July 17, 2024 • 32 mins
Caryl James, PhD, and Melissa Freizinger, PhD, join TheNPRD podcast delving into the 4th annual conference titled ‘Dying To Be Beautiful’ held on December 6-8 in Kingston, Jamaica. We discuss trends in body image, eating behaviors and health in the Caribbean and those specific to Jamaica and the impetus of this amazing conference.
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(00:01):
Hello,
and welcome to the Npr
podcast,
with nurse practitioner and registered diet.
Robin K.
Eating disorders, body image, medicine, they are all
interconnected.
But with so many programs,
techniques and advice to choose from it's easy
to be overwhelmed.
(00:21):
Robin with more than 25 years of experience
as a nurse practitioner, and registered diet offers
help and hope for everyone. Families,
children,
and adults.
Along with veteran talk show host and good
friend, Jordan Rich,
Robin invites you to learn much more right
here, on the N npr
(00:44):
podcast.
Welcome back to the N npr podcast us
today, we have 2 amazing guests. Welcome Carol.
Welcome Melissa.
I happy to be here. So Carol's joining
us from Jamaica,
and
Melissa is in Boston, and I'm in a
suburb, just West of Boston. I'm gonna read
(01:05):
Melissa. And Carol's Bios
for our listeners.
Carol James, Phd is a professor of eating
disorders, body image and mental health. She's a
clinical psychologist and eating disorder specialist as well
as an associate dean for undergraduate studies and
student experience in the faculty of social sciences,
at the University of West Indies mona.
(01:27):
She is deeply committed to improving mental health
in the Caribbean.
Through her research and work with her patient
she has recognized that culture plays a significant
role in the way patients seek and receive
treatment. Her research is focused mainly on eating
just disorders,
other forms of psycho
and the lived experiences of psychiatric patients. In
(01:48):
the end
international community, Carol is known to actively share
information on the Caribbean culture and its impact
on the presentation and treatment of eating disorders.
And Melissa Rising, Phd
is the associate director of the eating disorder
program in the division of Adolescent and young
adult medicine in the Department of Psychiatry at
(02:08):
Boston children's Hospital at an instructor at Harvard
Medical School. Doctor Fe received her doctor degree
Counseling psych from Northeastern universe
and went on to study dialect electrical behavioral
therapy in its approaches to eating disorders.
She was the 2006 Murphy fellow at the
harvard Medical school Massachusetts mental Health center Db
(02:28):
program.
Melissa has been a clinician researcher in consultant
in Boston for over twelfth 20 years, working
with patients with eating disorders, addictions, personality disorders
and anxiety disorders.
20 She has presented national and local workshops
and lectures on the topic of eating disorders,
and college students that's 1 of my favorite
topics and borderline personality disorders and eating. Orders.
(02:51):
And both of you are published
in the field
extensively.
So we are super lucky to have both
of you here orders where I'd like to
start today is how did you to meet?
Well, this is Melissa hi.
I have been going to Jamaica for... Where
I don't know. 20 plus years. It's always
had a special place in my heart. I
(03:11):
have friends and family down there. And in
2017,
my colleague,
doctor Michael Rich, who is a Adolescent medicine
doctor who
has written a lot. He just published a
book about, social media use and abuse was
going down there to speak. And I thought,
wait, I wanna get in on this. And
I was so cries
(03:33):
because it was... I was under the illusion
that
individuals from the Caribbean and people of Caribbean
descent had healthy body
and I was shocked. And once I started
reading Carol,
and her colleague,
doctor Abigail. Harrison. And once I started reading
their research, I have come to find out
well, actually, you know, eating disorders and unhealthy
(03:55):
behaviors are on the rise in the Caribbean,
neil So I was so intrigued that I
submitted
a workshop, and I started researching
about binge eating disorder in the Caribbean.
Because I was I was just really interested
and wanted to know more. So I invited
myself to the conference
(04:15):
luckily, Carol accept submission. And then I went
to,
her dying to be beautiful conference in 2017.
And it was really an amazing amazing event.
Carol was 20 17. The first year tell
the listeners how long the conference has been
Right. It's... No. That was the first year.
(04:36):
The first year was in
20 12, but we've had the conference
3 times since.
And
this is gonna be the fourth
conference that we're gonna have in December
6 to 8
and I was I was so happy to
have met Melissa So for some reason, I
(04:57):
think that we've been communicating even before.
20 17.
I I don't know. I think maybe we
have to look back at the email trail.
So maybe we were in touch
maybe when we had the first or the
second
dying to the beautiful conference.
But
Melissa has been an advocate for,
(05:19):
dying to be beautiful. Ever since she's been
to the conference itself, and she has been
promoting
dying to be beautiful. So it's it's really
an honor it to to have her on
on the team. In terms of what Melissa
mentioned mentioned,
about the myths surrounding
(05:39):
negative,
body image
in the Are,
that has been a myth for some time,
Mean even the
publications that we've had,
most of which Are in in Jamaica, in
particular,
Abigail Harrison and myself. We've done quite a
bit of work to inform
the the public about a negative body image,
(06:03):
even moving from weight and shape to now
skin leaching. That's something that,
has been topical
in in our,
country and
more in,
centric
populations,
or or non white
(06:23):
populations,
So we've been really talking about body image,
quite a bit and the the
ramifications of it.
Where do you see
in terms of
body imaging eating disorders?
Since the original conference in 20 12. Are
you seeing it mh. Worsen
(06:44):
significantly,
you know, eating disorders and and body image
issues in the caribbean?
I would say... So
because we didn't have
much research in the area to begin with.
