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How Anorexia and Bulimia Work · Stuff You Should Know

0:01
Speaker 1: Welcome to Stuff you should know, a production of My
0:03
Speaker 1: Heart Radios How Stuff Works. Hey, and welcome to the podcast.
0:12
Speaker 1: I'm Josh Clark, and there's Charles w Chuck Bryant, there's
0:15
Speaker 1: Jerry over there. Um, and it's just nice and pleasant,
0:20
Speaker 1: isn't it? Chuck and Jerry? I mean it smells in here?
0:25
Speaker 1: Is that what you're referencing? Yeah, gamey, I think, Yeah,
0:29
Speaker 1: how about this. We won't say who was in here
0:32
Speaker 1: just before us, but it was three men from our office.
0:37
Speaker 1: And the room smells a little gamy, a little musky.
0:42
Speaker 1: It's warm, and Jerry's headphones are hot, and her chair's
0:45
Speaker 1: lot and she's so creeped out, yeah, getting a little sweaty. Yeah. So, um,
0:51
Speaker 1: that's the last joke I'm gonna tell for this episode.
0:53
Speaker 1: By the way. You know, every time we say that,
0:55
Speaker 1: we end up like making jokes. So yeah, let's say it. Yes,
0:58
Speaker 1: this is going to be a very serious episode and
1:00
Speaker 1: there will be no jokes whatsoever. All right, hopefully we
1:03
Speaker 1: can work in a funnier two that is clearly not
1:06
Speaker 1: at anyone's expense. Yeah, yeah, I mean, it's gotta be organic,
1:09
Speaker 1: it's gotta be good, it's gotta be worth it, I guess,
1:13
Speaker 1: is what I'm trying to say, and about each other. Right. So, um,
1:18
Speaker 1: we're talking today, Chuck about anorexia and bulimia, known in
1:23
Speaker 1: the slang as anna and mia. Did you know that?
1:27
Speaker 1: I did not know that. Yeah, And um, they are
1:31
Speaker 1: actually very closely related eating disorders, so much so that
1:35
Speaker 1: if you went to the big Book of Eating disorders,
1:37
Speaker 1: the d s M five, and you said, ds M five,
1:41
Speaker 1: tell me what is the difference between anna and mia,
1:46
Speaker 1: the d s M five would just kind of shrug me, like,
1:48
Speaker 1: I don't know, man, we we are, We're not a sure.
1:51
Speaker 1: There are some big differences, but they are clearly connected
1:55
Speaker 1: to some underlying degree. Yeah, I mean you know they
1:59
Speaker 1: define anorexia as restrictive restrictive as in really restrictive, severely
2:07
Speaker 1: limited intake of food. Um, and binging and purging, which
2:11
Speaker 1: is if you don't know what that term is, that
2:13
Speaker 1: means eating and then vomiting afterward, are using laxatives to
2:18
Speaker 1: get that poop going really quickly. Uh. That is also
2:23
Speaker 1: under anorexia in the d s M five. But that's
2:26
Speaker 1: also binging and purging obviously characteristic of bolimia, which is
2:30
Speaker 1: has its own categorytion, so categorization. So it's a little um,
2:35
Speaker 1: I guess confusing is the best way to say it, right, right,
2:38
Speaker 1: So I looked into a little more and it looks
2:39
Speaker 1: like anorexia. Like you were saying, is is the hallmark
2:43
Speaker 1: of it is calorie restriction. But apparently some people who
2:46
Speaker 1: suffer from anorexia every once in a while binge and purge,
2:49
Speaker 1: so it can include that. Okay, yes, but bolimia doesn't
2:52
Speaker 1: necessarily involve any sort of even like weight component um,
2:58
Speaker 1: and it doesn't ut any kind of calorie restriction. It
3:02
Speaker 1: is strictly binging and purging. So you've got these two
3:05
Speaker 1: different things, but they're both related in that your relationship
3:08
Speaker 1: with food is just not healthy in any way, shape
3:10
Speaker 1: or form. And the other thing that really kind of
3:14
Speaker 1: ties the two things together is that they're based on
3:17
Speaker 1: a disturbed body image where you look in the mirror
3:21
Speaker 1: and what you see doesn't reflect reality at all. You
3:25
Speaker 1: might see yourself as maybe normal if it's on a
3:27
Speaker 1: good day, you probably more often than not see yourself
3:30
Speaker 1: as overweight, fat, gross, disgusting, any number of horrible things
3:34
Speaker 1: you can say about yourself, where if someone else is
3:37
Speaker 1: looking at you, they would be like, Wow, this person
3:39
Speaker 1: really needs to eat fast because they're emaciated their skin
3:42
Speaker 1: and bones. But the aner and arexia patient or believe me,
3:46
Speaker 1: a patient does not see that at all. And so
3:48
Speaker 1: that kind of continues the cycle of either calorie restriction
3:52
Speaker 1: or binging and purging. But they're they're both after the
3:55
Speaker 1: same goal essentially, right and included. And we're going to
3:58
Speaker 1: talk a lot about the symptoms and behaviors of people
4:01
Speaker 1: that suffer from both of these. But a lot of
4:05
Speaker 1: scale work. Weighing yourself a lot sometimes, you know, multiple
4:09
Speaker 1: times during a day, obsessing over like you know, half
4:13
Speaker 1: pounds I saw, like we're digital scales are really sort
4:17
Speaker 1: of a culprit, and you know, obsessing over like a
4:20
Speaker 1: tenth of a pound and eighth of a pound, um,
4:24
Speaker 1: being really upset over the gaining of any weight, even
4:28
Speaker 1: if it's just a half a pound, let's say. Uh.
4:31
Speaker 1: And like you said, the language around food and body
4:34
Speaker 1: and self image is really important, um, because this can
4:38
Speaker 1: often be one of the early indicators or just an
4:41
Speaker 1: indicator for friends and family if you listen to how
4:44
Speaker 1: people talk, because a lot, you know, most of the
4:46
Speaker 1: stuff is done behind closed doors, and one of the
4:50
Speaker 1: big components, one of the sad components is is staying
4:54
Speaker 1: in a lot and not eating out with people and
4:56
Speaker 1: keeping all that very private. So the words are really
4:58
Speaker 1: really important here, Yeah, because I mean, if you have
5:01
Speaker 1: anorexia and you're engaging in like severe calorie restriction, you
5:05
Speaker 1: know that doesn't just stop when you go out with friends.
5:08
Speaker 1: It's like it is a part of you. I've seen
5:11
Speaker 1: a uh described akin to a relationship, like a very
5:15
Speaker 1: intense obsessive relationship where the patient and this disorder are
5:20
Speaker 1: super tight. It's like their life, right. So if you're
5:23
Speaker 1: out and you're hanging out with friends and trying to
5:25
Speaker 1: appear normal, there's all sorts of stuff you have to
5:28
Speaker 1: do to make it look like you've eaten, hiding food,
5:30
Speaker 1: offering other people food, um, trying to make a big
5:34
Speaker 1: deal about you know what you did eat, like really
5:36
Speaker 1: showing everybody look I ate this. Um. Just just engaging
5:39
Speaker 1: in kind of some obvious and bizarre behavior, and that's exhausting.
5:44
Speaker 1: So it's kind of like what you said that ultimately
5:46
Speaker 1: results in the person just withdrawing from social activities because
5:49
Speaker 1: it's not worth like keeping up appearances. Yeah, and as
5:52
Speaker 1: far as beliemia goes uh you know, intentionally vomiting after
5:57
Speaker 1: a meal. Um. One of the hallmarks is excuse in
6:00
Speaker 1: yourself very quickly after a meal. And that's if you
6:03
Speaker 1: are over the social component you are actually eating out
6:05
Speaker 1: with friends or family. Uh. And then those laxatives taking
6:10
Speaker 1: you know, unhealthy doses of laxatives, laxatives to induce diarrhea
6:14
Speaker 1: as quickly as possible, um, and some other stuff you know, uh,
6:19
Speaker 1: trying to sweat off additional weight. Um. You know, wearing
6:22
Speaker 1: like a plastic suit and sitting in a sauna, like
6:26
Speaker 1: really extreme measures or just excessive exercise to try and
6:31
Speaker 1: get rid of the extra weight. Right. So, so what
6:35
Speaker 1: you have then is somebody who is convinced that they're overweight,
6:39
Speaker 1: first of all, even when they're not, and secondly, is
6:42
Speaker 1: obsessed with the idea of getting rid of that additional weight. Um.
6:46
Speaker 1: And they do it by engaging in unhealthy behaviors with food.
6:49
Speaker 1: And depending on how they do it, you've got anorexia
6:51
Speaker 1: or you have bulimia. And UM. There's some symptoms, some
6:55
Speaker 1: of which we kind of just went over, but some
6:58
Speaker 1: are are kind of obvious. UM. Some are red flags. UM.
7:02
Speaker 1: You know, like if somebody starts to become very thin
7:05
Speaker 1: to where you can see their bones. Um, that's a
7:08
Speaker 1: big sign that they have anorexia, but they you know,
7:13
Speaker 1: you can have anorexia and not ever necessarily become emaciated. UM.
