Disordered Eating, Body Image and Dieting Truths With Melainie Rogers - Eating Enlightenment Podcast
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Feb 20, 2023
Here’s a quick summary from my most recent podcast conversation with Melainie Rogers (Balancedtx.com and @Balancedtx): - The 3 Signs To Tell If You Are A Disordered Eater Or Have An Eating Disorder - Why Eating and Body Image Disorders Are On The Rise - Why Dieting Fails https://eatingenlightenment.com/2020/04/16/balancedtx
View Video Transcript
0:00
So, hey, Melanie, we're going to get started as dive in
0:04
I know you have a lot to say, a lot of thoughts about emotional eating in isolation, especially
0:11
during these crazy times. What is the difference if someone is trapped at home and their eating habits have changed
0:19
they're eating more or they're eating more disordered? How does that person know if they are a disordered eater or if they actually have an eating disorder
0:30
That's a great question, Jared. And what it comes down to is intensity, frequency of eating, and also how obsessive you're thinking and feeling
0:43
so because the difference between disordered eating and a full-blown eating disorder is really
0:50
the same group of symptoms but on a spectrum so more ramped up is a full-blown eating disorder
0:56
less so less less frequency less volume less um um sense of uh of feeling distressed about
1:06
the behaviors is more disordered eating and honestly from a population perspective far more
1:12
people fall into the disordered eating or kind of a bit obsessive with food than having a full-blown
1:18
eating disorder but the full-blown eating disorder folks are the people that we tend to hear much
1:23
more about in the media. Do you have any idea of the percentage of people that are disordered eaters
1:30
versus full-blown eating disorders? Well if I start with what we do know and engineer backwards
1:38
is we know that 10% of the population at any one time
1:42
will develop an eating disorder, 10%. So that's binge eating disorder or bulimia or anorexia
1:49
or some composition in between, right? So that leaves 90% of people who won't develop
1:55
a full-blown diagnosable eating disorder. But I would hazard a guess. Now, I live in New York, and I would suggest
2:02
that close to the other 90% have some kind of disordered eating
2:11
And by that I mean people in this current day and age
2:15
with social media being what it is and the messaging that we get in our current culture around the thin ideal
2:21
or the macho guy pumped up ripped kind of ideal, it's hard unless you're living under a rock
2:28
It's hard to not be influenced by that messaging. and it's hard to also not be influenced by all this so-called health and wellness messaging around
2:37
you should be doing this with your food or that with your food or whatever so I would suggest that
2:42
most people have played with how they eat and what they're eating or what they're not eating
2:50
etc to some degree now a certain percentage of those will then start to get really obsessive
2:55
about it and my god we see a lot of that we see a lot of that I think through social media so for
3:01
example, I've seen some Instagram stuff where people are taking photos of how they've set up
3:07
their fridge. And it's like, oh my God, OCD out the window. I feel you. And I do want to talk about
3:15
social media just a little bit, but you mentioned three symptoms, we'll say, frequency, amount
3:23
and distress. Do they always go hand in hand? Or do you feel that sometimes people are
3:30
eating a lot very frequently but aren't distressed about it? That's a great question
3:36
If people are eating a lot very frequently and they're not distressed about it? Or maybe they're distressed but they're eating a lot but not very frequently
3:48
or they're eating frequently and they're distressed but it's not a lot
3:54
Do all three symptoms go together? um to get it to a place where it starts to get a little bit out of control um i would say yes
4:03
but i think also that when we talk about normal eating that if someone's eating a little bit more
4:10
frequently than usual and they're noticing it and they know that they're stressed but they're not
4:16
distressed about it because they know it's very circumstantial i would say that that's an expansion
4:21
of normal eating because we all have moments when we're either for anxiety usually we're either
4:26
eating a bit more or for some of us we're eating less because we lose our appetite when we're
4:32
distressed and those might be just for certain periods of time we know that that's kind of how
4:36
we roll and I would again expand and say that's kind of just kind of your normal but for people
4:42
where it's ongoing and there's a lot of distress about it and they don't feel that they can control
4:47
it nor do they feel that there's a light at the end of the tunnel and it's not just due to some
4:52
short-term things such as right now with COVID-19, right? So I would suggest that those are the people
4:59
where it's much more into a disordered realm. I mean, I hate to label people. No, I feel you
5:05
Yeah, really just about, hey, if this is saying to distress you, then this is not okay because
5:11
distress is also not healthy for us, right? Absolutely. And what if COVID goes a really
5:20
long time. I understand what you're saying about how if you're anxious for a moment, it's pretty
5:26
normal and it's to have some food to cope with that and it's okay in some respect. But what if
5:33
COVID goes, let's just say six months a year and that temporary month of anxiety turns into something
5:39
much longer, would that be cause for an eating disorder? It could be. It could be. What would
5:48
have to happen for it to snowball into an eating disorder is the distress would have to start
5:53
ramping up right so if you were just going along and saying okay well for another six to twelve
5:58
months I just fully accept that I'm going to be overeating and I don't really have any thoughts
6:03
or feelings about that I would also be curious about what's going on for that person that they're
6:07
not so curious about that because it'd be kind of like let's translate it into alcohol let's say
6:13
