It Starts With Attraction
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It Starts With Attraction
Anorexia, Bulimia, and Binge Eating - The Science Behind Eating Disorders
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Eating disorders are more common than you might think, affecting millions of women and men. In this episode of It Starts With Attraction, Kimberly Beam Holmes and Jason Marcum dive deep into the different types of eating disorders – anorexia, bulimia, binge eating, and more. They explore the devastating consequences of these conditions and share heartbreaking personal stories that shed light on the struggles faced by those affected.
Discover the warning signs, risk factors, and available treatment options for eating disorders. Learn how social media, societal pressures, and even childhood experiences can contribute to the development of these complex conditions. Kimberly Beam Holmes and Jason Marcum provide valuable insights into how to support loved ones who might be struggling and emphasize the importance of early intervention.
Join us for this important conversation as we break the silence surrounding eating disorders and offer hope for recovery. If you or someone you know needs help, don't hesitate to reach out to the resources listed below. Remember, you are not alone.
Key Points:
• Shocking statistics: Discover the alarming prevalence of eating disorders and the devastating impact they have on individuals and families.
• Real stories: Hear personal experiences from Kimberly Beam Holmes that highlight the struggles and challenges faced by those with eating disorders.
• Warning signs and risk factors: Learn to identify the signs and understand the factors that can contribute to the development of eating disorders.
• Treatment and support: Explore available treatment options and resources for those struggling with eating disorders and their loved ones.
• Breaking the silence: Join us in raising awareness about eating disorders and offering hope for recovery.
Resources and Options for Help:
• National Association of Anorexia Nervosa - 1 (888) 375-7767
• National Eating Disorders Association - 1 (866) 662-1235
• Diabulimia Helpline - 1 (425) 985-3635
• Feast (Families Empowered and Supporting Treatment for Eating Disorders) Remember, It Starts With Attraction is committed to supporting your emotional, intellectual, spiritual, and physical well-being.
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Kimberly Beam Holmes has applied her master's degree in psychology for over ten years, acting as the CEO of Marriage Helper & CEO and Creator of PIES University, being a wife and mother herself, and researching how attraction affects relationships. Her videos, podcasts, and following reach over 500,000 people a month who are making changes and becoming the best they can be.
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In today's episode, we're going to be covering eating disorders. Now, this may be a sensitive topic for several listeners, but I want to encourage you, if you can, without being triggered or being uncomfortable, to listen to today's episode. Even if it may not be you that is struggling or in the past has struggled with an eating disorder, there may be someone that you love that is struggling and towards the end of the episode, we're specifically going to be getting into how you can help someone you love who may be struggling with an eating disorder. Now why are we covering this on today's podcast? As a woman, I know that eating disorders are twice more common in women than they are in men, and I know that they are relatively common. We'll get into that when we get into all of the stats and different things about eating disorders, but it's important.
Speaker 1:There is such a weight in society of looking a certain way, eating a certain way, being a certain way, wearing a certain size of clothes that is detrimental to women and men's health overall. Women aren't the only one who struggle with eating disorders. Men do as well, and in today's episode, while we will specifically be covering eating disorders things like anorexia, bulimia, binge eating and the sort. There's also disordered eating. We're not going to be touching as much into all the specifics about disordered eating, but disordered eating is different from eating disorders in the sense that disordered eating is when a relationship, a person's relationship with food is unhealthy to the sense that they begin omitting complete food groups, they begin to have fear around food and it can really begin to have some of the foundational beginnings of turning into an eating disorder over time. And I believe that this has become way more common, especially disordered eating. So today's episode is important. Why does it matter to our physical, intellectual, emotional and spiritual health? Well, eating disorders are really kind of a combination of the four. When someone is struggling with an eating disorder or disordered eating, they don't feel good enough. They typically use the eating disorder, not that they're necessarily choosing it, but the eating disorder is a way to feel like they are in control and it can lead to some very unhealthy habits and all of those things can kind of intertwine. Physically they want to look a certain way. Intellectually they're trying to be in control of something Same with emotional, spiritual they may not feel like they're good enough and so it really does kind of take over a person's life. But there is hope and there is freedom on the other side. So what is an eating disorder as we jump in, psychiatryorg defines an eating disorder as behavioral conditions characterized by severe and persistent disturbance in eating behaviors and associated distressing thoughts and emotions.
Speaker 1:Now, there are several types of eating disorders and we're not going to be getting into every single one of them in today's episode. We're mainly going to be covering the top three, but there are several, just so you know. The first, and perhaps most common one, and absolutely the most deadly one, is anorexia nervosa. Anorexia is self-starvation and weight loss, resulting in low weight for height and age. So these people are going to end up experiencing extremely low body mass index for their weight and for their height. And there really is a cognitive aspect of this, to where the person, even though they are very skinny most of the time they are very skinny and can see in the mirror that they are skinny the way that they actually see themselves is not the way that everyone else sees them. So there's a neurological aspect that is affected, not in the sense of like brain chemicals although maybe but like they actually see themselves differently than everyone else sees them. This one is the highest mortality rate of any not just eating disorder but psychiatric disorder. And the caveat for that is other than opioid use, which is a little bit different because it's an external substance that you're bringing in.
