WEBVTT - Is it an Eating Disorder or Disordered Eating? with Michelle Pillepich 0:00:01.240 --> 0:00:03.880 Maybe that's Lisa, and we're just two girls that want 0:00:03.880 --> 0:00:06.880 to have a conversation with you. Dear sixteen year old 0:00:06.960 --> 0:00:11.840 Andrea hey gorsgeous, Dear younger Lauren. Each episode is stories 0:00:11.880 --> 0:00:15.480 from people I would deprive myself. Why myself obsessively? Because 0:00:15.520 --> 0:00:17.840 I was eating healthy? I couldn't understand that I had 0:00:17.880 --> 0:00:20.799 a problem with food. Losing my period scared me the most. 0:00:21.000 --> 0:00:24.080 My story starts when I was around seven. That's when 0:00:24.079 --> 0:00:27.200 I started to hate my body. Body image is like 0:00:27.240 --> 0:00:31.000 our inner picture of our outer self healthy behaviors. I 0:00:31.120 --> 0:00:33.080 had a much bigger role at all health than the 0:00:33.080 --> 0:00:36.239 actual number on the scales. Internal dialogue can be so 0:00:36.440 --> 0:00:39.800 powerful and often it's super negative and critical in a 0:00:39.840 --> 0:00:41.760 way that we wouldn't talk to other people that we 0:00:41.880 --> 0:00:44.280 care about. When you start to share your story, that 0:00:44.360 --> 0:00:46.519 gives other people the courage to share theirs. I know 0:00:46.640 --> 0:00:48.519 you would be proud now of how far you have 0:00:48.680 --> 0:00:52.519 come in your relationship to food, exercise, and to yourself. 0:00:52.680 --> 0:00:56.560 I felt freedom, I've gained relationships. I've found my true 0:00:56.560 --> 0:00:59.360 sense of self worth. There's one thing I need you 0:00:59.400 --> 0:01:05.039 to take away. You're going to be okay, welcome to 0:01:05.200 --> 0:01:08.479 outweigh this is an intro that you know if you're 0:01:08.520 --> 0:01:11.399 listening to this podcast. We don't always do an intro, 0:01:11.560 --> 0:01:13.920 but if you hear us do one, it's because we 0:01:13.959 --> 0:01:16.240 had an afterthought and we want you to know it. 0:01:16.400 --> 0:01:19.720 Or we actually might need to put a trigger warning, 0:01:19.920 --> 0:01:22.320 and I want you to hear me now and receive 0:01:22.440 --> 0:01:25.800 this trigger warning and take it seriously. You're your own person. 0:01:25.880 --> 0:01:27.720 You can make your own decision what you're going to 0:01:27.800 --> 0:01:30.520 listen to. But this is an episode I would have 0:01:30.520 --> 0:01:32.920 maybe listened to to try to figure out what else 0:01:33.000 --> 0:01:36.640 I could do to help my body lose weight or 0:01:36.680 --> 0:01:39.160 do whatever it is I want to do. So my 0:01:39.319 --> 0:01:42.240 encouragement to you would be we're gonna try to talk 0:01:42.280 --> 0:01:46.440 about everything on Outweigh episodes. We don't want to censor 0:01:46.560 --> 0:01:48.920 and edit our content. We think that this is a 0:01:49.040 --> 0:01:52.200 very serious matter, and I would just encourage you mentally, 0:01:52.240 --> 0:01:54.840 if you're not in a place to really hear this 0:01:54.920 --> 0:01:58.080 episode and take it as help instead of part of 0:01:58.120 --> 0:02:02.560 your toolbook that you use to fuel you're eating disorder 0:02:02.720 --> 0:02:05.520 or disordered eating patterns. Then I would encourage you to 0:02:05.800 --> 0:02:08.280 press pause now and say this episode for when you're 0:02:08.280 --> 0:02:12.079 in a better place. Yeah, Hey, fam, I definitely piggybacking 0:02:12.080 --> 0:02:14.360 on what Amy said. This episode is so important. We're 0:02:14.440 --> 0:02:18.520 joined by an amazing eating disorder registered dietitian, and I 0:02:18.560 --> 0:02:20.400 think what you'll hear her say, but I want to 0:02:20.440 --> 0:02:22.760 just say it right now before you even move forward, 0:02:23.280 --> 0:02:25.880 is what is your intention in listening to this episode? 