WEBVTT - The Link Between Emotional Regulation and Eating Disorders with Megan Mikhail 0:00:00.400 --> 0:00:04.960 I won't lend my body out out everything that I'm 0:00:04.960 --> 0:00:08.800 made do. Won't spend my life trying to change. I'm 0:00:08.880 --> 0:00:12.440 learning a love who I am, I get, I'm strong, 0:00:12.840 --> 0:00:15.800 I feel free, I know who every part of me. 0:00:16.520 --> 0:00:24.000 It's beautiful and I will always out way. If you 0:00:24.079 --> 0:00:27.040 feel it with your eyes in the air, She'll love 0:00:27.120 --> 0:00:29.960 to the boom. I am there, say good day and 0:00:30.920 --> 0:00:36.320 did you and die out? Welcome back outway, fam Today 0:00:36.320 --> 0:00:39.720 it's just me. Amy is not here, sadly we miss her, 0:00:40.320 --> 0:00:42.960 but I'm here with a very special guest named Megan. 0:00:43.200 --> 0:00:48.120 And Meghan is a PhD student in clinical psychology, and 0:00:48.240 --> 0:00:51.640 Megan is doing amazing work that you're going to be 0:00:51.680 --> 0:00:55.520 so stoked to learn about. Megan's research broadly includes the 0:00:55.600 --> 0:01:01.720 interactions between biological and environmental risk for distort eating, particularly 0:01:01.800 --> 0:01:03.880 kind of translating that now into a little bit more 0:01:03.960 --> 0:01:08.000 human how our emotions play a role in disordered eating 0:01:08.080 --> 0:01:12.400 and eating disorders in disadvantage and marginalized communities. Megan is 0:01:12.400 --> 0:01:15.880 super passionate about integrating the research and clinical practice to 0:01:16.000 --> 0:01:19.480 advanced care for people with eating disorders, especially those who 0:01:19.520 --> 0:01:23.880 have been underserved. So you're doing awesome work because you're 0:01:23.920 --> 0:01:28.200 helping us understand how eating disorders and disordered eating come 0:01:28.360 --> 0:01:31.200 to be. Right. Yeah, well, thank you so much. And 0:01:31.240 --> 0:01:32.560 you know, I just want to say I think you 0:01:32.600 --> 0:01:34.959 all are doing really awesome work to kind of talking 0:01:34.959 --> 0:01:37.800 about eating disorders and getting that information out there. So 0:01:37.840 --> 0:01:40.040 thank you so much for having me. Thank you. I mean, 0:01:40.080 --> 0:01:42.640 our podcast is about a year old actually, but the 0:01:42.680 --> 0:01:47.199 past year it has become increasingly easy to get people 0:01:47.240 --> 0:01:52.000 to listen because we are talking about diet culture so 0:01:52.080 --> 0:01:55.080 much in the media and disrupting a lot of media 0:01:55.160 --> 0:01:59.840 norms even from body size to color to ability. You know, 0:02:00.000 --> 0:02:01.960 all these things are being disrupted in such a beautiful 0:02:02.000 --> 0:02:06.400 way that a lot of people understand how toxic the 0:02:06.480 --> 0:02:09.960 skinny mindset is, if you will. But what people don't 0:02:10.000 --> 0:02:12.720 know about eating disorders is that it's not just the 0:02:12.840 --> 0:02:16.160 drive to be thin. It can be caused by as 0:02:16.200 --> 0:02:20.280 you know, a multi fectoral you know, situation. And I 0:02:20.320 --> 0:02:22.720 love what you're focusing on. So let's kind of just 0:02:22.760 --> 0:02:26.160 start with your story. How did you get into this work? Sure, 0:02:26.440 --> 0:02:29.040 so this work is pretty personal for me. So I 0:02:29.160 --> 0:02:32.320 was diagnosed with anorexia when I was actually about eleven 0:02:32.600 --> 0:02:35.359 um and I struggled a lot with disordered eating all 0:02:35.400 --> 0:02:38.679 through my teenage years and into my twenties UM, both 0:02:38.720 --> 0:02:41.720 anorexia and kind of binge eating, and for a long time, 0:02:41.760 --> 0:02:44.400 I think it was a source of shame for me. UM. 0:02:44.480 --> 0:02:47.360 So eating disorders weren't really something that we're talked about 0:02:47.360 --> 0:02:49.840 in my family, UM. I think in part because you know, 0:02:49.919 --> 0:02:52.720 I come from a mixed ethnic background and my dad's 0:02:52.720 --> 0:02:56.360 a first generation American, my mom is Mexican American, and 0:02:56.400 --> 0:02:59.040 it just wasn't