Eating disorders

Food Psych #175: The Truth About Digestion and Gut Health with Marci Evans

Fellow anti-diet dietitian Marci Evans is back! We discuss the intersection of digestive disorders and eating disorders, the risks associated with elimination diets, the role of the gut microbiome in digestion and health, the importance of consistency in self-care and well-being, and so much more! Plus, Christy answers a listener question about why she as a dietitian doesn’t advise people to shift their food choices to less-processed foods.

Marci is a Food and Body Image Healer™. She has dedicated her career to counseling, supervising, and teaching in the field of eating disorders. She is a Certified Eating Disorder Registered Dietitian and Supervisor, Certified Intuitive Eating Counselor and Certified ACSM personal trainer. In addition to her group private practice, Marci launched an online eating disorders training platform for dietitians in 2015 and co-directs a specialized eating disorders dietetic internship at Simmons College. She volunteers for a number of national eating disorder organizations and has spoken locally and internationally at numerous conferences and media outlets. She loves social media and you can find her on all outlets @MarciRD. Find her online at MarciRD.com.

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We Discuss:

  • What Marci has been up to since she was last on the podcast

  • Christy’s upcoming book

  • How Marci became interested in digestive concerns in her work as an eating disorder dietitian

  • The risks associated with the low-FODMAP diet and other elimination diets

  • Alternative therapies to elimination diets

  • What defines a functional gut disorder

  • The overlap between eating disorders and functional gut disorders

  • The role of mental health in digestion

  • Why we shouldn’t dismiss psychosomatic symptoms

  • Whether eating disorders lead to functional gut disorders, or vice versa

  • The common risk factors between disordered eating and digestive issues

  • The mechanisms that lead to digestive concerns in eating disorders

  • Why symptoms can sometimes persist after recovery

  • How any disordered eating behaviors can contribute to gut symptoms

  • How dieting can lead to digestive concerns

  • The gut microbiome, and its role in digestion, weight, and health

  • Why it’s too early to draw many conclusions from gut microbiome research

  • The consequences of a restrictive diet

  • The limitations of nutrition and weight research

  • Anti-diet dietitians and medical nutrition therapy

  • Pelvic floor disorders, and how their symptoms can be similar to functional gut disorders

  • Why in many cases dietary interventions should be the last resort, not first-line care

  • The importance of consistency in self-care and well-being

  • Christy’s own experiences with digestive symptoms

  • Stress-management techniques, and how they can help calm gut symptoms

  • Body image and its intersection with digestive disorders

 

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

Is it possible to eat intuitively when you are choosing mostly highly-processed foods? Shouldn’t dietitians and health advisors be advising people to move away from fast food? How can you attune to your internal cues when there is so much external messaging associated with fast food and highly-processed foods? What does the science say about how our food environment and how it affects our eating habits? Why do we need to be skeptical of Brian Wansink’s research? What made his research so popular and widely cited? How can listening to our internal cues versus external cues change our eating habits? What is “gentle nutrition” in the context of intuitive eating? Why is gentle nutrition the last principle of intuitive eating? Why doesn’t Christy advise people to shift away from choosing fast food and highly-processed foods? What is the connection between food insecurity and disordered eating?

(Resources Mentioned: Food Psych® Podcast episode #127, Restrained Eating and Food Cues: Recent Findings and Conclusions, Food Insecurity and Eating Disorder Pathology - TW/CW for the last two resources for specific numbers and fatphobic language )

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Food Psych #171: Healthcare Without Diet Culture with Jennifer Gaudiani

Jennifer Gaudiani - rectangle.jpg

Physician and eating disorder specialist Jennifer Gaudiani joins us to discuss how healthcare professionals are doing harm by perpetuating diet culture, why people with eating disorders are often missed in our medical system, medical outcomes she has seen in some of her patients who have adopted Health At Every Size®, the role of social justice and acknowledging privilege in our work, and so much more! Plus, Christy answers a listener question about whether it’s a contradiction to be an eating-disorder treatment provider who also does bodybuilding and fitness competitions.

