Your Lifestyle Is Your Medicine
“Your Life Style Is Your Medicine” is a podcast that focuses on how a person's lifestyle can be the key to health and happiness. Routed in the principles of lifestyle medicine, Ed Paget, osteopath, and exercise scientist, interviews area-specific experts on how lifestyle impacts well-being, focusing on purpose, physical activity, nutrition, sleep, and stress, which could lead to a longer, happier life. Edward now runs immersive lifestyle medicine retreats, with the purpose of helping others take back control of their lives to live longer and healthier.
Your Lifestyle Is Your Medicine
Episode 56: Jessica Setnick
Jessica Setnick, a worldwide authority on eating disorders, explains how disordered eating exists on a spectrum that affects everyone, not just those with clinical diagnoses. Her anthropological background provides unique insights into why we make the food choices we do and how our emotional states influence eating patterns.
• Eating disorders exist on a spectrum – anyone who eats can have eating problems
• The key question is whether your eating habits support or detract from your life goals
• "How you're feeling after eating is how you were feeling before" – food often becomes a scapegoat for pre-existing emotions
• Past experiences, family patterns, and cultural messages all shape our relationships with food
• Trauma, including food insecurity, can significantly impact eating behaviors
• Shame about eating habits prevents healing, while regret opens the door to change
• The "apple test" helps distinguish between physical hunger and other emotional needs
• When seeking professional help, personality match is more important than credentials
If you want to watch the entire video, here's the link: https://youtu.be/Pu9elJltqII
Welcome to the your Lifestyle is your Medicine podcast, where we do deep dives into topics of mind, body and spirit. Through these conversations, you'll hear practical advice and effective strategies to improve your health and ultimately add healthspan to your lifespan. I'm Ed Padgett. I'm an osteopath and exercise physiologist with a special interest in longevity.
Speaker 1:Today, I'm joined by Jessica Setnick, a leading voice in eating disorder care. She's known worldwide for her eating disorder boot camp and has trained thousands of health professionals with a clear, practical approach. With a background in anthropology and sports nutrition, Jessica brings two decades of experience to hospitals, college campuses and now, as an educator and advocate, shaping the future of treatment. She's authored Key Resources, the Clinical Pocket Guide, the Academy of Nutrition and Dietetics Pocket Guide to Eating Disorders, among many other things, and she's collaborated on diagnostic criteria for orthorexia nervosa. Today, we're going to be talking all about eating disorders and why they should be seen on a spectrum, and towards the end, she's going to share one brilliant tip that can help you figure out if you're hungry or just need a hug. So, jessica, welcome to the show.
Speaker 2:Thank you, what a lovely introduction.
Speaker 1:Hey, no problems. I'm excited because when we spoke earlier getting ready for this podcast, you said something that really piqued my interest and I don't want to give too much away right now. But basically you said eating disorders are on a spectrum and to me, being a relative lay person, when it comes to eating disorders, I always think of them as the end result, sort of the anorexia we hear about in the news or the bulimia we hear the celebrities and that kind of stuff. But I would love in this podcast if you could explain to us how that spectrum works and why you have sort of gone into this field. What got you interested in eating disorders? Maybe we can actually start there.
Speaker 2:What got you interested in eating disorders? Maybe we can actually start there. Okay, sure. So eating disorders was not what I set out to do.
Speaker 2:I went to college with no direction and found myself basically in an anthropology degree accidentally, because those were the classes that intrigued me. And in anthropology I found human behavior to be so interesting. Right, because there's all different aspects of anthropology and some of them are dealing with long dead people and some of them are dealing with other cultures. But the part that affected me the most was sort of the thinking process. And if you're not familiar with anthropology which, by the way, I wasn't before I became a major in it it's really just a study of people, I mean, how interesting is that? Right? And the study of how people develop over time. So anthropology could look at how the human race develops over time, or it could look at how an individual develops over time within a culture. So that, to me, was what was so interesting.
Speaker 2:And when I took nutrition as an elective, I felt this mesh of these two things right, why people make the choices they make with their eating, how people feel about their eating, sometimes even the food that is accessible to you in the first place, how it got there, what you determine is an acceptable food, and in other cultures they might not eat that or they might eat something that you don't consider an acceptable food.
Speaker 2:So all of these aspects of nutrition fascinated me, and when I went to graduate school to get my master's in sports nutrition, it turned out and it's maybe different now, but in 1994, the only area of nutrition where it was sort of kosher to talk about this development and choices you make and the regret you might feel after eating those things that were so interesting to me. The only area that really was talking about that was eating disorders, even though we should really be talking about that in every aspect of nutrition. And so that's what I've tried to do in my career is bring those skills and tools and understanding that I developed in my work in the eating disorder field into the general field of nutrition, where anyone whether they have a diagnosis, whether it's ADD or diabetes or a broken ankle that everyone is looking at the behavioral aspects of eating, not just people who've been identified as having an eating disorder.
Speaker 1:Okay, and you now teach other professionals a certain approach, but once upon a time you saw clients. Is that correct?
Speaker 2:a certain approach, but once upon a time you saw clients. Is that correct? It did that's correct. For a long time, yeah, and that's where I realized that individuals with eating disorders are, in everyone else's mind, this very small segment of the population, and everyone is a big word. So many people think of eating disorders as this very small segment of the population and you even have a picture in your mind of what someone with an eating disorder might look like. Whatever that picture is, yes, someone like that could have an eating disorder, but really anyone who eats can have eating problems. And so that's why I came up with these models, like the origins of dysfunctional eating behavior, where I thought, if we take the wording off of eating disorders and the person who really actually helped me get there was a speaker coach.