7:19
Speaker 1: I think the diagnosis, as far as the American Psychological
7:22
Speaker 1: Association is concerned, is if you if a patient comes
7:25
Speaker 1: to you and they weigh fifteen percent less than their
7:28
Speaker 1: normal weight for their heightened age, you would be able
7:32
Speaker 1: to diagnose them with anorexia, or at the very least
7:34
Speaker 1: you should start asking them questions about whether or not
7:36
Speaker 1: they have anorexia. Yeah, and blieve me, is very complex too,
7:41
Speaker 1: because there's not one pattern. It's not it's not always
7:44
Speaker 1: just binge and purge every day, although it can mean
7:47
Speaker 1: that sometimes if you suffer from bolimia, you will eat um.
7:52
Speaker 1: You won't bench, You'll just eat normal meals and then
7:54
Speaker 1: purge those. Uh. Sometimes you will restrict eating um, just
8:00
Speaker 1: sort of as a rule. But then occasionally you will
8:03
Speaker 1: binge and then purge, like eat you know, a huge
8:06
Speaker 1: enormous meal, which you know bene eating is a is
8:09
Speaker 1: a whole different eating disorder that you know. All of
8:13
Speaker 1: these are sort of related and have some overlap, but
8:16
Speaker 1: I think for this uh, this show, we're just gonna
8:19
Speaker 1: kind of concentrate on anorexia and bolimia, right yeah, yeah,
8:24
Speaker 1: benj any disorder. I think it deserves its own thing
8:28
Speaker 1: because it's so prevalent and so many people have it
8:30
Speaker 1: and don't even realize it, which I suspect has to
8:34
Speaker 1: do with the food supply. I think we've been inadvertently,
8:38
Speaker 1: um addicted to food. Um have you I told you
8:43
Speaker 1: about that that book, The Dorrito Effect, right, yeah, yeah, Well,
8:46
Speaker 1: like in the premise of it is that, like, to
8:48
Speaker 1: feed this many people, we've had to basically create frankin
8:51
Speaker 1: foods and to make them taste good, we've had to
8:54
Speaker 1: use these different additives and artificial flavors and colors and
8:58
Speaker 1: all this stuff. And the kind of idea behind it
9:01
Speaker 1: is that in doing this, we've accidentally created these things
9:05
Speaker 1: that are super addictive, and people have become addicted to
9:09
Speaker 1: foodis is a very common thing. Whether it was intentional
9:11
Speaker 1: or unintentional. At this point, it doesn't really matter. People
9:15
Speaker 1: are just addicted to terrible food that's really bad for them. Yeah.
9:19
Speaker 1: So as far as the symptoms go, you know, if
9:21
Speaker 1: we talked about some of them. Uh, you know, the
9:24
Speaker 1: obvious ones that you could as a friend or family
9:26
Speaker 1: member maybe notice, as far as the exercise, not eating
9:30
Speaker 1: in public and stuff like that, the preoccupation with weight.
9:33
Speaker 1: But um physically, you know, you you can lead the
9:37
Speaker 1: things like brittle hair, um, difficulty thinking, fainting and passing out. Uh.
9:44
Speaker 1: And that's you know, stuff that people might notice in public. Uh.
9:48
Speaker 1: Something that they may not see on the inside is anemia, uh,
9:53
Speaker 1: chronic fatigue, constipation, um, slowed pulse. Uh. And then I
9:58
Speaker 1: hadn't heard of this. The growth of fine hair on
10:01
Speaker 1: the body that lanugo that the newborn babies is one
10:06
Speaker 1: of the most adorable little things, this little on a baby. Yeah,
10:10
Speaker 1: Supposedly there's some waxy substance that covers the baby in
10:14
Speaker 1: the womb and prevents them from getting chapped and chafed
10:17
Speaker 1: by the amniotic fluid, and that lanugo hair kind of
10:22
Speaker 1: grows in like this, this kind of downy fine fur
10:25
Speaker 1: that lets that waxy substance stick to the skin. And again,
10:30
Speaker 1: if you if you become malnourished, it triggers lenugo to
10:33
Speaker 1: grow like later on in life. Yeah, that's a that's
10:37
Speaker 1: a big sign. Another one is um a manorrhea, which
10:41
Speaker 1: is the absence of um menstruation or menstrual periods. Right,
10:45
Speaker 1: And that used to be like even I knew that
10:47
Speaker 1: as like a sixth grade boy or something back in
10:50
Speaker 1: the eighties, like that was like a huge thing. If
10:52
Speaker 1: if a girl didn't have a period, I meant she
10:54
Speaker 1: had anorexia. And apparently the d s M five, the
10:58
Speaker 1: latest version, said now we're going to take that up
11:00
Speaker 1: because it's not the case without everybody like, yes, it
11:03
Speaker 1: definitely can lead to that. And if you have a manorrhea,
11:06
Speaker 1: there's a possibility it's from anorexia. But if you have anorexia,
11:10
Speaker 1: it doesn't mean you're going to um stop having your period. Yeah,
11:14
Speaker 1: absolutely um. And you know, I wonder how many like
11:18
Speaker 1: fourteen year old girls listening to this we just lost
11:20
Speaker 1: because I said period twice. Hopefully there hanging there is
11:25
Speaker 1: exactly who should be listening to the show. And if
11:29
Speaker 1: we're talking about girls and women more, uh, and we'll
11:33
Speaker 1: get to the stats. They suffer from anorexi and believe
11:35
Speaker 1: me in more than men do. But that is not
11:38
Speaker 1: to say that men don't suffer from it, and they
11:40
Speaker 1: absolutely do. Um. I mean I might as well go
11:43
Speaker 1: with a few of these. Have some other statistics. I
11:45
Speaker 1: found at least thirty million people of all ages and
11:49
Speaker 1: genders suffer from eating disorder in the United States. And
11:52
Speaker 1: that's all eating disorders. Every sixty two minutes, at least
11:56
Speaker 1: one person dies as a direct result from an eating disord.
12:01
Speaker 1: Um the A few of these are just so sad.
12:04
Speaker 1: Eating disorders have the highest mortality rate of any mental
12:08
Speaker 1: illness period. Thirteen percent of women over the age of
12:13
Speaker 1: fifty engage in eating disorder behaviors. I saw three and
12:18
Speaker 1: a half percent can have UM like or have a
12:22
Speaker 1: diagnosable eating disorder three and a half over the age
12:25
Speaker 1: of fifty or forty. And that that midlife eating disorder
12:29
Speaker 1: thing is like a big and growing problem right now. Yeah,
12:33
Speaker 1: I mean, well, you know, we talked about adolescents a
12:35
Speaker 1: lot in here, but it's not something restricted to uh
12:37
Speaker 1: two young people. Um, this one is super sad as well.
12:41
Speaker 1: Six of transgender college students have reported and eating disorder.
12:47
Speaker 1: Uh boy, these are so sad to read out loud.
12:50
Speaker 1: Um of the risk for either one is genetic. Uh.
12:56
Speaker 1: And we'll talk about the genetics of it a little
12:58
Speaker 1: later too, And then more and half of bolimia patients
13:02
Speaker 1: have comorbid anxiety disorders. Yeah, I saw that too. It
13:05
Speaker 1: was like I saw something like fifty of people with
13:10
Speaker 1: anorexia have I think anxiety, and like percent or something
13:15
Speaker 1: of people with bolimia have have anxiety disorder. Yeah, anxiety disorders,
13:21
Speaker 1: mood disorders, substance abuse disorders. It says usually alcohol. It's
13:26
Speaker 1: one in ten boliemia patients. So it's just, you know,
13:30
Speaker 1: these are the worst kind of statistics to read off,
13:32
Speaker 1: but it's important to know that it's it's across the
13:34
Speaker 1: gender spectrum, across the age spectrum. Uh. If you think
13:39
Speaker 1: that it's just something teenage girls go through, that's just
13:42
Speaker 1: not the case. Yeah, and not just teenage girls. For
13:44
Speaker 1: a long time, it was a teenage white girl problem.
13:47
Speaker 1: And they're starting to realize, like, no, this is it
13:49
Speaker 1: was like you were saying, like it it spans ethnicities, genders, nationalities, ages,
13:56
Speaker 1: it's it's a much bigger problem than than we used
13:58
Speaker 1: to think. And I don't know if it's become a
14:00
Speaker 1: bigger problem or if just under awareness and understanding of
14:03
Speaker 1: it has grown or something like that. But did you
14:06
Speaker 1: mention suicide. I don't think I did, so you were
14:10
Speaker 1: saying that this is this is one of the reasons
14:12
Speaker 1: we're talking about this um. Anorexia and bolimia are one
14:16
Speaker 1: of the maybe the deadliest mental disorder there is as
14:20
Speaker 1: far as statistics go, like you were saying, and one
14:22
Speaker 1: of the big reasons is because so many people with
14:25
Speaker 1: anorexia or blieve me to die by suicide something like
14:28
Speaker 1: two hundred times at a two hundred times greater rate
14:32
Speaker 1: than the general population. Says here, one in five of
14:35
Speaker 1: anorexia deaths is by suicide. And then if it's not
14:39
Speaker 1: by suicide, there's a host of other ways that you
14:42
Speaker 1: can die from anorexia. You can simply starve to death,
14:45
Speaker 1: where your your you um, your heart can stop, your
14:50
Speaker 1: organs can shut down, and it's from this lack of
14:53
Speaker 1: energy that you're putting into your body. Your your body's
14:56
Speaker 1: organs start to um kind of slow down, to metabolize
15:01
Speaker 1: more slowly, to kind of conserve what little energy they
15:04
Speaker 1: do have, and eventually it just doesn't work any longer.