0:02:25.960 --> 0:02:28.280 So what is your intention? Ask yourself right now, and 0:02:28.320 --> 0:02:30.120 if it's coming from a place of I want to 0:02:30.240 --> 0:02:33.320 best support my body, then go for it. And if 0:02:33.320 --> 0:02:36.040 anything is coming up, as you know in your gut 0:02:36.080 --> 0:02:38.600 of I want to take advantage of what might be 0:02:38.720 --> 0:02:41.880 said here to further along and live in secrecy and 0:02:41.919 --> 0:02:43.800 have more tools to get away with what I've been 0:02:43.800 --> 0:02:46.880 getting away with, then perhaps pause this episode and don't 0:02:46.960 --> 0:02:49.360 don't take a listen. Lisa and I care about y'all, 0:02:49.480 --> 0:02:52.280 and that's why we feel it's important to share that 0:02:52.320 --> 0:02:55.840 with you before certain episodes that could be triggering. So 0:02:56.000 --> 0:02:58.799 there you go, that's our trigger warning. We hope you're 0:02:58.919 --> 0:03:02.320 enjoying all the guests and experts that we're having on 0:03:02.480 --> 0:03:05.640 and Michelle is amazing, and after you hear this, you'll 0:03:05.639 --> 0:03:08.800 realize why we'll definitely be having her back on Welcome 0:03:08.800 --> 0:03:12.600 back to Outweigh Today we have on eating disorder registered 0:03:12.639 --> 0:03:16.240 dietitian Michelle Pillow Pitch. You can find her on Instagram 0:03:16.280 --> 0:03:19.840 at Michelle two Els Pillow Pitch Nutrition. We'll drop that 0:03:19.880 --> 0:03:21.440 in the show notes because it's a little bit of 0:03:21.440 --> 0:03:23.960 a hard one and we're going to be learning all 0:03:24.000 --> 0:03:27.519 about how to discern if you have an eating disorder 0:03:27.600 --> 0:03:30.480 or disordered eating. So welcome, Michelle. We're so excited to 0:03:30.520 --> 0:03:32.600 have you. Thank you, thanks for having me. I'm excited 0:03:32.600 --> 0:03:35.480 to be here. So let's jump right in to the 0:03:35.520 --> 0:03:39.080 good stuff and help our listeners learn how to discern 0:03:39.120 --> 0:03:41.600 if it's disordered eating orn't eating disorder. What can we 0:03:41.640 --> 0:03:44.160 be on the lookout for. Yeah, it's a great question, 0:03:44.400 --> 0:03:47.480 and I think that there's a lot of crossover. So 0:03:47.520 --> 0:03:50.839 a lot of the disordered eating symptoms and traits like 0:03:51.000 --> 0:03:54.280 maybe counting calories or over exercise or things that are 0:03:54.880 --> 0:03:59.279 super common in our society are also present in eating disorders. 0:03:59.520 --> 0:04:03.920 What is the distinction is, I would say the intensity 0:04:03.960 --> 0:04:07.200 of both the symptoms, so maybe they happen more frequently, 0:04:07.440 --> 0:04:12.240 as well as the distress caused by food or the 0:04:12.240 --> 0:04:15.040 thought of weight gain. So, for example, if somebody has 0:04:15.360 --> 0:04:19.600 let's say anorexia, nerrosa, they would be really anxious to 0:04:19.640 --> 0:04:22.839 the point of like almost panic about eating foods that 0:04:22.960 --> 0:04:26.760 might cause weight gain. It's this real fear of a 0:04:26.880 --> 0:04:30.360 larger body size and with anoxia. Ing on that topic, 0:04:30.640 --> 0:04:34.760 the weight can also be a diagnosable factor, and I 0:04:34.839 --> 0:04:38.600 do like to really really emphasize that low weight is 0:04:38.640 --> 0:04:41.200 not necessary to have an eating disorder. Plenty of people 0:04:41.240 --> 0:04:44.960 have eating disorders, even anorexia, without being underweight. But if 0:04:45.000 --> 0:04:48.800 someone is underweight to the point of being medically unstable, 0:04:48.839 --> 0:04:51.800 having lab values that are off, feeling faint and dizzy, 0:04:51.920 --> 0:04:54.440 very often not being able to stand up too fast, 0:04:54.720 --> 0:04:58.279 those things can be signs that your weight is also 0:04:58.320 --> 0:05:00.680 a part of the diagnosis. That is part of that 0:05:00.800 --> 0:05:05.120 criteria for anorexia, and then for other disorders like bulimia 0:05:05.400 --> 0:05:09.400 or binge eating disorder, the frequency of behaviors is also 0:05:09.800 --> 0:05:12.360 part of that diagnosis. So the d s M five, 0:05:12.400 --> 0:05:16.039 for anyone who doesn't know, is the Diagnostic and Statistical 0:05:16.080 --> 0:05:19.240 Manual of Mental Disorders. I think that's the exact title. 