Speaker 1:Now there's two types of anorexia nervosa there's the restricting type and there is the binge eating and purging type. So the restricting type is where individuals lose weight by dieting, fasting or excessive exercising or a combination of those three, whereas the binge eating and purging type the individuals engage in periods where they eat a ton of food and then they purge through, most of the time bulimia. And then there's the binge eating and purging type where, in this type of anorexia, the person might eat and they might look like they're eating a normal amount of food, but then they have a system, kind of a rhythm that they're in, where they will eat food and then they will get rid of that food, either through trying to make themselves throw up, overuse of laxatives, different things like that. We'll get into more of that next when we talk about bulimia. But here's the thing, and this is why anorexia and even bulimia is something close to my heart.
Speaker 1:In high school I had a friend who struggled with both of these things, and this friend was, I mean, a wonderful and amazing person, but she I mean this affected her life. She ended up in rehab, she ended up just in a really difficult spot and situation, and so I saw firsthand what it looked like for someone to go through this. And not only seeing it firsthand, but there was definitely at the time that I was in high school, and not just with that friend, but there was an overarching kind of fad. I hate to put it that way, but there were many girls who would look at these pro-ana websites is what they were called so pro-anorexia websites and just look at how skinny these people were.
Speaker 1:And for a very short period of time, I was drawn into this and I remember going weeks on end trying to not eat because I thought that's what I was supposed to do as a girl and that's what I needed to do to be pretty and for all of the boys to like me, and it was very I mean, shaming isn't even the like there's not even a word I can think of right now strong enough when you're in a mindset where you think like I can't eat, which is something your body absolutely has to have and absolutely has to be able to do in order to survive and thrive to any extent. And then actually eating food leads when you're in that mindset, you feel ashamed to even just eat an apple and there's this shame cycle that begins within a person that can become incredibly difficult to break out of. It's one of the reasons that this is so important because, especially in adolescence, this is a very common type of the eating disorders. If someone's going to have it and we'll get into the stats a little bit more later but adolescence is kind of the peak time that this shows up in a person's life and there's so many changes happening in a person's body, especially in girls' bodies, and there's hormones and there's boys and all of these things that are happening where, ultimately, we want to be loved. And when these other ideas are kind of introduced into our minds as the option to go to, to be loved, it can be really hard to resist from engaging in some of these very destructive behaviors, such as anorexia.
Speaker 1:Bulimia is the next most common one bulimia nervosa, where individuals alternate between dieting or eating very low calorie, safe foods. I remember that celery was a safe food and kind of the idea was celery, it's so low calorie and has a lot of fiber. This isn't true, but what they would say is you burn more calories eating celery than celery gives you, and so that was kind of like a safe food for people to eat when they were going through this and then in the binge eating so bulimia, individuals can alternate between the dieting and eating low calorie foods, but then they'll have times where they begin to binge eat what is considered the forbidden foods and the more high calorie foods. We mentioned this back with anorexia as well, and one of the reasons that I mean, we're not going to get into all of the psychology and the neurobiology of what happens in a person's mind, but ultimately, if we just look at the physiology of it, people get so hungry that they get to a point where they kind of can't resist anymore, and so they end up eating a ton of food, number one because their body is hungry, but then number two, because the more that you try and resist something this is the psychological part of it the more tempting it is to want to indulge in. And so there comes a point where both the physiology and the psychology both break down and you kind of give in. And so there comes a point where both the physiology and the psychology both break down and you kind of give in. And there are these binge occurrences that happen. But then after a binge, what the person does, who's struggling with bulimia nervosa is they go through a purge. So binges may occur weekly and they are followed by compensating behaviors to avoid weight gain. So binge eating let's just talk about that a little bit more in detail.
Speaker 1:Binge eating is when an individual eats a large amount of food in a short period of time and it is associated with a feeling of a loss of control, a loss of a sense of control over how much or what a person is eating. Your kind of primitive brain, if you want to put it that way, is going into overdrive in this moment. The behavior is typically done secretly and it's associated with feelings of shame or embarrassment, and the food is often consumed quickly, to the point that a person is beyond fullness and may be nauseous or uncomfortable. Now, binge eating I have heard different stats on what makes something actually a binge, and again, this is such a large range. But the things that I have heard in this is eating anywhere from 10 to 100 times or not times, but percent more calories than a person normally should. Now here's the thing 10% more calories. For some people is 200 extra calories.
Speaker 1:I don't know that that for some people would classify as a binge, but if someone is ingesting 3,000 to 4,000 calories in one day or 5,000 calories, which is very hard to do you're going to feel a lot of gastric distress with that because it's a lot of food. This might be a sign if someone's kind of going through this, or maybe this is something you have struggled with. It may be a sign that you don't have a healthy relationship with food because there is something either physiologically you're not eating enough or psychologically you're trying to restrict yourself from too many things. That kind of. The floodwaters get so high with what you're trying to restrict yourself from, that they begin to. The floodwaters are too much for your body or your brain to keep holding back and the dam falls. All the floodwaters rush in and you feel like you don't have the ability to stop yourself. I definitely struggled with this in the past. And then the body's compensating behavior, like it said, is there's this fear of because I just ate so much, I'm going to gain weight. I can't gain weight. Therefore, let me either try to self-induce vomiting or let me try and take laxatives or different things to help move all of that food through the body. But here's the thing it's that psychological cycle that's happening.
