your own opinions, 0:01:21.560 --> 0:01:24.720 which can you know, go against the grain, especially in 0:01:24.720 --> 0:01:27.840 a classroom setting when we're being taught. So I always 0:01:27.880 --> 0:01:31.520 looked to you for you know, the answers and definitely 0:01:31.560 --> 0:01:33.640 made the class a little bit more fun. So I'm 0:01:33.680 --> 0:01:36.160 excited to be talking to you today. Well, thank you 0:01:36.200 --> 0:01:39.360 for having me here. So, yeah, I didn't expect you 0:01:39.440 --> 0:01:43.160 to go in the route that you've gone. Actually, you know, 0:01:43.360 --> 0:01:47.319 you're really passionate about exercise physiology, and I know you're 0:01:47.319 --> 0:01:51.280 still passionate about helping people form healthy relationships to exercise, 0:01:51.760 --> 0:01:55.880 but you ended up going down the eating disorder path professionally, 0:01:56.160 --> 0:01:59.720 I believe, right, yeah, totally, and so that's my specialty. 0:01:59.840 --> 0:02:02.760 And as you pointed out, it wasn't really expected. When 0:02:02.840 --> 0:02:05.760 when I tell people what I do, oftentimes the assumption is, 0:02:05.880 --> 0:02:08.560 oh my, like wow, that must be your vocation. You 0:02:08.639 --> 0:02:10.639 must have like, you know, seen the light. And I 0:02:10.720 --> 0:02:12.919 wanted to do this for so long, and really it 0:02:13.000 --> 0:02:15.839 was like, you know, balancing from thing to thing, experimenting 0:02:15.840 --> 0:02:17.680 with so many different eras and be like, okay, know 0:02:17.720 --> 0:02:19.920 what interests me? You know, you know, how can I 0:02:19.960 --> 0:02:23.200 make this work? And really, um, I had always had 0:02:23.240 --> 0:02:25.600 an interest in these topics. And at the same time, 0:02:25.880 --> 0:02:28.600 you know, when I was graduating my dietectic internship, once 0:02:28.639 --> 0:02:32.520 again faced with that existential crisis of going back out 0:02:32.560 --> 0:02:35.240 into the real world, like now what. And when I 0:02:35.280 --> 0:02:38.040 was thinking about my experiences, I had a lot of 0:02:38.080 --> 0:02:41.680 experience in stranding conditioning with athletes, I had experience in nutrition, 0:02:42.000 --> 0:02:44.760 had experience in counseling, and I'm like, okay, is there 0:02:44.800 --> 0:02:47.799 a way to put this all together? And so when 0:02:47.800 --> 0:02:49.960 I looked out there, you know, with the research literature 0:02:50.000 --> 0:02:52.239 as well as like in general, you know, I found 0:02:52.280 --> 0:02:56.280 that there wasn't really many resources available for athletes or 0:02:56.320 --> 0:03:00.399 people engaging in physicotivity who maybe we're struggling mental and 0:03:00.639 --> 0:03:04.040 whether it was disordered eating or inert behaviors or relationship 0:03:04.080 --> 0:03:06.840 with exercise and so for instance, like you know, growing 0:03:06.919 --> 0:03:08.960 up as an athlete but also as a coach, you know, 0:03:09.000 --> 0:03:11.320 you just hang out with so many different people and 0:03:11.520 --> 0:03:14.080 everyone's there training, but you know, you begin to realize 0:03:14.120 --> 0:03:17.320 that people are struggling at times, and there's this always 0:03:17.320 --> 0:03:20.200 this pressure to put up this image of you know, 0:03:20.600 --> 0:03:23.600 I'm fully in control, I'm stoic, and you know, I'm 0:03:23.639 --> 0:03:26.320 dedicated and I have every you know, handle on everything, 0:03:26.360 --> 0:03:29.760 and so when things are not going as one would 0:03:29.760 --> 0:03:32.760 expect or someone's struggling, really people will start to feel 0:03:32.800 --> 0:03:34.760 scared to reach out because they don't want to be 0:03:34.800 --> 0:03:36.680 perceived as weak, or they don't want to be perceived 0:03:36.720 --> 0:03:39.600 as less than or they don't want to be um shot, 0:03:39.720 --> 0:03:42.320 you know, shadow this image of you know, this athlete 0:03:42.360 --> 0:03:45.480 and then be considered, well, it looks like you're struggling. 