Jennifer Gaudiani, MD, CEDS, FAED, is the Founder/Medical Director of the Gaudiani Clinic. Board Certified in Internal Medicine, she completed her undergraduate degree at Harvard, medical school at Boston University School of Medicine, and her internal medicine residency/chief residency at Yale. From 2008 to 2016, she was one of the leaders of the ACUTE Center for Eating Disorders. She left after serving as its Medical Director to found the Gaudiani Clinic, which provides expert in-person and nationwide telemedicine outpatient medical care to patients of all genders with eating disorders/disordered eating and to those in recovery. The Clinic is a HAES-informed provider and embraces treating people of all shapes and sizes. Through a collaborative, multi-disciplinary approach, the Clinic cares for the whole person, in the context of their values.

She has lectured nationally and internationally, is widely published in the scientific literature as well as on blogs and is a current member of the editorial board of the International Journal of Eating Disorders and the Academy for Eating Disorders Medical Care Standards Committee.

Dr. Gaudiani is one of very few outpatient internists who carries the Certified Eating Disorder Specialist designation. She is also a Fellow in the Academy for Eating Disorders. Find her online at GaudianiClinic.com.

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This episode is also brought to you by TomboyX. Go to tomboyx.com/foodpsych and check out their special bundles and pack pricing. Food Psych listeners will also get an extra 15% off with the code FOODPSYCH.

We Discuss:

  • How her privilege and family background shaped her relationship with food

  • Her sister’s struggle with bulimia, and how that influenced her work in eating disorders

  • Weight stigma in the medical field

  • Recognizing the harm that we as health professionals have done in perpetuating diet culture

  • When she realized ‘calories in, calories out’ doesn’t work

  • How she discovered the Health At Every Size® model and began to use it in her practice

  • Why people with eating disorders are often missed in our medical system

  • What an initial assessment looks like at her clinic

  • Medical outcomes that she has seen in some of her patients who have adopted HAES

  • The importance of having a multidisciplinary, HAES-informed team

  • The links between our healthcare system, the supposed “obesity epidemic,” and diet culture

  • How our bodies adapt to starvation

  • “Survival” genetics vs. “sensitive” genetics

  • How diets can make health issues worse

  • Why she doesn’t recommend moderation (and what she recommends instead)

  • Letting go of diet fads and embracing all foods

  • What draws people to problematic alternative-medicine practices, and what providers can do to help them re-engage in evidence-based healthcare

  • How she’s continuing to learn and integrate HAES into her practice and her book

  • The role of social justice and acknowledging privilege in our work

  • Jennifer’s book, Sick Enough: A Guide to the Medical Complications of Eating Disorders

  • The problems with our current diagnostic criteria for eating disorders

  • Atypical anorexia nervosa, and its high mortality and complication rates

  • How we can stop the spread of diet culture

 

Resources Mentioned

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

  • Submit your questions for a chance to have them answered on the podcast!

  • My online course, Intuitive Eating Fundamentals, which includes monthly listener Q&A podcasts and access to my private Facebook support group

  • Carmen Cool’s work, and her Food Psych® Podcast episode

  • Deb Burgard’s work, and her Food Psych® Podcast episode

  • Hilary Kinavey’s work, and her Food Psych® Podcast episode

  • Desiree Adaway’s work

  • Jennifer’s book, Sick Enough: A Guide to the Medical Complications of Eating Disorders (TW: Contains detailed descriptions of eating disorder behaviors)

  • Gaudiani Clinic

  • Jennifer and the Gaudiani Clinic on Facebook, Twitter, and Instagram

  • This episode is brought to you by Paribus. Paribus helps you save money by monitoring online retailers to make sure that you get the best price, and will even help you get compensated if your shipment arrives late. Head to GetParibus.com to sign up.

  • Ready to learn how to cook, make movies, write books, and more from the masters? MasterClass has launched the All-Access Pass – a thoughtful gift for the home cooks or lifelong learners in your life. Food Psych listeners can get the All Access Pass at MasterClass.com/FOODPSYCH.

  • This episode is also brought to you by TomboyX. Go to tomboyx.com/foodpsych and check out their special bundles and pack pricing. Food Psych listeners will also get an extra 15% off with the code FOODPSYCH.

     

Listener Question of the Week

Is it contradictory for eating disorder professionals to promote body acceptance and intuitive eating alongside bodybuilding and fitness competitions? What is diet culture? Would bodybuilding and fitness competitions exist without it? How are other sports related to diet culture? What if you’re an eating disorder professional with diet culture beliefs? How do you approach someone who is sharing triggering content?

(Resources Mentioned: Sand Chang’s Food Psych® Podcast episode)

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