recovery

Food Psych #198: Preventing Disordered Eating in the Next Generation with Lauren Muhlheim, Psychologist and Eating-Disorder Specialist

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Eating-disorders psychologist Lauren Muhlheim joins us to discuss how we can model a peaceful relationship with food for the kids in our lives, the problem with “childhood obesity” interventions, how some eating-disorder-treatment methods are being co-opted for weight loss, the rise of orthorexia, weight bias in medicine and the eating-disorders field, and so much more! Plus, Christy answers a listener question about the Biggest Loser reboot and shares the official description that will be on the book jacket of her upcoming book, Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating.

Lauren Muhlheim, Psy.D., FAED, CEDS is a psychologist, certified eating disorder specialist (CEDS), and IAEDP (International Association of Eating Disorder Professionals) - approved supervisor who provides evidence-based treatment for eating disorders in the outpatient setting. She directs Eating Disorder Therapy LA in Los Angeles and is able to provide teletherapy in California and New York. She provides cognitive-behavioral therapy (CBT) for adults and family-based treatment (FBT) for adolescents and adheres to Health at Every Size® principles. She is certified in FBT by the Training Institute for Child and Adolescent Eating Disorders.

Dr. Muhlheim is the author of When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Overcome Anorexia, Bulimia, and Binge Eating, published by New Harbinger Publications in September, 2018. This book is an FBT-based book for parents who are helping adolescents with eating disorders.

Dr. Muhlheim is active in several professional organizations. Dr Muhlheim is the Eating Disorders Expert for Verywell (formerly About.com) and is Clinical Director of the Eating Disorder Information website, Mirror-Mirror Eating Disorders. She presents nationally to parents, professionals, and trainees. She is active on social media and in eating disorder advocacy efforts. Find her online at EatingDisorderTherapyLA.com

Christy’s upcoming book, Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating is NOW AVAILABLE FOR PRE-ORDER! Be one of the first to get a copy of the book and help spread the anti-diet message to more people when you pre-order at christyharrison.com/book.

We Discuss:

  • The lineage of dieting in Lauren’s family

  • Her different experiences with dieting

  • What helped her overcome dieting and disordered eating

  • What motivated her to become an eating-disorders psychologist

  • Psychodynamic therapy and cognitive-behavioral therapy (CBT)

  • Enhanced cognitive-behavioral therapy for eating disorders (CBT-E)

  • How CBT is often co-opted for weight loss

  • Adopting a weight-inclusive approach in the weight-centric healthcare field

  • Lauren’s different roles throughout her career as a psychologist, including starting the Shanghai International Mental Health Association

  • Family-based treatment (FBT)

  • Weight bias and diet mentality in the eating-disorders field

  • Goal weights in eating-disorder recovery, and the problem with setting them too low

  • Parents gaining weight and recovering from diet culture when helping their child recover from an eating disorder

  • Why diagnostic criteria for eating disorders can be problematic

  • Orthorexia, and how our culture has contributed to its development as an eating disorder

  • Health At Every Size as a treatment framework for eating-disorder recovery

  • How parents, especially those who are in eating-disorder recovery, can model a more peaceful relationship with food for their children

  • Ellyn Satter’s Division of Responsibility (DoR)

  • Why DoR doesn’t work for kids with eating disorders

  • Early signs of disordered eating in children

  • FBT as an early intervention for disordered eating in kids

  • How eating disorders are often missed in sports and healthcare

  • The problem with “childhood obesity” interventions

  • Lauren’s book, When Your Teen Has an Eating Disorder: Practical Strategies to Help Your Teen Overcome Anorexia, Bulimia, and Binge Eating

 

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

What is Christy and the Health At Every Size community saying about the return of The Biggest Loser? What were some of the harmful outcomes of the show? How does The Biggest Loser uphold The Wellness Diet? What makes The Wellness Diet so harmful? Why are there doubts that The Biggest Loser reboot won’t be different from the original version? What are some ways that people can speak out against this show?

(Resources Mentioned:

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Food Psych #197: Hormones, Disordered Eating, and How The Wellness Diet Harms Your Health with Robyn Nohling

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Nurse practitioner and fellow HAES dietitian Robyn Nohling joins us to discuss her experiences with disordered eating and hypothalamic amenorrhea (HA), how diet culture wreaks havoc on our hormones, why doing less may actually be better for our health, how The Wellness Diet is making us sicker, and so much more! Plus, Christy answers a listener question about how to navigate intuitive eating with diabetes.