that for right now, I'm not me, but let's accept that, you know, I'm going to have instead of one
6:19
glass of wine a night, I'm having two glasses of wine a night. And I'm going to be doing that for
6:23
the next month or two. And then if I said, well, now this could go on until a year. So are you
6:29
comfortable consuming that amount for the year? Then you might stop and think and think, God
6:33
I might have an alcoholic problem if I drink this way for a year. So maybe I need to start
6:40
modifying now. Do you see what I mean? So it's the same with food. And also if you're overeating
6:46
there may be weight gain tendencies that could start to happen, which could start to cause
6:51
concern around, you know, are my joints starting to hurt? Is this actually where my body's supposed
6:59
to be hanging out at from a weight perspective? And now artificially something's happening that
7:05
I'm inflating my weight and can my body handle that? And so there's a whole lot of different
7:09
scenarios that start to come up. And yeah, and the social stigma about being in a larger body
7:16
all that stuff. I'll get into this body image. Just one more question about this. When someone
7:22
is in the disordered phase, I feel like it's such a challenge to admit they have a problem
7:29
whether that's an official eating disorder or just I'm a disordered eater
7:34
what's your best piece of advice i know you have probably tons of wisdom on this but what's your
7:40
like top piece of advice on how should someone accept or admit that they have a problem around
7:47
food denial is part of the illness so denial is part of eating disorder thoughts because it
7:56
hijacks your brain starts to distort things so there's going to be an underestimation of how
8:04
much it's impacting your life so the question I like to ask is that is this impacting your life
8:09
in any way so for example your friends call you and say hey let's go out to eat dinner after COVID
8:16
of course and your first thought is what kind of restaurant what kind of food I don't know what
8:22
we're going to eat and therefore based upon they say we're going to do Italian and if you think no
8:27
I can't do that sorry guys I'm not coming that's a life disruptor I mean that that's that's kind of
8:33
that starts to get into a tricky terrain having someone admit that it's
8:39
starting to disrupt their social life and then thinking maybe I should do
8:43
something about this is a whole other like that that's that's really really
8:49
tricky what we know though is that when people start to make decisions or have um decisions around food disrupt their day patterns they at risk for when there a further
9:03
a future um anxiety or trigger or a lifestyle milestone a divorce or kids or something
9:11
it could really tip them over and into more full-blown symptoms so i code it wow yeah exactly
9:19
Exactly, exactly, Jared. Like we are seeing inquiries go through the roof right now
9:23
because of COVID. As what you said earlier, you know, people are stuck inside
9:28
the fridge is always calling their names, you know, or people are getting really obsessive and thinking, okay
9:35
this is my time to have that perfect workout and eat perfectly
9:38
and whatever else and they're getting really obsessed. They're channeling their anxiety into either overusing food
9:45
or underusing food or orthorexic tendencies, perfect eating with food um and and working out obsessively for some people that makes a lot of
9:55
sense and they're seeing some of these images on social media like a perfectly organized
10:00
refrigerator and you know 28 days of meal prep and who are these people it seems ridiculous
10:08
but um you know I understand that for some people that's the way that they channel their
10:17
anxiety and that that's how I see it you know was what just a quick question just was it specifically
10:26
social media or the internet like social media I think Facebook came around in 2009 but maybe the
10:32
internet was before that I know you have a lot of experience you know studying get your studying
10:38
at the obesity center and leading your groups in New York well before the internet did you see
10:45
an increase in eating disorders with the internet or was it specifically social media
10:49
it's a good question I think there I think there there are grades up so pre-internet so if you
10:59
think of internet um I think of internet starting around well pre-google we were kicked in around
11:05
what in the 90s right so with internet with the internet became more access to um
11:13
uh imagery and photoshop right so before that there was only print media so there were magazines
11:22
so I'm fully recovered clinician myself and when I had an eating disorder back in the day
11:27
um it was just as the internet was was starting up but mostly imagery was um confined to fashion
11:36
magazines you know or movies and watching and comparing yourself to celebrities or whatever
11:41
so then we saw the internet so we saw more imagery readily available so I would say that
11:47
body image angst would have increased again at that point and then with social media it's gone
11:53
through the roof I can see that because all these people are comparing do you know do you have a
11:59
sense of how how rapidly it's increased like a percentage like it's increased 500 each year or
12:07
anything like that? There are really good stats on this on the NIDA website. They have some really
12:13
great stats where they go study by study by study. I can't cite an exact percentage just off the top
12:18
of my head as I'm thinking about it. But one thing I'd like to add to that conversation, that timeline
12:23
Jared, is something else that was really, really important that was a driver in all of this is not
12:29
just the prevalence or the access to imagery for comparison. And I'm talking probably predominantly
12:37
talking about females historically and now unfortunately we're seeing a lot more guys
12:43
who are falling into this as well. But at a conference I went to a couple of years ago
12:51
they did a timeline of BMI of models and what they found is that, you know, 20, 30 years ago
12:59
the average model was a lot more curvaceous and then as over the decades the models became thinner
13:06