0:03:45.520 --> 0:03:47.560 So I don't know, if you can maintain your position 0:03:47.560 --> 0:03:49.560 on the team, you should probably go take some time off. 0:03:49.600 --> 0:03:52.360 And all of this is just really not conducive to 0:03:52.520 --> 0:03:56.320 providing a supportive environment. And to make matters worse, a 0:03:56.320 --> 0:03:59.240 lot of the environments were pretty toxic in many respects, 0:03:59.240 --> 0:04:01.640 and that's something that really kind of not talked about 0:04:01.800 --> 0:04:05.119 in relations to sports, and so, you know, that really 0:04:05.120 --> 0:04:07.480 inspired me to try to make a change, and that 0:04:07.560 --> 0:04:10.960 led me to working together with a great researcher. Her 0:04:11.000 --> 0:04:14.920 name is Paul Quatrimony. She's at Boston University, and together 0:04:15.040 --> 0:04:16.800 we came up with the idea of, hey, you know, 0:04:16.839 --> 0:04:20.480 why don't we actually create a program to help athletes 0:04:20.560 --> 0:04:24.160 struggling with eating disorders and problematic physical activity. And so 0:04:24.200 --> 0:04:26.120 the last five years that's what I did. You know, 0:04:26.120 --> 0:04:28.839 I pitched a program to all the behavioral care called 0:04:28.880 --> 0:04:32.920 the Goals Program and helped lots of different athletes in 0:04:32.960 --> 0:04:37.279 that program and created curriculums and various initiatives and produce 0:04:37.320 --> 0:04:40.719 some research back into efficacy of the program and its 0:04:40.760 --> 0:04:43.400 methods with the hopes that it would spur some more 0:04:43.480 --> 0:04:46.920 interests in the area. And you know, just recently I've 0:04:47.240 --> 0:04:49.560 opened up my own private practice to help people in 0:04:49.640 --> 0:04:52.520 other areas as well. So it's been a it's been 0:04:52.520 --> 0:04:55.560 an interesting journey, but eventually I ended up here. And 0:04:55.640 --> 0:04:58.120 it's it's hard because whether you're an athlete or not. 0:04:58.279 --> 0:05:00.719 You know, I'd say most of our audience, probably probably 0:05:00.760 --> 0:05:03.760 a handful of people do resonate with being an athlete 0:05:03.839 --> 0:05:06.800 or athlete in their past. But regardless or not, I 0:05:06.839 --> 0:05:10.040 think athletes have that extra pressure of eat healthy, you know, 0:05:10.200 --> 0:05:13.960 to perform better or whatever. But all of us are 0:05:13.960 --> 0:05:18.520 really taught that healthy living looks like something we can 0:05:18.600 --> 0:05:22.359 check off on paper or easily quantify, whether it's that 0:05:22.480 --> 0:05:28.039 number on the scale or certain food choices or regular exercises. 0:05:28.160 --> 0:05:30.120 And I think it starts for a lot of people 0:05:30.120 --> 0:05:32.159 that were doing these things in the name of health, 0:05:32.400 --> 0:05:35.640 and then all of a sudden, people are hearing, wait 0:05:35.680 --> 0:05:40.800 a second, your pursuit of healthy eating is actually disordered. 0:05:41.279 --> 0:05:44.200 And when we're just looking at this stuff on paper, right, 0:05:44.279 --> 0:05:48.040 like the behaviors eat more vegetables or move your body 0:05:48.040 --> 0:05:51.159 every single day, it can be really confusing for somebody 0:05:51.200 --> 0:05:53.200 to say, well, you told me to do these things 0:05:53.200 --> 0:05:56.960 to be healthy. How can you be saying that they're dysfunctional? 0:05:57.440 --> 0:05:59.760 So how how can this happen? And what are we 0:05:59.800 --> 0:06:03.200 miss saying when it comes to our healthy behaviors? Yeah, no, 0:06:03.279 --> 0:06:06.080 this is a really great question and something that I've 0:06:06.080 --> 0:06:08.640 thought a lot about because in the past I was 0:06:08.760 --> 0:06:12.320 very much that person where I was being told and 0:06:12.400 --> 0:06:16.600 congratulated and reinforced for certain types of you know, approaches 0:06:16.640 --> 0:06:20.239 to exercise and food and body composition, all these different things. 