February 19, 2024 • 42 mins
Welcome to an enlightening episode of the Inscape Quest podcast show, where we are thrilled to host Tabitha Farrar - a distinguished Eating Disorder Recovery coach, author and podcast host. In this episode, Tabitha shares her life experiences, challenges and recovery journey from an eating disorder. Delve into understanding various manifestations of restricting eating disorders, and explore the importance of listening to our bodies for optimized personal well-being.
In this episode, we also delve into the intricate world of nutritional science and its impact on our diets and eating disorders. The conversation underlines how misinterpretation of correlational study results and relying heavily on media-proclaimed diet norms can lead to problematic dietary practices. Discover the role of food restriction during the recovery process and the concept of a truly balanced diet being a result of listening and trusting our bodies.
Giving a new perspective on eating disorders, we delve into the theory of restrictive eating disorders being self-preserving responses to food scarcity, exploring a possible biological connection between the two. The episode concludes with a discussion on societal attitudes and misconceptions about eating disorders. Understand the importance of addressing the underlying biological stress before making psychological diagnoses.
From examining the impact of biological stress and energy deficits to exploring the role of neural rewiring and familial support in recovery, this episode offers rich insights into the intricate world of eating disorders. The episode underscores the pressing need for a reform in treatment systems and shares effective resources to aid understanding and recovery from eating disorders.
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Episode Transcript
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(00:02):
Hello, podcast listeners. Thank you for tuning in today.
You are listening to the InScape Quest podcast show, and I am your host, Trudi Howley.
Here I am talking with people about about how they engage with their relationships, work, and passions.
(00:28):
Please share this with a friend, and thanks to you, we can grow meaningful conversations
together, one episode at a time.
Music.
Welcome to this episode with my guest, Tabitha Farrar, eating disorder recovery coach, author,
(00:56):
podcast host, farm owner, and horse-mad equestrian.
Music.
I'm excited to get to talk to you today, Tabitha. Welcome. Hi, Trudi.
I'm curious about your day and how you just maintain this sense of easy,
(01:25):
straightforward, calm when you've got so many different things going on in your life.
I function quite well in a relatively chaotic environment and so that sort of
suits me to to have quite a lot going on which isn't to say that I don't get
tired and like I'm stressed by it all sometimes I do but I think that just generally
I like to have quite a few things,
(01:50):
happening and I get sort of pretty inspired and excited by all of that I do think though.
Some of that is going to come down to having having
had had an eating disorder for such a
a long time which is really if you have an
eating disorder it's just so incredibly stressful
(02:10):
and chaotic that for me
now sort of even a really sort of busy life without that on top is really quite
manageable okay sort of like an extra level of especially for me my experience
of an eating disorder was one with a really strong and high exercise compulsion.
(02:32):
And so I was having to exercise for around six hours a day, like sort of like
pretty extreme exercise as well.
And so even just sort of fitting that all in around work and around all of the
other movement compulsions that I had, because I have more than that six hours
a day of movement compulsion.
It's just, then if you think about it, now being recovered, it's like I've really
(02:55):
got got six to eight hours extra that I just didn't ever have before.
And it's always, everything feels easy after you've lived through that sort of thing.
That's great. So it's familiar to you to be able to juggle a lot all at once as well.
So you recently had an accident and surgery and your wonderful dog Breck also
(03:21):
is recovering from surgery.
And so what have you kind of learned about yourself in having to kind of really
slow slow down for a short time.
I do actually find that quite, not necessarily stressful, but it just removed,
when I removed doing a lot of the things that I really enjoy doing,
(03:43):
definitely for the first couple of weeks, I felt quite low and just,
you know, I can ride horses.
I can just do a lot of the things I was supposed to be doing.
I was just supposed to be sitting inside and resting. And although I was quite tired and I,
for at least, especially the first last week I really wanted to rest
so it was easier but then after that when I was my energy
came back I really actually struggled with just being like I can't do
(04:05):
any of the things I really like doing so I I
found that difficult and but
also really great when you actually get to the point where you can start doing
the things again that you enjoy doing because then you didn't take them for
granted and it just it's sort of really life is fun again that's great really
(04:27):
enjoying it So I'm glad you're having a good recovery.
I'm curious about this idea of when people are injured or laid up or if they
overexercise and they get injured.
It can be really challenging for so many people to have their routine disrupted.
(04:48):
Interrupted and I'm wondering what happens to
somebody when they're there in the throes of
an active eating disorder what what happens
to them when their normal life suddenly gets interrupted by yeah so you know
injury especially say if we're talking about injury for somebody that has so
(05:09):
not everybody who has a restrictive eating disorder has a compulsive movement
element but but I think the majority do.
I'd say 75% to 80% in my experience do.
And that compulsive movement element can look like a lot of different things.
Mine looked like a very extreme version of it.
And I think a lot of people get a bit confused by that because they might say,
(05:32):
well, I don't have compulsive movement just because they're thinking of the
extreme version of meaning that you have to be running six hours a day.
Whereas actually what compulsive movement can look like is, like a lot of people
have compulsive walking when they have an eating disorder.
And that's just so, you know, you're going for multiple walks a day.
And a lot of people even excuse that with, well, I have to walk the dog,
(05:54):
when really actually the underlying anxiety is not because you think that the
dog won't get a walk, it's the underlying anxiety comes from the movement compulsion.
And so I think that it can be really.
Difficult for a lot of people to even understand if they have
a compulsive movement element and overlooked a lot of the
time and it's definitely one that's very much overlooked by treatment
providers and doctors because everybody's like oh exercise is good for you always
(06:17):
and not really on the lookout for when it's not but one of the things that can
really be a big telltale sign is if somebody gets injured and then continues
to exercise through that injury can't do the rest period.
So I had, because I was doing a lot of running, I had a fair amount of injuries to my legs.
(06:38):
With that, I don't think I ever for injury took a day off running.
I would run through pain.
And I also, I had a broken elbow once and I was sort of still cycling with a
broken elbow and doing all these things, you know, I just never took a day off.
And so that's actually for a lot lot of people not being able to rest for an
(07:00):
injury and having to just continue to do their compulsive movement routines
is a big telltale sign that it is a problem.
And I think that one of the many reasons that make that even possible for people,
because I've known people that have really sort of like broken ankles and things
like that and continue to do an exercise routine.
(07:20):
And you might think, well, how is that even possible?
And I do think, or I do believe that when the the body is as biologically stressed
as it is when it has a compulsive eating disorder, it hasn't got enough energy,
and then it's got this compulsive movement element that.
It's not so much that we just develop a high pain threshold.
I think that the body artificially doesn't actually cure as in on pain as a
(07:45):
well person's body might be.
And I sort of trace that back to more evolutionary and maybe biological aspects.
So if you think of migrating animals, You know, that's a biological stressor
for sure to have to go through migration.
And if a bird has to migrate across the ocean, it can't just stop because its wings got tired.
(08:06):
And I see a lot of that happen in people who have restrictive eating disorders
is that I think that their ability to keep going and exercise day in,
day out is actually a function of the body thinking like we're in a environment
where we can't stop, got to keep going, got to keep going, got to keep going.
And so those sorts of traits can be real telltale signs.
(08:27):
When people have a compulsive movement element so yeah
the answer to your question would be that i it when i had an
eating disorder oh hell i would have just been wouldn't have
stopped for a day i would have been running through that and that's not
fun either you know like having to do that is quite distressing actually but
yeah not exercising would be more distressing so yeah so it's like a vicious
(08:50):
cycle there you know as you are an expert in eating disorder recovery and and
you coach many people all over the world,
like what are the different ways a restrictive eating disorder can show up?
Yeah. So a lot of people have, and I sort of think there's some stereotypical
ideas of what say anorexia is and what anorexia looks like.
(09:13):
And most of those ideas are sort of like a teenage girl who's very underweight
and not eating, you know, that's what restriction is, is just not eating.
And so a lot of people don't understand themselves that they may have a restrictive
eating disorder and a lot of treatment providers don't understand that their
client might have a restrictive eating disorder because there's just this stereotypical
(09:35):
view of what that looks like.