and thinner so much you know like Kate Moss etc so much so so she's a model of my generation
13:12
of my um you know when I when that would have been an influence for me but the point of that
13:18
being is that we got to a point with models where models were getting so skinny in the on the BMI
13:26
range that Italy had to impose you know a minimum um you know a minimum of 18.5 on a BMI because
13:34
models were dropping dead. So what's important when you look at the research around this is not
13:39
just exposure to social media, but it's the thin ideal becoming thinner and thinner and thinner and
13:45
thinner over the decades that has caused this, or caused, I would say that there's some good stats
13:51
that suggest this, that when you're comparing, you're seeing a thinner and thinner and thinner
13:55
ideal, and it just gets crazy. Yeah, interesting. I wonder what's more responsible for
14:04
the rise of eating disorders the the social media or the the body image i think they're so interlinked
14:13
um so we know that we know that the majority of eating disorders there's a genetic predisposition
14:19
and so therefore that hasn't gone away but with any genetic predisposition you also need an
14:26
environmental trigger to basically turn it on right um and so if you think about these layers
14:34
together where we've got a thinner and thinner ideal more and more access to comparisons
14:40
more and more um diets that are readily available because you can just google anything now
14:47
um and and and put all that together with higher anxiety because we know that social
14:55
media actually increases anxiety and depression so there's a mood piece that goes with eating
15:00
disorders as well you've got kind of a perfect storm there you know I'm just feeling so much
15:06
obsession like hearing you speak right now just obsessing about the body image you're being you're
15:13
anxious already from uh you know less social connection in general and and and more stress
15:20
these days and and then all that anxiety being channeled into obsession absolutely absolutely
15:28
i mean it's an oversimplification but i tend to think of eating disorders as um a manifestation
15:35
of just overwhelming anxiety you know and in a similar way um again this is a um this is an
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oversimplification but just to kind of get a handle on it alcohol use as well you know obviously
15:48
trauma anxiety those kind of elements where you have a lot of discomfort within yourself
15:54
and so you're trying to figure out a better way of just feeling better and so channeling your
16:02
anxiety into something that you feel you feel you can control how many calories you eat or how much
16:07
you exercise or how much you weigh although that's not necessarily controllable but we think
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can control it helps to channel that anxiety in the same way that alcohol or drugs for a moment
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gives people a respite from the discomfort they're feeling in their body or their mind
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Yeah, and that leads beautifully to the overall topic about dieting, about why diets don't work
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and etc. So someone, let's say someone starts a diet because they want to, on the surface they
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want to lose weight but oftentimes it's they want to control their emotions they want to channel
16:46
that anxiety um why does approaching weight loss from an anxiety control if your real reason i mean
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maybe any reason for weight loss is bound to fail but uh why doesn't why don't diets work especially
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when you're channeling that anxiety diets don't work uh for a number of reasons but probably the
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primary thing is first and foremost physiological and we we've known the physiological and biochemical
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consequences of dieting for more than 15 years now in a nutshell one of the key things is that
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when you lose weight below what your body normally is designed to be at from a genetic perspective
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your body fights back like it wants to be at the weight that it's designed to be at for optimal
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health Now that weight may be someone who has a BMI of 22 or 23 and if you look at social media and the magazines those images will say you overweight but in fact that the perfect body weight for you So the body fights back And most importantly I think a real important
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source of information for me in my studies was I was at a lecture at Columbia University
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and one of the professors was talking about fat cells. And it was like the pivotal key for me that
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made it all make sense. But basically, if you think of a fat cell as a little storage unit
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and its goal is to stay full of fat so that if you run out of food
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you've got energy stores to rely upon so you don't die. So when you lose weight, you don't lose fat cells
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you just lose the content in the fat cells. So the fat cells kind of shrink down and now they're semi-empty, right
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And that's when you lose weight. But guess what? That fat cell is not designed to be empty
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It's designed to be full. So the fat cell is not just sitting there doing nothing
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It's an active cell. So it's going to fight back and send signals to the brain and say
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please eat, I'm supposed to be full. So you get all of this increase in hunger
