Speaker 1: I won't lend my body out out everything that I'm
Speaker 1: made do. Won't spend my life trying to change. I'm
Speaker 1: learning a love who I am, I get, I'm strong,
Speaker 1: I feel free, I know who every part of me.
Speaker 1: It's beautiful and I will always out way. If you
Speaker 1: feel it with your eyes in the air, She'll love
Speaker 1: to the boom. I am there, say good day and
Speaker 1: did you and die out? Welcome back outway, fam Today
Speaker 1: it's just me. Amy is not here, sadly we miss her,
Speaker 1: but I'm here with a very special guest named Megan.
Speaker 1: And Meghan is a PhD student in clinical psychology, and
Speaker 1: Megan is doing amazing work that you're going to be
Speaker 1: so stoked to learn about. Megan's research broadly includes the
Speaker 1: interactions between biological and environmental risk for distort eating, particularly
Speaker 1: kind of translating that now into a little bit more
Speaker 1: human how our emotions play a role in disordered eating
Speaker 1: and eating disorders in disadvantage and marginalized communities. Megan is
Speaker 1: super passionate about integrating the research and clinical practice to
Speaker 1: advanced care for people with eating disorders, especially those who
Speaker 1: have been underserved. So you're doing awesome work because you're
Speaker 1: helping us understand how eating disorders and disordered eating come
Speaker 1: to be. Right. Yeah, well, thank you so much. And
Speaker 1: you know, I just want to say I think you
Speaker 1: all are doing really awesome work to kind of talking
Speaker 1: about eating disorders and getting that information out there. So
Speaker 1: thank you so much for having me. Thank you. I mean,
Speaker 1: our podcast is about a year old actually, but the
Speaker 1: past year it has become increasingly easy to get people
Speaker 1: to listen because we are talking about diet culture so
Speaker 1: much in the media and disrupting a lot of media
Speaker 1: norms even from body size to color to ability. You know,
Speaker 1: all these things are being disrupted in such a beautiful
Speaker 1: way that a lot of people understand how toxic the
Speaker 1: skinny mindset is, if you will. But what people don't
Speaker 1: know about eating disorders is that it's not just the
Speaker 1: drive to be thin. It can be caused by as
Speaker 1: you know, a multi fectoral you know, situation. And I
Speaker 1: love what you're focusing on. So let's kind of just
Speaker 1: start with your story. How did you get into this work? Sure,
Speaker 1: so this work is pretty personal for me. So I
Speaker 1: was diagnosed with anorexia when I was actually about eleven
Speaker 1: um and I struggled a lot with disordered eating all
Speaker 1: through my teenage years and into my twenties UM, both
Speaker 1: anorexia and kind of binge eating, and for a long time,
Speaker 1: I think it was a source of shame for me. UM.
Speaker 1: So eating disorders weren't really something that we're talked about
Speaker 1: in my family, UM. I think in part because you know,
Speaker 1: I come from a mixed ethnic background and my dad's
Speaker 1: a first generation American, my mom is Mexican American, and
Speaker 1: it just wasn't something that was necessarily talked about in
Speaker 1: their families either. So for a long time, I didn't
Speaker 1: really understand, you know, why this was something that I
Speaker 1: struggled with, UM and why it was so hard for me.
Speaker 1: And that made me really interested in kind of getting
Speaker 1: involved in research and figuring out why this is something
Speaker 1: people go through and what are all the reasons that
Speaker 1: can contribute to it. So one of the things that
Speaker 1: we know is that eating disorders are really closely related
Speaker 1: to other kinds of disorders moved off in things like
Speaker 1: anxiety or depression, and that's actually something that kind of
Speaker 1: runs in my family and that I've dealt with all
Speaker 1: my life. And I think that really helped me understand
Speaker 1: how my eating disorder and disordered eating behaviors were kind
Speaker 1: of functioning in a way to help me regulate my
Speaker 1: anxiety and my emotions. So that was really personally helpful
Speaker 1: to me and also made me want to just learn
Speaker 1: more about that and kind of get that information out
Speaker 1: there for other people who might be struggling with it. Well,
Speaker 1: thank you for sharing a bit of your personal story.
