August 27, 2025 • 60 mins
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Do you have a family member, friend or roommate whose relationship to food is a little...concerning? Eating disorders hide in plain sight, often disguised as diet culture, fitness goals, or "healthy eating." But beneath these socially acceptable lifestyles lie deadly mental health conditions that claim more lives than almost any other psychiatric disorder.
In this episode, we break down the clinical realities of various eating disorders while exploring the profound ways they impact both individuals and their loved ones. We examine anorexia's deadly grip and how it combines food restriction with a distorted body image so powerful that even severely underweight individuals see themselves as fat. The disorder's perfectionism and need for control create a psychological prison that's hard to escape.
We discuss bulimia's binge-purge cycle, where out-of-control eating episodes are followed by compensatory behaviors like vomiting or excessive exercise. We also discuss binge eating disorder and the lesser-known ARFID, which involves food restriction based on sensory issues rather than weight concerns.
As you probably already know, these disorders can be incredibly hard on the family dynamic. Eating disorders transform dinner tables into battlegrounds and marriages into war zones. We cover strategies for supporting loved ones without enabling disordered behaviors, emphasizing the importance of family therapy and creating an environment that de-emphasizes weight and appearance.
Whether you're worried about someone you love or seeking to understand these complex conditions better, check out KulaMind to get support and community around loving someone with eating disorders.
Resources:
- If you're navigating someone's mental health or emotional issues, join KulaMind, our community and support platform. In KulaMind, we'll help you set healthy boundaries, advocate for yourself, and support your loved one.
- Follow @kulamind on Instagram for podcast updates and science-backed insights on staying sane while loving someone emotionally explosive.
- For more info about this podcast, check out: www.alittlehelpforourfriends.com
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Jacqueline Trumbull (00:00):
Hey guys, welcome to A Little Help
for Our Friends, the podcast forpeople with loved ones
struggling with mental health.
Hi, little helpers, today we'vegot a topic that I think has,
um, we haven't talked about verymuch, which is eating disorders
, and this is going to be, Ithink, mainly like an
educational episode, um, justkind of going through the
(00:21):
different eating disorders andwhat it might be like to live
with somebody with one of thesedisorders, because it is, I
think, one of the absolutehardest group of disorders on
loved ones.
So, kibbe, can you tell us alittle bit about how KulaMind
could help?
Dr. Kibby McMahon (00:37):
Yeah, KulaMind is up and running.
Our community is thriving.
It's really exciting to seeeveryone coming together and
supporting each other having aloved one with mental illness or
addiction.
So KulaMind is our communityand support platform.
It teaches you.
You know, we talk about allthese different skills that we
talk about in this podcast, likehow to set healthy boundaries,
how to take care of yourself,how to understand what your
(01:00):
loved one is going through.
Like, what are these mentalhealth conditions?
So, if you have a loved onewho's struggling with, like,
what are these mental healthconditions?
Um, so if you have a loved onewho's struggling with eating
disorders or anything else, uh,just check us out.
We're at KulaMindcom.
K-u-l-a-m-i-n-dcom are the linkin the show notes.
Dr. Jacqueline Trumbull (01:18):
So eating disorders are an
interesting one.
I've never personally treatedit.
Um, this is the group ofillnesses that I would probably
refer out if if I got like a youknow a patient with this, just
because it's so high risk, and Iwould really want to make sure
that we've got like an you knowan expert working with them.
(01:38):
On the other hand, though, Ifeel like disordered eating is
so common, so I, though, I feellike disordered eating is so
common, so I mean I've certainlylike worked with you know
people with disordered eating,and like food in general and
eating in general has been atopic.
But have you you do haveexperience with eating disorders
?
It sounds like right.
Dr. Kibby McMahon (02:00):
Not extensively.
My first internship, my firstjob in mental health, was eating
disorders and actually I I Ithink it was in college.
Yeah, I was in college and Iinterned for the New York
Psychiatric Institute eatingdisorders clinic and I think it
(02:27):
was for a summer, I can'tremember I was so like young and
it was intense.
It was an inpatient unit so itwas like the most severe eating
disorders you could possibly get.
I mean, I mean, I didn't learna lot about like different
psychotherapies that can helpthem, but I saw what that was
like and was my first you knowtaste of mental health and it
was.
It was shocking.
I don't think I was in fact.
When I after I my first youknow taste of mental health and
it was it was shocking.
I don't think I was in fact.
(02:47):
When I, after I interned, Ithought, oh, I don't know if I
could be a clinician, I don'tknow if I'm strong enough, but
yeah, it took me a while to comeback from.
But I was like, wow, this is areally really severe illness and
I think that in popular cultureor whatever like popular
culture I'm so old, but whenpeople talk about it it's almost
kind of like a joke, likepeople are anorexic or whatever
(03:11):
you know, like it's.
Eating disorders and body imageissues are so common that
people don't realize how seriouseating disorders are.
I'm also shocked that wehaven't talked about it because
we talked so much about, likeyour, your thoughts about weight
that I'm like, oh, we't talkedabout it because we talked so
much about, like your, yourthoughts about weight that I'm
like, oh, we've talked about ittons, but I guess we haven't.
Dr. Jacqueline Trumbull (03:29):
We're talking about body image and we
had an episode on anorexia, wayyou know, early on in our
broadcast.
But I mean, I think the reasonwe have it is because it's not
our area of expertise and yet wewanted to do an episode on it,
at least kind of a primer,discussing the different
disorders, so that people couldbe aware of the differences and,
you know, maybe perk up theirears a little bit if they notice
(03:50):
some of this behavior in theirloved ones, because we don't, we
don't want to keep neglectingit.
At the same time, it's maybesomething that we'll invite
guests on to talk about in thefuture.
But I don't know, should westart with discussing just
disordered eating generally?
Dr. Kibby McMahon (04:07):
or should we Okay.
No, let's.
Let's go through the differentdisorders and kind of break them
down, because it it it knowingwhat the different disorders are
.
It's kind of confusing unlessyou have the training that we
have.
Dr. Jacqueline Trumbull (04:20):
So yeah , so I think you know the first
stop is usually anorexia Um,this is the one that most people
hear about, um, I think it's.
I remember, like growing up inthe aughts, and one of the one
of the most dangerous aspects, Ithink, of both anorexia and
(04:40):
bulimia is that there can be alot of uh community around it.
There are like Reddit groups, Ithink, social media groups that
talk about Anna and Mia,meaning like anorexia and
bulimia, and they'll be talkedabout as if they are your
friends and there'll be like alot of tips and that kind of
thing.
And so it can be really reallydangerous to lose people to this
(05:00):
disorder because they can finda lot of like encouragement for
it, like dogging of it online,and I remember being in high
school and it was a little bitsimilar in that case, it was
kind of glorified orromanticized to at least flirt
with anorexia.
Do you remember anything likethat?
Dr. Kibby McMahon (05:20):
Yeah.
And so for people who don'tknow the actual definition of
anorexia, it's extreme foodrestriction, um, and paired with
an intense fear of gainingweight.
So usually people with anorexiahave low body weight, like
they're really underweight, butno matter how small they get,
they could still see themselvesas overweight.
(05:40):
So it kind of has like somedelusional pieces to it where it
.
I mean, I remember in theclinic, um, girls were, you know
they, they're mostly girls,their bones were sticking out
and they were still saying, likeI'm just huge, I'm so fat, um,
so there is some sort of likedistorted, you know, perception
of themselves.
Um, I do remember I went to anall girls school and there was a
(06:04):
period of time, especially whenwe were going from, uh, I think
it was like in eighth grade,you know the, the kind of the
age where you start to like, getinterested in boys and start to
date more.
Um, some, some people startedto have sex, right, they started
to become like we're likesexual beings.
There was like rampant I don'tknow if it was a level of eating
(06:26):
disorders, but diets right.
And and it was really praised,like we really praise each other
when we would only eat.
I mean, even diets can can hidewhen someone has an eating
disorder, right, Like Atkinsdiet was really popular back in
my day, which meant that youonly ate like meat essentially,
(06:48):
so people would just have likeone slice of turkey and like two
celery sticks and we'd praiseeach other.
We'd be like, oh my God, it's sogreat and we'd lose so much
weight so quickly.
And yeah, it was something thatit probably would have taken
like a really really extremecase for us to get worried that
(07:08):
someone had an eating disorder,but otherwise it was like, oh,
they're doing what we're alldoing.
So, yeah, it was like thisreally encouraged thing.
Yeah, anorexia usually isdiagnosed with like rules around
eating and and food restriction, like eating really few
calories, like when we actuallydiagnose, when we do the
(07:31):
assessments, we ask you knowlike, don't talk me through a
typical day of eating, and ifit's a really low number of
calories, that's a.
That's a sign if they're lowweight.
But also, yes, if they'rereally low weight and but
exercise, so they might havelike normal amount of eating but
they're exercising to the pointwhere they're losing weight and
not, you know, not gettingenough nutrients.
(07:53):
That's another sign of anorexia.
Dr. Jacqueline Trumbull (07:57):
And it usually has.
I mean, what I was taught wasthat it has a different kind of
personality profile than theother eating disorders highly
perfectionistic, highly kind ofcontrolled.
Dr. Kibby McMahon (08:13):
These people really like control.
Anything else that you knowyeah, I mean all of all of the
eating disorders, especiallyanorexia, have a lot of
comorbidities with, um, anxiety,uh, ocdcd and personality
disorder.
So there's, and there's, a lotof perfectionistic right in
anorexia.
Bulimia that we'll talk aboutin a minute is a lot more
(08:34):
impulsivity.
So anorexia is, you know, oftenpeople with anorexia will come
from families that are reallyhighly, you know, into
perfection, into achievement,right.
This kind of like I can't, Ican't mess up.
So it's just like this, thisneed for control that is exerted
on the body, right.
Dr. Jacqueline Trumbull (08:55):
Yeah, and that's a very different
mechanism than than some ofthese other eating disorders.
It's so.
It's so interesting because youknow I mean anorexia and
bulimia can look similar Like ifyou're you know anorexia and
bulimia can look similar Like ifyou're you know, doing this
sort of extreme exercisebehavior, trying to limit.
I think we think of these aslike two disorders with the same
(09:16):
aim, but that's not necessarilytrue and it can be two like
different personality sort ofsubtypes that alter their one.
Anorexia is also the mostdangerous.
It's generally thought ofbecause, I mean, for diagnosis
of anorexia you need that lowweight which is actually not
required for the other disorders.
Dr. Kibby McMahon (09:36):
Yeah, it is the most, if not one of the most
, deadly disorders that we havein mental health.
So if yeah, anorexia kills a lotof people, right.
So it's really serious.
It's you are undernourishingyourself.
So a lot of people with severeanorexia end up dying and they
(09:57):
might die of different things.
Like they might have issueswith their electrolyte balance,
right, if you don't eat a lot,your electrolytes are kind of
all messed up and some of themmight have like heart issues,
heart failure, heart attacks.
So it's really deadly andbeyond deadly.
When you don't eat, it messes upa lot of other stuff, right,
(10:19):
obviously.
But when you don't eat,eventually the hunger cues kind
of shut off, so they might notfeel hungry.
They might even have like thissurge of like reward, like
dopamine, like runner's highkind of feeling when they don't
eat, when they restrict.
So it's like reinforcing in areally scary way.
And when you don't eat, you'dalso cognitively get messed up,
(10:46):
right, if you're super hungryand starved, everything else is
messed up, including likethinking and decision-making.
So they become kind of likeaddicts, where it's like it
hijacks the brain and in fact,if people are so undernourished
they can't actually do therapy,right, because their brains are
just like I can't eat, I don'tknow what they're talking about.
They can't actually do therapyright Because their brains are
just like I can't eat, I don'tknow what they're talking about.
(11:07):
I can't possibly, like you,can't think about your values or
your thoughts or changing yourperception if, like, you're
starving, right.
So actually, people withanorexia, like the severe cases,
have to eat first before theycould actually do psychotherapy,
and it was really hard to sitwith in the inpatient unit for
(11:31):
eating disorders.
A lot of patients with anorexiahad to be force-fed because they
were so close to death, sohealth compromised, that
sometimes they would oh gosh, Imean they would have to
sometimes be tied down and givenlike milk or food, because it's
, I mean, it sounds barbaric,but they were like starving
(11:54):
themselves to death, right.
So you know their safetybecomes the highest priority.
So they had to be force fedbecause, and sometimes even like
restricted physically becausesome of them would, once they
got the food, they would freakout and like do a bunch of sit
ups in their cells, in theirbeds, or they'd like do running
(12:15):
in place.
They'd be constantly trying towork out.
So you would have to likerestrain them from doing that
and feeding them.
So it just seems like restrainthem from doing that and feeding
them so it just seems like likeopposite of survival mechanisms
, right, Like it just seems likesomeone who's just like their
brains are have gone haywire.