something that was necessarily talked about in 0:02:59.040 --> 0:03:01.560 their families either. So for a long time, I didn't 0:03:01.560 --> 0:03:04.160 really understand, you know, why this was something that I 0:03:04.160 --> 0:03:06.639 struggled with, UM and why it was so hard for me. 0:03:06.840 --> 0:03:08.959 And that made me really interested in kind of getting 0:03:08.960 --> 0:03:11.919 involved in research and figuring out why this is something 0:03:12.280 --> 0:03:14.520 people go through and what are all the reasons that 0:03:14.600 --> 0:03:16.720 can contribute to it. So one of the things that 0:03:16.760 --> 0:03:19.720 we know is that eating disorders are really closely related 0:03:19.760 --> 0:03:22.040 to other kinds of disorders moved off in things like 0:03:22.120 --> 0:03:25.000 anxiety or depression, and that's actually something that kind of 0:03:25.080 --> 0:03:27.040 runs in my family and that I've dealt with all 0:03:27.080 --> 0:03:29.840 my life. And I think that really helped me understand 0:03:30.040 --> 0:03:33.320 how my eating disorder and disordered eating behaviors were kind 0:03:33.320 --> 0:03:36.080 of functioning in a way to help me regulate my 0:03:36.120 --> 0:03:39.200 anxiety and my emotions. So that was really personally helpful 0:03:39.240 --> 0:03:41.240 to me and also made me want to just learn 0:03:41.240 --> 0:03:43.839 more about that and kind of get that information out 0:03:43.840 --> 0:03:46.160 there for other people who might be struggling with it. Well, 0:03:46.200 --> 0:03:48.360 thank you for sharing a bit of your personal story. 0:03:48.400 --> 0:03:51.680 I definitely relate to anxiety and depression being kind of 0:03:51.680 --> 0:03:54.880 like known in my family, but eating disordered disordered eating 0:03:54.960 --> 0:03:58.240 being territory that my family didn't know about. But what's 0:03:58.280 --> 0:04:02.000 interesting is you said you've got diagno knows at age eleven, 0:04:02.120 --> 0:04:05.000 So we get a lot of moms listening who are 0:04:05.040 --> 0:04:08.240 concerned about their child's well being. Did a parents step 0:04:08.240 --> 0:04:11.280 in when you were eleven to, you know, say something's 0:04:11.320 --> 0:04:13.120 going on? You know, there seems to be some sort 0:04:13.160 --> 0:04:16.320 of conversation was happening for you? What was that like? Definitely? So, 0:04:16.400 --> 0:04:18.839 I think what we often see with adolescence, and we 0:04:18.880 --> 0:04:21.760 see this with adults too, is that sometimes kiddos might 0:04:21.800 --> 0:04:24.240 not know that something is wrong, um, and I think 0:04:24.240 --> 0:04:26.160 that was definitely the case for me. So when I 0:04:26.240 --> 0:04:29.000 was that young, I didn't really necessarily realize that I 0:04:29.080 --> 0:04:31.840 had a problem. So it's definitely my parents who noticed 0:04:31.880 --> 0:04:34.400 that I wasn't kind of eating the way that I should, 0:04:34.480 --> 0:04:37.200 or I was exercising too much. So I was doing 0:04:37.240 --> 0:04:39.400 cross country back then, but I would do kind of 0:04:39.440 --> 0:04:42.120 even extra exercise beyond that. So I think it was 0:04:42.160 --> 0:04:44.560 my parents noticing that and kind of getting me into 0:04:44.600 --> 0:04:47.080 the doctor that was actually really important for me getting 0:04:47.120 --> 0:04:49.520 help then and doing a little bit better. So I 0:04:49.600 --> 0:04:51.960 definitely say if parents are kind of noticing that kids 0:04:51.960 --> 0:04:54.320 are struggling with that, or not eating like they used to, 0:04:54.520 --> 0:04:57.119 or seem kind of anxious around food um, or maybe 0:04:57.160 --> 0:04:59.800 exercising more than kind of makes sense, or for reasons 0:04:59.839 --> 0:05:02.200 that not just like for fun um, those are definitely 0:05:02.200 --> 0:05:05.520 reasons to kind of seek help into getting that diagnosis 0:05:05.640 --> 0:05:09.719 at that age feel validating, shameful. Were you aware of 0:05:09.760 --> 0:05:13.160 that diagnosis personally as at age eleven? Yeah, So I 0:05:13.240 --> 0:05:16.200 got into treatment actually around age twelve, so about a 0:05:16.279 --> 0:05:19.440 year after I really started developing those serious symptoms, so 0:05:19.480 --> 0:05:21.680 I was pretty aware of it. I went to like 0:05:21.760 --> 0:05:24.880 an outpatient treatment program with my parents. Um so they 0:05:24.880 --> 0:05:27.720 were doing something called FBT. So I don't know if 0:05:27.720 --> 0:05:30.480 you're familiar with that, but it's a family based treatment. 