Speaker 1: I definitely relate to anxiety and depression being kind of
Speaker 1: like known in my family, but eating disordered disordered eating
Speaker 1: being territory that my family didn't know about. But what's
Speaker 1: interesting is you said you've got diagno knows at age eleven,
Speaker 1: So we get a lot of moms listening who are
Speaker 1: concerned about their child's well being. Did a parents step
Speaker 1: in when you were eleven to, you know, say something's
Speaker 1: going on? You know, there seems to be some sort
Speaker 1: of conversation was happening for you? What was that like? Definitely? So,
Speaker 1: I think what we often see with adolescence, and we
Speaker 1: see this with adults too, is that sometimes kiddos might
Speaker 1: not know that something is wrong, um, and I think
Speaker 1: that was definitely the case for me. So when I
Speaker 1: was that young, I didn't really necessarily realize that I
Speaker 1: had a problem. So it's definitely my parents who noticed
Speaker 1: that I wasn't kind of eating the way that I should,
Speaker 1: or I was exercising too much. So I was doing
Speaker 1: cross country back then, but I would do kind of
Speaker 1: even extra exercise beyond that. So I think it was
Speaker 1: my parents noticing that and kind of getting me into
Speaker 1: the doctor that was actually really important for me getting
Speaker 1: help then and doing a little bit better. So I
Speaker 1: definitely say if parents are kind of noticing that kids
Speaker 1: are struggling with that, or not eating like they used to,
Speaker 1: or seem kind of anxious around food um, or maybe
Speaker 1: exercising more than kind of makes sense, or for reasons
Speaker 1: that not just like for fun um, those are definitely
Speaker 1: reasons to kind of seek help into getting that diagnosis
Speaker 1: at that age feel validating, shameful. Were you aware of
Speaker 1: that diagnosis personally as at age eleven? Yeah, So I
Speaker 1: got into treatment actually around age twelve, so about a
Speaker 1: year after I really started developing those serious symptoms, so
Speaker 1: I was pretty aware of it. I went to like
Speaker 1: an outpatient treatment program with my parents. Um so they
Speaker 1: were doing something called FBT. So I don't know if
Speaker 1: you're familiar with that, but it's a family based treatment.
Speaker 1: I was actually really lucky to get that because it's
Speaker 1: one of the most evidence based treatments for young kiddos,
Speaker 1: and in that treatment, parents are actually really involved in
Speaker 1: helping kids eat and kind of feel better in that way.
Speaker 1: So I was aware of it, and I think, as
Speaker 1: you kind of mentioned, they think a lot of shame
Speaker 1: did come along with it, because it wasn't really something
Speaker 1: that I felt like I could talk about with other
Speaker 1: people or in school. It's a very secretive thing and
Speaker 1: it was kind of like a family secret for a
Speaker 1: long time that that was something I experienced, and I
Speaker 1: didn't actually even start sort of talking about it or
Speaker 1: telling my friends about it until I was in my twenties,
Speaker 1: um because I was worried about what people would think
Speaker 1: or if people would judge me or think that I
Speaker 1: was just obsessed with my appearance, if they kind of
Speaker 1: learned that about me. So it's really freeing when I
Speaker 1: finally did start to talk about it with people and
Speaker 1: realize that people can be really accepting of it, and
Speaker 1: also a lot of other people had gone through and
Speaker 1: experienced similar things, even if they hadn't necessarily gotten a
Speaker 1: diagnosis at that young age or at any age. Yeah,
Speaker 1: I think that speaks to so many, whether it's a
Speaker 1: mental illness or anything. Really is like we all kind
Speaker 1: of run around with these deep seated secrets that we think,
Speaker 1: you know, if people knew we would be we wouldn't
Speaker 1: belong or we'd be judged, or there'd be shame, And
Speaker 1: like every single one of us is running around with
Speaker 1: a different little seed of shame. And then you know,
Speaker 1: over a decade went by for you before you found
Speaker 1: your voice to speak about it. And it sounds like
Speaker 1: by doing so, you know your friends or your your colleagues,
Speaker 1: maybe we're like, oh well me too, me too, me too,
Speaker 1: And suddenly you know you're it's kind of just like
Speaker 1: a big relief to let that air out of the
Speaker 1: balloon and deflate and relax and say, Okay, you're not broken,
Speaker 1: or we're all a little bit broken, and that's that's okay, right,
Speaker 1: That's like being a human is exactly? Was that huge
Speaker 1: for your healing to be able to talk about something
Speaker 1: like that so young? I yeah, I definitely was. Um.