Once we had the conference or once,
Abigail, and I had burned to Jamaica
(07:07):
in 2009
after being trained
in eating disorders, how to treat eating disorders,
we've seen
patient surface,
and
patients had indicated that, you know, they've been
looking for...
Jamaican therapist or therapist from the Caribbean,
(07:27):
but hadn't...
They had no awareness that we existed.
So
there were agents, they're suffering
with eating disorders. But for those who could
afford it, they would go overseas for treatment,
and
their experience is that because of the cultural...
The difference in cultural
(07:49):
that it made it challenging for them,
to connect with environment.
And so for some patients, they had to
return
home
because there was more of a connection more
of an understanding in terms of our language
or food or or culture
and that has been rewarding for them. But
(08:09):
I I can say that since our research,
we've seen evidence
of...
I I don't want to say it has
been on the rise because we did have
anything to compare it with before.
But we've certainly seen
a lot of cases since doing
research in the area,
and that is also comparable in terms of
(08:32):
disordered eating behaviors.
We've seen it being comparable for the United
States
and even in some cases for or males
surpassing the disordered eating behaviors
in comparison
the adolescent mails in the United States. So
we've definitely seen more cases
(08:54):
come up. So I certainly people are talking
more about it. I'll have services changed in
Jamaica Carol
for treatment.
Yeah. So I would say that the services...
They've changed
in the sense that, no. You have 2
eating disorders, specialist, a physician and a psychologist.
(09:15):
And that that's about the change that we've
had.
So,
and in English speaking Caribbean, I only know
about the 2 of us. So even outside
of Jam jamaica,
and we've tried through the conference to educate
other,
physicians and other
(09:36):
psychologists.
But we haven't had persons
come board to join and support us.
And I'm I'm guessing it's because we have
quite a bit to do,
we don't have a lot of psychologist.
We don't have a lot of adolescent
health specialist
as well, and we we have,
(09:59):
communities to serve, and certainly we have quite
a bit on our plates. So
I imagine that others may not common board
because they also are serving
the the population with other
the needs as well.
What do you think the
adolescent male segment of the population is is,
(10:20):
you know, more significantly affected.
In comparison, meaning based on what I've spoken
about with the disordered eating behaviors
and
the United States. Yes. So so I would
say that the the adolescents in general. So
both females and males they're affected. Yes the
(10:42):
females
surpassed the males
in in our context as as we've seen
internationally
as well Well, but I I think that
the reason why or adolescents
are
being impacted.
Could be for several reasons, but perhaps the
(11:03):
medium do.
So we've seen
where
from an earlier study in the early 2000,
where,
I think 2004
where Anderson 5 was looking at body image
in,
bell belize,
and she noticed a shift
with the expansion of tourism in the body
(11:25):
image,
perception. So
initially,
the the females
embrace the coca cola lots of shape and,
you know, it c and
more of a.
But,
after
the expansion of tours and there was the
shift in more of the the thin ideal
(11:47):
of the hypothesis was that,
it was perhaps because of person because that
was the only change. And we've seen in
our research that the media does have an
influence. So for those who exhibit this disorder
Et behaviors and even skin bleaching.
That they have had higher frequency of engaging
(12:08):
with the media.
So so it is possible that that could
be 1 of the largest
contributing factors. And given that or,
I mean, they have access to social media,
they have access to the Internet. I mean,
they have their own phones,
and that's how they they connect?
(12:28):
Melissa. Can you speak to... You know, any
piece that you're seeing
consistently?
Yeah. We have seen a rise in eating
disorders and
adolescents
just by the admission since to our hospital
since Covid. Right. And it's it's on that
more than doubled, and then
(12:49):
we thought it would level off.
It has leveled off a little bit, but
we are still
always kind of concerned by the level of
acuity and the fact that kids are younger.
I
don't have the data
behind me to back it, but I believe
it's because of social media. Yeah. And also,
(13:11):
I mean, they're they're there are a lot
of data to support that Covid did... You
know, we did see increases of anxiety,
negative body image and eating disorders. And there
it's just different now than it used to
be. It's just... It's it's more severe
than it was before
and the kids are younger. So I I
(13:32):
believe it's social media use.
Melissa, what's your talk or talks going to
be at this 1? Symposium, do you know
yet?
Or are you too gonna keep that a
secret for a while.
I have not even given it a thought,
You know, I am just really concerned about
spreading the word,
because the thing that I have learned, I
(13:53):
mean, we we treat a lot of families
from the Caribbean of Boston children's and also
from Latin America
and Central America. And And my
campaign,
and I'm happy to say that, you know,
most clinicians know is that, you know, when
I... When I was... In in 2017,
I was concerned that clinicians weren't asking the
(14:15):
question
that if they saw someone from the Caribbean
and they would...
Assume that the person didn't have an disorder
because of, you know, healthy body image.
So my... You know, so I did a
lot of you know, reading and writing about
about educating clinicians, and I am happy to
say that most clinicians do ask the questions.
Most clinicians are savvy,
(14:37):
I I am not sure we we'd have
to ask our colleagues in the medical field
whether or not, they believe that their pediatricians.
Ask those questions
or not
based on someone's culture. But I think that
what we've learned is that eating disorders are
pretty constant cross.
And I think that most psychologists and and
mental health clinicians know that. I want you
(14:59):
to say what you just said again. That
eating disorders are prevalent. Please say that again
for our listeners.
Yeah. Eating disorders are pretty much the same
prevalence across all cultures.
Thank you. That's really, really important. So for
our listeners who are clinicians, which we have,
I think.
(15:20):
The dying to be beautiful conference is December
sixth through eighth in Kingston Jamaica 20 24.