15:07
Speaker 1: Your body stops basically, and you can die just from
15:11
Speaker 1: not eating and not because there wasn't any food. There
15:14
Speaker 1: was plenty of food and everyone who was around you
15:16
Speaker 1: wanted you to eat, you just wouldn't do it because
15:19
Speaker 1: you felt fat. Yeah, And I don't even think it's
15:22
Speaker 1: a lot of times a matter of if. I mean,
15:25
Speaker 1: if you don't get treated and you don't get help
15:28
Speaker 1: and it gets bad enough, then you will die from
15:31
Speaker 1: oregon failure at some point. Yes, But we have to
15:34
Speaker 1: say we don't want to get all like horribly grim,
15:37
Speaker 1: because there are studies that are coming out now that
15:39
Speaker 1: are saying, actually, we've been studying these people for like
15:42
Speaker 1: twenty five years, and we're finding that over the long haul,
15:46
Speaker 1: you can cure anorexia for good. It just takes a while.
15:50
Speaker 1: And it also, from what I've seen, takes a patient
15:52
Speaker 1: who wants to be cured absolutely. Uh. And then one
15:57
Speaker 1: more thing here, if we do need to talk about
15:59
Speaker 1: puberty and adolescence because it can have really um long
16:03
Speaker 1: lasting effects if that's the time of your life where
16:05
Speaker 1: this is happening, long term effects on your development, um
16:09
Speaker 1: on your growth. Uh. If you I think it says
16:12
Speaker 1: if you have anorexia beginning at age ten all the
16:17
Speaker 1: way through your twenties, you can have permanent stunted growth.
16:21
Speaker 1: You can ever do sex secondary sexual characteristics like um,
16:25
Speaker 1: your pubic care, won't grow in your breast won't develop. Uh.
16:29
Speaker 1: And maybe a lack of menstruation from the beginning, not
16:31
Speaker 1: like the cessation of menstruation, Like you may never get
16:34
Speaker 1: your period right and you may be infertile as a
16:37
Speaker 1: matter of fact as an adult. That's right. So yeah,
16:39
Speaker 1: just because of the age that it's the um, the
16:44
Speaker 1: age that it sets on, I guess, um, it's such
16:47
Speaker 1: an important time for the development your body. It's like
16:50
Speaker 1: the last time you should be like time, I'm just
16:52
Speaker 1: not gonna eat for a couple of days. Yeah. Um.
16:55
Speaker 1: It has some real sweeping effects for sure. Yeah. And
16:57
Speaker 1: bulimia too, for for its part, UH is really rough
17:01
Speaker 1: on the teeth, um, yellowing, decaying teeth, sensitive teeth, UH,
17:06
Speaker 1: swollen sore throat, acid reflux like all the time. Um.
17:11
Speaker 1: And then you know electrolyte imbalances being in the bathroom
17:14
Speaker 1: a lot because you're you're you're tricking your body essentially
17:18
Speaker 1: into thinking is getting some nutrition and then getting rid
17:21
Speaker 1: of that food really quickly, and that nutrition really quickly. Uh.
17:24
Speaker 1: And that can lead to you know, fainting, fatigue, and
17:26
Speaker 1: eventually heart attacks and strokes. Serious stuff. Yeah, it is
17:32
Speaker 1: extraordinarily serious stuff, and a lot of people are like, well,
17:34
Speaker 1: it's just you know, this is how my daughter, my sister,
17:38
Speaker 1: my friend likes to look. She likes to be skinny.
17:40
Speaker 1: And this is a really persistent problem with dealing with
17:43
Speaker 1: anorex he is that. Um, I've seen it multiple places.
17:46
Speaker 1: It's not a lifestyle, it's a mental health disorder, and
17:50
Speaker 1: it has to be treated because again, it is, statistically speaking,
17:55
Speaker 1: the deadliest mental health disorder there is. Should we take
17:58
Speaker 1: a break, Yes, we're gonna take a break, and we're
18:01
Speaker 1: gonna come back with a whole list of jokes. That's right, Okay,
18:28
Speaker 1: Chuck lay us the first joke on us. All right,
18:31
Speaker 1: I have no jokes, although I will say, uh, I
18:35
Speaker 1: think were it's time for a great sidebar. Um. You know,
18:39
Speaker 1: we we got one of those uh home I'm not
18:42
Speaker 1: gonna buzz market anyone, but one of those home units
18:44
Speaker 1: that you speak to and it tells you the weather
18:47
Speaker 1: and stuff, like one of those robots. Yeah, like a
18:50
Speaker 1: little robot you put. I've been testing it out with
18:53
Speaker 1: my daughter lately, and those robots that talk to you
18:57
Speaker 1: can tell jokes. Did you know that? Yes? I did,
19:00
Speaker 1: and they some of them are kind of funny, and
19:02
Speaker 1: they're all kind of great for four year olds. Well
19:05
Speaker 1: what you got, oh, I mean none of I mean
19:08
Speaker 1: some Thanksgiving jokes around this time, and they I think
19:11
Speaker 1: they try to be topical topical jokes. So there's like
19:15
Speaker 1: Christmas and Thanksgiving jokes going on right now. But you're
19:17
Speaker 1: not going to tell us one of the I'm trying
19:19
Speaker 1: to remember some of them. I mean, trust me, they're
19:22
Speaker 1: they're not great jokes for adults, but four year olds
19:23
Speaker 1: eat it up. It's they're probably like deeply copyrighted too.
19:28
Speaker 1: Maybe I don't know if you can copyright these kind
19:30
Speaker 1: of dumb jokes. Thanksgiving joke, you're kidding me. It's like
19:33
Speaker 1: what our country has founded on, all right, but writing Thanksgiving.
19:37
Speaker 1: So that that's been going on at our house is
19:38
Speaker 1: a lot of joke telling. And they can make Bourbon
19:41
Speaker 1: noises and two noises and it's uh, I'm trying to
19:46
Speaker 1: test the limits of how blue they can go. Remember
19:48
Speaker 1: that little handheld box we had that would make different
19:51
Speaker 1: like fart sounds and sharking sounds. So basically this is
19:55
Speaker 1: what this is is a high tech kind of robot
19:57
Speaker 1: butler that makes fart sounds. Yeah, it's great. Is it
20:00
Speaker 1: on wheels? Now, it's not on wheels, it's it's it
20:03
Speaker 1: sits on your nightstand or wherever you want it. I
20:06
Speaker 1: got you, so all right, enough, enough fun and games. Yeah,
20:11
Speaker 1: we should talk a little bit about the causes of anorexia,
20:13
Speaker 1: because this is one of the more confounding. Um well,
20:17
Speaker 1: I mean a lot of mental health disorders are confounding
20:19
Speaker 1: in this way, actually, but we don't know the cause
20:22
Speaker 1: of it. Um. It is probably a lot of causes. Um.
20:27
Speaker 1: Some of them may conflict with one another, but it
20:29
Speaker 1: is probably a very complex bag and mix of societal pressures,
20:34
Speaker 1: which we're gonna talk about your environment, and then genetics
20:39
Speaker 1: look like they do play a part. Yeah. They they
20:42
Speaker 1: think that it's a this get this man, this is
20:44
Speaker 1: what they call a grab bag catch all. That there
20:47
Speaker 1: is a bio psycho social mechanism underlying anorexia and bolimia. Yeah,
20:53
Speaker 1: it's biological, psychological, and social. And they're probably right. I mean,
20:57
Speaker 1: there's probably components of all of them put together there,
21:00
Speaker 1: which would explain why it's so hard to understand at
21:03
Speaker 1: this point and so hard to treat. It's very tough
21:05
Speaker 1: because it's not like you can point to one thing
21:08
Speaker 1: and say, correct this part of your life, and uh yeah,
21:13
Speaker 1: and it'll be better. It's like it's there's so many prongs.