Speaker 1: I have a friend who once said to me, like
Speaker 1: sunlight is the best disinfectant, and I think that's a
Speaker 1: really nice thing, because, like you're saying, I think we
Speaker 1: all carry around things that we feel ashamed of or
Speaker 1: feel like we're the only person struggling with it. And
Speaker 1: when it's something that's a deep secret that you're not
Speaker 1: sharing with anyone else, it's really easy for those feelings
Speaker 1: of guilt and shame to build up and you just
Speaker 1: kind of feel worse and worse about it um and
Speaker 1: I think it even makes it harder to change those
Speaker 1: behaviors if you're having disordered eating behaviors or other kinds
Speaker 1: of challenges. But once you start talking about it, you
Speaker 1: realize that you know it's okay, and other people are
Speaker 1: going through similar things. And so as part of my training,
Speaker 1: I also see therapy clients, and I think what I've
Speaker 1: realized is everyone has these things that they think they're
Speaker 1: the only one that they that experienced something like that,
Speaker 1: But usually I had someone else tell me that exact
Speaker 1: same thing like a week ago. So I think none
Speaker 1: of us are really as alone as we think. And
Speaker 1: when we kind of discovered that, or personally, when I
Speaker 1: discovered that, it definitely was very freeing and allowed me
Speaker 1: to let go of a lot of the guilt and
Speaker 1: shame I've been carrying around. That's awesome, and it clearly
Speaker 1: I think by doing so allowed you to do the
Speaker 1: amazing work that you're doing. So let's kind of dive
Speaker 1: into that work. When did you realize that anxiety or
Speaker 1: depression could be related to eating disorders? That's a great question.
Speaker 1: So I think I sort of realized it some through
Speaker 1: my own experience and kind of realizing that there were
Speaker 1: times when I was engaging in certain behaviors because it
Speaker 1: helped me feel calmer, help me feel better. But their
Speaker 1: research literature is actually pretty consistent about it as well.
Speaker 1: So the research shows that among people with eating disorders
Speaker 1: and disordered eating, they're really high levels of anxiety in depression,
Speaker 1: with a lot of research showing that more than half
Speaker 1: of people who struggle with eating disorders also struggle with
Speaker 1: anxiety and depression. Um, so there's a really strong link
Speaker 1: in their research, and part of the reason seems to
Speaker 1: be related to biology. So we know that eating disorders
Speaker 1: obviously are affected by the socio cultural context that we
Speaker 1: live in, but they're also affected by your underlying genetic
Speaker 1: risk for developing an eating disorder. And we see that
Speaker 1: the genes that contribute to eating disorders also contribute to
Speaker 1: things like anxiety and depression. So I was trained by
Speaker 1: as a biologist in my undergrad and that's how I
Speaker 1: sort of started getting interested in learning about genetic contributions
Speaker 1: to things UM, and started learning about the overlap that exists. Well,
Speaker 1: that must really take away the shame and for anybody
Speaker 1: who maybe wants to kind of like, let's boil that down.
Speaker 1: I think what you're saying is we have genes and
Speaker 1: the environment could turn those genes on or off, possibly
Speaker 1: the environment being anything around you. And if you have
Speaker 1: that gene and you're predisposed is to a factor that
Speaker 1: turns that gene on. I think I'm not getting this
Speaker 1: completely scientifically right. You're doing it really right. Yeah, then
Speaker 1: kind of very so I'm oversimplifying it. But outcomes the
Speaker 1: eating disorder behavior or the anxiety or the depression, etcetera.