0:05:19.360 --> 0:05:23.520 So that's like the Dictionary of Mental Illnesses. And so 0:05:23.800 --> 0:05:27.520 there are criteria for all these disorders, and for bulimia 0:05:27.560 --> 0:05:30.479 and binge eating disorder, the binges and the purges are 0:05:30.560 --> 0:05:33.040 occurring for I think it's once a week for at 0:05:33.120 --> 0:05:36.800 least three months to classify a diagnosis. If it's happening 0:05:36.800 --> 0:05:38.800 once a week and it hasn't been three months yet, 0:05:38.839 --> 0:05:41.080 that doesn't mean oh, don't get help yet. You know, 0:05:41.279 --> 0:05:44.560 anything that is disrupting your life is of course deserving 0:05:44.560 --> 0:05:47.119 of help. But that frequency is also kind of a key. 0:05:47.200 --> 0:05:49.520 So can we actually get just a quick definition of 0:05:49.560 --> 0:05:53.279 anorexia and bulimia and I guess binge eating disorder? Are 0:05:53.320 --> 0:05:56.520 those the three main eating disorders that you work with? Yeah, 0:05:56.560 --> 0:05:58.640 I would say those are the main ones. And then 0:05:58.760 --> 0:06:01.280 I mean orthorexia is a really big one. I think 0:06:01.320 --> 0:06:03.200 you guys have touched on it before. I don't think 0:06:03.200 --> 0:06:04.960 it's in the d S, m um, it would be 0:06:05.000 --> 0:06:08.960 considered eating disorder otherwise like unspecified something like that. But 0:06:09.320 --> 0:06:13.760 that's another main one. So anorexia is primarily a restrictive 0:06:14.040 --> 0:06:18.479 eating disorder, so limiting food intake to an inappropriate level 0:06:18.520 --> 0:06:21.880 based on your age and height and your calorie needs. 0:06:22.120 --> 0:06:25.719 Also that intense fear of weight gain and weight changes 0:06:25.839 --> 0:06:28.560 and body image. It can also have an aspect of 0:06:28.600 --> 0:06:33.160 body dysmorphia. And not seeing your body as it accurately appears, 0:06:33.360 --> 0:06:36.640 and low weight is part of that diagnosis. There's also 0:06:36.760 --> 0:06:40.839 something that is very unfortunately called a typical anorexia, which 0:06:40.839 --> 0:06:44.160 would be a restrictive eating disorder without low weight. And 0:06:44.520 --> 0:06:47.599 I would say probably every eating disorder professional is fighting 0:06:47.680 --> 0:06:50.960 against that name because obviously, like, that's not a typical 0:06:51.200 --> 0:06:55.159 that's just a human who is not at a severely 0:06:55.160 --> 0:06:57.919 low weight. So with the anorext it's primarily the restriction. 0:06:58.120 --> 0:07:04.000 Bulimia involves purjey, so that would be compensating after a binge. 0:07:04.240 --> 0:07:07.200 And I also like to define binge because a lot 0:07:07.240 --> 0:07:10.320 of people think, oh, I'm binging because I ate a 0:07:10.320 --> 0:07:12.720 bunch of Halloween candy and Halloween is on my mind. 0:07:12.840 --> 0:07:16.760 What classifies a binge is having a quantity of food 0:07:16.800 --> 0:07:20.400 that is larger than what is typically needed or what 0:07:20.440 --> 0:07:23.400 you would have in like a normal average meal to 0:07:23.440 --> 0:07:26.840 meet your needs in a distinct period of time, and 0:07:27.200 --> 0:07:30.000 having this feeling of being out of control, like you 0:07:30.040 --> 0:07:32.800 can't stop even if you wanted to. So that kind 0:07:32.840 --> 0:07:35.800 of compulsive and out of control feeling is also really 0:07:35.880 --> 0:07:39.360 characteristic of a binge. If it's Thanksgiving dinner and you 0:07:39.400 --> 0:07:42.200 eat a lot of extra pie because you only have 0:07:42.240 --> 0:07:43.480 it once a year and you just love it. Like, 0:07:43.560 --> 0:07:45.800 that's not necessarily a binge, you know. We can also 0:07:46.240 --> 0:07:49.000 choose to eat past fullness because it's enjoyable and we 0:07:49.040 --> 0:07:52.320 want to and those are completely normal things that like 0:07:52.480 --> 0:07:55.720 mentally distressing feeling of being out of control is really 0:07:55.800 --> 0:07:59.200 characteristic of a binge. Um, so that is kind of 0:07:59.240 --> 0:08:02.200 binge eating, just order having those frequent once