Robyn’s own health journey has been the catalyst to her career focused on counseling, nursing, mentoring, and teaching in the field of women's health and eating disorders. As a Board Certified Family Nurse Practitioner and Registered Dietitian, Robyn specializes in hormone & reproductive health along with eating disorders and disordered eating. She uses a weight-inclusive and non-diet approach and firmly believes health goes far beyond your plate and exercise routine. Alongside her private practice, blog and inpatient NP position, Robyn opened an online learning center in 2017 to both educate other practitioners and empower women to advocate for their own health and healing.

In both her RD and NP practices, Robyn works through the Intuitive Eating and Health At Every Size® framework. She is a member of and involved in several women's health and eating disorder organizations including the International Association of Eating Disorder Professionals, Nurse Practitioners in Women's Health, and the International Federation of Eating Disorder Dietitians.

When she's not working with women or behind the screen, she enjoys exploring Boston and the northeast with her husband and baby boy, traveling despite her fear of flying, cooking new recipes, hosting others in her home and experiencing the food scene wherever she might be. Robyn loves connecting on social media. Follow her on Instagram and Pinterest, join The Real Life Facebook community, and check out her blog, The Real Life RD.

We Discuss:

  • How Robyn’s relationship with food and her body started shifting in high school

  • How her weight loss was normalized as “healthy”

  • Hormonal and menstrual concerns, and how they are often overlooked

  • How Robyn’s eating disorder evolved throughout college

  • “Ideal body weight,” and why it is bullshit

  • Michael Pollan and the “real food” movement

  • The links between Michael Pollan’s work, fatphobia, and orthorexia

  • Alcohol, and its role in Robyn’s eating disorder

  • What sparked Robyn’s interest in hormonal health

  • Her and Christy’s experiences with hypothalamic amenorrhea (HA), and the lack of support they received

  • The prevalence of disordered eating in the dietetics field

  • Why Robyn feels nursing school was a “healing experience” for her

  • How she got her period back after missing it for 10 years

  • How diet culture affects our hormonal health

  • “Sick thyroid” syndrome, and how restriction can affect thyroid function

  • The lack of evidence for cutting out gluten and dairy for autoimmune conditions

  • Stress, cortisol, and their effects on hormonal health

  • How The Wellness Diet is actually making us sicker

  • Diet culture in conventional and alternative healthcare

  • Why diets and food rules can be appealing

  • How disordered eating clouds our intuition

  • Robyn’s experiences with pregnancy and breastfeeding

  • The harmful messages regarding body size for people who are pregnant or postpartum

  • Intuitive eating, and how it can benefit reproductive health

  • The need for more research on HAES®, healthcare, and fertility

  • What it would take to shift fertility medicine toward HAES

  • Robyn’s course for health professionals

 

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 can a person with diabetes or another chronic condition navigate intuitive eating? What can make intuitive eating particularly difficult for someone with type 1 diabetes? What is the difference between type 1 and type 2 diabetes, and not having diabetes? What are some intuitive eating skills that can apply for people with diabetes? Why is it important to make peace with all foods in diabetes? Why is it OK for people with diabetes to sometimes have blood sugars outside of the “normal” range?

(Resources Mentioned:

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Food Psych #190: Why Intuitive Eating Is NOT a Diet with Caroline Dooner

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Fellow author and podcaster Caroline Dooner returns! We discuss her new book, The F*ck It Diet: Eating Should Be Easy, why mental deprivation is just as much of a problem as physical deprivation, why people often treat intuitive eating as another diet (and why it’s not), the essential role of rest in healing our relationship with movement, why focusing on fullness can be problematic, and so much more! Plus, Christy answers a listener question about whether a certain model of treatment for binge-eating disorder is actually making the problem worse.

Caroline is the creator of The F*ck It Diet, where she teaches chronic dieters how to heal their relationship with food and weight. Caroline recently released her first book, The F*ck It Diet: Eating Should Be Easy. Find her online right here.

This episode is brought to you by Katie Dalebout’s let [a podcast] out course. If you’ve ever wanted to start a podcast, this workshop, which features interviews with over 100 podcasters (including Christy,) will help you learn the ins-and-outs of podcasting, so that you can focus on crafting your own unique content. To learn more and sign up, visit LetAPodcastOut.club, and use promo code FOODPSYCH for $25 off at checkout.