But it just is really.
It really is unbelievable andit's so sad.
Dr. Jacqueline Trumbull (12:38):
It's a it's.
It's such an interesting onebecause I think there's
something intuitive about it inthe beginning, which is diet
culture.
Right, like so, many of us aretrying to starve ourselves a
little.
Losing weight, even when we'realready thin, is very desirable.
But then you see these peopleand it's like how in the world
(12:58):
could you still want to loseweight more, like how you are on
the verge of death, you arestarving yourselves.
How is this still happening?
But we know that they have adelusional view of their own
body types.
So we know that if they were todraw themselves, for instance,
they would draw themselves witha much different body type than
(13:19):
they have in reality, with muchmore weight on it.
So there's, they're not seeingthemselves realistically, but
it's.
It's incredible that even evenon the, on the, on the verge of
actual starvation, there's stillthis belief that there has to
be more weight loss.
And I wonder if, at that point,it is even about weight, or if
(13:41):
this yeah, I don't know I thinkit was about weight or if this,
yeah, yeah, I don't know.
Dr. Kibby McMahon (13:46):
I think it's about weight and control, right,
you know a lot of um.
A lot of patients with anorexiahave said that they just they
were felt out of control inother parts of their lives, like
they've been through abuse oryou know there's other they
lived with you know an abusivefamily or something, and this
was something that they wereable to control.
Usually they're very smart.
(14:06):
Smart, they're good at school,they're thin, they're.
You know, because of all this,they're popular.
They're getting so muchreinforcement for being skinny
and I think also our culturalstandards for what is acceptably
skinny is also off.
So they might be starving andpeople are still praising them.
So it just yeah, it's just likesuch a, it's such a slippery
(14:30):
slope.
Dr. Jacqueline Trumbull (14:31):
It is interesting.
I mean it is the one disorderthat you get really like
positive reinforcement for avery long time, Like the whole
kind of up ramp for this or onramp for this.
Disorder is like losing weightand people admiring you,
admiring your discipline,admiring the exact mechanism
that is killing you, and then bythe time maybe that admiration
(14:55):
stops.
It's been so kind of embeddedin you that this is a good thing
to be doing.
Dr. Kibby McMahon (15:02):
I read a fascinating article a long time
ago, because it's so likecounterintuitive that humans
have to survive by eating.
So it's so counterintuitive thatthis mechanism would kick in
and they would just keepstarving themselves until they
die.
This article, I have to find itand, if I can, I'll link it to
(15:24):
the show notes.
But one theory is that theremight be an evolutionary
mechanism happening where,especially in groups that are
nomadic, there might be somebecause we know there's some
genetic propensity for gettingeating disorders.
(15:44):
So there might be somethinglike there's certain nomadic
cultures, or even you know, justin humanity, where there might
be cases where you need to notenough food, so you have to like
travel far distances in orderto like find new sustenance and
(16:09):
it makes sense for your hungercues and your body to kind of go
into this different mode oflike I'm, I'm running, I'm, I'm,
I'm not eating, I'm just goingto, I'm in nomadic like movement
I don't even know the word, butyou know what I mean Like we're
not eating, we're running andwe're going.
And so they think that theremight be some evolutionary ties
(16:31):
to that state where, when peoplestop eating, it kicks in like
oh, we're in danger, we have tosurvive by not eating.
So let's not eat.
So, that might be.
I mean, it's theoretical.
But I thought that wasinteresting because I was was
like why would people do this tothemselves?
Dr. Jacqueline Trumbull (16:47):
right.
Yeah, I mean, it's not likeanybody gets praised for
becoming depressed or becominganxious, becoming bpd or
becoming traumatized, likethere's no positive
reinforcement there, but thisyou've got both like a lot of
external positive and socialreinforcement and this kind of
biological um system that Isuppose is reinforcing it as
(17:08):
well.
So that's super interesting.
Um, and you're probably goingto see it.
I think that we know that thisis more prevalent in white
cultures, probably Asian as well.
It's less, it's less prevalentin cultures that are um, of
different body types, of curvierbody types.
(17:28):
So it does seem that there islike a social and cultural
aspect of this.
When the culture amplifiesthinness, then we're more at
risk of this.
And then adolescence is aparticularly dangerous time,
both because that is when ourbodies change and put on weight
rapidly and that can reallyfreak girls out, and because it
(17:50):
is a time when your life isreally out of your control, just
as you are trying to exerciseyour autonomy.
Dr. Kibby McMahon (17:59):
Yeah, and sometimes not eating has that,
like you know, reward, rewardingeffect.
So it can be emotion regulation, right, it can not only rewards
itself, but it could.
You know, just it's like aself-harm kind of thing where it
distracts from other sensationsor emotions that might be
intense.
And you're right, actuallythere are.
There is research showingthat's westernized or developed
(18:23):
countries are more likely tohave eating disorders.
I know now I'm like digginginto all of our grad school
research and like rememberingall the different factoids that
we learned that there'ssomething crazy about when
there's a link to eatingdisorder, rates of eating
disorders rising.
When TV and other kinds ofmedia are introduced to a
(18:46):
culture, like when a culturegets access to, like American TV
shows or Western standards ofbeauty, then eating disorders
goes up, you know.
So there is that environmentalcomponent.
Dr. Jacqueline Trumbull (19:01):
One thing I've been noticing with my
own like body image is I'vebeen going to a lot of like
saunas recently and I've beenlooking around and I'm like you
know, most people don't havebeautiful bodies, like most
people are average lookingbodies or like even wonky or
disproportionate, right Likethere's really different kinds
of bodies and it's I think it'sthe fact that I follow all of my
(19:25):
bachelor friends that has me socrazy not even that.
Dr. Kibby McMahon (19:30):
I mean like, I mean your bachelor friends, I
mean the people, the ones thatI've met in person.
I just it's just, it's crazy.
They are like such naturallybeautiful.
I mean, they're just likegenetic gods, like it's just
like are you serious?
Like this, is you on a bad day?
But not only that, but then wehave all social media where
(19:54):
there's like filters and thenthere's everyone doing, you know
, body modifications of diet and, uh, you know, like fillers and
all that.
So everyone's like conforming toa very specific look.
Yeah, let's not even talk aboutGLP-1s, where now people are
dropping weight like crazy.
So, yeah, I mean, all of thislike social comparisons can feed
(20:15):
into body image issues.
Dr. Jacqueline Trumbull (20:17):
Yeah, I also think it's an interesting
like if you are an adolescentand you bring this into your
family dynamic.
I mean, you have a toddler andI imagine food and eating is
already sometimes a battle,Maybe not with dads, I don't
(20:38):
know, but with a lot of familieswith toddlers, right Like
eating in the family, eatingwith like kids, eating behavior
can really kind of like hijackthe family dynamic and I would
think that bringing this back inas an adolescence would bring
in a lot of attention andawareness.
(20:58):
Yeah, I mean it would.
Dr. Kibby McMahon (21:01):
Just if you feel out of control, if you feel
like you are being controlledby others, then this is a way to
flip that script a little bitmy friends back in back in the
(21:26):
all-girls school that had eatingdisorders, like they had
pressures from their families,like they were ballet dancers or
eventually became actresses orjust in the public light, and
it's just so much more acceptedin, let's say, you know ballet
dance school to like comment onkids weight, especially with all
those different changes, and soyeah, they're gonna, that's
gonna create that kind ofpressure and normalize um being
(21:50):
super underweight, um.
I also did want to mention thatone if you, if you're not sure
if your loved one has um, like afriend or a sibling has um
eating disorder I don't know whyI said like friend or sibling,
like a few categories.
I was just if anyone you knowhas um eating disorder.
I don't know why I said likefriend or sibling, like if
anyone you know has eatingdisorders.
Um, one thing that's like a it's, it's a tell is not only are
(22:14):
they skinny, but um, if they arehaving different rules about
food, like it may not, I think II watched the show skins, I
think is, on netflix.
It was an old um, uh, british uhshow about teenagers and the
one character uh had like it wasjust like a really good example
(22:39):
of someone with severe anorexia.
Um, she would have all thesedifferent rules like like you
chop up certain foods and pushthem to the side, like they're.
They might have different waysto um like just like have rules,
so like yeah, to like cut downon the food, like oh, I'm just
(22:59):
like I could eat half of this orI'm gonna put on the side.
Like they're controlling theirfood in different ways, like
that.
Or they have like extreme, likeI'm a vegan right, like you're
like oh, okay, but then they areusing rules and justification
like I can't have this kind orthat kind, and so diets that are
structured somehow become likeall these very restrictive rules
(23:22):
, or they'll just do things todisguise that they're not eating
.
So they will like have tricksof um like putting things in
their mouth and spitting it outsomewhere, or cutting up food to
look like they're eating but.
And then having like a few bitesin different places, but, um,
yeah, so it's almost kind oflike an addiction where they
(23:43):
they are able to hide in plainsight that they look like
they're doing normal things butthey're actually like eating,
you know, super low calories.
Dr. Jacqueline Trumbull (23:52):
So yeah , oh, this is one of, honestly,
it's one of my worst fears as amom, as a future mom.
Yeah, I'm like, I'm absolutelyterrified if, if my daughter or
son, but much more likely to bea girl brought this home so we
can talk about bulimia, mm-hmm.
(24:12):
So bulimia, the core difference, I would say there's two A's,
that there's not necessarily anyweight loss, but B like you're
not, you wouldn't be diagnosedwith bulimia if you're
underweight, like I think a lotof people think of bulimia as
like alternative pathways forstarvation, but it's not.
(24:35):
Anorexia involves starvation.
Bulimia does not actuallyinvolve weight loss necessarily.
Dr. Kibby McMahon (24:42):
Yeah, I'm trying to remember.
Actually there's like adiagnostic criteria.
If you're seeing, for example,like intense exercise, the
difference is if you'reunderweight you might be
diagnosed with anorexia, but ifyou are average or overweight
you are diagnosed with bulimia.
So it can come with thosecompensatory behaviors to avoid
(25:04):
weight gain, like thestereotypical throwing up
laxatives, fasting, excessiveexercise, but they might not
actually be underweight.
Dr. Jacqueline Trumbull (25:16):
Right, and the reason so.
The second major differentiatoris the compensatory behaviors
are compensating for bingeeating.
You're not seeing that bingeeating and anorexia, that's
starvation.
So you might see purging umintense exercise and everything,
but that's in combination withlow eating.
The compensatory behaviors inbulimia are because you've just
(25:36):
binged, yeah, and so the bingeis actually the first, um kind
of response to like an emotionaltrigger yeah, and, and to be
clear, I think people usebinging very commonly.
Dr. Kibby McMahon (25:53):
So you know, whenever, whenever we do these
assessments with you know theskit interview, you go do you
eat a lot in a two-hour period?
That's like the first questionand everyone goes yeah, you're
like, give me an example, like,oh, last night I had a whole bag
of chips watching a movie.
It's like, yeah, that's a lot,but that's not binge eating.
Binge eating, binge eatinglooks like it's just like
(26:16):
inhaling like a lot, a lot offood in a short amount of time
and it has this feeling of lossand control kind of like.
Um, some, some people havedescribed it as like they kind
of like dissociate or go numb orgo on automatic, like they're
just eating like cartons andcarts of ice cream and then it's
it.
(26:36):
Yeah, it kind of feels like anarcotic.
It kind of feels like they justlike lose themselves in this.
Um, and usually that that is away of dealing with like
regulating, like pain or youknow, is that distraction, right
, but it's like this a lot.
I mean, I will say I didn'tknow what binge eating really
(26:57):
was until in college I saw afriend um having a binge.
Uh, she had a really roughnight where she felt rejected by
someone she was interested inand she came home with two huge
slices of pizza.
We have this thing calledCornette's Pizza near Columbia
(27:18):
where it was like literally afoot long slices.
She had two of those, ate thatand then had two.
My Alex, my now husband, waseating a white castle burger.
So it's disgusting like littlelike gray looking burgers like
that came in a box so they wereeating them and he was like he
(27:42):
was eating a lot of it, but sheate.
She grabbed and like ateseveral.
So after the two two foot longslices she ate like three or
four.
And then she grabbed a bunch ofcandy from my candy bag and ate
like 10 starbursts.
And then she went and I'llnever forget this she took um a
couple cans of tuna fish and atethem raw, like with no like
(28:07):
mayonnaise or mix it.
She just like ate them straight.
And I think she finished offwith like some canned soup.
She really liked and I remembersitting there watching her
because I remember it was likeon the course of a movie and
just watching her just eat this.
And she did kind of look likeshe was not there, like she
(28:28):
wasn't talking.
She was just like looking aheadand eating like robotically
almost, as if she was likesleepwalking, and the amount of
food I was like I don't know howphysically you could handle.