a week 0:08:02.280 --> 0:08:05.880 episodes at least of binge eating eating those larger quantities 0:08:05.880 --> 0:08:08.800 of food. And then bulimia is primarily the purging, so 0:08:08.960 --> 0:08:12.120 having a purging episode every time there is a binge, 0:08:12.320 --> 0:08:16.160 and anorexia can also have binge purge as a form 0:08:16.200 --> 0:08:20.280 of compensation for eating. So there's so much overlap. People 0:08:20.320 --> 0:08:23.120 don't often fit into just one little box. Can you 0:08:23.200 --> 0:08:26.520 also speak to what a purge might look like, because 0:08:26.560 --> 0:08:29.160 for some people, they're probably thinking in their heads that 0:08:29.200 --> 0:08:32.720 automatically means throwing up, but that could mean going to 0:08:32.760 --> 0:08:36.040 the gym for five hours exactly. Yes. Um, that's a 0:08:36.080 --> 0:08:38.760 really good point. So purging is really any form of 0:08:38.800 --> 0:08:43.400 compensation for food eaten. So it could be making yourself vomit, 0:08:43.520 --> 0:08:47.400 it could be purging getting rid of those calories and 0:08:47.679 --> 0:08:52.600 from over exercise, so exercising much more than your body 0:08:52.679 --> 0:08:56.160 kneeds or wants. It could be taking laxatives after meals, 0:08:56.280 --> 0:08:59.839 or diuretics and using that type of medication. It could 0:08:59.840 --> 0:09:02.920 be even like sitting in a sauna for a ton 0:09:02.960 --> 0:09:06.520 of time, all sorts of things. So primarily I would 0:09:06.520 --> 0:09:09.560 say the vomiting, the exercise, the laxatives, and diuretics are 0:09:09.760 --> 0:09:12.360 the main things. Um And yes, those are all forms 0:09:12.440 --> 0:09:14.520 of purge, which I would say could be kind of 0:09:14.559 --> 0:09:18.600 interchangeable with compensation. For the purpose of someone identifying and 0:09:18.640 --> 0:09:21.640 just for people listening right now that may feel shame 0:09:21.720 --> 0:09:26.040 around anything she just said, specifically laxatives or sitting in 0:09:26.080 --> 0:09:29.240 a sauna for long periods of time, Lisa can speak 0:09:29.280 --> 0:09:32.280 to her experience. But I've done every single thing you 0:09:32.360 --> 0:09:35.320 just mentioned, so there is no shame and we need 0:09:35.400 --> 0:09:37.319 to be talking about it. Because I didn't even realize 0:09:37.360 --> 0:09:41.240 my sauna sessions were harmful. But in college I would 0:09:41.280 --> 0:09:44.839 go sitting there after I'd already done tons of work 0:09:44.880 --> 0:09:47.439 out at the gym, and I would put saran wrap 0:09:47.480 --> 0:09:50.599 around my stomach and sweat it all out in the 0:09:50.679 --> 0:09:53.800 sauna for like forty five minutes and then I would 0:09:53.920 --> 0:09:57.480 The pleasure I would get from unwrapping the suran wrap 0:09:57.760 --> 0:10:03.600 is such a mental thinging But also I was completely miserable, 0:10:03.800 --> 0:10:06.080 but didn't really know that that what I was doing 0:10:06.280 --> 0:10:09.160 was wrong. But I still hit it from everybody. And 0:10:09.160 --> 0:10:10.880 I remember one time my roommate found a bunch of 0:10:10.880 --> 0:10:13.200 suran wrap in my trash can, and I was mortified. 0:10:13.320 --> 0:10:15.720 I just ignored it. But I mean, I still remember 0:10:15.800 --> 0:10:18.560 that clear as day, and that was twenty years ago. 0:10:18.880 --> 0:10:21.560 I remember on Season one about way you talked about 0:10:21.600 --> 0:10:24.560 the suran wrap and the sauna, And there's actually been 0:10:24.600 --> 0:10:29.440 a resurgence of that trend at a popular wellness I'm 0:10:29.440 --> 0:10:31.240 putting in quotes. I don't know anything about it. I'm 0:10:31.240 --> 0:10:33.240 not like mocking it, but like a wellness spot in 0:10:33.440 --> 0:10:35.760 New York City where a lot of models are doing 0:10:35.800 --> 0:10:38.720 this and and and it became very popular and it's 0:10:38.720 --> 0:10:41.720 really important. Not everybody, I'm sure that does the suran 0:10:41.840 --> 0:10:45.000 rap has a disordered relationship to food or an eating disorder, 0:10:45.040 --> 0:10:49.280 