0:06:20.279 --> 0:06:22.320 And then you know, it was beginning to wonder why 0:06:22.360 --> 0:06:24.919 I was struggling, and you know, why why am I 0:06:24.920 --> 0:06:27.000 struggling so much if people are telling me I'm doing 0:06:27.040 --> 0:06:29.320 the right thing. So that was very much a point 0:06:29.320 --> 0:06:31.560 of confusion. And when I went into the work that 0:06:31.600 --> 0:06:34.200 I've been doing, you know, it actually is very much 0:06:34.240 --> 0:06:36.279 actually what I would say at the focal point for 0:06:36.360 --> 0:06:39.080 most people I talked to. And so as you've mentioned, like, 0:06:39.160 --> 0:06:40.839 you know, how the heck do we tell the difference 0:06:40.880 --> 0:06:43.760 and you know, what's going on, and so in relation 0:06:43.800 --> 0:06:46.160 to answer this question, I think actually it's important to 0:06:46.200 --> 0:06:48.800 kind of back up a few steps um to really 0:06:48.880 --> 0:06:51.440 understand kind of what we're talking about, and you know, 0:06:51.520 --> 0:06:55.080 define you know what we're talking about. So the concepts 0:06:55.080 --> 0:06:58.560 that you've put forth are healthy and healthy is contrasted 0:06:58.600 --> 0:07:01.840 with unhealthy. And then maybe people will say, like what's 0:07:01.880 --> 0:07:06.520 functional in this contrasted with what is considered dysfunctional order disorder. 0:07:06.960 --> 0:07:08.719 So when when we look at like, you know, what 0:07:09.000 --> 0:07:11.400 is this way of categorizing stuff, this is very much 0:07:11.400 --> 0:07:14.240 an a binary and and kind of like a dualistic 0:07:14.240 --> 0:07:16.560 way of thinking. So there's a you know, there's a 0:07:16.560 --> 0:07:18.920 definition of something, and then the reason why we know 0:07:19.000 --> 0:07:21.320 it is something is because it's contrasted with what is 0:07:21.360 --> 0:07:23.640 not and and you know, this is kind of a 0:07:23.640 --> 0:07:27.120 baseline level thinking for for most individuals when they come 0:07:27.120 --> 0:07:29.200 into the world, Like we come to the world and 0:07:29.240 --> 0:07:33.120 people talk about what is safe or unsafe, edible versus inedible. 0:07:33.280 --> 0:07:35.800 So just from the start in many instances. You know, 0:07:36.040 --> 0:07:40.480 culture communicates you know, what is desirable versus what's not desirable, 0:07:40.880 --> 0:07:43.400 and and that guides us in our day to day. Uh. 0:07:43.440 --> 0:07:45.320 And so like in the past, you know, this would 0:07:45.320 --> 0:07:47.880 be like the local elders in the village, or the religion, 0:07:48.200 --> 0:07:50.400 or the state, or various authorities such as like the 0:07:50.880 --> 0:07:53.520 father in the household, and they would define, you know, 0:07:53.880 --> 0:07:56.160 what is a good Christian, what is a good citizen. 0:07:56.520 --> 0:07:59.240 You know what's a good son, a good daughter, good wife. 0:07:59.320 --> 0:08:02.080 This is right, that's wrong. And you know, this has 0:08:02.120 --> 0:08:04.920 been very much drilled into our day to day that 0:08:04.960 --> 0:08:08.720 it almost appears natural as if it's a reflection of reality. Now, 0:08:09.080 --> 0:08:11.360 you know, thinking about you know, how this relates to 0:08:11.360 --> 0:08:13.680 our current situation. It's also important to kind of look 0:08:13.680 --> 0:08:16.679 at the development of these ideas and so, for instance, 0:08:16.680 --> 0:08:19.360 like science and the post Enlightenment, you know, after the 0:08:19.400 --> 0:08:22.880 eighteenth century was very much thought to help elucidate the 0:08:23.360 --> 0:08:27.720 truth about the world and demystify and personal opinion and 0:08:27.760 --> 0:08:30.720 intuition and religion. These are subjective, kind of touching, feeling things, 0:08:30.720 --> 0:08:33.040 and they're not based in science. And so if we 0:08:33.360 --> 0:08:36.240 adhere to scientific principles, then we can really understand what's 0:08:36.280 --> 0:08:39.120 going on. So part of this was actually applied to 0:08:39.640 --> 0:08:43.720 very much like every topic, including humans themselves. So when 0:08:43.720 --> 0:08:46.199 we think about you know, Darwin and you know, theory 0:08:46.200 --> 0:08:49.160 of evolution, some people begin to think about this as 0:08:49.160 --> 0:08:53.800 like fitness in terms of evolution. And some people took 0:08:53.800 --> 0:08:56.360 that even further and said, well, you know, maybe we 0:08:56.360 --> 0:09:00.200 could actually improve the human race if we understood what 0:09:00.280 --> 0:09:03.080 the ideal human would look like. And and then from 0:09:03.120 --> 0:09:06.960 there we can now categorize humans based on superior humans 0:09:07.040 --> 0:09:11.000 versus inferior Now, at the time, this is very popular thinking, 0:09:11.040 --> 0:09:13.440 and now we would say, you know, this is eugenics. 0:09:13.480 --> 0:09:16.000 You know, this is very much you know, shady and 0:09:16.080 --> 0:09:18.400 and and not really something that we want to reinforce. 0:09:18.800 --> 0:09:21.840 At the time, though the Nazis, the communist but also 0:09:21.920 --> 0:09:26.079 lots of American scientists and the American establishment very much 0:09:26.120 --> 0:09:28.760 adhere to these ideas. And this actually is you know, 0:09:28.840 --> 0:09:32.319 where we have the origin of dietetics in many respects. 0:09:32.440 --> 0:09:35.560 Dietects was originally called home economics. How do we view 0:09:35.640 --> 0:09:38.920 food in a way that is economical so we can 0:09:38.960 --> 0:09:42.840 help optimize the human and optimize the diet, and then 0:09:42.920 --> 0:09:47.439 from there we can create an ideal workforce. And so 0:09:47.760 --> 0:09:49.760 we have these ideas emerging at the turn of the 0:09:49.760 --> 0:09:54.320 century that conceptualized humans as machines, and then we also 0:09:54.440 --> 0:09:57.719 conceptualize them as machines that are imperfect that could be analyzed, 0:09:57.920 --> 0:10:02.400 reduced into individual components and rebuilt um and restructure through 0:10:02.480 --> 0:10:07.319 ideal diets, ideal exercise, ideal medications, ideal you know, environments, 0:10:07.400 --> 0:10:10.360 and we could socially engineer you know, the ideal worker, 0:10:10.480 --> 0:10:14.080 the ideal soldier, and then the ideal societal machine. Now 0:10:14.280 --> 0:10:17.640 you know, Nazism, communism, and eugenics kind of faded out 0:10:17.679 --> 0:10:20.000 of the picture, but a lot of these ideas regarding 0:10:20.040 --> 0:10:22.920 fitness have very much for me the basis of how 0:10:22.960 --> 0:10:26.080 we conceptualized health. And so when we think about it 0:10:26.480 --> 0:10:29.319 from a public health standpoint, public health and like the 0:10:29.360 --> 0:10:34.280 scientific management of the population, examines everyone and then categorize 0:10:34.280 --> 0:10:37.000 them as such and create these various categories like B 0:10:37.280 --> 0:10:40.960 m I, blood work, dietary patterns, exercise patterns, and you know, 0:10:41.240 --> 0:10:45.080 from American psychology, how do we systematize the human psyche 0:10:45.120 --> 0:10:50.040 into understanding what is mentally healthy versus mentally ill? And 0:10:50.440 --> 0:10:52.720 similar to you know what I mentioned before in terms 0:10:52.720 --> 0:10:54.760 of this has not always been the case. This was 0:10:54.840 --> 0:10:57.640 not always the case. And at the same time, because 0:10:57.760 --> 0:11:00.920 it was very much repeated over time and constantly ingrained 0:11:00.920 --> 0:11:04.520 into our psyche, these categories that were based in you know, 0:11:04.600 --> 0:11:08.800 these um conceptions of biology and conceptions of psychology became 0:11:08.920 --> 0:11:11.240 naturalized to the point where now we think of the 0:11:11.280 --> 0:11:14.360 world