0:05:31.000 --> 0:05:32.960 I was actually really lucky to get that because it's 0:05:32.960 --> 0:05:36.040 one of the most evidence based treatments for young kiddos, 0:05:36.080 --> 0:05:38.760 and in that treatment, parents are actually really involved in 0:05:38.880 --> 0:05:42.000 helping kids eat and kind of feel better in that way. 0:05:42.080 --> 0:05:44.360 So I was aware of it, and I think, as 0:05:44.400 --> 0:05:45.960 you kind of mentioned, they think a lot of shame 0:05:46.040 --> 0:05:49.239 did come along with it, because it wasn't really something 0:05:49.279 --> 0:05:51.200 that I felt like I could talk about with other 0:05:51.320 --> 0:05:54.000 people or in school. It's a very secretive thing and 0:05:54.040 --> 0:05:56.320 it was kind of like a family secret for a 0:05:56.320 --> 0:05:58.800 long time that that was something I experienced, and I 0:05:58.839 --> 0:06:01.320 didn't actually even start sort of talking about it or 0:06:01.360 --> 0:06:04.000 telling my friends about it until I was in my twenties, 0:06:04.160 --> 0:06:06.520 um because I was worried about what people would think 0:06:06.600 --> 0:06:08.640 or if people would judge me or think that I 0:06:08.760 --> 0:06:11.000 was just obsessed with my appearance, if they kind of 0:06:11.120 --> 0:06:13.440 learned that about me. So it's really freeing when I 0:06:13.480 --> 0:06:15.840 finally did start to talk about it with people and 0:06:15.880 --> 0:06:18.440 realize that people can be really accepting of it, and 0:06:18.480 --> 0:06:20.640 also a lot of other people had gone through and 0:06:20.720 --> 0:06:24.240 experienced similar things, even if they hadn't necessarily gotten a 0:06:24.279 --> 0:06:27.960 diagnosis at that young age or at any age. Yeah, 0:06:28.080 --> 0:06:30.120 I think that speaks to so many, whether it's a 0:06:30.160 --> 0:06:33.400 mental illness or anything. Really is like we all kind 0:06:33.400 --> 0:06:36.440 of run around with these deep seated secrets that we think, 0:06:36.680 --> 0:06:38.880 you know, if people knew we would be we wouldn't 0:06:38.880 --> 0:06:41.039 belong or we'd be judged, or there'd be shame, And 0:06:41.080 --> 0:06:43.320 like every single one of us is running around with 0:06:43.360 --> 0:06:46.400 a different little seed of shame. And then you know, 0:06:46.640 --> 0:06:49.520 over a decade went by for you before you found 0:06:49.520 --> 0:06:51.800 your voice to speak about it. And it sounds like 0:06:51.880 --> 0:06:55.400 by doing so, you know your friends or your your colleagues, 0:06:55.440 --> 0:06:58.400 maybe we're like, oh well me too, me too, me too, 0:06:58.440 --> 0:07:01.039 And suddenly you know you're it's kind of just like 0:07:01.080 --> 0:07:04.080 a big relief to let that air out of the 0:07:04.080 --> 0:07:08.480 balloon and deflate and relax and say, Okay, you're not broken, 0:07:08.600 --> 0:07:11.640 or we're all a little bit broken, and that's that's okay, right, 0:07:11.760 --> 0:07:15.600 That's like being a human is exactly? Was that huge 0:07:15.640 --> 0:07:18.120 for your healing to be able to talk about something 0:07:18.400 --> 0:07:21.560 like that so young? I yeah, I definitely was. Um. 0:07:21.600 --> 0:07:23.360 I have a friend who once said to me, like 0:07:23.440 --> 0:07:26.240 sunlight is the best disinfectant, and I think that's a 0:07:26.280 --> 0:07:28.840 really nice thing, because, like you're saying, I think we 0:07:28.920 --> 0:07:31.720 all carry around things that we feel ashamed of or 0:07:31.800 --> 0:07:34.600 feel like we're the only person struggling with it. And 0:07:34.640 --> 0:07:36.720 when it's something that's a deep secret that you're not 0:07:36.760 --> 0:07:39.440 sharing with anyone else, it's really easy for