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When Food Feels Hard: Understanding Eating Disorders · Talking FACS

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  Welcome to Talking FACS, what you need to know about family,
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  food, finance, and fitness.
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  This nationally recognized, award-winning podcast is hosted by the University
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  of Kentucky Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families,
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  and communities to improve quality of life.
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  Hello, and welcome to Talking FACS. I'm your host, Dr.
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  Courtney Luecking, Extension Specialist for Maternal and Child Nutrition,
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  and I am thrilled to have Dr.
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  Abbigail Pace, an Assistant Professor in Dietetics and Human Nutrition, with us today. Welcome.
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  Hi, thank you so much for having me. Excited to be here. Now,
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  Abby, I know you've had some work experience with people who have eating disorders.
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  And I, as a parent of young girls, this is something that's on my mind a lot.
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  And having grown up and danced growing up, I just saw a lot of concerning behaviors.
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  And so I would love to get started with our conversation to help distinguish.
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  So people struggle at times with their body image or with food,
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  and maybe it's restrictive dieting or emotional eating.
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  And so how do we know when we really need to be concerned about what is happening?
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  One thing to keep in mind is that eating disorders are a mental illness.
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  And so it's important to distinguish that because it is the brain chemistry.
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  The brain is actually impacted by this.
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  So this is not someone who changes their diet to become healthier.
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  This is an actual challenge with the brain in processing information about food.
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  So eating disorders are what we call a disturbance in eating that cause an actual
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  impact, could be severe to our physical and mental health.
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  So we may have weight loss. We may not have weight loss. It just really depends.
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  And so it's important to know that because sometimes people have eating disorders
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  and we wouldn't be able to tell by just looking at them.
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  I'm so glad you said that because I think...
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  Our brains might automatically go to a certain image of someone who has an eating disorder.
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  And so you said weight loss might be kind of a symptom side effect,
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  if you will, but it might not.
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  Can you talk us through what some of those other impacts might be?
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  Absolutely. So mainly what we're looking at is a loss of nutrition.
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  And so we call it malnutrition in the field.
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  But what that term means is maybe they're losing muscle.
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  Maybe they're losing fat. Maybe they develop illnesses because they have deficiencies
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  in vitamins and minerals. So a lot of times we'll see that hair is falling out or nails get thinner.
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  Maybe their eyes get a glaze over them. So we can present in a lot of different
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  ways. And it's always good to watch out for those things.
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  And of course, those things can happen in other illnesses as well.
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  But it's good to keep in mind that maybe in conjunction with seeing a change
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  in eating pattern with someone,
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  that if we start seeing that their body is changing in a significant way,
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  or we notice that they're thinking about food more, or we notice that around
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  meal times and around snack times,
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  food seems to be really hard for them.
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  That could be an indication that something bigger is going on.
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  That's really helpful because I think our current culture is really interested
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  in food, kind of what is in the food that we eat, how we access food.
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  And then there's other...
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  A lot of different terms. I think I heard the term like menorexia.
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  Like menopause, like changes in eating habits related to menopause.
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  And so just thinking about kind of culturally where we're at in terms of the
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  focus on food and how there you can have a vegetarian focused diet and it's
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  possible to have a well balanced eating plan and maintain that nutrition.
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  Maybe there's pescatarian, flexitarian, but sometimes there's that moral connection with food.
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  So can you maybe help us better understand what those more severe types of eating
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  behaviors are that would be linked to some of these concerns with eating disorders?
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  Yeah, so one thing to remember, in my experience, people who have eating disorders
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  are thinking about food all day long.
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  They wake up and they're automatically planning out every single morsel of food
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  that is going to interact with their body.
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  They are thinking about grocery shopping in three weeks. You know,
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  they're thinking about what they're going to have for their birthday dinner.
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  They're thinking about food in a very significant way.
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  So this is not someone who gets to mealtimes and then is having difficulty.
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  They are thinking about food all day long. And so some other more severe consequences
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  that we might be looking at are maybe vomiting after eating.
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  So noticing that someone is always going to the restroom after they eat or taking
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  medications that are for certain conditions like diuretics that are intended,
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  again, have a completely normal and healthful use, but they're taking them to lose water weight.
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  Or maybe it is exercising for hours and hours each day.
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  So these specifically can have really harmful effects because they can impact
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  how hydrated we are and we'll start to see people passing out,
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  we'll start to see the potential for seizures and things like that.
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  Someone feels like they have a problem, we want you to get help.
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  But there are definitely some characteristics that require more emergent or more immediate care.
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  That's really helpful. And so I'm imagining some of these behaviors cluster
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  into different patterns that define eating disorders.
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  So can you walk us through what that looks like?
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  Right. So just broadly, I'm sure many of us have heard of anorexia nervosa,
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  which is the severe restriction of food. So these people are trying to eat as
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  few calories as possible.
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  There's bulimia nervosa, which is eating and then compensating for it in some way.
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  So we think of vomiting most classically, but exercise, taking diuretics, things like that.
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  But then we have others that are actually not connected to body image at all, what we believe.
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  So there's avoidant restrictive food intake disorder or ARFID.