Speaker 2:I had developed this workshop for professionals called Eating Disorders Boot Camp.
Speaker 2:It was very popular among a small group of people, small segment, and I really wanted to become a speaker to a bigger, wider audience.
Speaker 2:And this speaker coach it was the kind of thing in the era where you would put your videotapes and your audiotapes and CDs and everything in a box and send it to her and she would immerse herself in your speaking for a week and then give you a three-hour report on the phone on what she thought.
Speaker 2:And what she said was everything you say applies to everyone, not just people with eating disorders. You really need to take the words eating disorders out of your titles and of course that felt like a big blow to the gut. But she said if you are in a presentation or in a conference and there's two sessions and people can go to the eating disorder session or the session on anything name any other topic, most people will go to the other topic and they will really miss out on what you are talking about. And so, even though it kind of hurt to hear that, it really opened my eyes. And then my talk started becoming things like what's eating your clients, healing your inner eater, things like that food, fairy tales, things that where I could provide the information that I thought was so important. But it didn't turn people off from the beginning because of that image people had in their mind of what an eating disorder is.
Speaker 1:Yeah, and I think it was the healing in an eater that caught my attention as well. But when you mentioned, everyone else thinks of eating disorders as the end spectrum. That's myself included. So the end sort of symptoms.
Speaker 2:Yeah, I knew what you meant and you know. Another thing that really influenced me on my path was at one point I was on a college campus speakers bureau, and so I was in contact with a lot of speakers about alcohol abuse, and they don't define alcoholism or an alcohol problem as a certain amount of alcohol you drink in a day, or do you drink every morning, or you know. There's nothing like that. The definition now is do problems happen when you drink? Because that can be a totally different amount for different people, and so I adopted that too. Do problems happen when you eat or not eat? That is the definition of a dysfunctional eating behavior, and so that applies to everyone, and it really opens hearts and minds to someone who's never going to identify as having an eating disorder to really get some assistance.
Speaker 1:Yeah. So let's talk about these eating disorders. I always sort of think of my patients anyway. And let's say I have a lady in her 30s or something or 40s, and she's in a bad way. This is different from eating disorders. This is to do with bacteria or digestive stuff or whatever. And I always think back when that person was a little girl. They were probably full of energy, they probably slept great, they probably had no cares in the world and they did what they wanted, pain-free. And so I always ask myself what happened from that little girl to this person here, and I try and sort of go through their history to figure out all the points in their life that led them to this point where they're sitting in front of me. So I'd be interested to see put that sort of lens on an eating disorder. So when do they start?
Speaker 2:So that is part of the conundrum of eating disorders and the fact that, just like with you, there's a different pathway for every single person. Right, so there's a different pathway, but the one thing that we all have in common and I won't say all again, I'll say many people have in common is we're all swimming in the pool of diet, culture, appearance, culture, consumer culture, and so that is a big factor that we're pretty much surrounded by from a very young age, and so there are some common themes. And on top of those common themes, we also have the individual events that happen to each of us, right? If someone, for example, I threw up life cereal when I was in kindergarten, I don't want life cereal anymore. I don't know if you have that cereal where you live, but it has a very characteristic primary color word life on the box. I don't even like seeing the box, right, I don't want it, and I'm living a perfectly happy, healthy life without life cereal in it. So it's not affecting my nutrition, but just those specific incidents that happen can cause something to happen with our thoughts about food.
Speaker 2:There's also medical conditions that can lead to that. So that's one of the things we're always assessing is when someone comes in to talk about their eating, what medically may have been going on with them, what diagnoses may they have had? A career-ending sports injury could be something that could trigger an eating disorder. Concussion can trigger an eating disorder or eating problem, and so those are the kind of things that we're looking at. Also those individual factors, a bad experience with food, a bad experience in general, a new diagnosis, et cetera.
Speaker 2:And what Healing your Inner Eater brings in. That's completely new is the idea that also we have to look at the people who raised you and what were their experiences, because that affected their eating and if they didn't consciously choose to do things differently, they pass that right along to you and that's why we have a lot of people living now who didn't live through the great depression and didn't live through a refugee situation and didn't live through rationing in World War two. But we have that kind of you have to eat everything because there's children starving elsewhere in the world and all those kind of messages I paid for that food, you have to eat it those kind of messages that we got because our parents or our caregivers or the people who raised them lived through those things. So we still have a depression era mentality, even when food might be abundant and PS, there's also people across the street who don't have enough to eat. We didn't have to look in another country for that.
Speaker 2:And food insecurity is another thing that can happen in someone's history that can change the way that they think about food.
Speaker 2:So healing your inner eater is really trying to bring in that aspect of it's not just society and it's not just the individual things that happen to you.
Speaker 2:There's also a lineage to it and we need to look at that aspect and I love that you are thinking in terms of this was a child who was happy, healthy and active, and now something has changed.
Speaker 2:In the same way, I look at this research study that was done by dieticians where they gave three-year-olds and five-year-olds a different size plate of food on different days. It happened to be macaroni and cheese and the three-year-olds, no matter what size plate of food and how much macaroni you gave them, they would eat what they were hungry for and wander off and play. The five-year-olds would eat a different amount depending on what you put in front of them. So from that we learned somewhere between three and five, a lot of us are learning to use external cues for how much to eat, and so that's one example of something that may be going on in the bigger environment, may be going on individually in the family, and it may be something that's transmitted through family generations. But I, like you, want people to go back to that inner eater from childhood. Not try to convert into a new eater, but try to get back to that child who ate what was appropriate for them and then wandered off and did something else.