those feelings 0:07:39.440 --> 0:07:41.280 of guilt and shame to build up and you just 0:07:41.360 --> 0:07:43.560 kind of feel worse and worse about it um and 0:07:43.560 --> 0:07:45.600 I think it even makes it harder to change those 0:07:45.640 --> 0:07:48.760 behaviors if you're having disordered eating behaviors or other kinds 0:07:48.760 --> 0:07:51.600 of challenges. But once you start talking about it, you 0:07:51.720 --> 0:07:54.760 realize that you know it's okay, and other people are 0:07:54.800 --> 0:07:58.000 going through similar things. And so as part of my training, 0:07:58.040 --> 0:08:00.480 I also see therapy clients, and I think what I've 0:08:00.480 --> 0:08:03.600 realized is everyone has these things that they think they're 0:08:03.600 --> 0:08:07.000 the only one that they that experienced something like that, 0:08:07.160 --> 0:08:09.840 But usually I had someone else tell me that exact 0:08:09.840 --> 0:08:12.480 same thing like a week ago. So I think none 0:08:12.520 --> 0:08:14.560 of us are really as alone as we think. And 0:08:14.640 --> 0:08:16.840 when we kind of discovered that, or personally, when I 0:08:16.880 --> 0:08:19.960 discovered that, it definitely was very freeing and allowed me 0:08:20.000 --> 0:08:21.640 to let go of a lot of the guilt and 0:08:21.680 --> 0:08:24.600 shame I've been carrying around. That's awesome, and it clearly 0:08:24.640 --> 0:08:26.880 I think by doing so allowed you to do the 0:08:27.000 --> 0:08:30.120 amazing work that you're doing. So let's kind of dive 0:08:30.160 --> 0:08:33.880 into that work. When did you realize that anxiety or 0:08:33.960 --> 0:08:38.679 depression could be related to eating disorders? That's a great question. 0:08:38.960 --> 0:08:41.520 So I think I sort of realized it some through 0:08:41.600 --> 0:08:44.720 my own experience and kind of realizing that there were 0:08:44.800 --> 0:08:47.960 times when I was engaging in certain behaviors because it 0:08:48.000 --> 0:08:50.480 helped me feel calmer, help me feel better. But their 0:08:50.480 --> 0:08:53.720 research literature is actually pretty consistent about it as well. 0:08:53.800 --> 0:08:57.120 So the research shows that among people with eating disorders 0:08:57.120 --> 0:09:00.720 and disordered eating, they're really high levels of anxiety in depression, 0:09:00.760 --> 0:09:03.280 with a lot of research showing that more than half 0:09:03.320 --> 0:09:06.200 of people who struggle with eating disorders also struggle with 0:09:06.200 --> 0:09:09.440 anxiety and depression. Um, so there's a really strong link 0:09:09.480 --> 0:09:12.280 in their research, and part of the reason seems to 0:09:12.320 --> 0:09:15.599 be related to biology. So we know that eating disorders 0:09:15.640 --> 0:09:19.040 obviously are affected by the socio cultural context that we 0:09:19.120 --> 0:09:22.840 live in, but they're also affected by your underlying genetic 0:09:22.960 --> 0:09:26.160 risk for developing an eating disorder. And we see that 0:09:26.240 --> 0:09:29.600 the genes that contribute to eating disorders also contribute to 0:09:29.640 --> 0:09:32.720 things like anxiety and depression. So I was trained by 0:09:32.880 --> 0:09:35.480 as a biologist in my undergrad and that's how I 0:09:35.520 --> 0:09:38.920 sort of started getting interested in learning about genetic contributions 0:09:38.960 --> 0:09:42.720 to things UM, and started learning about the overlap that exists. Well, 0:09:42.720 --> 0:09:45.120 that must really take away the shame and for anybody 0:09:45.120 --> 0:09:47.360 who maybe wants to kind of like, let's boil that down. 0:09:47.400 --> 0:09:50.760 I think what you're saying is we have genes and 0:09:50.960 --> 0:09:54.240 the environment could turn those genes on or off, possibly 0:09:54.320 --> 0:09:58.240 the environment being anything around you. And if you have 0:09:58.360 --> 0:10:01.840 that gene and you're predisposed is to a factor that 0:10:01.880 --> 0:10:03.840 turns that gene on. I think I'm not getting this 0:10:03.880 --> 0:10:07.800 completely scientifically right. You're doing it really right. Yeah, then 0:10:07.880 --> 0:10:11.040 kind of very so I'm oversimplifying it. But outcomes the 0:10:11.080 --> 0:10:15.200 eating disorder behavior or the anxiety or the depression, etcetera. 