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  And it's like all the jam right now is talking about ARFID. We see it a lot
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  in autism spectrum disorders.
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  And so these are individuals who have a fear of food, but it's not connected to their body.
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  They're literally scared of it. So maybe they have a severe allergy and they
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  had a reaction at one point, so they're scared to eat, or they have a severe
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  preference or aversion to certain textures or temperatures.
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  And so like other eating disorders, their nutrition is severely impacted,
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  but it's not connected to how they look or how they feel about their body.
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  We also have orthorexia, which is a newer eating disorder, and that is connected
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  to the desire of purity of food.
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  So clean food, whole food, that ultra healthy, I have to eat perfectly.
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  And so we actually see that more in healthcare professionals because they know
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  a lot about nutrition and they know how nutrition impacts the body.
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  So we see that even in our field and among dietitians more often.
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  I appreciate kind of the spectrum of eating disorders that you discussed.
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  And I think it just circles back to when you were saying when it's a mental
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  health concern or issue that impacts what or how much people eat and that ultimately
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  influences their nutrition.
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  How prevalent are these types of eating disorders? Yeah, so we will see that
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  about 22% of children and adolescents will have some type of disordered eating.
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  So maybe not the classic eating disorder, but they'll have features of one.
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  So 22%. So as bodies are changing, as we're going into adult bodies,
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  it's very common for us to feel disturbed by that.
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  And so it can lead to disordered eating behaviors.
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  And then we know that about 9% of the U.S. population will have an eating disorder at some point.
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  Maybe it's not prolonged. Maybe it doesn't require treatment, but maybe it does.
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  So these severe eating disorders are much less common, about 1%.
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  But it's important that if food feels hard, seek help.
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  Because it doesn't matter if it is an eating disorder or if it's not.
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  If food feels hard, it is important to get help for whatever reason.
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  I'm so glad you brought that up. Let's follow along that train of thought.
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  So, if someone is listening to this and like, wow, this really feels close to
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  home for them as an individual, what can they do or who can they reach out to to get that support?
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  Absolutely. So first, I would recommend just going to your primary care physician
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  and talking to them about your concerns.
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  But next, see a dietician. And I cannot say that loud enough.
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  See a dietician because they'll be able to assess what your nutrition is like
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  and tell you if something needs to change.
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  In the show notes, I think we have links.
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  There are certain professionals that are certified in eating disorders.
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  And I would strongly recommend that if something feels familiar in this,
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  that you look on that website and you find a dietician that might know what's
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  going on and they can direct you to the right resources,
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  whether it is seeing them or maybe just working with someone who is not necessarily
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  certified in eating disorders, but knows what this feels like and knows how to help.
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  And so what are some of those unique skills or specialties that would be important
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  to look for in professionals who can help?
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  Yeah, so number one, it would be important to find someone who is understanding
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  of what eating disorders can look like.
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  So again, eating disorders can look different in so many people,
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  and it changes based off of who you are and what you have access to.
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  So find someone who's willing to listen. And I mean, our profession is wonderful about this.
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  They're wonderful in knowing what food looks like and how we may change it to
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  even just support health.
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  It's also just really important to find care providers who, especially for someone
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  in a larger body, a provider that would be able to hear you and would be able
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  to discuss some of these.
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  Because sometimes, again, we have this notion that eating disorders are only
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  in small-brained women or thin women, whereas eating disorders open all across the board.
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  And so, especially for people who are in larger bodies, it can be really hard to find a provider.
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  And so, looking for health at every size providers, intuitive eating,
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  those two key words can tell you that someone may be a little more knowledgeable
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  or trained in eating disorders. Fantastic.
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  And I think my last question for you is really from the lens of if someone's
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  listening to this and they're like, oh, this sounds like a family member or
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  a friend, what can they do to maybe...
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  Let someone know they're concerned about them? Or what recommendations do you have?
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  So first, just lean into your resources. So we've also linked the National Eating
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  Disorder Association and their resource hub, and it actually has sections for
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  this is for me, this is for a friend, this is for a family member.
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  So you can go and look at those resources.
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  Always approach it with care and be mindful of commenting on people's bodies.
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  And I think that that is just important across the board.
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  So sometimes, because remember that this is a concern of the brain.
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  So while you may be approaching it with care and concern, commenting that someone's
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  body looks like it changed may be hard for them to hear.
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  So just say that you care, say that you learned about these resources and you
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  want them to be safe and to be healthy.
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  Wonderful. Abby, thank you so much. I appreciate you walking us through kind
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  of the prevalence of the severe,
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  but then also knowing that it is much more common to have some potentially concerning
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  behaviors to lean into and support people through and sharing resources.
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  Are there any final thoughts that you'd like to leave us with?
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  If you are hearing this and you are in recovery from an eating disorder or you're
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  thinking about getting help I promise there is a brighter side and recovery
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  is not linear it has its ups and downs.
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  Anyone can do it. And I hope that that's you.
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  Wonderful. Thank you for leaving us on such a positive note.
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  Thank you to all for tuning into Talking FACS. We can be found anywhere that you listen to podcasts.
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