21:15
Speaker 1: It's really really tough. Yeah, absolutely, because let me think
21:18
Speaker 1: about it, Like if you have a person who has
21:21
Speaker 1: uh anorexia and they want to get better, but the
21:24
Speaker 1: reason that they developed anna rixie in the first place
21:27
Speaker 1: is because they have a parent who's on them about
21:29
Speaker 1: their weight all the time. You have to correct the
21:32
Speaker 1: parents behavior in addition to, you know, possibly treating the
21:37
Speaker 1: patient in the hospital for malnourishment. Like, it is a
21:40
Speaker 1: big complex ball of stuff, but there are there are
21:43
Speaker 1: studies that have kind of turned up like little little
21:46
Speaker 1: bits here. They're like, oh, here's a here's a little
21:49
Speaker 1: a little I don't know, like a hot a matchbox
21:53
Speaker 1: car or something. In a pile of rocks means what's
21:57
Speaker 1: something you want? Like a diamond in the basically, Okay,
22:02
Speaker 1: I haven't you ever found a match box kind of
22:04
Speaker 1: pil of rocks. But like, I was really glad that
22:06
Speaker 1: I found this. I thought it was just some dumb,
22:08
Speaker 1: boring pile of rocks. I've never I had no idea
22:11
Speaker 1: where you're going there. Well, but I'm glad, we gotta
22:14
Speaker 1: laugh out of this. I was being serious. Oh sorry, um,
22:19
Speaker 1: are you talking about the study the twin study, I'm
22:21
Speaker 1: talking about all the studies. Okay, Well, they did do
22:24
Speaker 1: a twin study, and they found as in studying human twins,
22:28
Speaker 1: not two different studies that look alike. But uh, they
22:32
Speaker 1: found that if and this is this is sort of
22:34
Speaker 1: helps back up evidence of a genetic component. But if
22:37
Speaker 1: one twin has anorexia, then they're identical twin, not fraternal
22:43
Speaker 1: um um more likely to also have that same disorder. Right,
22:50
Speaker 1: But not, like you said, among fraternal twins, because so
22:53
Speaker 1: because I mean you'd think, like, you know, you see
22:55
Speaker 1: identical twins and and think like what did your mother
22:59
Speaker 1: do to you too? How? How could this be allowed
23:02
Speaker 1: to go on? But if that's not the case with
23:03
Speaker 1: fraternal twins, then that removes that environmental component, strongly suggests
23:08
Speaker 1: that it's a genetic component. Yeah, and maybe to some
23:11
Speaker 1: degree a social component. I mean not all the time,
23:14
Speaker 1: but I would imagine fraternal twins are generally um subjected
23:18
Speaker 1: to this or similar social components. Yes. The only thing
23:23
Speaker 1: that would confound that is fraternal twins can also be
23:26
Speaker 1: like like boy and girl So I mean if the
23:30
Speaker 1: if they tossed out the boy and girl and just
23:33
Speaker 1: had like fraternal twin girls or fraternal twin boys in study,
23:37
Speaker 1: I would say that would strongly suggest it's a genetic component.
23:39
Speaker 1: But I mean, in in any home, a boy and
23:42
Speaker 1: a girl are going to be treating or a son
23:43
Speaker 1: and a daughter is going to be treated differently. Is
23:45
Speaker 1: just the way it is, unless you live in a
23:47
Speaker 1: skinner box. Oh gosh, that that should lighten the mood, right,
23:52
Speaker 1: unless you're dad shocks you for studies at home. Uh,
23:56
Speaker 1: they did not have not found a gene they can pinpoint.
23:59
Speaker 1: They have found thirty I'm sorry, forty three genes that
24:02
Speaker 1: could potentially be of use when it comes to linking
24:06
Speaker 1: genetics to these disorders, but they haven't. It's nothing is
24:10
Speaker 1: very clear cut at this point. Right. So that's the
24:13
Speaker 1: that's about as far as they've gotten on the biological component. UM.
24:17
Speaker 1: As far as the psychological component, like you were saying,
24:20
Speaker 1: they found there's a lot of comorbidity with other UM.
24:25
Speaker 1: Other behavior disorders and personality disorders like depression, anxiety disorder,
24:30
Speaker 1: obsessive compulsive disorder UM. They bear a lot of resemblance
24:36
Speaker 1: to one another and that um, like with with anorexia
24:40
Speaker 1: or bulimia, something called ritualized food behaviors develop where um,
24:45
Speaker 1: you cut food into small pieces first to make it
24:48
Speaker 1: seem like there's more or make it seem like you are,
24:52
Speaker 1: um are like eating more than you actually are. But
24:56
Speaker 1: the what makes it ritualizes you couldn't eat food any
25:00
Speaker 1: their way, or you have to arrange food a certain
25:03
Speaker 1: way on the plate before you eat it, or even
25:05
Speaker 1: like religiously counting and tracking calories is considered a ritualized
25:10
Speaker 1: food behavior, and it really kind of trapes is into
25:13
Speaker 1: the realm of something like obsessive compulsive disorder or experience
25:18
Speaker 1: the anxiety if you're forced to eat food on a
25:20
Speaker 1: plate that's not arranged in the way that you're used to.
25:23
Speaker 1: So the idea is that you eat one english pi
25:25
Speaker 1: at a time, you are you are taking a lot
25:27
Speaker 1: of bites and therefore, hey, look I'm eating a lot. Yeah,
25:31
Speaker 1: that's kind of more deceptive behavior and that would probably
25:34
Speaker 1: be like a two fer something. I mean self deceptive
25:36
Speaker 1: even you know, sure, sure, but also deceptive like your
25:40
Speaker 1: parents who might be watching you like a hawk or something.
25:42
Speaker 1: You're like, no, no, exactly, really interesting. But if you
25:46
Speaker 1: couldn't eat peas any other way but that then that
25:50
Speaker 1: would be a ritualized food behavior. Right. Uh, this statistic
25:55
Speaker 1: as far as meeting criteria for at least one other
25:57
Speaker 1: mental health disorder, it's fifty of anorexia patients and for bolimia. Yeah,
26:05
Speaker 1: that is really high. Yeah, and that's and you know,
26:08
Speaker 1: that's what makes it weird that the two are so overlapped,
26:11
Speaker 1: because so you've got anorexia nervosa and bolimia nervosa, and
26:15
Speaker 1: again they each have their own separate entries in the
26:18
Speaker 1: d s M. But then there's a kind of a
26:21
Speaker 1: binge and purge bolimia component to anorexia. But the personality
26:26
Speaker 1: disorders that are even the types of personalities that engage
26:30
Speaker 1: in each one are really really different. Like with anorexia
26:33
Speaker 1: nervosa UM, the patients are usually low novelty seeking, so
26:38
Speaker 1: they're not like trying out new things. They have a
26:41
Speaker 1: low emotional responsiveness, decreased pleasure, and reduce social spontaneity. That's
26:47
Speaker 1: typical someone with anorexia nervosa. With bolimia nervosa, it's like
26:51
Speaker 1: kind of the opposite. They tend to be impulsive, they
26:54
Speaker 1: look for new experiences, and they can have characteristics of
26:57
Speaker 1: a borderline personality disorder from whatever read So they're like
27:01
Speaker 1: two totally different types of people but engage in the
27:04
Speaker 1: same behavior. And it's one of those things where it's like, Okay,
27:07
Speaker 1: if you have two different types of people who are
27:09
Speaker 1: trying to do the same thing or trying to achieve
27:11
Speaker 1: the same end, what you know, what commonalities do they have?
27:15
Speaker 1: In exploring those commonalities, maybe we'll find like the answers
27:18
Speaker 1: to what causes eating disorders like this. Yeah, it's interesting.
27:22
Speaker 1: I mean it does make a little bit of sense
27:25
Speaker 1: when you look at the you know, like someone suffering
27:30
Speaker 1: from anorexia would avoid going out to eat spontaneously with friends,
27:34
Speaker 1: let's say at all costs. Someone with bulimia might jump
27:39
Speaker 1: right in there because in their mind they they may
27:42
Speaker 1: think that they have a solve for that behavior, which
27:45
Speaker 1: is I'll excuse myself to the bathroom right afterward, and
27:48
Speaker 1: I can still go out with my friends and eat
27:51
Speaker 1: a regular sized meal. I think that's a really good point.
27:53
Speaker 1: So either way that the regardless of how that person
27:58
Speaker 1: is personality wise, they're going to age in trying to
28:02
Speaker 1: maintain their weight. But depending on their type of personality,
28:05
Speaker 1: they're going to choose this route or that route. Yeah, yeah,
28:08
Speaker 1: I think I think you're onto something. Dr Chuck. Well,
28:11
Speaker 1: the other thing too, is with these personality traits, they
28:14
Speaker 1: found correlation with things like perfectionism, irritability, and like you
28:18
Speaker 1: were talking about this, sometimes being impulse over, sometimes the opposite.
28:23
Speaker 1: But what they found too is, uh, you know, if
28:26
Speaker 1: you're studying adolescence in puberty, a lot of these are
28:29
Speaker 1: normal traits of adolescence, so it's really hard to distinguish
28:32
Speaker 1: sometimes and a lot of times these things it's a
28:36
Speaker 1: chicken or the egg, these are caused by the eating
28:38
Speaker 1: disorder and not the other way around. Yeah. That also
28:41
Speaker 1: applies to differences in brain structure too, Like they found
28:45
Speaker 1: things like um reduction in the gray matter and the
28:49
Speaker 1: white matter in the brain of people with one of
28:52
Speaker 1: the nervosas or um they have more cerebral spinal fluid,
28:56
Speaker 1: and then other regions of the brain are smaller compared
28:59
Speaker 1: to people who don't have disorders, but they clear up
29:03
Speaker 1: when the um anorexia is successfully treated. Yeah, so that's
29:07
Speaker 1: it's kind of it really makes you wonder like where,
29:10
Speaker 1: you know, did it cause it or its like it doesn't.
29:13
Speaker 1: It doesn't prove or disprove it either way. It's just
29:16
Speaker 1: the two are related and we're not sure which causes which. Yeah.
29:19
Speaker 1: I thought this F m R I stuff was interesting
29:22
Speaker 1: because you know, our motto went in doubt, go into
29:25
Speaker 1: the wonder machine and see what's lighting up. Be very instructive.