Whereas really for most people, what restriction, restriction can be quite subtle,
but it can be if you're consistently eating slightly less than your body really wants you to eat,
then the accumulative effect of that.
Can be quite large. And so people with long and enduring eating disorders,
(10:00):
it was incredibly rare that I ever missed a meal.
I did not eat meals particularly frequently.
There was a period where I was consistently not eating some meals,
but overall, over the span of the years, I ate meals.
And so that was one of the reasons that I could tell myself,
I don't have I have anorexia because I eat every day.
And I eat what people might consider to be a fair amount every day.
(10:24):
But also, I was eating in a way that was restricting every time I ate.
I wasn't really allowing myself to eat exactly what I wanted in the quantity that I wanted.
I was restricting in terms of I was forcing myself to eat foods that I believe
to be lower calorie, lower fat than the versions of that food that would have
been higher calorie, higher fat.
(10:46):
That I was restricting in that I was forcing myself to eat just slightly less
or sometimes largely less than the quantity of those foods that I really wanted to eat.
And I was definitely restricting in that I was not listening to the hunger signals from my body.
So I had my set meal times when I would eat and if my body asked me for food
outside of those times, no hope, it wasn't going to happen.
(11:07):
And so restriction can look like a lot of different things and it's very very
rare, the restriction actually looks like not eating.
So that's pretty interesting to me that you use the phrase like listening to hunger signals.
So if somebody, you know, is on a diet or they're trying to slim and,
you know, it's so prevalent in our culture about, you know, fitting into your
(11:32):
genes and, you know, looking a certain way.
So So if you're on the path of restrictive eating, would you frame that as you're
not listening to your body's hunger signals? Absolutely.
We live in a culture, actually, that...
(11:53):
Teaches us to distrust the body when it comes to managing our food intake and our weight.
And so we live in a culture that teaches distrust of the hunger signals from the body.
And so because that's a cultural thing, that's not just something that people
with restrictive eating disorders do.
That's something that is culturally sort of encouraged a lot of the time,
(12:13):
and often a lot of the time encouraged by doctors and healthcare providers.
Providers and so that distrust teaching
that distrust well-meaning as it might be
kind of teaching that distrust of the body can
has numerous ill effects and
not just for people with eating disorders as well but you know it teaches us
to see the body as well especially hunger signals to see if that is a vice that
(12:37):
the body has to ask us for food yeah think about it it's just a biological system
and we have plenty of biological systems and the majority of them are mostly automatic.
We don't have to be particularly involved in them. And then there are some of
them like our food intake system and excretion system going to the toilet,
which every now and then the body needs our conscious involvement in.
(12:59):
And so it communicates to us when it needs that conscious involvement.
And because it's not a culturally encouraged thing to ignore the biological
cues for the excretion system when you need to go to the toilet,
you know we just if the body says hey i
need to go to the toilet you don't even think about it you just get up and you go to the toilet
and really the food intake system to work
(13:21):
optimally if mind and body are working optimally that
should be the similar sort of thing but obviously because of people's fear of
weight gain that gets massively distorted and i think that that just creates
real gap between mind and body and somebody be able to work with their body
and And if we're not working with our bodies,
(13:42):
our bodies can't function optimally because we're not in the habit of giving them what they need.
Yeah, absolutely. I love that you say that, like not giving your body what you optimally need.
And from my work, when I work from a somatic, you know, body-based view with therapy,
(14:03):
it's It's like so many people just distrust their body's signals in general
and distrust the sensation.
So as you bring this up, I'm curious,
like what percentage of the population actually might have some kind of restrictive
eating disorder because of all the complex messages we see in our cultures?
(14:28):
Yeah, it's kind of difficult not to, honestly, on some level.
You know, it's a spectrum, but on some level, a lot of people actually, when I.
Say talk to them about like a hunger signal is
just a cue from your body that something needs to
happen and it needs something from you kind of look
at me as if that's a radical concept because it's just so from the age dot instilled
(14:52):
in us that hunger is just this vice that humans have yeah it's like not a life-sustaining
function what about the difference between hunger and And nutrition in terms of,
you know, there's a lot of information out there and about healthy eating,
whether or not that's correct.
I don't know. I'm curious what your thoughts are.
(15:14):
Yeah, I think you hit the nail on it, whether or not that's correct. I don't know.
And I wish more people would express it like that, because the reality around
nutritional science as a science is that it's a science in its infancy.
We really don't know very much.
Most of the research and most of the studies, because it's unethical to do it
any other way, is correlational.
(15:36):
And so it's just looking at different variables and making drawing sort of conclusions
out of correlations, which then most scientific people know why correlation
doesn't equal causation.
But in nutritional science, that's happening all the time.
And it's limited because it's not okay to treat people like lab rats.
(15:57):
You can't lock them in a room and completely control all the variables in their
life. And so that's why it has to be that limited.
But the issue is not necessarily that nutritional science is in its infancy
because most science starts off that way.
The issue is actually that we don't treat nutritional science and the conclusions
that come out of such studies as if the science is in its infancy.
(16:20):
We take it as if it's word that someone said, there's a correlation between
sugar and X, therefore sugar is bad and we all need to cut sugar out of our diets.
And most of the researchers never even intend that to be the reaction.
It just gets taken by the media and it gets blown up.
And the reason it's newsworthy is because so many people are afraid of gaining
weight and so are constantly looking for things and ways that they can limit their food intake.
(16:44):
And so nutritional science is dodgy. It really is.
And one of the the scariest things is when we take something like nutritional
science and then make blanket statements over how all humans should eat and
how all humans should work with their bodies.
And then also people are taking suggestions from interpretations,
(17:08):
media interpretations of studies, you know, like, oh, you know,
if you're craving chocolate, you should actually eat pistachios.
That would be a suggestion, I think, that often does the rounds or something
like that. And they're taking that suggestion and they're trusting that.
Over the cues from their body. So the body is cuing them, hey,
I want to eat something like chocolate.
And then they're trusting some media representation of some study that didn't
(17:31):
even actually come to that conclusion, but that's the way it was interpreted
and actually making that decision and then giving their bodies something that
the body didn't actually ask for or want.
And that's where I think it becomes really problematic. matter yeah so
I know you mentioned chocolate and I've I'm
aware of you having eaten double
cream and cake in your
(17:54):
recovery process so are
there nutritional restrictions when someone's in recovery not in my book no
okay none at all none at all you know because well I actually think And I do
believe that it is restriction that causes the overconsumption of food.
(18:16):
And so I don't think humans have had such a big problem with overconsumption
of food before the diet industry really got hold.
And so it's often the restriction of a certain type of food or a food group
or a nutrient that causes the body to want to seek that food out.
And when it finds that food, actually eat as much of it as possible. and
(18:36):
so that's generally what happens in eating
disorder recovery is we binge eat because the
body is in deficit and the body believes that food
is scarce and when it gets any opportunity to eat it's going to get us to intake
as much fat and as much sugar as it possibly can because it's in deficit for
those things but that doesn't just happen with people with restrictive eating
disorders you can create deficit in a perfectly create deficit in a non-underweight
(19:02):
body by restricting a certain type of food,
you can make your brain crave that food and want to eat large amounts of that food.
I think that when we really are listening to our bodies, trusting our bodies,
then a naturally balanced diet is the result of that,
because the body doesn't have to override you and cause you to binge on a load
(19:24):
of foods that you haven't been allowing it to have.
You know, the body will always ask for things nicely first.
And then if you restrict, restrict, restrict, there does usually come a point
where the body just says, all right, I'm going to take it.
And that's when a binge happens. happens and so that's why a lot of people who
control shall we say their sugar intake are also people that say i can't have
sugary foods in the house because if i have them in the house then i'll binge
(19:45):
on them well there's a reason for that and if you stop trying to control your food intake,
yeah you'll go through that binge period when you have all that food in the
house but you'll also come out the other side of that and the brain won't feel
it needs to do that all the time and you'll be able to have all those foods
in the house and you'll just eat them when you eat them or want them and you won't when you don't.
So it's a process that we have to go through really to achieve a balanced diet.
(20:09):
And it's scary for a lot of people, the idea of unrestricted eating and that
idea of, well, I'm just going to drink pints of double cream and eat your whole
chocolate gatos like I did. That's a scary concept.