but you know when you're doing it excessively compensatory lee 0:10:49.600 --> 0:10:51.480 and so forth. So there's a line. And you know, 0:10:51.600 --> 0:10:54.760 this year, I think it was this year has been 0:10:54.760 --> 0:10:56.520 a weird year, but it was this year I wrote 0:10:56.559 --> 0:10:59.160 about my use of laxatives, and it was something I 0:10:59.200 --> 0:11:02.160 never spoke of out because even I've I've shared so 0:11:02.240 --> 0:11:06.600 much about my disordered eating journey, laxatives like that made 0:11:06.640 --> 0:11:10.120 me feel so disgusting and shameful. And I'm just gonna 0:11:10.120 --> 0:11:13.560 say it again here because it's so not okay. How 0:11:13.679 --> 0:11:16.400 you know, easy it is? But I pooped in my 0:11:16.440 --> 0:11:19.200 pants once as a college student. I can't blame gonna 0:11:19.200 --> 0:11:21.520 say this on that way. But the body is not 0:11:21.559 --> 0:11:25.600 supposed to do that. Like I was destroying my inside 0:11:25.640 --> 0:11:27.240 and that didn't stop me. By the way, that was 0:11:27.320 --> 0:11:31.160 just a moment of Wow, I'm doing something serious. I 0:11:31.280 --> 0:11:33.440 you know, maybe put a pause on it for a moment, 0:11:33.800 --> 0:11:37.720 But not okay at all. And what's even more not 0:11:37.800 --> 0:11:40.280 okay is any shame you may feel around something that 0:11:40.360 --> 0:11:42.480 you've done in the past. So that's why I told 0:11:42.520 --> 0:11:45.200 that very embarrassing story. So the one thing I just 0:11:45.240 --> 0:11:48.880 want to ask Michelle, is you know, with laxatives for me, 0:11:48.920 --> 0:11:51.880 it's very open about her story with binging and purging. 0:11:52.080 --> 0:11:54.559 I took laxatives, but it wasn't you know, three times 0:11:54.559 --> 0:11:56.720 a week for six months, so I was in that 0:11:56.800 --> 0:12:00.360 gray area. Again. If I'm not a clinical eating disor order, 0:12:00.440 --> 0:12:02.880 what am I? That doesn't make it okay? So what 0:12:02.920 --> 0:12:06.120 would you say to somebody who is using or participating 0:12:06.160 --> 0:12:09.959 in compensatory behaviors such as the shana or over exercising, 0:12:10.080 --> 0:12:13.840 or laxatives or diuretics, but not at the frequency that 0:12:13.920 --> 0:12:18.040 makes it, you know, bulimia, get help. I always say 0:12:18.120 --> 0:12:21.240 it's important for anyone to get help, to reach out 0:12:21.280 --> 0:12:25.120 to talk to a therapist, dietitian, someone close to you 0:12:25.200 --> 0:12:27.360 before that if that feels like too big of a step, 0:12:27.440 --> 0:12:30.559 because sure, maybe you didn't have a clinical eating disorder, 0:12:30.600 --> 0:12:33.920 but clearly that behavior was disrupting your life. You know 0:12:34.000 --> 0:12:36.880 that's not something that we want anyone to be doing. 0:12:37.000 --> 0:12:39.480 So I always always, always say, I probably say this 0:12:39.520 --> 0:12:41.880 a thousand times a day, what is your intention? The 0:12:41.920 --> 0:12:44.960 intention matters? I ask every single client that whenever they 0:12:45.000 --> 0:12:47.840 say is it's good, is it's bad? So if you're 0:12:47.840 --> 0:12:51.240 taking laxatives once because you're really backed up, you went 0:12:51.280 --> 0:12:54.160 on a trip, whatever, like okay, normal. If you are 0:12:54.240 --> 0:12:57.280 taking it because you ate something that you feel guilty about, 0:12:57.360 --> 0:12:59.520 or because you want to lose weight and it's clearly 0:12:59.559 --> 0:13:03.160 too many peelate your body. That's disordered intention that deserves 0:13:03.200 --> 0:13:06.960 help and attention. So I would say, reach out and 0:13:07.080 --> 0:13:10.920 the shame is something so important to talk about. I'm 0:13:10.960 --> 0:13:13.559 so glad that you guys are both sharing your stories 0:13:13.600 --> 0:13:16.400 because I mentioned at least earlier, I used to work 0:13:16.400 --> 0:13:19.880 in a residential treatment center and new clients when I 0:13:19.920 --> 0:13:21.880 was meeting them for the first time, would always say, Oh, 0:13:21.920 --> 0:13:23.199 