We Discuss:

  • What Caroline calls “F*ck It Diet 2.0”: her two-year commitment to resting and rejecting unrealistic societal pressures in other areas of her life, not just around food and body

  • Trust, and its role in recovering from diet culture

  • How Caroline initially interpreted intuitive eating as another diet, and how she stopped

  • Embodiment, and its importance in healing our relationship with food and body size

  • How various traumas, including diet culture, can disconnect us from our bodies

  • Recovery as a non-linear process, and how that can make it difficult

  • How yoga can be helpful and harmful in healing our relationship with food and our bodies

  • Our culture’s fear of feeling and honoring unpleasant feelings and emotions

  • Yoga nidra

  • Rest as a form of basic self-care

  • Over-exercising, and how it is reinforced by diet culture

  • Why it’s understandable for intuitive eating to feel “impossible”

  • The changes that Caroline has experienced in her relationship with food

  • Why focusing on fullness can be problematic

  • How quickly diet culture robs us of our innate ability to eat intuitively

  • Mental deprivation, and how it can affect our relationship with food in the same way as physical deprivation

  • Why intuitive eating is possible for anyone, and why it’s NOT another diet

  • Deprivation in people with larger bodies

  • Caroline’s book, The F*ck It Diet: Eating Should Be Easy (TW: weight and calorie numbers, and "o-words")

  • The “nocebo” effect

  • Diet food, and its role as a tool 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.

Listener Question of the Week

Should people be given the option to choose non-weight-inclusive treatment options for binge eating disorder? What is wrong with referring to intuitive eating as “healthy living”? How has diet culture twisted otherwise weight-inclusive therapies? What are the risks of intentional weight loss? How does offering intentional weight loss as a treatment option promote diet culture? Why doesn’t Christy debate folks who promote diet culture on the podcast? Why should eating-disorder treatment centers be free from diet-culture influences and messaging? What are some next steps for eating-disorder clinicians who want to move away from weight-centric messaging in their work?

(Resources Mentioned:

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Food Psych #189: False Pictures of Health with Tiffany Roe

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Mental-health counselor and fellow podcaster Tiffany Roe joins us to discuss how diet culture paints false pictures of what health and eating disorders “look like”; the connections between religion, shame, diet culture, and eating-disorder recovery; why we need to fight fatphobia in the eating-disorder-treatment field; the importance of learning to sit with feelings of distress and discomfort; why even therapists have internalized stigma about mental illness and treatment, and so much more! Plus, Christy answers a listener question about how navigating emotional eating fits into the intuitive eating process.

Tiffany Roe is a Licensed Clinical Mental Health Counselor, psychology teacher, speaker, podcast host, & the owner of Mindful Counseling in Orem, Utah. She passionately helps her clients remember they are enough. Tiffany has focused her career on treatment for women navigating disordered eating, poor body image, poor relationships with themselves and food, anxiety, life transitions, and low self-worth. Tiffany personally survived an eating disorder and has been fully recovered for over 12 years. She passionately works to dismantle diet culture and feels called to work with women and to help them find their true purpose and self-worth. Tiffany believes you can love yourself, your mind, your body, and your relationship with food.

She attended Argosy University where she graduated with honors and received her Master of Arts degree in Mental Health Counseling in 2011. She received her Bachelor degree in Sociology from Brigham Young University in 2008. Tiffany is an award-winning teacher & speaker. She taught psychology courses in the Behavioral Sciences Department for Utah Valley University from 2012-2017. Tiffany regularly speaks for community events, workshops, and retreats. She wants to change the mental health game and make therapy accessible and cool. Find her online at TiffanyRoe.com.

This episode is brought to you by Ori, a new clothing brand that makes cute, comfortable, and modern pieces specifically designed to fit larger bodies. Head over to WearOri.com/Psych for an exclusive 15% discount for Food Psych® listeners.

This episode is also brought to you today by Katie Dalebout’s let [a podcast] out course. If you’ve ever wanted to start a podcast, this workshop, which features interviews with over 100 podcasters (including Christy,) will help you learn the ins-and-outs of podcasting, so that you can focus on crafting your own unique content. To learn more and sign up, visit LetAPodcastOut.club, and use promo code FOODPSYCH for $25 off at checkout. Sign up before March 21, 2019 to receive an additional $75 off the course.