But it's also the understanding that you go through that to get out the other side and get to balance.
And it's the restriction that causes that huge consumption or the desire to.
(20:33):
When you talk about food being scarce, at what point does the body and the brain
decide that food is scarce?
So the way I look at restrictive eating disorders is as a biological function.
(20:53):
We have, or when I say we, I mean the industry has, Cindy Buick and her team
have shown that eating disorders have a genetic base.
So there's a genetic base. You either have the genetic predisposition for an
eating disorder or you don't.
And what triggers those genes to become active or start working is energy deficits.
(21:14):
So consistently not consuming as much food as you you need.
And so then I look at that from a, why would some people have a genetic element
to them that says when they consistently consume less food than they need, this thing happens,
which causes them to not want to eat very much and most of us to want to exercise a lot.
And so if we look at sort of animal models, it looks very close to migration.
(21:40):
And animal migration, say for bird, what triggers the desire to migrate is lack
of food in the environment. That is the signal to the bird's body.
And so that's not because the bird's looking around the environment and saying,
well, it doesn't look like there's much food here.
What's happening is the bird is starting to consume less and less and less every
day until it gets to a point or a threshold, which then triggers that migration response.
(22:02):
So that's how that works in birds. And that sounded to me very similar to what had happened to me.
I consistently didn't eat enough food, not massively.
I wasn't dieting massively or anything, but I was eating less than I needed. it.
And then at some point I got to a threshold where I couldn't reverse it.
My desire to move, my desire to exercise really took off.
And migrating animals also, one of the functions of migration in most migrating
(22:27):
animals is that the brain starts to disincentivize feeding behavior,
which makes sense if you think about it.
If there's not very much food in the environment, the brain doesn't want that
animal to hang out and hunt for food.
That brain wants that animal to actually be not very interested in food so it
can get on with the process of moving and and migrating out of there.
So disincentivization of feeding
(22:47):
behavior is also present in migrating animals. And that's what felt.
What my eating disorder felt like to me. I just felt like I was disincentivized
to eat. It's not that I didn't want to eat. It's not that I wasn't hungry.
I just felt huge anxiety about doing so. And I felt like it was wrong to do so.
I couldn't explain the wrong. I couldn't explain why I felt that.
(23:08):
It just felt like that. And it did feel like a very biological thing to me.
It felt like something that was
just happening to me that I didn't even necessarily want to have happen.
Happen but it was you know like our bodies are really
fantastic wonderful things that have evolved over years and
years and years for a large percent of the population to have
this genetic element to them that causes them to
(23:30):
be disincentivized around eating or reluctant to eat food and want to move a
lot there has to just it doesn't just be random there has to be a reason for
that and the only reason that i could really made sense to me was that it's
a human form of migration and so food scarcity in thousands of years ago when
famine was one of the biggest threats to humans,
(23:50):
that's what would create the environment of scarcity.
But for those of us that have that genetic element, which is probably all to
do with a very sort of old part of our genetics and bold part of our genetics,
scarcity now isn't being necessarily created by famine, but the idea or the
(24:11):
perception of famine as far as the brain is concerned is being created by dieting.
This is really fascinating in terms of like helping people who are in the process
of a restrictive eating disorder.
Like you mentioned the point of you couldn't reverse it, like you crossed that threshold.
(24:33):
Are there ways that other people can look out for friends and family,
roommates, if they think a restrictive eating disorder might be becoming problematic?
Yeah. Yeah. I think that one of the biggest and hardest things in our current
culture is that disordered behaviors such as food restriction and compulsive
(24:55):
movement are very glamorized and normalized in our culture.
And so that's really difficult, especially because weight Weight loss is also
congratulated in our culture.
And so even if you can look at things with the perception of not all weight
loss is good, not all exercise is healthy, dietary restriction is not healthy.
(25:17):
If you start to even look at things with that perception, and really what we're
tackling with all of that is a lot of implicit bias because we have grown up
and most of us are existing in a culture that,
just believes it is a truth that weight loss is good and weight gain is bad
and thin is good and fat is bad.
(25:39):
And so I think for a lot of people, you've got to be able to see your own implicit
bias first and then actually sometimes be able to remove that filter and look
at somebody else and see that stuff that they're doing is problematic.
Because while people have their own not very conscious bias that while weight
loss is always a good thing, exercise is always good, weight gain is always bad.
(26:00):
It's difficult for them to even see these behaviors in another person and see
how detrimental they can be.
And a lot of the time when the person does have a restrictive eating disorder,
we're absolutely miserable. I hated exercise.
I hated running. I felt compelled to do it.
And it didn't really help that when I went to the doctor presenting horribly
(26:21):
underweight, you know, all intents and purposes, you know, my body wasn't functioning
very well. And they'd They'd ask me, do your exercise?
And I say, yeah, I'm in the gym three times a day. And they'd say,
that's great. That's good. That didn't help me.
So it's just things like that.
But that's because they didn't even think about that reaction because they have
this bias that exercise is always a good thing.
(26:42):
You've almost said it without thinking, but I was sort of desperate for someone to say, stop it.
And it's very difficult in this culture to find that person that will say, hey, stop it.
Whether I would have stopped it or not, I probably wouldn't.
But then even just having somebody that could see that I wasn't,
what I was doing was not healthy would have been helpful.
(27:03):
Interesting when you say about just stopping it, it's about how therapists work
as well when they're not educated about eating disorders.
And there may be a very complex reason why somebody's developing a restrictive
eating disorder or reasons.
But in terms of helping somebody in the here and now,
(27:26):
how important do you think it is to just be very pragmatic about it rather than
going into all the kind of psychodynamic reasons of why?
I think first and foremost, understanding that if a person does have a restrictive
eating disorder, that creates or puts a huge biological stress on the body.
(27:48):
And if the body is biologically stressed, you know
it stresses the entire organism and so
if you are seeing somebody who is presenting with what could be many different
sort of diagnosable mental health issues I feel like unless you've addressed
the biological stress which could be the foundation of all of them you can't
(28:09):
really have a firm diagnosis on any of those things or really be able to understand.
Any of those things. So it's like always look, I think, look for the biological
stress first, because a person who's restricting food can present all different
sorts of OCD, high levels of anxiety.
There can just be a lot of things. Like I think a lot of people thought I was
autistic because of just the way I was.
(28:32):
I was very avoidant of antisocial because social situations often mean sitting
and eating food. So I avoided those like the plague and all those things.
And so I think that like a lot of people were looking at me and diagnosing all
of these mental health issues rather than actually looking at the,
and because again, their implicit bias won't let them see the biological problem.
This person's not eating enough food.
(28:54):
And funnily enough, when the biological stress, the restriction was addressed,
a lot of the other things that would have been diagnosable in me went away.
Yeah. And so I think you've always got to look for that first because otherwise
what happens or what tends to happen is somebody gets diagnosed nose or something else.
And then they're trying to treat that thing when that really wasn't the root
(29:18):
of the problem because the body's biologically stressed.
And there are also a lot of complicated factors like trauma can lead to a person
not eating enough food consistently.
And if that person has the genetic predisposition for an eating disorder,
that can lead to the development of an eating disorder.
(29:38):
But in that sense, the trauma is a contributing factor to energy deficit.
The trauma is not the cause of the eating disorder.
The genetic predisposition and the energy deficit, those are the cause.
The trauma contributed to the energy deficit. So it's a contributing factor, not a cause.
And I think that that really gets misunderstood a lot because a lot of people
(30:01):
will see somebody with an eating disorder, find out that they have a history
of of trauma and say, right, we have to treat the trauma.
But all the time, that person is still in energy deficit, they're still under
biological stress, and that's not getting any better.
So yes, you absolutely have to work with the trauma, and you have to get them out of energy deficit.