I don't think I need to be here. I really 0:13:23.240 --> 0:13:24.760 don't need to be here. I'm just doing it because 0:13:24.840 --> 0:13:27.080 my parents told me to blah blah blah whoever. And 0:13:27.080 --> 0:13:29.960 I always told people if we accepted clients based on 0:13:30.000 --> 0:13:31.920 who thinks they need to be here, I'd be out 0:13:31.920 --> 0:13:34.480 of the job. We would never have anyone nobody thinks 0:13:34.520 --> 0:13:38.040 they need help. But if you are resonating with any 0:13:38.080 --> 0:13:40.480 of these intentions in any of these stories, then you 0:13:40.640 --> 0:13:45.200 deserve help, and it's really important to reduce that stigma 0:13:45.400 --> 0:13:47.840 and to be able to reach out and get it. 0:13:47.920 --> 0:13:51.040 I'm just gonna throw something else in the laxative conversation, 0:13:51.200 --> 0:13:54.280 because again, trying to recognize whether or not you need help, 0:13:54.400 --> 0:13:58.280 maybe you're not taking laxatives like that, say laxative on 0:13:58.320 --> 0:14:02.400 the box, but you're drinking smooth Move tea every day 0:14:02.520 --> 0:14:05.800 or every night before bed, because I certainly was doing that. 0:14:05.800 --> 0:14:08.640 That is an easy way to disguise it because it's 0:14:08.679 --> 0:14:11.719 this organic herbal tea and it's like, oh, I just 0:14:11.800 --> 0:14:13.040 kind of need to go to the bathroom. And I 0:14:13.080 --> 0:14:15.840 would drink that publicly and openly in front of my 0:14:15.920 --> 0:14:17.840 family and be like, oh, I gotta make a smooth move, 0:14:18.080 --> 0:14:20.160 and that was more acceptable than I'm gonna go pop 0:14:20.160 --> 0:14:24.320 my laxative pills. So that is a warning. Look at 0:14:24.360 --> 0:14:28.680 that behavior as well, anything you're using to disguise. Yeah, 0:14:28.720 --> 0:14:31.680 that's actually how it started for me. At my college roommate. 0:14:31.760 --> 0:14:33.600 You know, we went to a health food store. Again, 0:14:33.680 --> 0:14:36.160 a health food store, so I assumed anything I'm buying 0:14:36.200 --> 0:14:39.200 from a health food store is good for me, and 0:14:39.240 --> 0:14:42.360 it's tea tea is good for me. And you know 0:14:42.400 --> 0:14:44.880 this is before Instagram with you know, now we see 0:14:44.880 --> 0:14:48.160 these laxative teas all over, So that was really important point. Amy, 0:14:48.200 --> 0:14:51.920 Thanks for bringing that up. You talked about lab values 0:14:52.160 --> 0:14:55.040 in anorexia, and I think that's something that a lot 0:14:55.080 --> 0:14:57.840 of people don't understand. When we talk about anorexia, we see, oh, 0:14:57.880 --> 0:15:00.560 they're just a thin person. You know, they're fine. What 0:15:00.800 --> 0:15:04.600 is going on health wise for somebody with anorexia? A 0:15:04.680 --> 0:15:07.920 lot of things can be going on, and it's also 0:15:08.120 --> 0:15:12.120 so individual, so in terms of lab values, they can 0:15:12.160 --> 0:15:14.440 be off in any sort of thing, like a lot 0:15:14.440 --> 0:15:18.400 of nutrient deficiencies, because of course you're not eating a lot. 0:15:18.440 --> 0:15:21.800 But I will say that it's actually fairly uncommon to 0:15:21.960 --> 0:15:25.520 have lab values that are really off. And that's another 0:15:25.560 --> 0:15:28.000 reason why so many clients come to me and say, 0:15:28.520 --> 0:15:31.400 I don't really need this, I'm fine, My labs are fine, 0:15:31.600 --> 0:15:34.520 and our bodies I know, Lisa, you know this as 0:15:34.520 --> 0:15:38.680 a dietician. Our bodies are so complex and work so 0:15:38.800 --> 0:15:42.400 hard to keep everything in balance, and I just always 0:15:42.400 --> 0:15:45.520 tell people it's normal till it's not. So maybe they're 0:15:45.560 --> 0:15:48.280 fine now, but if you continue down this path, it's 0:15:48.320 --> 0:15:50.960 not going to be fine. Bone health is really big, 0:15:51.040 --> 0:15:53.440 so even before things show up as off, I would 0:15:53.480 --> 0:16:00.240 say bones can be deteriorating osteopenia and osteoporosis. So using 0:16:00.280 --> 0:16:04.280 bone strength