Speaker 1: So that's so interesting. Would you say that, UM, And
Speaker 1: I don't know if you could really boil this down,
Speaker 1: but would you say that anxiety slash depression leads to
Speaker 1: a eating disorder or would you say an eating disorder
Speaker 1: leads to anxiety and depression or back and forth, back
Speaker 1: and forth, That's a really excellent question, and it's one
Speaker 1: that I think is still being debated in the research literature.
Speaker 1: And I think what you're saying about the back and
Speaker 1: forth is probably a big part of it, because what
Speaker 1: we know is that when people aren't getting enough to eat,
Speaker 1: that actually affects their brain as well in ways that
Speaker 1: can increase risk for anxiety and depression. So there probably
Speaker 1: is kind of a circular nature to it. Where people
Speaker 1: are engaging and disordered eating, it kind of affects their
Speaker 1: body and also their self image in a way that
Speaker 1: can increase anxiety and depression, and then disordered eating behaviors
Speaker 1: can kind of be used as a way to manage
Speaker 1: those symptoms as well. But the research does show that
Speaker 1: often anxiety is what shows up first for people. Um
Speaker 1: So people might have anxiety when they're younger, like when
Speaker 1: they're in childhood, and then later developed disordered eating. So
Speaker 1: that's the way it often seems to go, but definitely
Speaker 1: not for everyone. That makes sense in your research, do
Speaker 1: you distinguish between disordered eating and eating disorders or I
Speaker 1: know when I was in undergrad I was interested in
Speaker 1: learning about eating disorders and disordered eating because I was
Speaker 1: silently suffering with my own and wanted to learn more,
Speaker 1: although I couldn't put that into words, and I remember
Speaker 1: that I couldn't find any research that spoke to kind
Speaker 1: of what I was dealing with, which was more disordered
Speaker 1: eating than eating disorders such as an axia, bolimia, you know,
Speaker 1: eating disorders not otherwise specified even didn't really speak to
Speaker 1: what I was going through. Has the research expanded to
Speaker 1: encompass more broad definition of eating disorders. I think it has.
Speaker 1: I think there's still work to be done, but I
Speaker 1: think increasedly people recognize that most people who struggle with
Speaker 1: disordered eating are kind of having an experience like you described,
Speaker 1: so they don't neatly fit into a box of one
Speaker 1: of those diagnoses, but they may still be struggling with
Speaker 1: their eating or body image um and still suffering distress
Speaker 1: from it. And so what we think now is that
Speaker 1: disordered eating kind of exists on a spectrum um. So
Speaker 1: you might have people that have these very severe disorders
Speaker 1: that manifest in specific ways, but then there are a
Speaker 1: lot of other people out there who are really struggling
Speaker 1: with disordered eating symptoms in a way that might not
Speaker 1: fit that diagnosis. But it's still really important to address
Speaker 1: and when it comes to research and finding people to
Speaker 1: conduct research on, are we bringing more people into the
Speaker 1: mix who don't neatly fit into anorexia bulimia. Yeah. So, actually,
Speaker 1: almost all of our research is conducted with people from
Speaker 1: the community and the general population. So at Michigan State University,
Speaker 1: we are really lucky to have population based twin registry
Speaker 1: and um I won't go into all the details of that,
Speaker 1: but having twins is really helpeful for getting at some
Speaker 1: of those genetic components to things like disordered eating, and
Speaker 1: in the general population we see the kind of the
Speaker 1: whole spectrum. So there are some people who might say
Speaker 1: that they never struggle with disordered eating or body image,
Speaker 1: and then there are some people who have struggled with
Speaker 1: it really severely, and then kind of everyone in between.
Speaker 1: Um So, in our research, we think it's really important
Speaker 1: to capture that whole variability because even people who are
Speaker 1: not meeting criteria for a diagnosis, you know, might still
Speaker 1: be struggling and in need of help. One of the
Speaker 1: things that you research is specifically is our ability to
Speaker 1: emotionally regulate and how that plays a role in eating
Speaker 1: disorders and disordered eating. Can you define emotional regulation or
Speaker 1: emotional disregulation? Maybe both for us? I think of emotion
Speaker 1: regulation as being kind of how you manage and respond
Speaker 1: to your emotions. So sometimes people might have an emotion,
Speaker 1: but they might respond to that by criticizing themselves for
Speaker 1: how they feel or trying to suppress that emotion and
Speaker 1: not show it to other people. And we generally think
Speaker 1: of those as not very helpful ways to respond to
Speaker 1: emotions because they tend to make the emotion more intense
Speaker 1: or lead to other kinds of behaviors like disordered eating. Um.