29:30
Speaker 1: And they did the longest motto, every t you can
29:34
Speaker 1: fit on the front end, back of a T shirt,
29:36
Speaker 1: not a hat, kind of peters out down the bottom,
29:40
Speaker 1: that's right. Uh. And then the script just you know,
29:43
Speaker 1: like a pen like you fall asleep all writings, right, yeah, right,
29:47
Speaker 1: So the F m R I Wonder machine has found that, uh,
29:52
Speaker 1: it lights up those reward centers in the brain show
29:54
Speaker 1: increased activity. Um, if you have intorexy and you're shown
29:58
Speaker 1: photos of someone who is drastically underweight, So that's a
30:04
Speaker 1: pretty obvious you know sign right there. Another one is
30:08
Speaker 1: noticing fine details when you are shown a picture of
30:12
Speaker 1: your own face, that that reward response is just lighting
30:16
Speaker 1: up the reward center. So that that means that they
30:19
Speaker 1: are are hyper um aware of their appearance at all
30:24
Speaker 1: times for sure, and like they noticed things that might
30:28
Speaker 1: not even be there, right Um. And then finally you
30:32
Speaker 1: get to the social part of the biopsychosocial components. UM
30:37
Speaker 1: and that's the environmental factors. And one of the big
30:41
Speaker 1: ones that has kind of emerged is the idea of
30:44
Speaker 1: sexual abuse in creating antirects the universear starting it in
30:49
Speaker 1: in UM people. I saw that. I think John's Hawkins
30:52
Speaker 1: said sexual abuse has been reported in twenty of individuals
30:57
Speaker 1: with antorexts inniversa and bolimia innivosa, right, um, And it
31:01
Speaker 1: doesn't necessarily have to just be sexual abuse, but there
31:05
Speaker 1: is a consistent UM reporting of some sort of trigger.
31:09
Speaker 1: Like the people who have bolimia and anorexia typically can
31:14
Speaker 1: point to the moment that it started or the thing
31:17
Speaker 1: that created this idea in their mind. It could be
31:20
Speaker 1: apparent being overly critical of their weight. It oftentimes as
31:24
Speaker 1: a parent, I think, yeah, it could be a coach
31:27
Speaker 1: who is overly critical of their weight. Um. It can
31:30
Speaker 1: be a bully teasing them about their way. It could
31:33
Speaker 1: be a friend making a joke about their way. It
31:35
Speaker 1: just depends on the moment, you know how, like how
31:38
Speaker 1: something can bother you but it doesn't seem to bother
31:40
Speaker 1: anybody else um and vice versa. You know something that
31:43
Speaker 1: bothers someone else. You're like, that's not that big of
31:45
Speaker 1: a deal. But it's all just based on the person,
31:48
Speaker 1: in the context, in the setting, and maybe even just
31:50
Speaker 1: that perfect combination of neurotransmitters that happened to be active
31:54
Speaker 1: in their brain right then then just something got them
31:57
Speaker 1: just right that has been on to kickstart an xi
32:01
Speaker 1: and bolimia under a lot of circumstances. Yeah, and it's
32:05
Speaker 1: just for parents. It's so important how they talk about
32:09
Speaker 1: UH and not just to their kids, but any time
32:12
Speaker 1: your kid can hear you speaking words, how you talk
32:15
Speaker 1: about weight, and how you talk about your own body,
32:19
Speaker 1: and how you talk about health and um, you know,
32:22
Speaker 1: having a kid now, it's just it's made me realize
32:25
Speaker 1: how unkind I can be to my own self being overweight,
32:30
Speaker 1: and you you can't say those things in front of
32:32
Speaker 1: a four year old. You have to talk about um
32:37
Speaker 1: health and you know, daddy's exercising because daddy wants to
32:41
Speaker 1: be healthier and stuff like that, because you'd be surprised
32:45
Speaker 1: that you know, these little ears they hear it all.
32:48
Speaker 1: And um, the last thing that you want is for
32:51
Speaker 1: anything that you say to be UH two to have
32:55
Speaker 1: an impact on your child, uh in an unhealthy way
32:59
Speaker 1: about their body image. You know, it's just super super important,
33:02
Speaker 1: and I think it's gotten much much better than than
33:05
Speaker 1: the old days when you know, I know a lot
33:07
Speaker 1: of women who talk about, you know, whether or not
33:10
Speaker 1: they suffered from anorexi or not, uh, struggling with their
33:14
Speaker 1: body image because um, most of the time mom talking
33:19
Speaker 1: about it growing up. I'm sure Dad's played part two.
33:22
Speaker 1: But I've heard a lot of anecdotal examples of women
33:26
Speaker 1: talking about in this, you know, in the seventies, mom
33:29
Speaker 1: talking about, you know, you can't eat this, you can't
33:31
Speaker 1: eat that because you won't get a boyfriend, or this
33:33
Speaker 1: won't happen or that won't happen, right, and um, that's yeah.
33:38
Speaker 1: I've seen that a lot of places too for researching this.
33:41
Speaker 1: But one of the other things I saw is like
33:43
Speaker 1: what you were saying where you were talking about yourself.
33:45
Speaker 1: You have to watch what you say around your daughter.
33:47
Speaker 1: When you say disparaging things about your yourself, that's called
33:50
Speaker 1: fat talk. And it is like a pastime in the West,
33:55
Speaker 1: were like getting getting together with friends or just having
33:58
Speaker 1: a couple of conver station around the water cooler or
34:01
Speaker 1: something about how fat you are or how much you
34:03
Speaker 1: ate and how much you you need to lose weight,
34:05
Speaker 1: and that they found it can actually be a real
34:07
Speaker 1: driver for leading to um eating disorders as well. Yeah,
34:12
Speaker 1: I mean I make jokes all the time about that
34:14
Speaker 1: with you and everyone I know, but I don't use
34:17
Speaker 1: that word in my house. Uh. I have to stop
34:21
Speaker 1: myself from making jokes about myself. It's just it's no
34:23
Speaker 1: good for anyone. Know. One question I have though, is
34:27
Speaker 1: like I was a pretty like husky boy. You were robust.
34:32
Speaker 1: I was very like I had the Pillsbury doughboy nickname,
34:36
Speaker 1: and like I mean like I was the fat in
34:38
Speaker 1: class for sure, And uh it bothered me, like really
34:41
Speaker 1: set the tone of my childhood in a lot of ways.
34:44
Speaker 1: Like I had a really great childhood and I loved it,
34:46
Speaker 1: but I also had like a real bummer childhood in
34:48
Speaker 1: that sense too. Um But like, what do you do
34:53
Speaker 1: when your kid is demonstrably overweight and needs to lose
34:57
Speaker 1: weight or else they're going to spend the rest of
34:59
Speaker 1: their life uggling with their weight, which is not fun
35:02
Speaker 1: at all? Like what do you do? How do you
35:05
Speaker 1: approach the little fragile ego of a kid and saying
35:09
Speaker 1: we need to get some weight off you, you know,
35:11
Speaker 1: without leading them down this path to an eating disorder.
35:15
Speaker 1: That's got to be one of the trickiest things you
35:17
Speaker 1: you would ever have to to talk about with your
35:19
Speaker 1: kid in that in that situation. Yeah, and and also
35:23
Speaker 1: especially now in a day where there's such a movement
35:26
Speaker 1: to be accepting of who you are, no matter how
35:28
Speaker 1: what size you are. Um, it's just such a fine
35:32
Speaker 1: line to walk between good health and accepting who you are. Like,
35:37
Speaker 1: I don't necessarily have a super poor self image, but
35:40
Speaker 1: I want to be alive in thirty years for my daughter,
35:42
Speaker 1: you know, right, sure, like the vanity is kind of
35:45
Speaker 1: gone at this point. I'm for but I want to
35:48
Speaker 1: be healthy. Uh and and those you know, a healthy
35:53
Speaker 1: weight goes hand in hand with not having the stroke
35:55
Speaker 1: in the heart attack later on exactly. But I think
35:58
Speaker 1: a lot of people would say, like, Okay, yes, there
36:01
Speaker 1: is health to be gained from eating better or from
36:04
Speaker 1: exercising or doing both ideally. Um, but one of the
36:08
Speaker 1: problems that we have is this ideal where it's like, well,
36:11
Speaker 1: keep going until you have washboard abs, and until you
36:14
Speaker 1: have like these amazing biceps, and until you just want
36:18
Speaker 1: to do nothing but walk around in nospedo or something
36:20
Speaker 1: like that. And the fact that like those are the
36:22
Speaker 1: models that we see on the billboards, that drives even
36:25
Speaker 1: that idea of health, healthiness to this kind of perverted,
36:29
Speaker 1: weird place that can kind of develop eating disorders as well. Yeah,
36:34
Speaker 1: that's not me. I have no illusions about ever having
36:37
Speaker 1: a washboard stomach. I've given up on this. I don't
36:40
Speaker 1: want a washboard's stomach. I want to want to see,
36:44
Speaker 1: just to see what it's like, and then I'd be like,
36:47
Speaker 1: all right, give me a donna. I like a little
36:49
Speaker 1: softness to a body. It's nicer I hug on and
36:53
Speaker 1: lay around with. I don't want I do too. I mean,
36:56
Speaker 1: Emily didn't want to put her head down on a
36:58
Speaker 1: washboard stomach, right, she doesn't want to bounce a nickel
37:02
Speaker 1: off of the No, So I want I want to
37:05
Speaker 1: see what it would look like on me, and then
37:08
Speaker 1: that'd be fine. I mean, that's it. I don't really
37:11
Speaker 1: have like any it's not my ideal look or anything
37:13
Speaker 1: like that. I just want to see if I could
37:15
Speaker 1: ever do it. Yeah, I just I just need to
37:17
Speaker 1: get healthier and drop some weight and you know, feel
37:19
Speaker 1: a little bit better day to day, like moving around
37:22
Speaker 1: the world, because it has an impact on that stuff too.