You know, like once you getsick from that.
But that's when I was like, oh,that's what a binge looks like.
You know, this loss of control.
So, um, yeah, that was poorgirl.
(28:52):
She's better now.
She has a great life.
Dr. Jacqueline Trumbull (28:58):
Was she eating a purger, I mean, or was
she?
Was this?
Dr. Kibby McMahon (29:02):
Not that I know of, not that, not that I
know of.
So you can, she might've hadbinge eating disorder, which is
all of that without thecompensatory feelings, um and
but, bulimia.
I remember in the eatingdisorders unit some of the
bulimia I just I mean, imaginethat this is my first job in
(29:25):
mental health and I was justlike, yeah, I'm going to be a
psychologist maybe.
And there were cases where thebinging and purging had its own
rituals to it, like I meantrigger warning if anyone's
grossed out by this kind ofstuff, like body stuff.
In fact, this whole episode wastough on you.
(29:48):
There was people who had toweigh their vomit to make sure
and if it was too little thenthey would exercise.
They sometimes would keep itand store it in their closet and
the mom would discover it andstore it in their closet and
they're like the mom was adiscover it, um, or just like
(30:09):
really intense, like laxativefasting or diet stuff after like
they binge for a couple daysand then they'd like starve
themselves for several daysafter, right.
Or they would exercise forhours and I mean like on the
treadmill for two hours, right.
So I mean, yeah, it became kindof this like calculation
(30:30):
obsession of like I lost control, but then I had to get the
control back, you know, and um,it's a lot more of like this
impulsive drug, you know, drugseeking behavior than anorexia
looked.
Anorexia was like I controleverything and everything and
this is like I'm out of controland then I have to make up for
it.
I'm out of control, right?
Dr. Jacqueline Trumbull (30:46):
So yeah , it's just, it's just painful
to think about how much shame isgoing to go with bulimia too.
I mean the the idea of hidingyour vomit or hiding your
excrement, right, like you know,these people are deeply ashamed
of that and they're they'reliving like in extreme secrecy
(31:09):
because that, that is somethingthat's going to get you rejected
very, very quickly, and I mean,people are going to be shocked,
right, people are going to behorrified by that, but it's it's
, it's like it's compulsive.
And my heart just kind of breaksfor people who are living that
existence.
Dr. Kibby McMahon (31:31):
Yeah, that's a tough one.
At least they're less at riskof dying than anorexia because
they're not undernourished.
But they have a lot of healthissues themselves.
I mean they, as you can imagine, like electrolyte balance of
you know, vomiting all the timeis totally off.
So I think that people canactually have like other health
(31:53):
issues based on that and thenlike just like I mean the throat
.
Yeah, it's really hard on thethroat and the teeth so you
could tell someone has bulimia.
But if they have of rottingteeth or this moon face people
call it Especially because ofthe pressure and everything
(32:16):
Sorry, this is gross, butthey'll have a puffy face.
So that's a sign of bulimia aswell.
Dr. Jacqueline Trumbull (32:22):
Oh, that's so sad, I know.
So that's a sign of bulimia aswell.
Oh, that's so sad.
I know I believe Britt Nielsen,who was on the Bachelor, opened
up about her struggles with Ithink it was bulimia, and she's
(32:44):
given beautiful accounts of whatthis is like.
Anybody kind of wants, like afirsthand account from bachelor
nation.
I really I remember watchingher videos and really respecting
her for for talking about it,because she it was no holds
barred.
I mean, she really talked aboutwhat it was like for her to go
into this emotional place andyou know, and and the shame
afterwards, um, I was gonna sayI, I think, I, I think it's also
(33:05):
counterproductive.
I think scientifically ourbodies absorb the nutrients very
, very quickly and so the vomitactually doesn't really
compensate very much for it.
But also it probably alleviatesthe pressure that builds inside
the body when you eat that much, and that might be part of it.
Dr. Kibby McMahon (33:26):
Yeah, absolutely yeah, I don't know.
I mean bulimia of course isassociated with that body image
concern, right, but it seems tohave, as you were saying,
different mechanisms of moreabout like, about like the out
(33:47):
of control and the trying to getcontrol back.
So it's kind of like thisemotion regulation kind of issue
, about like feeling totallydysregulated and then trying to
get regulation back.
Dr. Jacqueline Trumbull (34:00):
Yeah, and of course, binge eating
disorder.
There's no compensatorybehavior, necessarily, but these
binges are happening usuallylike in private.
There's a lot of shame about it, a lot of guilt about it and
again that kind of dissociativestate, um, and this I think like
(34:24):
there's a lot of shame also iflike this creates, if this
exists, in like overweight orobese people who then can have
like shame about eating in frontof people in general because of
the judgment they feel likethey'll receive for eating too
much or eating the wrong things.
So I mean, it's just god, it'slike.
Dr. Kibby McMahon (34:45):
Anywhere you look within this, it's, it's so
painful yeah, yeah, yeah, bingeeating disorder apparently is
the most common eating disorder.
Um, it's not usually, you know,usually people are overweight
or, um, average weight, but yeah, it's like, it's like binging
and then having like the hugediscomfort and distress after I
(35:05):
have.
I have probably, probably thatgirl from college had it, to be
honest.
Honest, because I didn't thinkI saw her.
I mean, I don't know about herpurging behaviors, but it's so
sad and that, of course, like,as you imagine, with problems
with eating a lot, you're athigh risk for diabetes and heart
(35:26):
disease and other hypertensionproblems.
Dr. Jacqueline Trumbull (35:30):
So it was also very dangerous, okay,
so if we have a loved onestruggling, wait was also very
dangerous.
Okay, so if we have a loved onestruggling, wait wait, wait,
there's one more.
Dr. Kibby McMahon (35:38):
There's body dysmorphia, which we'll cover in
another episode, because Ithink you have it we talked
about this where I'm like, uh-oh, I think you have a disorder,
jacqueline, I think we shouldtalk about it.
Dr. Jacqueline Trumbull (35:51):
I do not think I have a disorder
Publicly.
Maybe be the light or something, but we can yeah.
Dr. Kibby McMahon (35:57):
This episode is my way to be like.
I think you have some of this.
I'm serious, Serious.
Loved ones, Loved ones, no,well, one more to remember.
I think this is getting alittle bit more attention
because sensory processingdisorders are getting more
attention.
But avoidant, restrictive foodintake disorder, ARFID is when
(36:19):
someone limits or controls whatthey eat because they're afraid
of other negative consequenceslike choking or throwing up like
they're.
They're like oh, there'scertain foods I don't eat
because I'm terrified ofthrowing up, or they don't like
the texture.
Um, of course there's levels ofthat.
That's normal, but it'sespecially if it's like the.
(36:40):
They really restrict their food, right, they only have certain
textures.
Dr. Jacqueline Trumbull (36:45):
Um, but it's not about weight, it's
about it's not.
Yeah, yeah, it's like a, it'sjust an intolerance, yeah.
But I mean like, if you are aloved one of somebody with one
of these disorders, I reallyfeel for you.
I mean, I feel for anybody withthe disorder as well.
But to watch someone you lovewaste away or not be able to
(37:11):
control what they're putting intheir body and not from, like
you know, binge eating disorderis not somebody loving to eat
this is not an enjoyableexperience.
It is a distress tolerance,it's a distress management
system that they hate and thatmakes them feel intensely
negative about themselves and itfeels out of control.
It's not like I'm going to, youknow, enjoy my time eating this
(37:34):
feast.
So you know, I mean it'swatching somebody engage in
legitimately dangerous behaviorand feel like they can't stop.
And I do think your kind ofjourney with it as a loved one
differs depending on the eatingdisorder.
But do you have kind of initialtips?
Dr. Kibby McMahon (37:56):
I mean the tips are, I mean just know that,
just knowing, first of all, andthe major tip is knowing these
different eating disorders soyou could pick it out, cause
some people might not alreadyknow oh, this is what you know.
If someone throws up, that's asign of eating disorder and not
realizing that their friends ortheir families, like dieting
behavior, could be eatingdisorders.
But it's really tough forfamilies and loved ones because
(38:21):
it's kind of like I think theissues kind of sound similar to
addiction or you know anythingelse like that, where there's a
lot of trust problems.
There's a lot of like uh sitesaround it, right, like I, you
know, trying to get your kid toeat or trying to, you know, get
someone to eat more or behealthier, and they, um, they
(38:44):
hide how much they, they don'teat, right, they like hide their
purging behaviors or, um, yeah,you could get into a battle of
like control over the person'seating.
You're like monitoring their,their eating, and so it could be
really stressful because it's,like, you know, eating is such a
social bonding experience, likedinner tables, you know.
(39:08):
You know family dinners cansuddenly become like, you know,
a dinners can suddenly becomelike a battleground, right, and
then on the other side, theremight be some ways you might be
accommodating or even enablingsome of those behaviors, like
allowing you know that loved oneto like not eat as much, or
(39:28):
make sure that you only havecertain foods or, you know, be
okay with their.
You know intense purging, but Imean tips.
Number one, we all knoweducation, yeah.
Dr. Jacqueline Trumbull (39:42):
And also education about therapy.
I mean, I think a lot of peoplethink, oh, my daughter has
anorexia, I need to get her atherapist.
But I would maybe think thatit's actually more appropriate
to at least additionally havefamily therapy, because this is
a family-related problem.
Dr. Kibby McMahon (40:01):
Yeah.
I mean to that point, you know,I should link our episode with
Nandini talking about familytherapy, for, especially like
teens and kids with eatingdisorders, because that really
does highlight that.
You know, this is the case withall the mental disorders we're
talking about, but especiallywith this, because food is so
(40:22):
food and eating are so, I don'tknow, relational that working on
the system needs to happen,right, like making sure that
you're not accidentallyreinforcing you know, some of
that, some of the disorderedeating, like, for example, like
try not to make comments abouttheir weight.
(40:45):
Right, like, I mean even justeven just saying like, oh,
you're looking good now, or youlook terrible, you look so
skinny, right, like all thesedifferent comments that you
could say to one person and itmight hurt their feelings or
whatever and might not have suchan effect, but someone with
eating disorder, it'll kind ofsend them into the spiral, right
(41:07):
, like, oh, you look skinny andit could be meant as a
compliment, but they go, oh, butoh, I, you know someone's
noticing my body, oh, I'mstarting to think about how I'm
actually fat and you know, itcould really, it could really,
you know, add to themselves.
So, like, try not to talk aboutlike weight, um, or eating or
dieting like that.
Dr. Jacqueline Trumbull (41:27):
I mean or accidentally reinforce them.
If you say, yeah, you lookterrifying, you work to
accidentally reinforce them.
If you say, yeah, terror, youlook terrifying, you look like
you're starving yourselves, itcould be seen as a great time
finally succeeding.
I mean, we don't know, but it'sright.
Bringing attention to the waythat the body looks is
counterproductive.
But also, I think like if, ifyou're struggling with anorexia
and bulimia in a different waythis I mean especially like as
(41:48):
an adolescent, it's it's likelythat there are dynamics within
the home about control likepower and control, and so
understanding those and helpingyour child have power or control
in different, healthy wayscould be an easier ticket there
than being like go work on yourproblems alone.
(42:08):
Go work on your problems alone.
Dr. Kibby McMahon (42:11):
Yeah, I imagine that that must be so
hard.
If you like see your kidessentially starving themselves
and not you know, try to getmore control over them, right,
just be like, no, you've got toeat, right, and that actually
will backfire because they'regoing to try to push for more
control.
So, yeah, like talking aboutpower dynamics and control and
agency and trust and buildingtrust slowly with that yeah, an
(42:38):
example of what not to do.
I don't know if you heard aboutTessa.
Have you heard about Tessa?
Dr. Jacqueline Trumbull (42:42):
No oh.
Dr. Kibby McMahon (42:44):
OK, tessa was an AI chatbot that the National
Eating Disorders Associationadded to its hotline chatbot
that the National EatingDisorders Association added to
its hotline, and this is also anexample of how AI can you know
kind of go rogue if you're notcareful with it, but it was.
it was supposed to.
You know, deal with the all thepeople calling in asking for
(43:05):
help with eating disorders, andif you don't, if you don't like
monitor and have oversight overthe chatbot.
This is what.
What happened.
So it started to recommend likeweight loss and calorie
counting and like measuring bodyfat.
Like I started to give diettips to the people calling in to
(43:27):
the hotline.
Um, yeah and so, so, like ofcourse, the chatbot is just
going to do whatever it asks.
So they were probably just likeit was probably just answering
the questions of like how tolose weight, but you don't do
that on a on a you know hotlinefor for eating disorders.
So it was quickly taken off.