0:10:15.520 --> 0:10:18.040 So that's so interesting. Would you say that, UM, And 0:10:18.080 --> 0:10:19.800 I don't know if you could really boil this down, 0:10:19.800 --> 0:10:22.720 but would you say that anxiety slash depression leads to 0:10:22.840 --> 0:10:25.080 a eating disorder or would you say an eating disorder 0:10:25.160 --> 0:10:28.040 leads to anxiety and depression or back and forth, back 0:10:28.080 --> 0:10:30.920 and forth, That's a really excellent question, and it's one 0:10:30.960 --> 0:10:34.360 that I think is still being debated in the research literature. 0:10:34.400 --> 0:10:36.040 And I think what you're saying about the back and 0:10:36.080 --> 0:10:39.160 forth is probably a big part of it, because what 0:10:39.200 --> 0:10:41.920 we know is that when people aren't getting enough to eat, 0:10:41.960 --> 0:10:44.680 that actually affects their brain as well in ways that 0:10:44.760 --> 0:10:48.000 can increase risk for anxiety and depression. So there probably 0:10:48.080 --> 0:10:50.720 is kind of a circular nature to it. Where people 0:10:50.760 --> 0:10:53.200 are engaging and disordered eating, it kind of affects their 0:10:53.240 --> 0:10:55.280 body and also their self image in a way that 0:10:55.400 --> 0:10:58.679 can increase anxiety and depression, and then disordered eating behaviors 0:10:58.679 --> 0:11:00.960 can kind of be used as a way to manage 0:11:00.960 --> 0:11:03.640 those symptoms as well. But the research does show that 0:11:03.760 --> 0:11:07.040 often anxiety is what shows up first for people. Um 0:11:07.080 --> 0:11:10.120 So people might have anxiety when they're younger, like when 0:11:10.120 --> 0:11:13.760 they're in childhood, and then later developed disordered eating. So 0:11:14.080 --> 0:11:16.199 that's the way it often seems to go, but definitely 0:11:16.200 --> 0:11:19.680 not for everyone. That makes sense in your research, do 0:11:19.760 --> 0:11:23.959 you distinguish between disordered eating and eating disorders or I 0:11:24.280 --> 0:11:27.480 know when I was in undergrad I was interested in 0:11:27.600 --> 0:11:30.040 learning about eating disorders and disordered eating because I was 0:11:30.080 --> 0:11:33.199 silently suffering with my own and wanted to learn more, 0:11:33.240 --> 0:11:35.880 although I couldn't put that into words, and I remember 0:11:36.080 --> 0:11:39.040 that I couldn't find any research that spoke to kind 0:11:39.040 --> 0:11:42.000 of what I was dealing with, which was more disordered 0:11:42.000 --> 0:11:46.240 eating than eating disorders such as an axia, bolimia, you know, 0:11:46.280 --> 0:11:49.400 eating disorders not otherwise specified even didn't really speak to 0:11:49.440 --> 0:11:52.280 what I was going through. Has the research expanded to 0:11:52.679 --> 0:11:56.920 encompass more broad definition of eating disorders. I think it has. 0:11:57.080 --> 0:11:59.240 I think there's still work to be done, but I 0:11:59.280 --> 0:12:03.360 think increasedly people recognize that most people who struggle with 0:12:03.440 --> 0:12:06.559 disordered eating are kind of having an experience like you described, 0:12:06.640 --> 0:12:09.160 so they don't neatly fit into a box of one 0:12:09.160 --> 0:12:12.320 of those diagnoses, but they may still be struggling with 0:12:12.360 --> 0:12:16.640 their eating or body image um and still suffering distress 0:12:16.720 --> 0:12:19.920 from it. And so what we think now is that 0:12:19.960 --> 0:12:23.000 disordered eating kind of exists on a spectrum um. So 0:12:23.040 --> 0:12:27.079 you might have people that have these very severe disorders 0:12:27.080 --> 0:12:29.760 that manifest in specific ways, but then there are a 0:12:29.760 --> 0:12:32.599 lot of other people out there who are really struggling 0:12:32.600 --> 0:12:35.240 with disordered eating symptoms in a way that might not 0:12:35.320 --> 0:12:38.480 fit that diagnosis. But it's still really important to address 0:12:38.679 --> 0:12:41.360 and when it comes to research and