Speaker 1:A hundred percent. So when it comes to children, I've got some teenagers who are particularly picky eaters and I picked up this book once and said something I think it was called like Not About the Broccoli or something like that. And I opened the first page and it said most parents fall into one of three categories. And I don't remember all three, but the one that spoke to me was the educational parent that tells the children all about the nutritional this, that and the other in the broccoli and why they should eat it. That's me 100% guilty. Now, my kids don't like healthy food, even though they've grown up around healthy food. I've educated them in healthy food and I sort of feel like I've made a mistake somewhere in the past of over-educating or over-p, pushing the healthy stuff and now it seems, you know, left their own devices, they will gravitate towards the unhealthy food Now on, in your sort of way of thinking about things is that an eating disorder like one end of the spectrum.
Speaker 2:Okay, can I delve into what you just?
Speaker 1:said, let's go.
Speaker 2:Okay, because the first thing I hear is you describing food in two binary categories, as healthy and unhealthy, and I know that that is an emotional statement because analytically you know that's not true. Food does not fall into two categories like that. Right, there's food that has more nutrition, food that has less nutrition, but no one food can make you healthy or not healthy, and so it's the balance of everything that you eat over time. And if you had come to me when your kids were little and I would have said, yes, stop with the education about macros and nutrients and vitamins, and this is maybe the appropriate age to be talking about. Oh yeah, lunch will give you tons of energy to play at the park this afternoon, and really age appropriate. But also, I would have advised you or counseled you or asked you more about where did you get this idea of healthy and unhealthy that you may not even realize? You are saying it in this way, but to a child who is very binary, if those are the only two choices and let's say they really like Cheetos, then they're like oh well, I guess I like the unhealthy stuff, and they're not identifying it as a problem. They're just now moved into that category and then every time you say here's some healthy food, they discount it right off the bat because they're not the healthy food eaters, kind of like when you tell your kids, like this is the smart one and this is the sporty one, and then they live up to that, right.
Speaker 2:So there may have been an aspect of the way food was talked about, but also the way you were thinking about it, and so are your kids, I mean, did they grow up healthy? Do they have um? Are they? You know? I guess their hair's not falling out and um? Are they stunted in growth? Like they're not malnourished? Right? There's nutrition in probably everything they eat. By the way, once the worry switch flips on in a parent, I mean before the baby's even born, you're going to worry about them for the rest of their life, right? And there's so many things we can't control.
Speaker 2:It's so alluring to think that we can control the way someone else eats, and in a world where it's gonna get really existential here for a minute okay and in a world where you really can't control almost anything, especially bad things that can happen to people we love, we would rather believe that we messed up and that's why things turned out a certain way than to believe we don't have control, because the idea that we don't have control is so, the idea that we don't have control is so alarming to our psyche that we would actually rather believe that there was something we could have done and we messed it up.
Speaker 2:So I'm here to say I don't think you messed up your kids. It sounds like they're fully functioning teens. But there's a way of thinking that you have adopted, that certain foods are healthy and unhealthy that I bet was given to you and that you have carried with you in terms of, if I were a good parent, my kids would eat foods in this category, whereas I have a feeling you're an excellent parent, because usually excellent parents are the ones worrying about their kids.
Speaker 1:Interesting. Yeah, no, I see all that and I resonate with everything you just said.
Speaker 2:So thanks for letting me dive in.
Speaker 1:So with that in mind, then, let's move away from my kids. But with this spectrum aspect of things, when? When should a person start thinking about getting some more help or more information about their relationship with food?
Speaker 2:Yes. So my signature word for this is congruence. When the way that you're eating is not congruent with the way you wish to be eating or with the goals that you have in life, that's when to ask for help. A lot of times, people will do it on a DIY, you know, do-it-yourself basis, and sometimes that works and that's great. But if not, if you've been trying to make changes and you find that they don't stick, that's when to talk to a professional, because a lot of times, professionals say things that are different than what you expect. We think, oh, I know what they're going to say, and so I always joke. If you think you know what they're going to say, and so I always joke, if you think you know what they're going to say, you should double ego, because if you already know what to do and you're not doing it well, then you actually need help, right so?
Speaker 2:But to me, the spectrum is not under eating to over eating, which is the way I think a lot of people think of it in their minds. The spectrum is is the way that you're eating supporting your life and your goals, or is the way you're eating distracting or detracting from your life and your goals? And then, of course, we can get all the way to the side of the spectrum where the way you're eating is threatening your life, and I think that's what we tend to talk about or think about as eating disorders. But there's a whole pathway toward that that I think is still warranting getting some support, and it could be anything. If your goal is to run a marathon and the way you're eating isn't supporting that, but it could be if your goal is to become a parent and you think there's ways you could be eating that could support that better.
Speaker 2:And it could just be that you want to have more energy, right? Anything. It could also just be this idea that I shouldn't eat as many sweets, and then you do and you regret it, right? It's that whole interplay where I think it was Einstein I'm not sure I'm probably very much misquoting it if it was but the idea that you can't solve a problem with the same mind that created it. It's just good to have another pair of eyes to look in. And so my answer to your question as a long answer to a short question, is anytime you feel like the way you're eating is not congruent to your life or your goals or the way you wish to be eating. That's a time to look at it.
Speaker 1:Okay. And when we look at like food, let's say the example is the sweet thing eating too many, and then you regret it. I mean, I think we've all been there. We've got the physiologist and the scientist saying well, actually that's a food problem. The food is hyper palatable, it's made with salt and fat levels that are designed to do crazy things in our brains. No wonder you can't stop. So when does it sort of come to be your responsibility, as opposed to like I feel like the scientists are giving us a bit of a way out by saying it's the food companies to blame for overeating. When is it your responsibility? Let's talk about overeating in this case.