Speaker 1:That is the basis of bulimia nervosa and binge eating and purging afterwards. So individuals with bulimia nervosa can be slightly underweight, they can be a completely normal weight, they can be overweight or they can be obese. This isn't just for people who look very skinny. Severely underweight would be anorexia nervosa, especially if it's combined with the binge eating and purging. But this is the one of those eating disorders or the one probably of all the eating disorders that can affect someone who looks any way. It is not just for people who look a certain way.
Speaker 1:Along with bulimia, there's binge eating disorder. This is where, as we said before, individuals eat a large amount of food in a short period of time. They feel like they're out of control as they're doing it. They can become distressed by their binge eating behavior and the diagnosis requires frequent binges. So something happening, a binge happening at least once a week for three months. Now, the difference in binge eating disorder and bulimia nervosa is that binge eating disorder does not include that compensatory behavior of trying to excrete the extra food eaten from the body, it's only the binges that are happening.
Speaker 1:And then we have avoidant, restrictive food intake disorder. This is a very interesting one, so it is a disturbance in eating resulting in a persistent failure to meet nutritional needs, and it includes extremely picky eating. So symptoms involve a lack of appetite, a lack of interest in eating food, especially different types of food. There's an extreme food avoidance based on sensory characteristics of foods, so their texture, their color, their appearance, their smell, and there can be a lot of anxiety or concern about the consequences of eating certain types of food, but not necessarily when it comes to, like, gaining weight. That would be more in anorexia, it might be more in bulimia, but this one, the fear, has more to do with. I'm scared, I'm going to choke if I eat that, or that I'm going to get sick, or that it's going to make me vomit or make me constipated, or I'm going to have an allergic reaction. So there's just a fear of what the food might do to other parts of their body. This can also lead to significant weight loss or failure to achieve expected weight gain in children.
Speaker 1:Significant nutritional deficiency, because people are omitting large food groups, not because they're trying to restrict those food groups, but because they have an aversion to those food groups. That's the difference here between this type of this ARFID as it's called for, short but avoidant, restrictive food intake disorder. It is a repulsion. They have an aversion to these foods which is separate from something like orthorexia, which we're not really going to get into, but I'll talk about that a little bit more next. So sometimes these people, when they're struggling with these strong aversions to food, they may need nutritional supplements because they're just not getting enough nutrients and it can interfere with their social functioning because they don't like to go out to eat or to eat with other people because of all of the feelings that they have around food. And the food avoidance typically develops in infancy or early childhood and can even lead into adulthood.
Speaker 1:Now the fifth one that we'll cover here and we won't really probably go much into it with any of the studies that we talk about today, but it's orthorexia. So orthorexia would definitely be the one that I have had, and this is where someone is so obsessed with the types of food that they're eating and eating healthy foods because they are terrified of gaining weight that they omit large groups of food because they are scared of what the food might do to their figure. So these are when people can become very obsessed with healthy eating and things like being very strict with paleo or Whole30 or going keto and having a fear of breaking their diet because it might lead to weight gain. It leads to very unhealthy relationships with food. This is the one that when I was about 22 years old, I believe, is when I started struggling with this and struggled with it until I was about 29 or 30.
Speaker 1:And I was very strict paleo for eight years, so strict that I would avoid going out to eat with people if there wasn't going to be something there that I knew was 100% compliant.
Speaker 1:I was terrified to eat.
Speaker 1:I mean, I would even not go on trips to certain places and I love traveling.
Speaker 1:But I remember there was a mission trip I was supposed to go on to Mexico and I was so scared that I was going to have to eat a corn tortilla or a wheat tortilla and I was so nervous and scared about that that I didn't even go on the mission trip. This was how deeply ingrained it was into me and the fear that I had within me, and it took a couple of years to really break free of that and it can be a really hard place to be. Now that orthorexia again, we're not going to talk much more about that in today's episode, but again that can be a kind of a an entry point into really struggling much further with even more difficult eating disorders that people women and men can struggle with, especially in fitness communities. This can be even harder because you're trying to look a certain way, you're trying to be a certain way, you're trying to fit in with a certain group of people, and so it can lead to even more of occurrences of things like this happening. Jason, we covered a lot so far.
Speaker 2:Yes.
Speaker 1:What are your takeaways so far?
Speaker 2:I have a question. Yeah, what? And do we know what is the most like common of these, like what the majority of people would?
Speaker 1:have For eating disorders?
Speaker 2:Yeah, I mean obviously not the majority of people, but the majority of people who have an eating disorder. Which one is the most common, do you think? Do we have the data on that?
Speaker 1:I think we are about to get into that. If I had to guess, though, I would assume it's going to be bulimia or binge eating.
Speaker 2:Yeah, I assumed it was probably going to be bulimia, but I wasn't for sure.
Speaker 1:And I appreciate you asking that. So I want to be clear. I don't actually know and I don't think it's. It's here in the notes.