finding people to 0:12:41.679 --> 0:12:45.680 conduct research on, are we bringing more people into the 0:12:45.720 --> 0:12:50.800 mix who don't neatly fit into anorexia bulimia. Yeah. So, actually, 0:12:50.840 --> 0:12:53.960 almost all of our research is conducted with people from 0:12:54.040 --> 0:12:58.040 the community and the general population. So at Michigan State University, 0:12:58.160 --> 0:13:02.120 we are really lucky to have population based twin registry 0:13:02.200 --> 0:13:04.679 and um I won't go into all the details of that, 0:13:04.720 --> 0:13:06.960 but having twins is really helpeful for getting at some 0:13:07.040 --> 0:13:10.880 of those genetic components to things like disordered eating, and 0:13:10.960 --> 0:13:13.400 in the general population we see the kind of the 0:13:13.480 --> 0:13:16.800 whole spectrum. So there are some people who might say 0:13:16.840 --> 0:13:19.840 that they never struggle with disordered eating or body image, 0:13:19.880 --> 0:13:21.960 and then there are some people who have struggled with 0:13:21.960 --> 0:13:25.240 it really severely, and then kind of everyone in between. 0:13:25.520 --> 0:13:27.760 Um So, in our research, we think it's really important 0:13:27.840 --> 0:13:31.800 to capture that whole variability because even people who are 0:13:31.840 --> 0:13:34.960 not meeting criteria for a diagnosis, you know, might still 0:13:35.000 --> 0:13:37.560 be struggling and in need of help. One of the 0:13:37.600 --> 0:13:41.360 things that you research is specifically is our ability to 0:13:41.720 --> 0:13:45.120 emotionally regulate and how that plays a role in eating 0:13:45.120 --> 0:13:49.840 disorders and disordered eating. Can you define emotional regulation or 0:13:50.160 --> 0:13:53.840 emotional disregulation? Maybe both for us? I think of emotion 0:13:53.920 --> 0:13:58.000 regulation as being kind of how you manage and respond 0:13:58.080 --> 0:14:01.320 to your emotions. So sometimes people might have an emotion, 0:14:01.400 --> 0:14:04.360 but they might respond to that by criticizing themselves for 0:14:04.400 --> 0:14:07.000 how they feel or trying to suppress that emotion and 0:14:07.040 --> 0:14:09.760 not show it to other people. And we generally think 0:14:09.760 --> 0:14:12.840 of those as not very helpful ways to respond to 0:14:12.880 --> 0:14:15.640 emotions because they tend to make the emotion more intense 0:14:15.800 --> 0:14:19.520 or lead to other kinds of behaviors like disordered eating. Um. 0:14:19.520 --> 0:14:22.479 But there are other ways that people sometimes manage their emotions, 0:14:22.720 --> 0:14:25.040 one of them being just accepting how you feel and 0:14:25.120 --> 0:14:27.400 kind of listening to what that emotion is telling you, 0:14:27.480 --> 0:14:29.480 which is actually kind of one of the most adaptive 0:14:29.480 --> 0:14:32.000 ways to respond, as well as just kind of thinking 0:14:32.040 --> 0:14:35.880 differently about the situation or maybe doing something to distract 0:14:35.920 --> 0:14:38.600 yourself or change the situation. And those are ways that 0:14:38.680 --> 0:14:42.200 often one can listen to on one's emotions and respond 0:14:42.240 --> 0:14:44.360 to them in a way that's less likely to lead 0:14:44.400 --> 0:14:46.880 to kind of feeling worse down the line. And our 0:14:46.920 --> 0:14:52.320 emotional regulation skills learned genetic both. So I think that's 0:14:52.320 --> 0:14:55.280 a question that the science actually hasn't fully answered, but 0:14:55.440 --> 0:14:58.680 they are definitely not a hundred percent genetic or even 0:14:58.880 --> 0:15:01.480 mostly genetic. I it's say because some of the things 0:15:01.520 --> 0:15:04.440 that we actually do to treat disordered eating and also 0:15:04.560 --> 0:15:08.520 things like anxiety and depression actually often involved teaching people 0:15:08.760 --> 0:15:12.120 how to pay attention to their emotions and regulate them 0:15:12.200 --> 0:15:15.240 more effectively. So that kind of starts with mindfulness and 0:15:15.320 --> 0:15:17.760 being aware of what it is that you're feeling, and 0:15:17.800 --> 0:15:20.600 also being aware that your