(30:22):
Those things have to happen simultaneously. spontaneously when if
anything needs to come first the energy deficit getting out
of energy deficit needs to come first because when we're in
energy deficit processing trauma and going through all
of that which is very energetically draining doesn't work
very well you know our brains aren't functioning optimally so
trying to do something like process trauma often doesn't have
(30:42):
great results when a person has an eating disorder yes it's
similar to people with substance substance use issues as
well like you you need to get that dealt with
before you dive into the trauma healing work
so really that's a really good sort of
like it is like that and it's not at all
saying that trauma work isn't important it really is but
(31:05):
it's just I feel like a lot of the time the tendency is to
go for well the trauma is causing the eating disorder so
therefore we have to treat the trauma as likely yeah so when
you're in the process of helping somebody kind
of we replenish their energy
deficit do you recommend getting
genetic testing done i mean
(31:28):
because it's not really we're not really that half
forward with it they only discovered the genetic element i
mean it's been it's been suspected for many years
but only i think it was 2017 when that genetic.
Element was actually properly discovered and so there's no
widespread testing for it and ultimately it doesn't
really matter because if somebody's in energy deficit they're
(31:49):
in energy deficit and they could be in energy deficit and suffering all
of the consequences of energy deficit and not actually have a full-blown eating
disorder triggered but you know they're still not eating enough food and that
is still making them and their body miserable so in a sense we don't necessarily
if we can establish that somebody is restricting food food,
(32:10):
then the answer to that should always be get them out of that restriction because
it usually makes people very miserable.
Making that shift to getting out of restriction, do you work with people when they're actually,
in the midst of that process or a bit further along in recovery?
(32:31):
I would love to say that I get to work with people when they're further along
in recovery because the treatment system looks after them when they are critically
underweight or in that sort of danger.
But unfortunately, that's just not how this works in this country or many other countries.
Ironically, a lot of treatment centers won't take somebody if
(32:53):
they are at very low weight because it's a liability to them
and so you get quite a lot of people that don't actually
have any options when they're at a very
low weight so it's it's it's really
difficult i do end up working with a lot of
the time with people where i'm just sitting there thinking like you need to be
in a hospital right now this is absolutely inappropriate yeah but
(33:14):
there's no other option that option isn't there for them
and so i mean you don't really
want to get me started on the problems in the eating disorder treatment field because
it's just it's such a minefield and it's and
and it knows it as well i think everybody knows
it it's just not changing fast enough
and that's that is the reason that people still die from
(33:35):
eating disorders this is not an unsolvable
problem you know like we we know that full
recovery is possible for people but a lot of people
are just not getting the treatment that they need and if
they are getting treatment is treatment that still has its basis
in fat phobia and actually
and it also encourages restriction which
(33:57):
is again very ironic but it does happen in
treatment centers a lot yeah so I really think what you said about it's not
changing fast enough is so important because it seems like so many things at
the moment that are kind of coming into our awareness of yeah these things really
need to change and change quickly.
(34:19):
And what is the hope that's out there in terms of culture and community changing?
Yeah, you know, for eating disorders, actually, there is a lot of hope.
And that's because the system fails so many people, there's actually a large
body of people in recovery that are...
(34:44):
Going and finding different routes and so
somebody like me who's a recovery coach
you know if the system was working optimally
i wouldn't have i wouldn't exist i wouldn't need to exist because people could
just go through treatment and then they'd be recovered they wouldn't need to
be going and out of pocket themselves paying somebody like me to talk them through
(35:05):
it and so i actually look forward sort of to the day when independent people like like me,
aren't needed because we actually have a system that employs people to put people through recovery,
but that's just not going to work for a long time because unlike other.
Mental health issues or recoveries, the eating disorder treatment system still
(35:29):
doesn't believe that recovered people are a particularly valuable voice.
I think that's changing a lot, but the reason it's changing is because it's
the ground movement that are actually people people in recovery are going and
finding people like me and saying, I need somebody who's been through it to help me get recovered.
And so the treatment centers are getting less business because of the ground
(35:50):
movement towards actually using recovered people to help other people recover.
And so I think that that is what the change will be. And I imagine it's already
starting to happen. Treatment centers are starting to cotton on.
There's a big business in recovery coaching and we actually need to bring these
people onto the inside because we can make money. Yeah, it's all about money, isn't it?
(36:11):
But when people are voting with their money at this point, I think,
when it comes to eating disorder recovery,
and unfortunately, a lot of them go through the traditional means and they waste
a lot of years doing that and then don't get fully recovered and then they seek other alternatives.
And so I think it is from the ground up, it's changing and the fact that there
(36:34):
is money to be made out of the change is what will.
Inspire the change which again is a little bit depressing but it's just recovering from an.
Eating disorder similar to sobriety
in terms of the okay so
do you see relapses or you're just recovered when
(36:58):
you know a large part of recovery for me which i talk about write about a lot
is neural rewiring so that's rewiring the belief systems that actually cause
a person to want to engage in behaviors that suppress their body weight and
so like i've talked about before a a lot of those belief systems are culturally created within us.
But when a person goes through recovery, they really need to actively rewire
(37:21):
and challenge and change those belief systems that their brain has about what
health is, what their body should be, and all of those things.
And so if somebody does what I call rewiring with their fear of weight gain
belief system, if they rewire, if they remove, if they teach their brain that
weight gain is not a threat to them, then they no longer feel inspired to suppress
their natural body weight because because they're not afraid of gaining weight.
(37:43):
So they don't need to restrict food because they're not afraid of gaining weight.
And that's what makes recovery sustainable.
It really actually takes us back to, you know, most people, if they think about
it, their most free point with, and their most sort of at ease point with their
body and eating is when they're about three to five years old.
You don't think about it too much. You don't have all of these judgments.
(38:03):
You haven't had all these things taught to you by the culture about you shouldn't
eat what you want and all of those things.
And you just happily get on with it. And when you're hungry,
you eat. And when you're not hungry, you don't. And that's how it's supposed to be.
And so really the process of new rewiring is unlearning a lot of the judgment
around food and eating and things that we think we know about nutrition and
(38:23):
taking ourselves back to just having that harmonious relationship with our bodies
where we don't fear eating and we don't fear weight gain.
And so if somebody can do all of that work, that rewiring work,
then it's a success again.
How important are family systems in in this picture you know i think that they're
especially if the person with the eating disorder is you know a teenager or child they're just.
(38:51):
A family is everything. And I think that somebody below the age of 16,
somebody who was living in a family trying to recover without the help of that
family is hugely problematic.
You know, the family, if involved in a person's recovery from an eating disorder,
it's just a game changer. It really is.
And I think that, again, a lot of what therapists are maybe taught erroneously
(39:15):
about eating disorders is that it's family systems that cause the eating disorder.
Whereas now we're looking at it and we're like, no, we can see it's biological,
it's genetics that cause the eating disorder and it's energy deficit.
So it's actually not this dysfunctional family problem.
And I think that especially years ago, one of the biggest problems with eating
disorder treatment is that people with eating disorders were being removed from
(39:39):
their family units because it was being assumed that the family unit was the
actual dysfunction or cause of the eating disorder.
Disorder and you know really actually bringing
the family in and explaining to them what needs
to happen in recovery and actually bringing the family in and
being part of the recovery and family-based treatment
family-based therapy for eating disorders has been shown to just be one of the
(40:02):
most evidence-based practices for getting a young person especially recovered
from restrictive eating disorder that said it's not easy a lot of people don't
want to recover and don't want to eat.
So it puts a lot of pressure on the parents that are trying to get their kid
to eat, but it's still...
I love that you said that it would be great at some point that when you're not
(40:25):
needed, if you got to the point in your life where you're not needed as a restrictive
eating disorder recovery coach, how would you like to spend your days?
Probably end up buying more horses, riding more horses. Yeah.
I do love writing because I do a lot of writing, you know, with all the books and stuff.
(40:49):
I love writing, but I'd love to try my hand end up like writing some
fiction or something like that you know yeah I actually
did write a book based on my pony club
experiences but I only drafted it and I've
never got around to finishing that so I definitely I think I do love writing
do more of that but not always writing about eating disorders yeah well I'd
(41:11):
love to read the pony club story sometime but in the meantime where Where can our listeners find you?
What's your website and your books you've written?
Yeah, it's abithafarar.com and there's loads of free resources on there.
So there's YouTube, podcasts, blogs.