Speaker 1: But there are other ways that people sometimes manage their emotions,
Speaker 1: one of them being just accepting how you feel and
Speaker 1: kind of listening to what that emotion is telling you,
Speaker 1: which is actually kind of one of the most adaptive
Speaker 1: ways to respond, as well as just kind of thinking
Speaker 1: differently about the situation or maybe doing something to distract
Speaker 1: yourself or change the situation. And those are ways that
Speaker 1: often one can listen to on one's emotions and respond
Speaker 1: to them in a way that's less likely to lead
Speaker 1: to kind of feeling worse down the line. And our
Speaker 1: emotional regulation skills learned genetic both. So I think that's
Speaker 1: a question that the science actually hasn't fully answered, but
Speaker 1: they are definitely not a hundred percent genetic or even
Speaker 1: mostly genetic. I it's say because some of the things
Speaker 1: that we actually do to treat disordered eating and also
Speaker 1: things like anxiety and depression actually often involved teaching people
Speaker 1: how to pay attention to their emotions and regulate them
Speaker 1: more effectively. So that kind of starts with mindfulness and
Speaker 1: being aware of what it is that you're feeling, and
Speaker 1: also being aware that your emotions are kind of there
Speaker 1: to help you as opposed to hurt you, and then
Speaker 1: figuring out different ways to kind of engage in self
Speaker 1: soothing techniques or problem solving techniques so that you can
Speaker 1: manage those emotions without trying to turn them off with
Speaker 1: things like disordered eating behaviors. Yeah, so what I'm hearing,
Speaker 1: and I was kind of applying my own personal story here,
Speaker 1: which is I had no emotional regulation skills growing up,
Speaker 1: which I think a lot of people don't, and everything
Speaker 1: that I've learned has been learned. I've you know, mindfulness
Speaker 1: is a huge part of my journey, and I teach
Speaker 1: what I call modern mindful eating to my students in
Speaker 1: a program called Fork the Noise. And what I find
Speaker 1: most amazing being about the work that I do is
Speaker 1: when students apply it, it bleeds into the rest of
Speaker 1: their life. So we start with the food and then
Speaker 1: it turns into regular life or sometimes my students have
Speaker 1: an easier time applying the mindfulness concept to life, and
Speaker 1: then it comes back to the food because you have
Speaker 1: this expanded, less reactive, less cyclical reaction to your negative
Speaker 1: thoughts or even your thoughts in general. And I kind
Speaker 1: of picture in a circle like if my my brain
Speaker 1: was going one way in one direction one day, it
Speaker 1: stopped and it started going in the other direction, and
Speaker 1: the first way didn't serve me, in the second way
Speaker 1: really did. But I don't know always how to put
Speaker 1: that into words. So do you find that, you know,
Speaker 1: working with a therapist is the best way to learn
Speaker 1: emotional regulation and things like that. Yeah, So I'm a
Speaker 1: big fan of therapy. I always think that if you
Speaker 1: think you can benefit from therapy, and often even if
Speaker 1: you don't think you can, you can. Um. So I
Speaker 1: think therapy can be a really helpful of resource for
Speaker 1: using these and learning these kinds of skills, especially therapy
Speaker 1: that's focused on things like mindfulness or um. Dialectical behavior therapy,
Speaker 1: which is sometimes called DBT, has been shown to be
Speaker 1: helpful for people with eating disorders in terms of recognizing
Speaker 1: and learning to regulate their emotions. And I think a
Speaker 1: therapist can also be really helpful in helping you learn
Speaker 1: to accept your emotions and not judge them as much
Speaker 1: or judge yourself for having them, because they think it
Speaker 1: can be really easy to get into the trap of
Speaker 1: thinking you should feel differently, or you're a bad person
Speaker 1: if you feel guilty or angry or sad, and really
Speaker 1: that's not true because we all experience those emotions, and
Speaker 1: so being able to learn that those emotions are natural
Speaker 1: and okay, I think is an important part of the process.