We Discuss:

  • How growing up in a large family steeped in diet culture affected her relationship with food and with her body

  • The factors that led to her eating disorder

  • How disordered eating is often normalized or ignored because of stereotypes of what eating disorders “look like”

  • Why people who are diet culture’s “picture of health” are often secretly struggling

  • How moving to another country as a Mormon missionary exacerbated her eating disorder

  • How recovery changed her relationship with her faith and identity

  • The connections between shame, religion, and diet culture

  • Post-traumatic growth

  • Intuitive eating, and its role in eating-disorder recovery

  • What inspired Tiffany and Christy to work with eating disorders

  • Why we need to fight fatphobia in eating-disorder treatment and dietetic training

  • The importance of recognizing our own biases

  • Being open to being called out/in and educated

  • Why it’s essential for helping professionals to be aware of social justice and systems of oppression

  • Healthism in healthcare institutions

  • Sitting with our shame and discomfort in growth and recovery

  • Mental-health stigma amongst therapists

  • Tiffany’s work to break down the stigma around mental illness and treatment

  • Vulnerability, and arriving at a place where it feels safe to share personal information and experiences

  • Trust in eating-disorder recovery and intuitive eating

  • Tiffany’s podcast, Therapy Thoughts

 

Resources Mentioned

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

  • Be Nourished, and Food Psych® episodes with co-founders Dana Sturtevant and Hilary Kinavey

  • Therapy Thoughts podcast

  • Tiffany’s website, counseling practice, Facebook, Twitter, and Instagram

  • This episode is brought to you by Ori, a new clothing brand that makes cute, comfortable, and modern pieces specifically designed to fit larger bodies. Head over to WearOri.com/Psych for an exclusive 15% discount for Food Psych® listeners.

  • This episode is also brought to you today by Katie Dalebout’s let [a podcast] out course. If you’ve ever wanted to start a podcast, this workshop, which features interviews with over 100 podcasters (including Christy,) will help you learn the ins-and-outs of podcasting, so that you can focus on crafting your own unique content. To learn more and sign up, visit LetAPodcastOut.club, and use promo code FOODPSYCH for $25 off at checkout. Sign up before March 21, 2019 to receive an additional $75 off the course.

     

Listener Question of the Week

Given that emotional eating is normal, does the intuitive eating principle “Honor Your Feelings Without Using Food” still apply? What truly drives what we call “emotional eating?” Is it possible to turn to food for comfort without a background of dieting or deprivation? Why is simply replacing emotional eating with other coping mechanisms usually not effective? What are the first steps that a person take to recover from disordered eating? What are some coping mechanisms that a person can use in addition to emotional eating? What are some ways to reframe the idea of emotional eating?

(Resources Mentioned:

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Food Psych #188: How to Improve Treatment for Disordered Eating with Marcella Raimondo

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Eating-disorders psychologist Marcella Raimondo joins us to discuss how to improve disordered-eating treatment for people who don’t fit diet culture’s idea of what an ED “looks like,” how eating disorders can affect our career choices, why more representation of marginalized identities benefits everyone, how fatphobia was born out of racist beliefs about body size, and so much more! Plus, Christy answers a listener question about how to handle the fact that there are hateful corners of the internet devoted to tearing down the fat-acceptance movement.

Marcella Raimondo, PhD, MPH is a passionate and spirited clinical trainer speaking from her heart on multicultural issues in eating disorders since 1995. Marcella is a licensed psychologist for Kaiser Permanente’s adult eating disorder clinic in Oakland and part of a regional leadership team. She runs her own practice in Oakland. She is also on the Board for Eating Disorders Recovery and Support (EDRS) as President, advisory board for Association of Size Diversity and Health (ASDAH,) Advisory Board for Nalgona Positivity Pride (NPP) and Board of Founders for About-Face. Marcella herself recovered from anorexia nervosa over 15 years ago. Her recovery and her martial arts training inspires her dedication to multicultural body nurturance and community celebration. Find her online at MarcellaEDTraining.com.

This episode is also brought to you by NurX, the game-changing company that’s here to make getting birth control easier. Visit nurx.com/foodpsych for a $20 credit, and you can get birth control delivered securely and confidentially to your door in less than a week.

We Discuss:

  • The mixed messages that Marcella received in adolescence about food as a way to connect to her heritage, while being aware of the changes in her body

  • Anti-fatness as a response to racism and trying to assimilate

  • The thoughts and emotions that pushed her to start dieting, and eventually fueled her eating disorder

  • What motivated her to pursue recovery

  • How eating disorders can affect our career choices

  • Her eating-disorder recovery experience

  • The effect of learning about the experiences of other women of color on her recovery

  • Privilege, and how it affects a person’s ability to access treatment

  • Why acknowledging eating disorders and disordered eating in marginalized identities helps everyone

  • Grassroots efforts to make eating-disorder treatment more accessible to everyone

  • Finding the balance as a small-business owner between making a living and offering accessible eating-disorder treatment

  • Fatphobia as a barrier to treatment and recovery

  • The many ways in which our current healthcare system is broken and harms marginalized folks

  • How martial arts and yoga can play a role in various parts of recovery

  • The importance of self-compassion and forgiveness

  • What drew Marcella into martial arts training, and how it affected her recovery and work today

 

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

What advice is there for dealing with anti-fat discourse on the internet? What motivates people to be hateful toward larger-bodied people? Why do some people get defensive toward the idea of fat acceptance? What are some strategies to handle the fact that there are hateful corners of the internet devoted to tearing down fat acceptance and other forms of social justice? How does the structure of the internet itself uphold hateful rhetoric? What are some trusted resources for fat-positive information?