Speaker 1:Um, you may be able to like Google that as we're as we're going through, but I think I'm glad that you clarified that, because I think I said something earlier that made it sound like anorexia was the most common one. I don't believe anorexia is not the most common one, but it is the most fatal one of all of them. On that line though. So, when it comes to prevalence, 9% of the US population, so just under 30 million people will have an eating disorder in their lifetime. Eating disorders, as we said before, they affect all genders, but females are twice as likely to struggle with an eating disorder, and 10,000 deaths occur every year as a result of an eating disorder, which equals one every 52 minutes, which I thought was an absolutely crazy statistic Every 10,000,. You know, when you think of 300 million people, you may think, well, 50 or 10,000 doesn't sound that many, but then you think of like one every 52 minutes that maybe didn't have to struggle with it, and 10,000 is way too many.
Speaker 2:I just confirmed, confirmed Binge eating. Binge eating Is the most common in the US anyway.
Speaker 1:Yeah, perfect, thank you. Both anorexia and bulimia have five more times increased mortality risk than any other eating disorder, with anorexia being the one that has the most increased mortality, and the incident and the incidences of bulimia has been declining which is great news, over the past five years. The peak age that bulimia tends to occur in people is between the ages of 15 and 29. So again, it's right around those teenage years, early adulthood, where there's increased pressure to look a certain way and be a certain way, and the rates in males are more difficult to find when it comes to bulimia, but the rate is lower for bulimia specifically, as well in males than in females. The incidence of anorexia nervosa, specifically in people less than 15 years old, is increasing. This is really bad news.
Speaker 1:Yeah, that's really sad and depressing it is really sad and depressing, but I mean it makes sense to me, because I was 13 and 14 when my friends were going through this and when I was first exposed to like do this, yeah, uh, yeah, I wasn't even 15 yet that's crazy.
Speaker 2:Yeah, it's so sad that this is happening.
Speaker 1:It is sad. The highest lifetime prevalence is found in adults, due to the peak age period being in adolescence. So what does that mean? The proportion of the population that has had the disorder at any moment in life up to the moment in the time that they said that they did that. They said that they did. So basically, it happens most commonly, or it begins most commonly, in adolescence, but anyone who has ever had it reported it as an adult. So it can happen anytime throughout life, but the peak time is in adolescence.
Speaker 1:Both anorexia and bulimia have high mortality, as we've already said, and the highest rates among those who received in, the highest rates of mortality, was among those who received inpatient treatment for anorexia. Put in an inpatient recovery or rehab center, then they are at a point where it is very difficult to break it, which is why early catching this early is so important, especially for children and young teenagers who may be beginning to struggle with anorexia. So a couple of more eating disorder stats. These come from the National Association of Anorexia Nervosa and Associated Disorders. 15% of women will suffer from an eating disorder by the time that they are 40 or 50 years old. Of the women who suffer from an eating disorder. Only about a fourth of them just over a fourth 27% of them will receive any type of treatment, which means that there is 73% of women who struggle with an eating disorder. Of the women who struggle with an eating disorder, 73% of them are struggling with it in silence in their homes, in their closets, in their bathrooms, and feel likely very alone. Fewer than 6% of individuals are medically diagnosed as underweight when they have an eating disorder, so 94% of individuals who are diagnosed with an eating disorder are not underweight. This does not only affect people who are skinny. This is incredibly important for people to know, especially if you're worried about friends or family members. People in larger bodies actually have the highest risk of developing an eating disorder, and 16% of adult patients in American emergency rooms screened positive for an eating disorder, which is an interesting stat.
Speaker 1:I've been doing some reading recently. I've been reading books about eating not eating disorders, but just like eating in general, hunger habits, things that we do, as well as books on trauma and things that have happened in people's past. Later in life is actually experiencing sexual abuse as a child, because it turns into a way to try and control the way that your body looks so that you won't experience either sexual abuse or sexual harassment, molestation, rape again in the future. So that is something to note as well. People with eating disorders and the highest symptom severity are 11. So those who are struggling with an eating disorder, and to the highest extent of each of the symptoms of it, are 11 times more likely to commit suicide than people who do not struggle with an eating disorder. Those with sub-threshold symptoms are still two times more likely to commit suicide. Patients with anorexia have a suicide risk 18 times higher than those without an eating disorder. This is heavy.
Speaker 2:Yeah, very, very heavy.