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You get all of this increase in chemical signals going to the brain. Seek out food and please eat and keep eating
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until all those fat cells get filled up again. And that, I feel, is one of
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there are a lot of mechanisms but that's one of the key mechanisms that I think we totally miss
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with the whole weight loss piece that therefore your body is going to fight back and it's a
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physiological response I think the biggest thing there Jared if I may that makes me honestly really
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angry is that people don't know that and when they start to eat again and overeat and so-called
19:30
fall off the wagon then we say oh you don't have enough willpower you couldn't sustain it
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it's your fault and it's not you know and that's the biggest joke that the weight loss industry has
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played on uh the population isn't it horrible it is it's horrible so unethical on so many levels
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i can't even tell you i know it's horrible and and they know you're speechless right now right
20:01
No, no, I mean, I'm just, I know, but it's horrible when you think about it
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I mean, if you go to weightwatchers.com and you go to, I think weightwatchers.com slash
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research, they have all these studies, right? But at the very first paragraph of like, before all they list all their studies, they say
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like, we find a lot of evidence for our program that works, but like all of our studies are
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only measured up to six months. Of course they are. So they say all of our studies work, but, you know, we're only counting the ones that are up to six months
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It's horrible. It's horrible. Because as we know, if you track anyone three to five years out after a weight loss attempt
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then 95% of people will have regained their weight plus some. And it's the plus some, the extra pounds that they've gained because they've messed up their metabolic
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they've messed with their body composition. and so each successive weight loss they go through there'll be weight gain weight regain plus some
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plus some plus some and now you're 20 pounds above where your body was designed to be
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and you may have health consequences you may have health consequences as a result of that so
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it's it's actually very very damaging and I think that there could be certainly some
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some ideas around the idea that the weight loss industry has significantly
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contributed to what people are now grappling with, which is more and more people struggling with being at a higher weight than
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they originally may have been. And, and the distress that is, is that goes along with that. So the joke here, I think it's not a joke
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That's not the right word. The irony is that the more we've focused on weight loss and all these weight
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um diets out there um as a society and i'm australian it's the same in australia
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as a society our average bmi has increased not decreased right and you're gonna ask the question
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what the hell's up with that it is very tricky how humans were so short term and we you know
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weight washers were whatever works for a few months and it's like this illusion that it's
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working it's very hard to to not blame yourself you know you see you see yourself working hard
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and you lose the weight and you think it's under your control and then your fat cells get empty and
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then and then your fat cells so tell me about this so your fat cells when they're empty they
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basically control your brain to overeat right like you lose control they send more signals to the
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grain eat eat eat yeah is it is it possible to to override them well that's what pharmacology
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is looking into that's what big farmers looking into right um and so the only thing we've come up
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with i say this in inverted commas because i know this is a podcast but in inverted commas
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what they've come up with to successfully help around this, you know, Vyvanse, et cetera, which are just stimulants
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So it's kind of like just if you do a lot of cocaine or a lot of Adderall, you'll be able to
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it suppresses your appetite. So that's the best that they've come up with
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I mean, there's a couple of other medications out there around insulin response and things of this nature
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but they're scrambling. And the thing is, you know, I've presented just one aspect of how our body weight is, how the body strives to keep equilibrium with our weight