(Resources Mentioned:

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Food Psych #179: How to Avoid Falling for The Wellness Diet This New Year with Colleen Reichmann

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Anti-diet therapist Colleen Reichmann joins us to discuss how to keep from falling prey to diet culture, the problem with Whole30 and other forms of The Wellness Diet, why true well-being is about so much more than food and movement, a quick way to tell if your “lifestyle change” is really a diet, why eating-disorder diagnoses are often problematic, and so much more! Plus, Christy answers a listener question about how to handle envy for people who seem to be “successfully managing” their weight.

Dr. Colleen Reichmann is a licensed clinical psychologist, practicing in Williamsburg, VA. She works in her private practice, Wildflower Therapy, and is a staff psychologist at the College of William and Mary. She is recovered from an eating disorder, and this experience sparked her passion for spreading knowledge and awareness that recovery is possible. She is now an eating disorders specialist, and has worked at various treatment facilities including University Medical Center of Princeton at Plainsboro Center for Eating Disorder Care, and The Center for Eating Disorders at Sheppard Pratt. She is an advocate for intersectional feminism, body liberation, fat acceptance, and Health At Every Size. She speaks at national and regional eating disorder conferences, and writes about body image and eating disorders for MORELove Project, Project HEAL, The Mighty, Recovery Warriors, Adios Barbie, and more. Find her online at ColleenReichmann.com.

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:

  • The different factors that contributed to Colleen’s multifaceted relationship with food growing up

  • The insidious nature of wellness culture

  • Colleen’s foray into dieting, and eventually her eating disorder

  • How diet culture keeps disordered eating under the radar

  • Why eating-disorder diagnoses are often problematic

  • The importance of receiving treatment even when diagnostic criteria are not met

  • The power of empathy and validation, and how feeling invalidated triggered Christy further into her eating disorder

  • How Colleen’s college experience intensified her eating disorder, and the restrictive culture at some college campuses

  • Bamboo as an analogy for eating-disorder recovery

  • How Colleen’s eating disorder morphed to a “wellness” focus in graduate school

  • The problem with Whole30 and other “wellness” diets

  • Orthorexia, and the need for more research and awareness

  • The Wellness Diet, how it is really the modern incarnation of diet culture, and why it’s so problematic

  • How wellness culture capitalizes on people’s fears of illness and death

  • Privilege and oppression in clean eating and diet culture

  • Christy’s upcoming book, and how it traces the history of diet culture

  • A quick way to tell whether your lifestyle change is really a diet

  • How true well-being is about so much more than food and movement

  • How Colleen recovered from her eating disorder, and why she works in eating disorder recovery today

  • Health At Every Size®, and why it is crucial in eating-disorder treatment and recovery

  • Diet culture and fatphobia in eating-disorder treatment, and how it gets in the way of full recovery

  • Why it’s important for clinicians to work through their own biases in order to provide ethical eating-disorder treatment

 

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 can we give up the envy of those who seem to be able to stay at a lower weight through dieting and restriction? How can we give up the feelings of failure for not being able to stay at a lower weight? What is some of the research that shows the high failure rates of diets? What is likely happening when people are able to maintain a lower weight? What is thin privilege, and how is it related to other forms of privilege like male privilege or white privilege?

(Resources Mentioned:

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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 #176: Confessions of a Former Weight-Loss-Surgery Dietitian with Vincci Tsui

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Anti-diet dietitian and certified intuitive eating counselor Vincci Tsui joins us to discuss weight loss surgery and its consequences on physical and mental health, her journey from working in bariatrics to specializing in intuitive eating and Health At Every Size®, how dietitians get caught up in The Wellness Diet, what thin privilege really means, disordered eating and how it interplays with bariatric surgery, and so much more! Plus, Christy answers a listener question about how to deal with the fear of weight gain in recovery from an eating disorder.

Vincci Tsui is a former bariatric dietitian turned Certified Intuitive Eating Counselor and Health At Every Size advocate. She is passionate about helping people find freedom in their relationship with food and with their body, so that they can worry less and get the most out of life. Ultimately, she is on a mission to prove that it is possible to improve health without focusing on weight.