Speaker 1:Black, indigenous and people of color. This population is affected by eating disorders at similar rates to the white peers, but they are half as likely to be diagnosed. So again, this is important for looking at the people in your life who may be struggling, who may not be diagnosed the black, indigenous and people of color. We cannot overlook what they may be struggling with. Bipoc patients are significantly less likely to even be asked about eating disorder symptoms by doctors than non-minority patients. In a study of adolescents between the ages of 11 and 25, only 40% received recommended treatment for malnutrition due to an eating disorder. In the BIPOC population and Latinx patients were half as likely to receive necessary treatment as well. Asian American college students report higher rates of eating restriction, purging, muscle building and cognitive restraint than their white peers and non-Asian BIPOC peers. So this is affecting every ethnicity, every group of people and each group. Each ethnicity is struggling in different ways and being overlooked, especially Black, indigenous, people of color, latinx, asian Americans. It affects everyone. All of us are the same in the struggles that we go through when it comes to this Co-occurring condition stats. So 70% of people with eating disorders also have other conditions like anxiety or mood disorders. There was a longitudinal study done of girls with type 1 diabetes between the ages of 9 and 13. 40% of them met the criteria for full or sub-threshold eating disorders by the time they were in their 20s and almost 60% of them engaged in dangerous, disordered eating behaviors. So type 1 diabetes again, like these girls because it was done on girls in that one are probably more likely to be self-conscious about their bodies because of insulin and the things that they already have to go through in their bodies, and it can lead to eating disorders. So that is another risk factor to be aware of 13 to 58% of ARFID. So these are the people who are averse to eating certain types of food. They also, interestingly, 13 to 58%, which is quite a range, that's quite a spectrum. But they can also have autism spectrum disorder and between 6% and 17% of people with an eating disorder also have ADHD. 10% to 35% of people with an eating disorder can have OCD unrelated to the actual eating disorder. So these are kind of comorbidities that can occur along with an eating disorder.
Speaker 1:Athletes are very likely to struggle with an eating disorder 77% of male athletes and 80% of female athletes. So if you have a child in sports, especially in middle school, high school or college. You need to check in with them, especially if the sport is weight dependent. Things like wrestling, I'm sure, matter a lot with this. Crossfit, bodybuilding, powerlifting things, where I mean probably even things like cycling, running, because I don't know that they necessarily make divisions of those things based on weight. Brazilian jiu-jitsu I believe that they do. But if your weight fluctuating means that you can get faster, more powerful or be put into a different category, then there's going to be even more of a chance that there is an eating disorder or disordered eating associated with that. And then 16% of female military personnel and veterans have suffered from an eating disorder.
Speaker 2:I guess I didn't realize this is much more common in the population than I realized originally. Yeah, there's a lot of people out there struggling with eating disorders.
Speaker 1:Yeah, I mean of the entire population it's going to be about 10%, so every 10 people, one of them is struggling.
Speaker 2:Yeah, which is, I mean. That's more than I would have thought, Right Going into this episode for sure.
Speaker 1:And then what was it? When it comes to just women specifically, it was 16 or 18%, 15%, 15% of women. So if you have 100 women, 15 of them.
Speaker 2:Yeah, that's insane.
Speaker 1:Yeah, I think those numbers are a bit low. But Really. I do, maybe not for just anorexia, bulimia and binge eating, but I think if we began to add in like orthorexia, yeah, and some of those more sub threshold- yeah. I think it would be more like 25. Wow to 30%.
Speaker 2:That's high.
Speaker 1:I don't know that. I know a woman who's never struggled with it to some extent, depending on the severity yeah, but of some severity. Of some severity.
Speaker 2:Yeah, wow.
Speaker 1:So what are the causes? Researchers are finding that eating disorders this comes from the US Department of Health and Human Services they are caused by, not related to someone who has suffered from anorexia. Then their likelihood of experiencing anorexia is 10 times more. When it comes to risk factors, this comes from the Journal of Eating Disorders that in this meta-analysis, this study looked at 284 studies and it found that genetics as we said before, having a parent with an eating disorder not just anorexia, but any eating disorder leads the child to be twice as likely to also struggle with an eating disorder as compared to children and parents who did not have eating disorders. Females are at a greater risk for disordered eating than males because of the drive for thinness. The body dissatisfaction that women tend to inherently have is lower, or that happens more in women than it does in men, and there may be an estrogen receptor part that goes into this that could also be leading that to happen as well. As we said before, there also tends to be a strong correlation between ADHD and all eating disorders, and we also know that having trauma in childhood can lead to more of a likelihood that someone would experience eating disorders as they get older Interestingly, even in utero. Exposure to high levels of cortisol from a pregnant mother who's experiencing high stress tends to correlate with the development of an eating disorder later in life which is really fascinating and higher weight during childhood has also been shown to link to an eating disorder, as well as high maternal expectations and negative parental attitudes about weight and obesity in childhood. That can tend to be more correlated to the onset of bulimia nervosa.
Speaker 1:I had a friend in middle school who was not overweight. I mean, she wasn't super skinny, she was like a normal 13-year-old, very normal build. She and I were on the track team together and her mother would constantly tell her that she needed to lose weight. Her mother would constantly tell her that if she ate a baked potato at lunch that it was too much food, she's 13. She's on the track team, like she's very active, and so I just remember my friend would get like these tiny things to eat at lunch and then go and run for five miles at after school and her mother consistently would say things to her about her weight and consistently made my friend just feel even worse. I mean to to the point that I'm I don't know for sure if she struggled with an eating disorder, but I would 100% not be shocked if she ended up struggling with one, because the way that a parent talks about not just their child's weight to them, but the way that a parent talks about their own body and their own weight in front of their children can absolutely impact the way that the child begins to think about themselves and how they think of talk about the choices they make with food, and all of that can absolutely impact the kids.