(41:32):
The only thing that you have to pay for is the books and those are not very
expensive either because I just made them as accessible as possible.
But really, you don't really have to actually buy any of the books because everything's in the blog.
It's just not very structurally laid
out in the blog you know because that's how blogs work so you can piece together
all the blogs then yeah you don't even have to buy a book okay great so that's
(41:55):
tabithafarrar.com and then you have your own podcast as well well thank you
so much for today it's been really great speaking to you yeah thank you.
Thank you for listening to the inscape quest
podcast show with me your host trudy
(42:18):
howley if you like my show and want to know more you can follow me on instagram
at inscape quest and send me your questions or submit things that you'd like
to hear about on your podcast,
Thank you for listening.
(42:39):
Music.
Hello, podcast listeners. Thank you for tuning in today.
You are listening to the InScape Quest podcast show, and I am your host, Trudi Howley.
Here I am talking with people about about how they engage with their relationships, work, and passions.
(00:28):
Please share this with a friend, and thanks to you, we can grow meaningful conversations
together, one episode at a time.
Music.
Welcome to this episode with my guest, Tabitha Farrar, eating disorder recovery coach, author,
(00:56):
podcast host, farm owner, and horse-mad equestrian.
Music.
I'm excited to get to talk to you today, Tabitha. Welcome. Hi, Trudi.
I'm curious about your day and how you just maintain this sense of easy,
(01:25):
straightforward, calm when you've got so many different things going on in your life.
I function quite well in a relatively chaotic environment and so that sort of
suits me to to have quite a lot going on which isn't to say that I don't get
tired and like I'm stressed by it all sometimes I do but I think that just generally
I like to have quite a few things,
(01:50):
happening and I get sort of pretty inspired and excited by all of that I do think though.
Some of that is going to come down to having having
had had an eating disorder for such a
a long time which is really if you have an
eating disorder it's just so incredibly stressful
(02:10):
and chaotic that for me
now sort of even a really sort of busy life without that on top is really quite
manageable okay sort of like an extra level of especially for me my experience
of an eating disorder was one with a really strong and high exercise compulsion.
(02:32):
And so I was having to exercise for around six hours a day, like sort of like
pretty extreme exercise as well.
And so even just sort of fitting that all in around work and around all of the
other movement compulsions that I had, because I have more than that six hours
a day of movement compulsion.
It's just, then if you think about it, now being recovered, it's like I've really
(02:55):
got got six to eight hours extra that I just didn't ever have before.
And it's always, everything feels easy after you've lived through that sort of thing.
That's great. So it's familiar to you to be able to juggle a lot all at once as well.
So you recently had an accident and surgery and your wonderful dog Breck also
(03:21):
is recovering from surgery.
And so what have you kind of learned about yourself in having to kind of really
slow slow down for a short time.
I do actually find that quite, not necessarily stressful, but it just removed,
when I removed doing a lot of the things that I really enjoy doing,
(03:43):
definitely for the first couple of weeks, I felt quite low and just,
you know, I can ride horses.
I can just do a lot of the things I was supposed to be doing.
I was just supposed to be sitting inside and resting. And although I was quite tired and I,
for at least, especially the first last week I really wanted to rest
so it was easier but then after that when I was my energy
came back I really actually struggled with just being like I can't do
(04:05):
any of the things I really like doing so I I
found that difficult and but
also really great when you actually get to the point where you can start doing
the things again that you enjoy doing because then you didn't take them for
granted and it just it's sort of really life is fun again that's great really
(04:27):
enjoying it So I'm glad you're having a good recovery.
I'm curious about this idea of when people are injured or laid up or if they
overexercise and they get injured.
It can be really challenging for so many people to have their routine disrupted.
(04:48):
Interrupted and I'm wondering what happens to
somebody when they're there in the throes of
an active eating disorder what what happens
to them when their normal life suddenly gets interrupted by yeah so you know
injury especially say if we're talking about injury for somebody that has so
(05:09):
not everybody who has a restrictive eating disorder has a compulsive movement
element but but I think the majority do.
I'd say 75% to 80% in my experience do.
And that compulsive movement element can look like a lot of different things.
Mine looked like a very extreme version of it.
And I think a lot of people get a bit confused by that because they might say,
(05:32):
well, I don't have compulsive movement just because they're thinking of the
extreme version of meaning that you have to be running six hours a day.
Whereas actually what compulsive movement can look like is, like a lot of people
have compulsive walking when they have an eating disorder.
And that's just so, you know, you're going for multiple walks a day.
And a lot of people even excuse that with, well, I have to walk the dog,
(05:54):
when really actually the underlying anxiety is not because you think that the
dog won't get a walk, it's the underlying anxiety comes from the movement compulsion.
And so I think that it can be really.
Difficult for a lot of people to even understand if they have
a compulsive movement element and overlooked a lot of the
time and it's definitely one that's very much overlooked by treatment
providers and doctors because everybody's like oh exercise is good for you always
(06:17):
and not really on the lookout for when it's not but one of the things that can
really be a big telltale sign is if somebody gets injured and then continues
to exercise through that injury can't do the rest period.
So I had, because I was doing a lot of running, I had a fair amount of injuries to my legs.
(06:38):
With that, I don't think I ever for injury took a day off running.
I would run through pain.
And I also, I had a broken elbow once and I was sort of still cycling with a
broken elbow and doing all these things, you know, I just never took a day off.
And so that's actually for a lot lot of people not being able to rest for an
(07:00):
injury and having to just continue to do their compulsive movement routines
is a big telltale sign that it is a problem.
And I think that one of the many reasons that make that even possible for people,
because I've known people that have really sort of like broken ankles and things
like that and continue to do an exercise routine.
(07:20):
And you might think, well, how is that even possible?
And I do think, or I do believe that when the the body is as biologically stressed
as it is when it has a compulsive eating disorder, it hasn't got enough energy,
and then it's got this compulsive movement element that.
It's not so much that we just develop a high pain threshold.
I think that the body artificially doesn't actually cure as in on pain as a
(07:45):
well person's body might be.
And I sort of trace that back to more evolutionary and maybe biological aspects.
So if you think of migrating animals, You know, that's a biological stressor
for sure to have to go through migration.
And if a bird has to migrate across the ocean, it can't just stop because its wings got tired.
(08:06):
And I see a lot of that happen in people who have restrictive eating disorders
is that I think that their ability to keep going and exercise day in,
day out is actually a function of the body thinking like we're in a environment
where we can't stop, got to keep going, got to keep going, got to keep going.
And so those sorts of traits can be real telltale signs.
(08:27):
When people have a compulsive movement element so yeah
the answer to your question would be that i it when i had an
eating disorder oh hell i would have just been wouldn't have
stopped for a day i would have been running through that and that's not
fun either you know like having to do that is quite distressing actually but
yeah not exercising would be more distressing so yeah so it's like a vicious
(08:50):
cycle there you know as you are an expert in eating disorder recovery and and
you coach many people all over the world,
like what are the different ways a restrictive eating disorder can show up?
Yeah. So a lot of people have, and I sort of think there's some stereotypical
ideas of what say anorexia is and what anorexia looks like.
(09:13):
And most of those ideas are sort of like a teenage girl who's very underweight
and not eating, you know, that's what restriction is, is just not eating.
And so a lot of people don't understand themselves that they may have a restrictive
eating disorder and a lot of treatment providers don't understand that their
client might have a restrictive eating disorder because there's just this stereotypical
(09:35):
view of what that looks like.
Whereas really for most people, what restriction, restriction can be quite subtle,
but it can be if you're consistently eating slightly less than your body really wants you to eat,
then the accumulative effect of that.
Can be quite large. And so people with long and enduring eating disorders,
(10:00):
it was incredibly rare that I ever missed a meal.
I did not eat meals particularly frequently.
There was a period where I was consistently not eating some meals,
but overall, over the span of the years, I ate meals.
And so that was one of the reasons that I could tell myself,
I don't have I have anorexia because I eat every day.
And I eat what people might consider to be a fair amount every day.
(10:24):
But also, I was eating in a way that was restricting every time I ate.
I wasn't really allowing myself to eat exactly what I wanted in the quantity that I wanted.