Speaker 2:Sure. And so in this case there's the food aspect. But who, who, what's the right word? Who engineered that food to be that way? And it's so tempting to blame the food companies, which is easy to blame, and I probably will, or would but at the same time, have you ever been really enjoying some cherries and you ate so many that you kind of had a stomachache, right. So sometimes it's just significant of human nature that we overdo on things that we love. Then there's other people who feel so guilty after they right. And the biggest differentiator to me is that time I ate cherries, so many cherries, and it gave me a stomachache. I learned from it and I moved on and I did it differently next time. The difference to me is what is going on mentally, so that even though you might know last time I got that candy, I ate the whole bag and then you buy the whole bag again next time, thinking you'll do it differently this time. I'll just eat two pieces right, that is expecting a whole lot of
Speaker 2:ourselves right. So that, to me, is the question mark is what is it? Yes, it could be any food, but there's lots of things out there that, like, I'm not going to eat this pillow. So if, if, a bag of candy is not good for me, then why did I eat it? I'm not stupid, I'm not doing stupid things.
Speaker 2:There has to be a reason why I did it, and so, along with those the negativity, there must be some kind of payoff, whether it changed the serotonin levels in my brain, right, or whether it gave me something to do, or whether it seemed like the chewing right, just the crunching actually changed my brain chemistry, right? Because that does make you feel better. So same reason, people bite their nails and bite pen caps. So that's the question is not necessarily is it the food problem, it's more why am I ingesting things that are known to not actually make me feel better long term? But there must be something that's making you feel better short term. And then the question is what is making you feel bad, that this food makes you feel better? Because that's the key. Are you experiencing depression? And so your body is sort of searching for medication for your depression? Are you experiencing anxiety, boredom. That's the key is what's happening before that gets you into the food.
Speaker 2:Rather than these foods exist. They've been engineered to be hyperpalatable. Great, but why are we craving them? Why are we going toward them? Why are we overdoing them? It's a big question and here's a secret how you are feeling after you eat a food is how you were feeling before you ate it. So if you feel regretful after eating too much candy, you were feeling regretful before, but there was some kind of cognitive dissonance where you couldn't really put your finger on why you're feeling regretful. But once you eat that bag of candy, you're like oh, now I know why I feel regretful. I ate a bag of candy, sort of becomes a punching bag. Or now I know why I feel regretful. I ate a bag of candy Sort of becomes a punching bag or a scapegoat.
Speaker 2:And so it's really important to think about, because someone else could eat that same bag of candy and be angry about it, and someone else could eat that same bag of candy and be delighted about it. So it can't be the candy causing the problem. It's something that was already in our experience, and then we now have the candy to blame.
Speaker 1:That is so interesting. I've never heard that before, but I can relate to that those sensations of how you feel afterwards.
Speaker 2:And here's how I know. Here's how I know, because a happy, delighted person does not eat something that they know will make them feel bad delighted person does not eat something that they know will make them feel bad.
Speaker 1:Okay, so this is interesting. Can we unpack something to do with more like people trying to lose weight and obesity? Is that something that you get into a little bit within eating disorders?
Speaker 2:My stance is that I don't know how to make someone lose weight. I know lots of stuff about nutrition and eating behavior and I wouldn't tell anyone anything differently if they were trying to lose weight. The same information, everything. Something different works for everyone.
Speaker 2:But the pursuit of weight loss specifically is challenging because there's no guarantee it will happen. And so if you're making amazing behavior changes and don't lose weight, does that mean you stop doing the amazing things because you haven't reached your goal? Or can you accept that this might be your normal size or the size you are at this stage of life and the amazing things you're doing to be healthy are still worth it? And I say this not as an empty gesture.
Speaker 2:I'm going through maybe TMI here, but I'm going through perimenopause and it is not fun to watch my body changing. I don't like it. I also know I'm not going to do anything differently because that will exacerbate the multiple problems, whether it's relapsed, my eating disorder from when I was in my 20s, like there's just a lot I don't want to do to mess with my food, but it's still with everything I know and everything I do. It's still hard to have clothes not fit, etc. But I know better than to mess with my eating as a meat. If I want to change my eating, great, but not as a means to change my body, because that is a path that for many people leads to problems.
Speaker 1:So to me it's two different buckets yeah, I understand, and so, more specifically, uh, I have some you know, patients and clients in mind who you know I like to share, like I I said before, the science that says oh, the portion size has increased since the 70s, and that's directly.
Speaker 2:Oh my gosh. Sure, as someone who grew up in the 70s, I can attest to that.
Speaker 1:I was cleaning out my mother's, my elderly mother's wine cabinet the other day and we pulled out the wine glasses. They were tiny, tiny little wine glasses and I remember as a kid that's what they used to drink out of when we had like a Christmas dinner and so on. And now you look at the wine glasses and they're huge. Anyway, I'm getting distracted. So that's one thing. Or the hyper-palatable foods is another one. The decrease in exercise is another one. So all these sort of factors confluence to people potentially eating more unknowingly and gaining weight. But when I've mentioned this, other people say to me yes, but what about trauma? You're not addressing the underlying cause of not that someone has changed everything. They're not losing weight. That's different. It's someone who's eating and they're putting on weight and they don't want to.
Speaker 2:But why can't it be both? Why can't it be that portion sizes have increased and that hyper palatability has increased and that exercise has decreased, and there's still people who maintain you know, for lack of a better word their appropriate size?
Speaker 1:Right.