But don't do that Like don't,don't, you know, unmask you have
(43:49):
eating to the people witheating disorders, diet tips, but
don't do that Like don't, don'tyou know a mass you have eating
to the people with eatingdisorders, diet tips, but don't
do that to your loved ones too.
If you see someone who'sstruggling with eating disorders
, try not to step in with youradvice, right?
Because all of this kind ofeating and body image, you know,
advice that we have are comingfrom not having a disorder,
(44:12):
right?
So if I say, oh, you look great,just cut out sugar, or um, wow,
but you look, so you know justthe, the, the diet tips that you
might have that might work foryou, um, or even like
compliments or reassurances,might land differently for
someone with eating disorders.
Dr. Jacqueline Trumbull (44:28):
So yeah , you know, don't do that.
You're also probably not anutritionist, so it's it's
probably not necessary forsomebody who's like, really,
really struggling with this kindof thing.
Um, and if you are anutritionist, also don't, don't
go that.
But, um, I just think that thethe like, maybe the well-meaning
(44:49):
advice, can be like oh, no, ifyou want to lose weight, like, I
can tell you how to do in ahealthy way, but it's like no,
we actually want to take thefocus away from weight loss and
from trying to control food.
Um, binge eating and bulimiacome with massive amounts of
shame.
I think you know, if you areaware of somebody struggling
with this, trying to be asvalidating as possible, trying
(45:11):
to be as de-shaming as possible,is helpful.
Dr. Kibby McMahon (45:15):
I think, keeping in mind all the things
that we said about this whereit's very dangerous to your
health, right, people witheating disorders might think
differently about food and theirbody image and everything like
that, and it hijacks your brain,so it becomes.
It's a disease, right?
(45:36):
So don't blame them or justassume like what's the problem?
Just eat, right.
Like, just eat a little bit,you look great, right?
So don't treat it like this issomething to make fun of them
for, or that they're have amoral failing or they don't have
a problem.
Like, take this as a serioushealth issue and don't blame
(45:57):
them or get mad at them or makefun of them, right?
Like teasing can really beawful, right?
Dr. Jacqueline Trumbull (46:03):
And I think also like looking out for
you know if you are the mom orsister or whatever the case may
be, but like really look out foryour other relationships.
I'm, you know, I've I've workedwith a couple who they, their
their kid, didn't have anyeating disorder per se, but
another like really, reallyrough, um, you know, disorder
(46:24):
and tore the marriage apartbecause they're so freaked out
all the time that this is theirfault and they're, you know,
when you feel like you'redealing with something life or
death in your kid, if you'rewatching your kids starve
themselves, then everything youdo feels like it has life or
death kind of consequences, andso the probability that you and
(46:46):
your spouse in particular willstart panicking over the
individual decisions that youmake, it just carries really
high risk.
Right, like it, you know it.
It makes it hard to like thisI'm trying to think of of an
example Um, let's say there's a,a couple um with a kid who is
(47:08):
couple um with a kid who is noteating at the dinner table and
the dad freaks out and says youare not leaving this dinner
table until you have five bitesof food Right, and then the mom
is like, oh my God, you'repushing her, you're you're going
to make eating an even morestressful experience, and she's
like it's okay, honey, it's okayyou don't have to eat.
(47:30):
But then he's like you'reletting her starve, right, like
(47:50):
I'd rather force feed her thanand then saying like we are
going to go in with the sameintentions here and we're going
to understand that each of uscan't be perfect all the time
and we're going to freak out.
And this is coming from a placeof being really scared because
we love somebody who'sdestroying themselves.
Dr. Kibby McMahon (48:08):
Yeah, no, that's a really good point.
And having the balance betweenthose two sides, right, like you
hear the polarizing, you know,I just maybe, I just heard that
in what you're saying One islike they've got to eat and we
got to make them eat, and theother one's like no, no, no, we
don't want to upset them.
Uh, eating disorders can hijack, like, the whole family dynamic
(48:33):
, right.
Like then, what do you do atdinners, you know?
Do you have?
Do you do you all just like noteat together, just so because
it's so triggering to eat infront of um, this one kid, or do
you force them to eat?
Like what?
What do you do?
And so, having a balance andhaving being on the same page,
like with a plan of how to dothat, and not having all these
different rules, but, you know,just being on the same page by
(48:54):
having some boundaries but alsogiving them some agency, like,
okay, we're going to have familydinners, we are going to eat
meat or whatever.
You know, fatty foods might,you know, be otherwise
triggering.
You're welcome to join, as longas you know, even if you just
sit with us, right?
So, just, I mean making surethat it doesn't get to.
(49:20):
I don't we don't like that wordenabling, but either
accommodating those you know theloved one with an eating
disorder.
Don't accommodate too much andshape your whole life and family
life around protecting theirfeelings around it.
So even maintaining some levelof normalcy and healthy
boundaries is really important.
Dr. Jacqueline Trumbull (49:40):
Yeah, I mean, I think that you can
include healthy aspects of yourmeal, include fruits and veggies
, but not say tonight we'rehaving celery for dinner.
You know, not necessarily turnthe entire family vegan suddenly
to say like, look you, you knowyou've got your safe foods on
the plate.
They're nutritious, um, this iswhat's for dinner.
(50:02):
And trying not to get into apower struggle with them, I
guess.
But I mean this is one I wouldnot wait to get help with.
So, finding a really qualifiedeating disorders therapist if
that is in your area, um, youknow, finding somebody that you
can talk to about this, notisolating, right, like hopefully
(50:23):
finding validating friends whoaren't blaming you, the parents
or siblings or whoever it is.
Then you, this family dynamic,um, and you know, like, I
actually have a friend who, whogrew up in a family who's where
his sister had this eatingdisorder and he felt very kind
of passed over.
His parents were just kind oflike, well, he's fine, you know,
(50:44):
we've got this crisis on ourhands.
So then he, he grew up kind ofneglected.
So you know, I mean there'sjust so there's so much here to
talk about, um, and that's whyfamily therapy can be so
important, right, because it'snot actually just about the
person with the eating disorder.
That little boy is part of thefamily too and he's kind of
wondering what about me?
And the parents are freakingout and their marriage is
(51:05):
falling apart, and you know?
I mean there's all of thesedifferent dynamics that need to
be brought in.
Dr. Kibby McMahon (51:17):
Yeah, and it's like the the extreme
examples can take over the wholefamily dynamic.
But also I also think thateating disorders unless people
are aware of it it's, it can besneaky and go and fly under the
radar, cause there might beother issues.
Especially if you're dealingwith someone with bulimia who
has impulsive behaviors ingeneral right, they're also
(51:39):
self-harming, or they're alsodriving drunk or they have
another addiction or somethinglike that then that might get
more attention.
But I think when you have aloved one who is like, dealing
with a lot of mental healthissues include, you know,
talking to their therapist thatyou don't notice right away like
, oh, they're eating less orthey're working out after eating
(52:16):
a lot.
Right, like that could seemalmost like in the realm of
normal.
They have this crazy diet thatthey're following and they're
dropping a ton of weight andthat's so great because they
look so good.
Right, Like it is easy to kindof like have those.
These disorders be like totallymasks, but they are part of the
problem and they take a lot ofpatience and a lot of like
(52:42):
specialized therapy to treat,because it's not just like, oh,
they start to eat normally andall the problems are are gone
like they might be eating andthey might actually be, like,
properly nourished, which isgreat, but there might be all
those other mechanisms involvedthat still need help, right,
Like you know.
Question of control, question ofdistress, tolerance, question
(53:04):
of like their self esteem right,their impulsivity right, this
it's, it's all these otherthings that could be like.
Okay, just because the eatingis fixed doesn't mean everything
else is fixed.
Dr. Jacqueline Trumbull (53:17):
Right.
Dr. Kibby McMahon (53:17):
Exactly.
I feel like we might be scaringpeople.
Dr. Jacqueline Trumbull (53:21):
This is a big deal, super deadly, super
dangerous.
Dr. Kibby McMahon (53:26):
You might not see it.
I mean, yeah, I think that's Idon't think we need to freak out
over weight loss.
Dr. Jacqueline Trumbull (53:32):
But I, especially in like early
twenties adolescence, I'd be,I'd be worried, you know, um, if
I saw eating behaviordrastically change in my kid and
fostering an environment of,like you know, we eat healthy,
but we eat to fuel our body, notto, like you know, sculpt our
body into perfection, which waswhat I learned.
Dr. Kibby McMahon (53:58):
It's important, yeah, you tell me
what are the tips for loved onesfriends podcast co-hosts of
someone you don't have eating?
I'm kidding, I just sit, justsit, like I told we just said
not to make a joke out of it.
Dr. Jacqueline Trumbull (54:13):
Look at me, you know, publicly shaming
you for this but what's tough isthat it's a lot of people have
behaviors along this line.
You know, like it's not like Ican really go through my week
not thinking about what I eat.
Every time I have a meal, Imean I calorie count.
I'm like if I have simple carbs, you know, then I'm starting to
freak out a little.
(54:33):
I mean I calorie count.
I'm like if I have simple carbs, you know, then I'm starting to
freak out a little bit, likehow am I going to get?
You know, how am I going toreverse this situation?
If I have takeout, I'mconstantly thinking about, like
what oils do they use?
Dr. Kibby McMahon (54:44):
Really.
Yeah, I shouldn't be surprised.
I mean you shouldn't, I mean I?
The thing that I get usually isyou thinking that you're, you
don't look good in like picturesor videos, and I'm like you
look great as always.
And then you're like look atthis, look at this flaw, and I'm
like I don't know what you'retalking about, but okay, but I
didn't realize that, like, everytime you eat, you did you do?
(55:06):
Do you do something in responseto that?
Like, do you actually likerestrict yourself or do you have
compensatory?
Dr. Jacqueline Trumbu (55:15):
behaviors .
I mean, I don't purge, no, that, um, that's a, that's a no.
But I'll go through periodswhere I'll restrict what I eat a
lot.
I just can't.
I, I don't, I actually don'thave the.
I don't want to use a positiveword here like self-discipline,
because I don't want to likereward the idea of restriction,
(55:38):
but I usually can't keep itgoing for more than a couple of
weeks.
Dr. Kibby McMahon (55:45):
Yeah, that's tough.
I remember when I went, youknow, when my friends and I all
got you know, you know eighthgrade started to get interested
in boys, started to becomesexual beings.
I did go on that Atkins diet.
I did diet intensely for acouple.
I was working out a lot.
I probably had an eatingdisorder if I were to think
(56:06):
about it.
But I wasn't like severelyunderweight, but I remember
always thinking about it, alwaysthinking about food, what I was
eating, I was.
It was right, we were writingthings down, we were calculating
.
It was there was no likeenjoying the food, it was all.
It was all like an achievement.
You know, it was all like thesame thing as like doing
(56:28):
homework and I just remember the, the immense like reinforcement
and the power that you get fromit.
Like you drop weight andsuddenly people are nice to you,
they're paying attention to you, they're praising you Like
they're, they're talking aboutyou as though you are like
(56:50):
better than them or somehow likehave other skills.
Like they're like, oh gosh, Iwish I could eat as little as
you are.
You know, I wish I could be sodisciplined as you while I was
like eating like one turkeyslice for lunch.
You know, it's like you reallyget a lot of social
reinforcement.
I always remember that and Ialways remember being kind of
scared of that.
I was scared at, you know,whenever I think about like
(57:17):
cutting back or, you know,dieting or getting healthier,
now I always remember and getscared of like the massive
change in how people treated you, but also like how much, how
consuming it can get.
Dr. Jacqueline Trumbull (57:26):
It's a lot to think about.
I mean it's it's tough, you know, because when I think about the
things I do, you know like I'lltry to eat less than $500 for
lunch so that I can eat 1000calories for dinner and then
still be at like a caloriedeficit.
(57:55):
But it's kind of like then yougo online and everyone's like
here's how to eat 1500 calories,or like here's how to eat 400
grams of protein, so that youknow you will lose weight
immediately, like it's just, andyou do have to think about what
you eat to an extent.
You know, like I I'm not goingto sit around eating 4,000
calories of Pringles, like youknow I'm.
I'm trying to think about fiberand and so it's not like we're
not supposed to think about whatwe eat at all.
But suddenly there's this sortof magical line where we have
crossed into like disorderedeating territory and it's very
(58:15):
confusing because it's like well, how much thinking about what
you eat is too much thinkingabout what you eat.
Intuitive eating like what isthat?
Because some people who havegrown up on ultra processed food
for them intuitive eating meansultra processed food Like I.
Just I don't know what theright answer is for a lot of
this stuff.
Dr. Kibby McMahon (58:34):
I mean when in doubt, seek help.
Yeah, I think that's thebiggest tip.
If you're not sure, if you'relike you notice that your loved
one is kind of going nutsTessa's got some great diet
advice I hear, so yeah, Greatdieting tips, tips Um, but yeah.