I was restricting in terms of I was forcing myself to eat foods that I believe
to be lower calorie, lower fat than the versions of that food that would have
been higher calorie, higher fat.
(10:46):
That I was restricting in that I was forcing myself to eat just slightly less
or sometimes largely less than the quantity of those foods that I really wanted to eat.
And I was definitely restricting in that I was not listening to the hunger signals from my body.
So I had my set meal times when I would eat and if my body asked me for food
outside of those times, no hope, it wasn't going to happen.
(11:07):
And so restriction can look like a lot of different things and it's very very
rare, the restriction actually looks like not eating.
So that's pretty interesting to me that you use the phrase like listening to hunger signals.
So if somebody, you know, is on a diet or they're trying to slim and,
you know, it's so prevalent in our culture about, you know, fitting into your
(11:32):
genes and, you know, looking a certain way.
So So if you're on the path of restrictive eating, would you frame that as you're
not listening to your body's hunger signals? Absolutely.
We live in a culture, actually, that...
(11:53):
Teaches us to distrust the body when it comes to managing our food intake and our weight.
And so we live in a culture that teaches distrust of the hunger signals from the body.
And so because that's a cultural thing, that's not just something that people
with restrictive eating disorders do.
That's something that is culturally sort of encouraged a lot of the time,
(12:13):
and often a lot of the time encouraged by doctors and healthcare providers.
Providers and so that distrust teaching
that distrust well-meaning as it might be
kind of teaching that distrust of the body can
has numerous ill effects and
not just for people with eating disorders as well but you know it teaches us
to see the body as well especially hunger signals to see if that is a vice that
(12:37):
the body has to ask us for food yeah think about it it's just a biological system
and we have plenty of biological systems and the majority of them are mostly automatic.
We don't have to be particularly involved in them. And then there are some of
them like our food intake system and excretion system going to the toilet,
which every now and then the body needs our conscious involvement in.
(12:59):
And so it communicates to us when it needs that conscious involvement.
And because it's not a culturally encouraged thing to ignore the biological
cues for the excretion system when you need to go to the toilet,
you know we just if the body says hey i
need to go to the toilet you don't even think about it you just get up and you go to the toilet
and really the food intake system to work
(13:21):
optimally if mind and body are working optimally that
should be the similar sort of thing but obviously because of people's fear of
weight gain that gets massively distorted and i think that that just creates
real gap between mind and body and somebody be able to work with their body
and And if we're not working with our bodies,
(13:42):
our bodies can't function optimally because we're not in the habit of giving them what they need.
Yeah, absolutely. I love that you say that, like not giving your body what you optimally need.
And from my work, when I work from a somatic, you know, body-based view with therapy,
(14:03):
it's It's like so many people just distrust their body's signals in general
and distrust the sensation.
So as you bring this up, I'm curious,
like what percentage of the population actually might have some kind of restrictive
eating disorder because of all the complex messages we see in our cultures?
(14:28):
Yeah, it's kind of difficult not to, honestly, on some level.
You know, it's a spectrum, but on some level, a lot of people actually, when I.
Say talk to them about like a hunger signal is
just a cue from your body that something needs to
happen and it needs something from you kind of look
at me as if that's a radical concept because it's just so from the age dot instilled
(14:52):
in us that hunger is just this vice that humans have yeah it's like not a life-sustaining
function what about the difference between hunger and And nutrition in terms of,
you know, there's a lot of information out there and about healthy eating,
whether or not that's correct.
I don't know. I'm curious what your thoughts are.
(15:14):
Yeah, I think you hit the nail on it, whether or not that's correct. I don't know.
And I wish more people would express it like that, because the reality around
nutritional science as a science is that it's a science in its infancy.
We really don't know very much.
Most of the research and most of the studies, because it's unethical to do it
any other way, is correlational.
(15:36):
And so it's just looking at different variables and making drawing sort of conclusions
out of correlations, which then most scientific people know why correlation
doesn't equal causation.
But in nutritional science, that's happening all the time.
And it's limited because it's not okay to treat people like lab rats.
(15:57):
You can't lock them in a room and completely control all the variables in their
life. And so that's why it has to be that limited.
But the issue is not necessarily that nutritional science is in its infancy
because most science starts off that way.
The issue is actually that we don't treat nutritional science and the conclusions
that come out of such studies as if the science is in its infancy.
(16:20):
We take it as if it's word that someone said, there's a correlation between
sugar and X, therefore sugar is bad and we all need to cut sugar out of our diets.
And most of the researchers never even intend that to be the reaction.
It just gets taken by the media and it gets blown up.
And the reason it's newsworthy is because so many people are afraid of gaining
weight and so are constantly looking for things and ways that they can limit their food intake.
(16:44):
And so nutritional science is dodgy. It really is.
And one of the the scariest things is when we take something like nutritional
science and then make blanket statements over how all humans should eat and
how all humans should work with their bodies.
And then also people are taking suggestions from interpretations,
(17:08):
media interpretations of studies, you know, like, oh, you know,
if you're craving chocolate, you should actually eat pistachios.
That would be a suggestion, I think, that often does the rounds or something
like that. And they're taking that suggestion and they're trusting that.
Over the cues from their body. So the body is cuing them, hey,
I want to eat something like chocolate.
And then they're trusting some media representation of some study that didn't
(17:31):
even actually come to that conclusion, but that's the way it was interpreted
and actually making that decision and then giving their bodies something that
the body didn't actually ask for or want.
And that's where I think it becomes really problematic. matter yeah so
I know you mentioned chocolate and I've I'm
aware of you having eaten double
cream and cake in your
(17:54):
recovery process so are
there nutritional restrictions when someone's in recovery not in my book no
okay none at all none at all you know because well I actually think And I do
believe that it is restriction that causes the overconsumption of food.
(18:16):
And so I don't think humans have had such a big problem with overconsumption
of food before the diet industry really got hold.
And so it's often the restriction of a certain type of food or a food group
or a nutrient that causes the body to want to seek that food out.
And when it finds that food, actually eat as much of it as possible. and
(18:36):
so that's generally what happens in eating
disorder recovery is we binge eat because the
body is in deficit and the body believes that food
is scarce and when it gets any opportunity to eat it's going to get us to intake
as much fat and as much sugar as it possibly can because it's in deficit for
those things but that doesn't just happen with people with restrictive eating
disorders you can create deficit in a perfectly create deficit in a non-underweight
(19:02):
body by restricting a certain type of food,
you can make your brain crave that food and want to eat large amounts of that food.
I think that when we really are listening to our bodies, trusting our bodies,
then a naturally balanced diet is the result of that,
because the body doesn't have to override you and cause you to binge on a load
(19:24):
of foods that you haven't been allowing it to have.
You know, the body will always ask for things nicely first.
And then if you restrict, restrict, restrict, there does usually come a point
where the body just says, all right, I'm going to take it.
And that's when a binge happens. happens and so that's why a lot of people who
control shall we say their sugar intake are also people that say i can't have
sugary foods in the house because if i have them in the house then i'll binge
(19:45):
on them well there's a reason for that and if you stop trying to control your food intake,
yeah you'll go through that binge period when you have all that food in the
house but you'll also come out the other side of that and the brain won't feel
it needs to do that all the time and you'll be able to have all those foods
in the house and you'll just eat them when you eat them or want them and you won't when you don't.
So it's a process that we have to go through really to achieve a balanced diet.
(20:09):
And it's scary for a lot of people, the idea of unrestricted eating and that
idea of, well, I'm just going to drink pints of double cream and eat your whole
chocolate gatos like I did. That's a scary concept.
But it's also the understanding that you go through that to get out the other side and get to balance.
And it's the restriction that causes that huge consumption or the desire to.
(20:33):
When you talk about food being scarce, at what point does the body and the brain
decide that food is scarce?
So the way I look at restrictive eating disorders is as a biological function.
(20:53):
We have, or when I say we, I mean the industry has, Cindy Buick and her team
have shown that eating disorders have a genetic base.
So there's a genetic base. You either have the genetic predisposition for an
eating disorder or you don't.
And what triggers those genes to become active or start working is energy deficits.
(21:14):
So consistently not consuming as much food as you you need.