37:24
Speaker 1: That's the key is feeling better day to day, feeling
37:27
Speaker 1: good in your clothes, feeling to the point where you're
37:29
Speaker 1: not thinking about what you're eating or how much you're
37:32
Speaker 1: exercising because you're getting enough. That's the key right there,
37:36
Speaker 1: that's the goal. Yeah, So let's talk about social pressure
37:40
Speaker 1: because that's kind of we're right in the middle of it.
37:42
Speaker 1: Um well, actually, let's take a break. Okay, I'm gonna
37:46
Speaker 1: go do some crunches, right, I'm gonna hold your feet down,
37:49
Speaker 1: and we're gonna we're gonna talk about social pressure right
37:52
Speaker 1: for this, So Chuck, those were pretty good. Crunches bad,
38:19
Speaker 1: not bad at all. I'm gonna go with a B plus.
38:22
Speaker 1: You know I started seeing a trainer, did you really? Yeah,
38:25
Speaker 1: well that's pretty cool, man. I didn't know that. So,
38:27
Speaker 1: like about a month then like like kind of cool
38:30
Speaker 1: and supportive or like drill instructor type, like army. Well
38:34
Speaker 1: she has former army funny enough, but she is cool
38:37
Speaker 1: and supportive and more than anything, it's just like I
38:39
Speaker 1: gotta show up at her house three days a week
38:42
Speaker 1: and do it and I can't. You know, I can't
38:45
Speaker 1: not do it. And that's I am one person who
38:47
Speaker 1: will not do it if given any opportunity to not
38:50
Speaker 1: do it. Yeah, it's so easy to just shirk on
38:52
Speaker 1: that kind of stuff and just you know, there's always
38:55
Speaker 1: reasons to not go or not do it or whatever.
38:57
Speaker 1: But if you have somebody there then like, you know,
39:00
Speaker 1: motivating you, that definitely helps. YEA, Thanks, good for you, man.
39:02
Speaker 1: Thanks dude. It's she's killing me, she's kicking my butt,
39:06
Speaker 1: but it's it's what I need right now. So one
39:10
Speaker 1: of those two, admittedly throwing it out there, I'll give
39:13
Speaker 1: you a number. Michelle, She's great. So, uh, social pressures
39:17
Speaker 1: we're talking about, Uh, you know, this is from a
39:21
Speaker 1: Western point of view here in the United States, uh, Canada,
39:26
Speaker 1: some places in Europe, although that can vary pretty pretty
39:29
Speaker 1: greatly on how they look at their bodies there, but
39:32
Speaker 1: definitely in the United States, our culture has demonstrably said
39:39
Speaker 1: loud and clear thin as in, you've got to be skinny,
39:43
Speaker 1: whether it's TV or advertising or Instagram now or YouTube. Um,
39:50
Speaker 1: it's starting to change a little bit more because there's
39:52
Speaker 1: there's another whole wave that I was talking about about
39:55
Speaker 1: accepting your accepting yourself and being happy with whatever side
40:00
Speaker 1: you are. But that still can't counter the onslaught that
40:03
Speaker 1: has happened for decades and decades in this country. No,
40:06
Speaker 1: but it is gratifying to see it changing over time,
40:08
Speaker 1: Like you see like plus size models everywhere, like they
40:11
Speaker 1: don't there's not like some big right up in people
40:14
Speaker 1: about how this daring um company clothing company used to
40:18
Speaker 1: plus size modeling, where it's just become a normal thing. Yes,
40:21
Speaker 1: it's becoming normalized. I think that's a big, big component
40:24
Speaker 1: because a lot of people point to the mass media
40:27
Speaker 1: in the West as the main driver for eating disorders
40:31
Speaker 1: because they say this is the ideal weight, body mass index, UM,
40:36
Speaker 1: body fat percentage, go attained to this, do whatever you
40:41
Speaker 1: need to do to get here, and if you don't,
40:42
Speaker 1: you're an ug face. Right. What I think is super
40:46
Speaker 1: interesting about this um because everyone knows that it's like yeah, sure,
40:50
Speaker 1: ads and models and and Instagram like that's that's stuff
40:56
Speaker 1: you should know, chump change. But what's really interesting is
41:01
Speaker 1: I mean, you know, we're not enlightening anyone as to
41:03
Speaker 1: that's not breaking news. Oh, I got what you meant,
41:05
Speaker 1: But uh, what's really interesting to me is to look
41:09
Speaker 1: at all, right, if it is media, what about pre television,
41:14
Speaker 1: like has this stuff increased? Or what about non Western cultures?
41:18
Speaker 1: What about if someone were to move over here from
41:20
Speaker 1: another country where Antorexi isn't very prevalent um, how would
41:25
Speaker 1: they change? And it appears that that does have an impact.
41:30
Speaker 1: It does, but not like h Night and Day kind
41:33
Speaker 1: of thing like you expect, Like the studies aren't just
41:36
Speaker 1: backing one another up left and right to where yes,
41:39
Speaker 1: it's the mass media, and that doesn't necessarily mean it's
41:42
Speaker 1: not the mass media. It just means that they haven't
41:44
Speaker 1: figured out how to control for all these confounding factors
41:48
Speaker 1: that also come along with something like moving to the
41:51
Speaker 1: US as an immigrant um and all the things that
41:54
Speaker 1: that come along with it in addition to being exposed
41:57
Speaker 1: to Western mass media. Or you know what else changed
42:00
Speaker 1: over time? Well, we got richer, food, got cheaper, junk
42:04
Speaker 1: food became more abundant. Maybe that has something to do
42:07
Speaker 1: with it and not just you know this this growing
42:09
Speaker 1: of mass media in the middle to late twentieth century.
42:12
Speaker 1: So there's a lot of studies that do say, yes,
42:14
Speaker 1: there does seem to be a correlation, just there's never
42:17
Speaker 1: been a smoking gun. It's like the same thing with
42:19
Speaker 1: violence in in media or sex in media. Like the
42:23
Speaker 1: the idea that the media just has no effect on
42:25
Speaker 1: us whatsoever is is ridiculous to me. But I also
42:29
Speaker 1: suspect it doesn't have quite the pronounced effect on us
42:32
Speaker 1: that we like to think or just assume. Yeah, they're
42:35
Speaker 1: like you said, they're just so many factors you can't
42:37
Speaker 1: UM control all of them. But there are a couple
42:40
Speaker 1: of interesting findings. This one study, they found a rate
42:43
Speaker 1: of eating disorders UH in places like Iran, Singapore, and
42:47
Speaker 1: Japan UM increased among women who were exposed to Western culture,
42:52
Speaker 1: either by being there for a little while or living
42:54
Speaker 1: there for a little while, even if it was just
42:56
Speaker 1: a vacation, or through media. And another one found that
43:00
Speaker 1: UM women who were at least one generation removed from
43:03
Speaker 1: immigration into Canada thought about dieting more than women who
43:07
Speaker 1: were immigrants themselves. Yeah, and and dieting behavior is UM
43:11
Speaker 1: a very Western thing, and it's starting to spread elsewhere.
43:14
Speaker 1: Like there's countries like Egypt and Iran and Japan and
43:17
Speaker 1: China UM where they're studying to notice eating disorders UM
43:22
Speaker 1: that are they're considered non Western cultures. But there again
43:25
Speaker 1: they're like, well, has the Western media kind of infiltrated
43:28
Speaker 1: those spaces more or is it people who have spent
43:31
Speaker 1: time in the West who are now coming back home
43:33
Speaker 1: and they've developed a neating disorder? What is it exactly?
43:36
Speaker 1: But there's a really big point to this that I
43:39
Speaker 1: think is easily overlooked. Is if if it is the
43:44
Speaker 1: Western media and it is something like saying, here's this
43:49
Speaker 1: ideal body image, get to it. However, you have to
43:52
Speaker 1: a lot of people in the West engage in diets
43:56
Speaker 1: and basically everybody in the West is exposed to that media.
44:00
Speaker 1: And yet less than five percent of people in the
44:03
Speaker 1: United States will ever develop an eating disorder in their lifetime.
44:07
Speaker 1: Why isn't it more prevalent if it's just the media
44:10
Speaker 1: or just trying to diet? You know, what is it
44:13
Speaker 1: that makes that extra step? And that, I think is
44:15
Speaker 1: where that um bio psycho component comes into the biopsychosocial thing.
44:21
Speaker 1: I think it's just kind of like a triple whammy
44:24
Speaker 1: that gets some people just right who may be genetically predisposed,
44:28
Speaker 1: who who maybe um psychologically predisposed, and then the right
44:31
Speaker 1: combination of social factors all converge to make somebody develop
44:35
Speaker 1: an orrexa or bolimia. Yeah, if you're an athlete, Um,
44:39
Speaker 1: this is interesting because you can have medical complications as
44:42
Speaker 1: an athlete who has to drop weight. Um. Either you know,
44:46
Speaker 1: some some sports you you have to have a lower weight,
44:50
Speaker 1: like if you're a dancer or a jockey or a
44:52
Speaker 1: gymnast or something like that. Other times, like if you're
44:56
Speaker 1: a wrestler you have to make a certain weight or
44:57
Speaker 1: a boxer a weight class. And this is not the
45:01
Speaker 1: same thing. I mean that it can be unhealthy weight loss.