Speaker 1:I began to notice this with my daughter, eliana, because and I didn't notice it until she was until probably a couple of years ago, but she would begin actually she only said it once and I was like I'm done, I'm never saying this again in front of I probably shouldn't say it ever. But she would begin actually she only said it once and I was like I'm done, I'm never saying this again in front of I probably shouldn't say it ever, but especially in front of my daughter. And she started like asking if she was fat, my seven-year-old who's like skinny as a rail. And I was like no, you are beautiful, eat anything you want. Are beautiful, eat anything you want, eat everything you want. And it made me realize how I likely say things like that and don't even think about it, but she's picking up on it.
Speaker 2:Yeah Well, kids are so like impressionable too. And you have to think this is coming from the. I mean, in most cases, the most influential person in a child's life is the parent, or the parents, and so anything you say they'll pick up on and they'll start believing it about themselves too. Yeah.
Speaker 1:We also know that social media plays a big role.
Speaker 2:Oh yeah.
Speaker 1:In a 2021 study. Social Media and Eating Disorder Psychopathology was the name of the paper. This was a meta-analysis and what they did the results showed. I mean, they looked at several different studies, but in the results it found that time spent on social media and the development of eating disorder psychopathologies were strongly related. So it's probably not brain science or breaking news to anyone. The overuse of social media is related to body image concerns, self-esteem and eating disorder psychopathologies. And then there was a 2017 study that found that the total number of friends and specific activities, like looking at other people's profile pictures or leaving comments, were directly related to body image, self-esteem and eating disorders among adolescents. You know what this makes me think of, jason. What if there was a social media where no one posted pictures of themselves Interesting? What would that be like? What would half the post even be of?
Speaker 2:Well, I feel like it would have to be like a text, only you know, like social media.
Speaker 1:Like Facebook when it first began.
Speaker 2:Yeah, or like Twitter without any images or video, right, yeah, I mean, this is. I mean, social media is so fake.
Speaker 1:For sure.
Speaker 2:I mean it really is. I mean nobody is posting the authentic version of themselves and it's sad that now we're seeing so many young people on social media, so earlier in their life, that are being made aware of what we, what they perceive as somebody's real life, and they're seeing these super skinny people and it's just not, that's not how everyone is. Some people I mean obviously some people are just naturally going to be thinner than others. But like I don't know, I just think it's so unhealthy that this is happening for young people.
Speaker 1:Well, you don't just think it, it's clear, yeah, I mean it's clear in the research, it's clear in the research that it's very much unhealthy yeah, very much unhealthy.
Speaker 1:41.8% of people that were asked in one study if smartphones prolonged or worsened food restriction behaviors, 42% of people said that they felt like eating disorder. Diseases were perpetuated by social media, because they are. I mean, it's just another way that society tries to sell us and tell us that the way we look isn't good enough, and it perpetuates this part of our brain that wants to be accepted, that wants to be loved, that wants to be liked and wants to be loved. That wants to be liked. And when we fear that we may not have that, then we feel like we have to do the things that everyone else is doing.
Speaker 1:Who we feel like. They are loved, they are liked, they are accepted. So I guess I need to be more like them. And that's where the likes come in, because the more likes a person has and they're probably like the more toned and ripped and skinny or whatever they are and the more provocative clothing they're wearing, they're probably getting more likes and so, like, our primitive brain sees that and says well then, I guess that's what I need to do to be liked.
Speaker 2:Yeah.
Speaker 1:But it's all fake.
Speaker 2:Yeah, but it's all fake. Yeah, and what's really shocking is this next one, which is the this 2017 study. Tell us about it. That's 60, 61% of females sought body image related products on social media. Yeah, I, I work in the marketing department. I know how marketing works and I know how how susceptible people can be to marketing campaigns, and the fact that I think some companies prey on the susceptibility of people through marketing campaigns to get this many people to buy body image related products is gross, it's disgusting and it's sad.
Speaker 1:Yeah.
Speaker 2:Because a lot of the times I mean I would venture to say there's a large percentage of that percentage that didn't need that body image related product, right, that they were persuaded by some marketing campaign of some super skinny person. Yep, I got to get off my soapbox. I'm going to get, I'm going to get fired up here in a minute.
Speaker 1:I love it. There's a really popular company out there that sells like workout, dietary recommendation things. I'm not going to say their name, but they have ads freaking everywhere and one of their big catches one of their big like lead magnets is you just need to eat for your body type and everything will change for you, and that's kind of one of the ways that they draw people in. So, but in all of their ads it's like this super ripped guy and this super ripped girl and it's like, at the end of the day, first of all, yes, like you're preying on people, trying to sell them this image and you're telling them lies to get their money, when really, everything we talk about in most of the Asteroid Attraction Podcasts are the best things to do for your health overall.
Speaker 1:And this is why it's so important for me that when we talk about the physical attraction part, it's not about being the model in the room. It's about being a person who's getting great sleep, who is moving your body, who is eating healthy foods and doing the things that give you energy so that you feel good in your body, not just focusing on how you look, because, at the end of the day, there's so many things we can't change about our bodies. We can change our body composition, some through very dedicated hard work, like in lifting weights or doing cardio but you can't change your build, your height, the bone structure that your body has, the way that you carry the weight that's on your body. There's just things you can't change. Yeah, and you shouldn't. It's another reason I'm not a fan of plastic surgery. But, all that to say, I believe everyone is beautiful and handsome as they are, and it's about believing that about ourselves.