And so then I look at that from a, why would some people have a genetic element
to them that says when they consistently consume less food than they need, this thing happens,
which causes them to not want to eat very much and most of us to want to exercise a lot.
And so if we look at sort of animal models, it looks very close to migration.
(21:40):
And animal migration, say for bird, what triggers the desire to migrate is lack
of food in the environment. That is the signal to the bird's body.
And so that's not because the bird's looking around the environment and saying,
well, it doesn't look like there's much food here.
What's happening is the bird is starting to consume less and less and less every
day until it gets to a point or a threshold, which then triggers that migration response.
(22:02):
So that's how that works in birds. And that sounded to me very similar to what had happened to me.
I consistently didn't eat enough food, not massively.
I wasn't dieting massively or anything, but I was eating less than I needed. it.
And then at some point I got to a threshold where I couldn't reverse it.
My desire to move, my desire to exercise really took off.
And migrating animals also, one of the functions of migration in most migrating
(22:27):
animals is that the brain starts to disincentivize feeding behavior,
which makes sense if you think about it.
If there's not very much food in the environment, the brain doesn't want that
animal to hang out and hunt for food.
That brain wants that animal to actually be not very interested in food so it
can get on with the process of moving and and migrating out of there.
So disincentivization of feeding
(22:47):
behavior is also present in migrating animals. And that's what felt.
What my eating disorder felt like to me. I just felt like I was disincentivized
to eat. It's not that I didn't want to eat. It's not that I wasn't hungry.
I just felt huge anxiety about doing so. And I felt like it was wrong to do so.
I couldn't explain the wrong. I couldn't explain why I felt that.
(23:08):
It just felt like that. And it did feel like a very biological thing to me.
It felt like something that was
just happening to me that I didn't even necessarily want to have happen.
Happen but it was you know like our bodies are really
fantastic wonderful things that have evolved over years and
years and years for a large percent of the population to have
this genetic element to them that causes them to
(23:30):
be disincentivized around eating or reluctant to eat food and want to move a
lot there has to just it doesn't just be random there has to be a reason for
that and the only reason that i could really made sense to me was that it's
a human form of migration and so food scarcity in thousands of years ago when
famine was one of the biggest threats to humans,
(23:50):
that's what would create the environment of scarcity.
But for those of us that have that genetic element, which is probably all to
do with a very sort of old part of our genetics and bold part of our genetics,
scarcity now isn't being necessarily created by famine, but the idea or the
(24:11):
perception of famine as far as the brain is concerned is being created by dieting.
This is really fascinating in terms of like helping people who are in the process
of a restrictive eating disorder.
Like you mentioned the point of you couldn't reverse it, like you crossed that threshold.
(24:33):
Are there ways that other people can look out for friends and family,
roommates, if they think a restrictive eating disorder might be becoming problematic?
Yeah. Yeah. I think that one of the biggest and hardest things in our current
culture is that disordered behaviors such as food restriction and compulsive
(24:55):
movement are very glamorized and normalized in our culture.
And so that's really difficult, especially because weight Weight loss is also
congratulated in our culture.
And so even if you can look at things with the perception of not all weight
loss is good, not all exercise is healthy, dietary restriction is not healthy.
(25:17):
If you start to even look at things with that perception, and really what we're
tackling with all of that is a lot of implicit bias because we have grown up
and most of us are existing in a culture that,
just believes it is a truth that weight loss is good and weight gain is bad
and thin is good and fat is bad.
(25:39):
And so I think for a lot of people, you've got to be able to see your own implicit
bias first and then actually sometimes be able to remove that filter and look
at somebody else and see that stuff that they're doing is problematic.
Because while people have their own not very conscious bias that while weight
loss is always a good thing, exercise is always good, weight gain is always bad.
(26:00):
It's difficult for them to even see these behaviors in another person and see
how detrimental they can be.
And a lot of the time when the person does have a restrictive eating disorder,
we're absolutely miserable. I hated exercise.
I hated running. I felt compelled to do it.
And it didn't really help that when I went to the doctor presenting horribly
(26:21):
underweight, you know, all intents and purposes, you know, my body wasn't functioning
very well. And they'd They'd ask me, do your exercise?
And I say, yeah, I'm in the gym three times a day. And they'd say,
that's great. That's good. That didn't help me.
So it's just things like that.
But that's because they didn't even think about that reaction because they have
this bias that exercise is always a good thing.
(26:42):
You've almost said it without thinking, but I was sort of desperate for someone to say, stop it.
And it's very difficult in this culture to find that person that will say, hey, stop it.
Whether I would have stopped it or not, I probably wouldn't.
But then even just having somebody that could see that I wasn't,
what I was doing was not healthy would have been helpful.
(27:03):
Interesting when you say about just stopping it, it's about how therapists work
as well when they're not educated about eating disorders.
And there may be a very complex reason why somebody's developing a restrictive
eating disorder or reasons.
But in terms of helping somebody in the here and now,
(27:26):
how important do you think it is to just be very pragmatic about it rather than
going into all the kind of psychodynamic reasons of why?
I think first and foremost, understanding that if a person does have a restrictive
eating disorder, that creates or puts a huge biological stress on the body.
(27:48):
And if the body is biologically stressed, you know
it stresses the entire organism and so
if you are seeing somebody who is presenting with what could be many different
sort of diagnosable mental health issues I feel like unless you've addressed
the biological stress which could be the foundation of all of them you can't
(28:09):
really have a firm diagnosis on any of those things or really be able to understand.
Any of those things. So it's like always look, I think, look for the biological
stress first, because a person who's restricting food can present all different
sorts of OCD, high levels of anxiety.
There can just be a lot of things. Like I think a lot of people thought I was
autistic because of just the way I was.
(28:32):
I was very avoidant of antisocial because social situations often mean sitting
and eating food. So I avoided those like the plague and all those things.
And so I think that like a lot of people were looking at me and diagnosing all
of these mental health issues rather than actually looking at the,
and because again, their implicit bias won't let them see the biological problem.
This person's not eating enough food.
(28:54):
And funnily enough, when the biological stress, the restriction was addressed,
a lot of the other things that would have been diagnosable in me went away.
Yeah. And so I think you've always got to look for that first because otherwise
what happens or what tends to happen is somebody gets diagnosed nose or something else.
And then they're trying to treat that thing when that really wasn't the root
(29:18):
of the problem because the body's biologically stressed.
And there are also a lot of complicated factors like trauma can lead to a person
not eating enough food consistently.
And if that person has the genetic predisposition for an eating disorder,
that can lead to the development of an eating disorder.
(29:38):
But in that sense, the trauma is a contributing factor to energy deficit.
The trauma is not the cause of the eating disorder.
The genetic predisposition and the energy deficit, those are the cause.
The trauma contributed to the energy deficit. So it's a contributing factor, not a cause.
And I think that that really gets misunderstood a lot because a lot of people
(30:01):
will see somebody with an eating disorder, find out that they have a history
of of trauma and say, right, we have to treat the trauma.
But all the time, that person is still in energy deficit, they're still under
biological stress, and that's not getting any better.
So yes, you absolutely have to work with the trauma, and you have to get them out of energy deficit.
(30:22):
Those things have to happen simultaneously. spontaneously when if
anything needs to come first the energy deficit getting out
of energy deficit needs to come first because when we're in
energy deficit processing trauma and going through all
of that which is very energetically draining doesn't work
very well you know our brains aren't functioning optimally so
trying to do something like process trauma often doesn't have
(30:42):
great results when a person has an eating disorder yes it's
similar to people with substance substance use issues as
well like you you need to get that dealt with
before you dive into the trauma healing work
so really that's a really good sort of
like it is like that and it's not at all
saying that trauma work isn't important it really is but
(31:05):
it's just I feel like a lot of the time the tendency is to
go for well the trauma is causing the eating disorder so
therefore we have to treat the trauma as likely yeah so when
you're in the process of helping somebody kind
of we replenish their energy
deficit do you recommend getting
genetic testing done i mean
(31:28):
because it's not really we're not really that half
forward with it they only discovered the genetic element i
mean it's been it's been suspected for many years
but only i think it was 2017 when that genetic.