Speaker 2:So it has to be both. It has to be the confluence Is that a word? It has to be both because for someone, I mean I've seen patients who are overeating, over exercising and gaining weight. I've seen people who are under eating and under exercising who are gaining weight.
Speaker 2:I mean it's there's a lot of physiology that's going on inside our bodies, right, and who hasn't had something traumatic happen to them? I mean, there's, there's sort of you know. So, yes, it's all of the above, it's the chemistry inside our body. What it's not is calories in, calories out, and people are still believing that and and I feel like that take that just sort of discounts everything that's happening inside your body, and so I mean there's so much we could talk about here, but it's, it's um, I'll just stop so you can ask me your next question, because we could just, I could just keep going.
Speaker 1:Well, what I was, what I was going with, that is like when you're sort of unpacking the, the, the spectrum, do you? Is trauma in the past, something that you would like to tease out and discuss?
Speaker 2:often that we are making our own food choices and we forget there are someone else who made so many choices already right, the person who developed the food to make it hyper palatable, the people who picked it to be at the grocery store in our area, and there's so much unconscious or sorry other people's decisions. And then there's our own unconscious stuff. So having not had enough food in the past would be a big one, and that is a trauma that people maybe don't identify as traumatic there can be. I'm thinking of, unfortunately, someone that I heard of that was another dietitian's patient who would not go to the grocery store because the perpetrator of her abuse worked at the grocery store, right. So there's lots of insidious ways that past traumatic events can influence us, including, unfortunately, barrier weights, which is kind of the psychobabble name for someone whose weight is maintaining their weight, heavier than what is their normal, because that makes them feel safe from predators and because there was a certain weight at which they were assaulted, let's say, and being at a different weight makes them feel somehow safe, and so there's. So there's just so much.
Speaker 2:So, yes, that is not to say that every person who overeats has had past trauma. There are, there is some research that suggests that individuals who've had adverse child experiences as you know, determined by the ACEs scale, have less success when they have weight loss surgery and things like that. So I would say there is an aspect of traumatic events in the past that can influence someone's eating, but it can't, it can't be all of it, right. So there's just, there's so much, and that's why it's so individual. But again, that's where I feel like it can't be one or the other. So for someone to say you're not addressing the trauma, you're only looking at the science, there's probably an equal number of people who would say, well, you're not addressing the science, you're only addressing the trauma and I've seen that too where symptoms of actual medical conditions go unexplored because it's all in your head, it's all your trauma, right, and you have to get over that.
Speaker 1:Yeah, that's very interesting. We had the same thing in the manual therapy world, where some great research came out about pain sort of pain modulating in the brain and so then a lot of physical therapists just talked about pain and didn't touch their patients and there was like easy fixes that weren't being done because you could explain it with your reasoning. And now I think it's swinging back where, okay, we're learning how to explain the processes, but we're also giving people exercise and doing manual therapy again.
Speaker 2:Yes, yes, yes, that's what I'm talking about. Yes.
Speaker 1:Okay, so let's go back to a person who's not overtly showing signs of an eating disorder. They are, but they're making these food choices that you like. You say they lead you. It's not helping your life. They're making the same mistake again and again. Unlike I just want to share this. Unlike me, but that's not quite right. But unlike me, I try not to go into certain aisles in the supermarket because I know if I go in the aisle and I buy something, then it's going to lead to me overeating whatever food is. And so my coping mechanism just not go into the aisle. Not go into the aisle.
Speaker 2:Ed, you know what? I have certain things that, if they are here, I'll eat three of them in the middle of the night when I wake up with my perimenopause insomnia, and so I choose not to put them on the shopping list because that's self-care to me. And so it's not about restricting, it's not about being anorexic, it's not about dieting, it's simply about these things. Don't make me feel good about myself.
Speaker 1:And so.
Speaker 2:I choose not to have them in the house. I think that's very appropriate, but it wouldn't be appropriate for me to say nobody should have them in the house, right? That's the difference.
Speaker 1:That's the difference. Yeah, actually I don't drink. I haven't drunk for a couple of years, and even when I did drink, what I found was if I had you know, some people have alcohol in the fridge and it's always there A friend comes over, there's always a beer in the fridge. But what I found was if I had a beer in the fridge then it would sort of want me to drink it, but if it was outside the fridge then I wouldn't drink it. So I was fine with beers just sitting on the sideboard. I could have that. You know problems.
Speaker 1:But as soon as it went into the fridge yeah, and I'll be like, huh, it's just cold, it's there, it's an evening and I'll have a beer and like cash in your pocket. Yeah, what exactly exactly? Anyway, I was explaining this to a friend of mine and, uh, and she said, um, yeah, yeah, I had the same thing. It's like there's there's wine in the, in the store, and I go down there and I buy it. I'm like no, no, that's not the same thing she was. She was basically telling me in a very overt way that she had a problem with alcohol and even having the store in the town was a problem for her. Wow, yeah, and so she ended up taking some measures. But anyway, it was just a sort of funny, different way of looking at how you cope with things, and I'm glad she told me that, because I was like, you know, that's not normal and she wasn't joking, she thought it was.
Speaker 1:So let's go back. Let's go back to these, these, these people who, um, they, they don't avoid the aisle, they don't take the stuff off the, off the shopping list, because they think that having it in the house or buying it's not a problem. But then they end up eating the whole thing and they do it again and again and they feel, whatever the feeling is depressed, afterwards, miserable regret. You know the thing that they're probably hiding from when they seek help. What does that help look like?