This will be the fourth conference. This many
Is a conference that brings focus and conversations
to health challenges, marginalized topics such as body
image, color is them excessive social media use,
which we've just spoken to,
weight concerns, eating behaviors faced by people in
(15:42):
the Caribbean and by extension, them other similar
ethnic groups and colonized nations.
And 4 clinicians interested in
applying
to speak. The deadline is July 30 first.
Is that correct? That is correct. Okay.
And so what are you what are your
goals for this year? Like, what makes this
(16:05):
year maybe a little different or...
Pin know now that it's the fourth year
with some of the different work you 2
have done since you met each other and
since this started and since the world has
changed,
you know, what are... What are you really
looking for in terms of
not just educating
clinicians to ask the questions,
(16:27):
but where do you wanna see shifts?
Folks go to these conferences to learn and
to feel empowered and to help them not
burn out to be frank. To connect with
like minded colleague. So where do you 2
see sort of this this year's
Shifts?
Right. I can start and then Melissa melissa
(16:47):
can can add. I I think it's more
in terms of an open
conversation. Meaning in terms of what we're seeing
here in the Caribbean
as well as what is being
observed
internationally,
But also,
I think it would be good for clinicians
to be mae in
the
(17:07):
Jamaican,
cultural
and to have some of those experiences
because when
when when they meet immigrants, if they're able
to add context
and able to understand the history, able to
understand and appreciate
the culture.
I think that that can bring they can
bring that back with them. So even
(17:28):
even if they're not fully engaged with them
or working with them,
at least they have that context of of
understanding,
and,
certainly from the the findings and us sharing
information,
I I think that we can really help
our patients
across the board.
So so not just only Caribbean patients, but
(17:52):
if if we're able to understand the cultural
of others,
and, you know, we can put ourselves in
in their position, then I think we can
certainly add value to for any any patient.
So
that's that's what I'm thinking in in terms
of the gold Yeah. And it's not just
about eating disorders and body image. I have
(18:13):
a college student I work with who's from
the Caribbean jean from Jamaica from another island
and
there is trauma in her family of origin.
So the way that the trauma from Has
played out in her family is very different.
And I was lucky to have a colleague
of Caribbean descent who was working with me
(18:34):
and said, oh, it's going to look like
this, and if this happens, you need to
do, you know, so it was very different,
and I had to approach it from a
different standpoint or else I would not have
been able to to help her and support
her in the way that she needed and
I needed to understand her culture and the
way the trauma
was disclosed and how how it would unfold
(18:55):
within her family, and it's different.
It was different than how it would unfold
in a family
mostly white, you know, you know, Americans. So
as clinicians, we need to understand that or
else, we are not really doing our clients
of service,
So it is good to immerse yourself in
another culture to understand things from a different
(19:17):
lens.
Well, or also, we're we're missing seeing another
human.
We're missing seeing them, and then it's biased.
It's not, you know, unbiased. Care because it's
like bias through
a western lens, and that's just not okay.
So, you know, clinicians are so
(19:39):
most clinicians we know are so thoughtful and
want to do right by our clients that
we really do seek supervision and training when
we know it's needed.
So this conference is really a great way
to learn about different things that we may
see. I mean, the the dia 4 is
real. Like, there are many many
caribbean
(20:00):
people up here in college, working and they're
going to come across our doors.
And also, I think part of Carol's mission
is to really
d, you know, d
health that it's okay for someone from the
Caribbean to get treatment.
Has that that,
Carol, do you feel an an even bigger
(20:21):
barrier or the Jimmy jamaican population specifically?
Yes. III think that we do have a
far away to go. We we are improving
in terms of having more.
Conversation, and, you know, for the younger generation,
they're more open and more accepting
of receiving help.
But
(20:42):
it's it's it's usually
specific to, the more affluent
section of of the society,
and we would like for it to be
across the board. And a part of the
the proceeds of the conference as well is
to have a virtual platform
where we serve not only or students at
(21:04):
the university,
but also
for
other people
in Jamaica and the Caribbean to be able
to access
information. So we'd like to take social media
to another level to inform others, but also
to provide them with support
for... For those who can't afford it as
(21:27):
as well.
For the upcoming conference,
you've both talked about, you know, where you
see wanting it to shift to and spotlight
it. And in that same sort of vein,
where do you see
the field going
you know, where do both of you see
the field of eating disorders going? And is
(21:49):
that the same direction you want it to
go?
Well, I I think that there are a
lot of exciting new
developments in the field. And
personally very interested in the application of, psychedelic
medicine,
to the treatment of eating disorders,
(22:09):
there are a lot of great people in
San Diego and
hopkins in London,
doing research,
looking at that, which I think is really
interesting.
I think it has a long way to
go. I'm a little skeptical, but I think
that it might be very helpful.
And I'm also
really,
(22:30):
I'm interested in
a atypical an,
which I don't like that lady at all,
but, you know, ana
in people,
with higher body weights. I think that that
has come a long way and also just
really
working to educate
clinicians that Ana cia
(22:51):
She is garcia,
and it doesn't really
matter what label we put on it. She
additionally, the same with avoid restricted food intake
disorder, I'm very interested. I mean, the the
folks at Mg are doing phenomenal research. And
I'm interested in where they will take us,
(23:12):
because that's an area I feel,
though we're not really
Sharing the the Dsm 5 is not not
us. We know as clinicians, but the Dsm
5 is not really capturing
the nuance of the,
Mh. So I'm really
excited about the research coming out of mass
general hospital.
(23:32):
Me...