45:04
Speaker 1: It's not the same thing necessarily as anorexia. But it
45:07
Speaker 1: looks like that could be a trigger for uh, anorexia,
45:11
Speaker 1: you know, after you stop your athletic career. Yeah, it's
45:15
Speaker 1: like that part in um, what was that that Channing
45:18
Speaker 1: Tatum Steve Carell movie set in the eighties where he's
45:21
Speaker 1: the wrestler. Oh yeah, the Fox whatever Yeah, Fox Hawk
45:26
Speaker 1: or something like that. Anyway, where that part where he
45:30
Speaker 1: loses a match and he goes and just binges, and
45:33
Speaker 1: I think his brother comes up and makes him like
45:36
Speaker 1: throw up because he's gotta keep wrestling and he needs
45:39
Speaker 1: to make that that class, that weight class. So the
45:43
Speaker 1: idea that that some people who engage in these sports
45:46
Speaker 1: kind of internalize that idea and that behavior and can
45:50
Speaker 1: become anorexic or um belimic. Uh. That like that just
45:55
Speaker 1: kind of makes uttering complete sense. Yeah, same with the
45:58
Speaker 1: army too, or not just the army, but the military
46:01
Speaker 1: where they have you know, weigh ends and fitness benchmarks.
46:04
Speaker 1: If you miss those, you're in big trouble. So people
46:07
Speaker 1: will engage in this this kind of eating disorder like behavior,
46:11
Speaker 1: but they don't necessarily develop in eating disorder, although some
46:14
Speaker 1: people go on to do just that. Yeah, it says
46:17
Speaker 1: there's this there's one study that found enrolling in the
46:19
Speaker 1: military led to an increase and eating disorders. Yeah, it's interesting,
46:24
Speaker 1: um and true stuff. He should know. Fashion. We'll talk
46:27
Speaker 1: about history here at the end, because I think all
46:31
Speaker 1: the other stuff was probably more important than the history
46:34
Speaker 1: and who first named it, but we like to cover
46:37
Speaker 1: our bases. And Anorexia nervosa was named by Sir William Gull.
46:42
Speaker 1: He was Queen Victoria's doctor, and he published a paper
46:46
Speaker 1: and this was, well, you're just walking my past, like
46:49
Speaker 1: one of the most interesting facts of the podcast. You
46:52
Speaker 1: like that fact? Yes, you take it man, I was
46:55
Speaker 1: being so generous. Oh, thank you, sir. He uh he
47:01
Speaker 1: Sir William Gull is one of the dudes who they
47:04
Speaker 1: all right, you think this is interesting? Fine? He may
47:07
Speaker 1: or may not have been Jack the Ripper. Yes, this
47:11
Speaker 1: guy who coined the term anorexia, was one of the
47:14
Speaker 1: first to to describe it in a scientific paper, is
47:19
Speaker 1: also one of the one of the people that is
47:22
Speaker 1: liked for Jack the Ripper. Yeah, you just said it again.
47:25
Speaker 1: So why did I even bother because you didn't You
47:28
Speaker 1: didn't enjoy it enough, you didn't relish it enough. Okay,
47:31
Speaker 1: I got you. So Jack the Ripper published a paper,
47:35
Speaker 1: uh in eighteen seventy three, and this is after treating
47:39
Speaker 1: young women who, by all appearances had anorexia what we
47:43
Speaker 1: now know is anorexia, right, And you could tell it
47:45
Speaker 1: was he was Jack the Ripper because the paper started
47:48
Speaker 1: dear boss, how long have you been sitting on that one, buddy?
47:54
Speaker 1: That just came up right now? Yeah? Why does this
47:57
Speaker 1: say dear boss on your paper? So? Uh? He had
48:02
Speaker 1: drawings in there. Um, eventually he had photos in there
48:05
Speaker 1: before and after treatments, and um, just like us today,
48:09
Speaker 1: he was uncertain about the nature of the disorder to
48:12
Speaker 1: begin with. Um, what we do know historically is the
48:16
Speaker 1: nineteen seventies here in America is where it really kind
48:19
Speaker 1: of became a big thing. And thanks to a couple
48:22
Speaker 1: of things. In nineteen seventy eight, there was a very
48:25
Speaker 1: popular book published by Hilda Brutsch, the Golden Cage Colon
48:31
Speaker 1: the Enigma of Anorexia Nervosa and obviously and super sad Um.
48:39
Speaker 1: Karen Carpenter was the face of anorexia in America, and
48:43
Speaker 1: America got to see her struggle off and on with
48:46
Speaker 1: this for years until she died from complications from anorex
48:51
Speaker 1: in nine eight three. Yeah, she died basically from oregon
48:55
Speaker 1: failure from drinking too much ipecac over the course of
48:58
Speaker 1: her life. It was a big deal in the United States.
49:00
Speaker 1: I mean that really put it on the map in
49:02
Speaker 1: a big, big way. Yeah. So there is like, if
49:04
Speaker 1: there's a silver lining to the death of Karen Carpenter,
49:07
Speaker 1: and there are very few of those. And if you're
49:09
Speaker 1: too young to know who Karen Carpenters, do yourself a
49:11
Speaker 1: favor and go look up the Carpenters right now and
49:14
Speaker 1: have fun listening to that. Yeah. But ipocac is an
49:17
Speaker 1: a medic, which means you drink it and it makes
49:19
Speaker 1: you throw up. And for the twentieth century, maybe even
49:22
Speaker 1: the nineteenth century, to doctors recommended parents keep that stuff
49:25
Speaker 1: around their house. So if they're dumb little kid, you know,
49:28
Speaker 1: rat poison under the sink, you've give them some ipocactu
49:31
Speaker 1: they throw it up in their life would be safe. Well,
49:33
Speaker 1: they started to realize, especially after Karen Carpenter, that this
49:36
Speaker 1: epocac serve was being abused by UM and XIA patients
49:41
Speaker 1: and believe me, A patients all over the US. And
49:44
Speaker 1: they apparently called for a band on over the counter
49:48
Speaker 1: sales of ipocac, and that directly came from Karen Carpenter's death.
49:53
Speaker 1: But I didn't see that it actually ever went through.
49:55
Speaker 1: Oh really, Yeah, as as recently as two thousand three
49:58
Speaker 1: they were calling for a ban on non prescription epocac sales.
50:03
Speaker 1: And unless over the counter and non prescription are not
50:06
Speaker 1: the same thing, then no, they didn't get it pushed through.
50:10
Speaker 1: Can you buy it today? Do you know at all? Yeah?
50:13
Speaker 1: I mean I believe at the very least you could
50:15
Speaker 1: get it from a pharmacist, but I think you might
50:18
Speaker 1: be able to still buy it in a in a
50:21
Speaker 1: drug store. I'm not sure. I haven't tried, and this
50:24
Speaker 1: was two thousand three, but I didn't see anything about
50:26
Speaker 1: it actually being banned. Well, I just really quickly as
50:30
Speaker 1: you can see here two thousand eight as an article
50:33
Speaker 1: called epochac the most dangerous over the counter drug. So um. Interesting. Yeah,
50:40
Speaker 1: so they've basically just in to that tarnished Karen Carpenter's memory.
50:45
Speaker 1: So treatment is tough because, like we said, there are
50:49
Speaker 1: so many prongs, um, and we don't want to be
50:51
Speaker 1: down on it, because you can overcome this. But the
50:55
Speaker 1: obviously the end goal is is multi pronged as well.
50:59
Speaker 1: What obviously you want just physically is um to eat
51:03
Speaker 1: healthily again, um. But another big part of that is
51:07
Speaker 1: to feel better about yourself and to have a better
51:11
Speaker 1: self image and to overcome this mental illness that's the
51:14
Speaker 1: underlying cause of these physical symptoms. Yeah. UM, if you
51:18
Speaker 1: have a friend or a loved one or somebody you
51:21
Speaker 1: care about that has anorexia UM or bulimia UM, one
51:26
Speaker 1: of the things you can do is just be supportive
51:29
Speaker 1: and non judgmental in the hopes of, like you were saying,
51:32
Speaker 1: kind of help build their self esteem because it is
51:34
Speaker 1: definitely a crisis of self esteem is a big component
51:37
Speaker 1: of it. But what you don't want to do is
51:39
Speaker 1: make them feel bad or shameful for not eating. Um.
51:44
Speaker 1: You don't want to focus on the food because it's
51:47
Speaker 1: really not the food. The food is almost like a
51:49
Speaker 1: convenient UM. Basically, the food is the one thing that, say,
51:54
Speaker 1: a teenage girl can control in her life in some
51:57
Speaker 1: cases how much she eats or doesn't eat, and this
52:00
Speaker 1: becomes manifested in interacts the nervosa. So the idea that
52:04
Speaker 1: that no, just eat the food. What's your problem with food?
52:07
Speaker 1: It really doesn't have much to do with the food.
52:09
Speaker 1: The food is just this um kind of red herring
52:11
Speaker 1: in the whole thing. Yeah, the food is almost like
52:14
Speaker 1: the drug, except the ideas to not take the drug.
