atypical anorexia

Food Psych #178: The Truth About High-Weight Anorexia with Erin Harrop

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Weight-stigma researcher Erin Harrop joins us to discuss how anorexia is treated (or not) in people of different sizes, how diet culture and weight stigma influence treatment and recovery for disordered eating, the problem with the “atypical” anorexia label, how improving eating-disorder treatment in people with larger bodies can benefit everyone, and so much more! Plus, Christy answers a listener question about what to do if you develop binge eating in recovery from restrictive eating behaviors.

Erin Harrop received her B.S. and MSW from the University of Washington, where she is currently a fourth-year doctoral student in social welfare. Her research interests concern eating disorders, substance abuse, and weight stigma. She sees weight-based discrimination as a critical, and often ignored, social justice issue, and her research agenda seeks to address this limitation by focusing on the systemic factors of weight stigma which impact the illness journeys of eating disorder patients. She employs an interpretive, critical feminist theory and anti-oppression lens to her work, as well as an explicit Health at Every Size® approach to the promotion of health behaviors. Her research is informed by her clinical experience as a medical social worker at Seattle Children’s Hospital, where she has worked for the past five years. Erin recently was funded for two NIH TL1 Translational Research Training grants for her dissertation research with women who have atypical anorexia. Erin is also active in the student group, SWAG (Sizeism, Weightism Advocacy Group), which she co-founded in 2012. Find her online at facebook.com/erin.harrop.3

From now until New Year’s, we’re offering gift subscriptions to the Intuitive Eating Fundamentals course. It’s the perfect gift for someone looking for anti-diet inspiration, or put it on your wishlist so that others know to get it for you. For more information, visit christyharrison.com/gift.

This episode is brought to you by Poshmark, the fun and simple way to buy and sell fashion (including many plus-sized options!) Get $5 off your first purchase when you sign up with the invite code FOODPSYCH.

We Discuss:

  • “Intuitive cooking,” and how it helped to bring experimentation and joy to Erin’s relationship with food

  • Gendered messages around food

  • Diet culture, and how it steals our pleasure from food

  • Learning to trust our body’s desires for different foods

  • How diet culture and The Wellness Diet can twist our expectations of intuitive eating

  • The Restriction Pendulum

  • The role of Health At Every Size®, fat activism, and intuitive eating in Erin’s eating-disorder-recovery journey

  • Pushing beyond the “Recovery Diet”

  • How diet mentality and weight stigma amongst eating-disorder clinicians and treatment centers can hinder people’s recovery

  • Erin’s personal experiences in treatment as someone with anorexia in a lower-weight and higher-weight body

  • Why improving eating-disorder treatment for people in higher-weight bodies would improve treatment for everyone

  • Erin’s research on how anorexia is treated (or not) in people of different sizes

  • The reliance on weight in anorexia diagnoses, and how that is causing harm

  • How restriction, not weight loss or low weight, leads to the medical complications associated with anorexia

  • The delays and gaps in eating-disorder care

  • How our own biases can affect eating-disorder treatment and recovery

  • Why we shouldn’t make assumptions when people say that they’ve “restricted” or “binged”

  • How diet culture blurs the line between normal eating and disordered eating

  • Why we need to validate people’s problematic experiences with food

 

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. From now until New Year’s, we’re offering gift subscriptions! It’s the perfect gift for someone looking for anti-diet inspiration, or put it on your wishlist so that others know to get it for you. For more information, visit christyharrison.com/gift.

  • Erin’s Facebook page and email

  • This episode is brought to you by Poshmark, the fun and simple way to buy and sell fashion (including many plus-sized options!) Get $5 off your first purchase when you sign up with the invite code FOODPSYCH.

     

Listener Question of the Week

What can a person do if they’re still binge eating after they stop restricting their food? How can they accept their body while believing that they’ll gain weight eating so many calories? What are some less-obvious signs of disordered eating or thinking that can still lead to a feeling of deprivation? What’s the difference between physical and mental restriction? What’s the difference between diet culture and diet mentality? How are diet mentality and binge eating linked? Where can a person get support to overcome diet mentality and pursue eating-disorder recovery? How can a person tell whether they’re binge eating as a result of restriction or as a coping mechanism for difficult emotions? What are some ways that eating-disorder treatment can hinder recovery?

(Resources Mentioned: Anti-Diet, Health At Every Size, and Intuitive Eating Providers for Disordered-Eating Recovery, Food Psych® podcast episode 151 with Judith Matz)

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

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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.

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.

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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