Speaker 2:Yeah, and you say it all the time too with talking about physical traction. Physical traction is not just how you look.
Speaker 1:No.
Speaker 2:It's about how you feel.
Speaker 1:That's right. So then, what are the signs that someone may have an eating disorder and what are the treatment options that are available? Well, we've talked a lot about risk factors already. Being a woman is a risk factor. Being a person of color is a risk factor, especially for being overlooked. Having a history of sexual trauma is a risk factor. Being a veteran, being an athlete, having other anxiety disorders all of these things are already risk factors that could mean that someone is struggling, or has a higher propensity to struggle, with an eating disorder.
Speaker 1:But let's talk a little bit more about behaviors that a person might have. So emotional and behavioral signs is a sign to look for that someone could be struggling, so a preoccupation with weight loss, with food and with dieting and with calories. This is one of those things. Now you might hear that and think this is 99% of Americans and yes, that is true, but we're also, so that's just something that you can begin to look at. And again, it's this preoccupation. It's like everything they think of or do. There seems to be a thought given to how is this going to affect my calories? How is this going to affect my food? Am I going to be able to follow my diet while I'm there. And it's not just someone who's like, oh, I'm eating healthy and I want to make good choices. It's someone who's like, no, I can't make a wrong choice. That's kind of the difference that we're looking for here A person who refuses to eat certain foods or eliminates whole food groups just at their core.
Speaker 1:Someone might look at this and say, well, what about the people who are keto and eliminate carbs? They have a risk of developing disordered eating or an eating disorder. So these are the things to just look for and to keep an eye on People who make excuses to avoid mealtimes or situations involving food because they might feel ashamed about the way that they eat or the way that they don't eat and they don't want to hear about it. And you also want to look for someone who might have these food rituals so a compulsive way that a person interacts with food and these. So, for example, some people may take abnormally small bites of food and may feel anxiety if they're not allowed to take small bites, so they have a way that they eat. And if people start to say like, why are you taking such a small bite of food? Why are you taking three bites to eat that goldfish when I'm over here putting a whole plop of them in my mouth all at once. These are the things that you want to look for.
Speaker 1:They withdraw from friends, activities, social gatherings. They can become isolated and secretive. Extreme concern about their body, size or shape, frequent checking themselves in the mirror and looking at their appearance, and they continue to seem. They seem like they can see flaws in themselves that no one else can see. These are some of the emotional and behavioral signs to be aware of, and that comes from the National Eating Disorders Association.
Speaker 1:Along with that, also from the National Eating Disorders Association, there's physical symptoms and physical signs that you can be aware of Fluctuations in a person's weight up or down, stomach cramps, gastrointestinal complaints, menstrual irregularities, especially for anorexia, this is a huge one. Women, if they do not eat enough food, will lose their periods. This is not a good thing. So be aware of primary or secondary amenorrhea, which is the loss of menstrual cycle, or only experiencing a period. If they're on hormonal supplements like birth control, that may be able to keep your period happening, but ultimately, if you are not feeding your body enough food, your menstrual cycle will shut down. This can even happen with well-meaning activities. I had a friend who recently did a 21-day fast for church and because of that lost her period for at least one cycle. Ultimately it may end up being two, but it's a sign that your body isn't getting what it needs and it begins to shut down vital components, especially of being a woman.
Speaker 1:Difficulties concentrating is another symptom, physical sign that someone may be struggling with an eating disorder. Abnormal labs, especially anemia, with low iron, low thyroid hormone levels that are off, low potassium, low white blood cell and red blood cell counts, are things to look for, although some people may not have abnormal labs. But that's just one other thing. Dizziness, fainting, feeling cold all of the time because the body doesn't have enough thermal energy in it from the food that it's eating. Sleep problems you really can't sleep well if you haven't eaten enough. You also can't sleep well if you've eaten too much. So finding that good balance there Cuts and calluses on the tops of finger joints. So this could be a sign of someone who's inducing vomiting.
Speaker 1:Dental problems Again, that comes from inducing vomiting. Dry skin and hair, brittle nails, a general look of looking unhealthy. Muscle weakness, yellow skin, which, interestingly, could be because they're eating a lot of carrots, because the carrots are lower in calories, and that's something that people who are bulimic or anorexic tend to do. Cold hands, poor wound healing, impaired immune function, someone who's getting sick all the time these are things to look for, especially in addition to the preoccupation with food, the food, rituals, the isolation and different things like that.
Speaker 1:Some additional physical signs include of anorexia, specifically thinning of bones. They're not getting enough calcium, so if they were to do a DEXA scan, for example, it would probably show very low bone density. Low blood pressure, damage to the structure and function of the heart. These are the things that can end up happening over time Brain damage, multi-organ failure, infertility this is a big deal. Bulimia nervosa some other symptoms and signs to look for A chronically inflamed sore throat from how much they vomit. Swollen salivary glands in the neck or the jaw for the same reason. Acid reflux disorder and electrolyte imbalances. So these are the things to look for in people that you love.
Speaker 1:Now, what can you do for treatment? Again, looking at the US Department of Health and Human Services, treatment is typically centered around four main things Restoring adequate nutrition number one, that's the body's most immediate need. Bringing weight to a healthy level either way. Reducing excessive exercise if that's part of what a person is struggling with, and then stopping the psychological part of it, so the binge purge or the binge eating behaviors that could be happening in a person. So overall there are several different options.