emotions are kind of there 0:15:20.640 --> 0:15:23.200 to help you as opposed to hurt you, and then 0:15:23.480 --> 0:15:26.160 figuring out different ways to kind of engage in self 0:15:26.200 --> 0:15:29.400 soothing techniques or problem solving techniques so that you can 0:15:29.440 --> 0:15:32.720 manage those emotions without trying to turn them off with 0:15:32.800 --> 0:15:36.320 things like disordered eating behaviors. Yeah, so what I'm hearing, 0:15:36.400 --> 0:15:39.240 and I was kind of applying my own personal story here, 0:15:39.320 --> 0:15:42.640 which is I had no emotional regulation skills growing up, 0:15:42.680 --> 0:15:45.800 which I think a lot of people don't, and everything 0:15:45.840 --> 0:15:49.760 that I've learned has been learned. I've you know, mindfulness 0:15:49.800 --> 0:15:52.360 is a huge part of my journey, and I teach 0:15:52.520 --> 0:15:55.960 what I call modern mindful eating to my students in 0:15:55.960 --> 0:15:59.320 a program called Fork the Noise. And what I find 0:15:59.400 --> 0:16:01.680 most amazing being about the work that I do is 0:16:02.040 --> 0:16:04.960 when students apply it, it bleeds into the rest of 0:16:05.000 --> 0:16:07.560 their life. So we start with the food and then 0:16:07.720 --> 0:16:10.360 it turns into regular life or sometimes my students have 0:16:10.360 --> 0:16:13.480 an easier time applying the mindfulness concept to life, and 0:16:13.520 --> 0:16:16.280 then it comes back to the food because you have 0:16:16.320 --> 0:16:22.720 this expanded, less reactive, less cyclical reaction to your negative 0:16:22.720 --> 0:16:25.920 thoughts or even your thoughts in general. And I kind 0:16:25.920 --> 0:16:28.240 of picture in a circle like if my my brain 0:16:28.280 --> 0:16:30.440 was going one way in one direction one day, it 0:16:30.560 --> 0:16:33.280 stopped and it started going in the other direction, and 0:16:33.320 --> 0:16:35.400 the first way didn't serve me, in the second way 0:16:35.720 --> 0:16:38.800 really did. But I don't know always how to put 0:16:38.840 --> 0:16:42.480 that into words. So do you find that, you know, 0:16:42.520 --> 0:16:45.680 working with a therapist is the best way to learn 0:16:45.720 --> 0:16:49.320 emotional regulation and things like that. Yeah, So I'm a 0:16:49.360 --> 0:16:52.240 big fan of therapy. I always think that if you 0:16:52.320 --> 0:16:54.920 think you can benefit from therapy, and often even if 0:16:54.960 --> 0:16:57.760 you don't think you can, you can. Um. So I 0:16:57.840 --> 0:17:00.760 think therapy can be a really helpful of resource for 0:17:00.920 --> 0:17:04.480 using these and learning these kinds of skills, especially therapy 0:17:04.560 --> 0:17:09.280 that's focused on things like mindfulness or um. Dialectical behavior therapy, 0:17:09.320 --> 0:17:12.359 which is sometimes called DBT, has been shown to be 0:17:12.440 --> 0:17:15.760 helpful for people with eating disorders in terms of recognizing 0:17:15.800 --> 0:17:18.280 and learning to regulate their emotions. And I think a 0:17:18.359 --> 0:17:21.680 therapist can also be really helpful in helping you learn 0:17:21.760 --> 0:17:24.760 to accept your emotions and not judge them as much 0:17:24.840 --> 0:17:27.280 or judge yourself for having them, because they think it 0:17:27.320 --> 0:17:29.520 can be really easy to get into the trap of 0:17:29.560 --> 0:17:32.679 thinking you should feel differently, or you're a bad person 0:17:32.720 --> 0:17:35.840 if you feel guilty or angry or sad, and really 0:17:35.880 --> 0:17:38.800 that's not true because we all experience those emotions, and 0:17:38.840 --> 0:17:41.679 so being able to learn that those emotions are natural 0:17:41.680 --> 0:17:44.720 and okay, I think is an important part of the process. 