Vincci takes a collaborative and compassionate approach to nutrition counselling and coaching that is rooted in HAES® and Intuitive Eating philosophy. She believes in helping clients learn to listen to their body and their inner wisdom when it comes to making decisions around food, eating and health. Aside from her private practice, Vincci serves as the Community & Content Manager for Food Psych® Programs Inc, and is the author of The Mindful Eating Workbook: Simple Practices for Nurturing a Positive Relationship with Food. Find her online at VincciTsui.com.

Early bird registration for my Master Your Anti-Diet Message course is open for a few more days! If you’re a fellow Health At Every Size practitioner who would like to learn how to refine your marketing messages so that they are aligned with HAES philosophy, sign up at christyharrison.com/message.

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We Discuss:

  • How her different privileges helped to protect her relationship with food and body

  • Some of the food rules that she had growing up

  • Why so many people value “cleaning their plate”

  • Thin privilege, and how it can show up in our society

  • Why losing weight isn’t the answer to avoiding weight stigma

  • Why she pursued a career in dietetics

  • How becoming a dietitian changed her relationship with food

  • Diet culture, and how it can affect dietitians and nutrition advice

  • Her work with bariatric surgery patients

  • How current narratives around “obesity” actually helped her become a HAES practitioner

  • The Wellness Diet’s rhetoric, and how it shows up in “obesity” and bariatric care

  • What sparked her interest in HAES and intuitive eating

  • How she tried to introduce HAES concepts to people pursuing weight loss surgery

  • The Association for Size Diversity and Health (ASDAH), and its position on bariatric surgery

  • Finding the middle ground between respecting body autonomy and holding the position that weight loss surgery is harmful

  • Complications that are associated with bariatric surgery, including strictures, nutrient deficiencies, and dumping syndrome

  • Disordered eating, and how it can interact with weight loss surgery

  • Why diagnostic criteria for eating disorders can sometimes be problematic

  • Eating disorders, and how they can get missed in diet culture

  • Nutrition recommendations post-bariatric surgery, and how they can affect a person’s relationship with food

  • How bariatric surgery is presented to patients, and how that can affect their mindset and expectations of the surgery

  • The consequences of bariatric surgery on physical and mental health

  • When bariatric surgery outcomes don’t meet expectations

  • HAES as an alternative to weight loss surgery

  • Finding her niche in HAES and intuitive eating

  • Attracting clients as a private practice dietitian

  • Vincci’s current and upcoming projects

  • The overlap between yoga, intuitive eating and mindful eating

 

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

What if my set point weight is much higher than my current weight? How can I keep my fear of weight gain from getting in the way of my eating disorder recovery? Why is getting rid of the diet mentality and embracing Health At Every Size so important in eating disorder recovery? What are the risks of bulimia and other eating disorders to health? If higher weights don’t cause poor health, then what does? What are some strategies to help overcome internalized weight stigma? Why is it not recommended to jump into intuitive eating directly from an eating disorder? Where can I find support for eating disorder recovery? What if my finances are limited?

(Resources Mentioned: Intuitive Eating Fundamentals course, Food Psych® Podcast episode #172, Slides from Christy’s FNCE debate, Meredith Noble’s work and Food Psych® Podcast episode, Body Positive Instagram Accounts, Certified Intuitive Eating Counselor directory, Heidi Schauster’s work and Food Psych® Podcast episode, Jessi Haggerty’s work and Food Psych® Podcast episode, Haley Goodrich’s work and Food Psych® Podcast episode, Marci Evans’ work and latest Food Psych® Podcast episode, Project HEAL, Nalgona Positivity Pride)

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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.

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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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Food Psych #168: Gentle Nutrition vs. Diet-Culture Nutrition with Heidi Schauster

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Health At Every Size® dietitian, eating-disorders specialist, and author Heidi Schauster returns to discuss her new book, unlearning diet-culture messaging, connecting with our body’s inner wisdom, gentle nutrition as an act of self-care, and so much more! Plus, Christy answers a listener question about what to do when it seems like your disordered eating behaviors have more to do with individual mental-health issues than with diet culture.

Heidi Schauster, MS, RDN, CEDRD-S is a nutrition therapist with over 20 years of experience in the field of eating disorders and emotional eating issues. She is a writer, consultant, and certified eating disorders registered dietitian, based in the Greater Boston area. Heidi is the founder of Nourishing Words Nutrition Therapy, facilitates the No Diet Book Clubs, and supervises other nutrition therapists in the field of eating disorders. She is the author of the new book Nourish: How to Heal Your Relationship with Food, Body, and Self. Heidi lives in Arlington, Massachusetts with her partner David and twin daughters, Ava and Kyla. Heidi and her family enjoy hiking, swimming, herb gardening, tea-making, storytelling, and professional stilt performing. Heidi enjoys most food that is lovingly and consciously prepared, especially if it’s followed by a dishwashing dance party. Find her online at ANourishingWord.com.