Speaker 1: And your research keeps showing us that this emotional regulation
Speaker 1: plays a role in the development of disordered eating and
Speaker 1: eating disorders. Yeah, so, um, there's been a lot of
Speaker 1: research looking at that across time. So what you see
Speaker 1: is that when people have a hard time regulating their
Speaker 1: emotions or a kind of prone to anxiety or depression
Speaker 1: like we were talking about earlier, that kind of sets
Speaker 1: them up for being at higher risk for disordered eating
Speaker 1: down the line. And what we see is that when
Speaker 1: people get treatment and learn kind of how to manage
Speaker 1: their emotions more effectively than their disordered eating tends to
Speaker 1: go down, as well as their symptoms of anxiety and depression. So,
Speaker 1: like you were talking about, it can kind of generalize
Speaker 1: to multiple things, and especially a lot of research has
Speaker 1: been conducted with people who might experience binge eating or
Speaker 1: other kinds of disregulated eating. We're often that kind of
Speaker 1: eating can be triggered by really intense negative emotions, and
Speaker 1: the thinking is that when you have that behavior, it
Speaker 1: might help you feel better temporarily, but often people afterwards
Speaker 1: um will feel sort of guilty or ashamed, and it
Speaker 1: can lead to sort of a vicious cycle, though definitely
Speaker 1: plays an important role, and then more anxiety, more shame,
Speaker 1: more feelings like you need to you know, usually restrict,
Speaker 1: which leads to another binge and then before or you
Speaker 1: know what, you're in that cycle exactly. So it's pretty
Speaker 1: cool because your research isn't just looking for what causes
Speaker 1: eating disorders. You're also looking for not just the cause,
Speaker 1: but how to escape it or break the cycle. Right, Yeah,
Speaker 1: what would you say most of your research is focused on?
Speaker 1: That's a good question. So I think that I often
Speaker 1: kind of think about those things as being a little
Speaker 1: bit interchangeable in terms of like what causes it and
Speaker 1: what maintains it. They can sometimes be different, but often
Speaker 1: the things that started off can be the things that
Speaker 1: sort of keep it going. So my research focuses on
Speaker 1: kind of how emotions can play a role in any
Speaker 1: part of that. So in getting started with disordered eating,
Speaker 1: um in terms of anxiety and depression contributing to that,
Speaker 1: but also why eating disorders or disordered eating might continue.
Speaker 1: And you know, I think it's kind of complicated sometimes
Speaker 1: to disentangle what kind of first and what came second.
Speaker 1: So we use special research designs to do things like that,
Speaker 1: like having longitudinal studies where we track people over time.
Speaker 1: M some of our research looks at that to kind
Speaker 1: of see like what came first and what came second.
Speaker 1: But I think when you have people who are struggling
Speaker 1: with disordered eating, like the most important thing I guess
Speaker 1: is trying to figure out how to help them feel
Speaker 1: better once they're in that situation. So I hope is
Speaker 1: that by researching kind of how emotions contribute, we can
Speaker 1: sort of develop better treatments to help people who might
Speaker 1: be experiencing eating disorders. An alway has quite the range
Speaker 1: of listeners when it comes to age, probably sixteen year olds,
Speaker 1: I'm sure we have, but a lot of our listeners
Speaker 1: who write in are fifty sixty seventy, and they feel
Speaker 1: like it's too late for them, And they'll ask us,
Speaker 1: you know, do I have a chance at this? And
Speaker 1: I personally think they do. But I'd love to know
Speaker 1: if your research looks at populations who are perhaps forty
Speaker 1: six seventy. Even so, my research hasn't looked at that specifically.