Agree with Melissa in terms of... We we
do have a far way to go. And
I think that the research is helping others
to
understand it more. And to even
become more intros
because, there are other individuals who haven't been
diagnose who we've we've overlooked. And because they're
(23:56):
they're able to get this information and they're
not able to step up and ask for
help. But the direction that I would like
for us to also take is
outside of eating disorders. I mean, body
dissatisfaction
has many different eras.
And certainly for people of ko, we do
(24:18):
have,
skin bleaching and skin tone, dissatisfaction,
color in happening,
And I would like for us because they're
very similar
in terms of the the body is satisfaction
with skin tone. And the body is satisfaction
with weight and shape.
I I would like to see both be
(24:38):
treated
equally
and for resources to be there for others
who are struggling with skin tone dissatisfaction,
and who have no clue
of,
like, the the health consequences is associated with
it because we're seeing it in in or
setting
and the education there, it's it's not being
(24:59):
fully highlighted.
So I like for the field the shift
to incorporate other, what it is satisfactory as
well. And this is something that will be
covered at the simple symposium stance. Yes. We.
So So I'm gonna submit to speak. We'll
see if I get accepted. I would love
to to meet Carol you in person. I've
met Melissa in person. So fact, I saw
(25:21):
her at the Meta conference a while back.
And
I I... There was something we were... In
talking about... Oh, I think it was like,
a... We we had a conversation about Psychedelics.
That was interesting. But I wanted to ask
also for folks that are listening in our
maybe contemplating putting in to speak
or just thinking about attending because it's so
(25:43):
dynamic and covers this comfort... Covers so much.
What value Melissa,
tell other clinicians in the states who are
thinking about attending? What's the value of going
besides meeting Carolyn in person, which I really
would love to do.
But please please share.
(26:04):
Well, it's fun. It's so fun. Jamaica is
so fun.
It's a beautiful campus.
That food is amazing.
The best conference food you'll ever have.
But,
what's important about it is, I mean, it's
really fun going to conferences,
And when you go to... I go to
the tend to go the same conferences
(26:25):
every year. And, you know, sometimes that there
are new and interesting.
Developments and sometimes not,
this is a new and interesting area for
most people.
And just to hear about the work that
other people people are doing. It's very important
to support that work.
And it's very important to inform our own
practice, and I feel like if you go
(26:46):
to dying to be beautiful, people in December.
You will learn several tidbits of clinical information
that you can integrate into your own practice.
And I feel as that when we have
a wider world view, we'd only serve our
clients
better. And we have sir... We have some
kilos. I don't know if if we can...
Or if we should speak about them,
(27:09):
but certainly in terms of the experience of
the food and the cultural,
we have Andre referrals who will be speaking
to us, and we have all the chefs,
Jamaican of Jamaican inherit... Who will also be
there, like, giving talks as to how you
can
incorporate, like, food or meals
(27:30):
on a budget,
maybe some cooking tips as well as well
as, you know, Resilience. So a lot of
story sharing in terms of
coming from, a background
where there are limited resources and being able
to make it to,
a developed country where they're...
(27:53):
You have more resources and, you know, what
drives that individual to get to that place.
So we have lots of learning tips even
outside of,
mental health. So more, meaning like clinical diagnosis.
With more in terms of, like, personal resilience
as well and how to develop that.
I love that
(28:14):
you're having
the chefs
approaching the topic of, you know, how to
nourish on a budget and how to just
nourish. I think that's so important and I
don't remember that like, being a topic, any
recent conference,
you know, 1 thing we didn't talk about,
and III
(28:35):
think it's really important because it's not really
advertised. Well, about the conference, but since Covid,
like, so many college students experience in this
country too,
experienced food scarcity and food security.
So
the mission
of the conference and anyone who donate money
(28:57):
is going to help food scarcity,
and Carol, if you could talk a little
bit about that, but we want the students
to be able to eat
for 3 days for free, we want them
to attend the conference for free and really
address,
you know, on a small way, this small
in any manner that we can, the food
insecurity that people are are going through right
(29:18):
now as a result of the pandemic.
Yeah. I mean, we're seeing...
I I I've never seen this in or
setting in terms of or
students at the tertiary level,
like, struggling
to to nourish their bodies,
and that has been a mission
(29:39):
for our faculty
to to address to provide support for the
students
because we've had students who
come in and they don't... They haven't had
food for the entire day, but, you know,
education is important, but how sustainable that if
you don't have the nutrition to keep you
awake or to keep your alert
(29:59):
or to keep you engaged with the with
the material.
I I think also to add to the
the
issue of food scarcity
I I thought about another... Keynote,
Char
small who
specializes
in in treating black woman,
and I think that that is very important
(30:21):
because because it goes back to the myth
that,
Melissa spoke about initially, like, thinking that, cabin
people are even black women
having,
more secured body image,
and not, and that's a conversation that we
need to continue to have
so that we cover all ethnic groups,
(30:44):
I really appreciate the topic of scarcity of
nourishment
in college students. I worked in college health
for over a decade.
1 of the things that came up frequently
was just what we were talking about over
and over and over again. And this was,
like, you know, 2005
to 2014.
The other crossover, I think,
(31:04):
there's a newer book out by a a
woman named Stephanie Land, she wrote made and
class.
And glass very much speaks to her experience.
She is a white woman in collagen the
United States, but it speaks to her living
in poverty and not having enough food for
her or her daughter,
(31:24):
and yet pursuing this this degree.
So we've We've covered so much, and I
appreciate you both so much. And I am
very excited to see you in Jamaica. I
hope that I get chosen we'll see. Just
thank you. Thank you For all you're doing,
and I hope that our pass continued to
cross over significantly. And thank you for having
(31:45):
us.