in this way in many respects that you know 0:11:14.480 --> 0:11:17.840 that these categories that were devised over time are actually 0:11:17.920 --> 0:11:20.760 reflections of reality. And you know, another question that I 0:11:20.760 --> 0:11:22.920 want to ask when we talk about what is defined 0:11:22.920 --> 0:11:26.280 as healthy or functional, is like, is this actually reflection 0:11:26.280 --> 0:11:28.920 of reality or is this sign of like what the 0:11:28.960 --> 0:11:32.040 society values. So, for instance, is it a sign of 0:11:32.080 --> 0:11:35.600 health to be well adjusted to a six society that constantly, 0:11:36.120 --> 0:11:39.920 you know, views the individual as merely in you know, 0:11:40.000 --> 0:11:43.319 a machine, you know, who is supposed to control themselves, 0:11:43.559 --> 0:11:47.280 a spouse, you know, rationality and be obsessed with productivity 0:11:47.320 --> 0:11:50.840 and self governance, trying to obtain a particular body and 0:11:50.920 --> 0:11:54.560 a perfect way of eating, to check all these various boxes. 0:11:55.080 --> 0:11:57.800 And so you know, I'll pause right there, but essentially 0:11:58.160 --> 0:12:01.200 this is stuff that's talked about that is just naturalized, 0:12:01.520 --> 0:12:05.240 but in many respects it's missing a lot of different 0:12:05.280 --> 0:12:07.920 factors that we can really go into on a tuper 0:12:08.040 --> 0:12:10.760 level to help elucidate, you know, what do we make 0:12:10.800 --> 0:12:14.600 of this? These are obviously more intellectual conversations than we've 0:12:14.600 --> 0:12:18.440 had on this podcast before, and certainly the framework of 0:12:18.559 --> 0:12:22.120 looking at history, it's very interesting to really see how 0:12:22.200 --> 0:12:25.480 it came from, what it came from, the cultures that 0:12:25.600 --> 0:12:28.960 came from, and some of the different ways that that 0:12:29.480 --> 0:12:33.360 we've come to view what is fit meaning, you know, 0:12:33.559 --> 0:12:37.160 survival of the fittest, And that first sentence you said 0:12:37.200 --> 0:12:40.440 really struck me is people were trying to survive and 0:12:40.480 --> 0:12:44.400 they qualified or quantified what a body type looks like 0:12:44.800 --> 0:12:48.640 that would survive. But the truth is the times have changed. 0:12:48.760 --> 0:12:51.040 We live in much more modern world. You know, we've 0:12:51.040 --> 0:12:56.280 expanded our lifespan without having to fight off animals to survive, 0:12:56.480 --> 0:12:59.679 you know, so our idea of what health looks like 0:12:59.800 --> 0:13:04.720 or be quantified wasn't really updated, even though the way 0:13:04.760 --> 0:13:06.960 we live and the way we think and the way 0:13:06.960 --> 0:13:10.280 we behave has. So I think that's super interesting and 0:13:10.360 --> 0:13:15.600 definitely allows us to expand out that black and white 0:13:15.679 --> 0:13:18.000 that you talked about between you know, is this healthy 0:13:18.080 --> 0:13:21.559 or is this dysfunctional? It's not black and white, it's 0:13:21.640 --> 0:13:23.960 why are we doing this? What are we thinking about? 0:13:24.280 --> 0:13:26.640 What is our motivation? What other things are kind of 0:13:26.679 --> 0:13:29.480 missing there in relation to you know, how can we 0:13:29.520 --> 0:13:31.560 relate this to our lives. That the frameworks that have 0:13:31.600 --> 0:13:35.199 been presented to us as deemed functional and healthy are 0:13:35.240 --> 0:13:39.920 often reflections of what society values in relation to what 0:13:40.040 --> 0:13:43.560 is considered acceptable or desirable. And so you know, going 0:13:43.600 --> 0:13:46.520 back to the fitness category, it actually in many respects 0:13:46.559 --> 0:13:50.400 reflects what the conception was of creating que unquote you know, 0:13:50.800 --> 0:13:54.080 a fitter population in terms of you know, ability to 0:13:54.559 --> 0:13:58.280 compete on you know, this huge scale. So for instance, 0:13:58.320 --> 0:14:00.920 like how can we have the deal worker, how can 0:14:00.960 --> 0:14:04.040 we have the ideal soldier? And and that is constructed 0:14:04.240 --> 0:14:08.000 in relation to health is primarily you know, a function 0:14:08.120 --> 0:14:11.439 of one's ability to function within um the framework that 0:14:11.520 --> 0:14:15.079 society values. Now that being said as m S before, 0:14:15.320 --> 0:14:18.960 this is often conflated as this is the objective reality. 