Speaker 1: We have tended to focus on younger populations just because
Speaker 1: of some other aspects of our research. But I think,
Speaker 1: you know, to what your listeners would say, I think,
Speaker 1: you know, there's no evidence that it's ever too late
Speaker 1: for someone to be helped with something like, no matter
Speaker 1: the age of the person coming in, whether they're really
Speaker 1: young or whether they're kind of more advanced in life, like,
Speaker 1: people can always kind of benefit from help, and like
Speaker 1: it's never too late to change or to start to
Speaker 1: feel better. So all the research that we have shows
Speaker 1: that the treatments that work for people who are in
Speaker 1: their twenties should also work really well for people who
Speaker 1: are in their fifties and older, although obviously some aspects
Speaker 1: of a person's life might be different at that time.
Speaker 1: So I think, you know, no matter what a person's age,
Speaker 1: there's definitely hope for them to recover. That's awesome. Thank
Speaker 1: you for sharing that. And tell us a little bit
Speaker 1: about eating disorders and the prevalence in disadvantaged or marginalized populations.
Speaker 1: What are we seeing they're compared to I don't know
Speaker 1: the right word, their regular populations. Now that doesn't sound right, Yeah,
Speaker 1: I think more advantaged populations. Yeah, yeah, So that's kind
Speaker 1: of the other arm of my research, and I think
Speaker 1: of them as being related because people who are disadvantaged
Speaker 1: or marginalized, who are experiencing discrimination or poverty, there under
Speaker 1: a lot of stress. Right, So if we think that
Speaker 1: being under a lot of stress and experiencing a lot
Speaker 1: of negative emotions can be a risk factor for eating disorders,
Speaker 1: then it makes sense that people who are experiencing that
Speaker 1: kind of stress um or those kinds of negative emotions
Speaker 1: might also be at higher risk um And for a
Speaker 1: long time, I think there have been stereotypes out there
Speaker 1: about who eating disorders effects. So usually it's a thin,
Speaker 1: young white female individual. And what we know now and
Speaker 1: also you know, I think this resonates with what you
Speaker 1: said about your listeners, is that that just is not
Speaker 1: true that eating disorders occur in all kinds of people
Speaker 1: of all racial and ethnic backgrounds and ages and socioeconomic
Speaker 1: status is and what their research increasingly shows is actually
Speaker 1: that belonging to a disadvantaged or marginalized group can really
Speaker 1: increase your risk. So one of the places that that
Speaker 1: shows up is food insecurity, and this probably makes sense,
Speaker 1: like if you can't get enough food to eat and
Speaker 1: you're also experiencing other stressors that go along with poverty,
Speaker 1: your chances of experiencing and eating disorder are actually a
Speaker 1: lot higher on both at that time and then if
Speaker 1: you experience that as a child later on in life.
Speaker 1: So those that's kind of what their research is showing.
Speaker 1: And for people who experience things like discrimination because of
Speaker 1: their race or their sexual orientation, the risk is actually
Speaker 1: higher for those people as well. And there's some research
Speaker 1: showing that it may be actually that discrimination per se,
Speaker 1: that it is increasing their stress and increasing their risk.
Speaker 1: So the risk factor is the discrimination. Exactly, how can
Speaker 1: we help those communities who are most in need. What
Speaker 1: can we in the advantage communities due to help those
Speaker 1: struggling with disordered eating and eating disorders in disadvantaged populations.