Thank you for joining us for the N
npr
podcast
with Robin K. We invite you to subscribe
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Help, and hope is found here. For more,
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(32:06):
R0BYNKIEVIT
dot com or check out VNPRD
dot com.
Hello,
and welcome to the Npr
podcast,
with nurse practitioner and registered diet.
Robin K.
Eating disorders, body image, medicine, they are all
interconnected.
But with so many programs,
techniques and advice to choose from it's easy
to be overwhelmed.
(00:21):
Robin with more than 25 years of experience
as a nurse practitioner, and registered diet offers
help and hope for everyone. Families,
children,
and adults.
Along with veteran talk show host and good
friend, Jordan Rich,
Robin invites you to learn much more right
here, on the N npr
(00:44):
podcast.
Welcome back to the N npr podcast us
today, we have 2 amazing guests. Welcome Carol.
Welcome Melissa.
I happy to be here. So Carol's joining
us from Jamaica,
and
Melissa is in Boston, and I'm in a
suburb, just West of Boston. I'm gonna read
(01:05):
Melissa. And Carol's Bios
for our listeners.
Carol James, Phd is a professor of eating
disorders, body image and mental health. She's a
clinical psychologist and eating disorder specialist as well
as an associate dean for undergraduate studies and
student experience in the faculty of social sciences,
at the University of West Indies mona.
(01:27):
She is deeply committed to improving mental health
in the Caribbean.
Through her research and work with her patient
she has recognized that culture plays a significant
role in the way patients seek and receive
treatment. Her research is focused mainly on eating
just disorders,
other forms of psycho
and the lived experiences of psychiatric patients. In
(01:48):
the end
international community, Carol is known to actively share
information on the Caribbean culture and its impact
on the presentation and treatment of eating disorders.
And Melissa Rising, Phd
is the associate director of the eating disorder
program in the division of Adolescent and young
adult medicine in the Department of Psychiatry at
(02:08):
Boston children's Hospital at an instructor at Harvard
Medical School. Doctor Fe received her doctor degree
Counseling psych from Northeastern universe
and went on to study dialect electrical behavioral
therapy in its approaches to eating disorders.
She was the 2006 Murphy fellow at the
harvard Medical school Massachusetts mental Health center Db
(02:28):
program.
Melissa has been a clinician researcher in consultant
in Boston for over twelfth 20 years, working
with patients with eating disorders, addictions, personality disorders
and anxiety disorders.
20 She has presented national and local workshops
and lectures on the topic of eating disorders,
and college students that's 1 of my favorite
topics and borderline personality disorders and eating. Orders.
(02:51):
And both of you are published
in the field
extensively.
So we are super lucky to have both
of you here orders where I'd like to
start today is how did you to meet?
Well, this is Melissa hi.
I have been going to Jamaica for... Where
I don't know. 20 plus years. It's always
had a special place in my heart. I
(03:11):
have friends and family down there. And in
2017,
my colleague,
doctor Michael Rich, who is a Adolescent medicine
doctor who
has written a lot. He just published a
book about, social media use and abuse was
going down there to speak. And I thought,
wait, I wanna get in on this. And
I was so cries
(03:33):
because it was... I was under the illusion
that
individuals from the Caribbean and people of Caribbean
descent had healthy body
and I was shocked. And once I started
reading Carol,
and her colleague,
doctor Abigail. Harrison. And once I started reading
their research, I have come to find out
well, actually, you know, eating disorders and unhealthy
(03:55):
behaviors are on the rise in the Caribbean,
neil So I was so intrigued that I
submitted
a workshop, and I started researching
about binge eating disorder in the Caribbean.
Because I was I was just really interested
and wanted to know more. So I invited
myself to the conference
(04:15):
luckily, Carol accept submission. And then I went
to,
her dying to be beautiful conference in 2017.
And it was really an amazing amazing event.
Carol was 20 17. The first year tell
the listeners how long the conference has been
Right. It's... No. That was the first year.
(04:36):
The first year was in
20 12, but we've had the conference
3 times since.
And
this is gonna be the fourth
conference that we're gonna have in December
6 to 8
and I was I was so happy to
have met Melissa So for some reason, I
(04:57):
think that we've been communicating even before.
20 17.
I I don't know. I think maybe we
have to look back at the email trail.
So maybe we were in touch
maybe when we had the first or the
second
dying to the beautiful conference.
But
Melissa has been an advocate for,
(05:19):
dying to be beautiful. Ever since she's been
to the conference itself, and she has been
promoting
dying to be beautiful. So it's it's really
an honor it to to have her on
on the team. In terms of what Melissa
mentioned mentioned,
about the myths surrounding
(05:39):
negative,
body image
in the Are,
that has been a myth for some time,
Mean even the
publications that we've had,
most of which Are in in Jamaica, in
particular,
Abigail Harrison and myself. We've done quite a
bit of work to inform
the the public about a negative body image,
(06:03):
even moving from weight and shape to now
skin leaching. That's something that,
has been topical
in in our,
country and
more in,
centric
populations,
or or non white
(06:23):
populations,
So we've been really talking about body image,
quite a bit and the the
ramifications of it.
Where do you see
in terms of
body imaging eating disorders?
Since the original conference in 20 12. Are
you seeing it mh. Worsen
(06:44):
significantly,
you know, eating disorders and and body image
issues in the caribbean?
I would say... So
because we didn't have
much research in the area to begin with.
Once we had the conference or once,
Abigail, and I had burned to Jamaica
(07:07):
in 2009
after being trained
in eating disorders, how to treat eating disorders,
we've seen
patient surface,
and
patients had indicated that, you know, they've been
looking for...