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So it's very multifaceted. And from working at the Obesity Research Centre, you know, I know that there are over 100 chemicals at least involved in this very, very, it's like an orchestrated response
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It's a very delicate and very sophisticated orchestrated response with a lot of redundancy
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because obviously you don't want just one mechanism that controls if you're hungry or
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not because if that mechanism gets out of whack, you die because there's no backup system
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Like if I forget to eat and that system's not working anymore, I'm just going to continue
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to forget to eat and then that's it. So there's a lot of redundancies, et cetera
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The point of that being, Jared, is just that it's really complicated and therefore to try and find one key medication that could work, I only can imagine would be very difficult
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I know it seems like the appetite suppressants that speed you up will just, you know, you speed up and then you crash back down later, back down like a cup of coffee or something like that
24:51
You know, they work for as long as you're on them, but they've also got their own risks
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So, you know, if you come off that medication, it's not like your physiology has changed or your behaviors have changed
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So you're likely to just regain the weight. Yeah. Are there any, what's one of the best tips you have for someone who is struggling to understand that when they lose control, it's not their fault
25:20
Or rather, yeah, how does someone kind of let go of that shame like that
25:24
it's my fault I lost weight I'm lazy or I gained weight I'm lazy that voice
25:29
there's I mean talking about that voice can be a whole book it can be a whole thing
25:35
but just what's like one piece of wisdom you have about counteracting that voice that it's your fault
25:42
we use radical acceptance um at at my treatment center radical acceptance is kind of accepting
25:50
what you, you know, kind of like that mantra that's often used
25:55
in Alcoholics Anonymous, accept what you can't change, change what you can
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But also I think it's education then, isn't it, knowing that it isn't your fault
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So first and foremost you have to know that it's not your fault to therefore not take it on because the diet industry will tell you
26:10
it's your fault. So I therefore think it's so important that the anti-diet messaging
26:18
that is starting to gain momentum now, thank goodness. I'm hoping that more mainstream, the mainstream population
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not just in our eating disorder and disordered eating field, we've known about this stuff for ages, but mainstream population
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if they hear more and more about this science and therefore they get to that point of realising hey what up with this This isn my fault after all that will help so education will help in being able to say this is not my fault okay but therefore what do I do now
26:52
you know um yeah and once person once that person is able to say it's not my fault
26:58
they practice that radical acceptance which is which is really radical can you describe that
27:04
briefly radical acceptance is is is really just in the moment where you feel like you want to scream
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just just saying okay I can't do anything about this so I'm just going to accept it for what it
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is right now and and and literally going through that cognitive process with yourself
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it can be really freeing because there are things that we can hang on to and we ruminate right that's
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how our brains go when we have anxiety we ruminate this is my fault I'm worthless I'm lazy just like
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my mother told me or whatever whatever whatever like it spirals you go down a black hole and so
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to really just kind of put a pause on all that internal stuff and just say I can't I've done
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the best I can do I can't change this this is physiological at this point it is what it is I
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hate it but for right now I'm just going to have to accept it because otherwise I'm going to be
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just beating myself up and that's a lot worse so it is it is that cognitive process yeah it seems
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like so much of this comes back to rejecting diets and intuitive eating that's the number one
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principle what's the most important principle for you is it is it rejecting the diet first or is it
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is or is there is there some other and more important principle than that
28:27
i think and it's it's not something that our clients readily embrace um is you have to i
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think at first come to some understanding that your genetics are your genetics like if you have a
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what i forget it's like a meta uh there's some word for a bigger body basically um but if you
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have a naturally bigger body kind of making some peace with that yeah if you're in a higher weight
28:56
body or whatever body you're in because I think that no matter our bodies I mean you talk to