Speaker 2:Well, it certainly depends. But if they came to me, I would say I want to teach you the word regret, because in my experience, most of the time people are feeling a lot of shame about that why can't I change? And shame really is one of those things that makes you want to sort of hide it and you know very much black or white, thinking right, there's something wrong with me. Why can't I stop doing this? Regret opens the door more. Let me use an example that's not related to food. If I feel embarrassed because I forgot to reapply my sunscreen halfway through the day and now I'm red lobster and everybody knows that you're supposed to put on sunscreen and so walking around with a sunburn, it's so embarrassing and I don't want to go out, right, it can kind of build into into wow, I'm really a failure. Instead, if I think, oh, I regret that I didn't put on sunscreen halfway through the day, I can laugh about it with others. I can plan to do things differently next time. I'm gonna set a timer on my watch to remind me to reapply sunscreen. Regret opens the door to. I'm not a screwed up person, I just have a lot going on, and so that's.
Speaker 2:My first step is to teach regret. You're going to do things that you regret, but it doesn't make you a bad person. We need to actually look through it more closely to see what was going on, and if you just don't wanna talk about it, then we don't have the value that comes from looking at it. The second thing is a lot of times people will say things like this I mean, they just jumped in my mouth, it just happened. I went into a trance and then I woke up and all the packages were empty. And so to try to slow down that process and ask someone to really look at what are the steps that got you there right Like, at what point did you go to the pantry or did you go to the refrigerator? At what point did you did this happen? Did this happen right? And to ask someone to really look at it, like an anthropologist with binoculars behind a bush, kind of really examining their own behavior, not to find where they screwed up, but to find out what is the pathway to this behavior and where could we derail it. And for you and for me, in those things that we don't bring into the house, we've learned that once it's in the house, it's very hard to stop that moving train. So to derail it no one is injured in this derailment, I'm just using a metaphor. But to derail the train that's just going down the path, we have to not bring it into the house. And so that's our sort of junction point where we can make a decision and go down a different path.
Speaker 2:And so we really have to look closely at an individual's process, and I'm thinking of a patient I had once who she would go through a fried chicken place here and she would order a lot and then she would order two beverages because she wanted. In her mind this made it okay, because she could sort of fool the people who, by the way, did not care, who worked there that she was buying food for two people and she would take the bucket of chicken home and eat it and kind of fall into a food coma. And one day she came to see me and we had talked about, you know, taking the shame out of this and you know you can regret it, but she ate one piece of chicken and then decided she was going to we had planned this, I can't remember it Maybe do an experiment and do something else for 20 minutes and then come back and eat more chicken if she wanted it. Well, she fell asleep and woke up in the morning and she came to me telling me how terrible she felt because she let all this chicken stay out of the refrigerator and it was ruined in the morning. And I was doing like a celebratory dance, right? It's so amazing the way that this stuff can get in your head right, and here she is thinking I wasted all this food and I'm thinking, yes, that is unfortunate, but in the pathway to not eating a bucket of chicken, this was a great step in the right direction.
Speaker 2:So, really working on decreasing that shame and just thinking of it, as this is my life's experience with food, and if I want my life's experience to be different, I have to try doing different things. So experimenting is really good with that. And then the last thing I'll mention that can be a really good technique in this situation is putting something that doesn't belong where you eat. So, for example, let's say a legal pad and a pen. Put that in the fridge. When you go to get your midnight binging food, you'll see the pen and the legal pad and realize, oh right, I'm supposed to write my feelings write your feelings while you eat.
Speaker 2:That's fine. It's not supposed to get you not to eat, but it's to sort of try to understand what is the pathway getting there. And some of my patients have had good luck putting some kind of self-care something in the pantry some nail polish, some hand lotion you can't eat while you're sort of, you know, lotioning up or painting your nails, right, so something that reminds you. Oh, a lot of my patients have had good luck putting sticky notes on the scale, taping something to the scale that says you can't tell me how to feel, or something like that that reminds you that you're going to this item whether it's a scale, whether it's food for something that that item cannot provide, and so helping you remain conscious instead of going into that, that trance or or that automatic pathway.
Speaker 1:It's like a pattern interrupt. It's interrupting those subconscious patterns so interesting. Yeah, there's many different ways. I remember I had a client once who we weren't really talking about eating disorders, but she discovered this in herself that whenever there was a family gathering she would overeat a buffet, she would overeat, and she didn't really know why and she thought she just had a problem. Right, it was always overeating.
Speaker 1:And then and this is out there, but she did one of these past life regressions. And during the past life regression the therapist said to her in a past life you were part of a nomadic tribe, but you were sick or old and the nomadic tribe would leave you that was the rules of the tribe, right, and they would move. But then you would walk through the tribe, right, and they would move, but then you would walk through the desert, whatever, catch up, eat as much as you can to survive. The next time they moved. And she was like, oh, that's so interesting, because when I go to buffets or whatever, I eat a lot of food. Anyway, all she had to do was think about that old lady when she was at a family gathering and say I'm not that person, I'm OK.
Speaker 2:And she got over her binge eating at family gatherings the craziest story, but it was, it is, and you know what, whether you believe in past lives which sometimes I'm very tempted to do or whether you think that was a part of her psyche that was coming forward right, like just a part of her current life, it's great, because that's the whole. Key is to remember I'm safe, I don't have to eat all this food now because I will have food later. And I'm thinking of. You know a past life.
Speaker 2:You could think of your childhood in a way as a past life, and I had a patient who was a very successful you know business owner as an adult coming to see me, and when he was a child he was adopted by a family who also had a son almost the same age, and the biological son had a very different body type than my patient. And so the biological son was allowed to eat as much as he wanted and my patient was only allowed to have one serving. And now this person had grown into an adult who, somewhere in his psyche, was that inner child saying you can't tell me how much to eat, and he actually, to try to stem his overeating, had food delivered. He had a meal service where they delivered set portions of food and he'd keep it in the freezer and then he'd eat three.