Jamaican therapist or therapist from the Caribbean,
(07:27):
but hadn't...
They had no awareness that we existed.
So
there were agents, they're suffering
with eating disorders. But for those who could
afford it, they would go overseas for treatment,
and
their experience is that because of the cultural...
The difference in cultural
(07:49):
that it made it challenging for them,
to connect with environment.
And so for some patients, they had to
return
home
because there was more of a connection more
of an understanding in terms of our language
or food or or culture
and that has been rewarding for them. But
(08:09):
I I can say that since our research,
we've seen evidence
of...
I I don't want to say it has
been on the rise because we did have
anything to compare it with before.
But we've certainly seen
a lot of cases since doing
research in the area,
and that is also comparable in terms of
(08:32):
disordered eating behaviors.
We've seen it being comparable for the United
States
and even in some cases for or males
surpassing the disordered eating behaviors
in comparison
the adolescent mails in the United States. So
we've definitely seen more cases
(08:54):
come up. So I certainly people are talking
more about it. I'll have services changed in
Jamaica Carol
for treatment.
Yeah. So I would say that the services...
They've changed
in the sense that, no. You have 2
eating disorders, specialist, a physician and a psychologist.
(09:15):
And that that's about the change that we've
had.
So,
and in English speaking Caribbean, I only know
about the 2 of us. So even outside
of Jam jamaica,
and we've tried through the conference to educate
other,
physicians and other
(09:36):
psychologists.
But we haven't had persons
come board to join and support us.
And I'm I'm guessing it's because we have
quite a bit to do,
we don't have a lot of psychologist.
We don't have a lot of adolescent
health specialist
as well, and we we have,
(09:59):
communities to serve, and certainly we have quite
a bit on our plates. So
I imagine that others may not common board
because they also are serving
the the population with other
the needs as well.
What do you think the
adolescent male segment of the population is is,
(10:20):
you know, more significantly affected.
In comparison, meaning based on what I've spoken
about with the disordered eating behaviors
and
the United States. Yes. So so I would
say that the the adolescents in general. So
both females and males they're affected. Yes the
(10:42):
females
surpassed the males
in in our context as as we've seen
internationally
as well Well, but I I think that
the reason why or adolescents
are
being impacted.
Could be for several reasons, but perhaps the
(11:03):
medium do.
So we've seen
where
from an earlier study in the early 2000,
where,
I think 2004
where Anderson 5 was looking at body image
in,
bell belize,
and she noticed a shift
with the expansion of tourism in the body
(11:25):
image,
perception. So
initially,
the the females
embrace the coca cola lots of shape and,
you know, it c and
more of a.
But,
after
the expansion of tours and there was the
shift in more of the the thin ideal
(11:47):
of the hypothesis was that,
it was perhaps because of person because that
was the only change. And we've seen in
our research that the media does have an
influence. So for those who exhibit this disorder
Et behaviors and even skin bleaching.
That they have had higher frequency of engaging
(12:08):
with the media.
So so it is possible that that could
be 1 of the largest
contributing factors. And given that or,
I mean, they have access to social media,
they have access to the Internet. I mean,
they have their own phones,
and that's how they they connect?
(12:28):
Melissa. Can you speak to... You know, any
piece that you're seeing
consistently?
Yeah. We have seen a rise in eating
disorders and
adolescents
just by the admission since to our hospital
since Covid. Right. And it's it's on that
more than doubled, and then
(12:49):
we thought it would level off.
It has leveled off a little bit, but
we are still
always kind of concerned by the level of
acuity and the fact that kids are younger.
I
don't have the data
behind me to back it, but I believe
it's because of social media. Yeah. And also,
(13:11):
I mean, they're they're there are a lot
of data to support that Covid did... You
know, we did see increases of anxiety,
negative body image and eating disorders. And there
it's just different now than it used to
be. It's just... It's it's more severe
than it was before
and the kids are younger. So I I
(13:32):
believe it's social media use.
Melissa, what's your talk or talks going to
be at this 1? Symposium, do you know
yet?
Or are you too gonna keep that a
secret for a while.
I have not even given it a thought,
You know, I am just really concerned about
spreading the word,
because the thing that I have learned, I
(13:53):
mean, we we treat a lot of families
from the Caribbean of Boston children's and also
from Latin America
and Central America. And And my
campaign,
and I'm happy to say that, you know,
most clinicians know is that, you know, when
I... When I was... In in 2017,
I was concerned that clinicians weren't asking the
(14:15):
question
that if they saw someone from the Caribbean
and they would...
Assume that the person didn't have an disorder
because of, you know, healthy body image.
So my... You know, so I did a
lot of you know, reading and writing about
about educating clinicians, and I am happy to
say that most clinicians do ask the questions.
Most clinicians are savvy,
(14:37):
I I am not sure we we'd have
to ask our colleagues in the medical field
whether or not, they believe that their pediatricians.
Ask those questions
or not
based on someone's culture. But I think that
what we've learned is that eating disorders are
pretty constant cross.
And I think that most psychologists and and
mental health clinicians know that. I want you
(14:59):
to say what you just said again. That
eating disorders are prevalent. Please say that again
for our listeners.
Yeah. Eating disorders are pretty much the same
prevalence across all cultures.
Thank you. That's really, really important. So for
our listeners who are clinicians, which we have,
I think.
(15:20):
The dying to be beautiful conference is December
sixth through eighth in Kingston Jamaica 20 24.
This will be the fourth conference. This many
Is a conference that brings focus and conversations
to health challenges, marginalized topics such as body
image, color is them excessive social media use,
which we've just spoken to,
weight concerns, eating behaviors faced by people in
(15:42):
the Caribbean and by extension, them other similar
ethnic groups and colonized nations.