Dr. Jacqueline Trumbull (58:51):
Well, on that depressing note, um, you
know, I, I mean it, it, theseare, these are a really scary
group of disorders, like I, Idon't think that there is
necessarily too much fearmongering here.
I think if it's something thatyou suspect about your kid or
somebody that you love and it'sworth a conversation and it's,
it's worth thinking about, likewhat kinds of resources are
available to our family, um, andI just want to like validate
(59:14):
anybody's experience who's outthere, you know, dealing with
this, because it must be reallyscary.
Okay, well, with that, if youappreciate this episode, um, or
any of our episodes, pleaseleave us a five-star reading on
apple podcast or spotify.
It really helps us out andwe'll see you next week.
(01:00:27):
Thank you, or organizationpresented or mentioned in this
podcast and information fromthis podcast should not be
referenced in any way to implysuch approval or endorsement.
Hey guys, welcome to A Little Help
for Our Friends, the podcast forpeople with loved ones
struggling with mental health.
Hi, little helpers, today we'vegot a topic that I think has,
um, we haven't talked about verymuch, which is eating disorders
, and this is going to be, Ithink, mainly like an
educational episode, um, justkind of going through the
(00:21):
different eating disorders andwhat it might be like to live
with somebody with one of thesedisorders, because it is, I
think, one of the absolutehardest group of disorders on
loved ones.
So, kibbe, can you tell us alittle bit about how KulaMind
could help?
Dr. Kibby McMahon (00:37):
Yeah, KulaMind is up and running.
Our community is thriving.
It's really exciting to seeeveryone coming together and
supporting each other having aloved one with mental illness or
addiction.
So KulaMind is our communityand support platform.
It teaches you.
You know, we talk about allthese different skills that we
talk about in this podcast, likehow to set healthy boundaries,
how to take care of yourself,how to understand what your
(01:00):
loved one is going through.
Like, what are these mentalhealth conditions?
So, if you have a loved onewho's struggling with, like,
what are these mental healthconditions?
Um, so if you have a loved onewho's struggling with eating
disorders or anything else, uh,just check us out.
We're at KulaMindcom.
K-u-l-a-m-i-n-dcom are the linkin the show notes.
Dr. Jacqueline Trumbull (01:18):
So eating disorders are an
interesting one.
I've never personally treatedit.
Um, this is the group ofillnesses that I would probably
refer out if if I got like a youknow a patient with this, just
because it's so high risk, and Iwould really want to make sure
that we've got like an you knowan expert working with them.
(01:38):
On the other hand, though, Ifeel like disordered eating is
so common, so I, though, I feellike disordered eating is so
common, so I mean I've certainlylike worked with you know
people with disordered eating,and like food in general and
eating in general has been atopic.
But have you you do haveexperience with eating disorders
?
It sounds like right.
Dr. Kibby McMahon (02:00):
Not extensively.
My first internship, my firstjob in mental health, was eating
disorders and actually I I Ithink it was in college.
Yeah, I was in college and Iinterned for the New York
Psychiatric Institute eatingdisorders clinic and I think it
(02:27):
was for a summer, I can'tremember I was so like young and
it was intense.
It was an inpatient unit so itwas like the most severe eating
disorders you could possibly get.
I mean, I mean, I didn't learna lot about like different
psychotherapies that can helpthem, but I saw what that was
like and was my first you knowtaste of mental health and it
was.
It was shocking.
I don't think I was in fact.
When I after I my first youknow taste of mental health and
it was it was shocking.
I don't think I was in fact.
(02:47):
When I, after I interned, Ithought, oh, I don't know if I
could be a clinician, I don'tknow if I'm strong enough, but
yeah, it took me a while to comeback from.
But I was like, wow, this is areally really severe illness and
I think that in popular cultureor whatever like popular
culture I'm so old, but whenpeople talk about it it's almost
kind of like a joke, likepeople are anorexic or whatever
(03:11):
you know, like it's.
Eating disorders and body imageissues are so common that
people don't realize how seriouseating disorders are.
I'm also shocked that wehaven't talked about it because
we talked so much about, likeyour, your thoughts about weight
that I'm like, oh, we't talkedabout it because we talked so
much about, like your, yourthoughts about weight that I'm
like, oh, we've talked about ittons, but I guess we haven't.
Dr. Jacqueline Trumbull (03:29):
We're talking about body image and we
had an episode on anorexia, wayyou know, early on in our
broadcast.
But I mean, I think the reasonwe have it is because it's not
our area of expertise and yet wewanted to do an episode on it,
at least kind of a primer,discussing the different
disorders, so that people couldbe aware of the differences and,
you know, maybe perk up theirears a little bit if they notice
(03:50):
some of this behavior in theirloved ones, because we don't, we
don't want to keep neglectingit.
At the same time, it's maybesomething that we'll invite
guests on to talk about in thefuture.
But I don't know, should westart with discussing just
disordered eating generally?
Dr. Kibby McMahon (04:07):
or should we Okay.
No, let's.
Let's go through the differentdisorders and kind of break them
down, because it it it knowingwhat the different disorders are
.
It's kind of confusing unlessyou have the training that we
have.
Dr. Jacqueline Trumbull (04:20):
So yeah , so I think you know the first
stop is usually anorexia Um,this is the one that most people
hear about, um, I think it's.
I remember, like growing up inthe aughts, and one of the one
of the most dangerous aspects, Ithink, of both anorexia and
(04:40):
bulimia is that there can be alot of uh community around it.
There are like Reddit groups, Ithink, social media groups that
talk about Anna and Mia,meaning like anorexia and
bulimia, and they'll be talkedabout as if they are your
friends and there'll be like alot of tips and that kind of
thing.
And so it can be really reallydangerous to lose people to this
(05:00):
disorder because they can finda lot of like encouragement for
it, like dogging of it online,and I remember being in high
school and it was a little bitsimilar in that case, it was
kind of glorified orromanticized to at least flirt
with anorexia.
Do you remember anything likethat?
Dr. Kibby McMahon (05:20):
Yeah.
And so for people who don'tknow the actual definition of
anorexia, it's extreme foodrestriction, um, and paired with
an intense fear of gainingweight.
So usually people with anorexiahave low body weight, like
they're really underweight, butno matter how small they get,
they could still see themselvesas overweight.
(05:40):
So it kind of has like somedelusional pieces to it where it
.
I mean, I remember in theclinic, um, girls were, you know
they, they're mostly girls,their bones were sticking out
and they were still saying, likeI'm just huge, I'm so fat, um,
so there is some sort of likedistorted, you know, perception
of themselves.
Um, I do remember I went to anall girls school and there was a
(06:04):
period of time, especially whenwe were going from, uh, I think
it was like in eighth grade,you know the, the kind of the
age where you start to like, getinterested in boys and start to
date more.
Um, some, some people startedto have sex, right, they started
to become like we're likesexual beings.
There was like rampant I don'tknow if it was a level of eating
(06:26):
disorders, but diets right.
And and it was really praised,like we really praise each other
when we would only eat.
I mean, even diets can can hidewhen someone has an eating
disorder, right, Like Atkinsdiet was really popular back in
my day, which meant that youonly ate like meat essentially,
(06:48):
so people would just have likeone slice of turkey and like two
celery sticks and we'd praiseeach other.
We'd be like, oh my God, it's sogreat and we'd lose so much
weight so quickly.
And yeah, it was something thatit probably would have taken
like a really really extremecase for us to get worried that
(07:08):
someone had an eating disorder,but otherwise it was like, oh,
they're doing what we're alldoing.
So, yeah, it was like thisreally encouraged thing.
Yeah, anorexia usually isdiagnosed with like rules around
eating and and food restriction, like eating really few
calories, like when we actuallydiagnose, when we do the
(07:31):
assessments, we ask you knowlike, don't talk me through a
typical day of eating, and ifit's a really low number of
calories, that's a.
That's a sign if they're lowweight.
But also, yes, if they'rereally low weight and but
exercise, so they might havelike normal amount of eating but
they're exercising to the pointwhere they're losing weight and
not, you know, not gettingenough nutrients.
(07:53):
That's another sign of anorexia.
Dr. Jacqueline Trumbull (07:57):
And it usually has.
I mean, what I was taught wasthat it has a different kind of
personality profile than theother eating disorders highly
perfectionistic, highly kind ofcontrolled.
Dr. Kibby McMahon (08:13):
These people really like control.
Anything else that you knowyeah, I mean all of all of the
eating disorders, especiallyanorexia, have a lot of
comorbidities with, um, anxiety,uh, ocdcd and personality
disorder.
So there's, and there's, a lotof perfectionistic right in
anorexia.
Bulimia that we'll talk aboutin a minute is a lot more
(08:34):
impulsivity.
So anorexia is, you know, oftenpeople with anorexia will come
from families that are reallyhighly, you know, into
perfection, into achievement,right.
This kind of like I can't, Ican't mess up.
So it's just like this, thisneed for control that is exerted
on the body, right.
Dr. Jacqueline Trumbull (08:55):
Yeah, and that's a very different
mechanism than than some ofthese other eating disorders.
It's so.
It's so interesting because youknow I mean anorexia and
bulimia can look similar Like ifyou're you know anorexia and
bulimia can look similar Like ifyou're you know, doing this
sort of extreme exercisebehavior, trying to limit.
I think we think of these aslike two disorders with the same
(09:16):
aim, but that's not necessarilytrue and it can be two like
different personality sort ofsubtypes that alter their one.
Anorexia is also the mostdangerous.
It's generally thought ofbecause, I mean, for diagnosis
of anorexia you need that lowweight which is actually not
required for the other disorders.
Dr. Kibby McMahon (09:36):
Yeah, it is the most, if not one of the most
, deadly disorders that we havein mental health.
So if yeah, anorexia kills a lotof people, right.
So it's really serious.
It's you are undernourishingyourself.
So a lot of people with severeanorexia end up dying and they
(09:57):
might die of different things.
Like they might have issueswith their electrolyte balance,
right, if you don't eat a lot,your electrolytes are kind of
all messed up and some of themmight have like heart issues,
heart failure, heart attacks.
So it's really deadly andbeyond deadly.
When you don't eat, it messes upa lot of other stuff, right,
(10:19):
obviously.
But when you don't eat,eventually the hunger cues kind
of shut off, so they might notfeel hungry.
They might even have like thissurge of like reward, like
dopamine, like runner's highkind of feeling when they don't
eat, when they restrict.
So it's like reinforcing in areally scary way.
And when you don't eat, you'dalso cognitively get messed up,
(10:46):
right, if you're super hungryand starved, everything else is
messed up, including likethinking and decision-making.
So they become kind of likeaddicts, where it's like it
hijacks the brain and in fact,if people are so undernourished
they can't actually do therapy,right, because their brains are
just like I can't eat, I don'tknow what they're talking about.
They can't actually do therapyright Because their brains are
just like I can't eat, I don'tknow what they're talking about.
(11:07):
I can't possibly, like you,can't think about your values or
your thoughts or changing yourperception if, like, you're
starving, right.
So actually, people withanorexia, like the severe cases,
have to eat first before theycould actually do psychotherapy,
and it was really hard to sitwith in the inpatient unit for
(11:31):
eating disorders.
A lot of patients with anorexiahad to be force-fed because they
were so close to death, sohealth compromised, that
sometimes they would oh gosh, Imean they would have to
sometimes be tied down and givenlike milk or food, because it's
, I mean, it sounds barbaric,but they were like starving
(11:54):
themselves to death, right.
So you know their safetybecomes the highest priority.
So they had to be force fedbecause, and sometimes even like
restricted physically becausesome of them would, once they
got the food, they would freakout and like do a bunch of sit
ups in their cells, in theirbeds, or they'd like do running
(12:15):
in place.
They'd be constantly trying towork out.
So you would have to likerestrain them from doing that
and feeding them.
So it just seems like restrainthem from doing that and feeding
them so it just seems like likeopposite of survival mechanisms
, right, Like it just seems likesomeone who's just like their
brains are have gone haywire.
But it just is really.
It really is unbelievable andit's so sad.
Dr. Jacqueline Trumbull (12:38):
It's a it's.
It's such an interesting onebecause I think there's
something intuitive about it inthe beginning, which is diet
culture.
Right, like so, many of us aretrying to starve ourselves a
little.
Losing weight, even when we'realready thin, is very desirable.
But then you see these peopleand it's like how in the world
(12:58):
could you still want to loseweight more, like how you are on
the verge of death, you arestarving yourselves.
How is this still happening?
But we know that they have adelusional view of their own
body types.
So we know that if they were todraw themselves, for instance,
they would draw themselves witha much different body type than
(13:19):
they have in reality, with muchmore weight on it.
So there's, they're not seeingthemselves realistically, but
it's.