Speaker 1:We've talked about that. There's rehabs, there's therapies, people that can go to. There's a transdiagnostic cognitive behavioral therapy for eating disorders, so it's a CBT-E. If you or a loved one is struggling with an eating disorder, google this for your area. Find a reputable counselor or therapist who can administer this type of cognitive behavioral therapy for eating disorders. You typically want to look at 20 weeks, or for bulimia or binge eating disorders, it's a 20-week program and it can be up to 40 weeks for anorexia nervosa, and the first stage of what they're going to do in this type of for bulimia or binge eating disorders, it's a 20-week program and it can be up to 40 weeks for anorexia nervosa, and the first stage of what they're going to do in this type of cognitive behavioral therapy is help the person who's struggling with the eating disorder to understand that they have a problem and help to modify or stabilize their current pattern of eating. The second thing that they're going to do is help make plans for future treatment. The third thing that they'll do is have weekly sessions that focus on problems that maintain the eating disorder. So looking at relational problems, trauma from the past, things that have led to the eating disorder happening, and then focus on the future is the fourth stage.
Speaker 1:Family-based interventions are the first line of defense for children and adolescents, and those types of sessions may involve the entire family, because it's important for everyone to be on the road to recovery with the child or the adolescent that's involved. Cognitive behavioral therapy for adolescents is also an option here. It's a modified form of cognitive behavioral or cognitive behavioral therapy for eating disorders and it's not as good as a family-based intervention, but it could help, and it could especially help for children who are experiencing the aversion to certain types of food groups that ARFID that we talked about earlier. But there are no medicines, there are no magic pills. Really, when someone is struggling with an eating disorder, therapy, support from the family and helping the person to break free from the mental mess that's going on in their minds, that's keeping them stuck in these unhelpful patterns of behavior, are the number one things that we can do.
Speaker 1:There are outpatient options. I would encourage you if you are a loved one or struggling especially with anorexia and none of these other items have worked to look into the outpatient options. Yes, they are expensive, but nothing is expensive enough that a person's life doesn't matter. You can also look into dialectical behavioral therapy for eating disorders. This really starts to get into the stories that people tell themselves that's why it's called dialectical behavioral therapy and this one is specifically focused on eating disorders. It can be delivered outpatient, although there are inpatient options for dialectical behavioral therapy. That could be something that you look into for yourself or others, and this is specifically helpful for bulimia, for binge eating disorders and for other types of eating disorders that include binges.
Speaker 1:There are many other types that we will include in the show notes below, just as resources for you to Google for your local area if you or a loved one could be struggling with eating disorders, and we're also going to include options for help in terms of national hotlines. There is the National Association of Anorexia Nervosa and Associated Disorders Helpline. There's the National Alliance for Eating Disorders Helpline, the Diabolemia Helpline, and one called FEAST, which stands for Families Empowered and Supporting Treatment for Eating Disorders. This one is an international nonprofit organization and it's for the caregivers and family of someone who is suffering with an eating disorder. Here is my key takeaway for all of you.
Speaker 1:You may just think like, oh, my daughter or my son is just a teenager or just an adolescent, and so maybe they're just skipping meals because their hormones are crazy or whatever it might be, or they're just saying that about their bodies because they're young and they're just going through a phase. I believe it's incredibly important to take eating disorders seriously because they have very real and negative consequences to definitely the person's life who struggles with them, but the entire family's life. It's important to have a healthy way that you talk in your household about the way you look, about the way your children look, and have a healthy relationship with food all around. And if you really believe that you or a loved one, a family member, a friend is struggling with an eating disorder, talk to them. Be the person who has the courageous compassion to step into the middle and ask them what's going on and help them get help. Jason, what are your takeaways?
Speaker 2:I think you pretty much covered it. I think the only thing that I would add is for parents especially, make sure that if your kids have access to social media, to at least monitor what they're looking at, because there are things out there that will I don't want to say brainwash, but will try and manipulate their view of their own body. So be sure to at least monitor or know what your child is looking at online so that they don't develop one of these eating disorders from something that they end up seeing because it's everywhere 100%.
Speaker 1:That's great. And before someone is 18, they don't even have a fully developed brain to be able to understand how to categorize what it is that they're seeing. So I would absolutely recommend that too. Subject matter Thank you for sticking through with it with us.
Speaker 1:If you feel like this is an episode you need to share with someone, then I encourage you to do that.
Speaker 1:But I would encourage you, if you're wanting to share this with someone who you feel like is struggling with an eating disorder, to not just share this episode. I would first encourage you to go and talk to them and let them know you love them and that you care about them and that you're worried about them. That is going to speak volumes more than anything I who they don't even know me could ever say to them in their ears. It's the relationship connection that can help people break out of the cycles of complete just destruction and enslavement that people can feel like they find themselves in, like what an eating disorder can do. However, if you do feel like this episode would be helpful to share to someone else, then of course, you always have the option to do that. Remember, we have links in the show notes below for resources to help you in helping either yourself or the people in your life who may be struggling. Until next week, remember, stay strong.
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