And 4 clinicians interested in
applying
to speak. The deadline is July 30 first.
Is that correct? That is correct. Okay.
And so what are you what are your
goals for this year? Like, what makes this
(16:05):
year maybe a little different or...
Pin know now that it's the fourth year
with some of the different work you 2
have done since you met each other and
since this started and since the world has
changed,
you know, what are... What are you really
looking for in terms of
not just educating
clinicians to ask the questions,
(16:27):
but where do you wanna see shifts?
Folks go to these conferences to learn and
to feel empowered and to help them not
burn out to be frank. To connect with
like minded colleague. So where do you 2
see sort of this this year's
Shifts?
Right. I can start and then Melissa melissa
(16:47):
can can add. I I think it's more
in terms of an open
conversation. Meaning in terms of what we're seeing
here in the Caribbean
as well as what is being
observed
internationally,
But also,
I think it would be good for clinicians
to be mae in
the
(17:07):
Jamaican,
cultural
and to have some of those experiences
because when
when when they meet immigrants, if they're able
to add context
and able to understand the history, able to
understand and appreciate
the culture.
I think that that can bring they can
bring that back with them. So even
(17:28):
even if they're not fully engaged with them
or working with them,
at least they have that context of of
understanding,
and,
certainly from the the findings and us sharing
information,
I I think that we can really help
our patients
across the board.
So so not just only Caribbean patients, but
(17:52):
if if we're able to understand the cultural
of others,
and, you know, we can put ourselves in
in their position, then I think we can
certainly add value to for any any patient.
So
that's that's what I'm thinking in in terms
of the gold Yeah. And it's not just
about eating disorders and body image. I have
(18:13):
a college student I work with who's from
the Caribbean jean from Jamaica from another island
and
there is trauma in her family of origin.
So the way that the trauma from Has
played out in her family is very different.
And I was lucky to have a colleague
of Caribbean descent who was working with me
(18:34):
and said, oh, it's going to look like
this, and if this happens, you need to
do, you know, so it was very different,
and I had to approach it from a
different standpoint or else I would not have
been able to to help her and support
her in the way that she needed and
I needed to understand her culture and the
way the trauma
was disclosed and how how it would unfold
(18:55):
within her family, and it's different.
It was different than how it would unfold
in a family
mostly white, you know, you know, Americans. So
as clinicians, we need to understand that or
else, we are not really doing our clients
of service,
So it is good to immerse yourself in
another culture to understand things from a different
(19:17):
lens.
Well, or also, we're we're missing seeing another
human.
We're missing seeing them, and then it's biased.
It's not, you know, unbiased. Care because it's
like bias through
a western lens, and that's just not okay.
So, you know, clinicians are so
(19:39):
most clinicians we know are so thoughtful and
want to do right by our clients that
we really do seek supervision and training when
we know it's needed.
So this conference is really a great way
to learn about different things that we may
see. I mean, the the dia 4 is
real. Like, there are many many
caribbean
(20:00):
people up here in college, working and they're
going to come across our doors.
And also, I think part of Carol's mission
is to really
d, you know, d
health that it's okay for someone from the
Caribbean to get treatment.
Has that that,
Carol, do you feel an an even bigger
(20:21):
barrier or the Jimmy jamaican population specifically?
Yes. III think that we do have a
far away to go. We we are improving
in terms of having more.
Conversation, and, you know, for the younger generation,
they're more open and more accepting
of receiving help.
But
(20:42):
it's it's it's usually
specific to, the more affluent
section of of the society,
and we would like for it to be
across the board. And a part of the
the proceeds of the conference as well is
to have a virtual platform
where we serve not only or students at
(21:04):
the university,
but also
for
other people
in Jamaica and the Caribbean to be able
to access
information. So we'd like to take social media
to another level to inform others, but also
to provide them with support
for... For those who can't afford it as
(21:27):
as well.
For the upcoming conference,
you've both talked about, you know, where you
see wanting it to shift to and spotlight
it. And in that same sort of vein,
where do you see
the field going
you know, where do both of you see
the field of eating disorders going? And is
(21:49):
that the same direction you want it to
go?
Well, I I think that there are a
lot of exciting new
developments in the field. And
personally very interested in the application of, psychedelic
medicine,
to the treatment of eating disorders,
(22:09):
there are a lot of great people in
San Diego and
hopkins in London,
doing research,
looking at that, which I think is really
interesting.
I think it has a long way to
go. I'm a little skeptical, but I think
that it might be very helpful.
And I'm also
really,
(22:30):
I'm interested in
a atypical an,
which I don't like that lady at all,
but, you know, ana
in people,
with higher body weights. I think that that
has come a long way and also just
really
working to educate
clinicians that Ana cia
(22:51):
She is garcia,
and it doesn't really
matter what label we put on it. She
additionally, the same with avoid restricted food intake
disorder, I'm very interested. I mean, the the
folks at Mg are doing phenomenal research. And
I'm interested in where they will take us,
(23:12):
because that's an area I feel,
though we're not really
Sharing the the Dsm 5 is not not
us. We know as clinicians, but the Dsm
5 is not really capturing
the nuance of the,
Mh. So I'm really
excited about the research coming out of mass
general hospital.
(23:32):
Me...
Agree with Melissa in terms of... We we
do have a far way to go. And
I think that the research is helping others
to
understand it more. And to even
become more intros
because, there are other individuals who haven't been
diagnose who we've we've overlooked. And because they're
(23:56):
they're able to get this information and they're
not able to step up and ask for
help. But the direction that I would like
for us to also take is
outside of eating disorders. I mean, body
dissatisfaction
has many different eras.
