coping

Food Psych #150: Disordered Eating & Gender Identity with Sand Chang

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Psychologist and trans-health educator Sand Chang joins us to talk about the complex experience of body acceptance for trans folks, the intersections of trans advocacy and Health at Every Size work, the growing body of research around trans folks and eating disorders, the shape-shifting nature of fatphobia and diet culture, and so much more! Plus, Christy answers a listener question about how food restrictions to try to cure acne can exacerbate an eating disorder.

Dr. Sand Chang is a Chinese American clinical psychologist, educator, and writer based in Oakland, CA. Sand identifies as queer, nonbinary, and genderfluid and uses they, them pronouns.

Sand currently divides their time between working at Stanford University’s counseling center, Northern California Kaiser Permanente Transgender Services, and a private practice specializing in trans health, relationships and sexuality, trauma, EMDR, eating disorders, and addictions. As a psychotherapist, trainer, and advocate, Sand is invested in healing and empowerment within marginalized communities and disrupting systems of oppression.

Sand co-authored the 2015 APA Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients and is the past Chair of the APA Committee on Sexual Orientation and Gender Diversity. They regularly present at conferences and provide trainings on a wide number of topics for health care systems, educators, and organizations. Sand’s upcoming book, A Clinician’s Guide to Gender-Affirming Care: Working with Transgender and Gender Nonconforming Clients, which they co-authored with their colleagues Drs. lore dickey and Anneliese Singh, will be published by New Harbinger in late 2018.

Outside of their professional work, Sand is a dancer, avid foodie, punster, and pug enthusiast. They live in Oakland, CA with their pug Zelda Sesame. Find them online at SandChang.com.

 


WE DISCUSS:

  • Sand’s relationship with food growing up, including how their Chinese-American heritage influenced how they related to food

  • Sand’s first exposure to diet culture and fatphobia, including how unconscious and covert diet mentality was while they were growing up

  • How being involved in dance negatively influenced Sand’s body image

  • Sand’s experience with an eating disorder and over-exercise, and how trauma and coping played a role in the development of their disordered behaviors

  • How positive feedback from weight loss egged on Sand’s disordered relationship with food and the issue with body appraisals

  • Sand’s process of seeking recovery, including the ways in which healthcare practitioners both help and harm individuals attempting to heal

  • How weight bias prevents folks from getting the proper care for their eating disorder

  • Sand’s discovery of size acceptance and fat liberation, and struggling with applying body acceptance to our own bodies

  • Trans healthcare and body image, including the fatphobia and binaries embedded in queer communities and body norms within the trans community

  • Sand’s experience discovering their gender non-conforming identity

  • The growing body of research around trans folks and eating disorders

  • How the minority stress around being misgendered feeds into disordered eating

  • The current limitations within the healthcare field around trans identity and barriers to care for trans folks

  • Gender dysphoria vs body dysmorphia

  • The limitations of the current DSM mental-health diagnoses for eating disorders and for the trans experience

  • The complex experience of body acceptance for trans folks

  • The intersections of trans advocacy and anti-diet, Health at Every Size work

  • Why gender-affirming surgery isn’t a cosmetic surgery and why it saves lives

  • Sand’s experience finding their way back to inclusive eating disorder work

  • The need for the HAES movement and eating disorder work to become more intersectional and move away from the gender binary

  • “White feminism” vs intersectional feminism

  • Sand’s experience with orthorexia, how their experience navigating their gender identity within the healthcare system reinforced their disordered experience, and their path to breaking out of diet culture for good

  • Sand’s path to finding intuitive eating, joyful movement, and body acceptance

  • How diet culture keeps up in the limbo period between disordered and recovered

  • Moving away from the perfectionism around the idea of recovery

  • The positive and negative takeaways from Sand’s time in Overeaters Anonymous

  • How valuable it is to have a community by your side during healing

 

RESOURCES MENTIONED

Some of the links below are affiliate links. Affiliates or not, we only recommend products and services that align with our values.

 

 

LISTENER QUESTION OF THE WEEK

Can eating in certain ways and cutting out certain foods help cure cystic acne? What are the dangers of trying to heal our skin through food restriction? Can disordered eating contribute to hormonal acne issues?