is very common in young people who suffer 0:16:04.320 --> 0:16:07.160 from anorexia, so that is of course not something we want. 0:16:07.360 --> 0:16:12.200 Hormones and your menstrual cycle can be affected. And again 0:16:12.440 --> 0:16:14.680 I always want to give a disclaimer that it doesn't 0:16:14.680 --> 0:16:18.280 always happen, and so some people are super sensitive and 0:16:18.320 --> 0:16:21.040 if they lose two pounds, they lose their period. Some 0:16:21.200 --> 0:16:24.080 people I personally have worked with clients who have had 0:16:24.280 --> 0:16:28.680 a twenty thirty year long battle with anorexia never lost 0:16:28.680 --> 0:16:32.240 their period, had children, and been severely underweight the whole time. 0:16:32.520 --> 0:16:35.680 So if you still have your period, that doesn't necessarily 0:16:35.720 --> 0:16:37.800 mean I don't have a problem. But if you lose 0:16:37.840 --> 0:16:40.320 your period, that's definitely a sign that something is off. 0:16:40.600 --> 0:16:43.200 I like what you said, it's normal until it's not. 0:16:43.880 --> 0:16:46.960 That's a really good reminder, and I would think, and again, 0:16:47.040 --> 0:16:49.600 we've spoken about this and we shared our stories on 0:16:49.720 --> 0:16:53.880 the first four episodes of Our WAGH. But I was 0:16:53.960 --> 0:16:57.320 once told when I was much younger, by a mentor 0:16:57.400 --> 0:17:01.720 to me that every time I threw up, it was 0:17:01.960 --> 0:17:04.679 a slow suicide. And so can you just speak to 0:17:04.760 --> 0:17:07.439 the harm that we're doing to our bodies all to 0:17:07.560 --> 0:17:10.720 fit into some whatever box of what we think we 0:17:10.720 --> 0:17:13.359 should look like. Describe what that really means, because I 0:17:13.359 --> 0:17:16.080 feel like that can sound really drastic to someone that's like, 0:17:16.160 --> 0:17:19.840 what stop like slow suicide? Don't even but it's it's 0:17:19.920 --> 0:17:23.160 so true. Yeah, no, it is. There are so many 0:17:23.240 --> 0:17:26.240 things that are harmful and people only think about I 0:17:26.240 --> 0:17:28.800 shouldn't say only, but tend to think about the external 0:17:28.880 --> 0:17:30.960 and well, I don't look thin enough where my teeth 0:17:30.960 --> 0:17:34.119 aren't ritting out of my head. But yeah, especially like 0:17:34.200 --> 0:17:38.919 with purging, the integrity of your esophagus and digestive system 0:17:39.119 --> 0:17:41.199 is being damaged. I don't want to be like a 0:17:41.240 --> 0:17:43.640 horror story here kind of scaring people, but I think 0:17:43.640 --> 0:17:47.400 it's important to know what's possible that it can get 0:17:47.440 --> 0:17:50.960 to a point where you can't stop the sort of 0:17:51.000 --> 0:17:55.440 opposite flow of your digestion and there is involuntary regurgitation 0:17:55.560 --> 0:17:59.560 that happens. Even just your digestive health being off poor 0:17:59.640 --> 0:18:03.879 neutral and absorption as your intestines are being damaged, really 0:18:03.920 --> 0:18:07.640 your whole digestive system being totally ruined. I've seen people 0:18:07.800 --> 0:18:11.200 end up with a colostomy bag from an eating disorder 0:18:11.200 --> 0:18:14.239 and other complications of it. You know, it's kind of 0:18:14.280 --> 0:18:17.000 interesting that, like gut health is so trendy, but at 0:18:17.040 --> 0:18:20.000 the same time, people are doing these behaviors to change 0:18:20.040 --> 0:18:24.240 their body that really impact your digestion, your bone health, 0:18:24.400 --> 0:18:27.760 you know, being able to so easily break a bone 0:18:27.760 --> 0:18:31.040 at a very young age having fractures. Heart health is 0:18:31.080 --> 0:18:35.000 also really really dangerous, and I tell people when you're 0:18:35.000 --> 0:18:38.000 not eating enough, someone who has a restrictive eating disorder, 0:18:38.240 --> 0:18:41.640 your body, if it doesn't have enough carbohydrate to use 0:18:41.680 --> 0:18:44.959 for energy, then it goes to breaking down fat and muscle. 