Speaker 1: So I think one thing that's really important is awareness
Speaker 1: because going back to those stereotypes, um, and it's really unfortunate,
Speaker 1: but the research shows that even clinicians or people who
Speaker 1: work with people with eating disorders might hold some of
Speaker 1: those stereotypes, even potentially without being aware of them. So
Speaker 1: just being aware that someone who might not look like
Speaker 1: the eating disorder stereotype might be suffering from an eating disorder,
Speaker 1: I think is really important. And kind of related to that,
Speaker 1: I think making sure that services are available and accessible
Speaker 1: to people is really important. So often, for example, a
Speaker 1: person might have Medicaid insurance and there are not a
Speaker 1: lot of therapists who take that kind of insurance. So
Speaker 1: I think increasing availability and making sure that people who
Speaker 1: may not have the financial resources to pay out of pocket,
Speaker 1: for example, can still access services and access care is
Speaker 1: really important. A lot of public health initiatives need to
Speaker 1: be changed so that these people in these communities have
Speaker 1: access to mental health care exactly. Yeah, I think that
Speaker 1: there can be a lot of barriers for accessing treatment
Speaker 1: even for people who are advantaged in many ways, especially
Speaker 1: when it comes to eating disorders. So you can imagine
Speaker 1: that if someone doesn't have very many resources or connections
Speaker 1: to mental health services, it might be even harder. I
Speaker 1: think increasing awareness and also increasing access is kind of
Speaker 1: what's most important to help people get the assistance that
Speaker 1: they might need. And when it comes to kind of
Speaker 1: going back out to your work relating to anxiety and depression,
Speaker 1: do you study how the variables change when a person
Speaker 1: is put on medication like an anti anxiety medication or
Speaker 1: an antidepressant. Yeah, so we don't study that directly, but
Speaker 1: there is some research on it. So the research suggests
Speaker 1: that medication can actually really help some people with disordered
Speaker 1: eating with some caveats. So sometimes when people are really
Speaker 1: underweight or engaging in a lot of disordered eating behaviors,
Speaker 1: it actually changes their biochemistry so that the medications don't
Speaker 1: work quite as well in their brain as they otherwise would.
Speaker 1: So sometimes the first step is really helping the person's
Speaker 1: body kind of get back to a more stabilized place
Speaker 1: where their brain and their biochemistry is functioning maybe more typically,
Speaker 1: and then the medications can be helpful for things like
Speaker 1: depression and anxiety that might be fueling eating disorders, so
Speaker 1: it's kind of a dual barrel approach there. That's probably
Speaker 1: why it's so important to be working with a team
Speaker 1: that includes a therapist, oftentimes a dietitian to make sure
Speaker 1: that you are eating enough that your brain is getting
Speaker 1: all the nutrients that it needs so that the medications
Speaker 1: can be dosed properly and changed accordingly, but knowing that
Speaker 1: they are kind of working as they should be exactly exactly.
Speaker 1: I think eating disorders are really complicated, and they involve
Speaker 1: our minds but also our bodies, and so making sure
Speaker 1: that we're sort of taking care of all those aspects
Speaker 1: of it is really critical just kind of give people
Speaker 1: the best opportunity to achieve recovery and just feel better
Speaker 1: in life. And I think you hit the nail on
Speaker 1: the head, which is eating disorders are complicated, and most
Speaker 1: people don't understand that. Even people with eating disorders don't
Speaker 1: understand that. They feel frustrated that they can't just recover,
Speaker 1: that they can't just eat the food or not binge
Speaker 1: on the food, or not compensate for the food. But
Speaker 1: what you're doing is so important because it's really assessing
Speaker 1: all the variables and kind of showing, you know, us public,
Speaker 1: that there's so many more pieces to the public that
Speaker 1: doesn't meet the eye. So your work is so important
Speaker 1: and Amy and I want to thank you for doing
Speaker 1: it and for sharing it with us, and for also
Speaker 1: sharing your personal story today. We really appreciate it. Yeah,
Speaker 1: thank you so much, um, and thank you again for
Speaker 1: having me and for doing this and sharing this information
Speaker 1: with people out there. It's really great. Do you have
Speaker 1: social media or anything where anybody can go find you
Speaker 1: or you stay under the radar and we can just
Speaker 1: maybe read your research? Can we link anything in the
Speaker 1: show notes to show off the amazing work you're doing. Yes,
Speaker 1: So I'm a nerd and I have no social media,
Speaker 1: we like, uh, I do have um like a research page.
Speaker 1: I can definitely send you the link to that so
Speaker 1: you can take a look at some of the research
Speaker 1: articles that I've worked on. That'll be awesome. We have
Speaker 1: tons of like nutrition students and social work students who
Speaker 1: I'm sure would also just be interested to just read
Speaker 1: the amazing papers that I got to take a look
Speaker 1: at before this episode. And you're really doing amazing work.
Speaker 1: So thank you so much for your time, Megan, thank you.
Speaker 1: I really appreciate it.