It's incredible that even evenon the, on the, on the verge of
actual starvation, there's stillthis belief that there has to
be more weight loss.
And I wonder if, at that point,it is even about weight, or if
(13:41):
this yeah, I don't know I thinkit was about weight or if this,
yeah, yeah, I don't know.
Dr. Kibby McMahon (13:46):
I think it's about weight and control, right,
you know a lot of um.
A lot of patients with anorexiahave said that they just they
were felt out of control inother parts of their lives, like
they've been through abuse oryou know there's other they
lived with you know an abusivefamily or something, and this
was something that they wereable to control.
Usually they're very smart.
(14:06):
Smart, they're good at school,they're thin, they're.
You know, because of all this,they're popular.
They're getting so muchreinforcement for being skinny
and I think also our culturalstandards for what is acceptably
skinny is also off.
So they might be starving andpeople are still praising them.
So it just yeah, it's just likesuch a, it's such a slippery
(14:30):
slope.
Dr. Jacqueline Trumbull (14:31):
It is interesting.
I mean it is the one disorderthat you get really like
positive reinforcement for avery long time, Like the whole
kind of up ramp for this or onramp for this.
Disorder is like losing weightand people admiring you,
admiring your discipline,admiring the exact mechanism
that is killing you, and then bythe time maybe that admiration
(14:55):
stops.
It's been so kind of embeddedin you that this is a good thing
to be doing.
Dr. Kibby McMahon (15:02):
I read a fascinating article a long time
ago, because it's so likecounterintuitive that humans
have to survive by eating.
So it's so counterintuitive thatthis mechanism would kick in
and they would just keepstarving themselves until they
die.
This article, I have to find itand, if I can, I'll link it to
(15:24):
the show notes.
But one theory is that theremight be an evolutionary
mechanism happening where,especially in groups that are
nomadic, there might be somebecause we know there's some
genetic propensity for gettingeating disorders.
(15:44):
So there might be somethinglike there's certain nomadic
cultures, or even you know, justin humanity, where there might
be cases where you need to notenough food, so you have to like
travel far distances in orderto like find new sustenance and
(16:09):
it makes sense for your hungercues and your body to kind of go
into this different mode oflike I'm, I'm running, I'm, I'm,
I'm not eating, I'm just goingto, I'm in nomadic like movement
I don't even know the word, butyou know what I mean Like we're
not eating, we're running andwe're going.
And so they think that theremight be some evolutionary ties
(16:31):
to that state where, when peoplestop eating, it kicks in like
oh, we're in danger, we have tosurvive by not eating.
So let's not eat.
So, that might be.
I mean, it's theoretical.
But I thought that wasinteresting because I was was
like why would people do this tothemselves?
Dr. Jacqueline Trumbull (16:47):
right.
Yeah, I mean, it's not likeanybody gets praised for
becoming depressed or becominganxious, becoming bpd or
becoming traumatized, likethere's no positive
reinforcement there, but thisyou've got both like a lot of
external positive and socialreinforcement and this kind of
biological um system that Isuppose is reinforcing it as
(17:08):
well.
So that's super interesting.
Um, and you're probably goingto see it.
I think that we know that thisis more prevalent in white
cultures, probably Asian as well.
It's less, it's less prevalentin cultures that are um, of
different body types, of curvierbody types.
(17:28):
So it does seem that there islike a social and cultural
aspect of this.
When the culture amplifiesthinness, then we're more at
risk of this.
And then adolescence is aparticularly dangerous time,
both because that is when ourbodies change and put on weight
rapidly and that can reallyfreak girls out, and because it
(17:50):
is a time when your life isreally out of your control, just
as you are trying to exerciseyour autonomy.
Dr. Kibby McMahon (17:59):
Yeah, and sometimes not eating has that,
like you know, reward, rewardingeffect.
So it can be emotion regulation, right, it can not only rewards
itself, but it could.
You know, just it's like aself-harm kind of thing where it
distracts from other sensationsor emotions that might be
intense.
And you're right, actuallythere are.
There is research showingthat's westernized or developed
(18:23):
countries are more likely tohave eating disorders.
I know now I'm like digginginto all of our grad school
research and like rememberingall the different factoids that
we learned that there'ssomething crazy about when
there's a link to eatingdisorder, rates of eating
disorders rising.
When TV and other kinds ofmedia are introduced to a
(18:46):
culture, like when a culturegets access to, like American TV
shows or Western standards ofbeauty, then eating disorders
goes up, you know.
So there is that environmentalcomponent.
Dr. Jacqueline Trumbull (19:01):
One thing I've been noticing with my
own like body image is I'vebeen going to a lot of like
saunas recently and I've beenlooking around and I'm like you
know, most people don't havebeautiful bodies, like most
people are average lookingbodies or like even wonky or
disproportionate, right Likethere's really different kinds
of bodies and it's I think it'sthe fact that I follow all of my
(19:25):
bachelor friends that has me socrazy not even that.
Dr. Kibby McMahon (19:30):
I mean like, I mean your bachelor friends, I
mean the people, the ones thatI've met in person.
I just it's just, it's crazy.
They are like such naturallybeautiful.
I mean, they're just likegenetic gods, like it's just
like are you serious?
Like this, is you on a bad day?
But not only that, but then wehave all social media where
(19:54):
there's like filters and thenthere's everyone doing, you know
, body modifications of diet and, uh, you know, like fillers and
all that.
So everyone's like conforming toa very specific look.
Yeah, let's not even talk aboutGLP-1s, where now people are
dropping weight like crazy.
So, yeah, I mean, all of thislike social comparisons can feed
(20:15):
into body image issues.
Dr. Jacqueline Trumbull (20:17):
Yeah, I also think it's an interesting
like if you are an adolescentand you bring this into your
family dynamic.
I mean, you have a toddler andI imagine food and eating is
already sometimes a battle,Maybe not with dads, I don't
(20:38):
know, but with a lot of familieswith toddlers, right Like
eating in the family, eatingwith like kids, eating behavior
can really kind of like hijackthe family dynamic and I would
think that bringing this back inas an adolescence would bring
in a lot of attention andawareness.
(20:58):
Yeah, I mean it would.
Dr. Kibby McMahon (21:01):
Just if you feel out of control, if you feel
like you are being controlledby others, then this is a way to
flip that script a little bitmy friends back in back in the
(21:26):
all-girls school that had eatingdisorders, like they had
pressures from their families,like they were ballet dancers or
eventually became actresses orjust in the public light, and
it's just so much more acceptedin, let's say, you know ballet
dance school to like comment onkids weight, especially with all
those different changes, and soyeah, they're gonna, that's
gonna create that kind ofpressure and normalize um being
(21:50):
super underweight, um.
I also did want to mention thatone if you, if you're not sure
if your loved one has um, like afriend or a sibling has um
eating disorder I don't know whyI said like friend or sibling,
like a few categories.
I was just if anyone you knowhas um eating disorder.
I don't know why I said likefriend or sibling, like if
anyone you know has eatingdisorders.
Um, one thing that's like a it's, it's a tell is not only are
(22:14):
they skinny, but um, if they arehaving different rules about
food, like it may not, I think II watched the show skins, I
think is, on netflix.
It was an old um, uh, british uhshow about teenagers and the
one character uh had like it wasjust like a really good example
(22:39):
of someone with severe anorexia.
Um, she would have all thesedifferent rules like like you
chop up certain foods and pushthem to the side, like they're.
They might have different waysto um like just like have rules,
so like yeah, to like cut downon the food, like oh, I'm just
(22:59):
like I could eat half of this orI'm gonna put on the side.
Like they're controlling theirfood in different ways, like
that.
Or they have like extreme, likeI'm a vegan right, like you're
like oh, okay, but then they areusing rules and justification
like I can't have this kind orthat kind, and so diets that are
structured somehow become likeall these very restrictive rules
(23:22):
, or they'll just do things todisguise that they're not eating
.
So they will like have tricksof um like putting things in
their mouth and spitting it outsomewhere, or cutting up food to
look like they're eating but.
And then having like a few bitesin different places, but, um,
yeah, so it's almost kind oflike an addiction where they
(23:43):
they are able to hide in plainsight that they look like
they're doing normal things butthey're actually like eating,
you know, super low calories.
Dr. Jacqueline Trumbull (23:52):
So yeah , oh, this is one of, honestly,
it's one of my worst fears as amom, as a future mom.
Yeah, I'm like, I'm absolutelyterrified if, if my daughter or
son, but much more likely to bea girl brought this home so we
can talk about bulimia, mm-hmm.
(24:12):
So bulimia, the core difference, I would say there's two A's,
that there's not necessarily anyweight loss, but B like you're
not, you wouldn't be diagnosedwith bulimia if you're
underweight, like I think a lotof people think of bulimia as
like alternative pathways forstarvation, but it's not.
(24:35):
Anorexia involves starvation.
Bulimia does not actuallyinvolve weight loss necessarily.
Dr. Kibby McMahon (24:42):
Yeah, I'm trying to remember.
Actually there's like adiagnostic criteria.
If you're seeing, for example,like intense exercise, the
difference is if you'reunderweight you might be
diagnosed with anorexia, but ifyou are average or overweight
you are diagnosed with bulimia.
So it can come with thosecompensatory behaviors to avoid
(25:04):
weight gain, like thestereotypical throwing up
laxatives, fasting, excessiveexercise, but they might not
actually be underweight.
Dr. Jacqueline Trumbull (25:16):
Right, and the reason so.
The second major differentiatoris the compensatory behaviors
are compensating for bingeeating.
You're not seeing that bingeeating and anorexia, that's
starvation.
So you might see purging umintense exercise and everything,
but that's in combination withlow eating.
The compensatory behaviors inbulimia are because you've just
(25:36):
binged, yeah, and so the bingeis actually the first, um kind
of response to like an emotionaltrigger yeah, and, and to be
clear, I think people usebinging very commonly.
Dr. Kibby McMahon (25:53):
So you know, whenever, whenever we do these
assessments with you know theskit interview, you go do you
eat a lot in a two-hour period?
That's like the first questionand everyone goes yeah, you're
like, give me an example, like,oh, last night I had a whole bag
of chips watching a movie.
It's like, yeah, that's a lot,but that's not binge eating.
Binge eating, binge eatinglooks like it's just like
(26:16):
inhaling like a lot, a lot offood in a short amount of time
and it has this feeling of lossand control kind of like.
Um, some, some people havedescribed it as like they kind
of like dissociate or go numb orgo on automatic, like they're
just eating like cartons andcarts of ice cream and then it's
it.
(26:36):
Yeah, it kind of feels like anarcotic.
It kind of feels like they justlike lose themselves in this.
Um, and usually that that is away of dealing with like
regulating, like pain or youknow, is that distraction, right
, but it's like this a lot.
I mean, I will say I didn'tknow what binge eating really
(26:57):
was until in college I saw afriend um having a binge.
Uh, she had a really roughnight where she felt rejected by
someone she was interested inand she came home with two huge
slices of pizza.
We have this thing calledCornette's Pizza near Columbia
(27:18):
where it was like literally afoot long slices.
She had two of those, ate thatand then had two.
My Alex, my now husband, waseating a white castle burger.
So it's disgusting like littlelike gray looking burgers like
that came in a box so they wereeating them and he was like he
(27:42):
was eating a lot of it, but sheate.
She grabbed and like ateseveral.
So after the two two foot longslices she ate like three or
four.
And then she grabbed a bunch ofcandy from my candy bag and ate
like 10 starbursts.
And then she went and I'llnever forget this she took um a
couple cans of tuna fish and atethem raw, like with no like
(28:07):
mayonnaise or mix it.
She just like ate them straight.
And I think she finished offwith like some canned soup.
She really liked and I remembersitting there watching her
because I remember it was likeon the course of a movie and
just watching her just eat this.
And she did kind of look likeshe was not there, like she
(28:28):
wasn't talking.
She was just like looking aheadand eating like robotically
almost, as if she was likesleepwalking, and the amount of
food I was like I don't know howphysically you could handle.
You know, like once you getsick from that.
But that's when I was like, oh,that's what a binge looks like.
You know, this loss of control.
So, um, yeah, that was poorgirl.
(28:52):
She's better now.
She has a great life.
Dr. Jacqueline Trumbull (28:58):
Was she eating a purger, I mean, or was
she?
Was this?
Dr. Kibby McMahon (29:02):
Not that I know of, not that, not that I
know of.
So you can, she might've hadbinge eating disorder, which is
all of that without thecompensatory feelings, um and
but, bulimia.
I remember in the eatingdisorders unit some of the
bulimia I just I mean, imaginethat this is my first job in
(29:25):
mental health and I was justlike, yeah, I'm going to be a
psychologist maybe.
And there were cases where thebinging and purging had its own
rituals to it, like I meantrigger warning if anyone's
grossed out by this kind ofstuff, like body stuff.