0:18:45.240 --> 0:18:46.960 And people think, oh, yeah, I'm going to use up 0:18:46.960 --> 0:18:49.480 all my fat, but also protein and muscle, and your 0:18:49.560 --> 0:18:53.119 heart is a muscle, and your heart can deteriorate. Your 0:18:53.160 --> 0:18:58.480 heart can stop from purging too much from refeating syndrome. 0:18:58.520 --> 0:19:01.880 If you restrict too far and then reintroduced food when 0:19:01.880 --> 0:19:03.840 your body is not ready for it or too quickly, 0:19:04.440 --> 0:19:08.920 that can cause electrolyte imbalances. It's really dangerous for heart rhythms. 0:19:08.960 --> 0:19:12.320 So it's a serious thing. I think a common statistics 0:19:12.400 --> 0:19:16.360 thrown around is the anorexia is the deadliest mental illness, 0:19:16.640 --> 0:19:19.359 and people don't really realize that. So, yeah, that's actually 0:19:19.359 --> 0:19:22.639 a great pivot because eating disorders so much right now 0:19:22.680 --> 0:19:25.560 on the internet is to blame quote unquote diet culture. 0:19:25.680 --> 0:19:28.600 And obviously, you know there is this pursuit of thinness 0:19:28.760 --> 0:19:31.040 ingrained in all of us. But one thing that I 0:19:31.080 --> 0:19:33.320 think is kind of getting lost in the mix, is 0:19:33.359 --> 0:19:36.080 that eating disorders in the nature that we're discussing them 0:19:36.119 --> 0:19:40.080 today are not just because of diet culture. Right, What 0:19:40.160 --> 0:19:43.159 are some of the factors that could go into causing 0:19:43.160 --> 0:19:46.880 and eating disorder? So many and it's never just one thing. 0:19:47.160 --> 0:19:50.080 So you know, if someone is listening and has a 0:19:50.200 --> 0:19:52.640 child or parent or best friend with an eating disorder, 0:19:52.680 --> 0:19:55.879 nothing is your fault or any one person's fault. They 0:19:55.920 --> 0:20:01.040 are biopsychosocial disorders. So there's a biological component. It is 0:20:01.520 --> 0:20:04.040 ingrained in our biology of our body. There is a 0:20:04.080 --> 0:20:07.480 genetic component. I actually researched that for my master's degree. 0:20:07.480 --> 0:20:11.280 It was really interesting and psychological. So there is a 0:20:11.320 --> 0:20:15.840 mental health component. These are mental disorders, so there's that 0:20:15.880 --> 0:20:21.240 whole piece, often probably always co occurring with anxiety, depression, 0:20:21.640 --> 0:20:25.800 any type of other psychiatric diagnosis, and social So yes, 0:20:25.880 --> 0:20:29.520 there is the diet culture piece, the people you're around, 0:20:29.600 --> 0:20:33.080 the sports you're in, the cultures and activities that can 0:20:33.119 --> 0:20:36.200 also influence things. And it has to be that perfect storm. 0:20:36.320 --> 0:20:40.240 So you know, one person might be in competitive dance 0:20:40.359 --> 0:20:44.000 or something that is a community in which eating disorders 0:20:44.000 --> 0:20:46.399 are prominent, and maybe they don't have the genes that 0:20:46.480 --> 0:20:48.639 predispose them to the eating disorder, and they're fine. But 0:20:48.720 --> 0:20:52.600 somebody else does have that genetic makeup and that psychiatric 0:20:52.680 --> 0:20:55.440 makeup and they do develop an eating disorder. So it's 0:20:55.440 --> 0:20:59.280 really complex, certainly. And so for somebody listening that resonated 0:20:59.359 --> 0:21:02.439 with either the arexia the bolimia, somebody might be listening 0:21:02.440 --> 0:21:05.119 and they're they're nervous. What is the first step that 0:21:05.280 --> 0:21:07.600 they should take, because I think that's where a lot 0:21:07.640 --> 0:21:11.000 of people actually get stuck. Yeah, the first step is 0:21:11.400 --> 0:21:16.480 I would say tell someone eating disorders thrive in secrecy, 0:21:16.560 --> 0:21:21.320 So putting it out there to whoever you're comfortable with, Well, 0:21:21.520 --> 0:21:24.960 then get the ball rolling with somebody holding you accountable, 0:21:25.000 --> 0:21:27.200 helping you get help, helping you make the phone call 0:21:27.240 --> 0:21:30.480 to a therapist or a dietitian or your doctor or 0:21:30.520 --> 0:21:32.800 whatever you need to do. That is the first step 0:21:32.800 --> 0:21:36.760