0:14:19.320 --> 0:14:22.200 So when we look at like these values of you know, 0:14:22.480 --> 0:14:27.040 understandings of research that relate to weight and and biometrics 0:14:27.120 --> 0:14:30.400 and you know, dietary patterns and exercise patterns, these are 0:14:30.520 --> 0:14:36.640 archetypal or like patterns that essentially describe predictions or describe observations, 0:14:37.080 --> 0:14:39.560 and we can relate them to lots of different things. 0:14:39.560 --> 0:14:43.280 But it would be a mistake to view these maps 0:14:43.440 --> 0:14:45.920 as the territory. So, you know, these are maps that 0:14:45.960 --> 0:14:49.880 help us navigate various things and relate them, but that 0:14:49.920 --> 0:14:53.200 doesn't mean it's the actual territory itself. So, you know, 0:14:53.240 --> 0:14:56.200 how do we actually deem what's healthier functional? The way 0:14:56.240 --> 0:14:57.920 we do this in terms of what works for the 0:14:58.000 --> 0:15:01.040 person is to sit down with the individual and to 0:15:01.080 --> 0:15:04.320 actually get to know them and and understand, you know, 0:15:04.400 --> 0:15:06.880 what their values are, what you know, how do they 0:15:06.880 --> 0:15:09.000 think about the world, how do they conceptualize, how do 0:15:09.040 --> 0:15:12.480 they feel, how do they experience, and how do the 0:15:12.640 --> 0:15:15.360 you know, the multidimensional aspects of their life relate to 0:15:15.360 --> 0:15:19.480 each other. So, for instance, something that's talked about a 0:15:19.560 --> 0:15:23.359 lot is you know, healthy eating, this that, blah blah, exercise, 0:15:23.480 --> 0:15:26.160 But not many people talk about social connection and the 0:15:26.200 --> 0:15:28.720 meaning that they have in their life, and you know, 0:15:28.920 --> 0:15:31.600 how they approach and think about food and how it's 0:15:31.640 --> 0:15:34.720 felt and experienced. Most people want to just break it 0:15:34.760 --> 0:15:37.680 down into simply just numbers, and it's like, you know, 0:15:37.680 --> 0:15:41.040 what's the lab value how much saturated as opposed to 0:15:41.520 --> 0:15:43.640 you know, do you sit down and relax and like 0:15:43.720 --> 0:15:46.680 have a nice conversation with someone when you eat, and like, 0:15:46.760 --> 0:15:49.160 how does this relate to the other values in your life? 0:15:49.200 --> 0:15:52.040 And you know, you're thinking about losing weight and at 0:15:52.040 --> 0:15:54.960 the same time, how might this affective relationship with food? Like, 0:15:55.120 --> 0:15:58.240 there's lots of more nuance that can only be really 0:15:58.320 --> 0:16:00.400 fleshed out if you get to know some on an 0:16:00.400 --> 0:16:03.720 individual basis. The problem is this isn't really easy to 0:16:03.760 --> 0:16:06.360 systematizes across the population if you're looking at it from 0:16:06.400 --> 0:16:10.480 like a bureaucratic managerial standpoint, right, But when you know, 0:16:10.560 --> 0:16:12.760 you do work with athletes, or you've worked with athletes 0:16:12.800 --> 0:16:14.720 in the past, and I think there's such an interesting 0:16:14.800 --> 0:16:18.359 population just because they quote unquote look like the healthiest, 0:16:18.400 --> 0:16:21.480 the fittest what we've come to deem as the goal 0:16:21.720 --> 0:16:24.960 for every human to become in some way. But when 0:16:25.040 --> 0:16:28.680 you talk to these individuals, how do they describe their 0:16:28.720 --> 0:16:33.560 emotional experience