Speaker 1:And that worked.
Speaker 2:Well, it worked to help him feel better, but it didn't work for him in the sense that he was gaining weight.
Speaker 1:Oh, I see what you mean. I see what you mean.
Speaker 2:Yeah, but I'm just saying your childhood, you could almost think of your childhood as a past life that you had, where you're sort of acting out some of those things.
Speaker 2:And that's why, healing that child, it sounds kind of ridiculous because people think it happened so long ago it's not affecting me of ridiculous because people think it happened so long ago it's not affecting me. But the longer ago it happened, the more of your life was crafted around those beliefs that you're not good enough, that you have to eat less, those kind of things, and so the younger you were, the less resources you had to deal with it, the less discernment you had to understand it, and so the more it probably is affecting you. And this even leads to now we could get like crystalline cookie and you know, even beyond past lives. But there's things that are pretty verbal that happened to you that you can be acting upon, because they change your brain chemistry and your body chemistry in a way that you couldn't even describe. You couldn't even put your finger on it if you tried, because you didn't have the words to even understand that it was happening to you at the time 100%, 100%, maybe even way back into the womb and mother's trauma.
Speaker 2:Oh, well, then we could talk about epigenetics and how? Yeah, oh yeah, Mother's trauma, mother's malnutrition, yes, and so this advice that I can't remember when it was, but maybe 10 years ago. The advice was for women who are large to not gain any weight during pregnancy, and I just thought so you're just going to make a baby who is already starved. This is not okay. It's going to affect that baby for the rest of their life. So, yeah, absolutely, there's so much, there's so much.
Speaker 1:There's a lot to unpack, but let's go back to this spectrum. So we've got, we've got someone who identifies that there's so much there is. There is a lot, a lot to unpack, but let's go back to this spectrum. So we've got, we've got someone who identifies that there's something amiss in the way that they're eating, and then they seek help or they come up with strategies, like the people we, we, we highlighted. But then there's going to be the the, the far end of the spectrum when it becomes a sort of overtly recognizable disorder. Yeah, when should a person seek that kind of professional help and medical help?
Speaker 2:Well, I think it's the same thing for anything, right? I mean, if you're talking about someone who's having shortness of breath or getting dizzy when they stand up, heart palpitations, I mean, we hope that it doesn't get to that point. But if someone's throwing up and they see blood when they throw up, I mean all the things I think that you would normally recommend, but my dream is that someone should get help a long time before that. The problem is, the most medical providers aren't asking about any of those things, things, and so people usually only answer the questions that they're directly asked.
Speaker 2:So yeah, I see what you mean, and because it's very shameful, a lot of people aren't going to bring that up okay, you never told their doctor what they were doing and that's a person who sees you naked and they still haven't talked about what they're doing with their food.
Speaker 1:Yeah, okay. So we've got like medical, you know, emergency type type situation. But when, what should someone or who should someone see? Like I know you train professionals who should someone see if they feel like they do have bulimia or anorexia? What should they be looking for in a someone that they want to work with?
Speaker 2:Gotcha Okay. So thank goodness for the internet because you have the ability to see who is available in your area, who takes your health insurance, if that's an issue, and, most importantly, kind of who feels like a personality match. That's really the most important thing to me is the personality match, and for me it might have been someone like kind of a older woman, like a wise woman. For someone else it might feel more like a peer or a big sister or big brother, or it might feel like someone who's sort of a like for my husband. I'm thinking if it were him he couldn't go see a woman because he would just put this is my nagging wife right, like he would have to see a man, right. But a personality match, in other words, that's really the best thing.
Speaker 2:And then a philosophy match, and so the philosophy isn't necessarily what I mean. You're supposed to learn about this person's philosophy, so you might not already agree with it, but someone who I don't know. If you're looking for a drill sergeant, you're probably not going to find that in an eating disorder specialist, but you know you can look, you can try to find someone who has sort of a philosophy similar. And I always tell people you can interview people, you can call on the phone and say these are the things I want to work on. Are you available to do that and see what the answer is? Because you can direct your own care in some ways ways and you want to make sure it's someone who you feel comfortable talking with, which is not always the case.
Speaker 2:I mean, I don't want to say they should have been in school this number of years, or they should have been in the workforce this number of years, or they should have had this experience or that. But I do know that there are a lot of people who say that they specialize in treating eating disorders, that they may not.
Speaker 1:Right, Okay Now. I mentioned at the beginning that you were going to share one tip, and I think you've already shared something amazing about the feeling that you get after eating. A certain way is probably how you felt before. It's just masked.
Speaker 2:But let's share with the listeners this one tip that you share with me before we speaking so it's called the apple test and I always joke that my mom invented it and so did your mom probably. It's very gendered, but that's who I was raised by. And the idea is when you're driving down the street as a kid and you see the ice cream shop and you say, mom, can we stop and get ice cream? And mom says I have a cut up apple in my purse, you can have it if you're hungry. It really kind of boils it down right to whether you in fact are hungry or you just sort of have this delighted idea about ice cream.