Element was actually properly discovered and so there's no
widespread testing for it and ultimately it doesn't
really matter because if somebody's in energy deficit they're
(31:49):
in energy deficit and they could be in energy deficit and suffering all
of the consequences of energy deficit and not actually have a full-blown eating
disorder triggered but you know they're still not eating enough food and that
is still making them and their body miserable so in a sense we don't necessarily
if we can establish that somebody is restricting food food,
(32:10):
then the answer to that should always be get them out of that restriction because
it usually makes people very miserable.
Making that shift to getting out of restriction, do you work with people when they're actually,
in the midst of that process or a bit further along in recovery?
(32:31):
I would love to say that I get to work with people when they're further along
in recovery because the treatment system looks after them when they are critically
underweight or in that sort of danger.
But unfortunately, that's just not how this works in this country or many other countries.
Ironically, a lot of treatment centers won't take somebody if
(32:53):
they are at very low weight because it's a liability to them
and so you get quite a lot of people that don't actually
have any options when they're at a very
low weight so it's it's it's really
difficult i do end up working with a lot of
the time with people where i'm just sitting there thinking like you need to be
in a hospital right now this is absolutely inappropriate yeah but
(33:14):
there's no other option that option isn't there for them
and so i mean you don't really
want to get me started on the problems in the eating disorder treatment field because
it's just it's such a minefield and it's and
and it knows it as well i think everybody knows
it it's just not changing fast enough
and that's that is the reason that people still die from
(33:35):
eating disorders this is not an unsolvable
problem you know like we we know that full
recovery is possible for people but a lot of people
are just not getting the treatment that they need and if
they are getting treatment is treatment that still has its basis
in fat phobia and actually
and it also encourages restriction which
(33:57):
is again very ironic but it does happen in
treatment centers a lot yeah so I really think what you said about it's not
changing fast enough is so important because it seems like so many things at
the moment that are kind of coming into our awareness of yeah these things really
need to change and change quickly.
(34:19):
And what is the hope that's out there in terms of culture and community changing?
Yeah, you know, for eating disorders, actually, there is a lot of hope.
And that's because the system fails so many people, there's actually a large
body of people in recovery that are...
(34:44):
Going and finding different routes and so
somebody like me who's a recovery coach
you know if the system was working optimally
i wouldn't have i wouldn't exist i wouldn't need to exist because people could
just go through treatment and then they'd be recovered they wouldn't need to
be going and out of pocket themselves paying somebody like me to talk them through
(35:05):
it and so i actually look forward sort of to the day when independent people like like me,
aren't needed because we actually have a system that employs people to put people through recovery,
but that's just not going to work for a long time because unlike other.
Mental health issues or recoveries, the eating disorder treatment system still
(35:29):
doesn't believe that recovered people are a particularly valuable voice.
I think that's changing a lot, but the reason it's changing is because it's
the ground movement that are actually people people in recovery are going and
finding people like me and saying, I need somebody who's been through it to help me get recovered.
And so the treatment centers are getting less business because of the ground
(35:50):
movement towards actually using recovered people to help other people recover.
And so I think that that is what the change will be. And I imagine it's already
starting to happen. Treatment centers are starting to cotton on.
There's a big business in recovery coaching and we actually need to bring these
people onto the inside because we can make money. Yeah, it's all about money, isn't it?
(36:11):
But when people are voting with their money at this point, I think,
when it comes to eating disorder recovery,
and unfortunately, a lot of them go through the traditional means and they waste
a lot of years doing that and then don't get fully recovered and then they seek other alternatives.
And so I think it is from the ground up, it's changing and the fact that there
(36:34):
is money to be made out of the change is what will.
Inspire the change which again is a little bit depressing but it's just recovering from an.
Eating disorder similar to sobriety
in terms of the okay so
do you see relapses or you're just recovered when
(36:58):
you know a large part of recovery for me which i talk about write about a lot
is neural rewiring so that's rewiring the belief systems that actually cause
a person to want to engage in behaviors that suppress their body weight and
so like i've talked about before a a lot of those belief systems are culturally created within us.
But when a person goes through recovery, they really need to actively rewire
(37:21):
and challenge and change those belief systems that their brain has about what
health is, what their body should be, and all of those things.
And so if somebody does what I call rewiring with their fear of weight gain
belief system, if they rewire, if they remove, if they teach their brain that
weight gain is not a threat to them, then they no longer feel inspired to suppress
their natural body weight because because they're not afraid of gaining weight.
(37:43):
So they don't need to restrict food because they're not afraid of gaining weight.
And that's what makes recovery sustainable.
It really actually takes us back to, you know, most people, if they think about
it, their most free point with, and their most sort of at ease point with their
body and eating is when they're about three to five years old.
You don't think about it too much. You don't have all of these judgments.
(38:03):
You haven't had all these things taught to you by the culture about you shouldn't
eat what you want and all of those things.
And you just happily get on with it. And when you're hungry,
you eat. And when you're not hungry, you don't. And that's how it's supposed to be.
And so really the process of new rewiring is unlearning a lot of the judgment
around food and eating and things that we think we know about nutrition and
(38:23):
taking ourselves back to just having that harmonious relationship with our bodies
where we don't fear eating and we don't fear weight gain.
And so if somebody can do all of that work, that rewiring work,
then it's a success again.
How important are family systems in in this picture you know i think that they're
especially if the person with the eating disorder is you know a teenager or child they're just.
(38:51):
A family is everything. And I think that somebody below the age of 16,
somebody who was living in a family trying to recover without the help of that
family is hugely problematic.
You know, the family, if involved in a person's recovery from an eating disorder,
it's just a game changer. It really is.
And I think that, again, a lot of what therapists are maybe taught erroneously
(39:15):
about eating disorders is that it's family systems that cause the eating disorder.
Whereas now we're looking at it and we're like, no, we can see it's biological,
it's genetics that cause the eating disorder and it's energy deficit.
So it's actually not this dysfunctional family problem.
And I think that especially years ago, one of the biggest problems with eating
disorder treatment is that people with eating disorders were being removed from
(39:39):
their family units because it was being assumed that the family unit was the
actual dysfunction or cause of the eating disorder.
Disorder and you know really actually bringing
the family in and explaining to them what needs
to happen in recovery and actually bringing the family in and
being part of the recovery and family-based treatment
family-based therapy for eating disorders has been shown to just be one of the
(40:02):
most evidence-based practices for getting a young person especially recovered
from restrictive eating disorder that said it's not easy a lot of people don't
want to recover and don't want to eat.
So it puts a lot of pressure on the parents that are trying to get their kid
to eat, but it's still...
I love that you said that it would be great at some point that when you're not
(40:25):
needed, if you got to the point in your life where you're not needed as a restrictive
eating disorder recovery coach, how would you like to spend your days?
Probably end up buying more horses, riding more horses. Yeah.
I do love writing because I do a lot of writing, you know, with all the books and stuff.
(40:49):
I love writing, but I'd love to try my hand end up like writing some
fiction or something like that you know yeah I actually
did write a book based on my pony club
experiences but I only drafted it and I've
never got around to finishing that so I definitely I think I do love writing
do more of that but not always writing about eating disorders yeah well I'd
(41:11):
love to read the pony club story sometime but in the meantime where Where can our listeners find you?
What's your website and your books you've written?
Yeah, it's abithafarar.com and there's loads of free resources on there.
So there's YouTube, podcasts, blogs.
(41:32):
The only thing that you have to pay for is the books and those are not very
expensive either because I just made them as accessible as possible.
But really, you don't really have to actually buy any of the books because everything's in the blog.
It's just not very structurally laid
out in the blog you know because that's how blogs work so you can piece together
all the blogs then yeah you don't even have to buy a book okay great so that's
(41:55):
tabithafarrar.com and then you have your own podcast as well well thank you
so much for today it's been really great speaking to you yeah thank you.
Thank you for listening to the inscape quest
podcast show with me your host trudy
(42:18):
howley if you like my show and want to know more you can follow me on instagram
at inscape quest and send me your questions or submit things that you'd like
to hear about on your podcast,
Thank you for listening.
(42:39):
Music.
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