In fact, this whole episode wastough on you.
(29:48):
There was people who had toweigh their vomit to make sure
and if it was too little thenthey would exercise.
They sometimes would keep itand store it in their closet and
the mom would discover it andstore it in their closet and
they're like the mom was adiscover it, um, or just like
(30:09):
really intense, like laxativefasting or diet stuff after like
they binge for a couple daysand then they'd like starve
themselves for several daysafter, right.
Or they would exercise forhours and I mean like on the
treadmill for two hours, right.
So I mean, yeah, it became kindof this like calculation
(30:30):
obsession of like I lost control, but then I had to get the
control back, you know, and um,it's a lot more of like this
impulsive drug, you know, drugseeking behavior than anorexia
looked.
Anorexia was like I controleverything and everything and
this is like I'm out of controland then I have to make up for
it.
I'm out of control, right?
Dr. Jacqueline Trumbull (30:46):
So yeah , it's just, it's just painful
to think about how much shame isgoing to go with bulimia too.
I mean the the idea of hidingyour vomit or hiding your
excrement, right, like you know,these people are deeply ashamed
of that and they're they'reliving like in extreme secrecy
(31:09):
because that, that is somethingthat's going to get you rejected
very, very quickly, and I mean,people are going to be shocked,
right, people are going to behorrified by that, but it's it's
, it's like it's compulsive.
And my heart just kind of breaksfor people who are living that
existence.
Dr. Kibby McMahon (31:31):
Yeah, that's a tough one.
At least they're less at riskof dying than anorexia because
they're not undernourished.
But they have a lot of healthissues themselves.
I mean they, as you can imagine, like electrolyte balance of
you know, vomiting all the timeis totally off.
So I think that people canactually have like other health
(31:53):
issues based on that and thenlike just like I mean the throat
.
Yeah, it's really hard on thethroat and the teeth so you
could tell someone has bulimia.
But if they have of rottingteeth or this moon face people
call it Especially because ofthe pressure and everything
(32:16):
Sorry, this is gross, butthey'll have a puffy face.
So that's a sign of bulimia aswell.
Dr. Jacqueline Trumbull (32:22):
Oh, that's so sad, I know.
So that's a sign of bulimia aswell.
Oh, that's so sad.
I know I believe Britt Nielsen,who was on the Bachelor, opened
up about her struggles with Ithink it was bulimia, and she's
(32:44):
given beautiful accounts of whatthis is like.
Anybody kind of wants, like afirsthand account from bachelor
nation.
I really I remember watchingher videos and really respecting
her for for talking about it,because she it was no holds
barred.
I mean, she really talked aboutwhat it was like for her to go
into this emotional place andyou know, and and the shame
afterwards, um, I was gonna sayI, I think, I, I think it's also
(33:05):
counterproductive.
I think scientifically ourbodies absorb the nutrients very
, very quickly and so the vomitactually doesn't really
compensate very much for it.
But also it probably alleviatesthe pressure that builds inside
the body when you eat that much, and that might be part of it.
Dr. Kibby McMahon (33:26):
Yeah, absolutely yeah, I don't know.
I mean bulimia of course isassociated with that body image
concern, right, but it seems tohave, as you were saying,
different mechanisms of moreabout like, about like the out
(33:47):
of control and the trying to getcontrol back.
So it's kind of like thisemotion regulation kind of issue
, about like feeling totallydysregulated and then trying to
get regulation back.
Dr. Jacqueline Trumbull (34:00):
Yeah, and of course, binge eating
disorder.
There's no compensatorybehavior, necessarily, but these
binges are happening usuallylike in private.
There's a lot of shame about it, a lot of guilt about it and
again that kind of dissociativestate, um, and this I think like
(34:24):
there's a lot of shame also iflike this creates, if this
exists, in like overweight orobese people who then can have
like shame about eating in frontof people in general because of
the judgment they feel likethey'll receive for eating too
much or eating the wrong things.
So I mean, it's just god, it'slike.
Dr. Kibby McMahon (34:45):
Anywhere you look within this, it's, it's so
painful yeah, yeah, yeah, bingeeating disorder apparently is
the most common eating disorder.
Um, it's not usually, you know,usually people are overweight
or, um, average weight, but yeah, it's like, it's like binging
and then having like the hugediscomfort and distress after I
(35:05):
have.
I have probably, probably thatgirl from college had it, to be
honest.
Honest, because I didn't thinkI saw her.
I mean, I don't know about herpurging behaviors, but it's so
sad and that, of course, like,as you imagine, with problems
with eating a lot, you're athigh risk for diabetes and heart
(35:26):
disease and other hypertensionproblems.
Dr. Jacqueline Trumbull (35:30):
So it was also very dangerous, okay,
so if we have a loved onestruggling, wait was also very
dangerous.
Okay, so if we have a loved onestruggling, wait wait, wait,
there's one more.
Dr. Kibby McMahon (35:38):
There's body dysmorphia, which we'll cover in
another episode, because Ithink you have it we talked
about this where I'm like, uh-oh, I think you have a disorder,
jacqueline, I think we shouldtalk about it.
Dr. Jacqueline Trumbull (35:51):
I do not think I have a disorder
Publicly.
Maybe be the light or something, but we can yeah.
Dr. Kibby McMahon (35:57):
This episode is my way to be like.
I think you have some of this.
I'm serious, Serious.
Loved ones, Loved ones, no,well, one more to remember.
I think this is getting alittle bit more attention
because sensory processingdisorders are getting more
attention.
But avoidant, restrictive foodintake disorder, ARFID is when
(36:19):
someone limits or controls whatthey eat because they're afraid
of other negative consequenceslike choking or throwing up like
they're.
They're like oh, there'scertain foods I don't eat
because I'm terrified ofthrowing up, or they don't like
the texture.
Um, of course there's levels ofthat.
That's normal, but it'sespecially if it's like the.
(36:40):
They really restrict their food, right, they only have certain
textures.
Dr. Jacqueline Trumbull (36:45):
Um, but it's not about weight, it's
about it's not.
Yeah, yeah, it's like a, it'sjust an intolerance, yeah.
But I mean like, if you are aloved one of somebody with one
of these disorders, I reallyfeel for you.
I mean, I feel for anybody withthe disorder as well.
But to watch someone you lovewaste away or not be able to
(37:11):
control what they're putting intheir body and not from, like
you know, binge eating disorderis not somebody loving to eat
this is not an enjoyableexperience.
It is a distress tolerance,it's a distress management
system that they hate and thatmakes them feel intensely
negative about themselves and itfeels out of control.
It's not like I'm going to, youknow, enjoy my time eating this
(37:34):
feast.
So you know, I mean it'swatching somebody engage in
legitimately dangerous behaviorand feel like they can't stop.
And I do think your kind ofjourney with it as a loved one
differs depending on the eatingdisorder.
But do you have kind of initialtips?
Dr. Kibby McMahon (37:56):
I mean the tips are, I mean just know that,
just knowing, first of all, andthe major tip is knowing these
different eating disorders soyou could pick it out, cause
some people might not alreadyknow oh, this is what you know.
If someone throws up, that's asign of eating disorder and not
realizing that their friends ortheir families, like dieting
behavior, could be eatingdisorders.
But it's really tough forfamilies and loved ones because
(38:21):
it's kind of like I think theissues kind of sound similar to
addiction or you know anythingelse like that, where there's a
lot of trust problems.
There's a lot of like uh sitesaround it, right, like I, you
know, trying to get your kid toeat or trying to, you know, get
someone to eat more or behealthier, and they, um, they
(38:44):
hide how much they, they don'teat, right, they like hide their
purging behaviors or, um, yeah,you could get into a battle of
like control over the person'seating.
You're like monitoring their,their eating, and so it could be
really stressful because it's,like, you know, eating is such a
social bonding experience, likedinner tables, you know.
(39:08):
You know family dinners cansuddenly become like, you know,
a dinners can suddenly becomelike a battleground, right, and
then on the other side, theremight be some ways you might be
accommodating or even enablingsome of those behaviors, like
allowing you know that loved oneto like not eat as much, or
(39:28):
make sure that you only havecertain foods or, you know, be
okay with their.
You know intense purging, but Imean tips.
Number one, we all knoweducation, yeah.
Dr. Jacqueline Trumbull (39:42):
And also education about therapy.
I mean, I think a lot of peoplethink, oh, my daughter has
anorexia, I need to get her atherapist.
But I would maybe think thatit's actually more appropriate
to at least additionally havefamily therapy, because this is
a family-related problem.
Dr. Kibby McMahon (40:01):
Yeah.
I mean to that point, you know,I should link our episode with
Nandini talking about familytherapy, for, especially like
teens and kids with eatingdisorders, because that really
does highlight that.
You know, this is the case withall the mental disorders we're
talking about, but especiallywith this, because food is so
(40:22):
food and eating are so, I don'tknow, relational that working on
the system needs to happen,right, like making sure that
you're not accidentallyreinforcing you know, some of
that, some of the disorderedeating, like, for example, like
try not to make comments abouttheir weight.
(40:45):
Right, like, I mean even justeven just saying like, oh,
you're looking good now, or youlook terrible, you look so
skinny, right, like all thesedifferent comments that you
could say to one person and itmight hurt their feelings or
whatever and might not have suchan effect, but someone with
eating disorder, it'll kind ofsend them into the spiral, right
(41:07):
, like, oh, you look skinny andit could be meant as a
compliment, but they go, oh, butoh, I, you know someone's
noticing my body, oh, I'mstarting to think about how I'm
actually fat and you know, itcould really, it could really,
you know, add to themselves.
So, like, try not to talk aboutlike weight, um, or eating or
dieting like that.
Dr. Jacqueline Trumbull (41:27):
I mean or accidentally reinforce them.
If you say, yeah, you lookterrifying, you work to
accidentally reinforce them.
If you say, yeah, terror, youlook terrifying, you look like
you're starving yourselves, itcould be seen as a great time
finally succeeding.
I mean, we don't know, but it'sright.
Bringing attention to the waythat the body looks is
counterproductive.
But also, I think like if, ifyou're struggling with anorexia
and bulimia in a different waythis I mean especially like as
(41:48):
an adolescent, it's it's likelythat there are dynamics within
the home about control likepower and control, and so
understanding those and helpingyour child have power or control
in different, healthy wayscould be an easier ticket there
than being like go work on yourproblems alone.
(42:08):
Go work on your problems alone.
Dr. Kibby McMahon (42:11):
Yeah, I imagine that that must be so
hard.
If you like see your kidessentially starving themselves
and not you know, try to getmore control over them, right,
just be like, no, you've got toeat, right, and that actually
will backfire because they'regoing to try to push for more
control.
So, yeah, like talking aboutpower dynamics and control and
agency and trust and buildingtrust slowly with that yeah, an
(42:38):
example of what not to do.
I don't know if you heard aboutTessa.
Have you heard about Tessa?
Dr. Jacqueline Trumbull (42:42):
No oh.
Dr. Kibby McMahon (42:44):
OK, tessa was an AI chatbot that the National
Eating Disorders Associationadded to its hotline chatbot
that the National EatingDisorders Association added to
its hotline, and this is also anexample of how AI can you know
kind of go rogue if you're notcareful with it, but it was.
it was supposed to.
You know, deal with the all thepeople calling in asking for
(43:05):
help with eating disorders, andif you don't, if you don't like
monitor and have oversight overthe chatbot.
This is what.
What happened.
So it started to recommend likeweight loss and calorie
counting and like measuring bodyfat.
Like I started to give diettips to the people calling in to
(43:27):
the hotline.
Um, yeah and so, so, like ofcourse, the chatbot is just
going to do whatever it asks.
So they were probably just likeit was probably just answering
the questions of like how tolose weight, but you don't do
that on a on a you know hotlinefor for eating disorders.
So it was quickly taken off.
But don't do that Like don't,don't, you know, unmask you have
(43:49):
eating to the people witheating disorders, diet tips, but
don't do that Like don't, don'tyou know a mass you have eating
to the people with eatingdisorders, diet tips, but don't
do that to your loved ones too.
If you see someone who'sstruggling with eating disorders
, try not to step in with youradvice, right?
Because all of this kind ofeating and body image, you know,
advice that we have are comingfrom not having a disorder,
(44:12):
right?
So if I say, oh, you look great,just cut out sugar, or um, wow,
but you look, so you know justthe, the, the diet tips that you
might have that might work foryou, um, or even like
compliments or reassurances,might land differently for
someone with eating disorders.
Dr. Jacqueline Trumbull (44:28):
So yeah , you know, don't do that.
You're also probably not anutritionist, so it's it's
probably not necessary forsomebody who's like, really,
really struggling with this kindof thing.
Um, and if you are anutritionist, also don't, don't
go that.