We Discuss:

  • Heidi’s new book, Nourish: How to Heal Your Relationship with Food, Body, and Self, and what inspired her to write it

  • Why I created my Intuitive Eating Fundamentals course

  • The different chapters within the book, which are based on how Heidi works with her clients

  • Becoming aware of our eating habits in a non-judgmental way

  • Creating a resource that presents nutrition in a non-triggering way

  • How she defines “nourishment,” and the concept of “nutrition common sense”

  • Why intuitive eating requires some planning

  • The role of intention in our relationship with food

  • The contrast between abundance and scarcity, and how they affect eating disorder recovery

  • How small changes in our eating habits can sometimes make a big difference in how we feel

  • Joyful movement and gentle nutrition as acts of self-care

  • Overcoming fears around food and carbohydrates

  • Unlearning the patterns of restriction from diet culture

  • What guides her work in nutrition counselling

  • Why gentle nutrition is often considered “advanced” intuitive eating

  • Connecting with our body’s wisdom through mindfulness practice

  • The benefits of recovering from diet culture, and what motivates our work in helping others in this process

  • Anger as part of the recovery journey

  • Arriving at a positive relationship 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.

Listener Question of the Week

Is it just easier to take aim at diet culture rather than focus on individual mental health? What if a person’s disordered eating behaviors have more to do with individual mental-health concerns as opposed to diet culture? Can recovery at the individual level happen without addressing diet culture and fatphobia? How can cultural factors affect individual mental-health concerns? Does binge eating always happen in response to restriction? What are some subtle ways that diet mentality might be showing up for me?

(Resources Mentioned: Intuitive Eating Fundamentals online course, Judith Matz’s Food Psych Podcast episode)

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Food Psych #167: Food, Sex, and Body Liberation with Kimberly Dark

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Sociology professor, writer, and performer Kimberly Dark joins us to discuss the connections between our relationship with food and our relationship with sex, the harms of “medically supervised” diets, how to view diet culture through a critical lens, how food can help connect us with our inner wisdom, and so much more! Plus, Christy answers a listener question about how to stop calorie counting and worrying about weight gain when transitioning to intuitive eating.

Kimberly Dark is a writer, professor and raconteur, working to reveal the hidden architecture of everyday life one clever essay, poem, and story at a time. She uses humor, surprise and intimacy to help audiences discover their influences, and reclaim their power as social creators. Kimberly teaches in Sociology at CSU, San Marcos along with writing and theatre courses for Cal State Summer Arts. She also facilitates experiential retreats in Hawaii for Conscious Practitioners - examining how our own embodiment and social relationships influence how we work with others in helping professions and Yoga is for Every Body retreats for all.

Kimberly Dark has written award-winning plays, taught and performed for a wide range of audiences in various countries over the past two decades. She is the author of Love and Errors, a book of poetry and Co-Editor of the anthology Ways of Being in Teaching. Her novel, The Daddies is forthcoming in 2018. Her essays appear in popular online publications, such as Everyday Feminism, and Ravishly. Kimberly's storytelling performances and interactive lectures make big, complex ideas relatable at campuses, conferences, companies, and anywhere people seek startling revelations and positive change. Learn more at KimberlyDark.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:

  • Kimberly’s relationship with food as a child in a larger body

  • How fatphobia is normalized in our society

  • Receiving praise for weight loss while struggling with an eating disorder

  • The harms of “medically supervised” diets

  • What started her recovery from disordered eating

  • Bingeing as our body’s way of responding to restriction

  • How Kimberly used her trauma history to help with her recovery

  • The connections between food and sex

  • Engaging critically with diet culture

  • Kimberly’s unique career as a sociology professor and performer

  • Autoethnography, the practice of writing about the self in order to understand the culture

  • The institution of academia, and how it silences certain types of knowledge

  • Our bodies as a site of knowledge

  • Conventional research, and how it imposes intellectual knowledge instead of considering lived experiences

  • The role of patriarchy in diet culture

  • Food as a vehicle to attune to the body’s inner wisdom

  • The performative element of wellness culture, and how it relates to sexuality

  • Social media and selfie culture

  • The emotional labor of creating content

  • The body as part of the visual narrative

 

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 we unlearn the food rules and calorie counting from the diet mentality when trying to eat intuitively? How can we separate ourselves from our eating-disorder thoughts? How do we stop worrying about weight gain? What are some steps we can take to overcome internalized oppression from diet culture? Where can we get support when we’re at the beginning of eating disorder recovery?