(Resources Mentioned: Dr. Steven Bratman’s work on orthorexia, Julie Duffy Dillon’s anti-diet resources for PCOS, the Certified Intuitive Eating Counselors Directory, the Health at Every Size Registry)

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Food Psych #149: The Truth About Binge Eating with Amy Pershing

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Anti-diet therapist and Binge Eating Disorder expert Amy Pershing joins us to discuss how our fatphobic culture hinders eating disorder recovery, how diet culture steals our personal power, the healing that can be found in getting angry, the role of restriction and trauma in binge eating, and so much more! Plus, Christy answers a listener question about quick ways for primary-care providers to talk to patients about intuitive eating and HAES.

Amy Pershing LMSW, ACSW is the Clinical Director of the Center for Eating Disorders (CED) in Ann Arbor. In 1993, she developed “Bodywise™,” a comprehensive treatment program to serve a growing population of clients coming to the center with binge eating disorder (BED). In 2008, Pershing and Chevese Turner, CEO and founder of Binge Eating Disorder Association (BEDA), joined forces to found Pershing Turner Consulting LLC which offers training to clinicians treating BED nationwide.

Pershing has pioneered an integrated approach based on almost 30 years of clinical experience. Her approach is strengths-based, incorporating Internal Family Systems, mindfulness strategies, Self Compassion interventions, and a range of somatic trauma techniques. Her approach also integrates intuitive eating and movement and a “health at every size” philosophy. Pershing offers two- and three-day Intensives for those in recovery, as well as “Hungerwise™,” a 10-week program for ending chronic dieting and weight cycling offered jointly with with St. Joseph Mercy Health System in Michigan.

Pershing lectures internationally and writes extensively on the treatment of BED and her own recovery journey for both professional and lay communities. She has been featured on numerous radio and television programs speaking about BED treatment and recovery, relapse prevention, weight stigma, and mindful eating and movement. She is the winner of BEDA's Pioneer in Clinical Advocacy ward. Pershing has also served on a variety of professional boards and is the Past Chair of the Binge Eating Disorder Association. Her book, published by Taylor and Francis, will be out in late summer 2018. She maintains a clinical practice in Ann Arbor. Find her online at TheBodyWiseProgram.com.

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We Discuss:

  • Amy’s relationship with food growing up, including learning conflicting narratives related to food

  • The ways in which parents try to shield their children from fatphobia and weight stigma

  • The many different iterations of diet culture over the years

  • Amy’s experience with restriction and hunger, and internalizing the moralization of food and the virtue in being hungry

  • Amy’s discovery of intuitive eating, and why food preoccupation is an inevitable side effect of restriction

  • Why foods with quick energy are most desireable in times of deprivation, and the role of pleasure and joy and eating

  • Diet culture’s message of personal responsibility and blaming the victim

  • How body shame and the thin ideal feeds into diet culture

  • Diet culture’s shift from aesthetics and the beauty ideal to health and “clean eating”

  • The classism embedded within the moralization of food

  • The seduction of the thin ideal, including the messages around desirability and love

  • Amy’s experience with weight stigma

  • How our fatphobic culture hinders eating disorder recovery

  • The value in weight-inclusive communities and the Health at Every Size message

  • The intersection between body image and self-compassion

  • Amy’s experience with the restrict-binge cycle and Overeaters Anonymous, and how she eventually reached out for help and support in her path towards recovery

  • The soothing effect of food, and understanding that food behaviors are often more about coping than about willpower

  • Amy’s training in trauma, and learning that our body will push us towards survival

  • How feminism, gender studies, and learning about the trauma of weight stigma informed Amy’s professional path

  • The power of shame and trauma narratives

  • How we attach moral value to movement, and how Amy embraced joyful movement

  • The power in throwing food and movement rules out the window in the recovery process

  • How Amy’s clients and colleagues have taught her to appreciate beauty in new ways

  • The value, healing, and power that comes with getting angry at the systems that oppress us

  • How diet culture steals our personal power, and how moving away from diet culture allows us to take that power back and put it towards more beneficial pursuits

  • Amy’s process of finding organic structure around movement and food

  • Why we need to focus on self-care, not self-control

  • The other ways in which the beauty ideal oppresses those around us

 

Resources Mentioned

Some of the links below are affiliate links. Affiliates or not, we only recommend products and services that align with our values.

 

Listener Question of the Week

How do primary care providers give compassionate care around intuitive eating and Health at Every Size? What are some ways that physicians can promote an anti-diet perspective when they only have a short amount of time with each patient? How does weight stigma and chronic stress put individuals at risk for health conditions that are often blamed on a larger body size? How do referrals play a role in helping people break free from diet culture?

(Resources Mentioned: Body Respect by Linda Bacon and Lucy Aphramor, Intuitive Eating, 3rd ed. by Evelyn Tribole and Elyse Resch)

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