And certainly for people of ko, we do
(24:18):
have,
skin bleaching and skin tone, dissatisfaction,
color in happening,
And I would like for us because they're
very similar
in terms of the the body is satisfaction
with skin tone. And the body is satisfaction
with weight and shape.
I I would like to see both be
(24:38):
treated
equally
and for resources to be there for others
who are struggling with skin tone dissatisfaction,
and who have no clue
of,
like, the the health consequences is associated with
it because we're seeing it in in or
setting
and the education there, it's it's not being
(24:59):
fully highlighted.
So I like for the field the shift
to incorporate other, what it is satisfactory as
well. And this is something that will be
covered at the simple symposium stance. Yes. We.
So So I'm gonna submit to speak. We'll
see if I get accepted. I would love
to to meet Carol you in person. I've
met Melissa in person. So fact, I saw
(25:21):
her at the Meta conference a while back.
And
I I... There was something we were... In
talking about... Oh, I think it was like,
a... We we had a conversation about Psychedelics.
That was interesting. But I wanted to ask
also for folks that are listening in our
maybe contemplating putting in to speak
or just thinking about attending because it's so
(25:43):
dynamic and covers this comfort... Covers so much.
What value Melissa,
tell other clinicians in the states who are
thinking about attending? What's the value of going
besides meeting Carolyn in person, which I really
would love to do.
But please please share.
(26:04):
Well, it's fun. It's so fun. Jamaica is
so fun.
It's a beautiful campus.
That food is amazing.
The best conference food you'll ever have.
But,
what's important about it is, I mean, it's
really fun going to conferences,
And when you go to... I go to
the tend to go the same conferences
(26:25):
every year. And, you know, sometimes that there
are new and interesting.
Developments and sometimes not,
this is a new and interesting area for
most people.
And just to hear about the work that
other people people are doing. It's very important
to support that work.
And it's very important to inform our own
practice, and I feel like if you go
(26:46):
to dying to be beautiful, people in December.
You will learn several tidbits of clinical information
that you can integrate into your own practice.
And I feel as that when we have
a wider world view, we'd only serve our
clients
better. And we have sir... We have some
kilos. I don't know if if we can...
Or if we should speak about them,
(27:09):
but certainly in terms of the experience of
the food and the cultural,
we have Andre referrals who will be speaking
to us, and we have all the chefs,
Jamaican of Jamaican inherit... Who will also be
there, like, giving talks as to how you
can
incorporate, like, food or meals
(27:30):
on a budget,
maybe some cooking tips as well as well
as, you know, Resilience. So a lot of
story sharing in terms of
coming from, a background
where there are limited resources and being able
to make it to,
a developed country where they're...
(27:53):
You have more resources and, you know, what
drives that individual to get to that place.
So we have lots of learning tips even
outside of,
mental health. So more, meaning like clinical diagnosis.
With more in terms of, like, personal resilience
as well and how to develop that.
I love that
(28:14):
you're having
the chefs
approaching the topic of, you know, how to
nourish on a budget and how to just
nourish. I think that's so important and I
don't remember that like, being a topic, any
recent conference,
you know, 1 thing we didn't talk about,
and III
(28:35):
think it's really important because it's not really
advertised. Well, about the conference, but since Covid,
like, so many college students experience in this
country too,
experienced food scarcity and food security.
So
the mission
of the conference and anyone who donate money
(28:57):
is going to help food scarcity,
and Carol, if you could talk a little
bit about that, but we want the students
to be able to eat
for 3 days for free, we want them
to attend the conference for free and really
address,
you know, on a small way, this small
in any manner that we can, the food
insecurity that people are are going through right
(29:18):
now as a result of the pandemic.
Yeah. I mean, we're seeing...
I I I've never seen this in or
setting in terms of or
students at the tertiary level,
like, struggling
to to nourish their bodies,
and that has been a mission
(29:39):
for our faculty
to to address to provide support for the
students
because we've had students who
come in and they don't... They haven't had
food for the entire day, but, you know,
education is important, but how sustainable that if
you don't have the nutrition to keep you
awake or to keep your alert
(29:59):
or to keep you engaged with the with
the material.
I I think also to add to the
the
issue of food scarcity
I I thought about another... Keynote,
Char
small who
specializes
in in treating black woman,
and I think that that is very important
(30:21):
because because it goes back to the myth
that,
Melissa spoke about initially, like, thinking that, cabin
people are even black women
having,
more secured body image,
and not, and that's a conversation that we
need to continue to have
so that we cover all ethnic groups,
(30:44):
I really appreciate the topic of scarcity of
nourishment
in college students. I worked in college health
for over a decade.
1 of the things that came up frequently
was just what we were talking about over
and over and over again. And this was,
like, you know, 2005
to 2014.
The other crossover, I think,
(31:04):
there's a newer book out by a a
woman named Stephanie Land, she wrote made and
class.
And glass very much speaks to her experience.
She is a white woman in collagen the
United States, but it speaks to her living
in poverty and not having enough food for
her or her daughter,
(31:24):
and yet pursuing this this degree.
So we've We've covered so much, and I
appreciate you both so much. And I am
very excited to see you in Jamaica. I
hope that I get chosen we'll see. Just
thank you. Thank you For all you're doing,
and I hope that our pass continued to
cross over significantly. And thank you for having
(31:45):
us.
Thank you for joining us for the N
npr
podcast
with Robin K. We invite you to subscribe
download, rate and review us and share this
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Help, and hope is found here. For more,
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(32:06):
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