But, um, I just think that thethe like, maybe the well-meaning
(44:49):
advice, can be like oh, no, ifyou want to lose weight, like, I
can tell you how to do in ahealthy way, but it's like no,
we actually want to take thefocus away from weight loss and
from trying to control food.
Um, binge eating and bulimiacome with massive amounts of
shame.
I think you know, if you areaware of somebody struggling
with this, trying to be asvalidating as possible, trying
(45:11):
to be as de-shaming as possible,is helpful.
Dr. Kibby McMahon (45:15):
I think, keeping in mind all the things
that we said about this whereit's very dangerous to your
health, right, people witheating disorders might think
differently about food and theirbody image and everything like
that, and it hijacks your brain,so it becomes.
It's a disease, right?
(45:36):
So don't blame them or justassume like what's the problem?
Just eat, right.
Like, just eat a little bit,you look great, right?
So don't treat it like this issomething to make fun of them
for, or that they're have amoral failing or they don't have
a problem.
Like, take this as a serioushealth issue and don't blame
(45:57):
them or get mad at them or makefun of them, right?
Like teasing can really beawful, right?
Dr. Jacqueline Trumbull (46:03):
And I think also like looking out for
you know if you are the mom orsister or whatever the case may
be, but like really look out foryour other relationships.
I'm, you know, I've I've workedwith a couple who they, their
their kid, didn't have anyeating disorder per se, but
another like really, reallyrough, um, you know, disorder
(46:24):
and tore the marriage apartbecause they're so freaked out
all the time that this is theirfault and they're, you know,
when you feel like you'redealing with something life or
death in your kid, if you'rewatching your kids starve
themselves, then everything youdo feels like it has life or
death kind of consequences, andso the probability that you and
(46:46):
your spouse in particular willstart panicking over the
individual decisions that youmake, it just carries really
high risk.
Right, like it, you know it.
It makes it hard to like thisI'm trying to think of of an
example Um, let's say there's a,a couple um with a kid who is
(47:08):
couple um with a kid who is noteating at the dinner table and
the dad freaks out and says youare not leaving this dinner
table until you have five bitesof food Right, and then the mom
is like, oh my God, you'repushing her, you're you're going
to make eating an even morestressful experience, and she's
like it's okay, honey, it's okayyou don't have to eat.
(47:30):
But then he's like you'reletting her starve, right, like
(47:50):
I'd rather force feed her thanand then saying like we are
going to go in with the sameintentions here and we're going
to understand that each of uscan't be perfect all the time
and we're going to freak out.
And this is coming from a placeof being really scared because
we love somebody who'sdestroying themselves.
Dr. Kibby McMahon (48:08):
Yeah, no, that's a really good point.
And having the balance betweenthose two sides, right, like you
hear the polarizing, you know,I just maybe, I just heard that
in what you're saying One islike they've got to eat and we
got to make them eat, and theother one's like no, no, no, we
don't want to upset them.
Uh, eating disorders can hijack, like, the whole family dynamic
(48:33):
, right.
Like then, what do you do atdinners, you know?
Do you have?
Do you do you all just like noteat together, just so because
it's so triggering to eat infront of um, this one kid, or do
you force them to eat?
Like what?
What do you do?
And so, having a balance andhaving being on the same page,
like with a plan of how to dothat, and not having all these
different rules, but, you know,just being on the same page by
(48:54):
having some boundaries but alsogiving them some agency, like,
okay, we're going to have familydinners, we are going to eat
meat or whatever.
You know, fatty foods might,you know, be otherwise
triggering.
You're welcome to join, as longas you know, even if you just
sit with us, right?
So, just, I mean making surethat it doesn't get to.
(49:20):
I don't we don't like that wordenabling, but either
accommodating those you know theloved one with an eating
disorder.
Don't accommodate too much andshape your whole life and family
life around protecting theirfeelings around it.
So even maintaining some levelof normalcy and healthy
boundaries is really important.
Dr. Jacqueline Trumbull (49:40):
Yeah, I mean, I think that you can
include healthy aspects of yourmeal, include fruits and veggies
, but not say tonight we'rehaving celery for dinner.
You know, not necessarily turnthe entire family vegan suddenly
to say like, look you, you knowyou've got your safe foods on
the plate.
They're nutritious, um, this iswhat's for dinner.
(50:02):
And trying not to get into apower struggle with them, I
guess.
But I mean this is one I wouldnot wait to get help with.
So, finding a really qualifiedeating disorders therapist if
that is in your area, um, youknow, finding somebody that you
can talk to about this, notisolating, right, like hopefully
(50:23):
finding validating friends whoaren't blaming you, the parents
or siblings or whoever it is.
Then you, this family dynamic,um, and you know, like, I
actually have a friend who, whogrew up in a family who's where
his sister had this eatingdisorder and he felt very kind
of passed over.
His parents were just kind oflike, well, he's fine, you know,
(50:44):
we've got this crisis on ourhands.
So then he, he grew up kind ofneglected.
So you know, I mean there'sjust so there's so much here to
talk about, um, and that's whyfamily therapy can be so
important, right, because it'snot actually just about the
person with the eating disorder.
That little boy is part of thefamily too and he's kind of
wondering what about me?
And the parents are freakingout and their marriage is
(51:05):
falling apart, and you know?
I mean there's all of thesedifferent dynamics that need to
be brought in.
Dr. Kibby McMahon (51:17):
Yeah, and it's like the the extreme
examples can take over the wholefamily dynamic.
But also I also think thateating disorders unless people
are aware of it it's, it can besneaky and go and fly under the
radar, cause there might beother issues.
Especially if you're dealingwith someone with bulimia who
has impulsive behaviors ingeneral right, they're also
(51:39):
self-harming, or they're alsodriving drunk or they have
another addiction or somethinglike that then that might get
more attention.
But I think when you have aloved one who is like, dealing
with a lot of mental healthissues include, you know,
talking to their therapist thatyou don't notice right away like
, oh, they're eating less orthey're working out after eating
(52:16):
a lot.
Right, like that could seemalmost like in the realm of
normal.
They have this crazy diet thatthey're following and they're
dropping a ton of weight andthat's so great because they
look so good.
Right, Like it is easy to kindof like have those.
These disorders be like totallymasks, but they are part of the
problem and they take a lot ofpatience and a lot of like
(52:42):
specialized therapy to treat,because it's not just like, oh,
they start to eat normally andall the problems are are gone
like they might be eating andthey might actually be, like,
properly nourished, which isgreat, but there might be all
those other mechanisms involvedthat still need help, right,
Like you know.
Question of control, question ofdistress, tolerance, question
(53:04):
of like their self esteem right,their impulsivity right, this
it's, it's all these otherthings that could be like.
Okay, just because the eatingis fixed doesn't mean everything
else is fixed.
Dr. Jacqueline Trumbull (53:17):
Right.
Dr. Kibby McMahon (53:17):
Exactly.
I feel like we might be scaringpeople.
Dr. Jacqueline Trumbull (53:21):
This is a big deal, super deadly, super
dangerous.
Dr. Kibby McMahon (53:26):
You might not see it.
I mean, yeah, I think that's Idon't think we need to freak out
over weight loss.
Dr. Jacqueline Trumbull (53:32):
But I, especially in like early
twenties adolescence, I'd be,I'd be worried, you know, um, if
I saw eating behaviordrastically change in my kid and
fostering an environment of,like you know, we eat healthy,
but we eat to fuel our body, notto, like you know, sculpt our
body into perfection, which waswhat I learned.
Dr. Kibby McMahon (53:58):
It's important, yeah, you tell me
what are the tips for loved onesfriends podcast co-hosts of
someone you don't have eating?
I'm kidding, I just sit, justsit, like I told we just said
not to make a joke out of it.
Dr. Jacqueline Trumbull (54:13):
Look at me, you know, publicly shaming
you for this but what's tough isthat it's a lot of people have
behaviors along this line.
You know, like it's not like Ican really go through my week
not thinking about what I eat.
Every time I have a meal, Imean I calorie count.
I'm like if I have simple carbs, you know, then I'm starting to
freak out a little.
(54:33):
I mean I calorie count.
I'm like if I have simple carbs, you know, then I'm starting to
freak out a little bit, likehow am I going to get?
You know, how am I going toreverse this situation?
If I have takeout, I'mconstantly thinking about, like
what oils do they use?
Dr. Kibby McMahon (54:44):
Really.
Yeah, I shouldn't be surprised.
I mean you shouldn't, I mean I?
The thing that I get usually isyou thinking that you're, you
don't look good in like picturesor videos, and I'm like you
look great as always.
And then you're like look atthis, look at this flaw, and I'm
like I don't know what you'retalking about, but okay, but I
didn't realize that, like, everytime you eat, you did you do?
(55:06):
Do you do something in responseto that?
Like, do you actually likerestrict yourself or do you have
compensatory?
Dr. Jacqueline Trumbu (55:15):
behaviors .
I mean, I don't purge, no, that, um, that's a, that's a no.
But I'll go through periodswhere I'll restrict what I eat a
lot.
I just can't.
I, I don't, I actually don'thave the.
I don't want to use a positiveword here like self-discipline,
because I don't want to likereward the idea of restriction,
(55:38):
but I usually can't keep itgoing for more than a couple of
weeks.
Dr. Kibby McMahon (55:45):
Yeah, that's tough.
I remember when I went, youknow, when my friends and I all
got you know, you know eighthgrade started to get interested
in boys, started to becomesexual beings.
I did go on that Atkins diet.
I did diet intensely for acouple.
I was working out a lot.
I probably had an eatingdisorder if I were to think
(56:06):
about it.
But I wasn't like severelyunderweight, but I remember
always thinking about it, alwaysthinking about food, what I was
eating, I was.
It was right, we were writingthings down, we were calculating
.
It was there was no likeenjoying the food, it was all.
It was all like an achievement.
You know, it was all like thesame thing as like doing
(56:28):
homework and I just remember the, the immense like reinforcement
and the power that you get fromit.
Like you drop weight andsuddenly people are nice to you,
they're paying attention to you, they're praising you Like
they're, they're talking aboutyou as though you are like
(56:50):
better than them or somehow likehave other skills.
Like they're like, oh gosh, Iwish I could eat as little as
you are.
You know, I wish I could be sodisciplined as you while I was
like eating like one turkeyslice for lunch.
You know, it's like you reallyget a lot of social
reinforcement.
I always remember that and Ialways remember being kind of
scared of that.
I was scared at, you know,whenever I think about like
(57:17):
cutting back or, you know,dieting or getting healthier,
now I always remember and getscared of like the massive
change in how people treated you, but also like how much, how
consuming it can get.
Dr. Jacqueline Trumbull (57:26):
It's a lot to think about.
I mean it's it's tough, you know, because when I think about the
things I do, you know like I'lltry to eat less than $500 for
lunch so that I can eat 1000calories for dinner and then
still be at like a caloriedeficit.
(57:55):
But it's kind of like then yougo online and everyone's like
here's how to eat 1500 calories,or like here's how to eat 400
grams of protein, so that youknow you will lose weight
immediately, like it's just, andyou do have to think about what
you eat to an extent.
You know, like I I'm not goingto sit around eating 4,000
calories of Pringles, like youknow I'm.
I'm trying to think about fiberand and so it's not like we're
not supposed to think about whatwe eat at all.
But suddenly there's this sortof magical line where we have
crossed into like disorderedeating territory and it's very
(58:15):
confusing because it's like well, how much thinking about what
you eat is too much thinkingabout what you eat.
Intuitive eating like what isthat?
Because some people who havegrown up on ultra processed food
for them intuitive eating meansultra processed food Like I.
Just I don't know what theright answer is for a lot of
this stuff.
Dr. Kibby McMahon (58:34):
I mean when in doubt, seek help.
Yeah, I think that's thebiggest tip.
If you're not sure, if you'relike you notice that your loved
one is kind of going nutsTessa's got some great diet
advice I hear, so yeah, Greatdieting tips, tips Um, but yeah.
Dr. Jacqueline Trumbull (58:51):
Well, on that depressing note, um, you
know, I, I mean it, it, theseare, these are a really scary
group of disorders, like I, Idon't think that there is
necessarily too much fearmongering here.
I think if it's something thatyou suspect about your kid or
somebody that you love and it'sworth a conversation and it's,
it's worth thinking about, likewhat kinds of resources are
available to our family, um, andI just want to like validate
(59:14):
anybody's experience who's outthere, you know, dealing with
this, because it must be reallyscary.
Okay, well, with that, if youappreciate this episode, um, or
any of our episodes, pleaseleave us a five-star reading on
apple podcast or spotify.
It really helps us out andwe'll see you next week.
(01:00:27):
Thank you, or organizationpresented or mentioned in this
podcast and information fromthis podcast should not be
referenced in any way to implysuch approval or endorsement.
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