0:17:45.080 --> 0:17:49.520 And your research keeps showing us that this emotional regulation 0:17:50.040 --> 0:17:53.240 plays a role in the development of disordered eating and 0:17:53.280 --> 0:17:56.760 eating disorders. Yeah, so, um, there's been a lot of 0:17:56.840 --> 0:18:00.359 research looking at that across time. So what you see 0:18:00.400 --> 0:18:02.960 is that when people have a hard time regulating their 0:18:03.000 --> 0:18:06.160 emotions or a kind of prone to anxiety or depression 0:18:06.240 --> 0:18:08.920 like we were talking about earlier, that kind of sets 0:18:08.920 --> 0:18:11.879 them up for being at higher risk for disordered eating 0:18:11.880 --> 0:18:14.200 down the line. And what we see is that when 0:18:14.200 --> 0:18:17.119 people get treatment and learn kind of how to manage 0:18:17.119 --> 0:18:20.280 their emotions more effectively than their disordered eating tends to 0:18:20.320 --> 0:18:23.199 go down, as well as their symptoms of anxiety and depression. So, 0:18:23.280 --> 0:18:25.560 like you were talking about, it can kind of generalize 0:18:25.600 --> 0:18:28.400 to multiple things, and especially a lot of research has 0:18:28.440 --> 0:18:31.600 been conducted with people who might experience binge eating or 0:18:31.640 --> 0:18:34.600 other kinds of disregulated eating. We're often that kind of 0:18:34.640 --> 0:18:38.320 eating can be triggered by really intense negative emotions, and 0:18:38.680 --> 0:18:41.879 the thinking is that when you have that behavior, it 0:18:41.960 --> 0:18:45.640 might help you feel better temporarily, but often people afterwards 0:18:45.840 --> 0:18:48.240 um will feel sort of guilty or ashamed, and it 0:18:48.280 --> 0:18:51.800 can lead to sort of a vicious cycle, though definitely 0:18:51.800 --> 0:18:54.960 plays an important role, and then more anxiety, more shame, 0:18:55.480 --> 0:18:58.160 more feelings like you need to you know, usually restrict, 0:18:58.200 --> 0:19:00.159 which leads to another binge and then before or you 0:19:00.200 --> 0:19:03.080 know what, you're in that cycle exactly. So it's pretty 0:19:03.080 --> 0:19:06.440 cool because your research isn't just looking for what causes 0:19:06.640 --> 0:19:10.800 eating disorders. You're also looking for not just the cause, 0:19:10.960 --> 0:19:15.280 but how to escape it or break the cycle. Right, Yeah, 0:19:15.480 --> 0:19:17.639 what would you say most of your research is focused on? 0:19:17.800 --> 0:19:20.000 That's a good question. So I think that I often 0:19:20.080 --> 0:19:22.240 kind of think about those things as being a little 0:19:22.280 --> 0:19:25.160 bit interchangeable in terms of like what causes it and 0:19:25.160 --> 0:19:28.040 what maintains it. They can sometimes be different, but often 0:19:28.080 --> 0:19:30.399 the things that started off can be the things that 0:19:30.480 --> 0:19:33.560 sort of keep it going. So my research focuses on 0:19:34.000 --> 0:19:36.040 kind of how emotions can play a role in any 0:19:36.080 --> 0:19:39.240 part of that. So in getting started with disordered eating, 0:19:39.400 --> 0:19:42.120 um in terms of anxiety and depression contributing to that, 0:19:42.320 --> 0:19:46.240 but also why eating disorders or disordered eating might continue. 0:19:46.480 --> 0:19:49.600 And you know, I think it's kind of complicated sometimes 0:19:49.640 --> 0:19:52.399 to disentangle what kind of first and what came second. 0:19:52.480 --> 0:19:55.280 So we use special research designs to do things like that, 0:19:55.359 --> 0:19:58.919 like having longitudinal studies where we track people over time. 0:19:59.600 --> 0:20:01.920 M some of our research looks at that to kind 0:20:01.920 --> 0:20:04.359 of see like what came first and what came second. 0:20:04.480 --> 0:20:06.880 But I think when you have people who are struggling 0:20:06.920 --> 0:20:09.480 with disordered eating, like the most important thing I guess 0:20:09.560 --> 0:20:11.440 is trying to figure out how to help them feel 0:20:11.520 --> 0:20:15.119 better once they're in that situation. So I hope is 0:20:15.160 --> 0:20:19.119 that by researching kind of how emotions contribute, we can 0:20:19.400 --> 0:20:22.080 sort of develop better treatments to help people who might 0:20:22.280 --> 0:20:26.679 be experiencing eating disorders. An alway has quite the range 0:20:26.840 --> 0:20:31.200 of listeners when it comes to age, probably sixteen year olds, 0:20:31.200 --> 0:20:33.760 I'm sure we have, but a lot of our listeners 0:20:33.840 --> 0:20:39.879