despite being quote unquote healthy. I think something 0:16:33.600 --> 0:16:36.320 and this can also relate to insurers as well, is 0:16:36.440 --> 0:16:39.600 you know, there's a difference between you know, the behaviors 0:16:39.640 --> 0:16:42.640 that we're doing versus kind of what we're experiencing on 0:16:42.680 --> 0:16:46.000 the inside as well, and and how all these various 0:16:46.160 --> 0:16:50.240 aspects relate. And so in many respects, the system that 0:16:50.320 --> 0:16:53.640 you know, the managed healthcare system but also sports as 0:16:53.640 --> 0:16:56.960 well very much emphasizes, you know, what is called like 0:16:57.080 --> 0:17:02.280 procedural authenticity, where essentially, how does one's actions essentially relate 0:17:02.360 --> 0:17:06.159 to like external values or external you know boxes that 0:17:06.200 --> 0:17:10.199 we can check that signify a particular concept um, and 0:17:10.240 --> 0:17:13.520 not many people really think about, you know, other aspects 0:17:13.640 --> 0:17:17.320 such as you know, epistemic authenticity, where you know, you know, 0:17:17.320 --> 0:17:19.359 what that means is essentially it's like how this relates 0:17:19.400 --> 0:17:23.440 to your internal experiences and your intentions and how you're 0:17:23.440 --> 0:17:26.800 experiencing this. And so a lot of athletes check a 0:17:26.840 --> 0:17:30.000 lot of quote unquote the boxes in terms of what 0:17:30.200 --> 0:17:34.320 is considered healthy and desirable and functional, and in many respects, 0:17:34.359 --> 0:17:36.960 no one sits down and actually asked them, you know, 0:17:37.080 --> 0:17:40.920 what they're subjective experiences like as well as their intersubjective 0:17:40.920 --> 0:17:43.080 experience in terms of how they relate to other people. 0:17:43.720 --> 0:17:48.119 And that right there opens up a lot of you know, 0:17:48.440 --> 0:17:52.160 potential avenues for exploration because no one really digs deeper. 0:17:52.200 --> 0:17:54.720 They look at the image of the representation and never 0:17:54.840 --> 0:17:57.360 say how does this feel for you? You know, how 0:17:57.440 --> 0:17:59.720 is this experience? How does this relate to the other 0:18:00.000 --> 0:18:02.800 spects of your life? And when you have those conversations, 0:18:02.840 --> 0:18:05.639 you get to see the difference between what someone is 0:18:05.680 --> 0:18:08.679 doing versus how they're experiencing it and how it relates 0:18:08.680 --> 0:18:11.320 to the other aspects of your life. But specifically, tell 0:18:11.359 --> 0:18:14.320 me what is their emotional experience? How do they describe it? 0:18:14.840 --> 0:18:17.600 When I'm sitting down with an individual, They're checking all 0:18:17.640 --> 0:18:20.400 the boxes, you know, they're winning the awards, they're doing 0:18:20.400 --> 0:18:22.520 all this stuff, and in some respects they feel proud 0:18:22.600 --> 0:18:25.439 and they feel maybe good about that, and at the 0:18:25.480 --> 0:18:28.240 same time, the way that they've achieved that is through 0:18:28.480 --> 0:18:32.159 these intense repression of their feelings. And similar to like 0:18:32.200 --> 0:18:34.320 a boogie board, like you know at the pool, like 0:18:34.359 --> 0:18:36.199 you push the board underneath the water and it just 0:18:36.280 --> 0:18:38.080 ends up flying you up, you know, and hitting you 0:18:38.119 --> 0:18:40.199 back in the face. A lot of the athletes I 0:18:40.240 --> 0:18:43.639 work with are constantly feeling torn and stuck in these contradictions, 0:18:43.680 --> 0:18:46.960 and like you can see this in terms of um 0:18:47.000 --> 0:18:50.000 They're getting padded on the back, uh to win the 0:18:50.040 --> 0:18:52.840 award and at the same time, they're feeling depressed, anxious, 0:18:52.840 --> 0:18:56.320 and suicidal because their mental health has been uh you 0:18:56.359 --> 0:18:59.240 know that they've been anxious and isolated for so long 0:18:59.280 --> 