Speaker 2:And so the idea is not in a punitive way, to ask yourself that question Would I eat an apple right now and we could do it right now? Would I eat an apple right now and we could do it right now? Would I eat an apple? I'm so, so probably I could eat an apple in a little while. So maybe after we get off this interview I'll go start foraging for some food. Doesn't mean I have to eat an apple. It's just a way of tapping in physiologically to say how am I I feeling about food Now? The caveat is, if you love apples and would eat 100 apples until your stomach hurt, don't use apples. If you hate apples and never eat an apple, don't use apples. Come up with something kind of boring, kind of bland, so it could be the carrot stick test for you, or the saltine cracker test or something like that, and that's how you now also you can't use. For me, saltine crackers are like I would have to be famished before I eat saltine crackers.
Speaker 2:I will eat them, but that's not the appropriate test for this, because that means waiting way too long to eat. So, this bland food that you would eat if you were hungry, but you wouldn't be excited about it if you weren't that's the food. So you just ask yourself, and then the response is hopefully something insightful If you wouldn't eat an apple, you can go to the next step. That's interesting. I wonder why I wanted ice cream. I wouldn't eat an apple. What is it about ice cream? Oh, ice cream is one of those things that's not allowed on my diet. Or ice cream reminds me of being carefree and I have so many worries now. Or ice cream really tastes good and I feel like I haven't had anything delicious lately. Right, there's lots of places you could go if you're not hungry. And PS, it doesn't even mean you can't eat. You could go get ice cream, but it's just.
Speaker 2:Don't pretend that you're eating ice cream because you're hungry. Recognize that you're eating ice cream because it's someone's birthday or it looks good or something like that. Just be honest with yourself. And if the answer is yes, I would eat an apple. It doesn't mean you have to go find an apple, and I've seen this in people. I've taught? Who taught other people? I've seen it on the internet where they reference the apple test and they say the apple test is bad because it makes you feel bad for eating. Well then you're doing it wrong, because it is not supposed to make you feel bad for eating. It's not about healthy food and unhealthy food. It is just supposed to be a binary check-in Am I physically hungry or not? And what you do with that information is totally individual. You could go get a turkey sandwich.
Speaker 1:Yeah.
Speaker 1:I think that's brilliant, because you know we all sort of do this. Well, I say we all, I'm making an assumption. But with our kids, you know, they say, oh, I want this. Oh, actually, here, have a cucumber, I'm not hungry, Okay, cool. So we sort of forgot. I think, as we get older, that that test still applies to us, that we stand there in front of the open fridge looking for something to eat and yet if someone shoved a carrot or an apple in our hand, we might not eat it. So we're probably not hungry, we're just bored.
Speaker 2:And when you apply this to kids, the question is what does that kid need?
Speaker 1:Right.
Speaker 2:So for kids, we should help them go through the process. Oh, that's interesting. So you're not really hungry. I wonder what you could be feeling. You know a lot of feelings feel empty, not just hungry. Being bored feels empty. Would you like me to help you find something to do? Being lonely feels empty. Would you like me to come play with you for a little while? Or I can't play with you right now. Can I give you a hug and send you on your merry way and then later I can play with you? Right, being confused can feel empty. Right, what have you been working on? Is there any way I can help you? So taking it to the next step with those kids is the way to not just say, well, if you didn't want a cucumber, you must not be hungry. Right, and rub it in their face. That's not the idea. It's that they're trying to communicate something to us that they don't have the words for.
Speaker 2:Yeah, or they're trying to connect with us in a way that they don't have the words for.
Speaker 1:Don't say I. Potentially I think I'm guilty of that. I'm always like all right, if you're not hungry, you must be thirsty, and then get out of the kitchen so, yeah, that's why it was I need to.
Speaker 2:I need to reevaluate my parenting skills slightly there. Well, you know what? I have good news for you, because it turns out that in order to raise healthy, well-adjusted kids, you do not have to be the perfect parent. You can also go back and repair and you you can say I had this most interesting guest on my podcast today, and these are some of the things she said. Or will you listen to the podcast? I know that's you don't want to, but would you think about listening to it and would you tell me what you think? I'd love to open a conversation with you about how I talk about food when you were kids. And you can repair, and that is one of the best parenting things you can do is to say I'm not sure if I should regret this or if really it turned out OK.
Speaker 2:Yeah you can just ask them.
Speaker 1:Yeah, I will get them to. I think I'm going to get them to listen to this and then we can have a discussion about my kids. There we go. Hey, jessica, it's been a lot of fun having you on this podcast and I would love you to just share if someone's listening to this not necessarily a client or patient, but maybe. But I know that you work with clinicians mainly, so where would someone find out more about you and can learn about more what you do?
Speaker 2:So my umbrella website is JessicaSutnickcom, and that's where you can set up a consultation, see my books, et cetera, et cetera. But then I also have Eating Disorders Bootcamp, which is my training for professionals eatingdisordersbootcampcom. And then healingyourinnereatercom is where you can get the Healing your Inner Eater workbook, and I'll put in a code. Podcast will be the code that will bring that price down for anyone who's listening, who wants to get the workbook and kind of start doing some of the work at home on your own. And then you can also sign up on any of those places to be on my email newsletter and find out when my next workshops will be.
Speaker 1:Perfect. Thank you very much for being on the show.
Speaker 2:My pleasure. It was really fun talking with you, Ed.
Speaker 1:Thank you for joining me in my conversation with Jessica, and if you've enjoyed listening to and learning from this podcast, please leave a comment and leave a suggestion for a future podcast guest that you would like us to feature. Now listen. If you're on Apple, you can actually leave a comment and a star rating review. Obviously, five stars are the best, so if you would do that, I would be forever grateful. Thank you very much and remember, if you want my direct help, just send me an email, ed at edpadgettcom, or visit my website, edpadgettcom, and once you're there, you can learn a little bit more about how I can help you make your lifestyle your medicine. Thank you.