52:18
Speaker 1: If that makes any sense. It does not. I thought
52:22
Speaker 1: that was making sense as it was coming out of
52:24
Speaker 1: my mouth. I started to realize it didn't. Right up
52:26
Speaker 1: to the end. Uh, treating it is can be done
52:30
Speaker 1: on an outpatient basis. UM. They have high calorie supplements,
52:34
Speaker 1: dietary recommendations. Obviously, UM, if you have serious medical complications,
52:39
Speaker 1: you might have to have a hospital stay. But they
52:42
Speaker 1: have shown that just putting someone in the hospital has
52:46
Speaker 1: no improvement on the outcome of their mental health. Like
52:49
Speaker 1: you've you've really have to attack it from all angles. Yeah,
52:52
Speaker 1: and that's a big problem too. Is like when you
52:54
Speaker 1: have a medical like medical issues like a low pulse
52:59
Speaker 1: UM and you you are say emaciated, like they're going
53:02
Speaker 1: to take you the hospital, and the doctors are not
53:04
Speaker 1: necessarily psychologists or psychiatrists. Their doctors who are going to
53:09
Speaker 1: try to treat your emaciation or treat your low pulse UM.
53:13
Speaker 1: And that's good, you need that kind of treatment, but
53:16
Speaker 1: it doesn't actually heal the anorexia at all. UM. So
53:20
Speaker 1: there has to be a multi pronged approach. And in particular,
53:23
Speaker 1: if you do need to be nourished, like you're at
53:26
Speaker 1: death store because you haven't eaten and too long and
53:29
Speaker 1: your body has become malnourished in your organs are starting
53:31
Speaker 1: to fail um, you have to go to a specialist
53:35
Speaker 1: in this because I think we talked about in the
53:37
Speaker 1: Angus Barbieri short stuff the idea of refeeding syndrome, where
53:42
Speaker 1: if you introduce nutrients too quickly to somebody who hasn't
53:45
Speaker 1: eaten in too long, they can die basically from overdosing
53:48
Speaker 1: on nutrients. So you have to go to a specialist
53:51
Speaker 1: in in refeeding. It's not just something that anybody can do.
53:54
Speaker 1: The ideally you will catch this long before you could
53:57
Speaker 1: die from refeeding syndrome or anything like that. But it is,
54:01
Speaker 1: it is. It is a concern in an issue that
54:03
Speaker 1: you would want to go to a specialist physician for refeating. Yeah,
54:07
Speaker 1: and it's um we were talking about parents earlier too.
54:09
Speaker 1: It's also interesting that early on Gull and this continued
54:13
Speaker 1: for a while, UM felt that you know, the parents
54:16
Speaker 1: were could be a big part of the problem in
54:18
Speaker 1: this negative influence, especially if like it's all of a
54:22
Speaker 1: sudden it is being treated and parents like, you know,
54:25
Speaker 1: you need to eat and need to eat this, you
54:26
Speaker 1: need to eat that. Uh. And so they would they
54:29
Speaker 1: would move kids out of the home in order to
54:32
Speaker 1: treat them more successfully because a lot of times the
54:35
Speaker 1: parents were contributing to the the whole cause. And to
54:38
Speaker 1: begin with, you know, yep, they would call that a
54:40
Speaker 1: parent ectomy. Oh really, yeah, that's what Goal called it. UM.
54:46
Speaker 1: And so that's like one theory of treatment that the
54:49
Speaker 1: parents are the problem and you need to get the
54:51
Speaker 1: kid away from the parents, not not like get them
54:53
Speaker 1: into foster care or anything like that, but more that
54:56
Speaker 1: the the kids are are being oppressed in some wave
55:00
Speaker 1: by the parents. And Hilda Brooke b r U c H.
55:04
Speaker 1: I'm going with Brooke, Um, yeah, the one who wrote
55:08
Speaker 1: who wrote The Golden Cage. She concluded that the reason
55:12
Speaker 1: for anorexia was that the teenagers were afraid of becoming teenagers,
55:17
Speaker 1: that they just pleased the adults in their parents their
55:20
Speaker 1: whole life, and they were afraid to kind of venture
55:23
Speaker 1: out on their own. Um. And so this was some
55:25
Speaker 1: means of control. Maybe I'm not sure, but it definitely
55:28
Speaker 1: goes in with that paran ectomy thing where if you
55:30
Speaker 1: take the kid out and um teach them to take
55:34
Speaker 1: on this disorder on their own, it can really boost
55:37
Speaker 1: their self esteem quite a bit and potentially cure anorexia.
55:40
Speaker 1: As it is, that's one theory. There's another that basically
55:44
Speaker 1: is the opposite. It says, hey, family, let's let's get
55:47
Speaker 1: together and help this. That's right, it's like a family therapy.
55:49
Speaker 1: It's it's the Maudsley method. And this was based on
55:54
Speaker 1: the work of psychiatrist named Salvador, not Maudsley. Salvador uh, Menuchin. Yes,
56:02
Speaker 1: it's not the Manuchian method, though no one knows who
56:05
Speaker 1: Monsley is. Maybe that was his hotel pseudonym maybe. But
56:08
Speaker 1: this is like you said this, and this makes a
56:10
Speaker 1: lot of sense to like getting the whole family in there,
56:13
Speaker 1: because uh, if you go to therapy as a family
56:17
Speaker 1: or as metallica, uh, it's gonna it's gonna bear fruit
56:22
Speaker 1: most likely because especially with something like Interrexi and bolimia,
56:26
Speaker 1: that's there may be a lot of tendrils throughout your
56:29
Speaker 1: family that is, uh is potentially causing some of this
56:33
Speaker 1: to begin with. So get mom and dad in there,
56:36
Speaker 1: get brothers and sisters in there, and and I'll talk
56:39
Speaker 1: it out. It will probably help everyone involved. Get weird
56:42
Speaker 1: uncle al in there, oh no, never, just keep him
56:45
Speaker 1: at Thanksgiving and keep them quiet. But one of the
56:47
Speaker 1: things I saw about that family method is one of
56:50
Speaker 1: the techniques to use is called externalizing, where they're saying
56:53
Speaker 1: where they basically say, you have an interloper in your
56:56
Speaker 1: family known as this eating disorder, and need to come
57:00
Speaker 1: together as a family to get this eating disorder out
57:03
Speaker 1: of your family. You like, you guys, gang up as
57:05
Speaker 1: a family against the eating disorder, not against the person
57:08
Speaker 1: with the eating disorder or against one another, getting up
57:11
Speaker 1: on the eating disorder and support the person with it
57:13
Speaker 1: to help him right, Which is great. And like we said,
57:17
Speaker 1: you can recover from an eating disorder. JOHNS. Hopkins says
57:21
Speaker 1: that fifty to seventy five of patients with anorexia or
57:25
Speaker 1: bulimia will eventually recover. It's a lot. It's a really
57:32
Speaker 1: great recovery rate for what is ultimately, um a chronic
57:36
Speaker 1: mental disorder. Yeah, and can we shout out a website here? Yeah,
57:41
Speaker 1: there is a website called alsana dot com and it
57:46
Speaker 1: is an eating disorder Helpline of all stripes. So anorexia, bulimia, UM,
57:53
Speaker 1: I imagine bench eating, any kind of eating disorders. You
57:56
Speaker 1: can call eight eight eight eight to two eight nine
58:00
Speaker 1: three eight at any time and someone is going to
58:02
Speaker 1: be there and try and help you out. And you
58:05
Speaker 1: know we talked about all the time, just that first
58:07
Speaker 1: step super crucial. Yep, good job, thanks you too. Uh. Well,
58:14
Speaker 1: if you want to know more about eating disorders like
58:17
Speaker 1: an rexia or bulimia, you can go to where Chuck
58:20
Speaker 1: just sent you, or you pick up the phone and
58:22
Speaker 1: call and uh you can also just hold tight and
58:25
Speaker 1: wait for listener mail, which is coming right now. That's right,
58:28
Speaker 1: And yeah, we we should mention there are there are many, many,
58:31
Speaker 1: many helplines and many organizations. But again, everything I've seen
58:35
Speaker 1: is if you suspect that your friend or loved wine
58:38
Speaker 1: or sister or son or daughter has a eating disorder,
58:41
Speaker 1: like you need to confront it. They don't just clear
58:44
Speaker 1: up on their own. And it's not just a lifestyle choice. Yeah,
58:47
Speaker 1: that's right. The National Eating Disorder Helpline is another one
58:50
Speaker 1: E two to seven. N's to put that in our
58:55
Speaker 1: in our slogan or motto on the T shirt. Well,
58:58
Speaker 1: how about this, UH have a great listener mail today.
59:01
Speaker 1: So let's just encourage everyone to look out for their
59:04
Speaker 1: friends and family. And if you have someone in your
59:07
Speaker 1: family that you think may be suffering from one of
59:09
Speaker 1: these disorders, then UH reach out to them with compassion.
59:14
Speaker 1: And if you have one of these disorders, call one
59:16
Speaker 1: of those numbers and just take that first step toward
59:19
Speaker 1: getting some help. Yeah, very nice, Chuck, Thanks. I think
59:22
Speaker 1: that was even better than any listener mail. Of course,
59:25
Speaker 1: I've heard a lot of listener mail. Anything is better
59:27
Speaker 1: than listener mail. Tops. We're just kidding. We love listener
59:31
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