0:19:01.640 and and they feel like they have to constantly suppress 0:19:01.680 --> 0:19:04.560 their feelings. And so there's this deep emptiness or deep 0:19:04.640 --> 0:19:07.320 sadness that you know, I hear, But like, who am 0:19:07.359 --> 0:19:09.720 I if if I'm not winning? Am I allowed to 0:19:09.760 --> 0:19:11.919 feel sad? Or is this a form of weakness? You 0:19:11.960 --> 0:19:15.000 have these contradictions when I'm working with like football athletes 0:19:15.080 --> 0:19:18.120 or mixed martial arts, where in one mode they're supposed 0:19:18.119 --> 0:19:20.840 to be ultra violent and and hurt the other person 0:19:20.880 --> 0:19:23.520 as much as possible, and then just like that, they're 0:19:23.560 --> 0:19:26.080 supposed to stab their fingers and transition out and all 0:19:26.119 --> 0:19:28.840 of a sudden no longer feel angry, and and now 0:19:28.880 --> 0:19:31.399 they're supposed to integrate, you know, into the society that 0:19:31.560 --> 0:19:34.399 is non violent, and so you just you see just 0:19:34.560 --> 0:19:39.600 so many internal conflicts across the board, and oftentimes, unfortunately, 0:19:39.640 --> 0:19:42.879 similar to the military people I work with or people 0:19:43.000 --> 0:19:46.720 you know in the police force, athletes often conceptualize their 0:19:46.760 --> 0:19:51.919 emotions as as weaknesses or as barriers to success, and 0:19:52.160 --> 0:19:55.800 often kind of over emphasized rationality as a means of 0:19:56.000 --> 0:20:00.000 guiding them and you know, controlling their emotions. But usually 0:20:00.000 --> 0:20:02.800 of what this leads to is people suffering for prolonged 0:20:02.800 --> 0:20:05.880 periods of time and thinking that it is a failure 0:20:05.920 --> 0:20:09.720 of their personal will, a failure of their rationality, and 0:20:09.760 --> 0:20:13.159 they shouldn't be feeling this. But eventually, you know, people 0:20:13.800 --> 0:20:15.760 can only take so much and it really takes its 0:20:15.800 --> 0:20:17.840 sole you know, we don't get to really hear about 0:20:17.880 --> 0:20:19.840 men a lot on this podcast, and we get a 0:20:19.880 --> 0:20:23.080 lot of listeners that do enquire about their significant others 0:20:23.160 --> 0:20:26.440 or their sons or their brothers. And you know, the 0:20:26.480 --> 0:20:29.480 assumption is that eating disorders are way more common in 0:20:29.560 --> 0:20:32.879 women in the US, and as a male, I assume 0:20:33.000 --> 0:20:36.440 that you attract male clients who might feel more comfortable 0:20:36.520 --> 0:20:40.160 with you. Perhaps perhaps not. Do you find that this 0:20:40.240 --> 0:20:43.000 is really true? Are eating disorders more common in women? 0:20:43.160 --> 0:20:46.600 In terms of research, the research is fairly limited in 0:20:46.640 --> 0:20:50.640 relation to in disorders, and it often asks questions that 0:20:51.040 --> 0:20:53.720 don't really necessarily capture kind of like you know, what's 0:20:53.720 --> 0:20:56.679 going on. I mean, this is still a challenge that 0:20:56.760 --> 0:20:58.840 is very much laden with a lot of stigma. So 0:20:59.280 --> 0:21:01.720 it's unlike for people to show up and say, oh, 0:21:01.760 --> 0:21:04.040 by the way, yeah, I know, I'm experiencing all the 0:21:04.080 --> 0:21:06.439 stigma and I'd love to participate in this research study. 0:21:06.600 --> 0:21:10.440 This is already present in women, and it's way more 0:21:10.640 --> 0:21:13.600 present in men. Who really have you know, in our 0:21:13.600 --> 0:21:17.520 country in many respects, you know, mental health services and 0:21:17.720 --> 0:21:20.680 talking about you know, therapy, talking you know, having conversations 0:21:20.680 --> 0:21:24.000 about your feelings, uh, is not something that is really 0:21:24.080 --> 0:21:27.280 promoted up until kind of like recently, and really where 0:21:27.400 --> 0:21:31.040 athletes and people in the military are coming forward, you 0:21:31.040 --> 0:21:33.840