(Resources Mentioned: Kylie Mitchell’s Food Psych Podcast episode, Intuitive Eating Fundamentals online course, Certified Intuitive Eating Counselors Directory)

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Food Psych #166: How to Resist Diet Culture & Build Community with Lilia Graue

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Eating-disorders specialist and Certified Body Trust® Provider Dr. Lilia Graue joins us to discuss letting go of perfectionism, the importance of community in body acceptance and overcoming shame, diet culture as a form of trauma, why working toward societal change is just as important as individual recovery, and so much more! Plus, Christy answers a listener question about how the Health At Every Size® framework addresses the notion of an “obesity epidemic.” 

Lilia Graue, MD, LMFT, is an eating disorders specialist and clinical supervisor; mindfulness, compassion and mindful eating instructor; and Certified Body Trust® Provider. With 18 years of clinical experience, she is intimately familiar with bodies and minds and our healing processes, and how we relate to, nourish and take care of ourselves and our bodies in ways that bring us closer to wholeness, radical presence, fierce embodiment and joy.

Lilia practices at the intersection of different healing modalities, centering lived experience and the body as a source of knowing. Her own life experiences with developmental and complex trauma, depression, anxiety, chronic pain, and a healing journey through psychotherapy and mind-body practices, have shaped her approach. Her practice is trauma informed, and rooted in intersectional feminism. She is Mexican and provides services in both English and Spanish.

Lilia loves working with providers navigating the challenges of advocating bravely for body liberation, embodiment and freedom from performative health who wish to cultivate and honor boundaries that allow for their self-care and replenishing empathy and compassion. 
Lilia is an avid amateur cook, baker, and foodie. She and her partner share their home with their beloved cats, Thomas and Ziggy. Find her online at fiercelyembodied.com.

This episode is brought to you by Casper. Get $50 toward select mattresses by visiting casper.com/foodpsych and using the code FOODPSYCH at checkout.

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!

You can also get my Master Your Anti-Diet Message course in Spanish thanks to today’s guest, Lilia Graue! Just go to christyharrison.com/spanish to learn more and sign up.

 

We Discuss:

  • Lilia’s complex relationship with food as a child

  • Growing up with, and eating around, family members that had mental health concerns

  • How being a competitive swimmer while going through puberty affected her relationship with food and with her body

  • The interrelationship between depression and disordered eating

  • Fatphobia and healthism in the medical field

  • How performative health can actually push people into a disordered relationship with food and body

  • The role of privilege in intuitive eating and recovery

  • Being more connected to food through eating and cooking with our hands

  • Sensory issues, and how they can affect a person’s eating preferences and relationship with food

  • Incorporating gentle nutrition without falling back into the diet mentality

  • Yoga, meditation, and mindful eating

  • Attuning to our body’s own needs instead of trying to be “normal”

  • Learning from our mistakes in our intuitive eating practice

  • The role of trauma in our relationship with food

  • Diet culture as a form of trauma

  • Why intuitive eating and mindful eating are about more than our relationship with food

  • How our societal ideals are causing harm to non-conforming bodies

  • The importance of community in body acceptance and overcoming shame

  • White supremacy and the mythic norm

  • Why it’s typical for people with a history of trauma to become caretakers

  • Connection through embodiment and vulnerability

  • Moving past black-and-white terms in eating disorder recovery

  • Living with and resisting diet culture at the same time

  • Finding community in your recovery journey

  • The difficulty of translating concepts across cultures, and the need for local communities within different cultures

  • How diet culture has co-opted mindful eating

  • Why we need to work toward societal change along with individual recovery

  • Lilia’s current projects as a medical provider and mindful eating teacher

 

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 does Health At Every Size® fit in with research that shows that we are becoming heavier as a population? Is HAES® concerned with “obesity” prevention? If HAES views that there is nothing wrong with being in a larger body, and that there is no effective way to lose weight, does it matter what causes some bodies to be larger than others? How can “obesity” prevention potentially be harmful? What other changes have happened at the same time as our population increasing in weight? What are some resources where I can continue to learn about HAES?

(Resources Mentioned: Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005-2012, Perceived Weight Discrimination and 10-Year Risk of Allostatic Load Among US Adults, Weight Science: Evaluating the Evidence for a Paradigm Shift, What’s Wrong with Fat? by Abigail Saguy, Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer)

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