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supermodels and they'll tell you that they don't like aspects of their body so I don't think any of
29:06
us are escape that but no matter our body to find some way to at least be neutral our goal with our
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clients is to move them from hating their body to just body neutrality I don't need you to get to
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body love because that can be like too far a stretch and feel like these people are on something
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because there's no way I'm loving my body but just to try to accept or at least intellectually go
29:35
through the process of saying okay these are my genetics just like I can't change my height or I
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can't change my hair color or I can't change my eye color I was born with a genetic predisposition
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to be more or less a certain weight within a range, right? And to try to embrace that reality can give you a little bit more compassion
29:55
with accepting your body for what it is and also accepting your body
29:59
for what it can do for you as opposed to the externalisation of my body is supposed to look a certain way for me to be accepted
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which is what we promote in society, but it's so, as we know
30:11
artificial and BS at the end of the day, right? I mean, I say that in a way
30:44
But she has dieted many times before and done that whole cycle
30:48
So she's, let's say like, I hate to put a number, let's say 400 pounds
30:53
I'll just use a huge example. So she knows that her jeans are naturally bigger
30:57
but she also knows that her current size is bigger than her jeans
31:04
That can be hard to accept. Do you have any advice for someone who's bigger than their jeans
31:11
yeah this is the tricky part jared um and i hope that anyone who's listening to this might reach
31:21
out to you or even you know via you to me for further explanation because it's it's it's
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complicated but the reality is is that if you've gone on diet after diet um you've changed your
31:32
body composition and your metabolic rate um at this juncture we we think that there are irreversible
31:40
changes that have occurred biochemically and one of those is that those fat cells I was telling you
31:45
about we're born with a genetic blueprint of how many fat cells we actually have in our body and
31:51
when you go through particularly with clients who struggle with binge eating disorder and they go
31:56
through rapid weight gain over time if you if you if you gain a certain amount of weight and that
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number is is is not really clear but let's say 50 to 100 pounds above where you were genetically
32:09
you know going to be hanging out at we think that those fat cells actually uh then have to duplicate
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because they you max out your storage and that once you duplicate your fat cells you've got more
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fat cells signaling to the brain to keep full so we feel that from this research that becomes the
32:30
irreversible part of this so you're right that for our clients who and this is the stuff that
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breaks my heart and this is breaking my heart right now and I appreciate you for telling it
32:42
the way it is it's heartbreaking so you you're in a situation now where you can't reverse the
32:47
so-called damage of the dieting so then and this is where I think that health at every size and
32:54
that movement has really helped a lot of people in the sense of we can't necessarily now control
32:59
where our weight is but we can be the healthiest version of ourselves at whatever weight we are
33:06
which is really the principle of health at every size, um, is, is to try to be the healthiest
33:14
version that you can be. So that means having some activity and trying to be mindful of what
33:19
you eat and make sure you get your vitamins and minerals and you get enough sleep and you try to
33:24
reduce your stress and everything that we try to promote. Right. So, so that, that's, that's where
33:30
that is. Um, thank you so much. That actually clarified something for me right there too
33:35
because, yeah, that helped me right there as well. And, yeah, and thanks for just speaking the truth
33:45
It's a heartbreaking thing. Yeah. I mean, it is the truth, so we've got to face it
33:54
I mean, but that next diet just seems so appealing, right? It's so, you know, I don't want to believe you
34:05
that I'm, you know, irreversible. That's, that's horrible. You know, I want to be like, yeah, it's
34:11
it's tricky. And I do want to wrap up a little bit because, but you know, please, please, please
34:17
tell us about your, your center in New York and yeah, tell us about the center and where people
34:26
can reach you and all that. Absolutely. Thanks, Jared. So I own and run balanced, balanced eating
34:33
Disorder Treatment Center and our website is balancedtx.com and you can check us out online
34:41
and we have an Instagram account and Twitter and all the rest of it and we have we have free
34:46
a free 20-minute consult call with our admissions people who are all trained therapists if people are
34:53
wondering about themselves or maybe want to know about hey my friend or family member is kind of
34:58
got these behaviors. What do you guys think? Um, and we also have a really great free downloadable
35:04
Jared, um, uh, redefining wellness, which is our response to the diet culture. And also we took on
35:11
Weight Watchers two years ago when they came out with a free diet program for teens. And, um
35:18
and this was our, our response to that. So that's a free downloadable book that people can download
35:22
as well. That's balancedtx.com. This is Melanie. Thank you so much for coming on. I have really
35:32
appreciated it. It was really fun, Jared. Thank you
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