We welcomed Mollie Birney, Clinical Coach and Recovery Consultant with a specialization in the area of Eating Disorders and compulsive behaviors around food to the Dietitians Unplugged podcast.
Mollie holds a Masters in Clinical Psychology with a concentration in Addiction and Eating Disorders from Antioch University in Los Angeles, and has been in the field of mental health and addiction recovery since 2009. She has worked as a therapist with groups and individuals at all levels of care including inpatient, residential and outpatient treatment programs, as an interventionist for families in crisis, and as a private coach for high-performing individuals grappling with transitions and behavioral change. Her coaching style is deeply influenced by the principles of narrative therapy, and aims to arm her clients with strategies for challenging ingrained, and often trauma-informed belief systems. She has been in recovery from her own ass-kicking bulimia since 2007.
Diet culture and eating disorders can make one’s relationship to exercise complicated.
Allow me to flashback for a moment…
It’s the 1980s, and Jane Fonda has just ruined, oops, I mean revolutionized women’s lives with aerobic exercise. Who could resist those neon-and-pastel body suits, leggings and headbands? Without reading too much into the actual history of it all, this, in my mind, is the moment where exercise became some sort of imperative for being “the right kind of female.”
And me? I hated formal exercise. I was a rough-and-tumble kid who liked to play outside at made-up games, pick-up softball and kick-ball games, and still remember the glorious summer when the oldest kid in our neighborhood would organize block-wide games of hide-and-seek, kick-the-can and ghost-in-the-graveyard (Damn my childhood seems idyllic now). I was good at nothing except being scrappy and determined. Always the slowest, but it didn’t seem to matter when we were at play.
Anyhoo, along came high school and uninspired gym teachers who, on occasion, would play videos of “The 20 Minute Workout“, which, upon remembrance, actually came with a health hazard warning, and truly felt like a cardiac nightmare even for a teenager (or maybe just this teenager??). I mean, what was with all the damn jumping??
And then, later, the years of exercising because I felt I should because that’s what thin people did. Needless to say, that ended up feeling like more of a punishment than anything else and did not endear me to exercise for a lifetime.
Flash forward to the present. It’s been a long, circuitous journey to where I am now. I’ve found what works for me for now. And what works for me might not work for someone else, and that’s okay. No one is obligated to exercise either – it’s not a marker of your worthiness as a human in any way.
So what’s your relationship to movement feel like? Do you feel compelled to exercise even when you don’t want to? Do you struggle to incorporate movement into your life even though you truly want to? If so, you might enjoy this Dietitians Unplugged podcast episode that we did with my good friend, colleague and mentor, Lauren Anton MS, RD, CEDRD-S, CPT. She’s knowledgable in all things exercise and eating disorders and Health at Every Size® and non-diet sports nutrition. She’s amazing and I think you will find her story interesting and her advice helpful.
In this episode of the Dietitians Unplugged podcast, we were thrilled to talk to Dr. Jennifer Gaudiani of the Gaudiani Clinic in Denver, CO which provides in-person and telehealth care to people with current or a history of eating disorders.
Dr. G is the author of the book Sick Enough, a Guide to the Medical Complications of Eating Disorders. She talked to us about her journey to becoming a HAES-aligned doctor, and how she realized that HAES is the only ethical way to treat patients, especially those in larger bodies. She explains her “house on fire” analogy which helps those who struggle to understand that they are already sick enough with their eating disorder and don’t need to delay treatment any longer. We think everyone will benefit from listening to this podcast – patients and doctors alike.
Our bodies tell so much of the story of ourselves. In an ideal world, we’d be good friends with our bodies, appreciate them for what they allow us to experience of the world, and be in tune with what they tell us about those experiences. But because we don’t live in a perfect world, we can lose touch with the wisdom of our bodies. Or, because of past trauma, our bodies have become a scary place for us to be.
Getting back into our bodies can be a challenge, so we asked Tracy Brown, RDN, LD/N, a somatic nutrition therapist, how she helps people do just that. She talked about the effects of trauma on the body, how “feeling fat” isn’t really about body size at all, how the fight/flight/freeze reflex can keep us trapped in the diet cycle and how reconnecting with the body can help end the cycle.
And if you want to see body disconnection in action, I provided a spectacular example during this episode (you’ll probably know it when you hear it!). Last year was great professionally, but tough and also way too busy. I spent too much time working and growing, and not enough relaxing and regenerating. And I am someone that needs a fair amount of relaxation in order to function optimally for the long run. When we recorded this episode, I was experiencing the late effects of total body breakdown: exhaustion, headaches, and a real difficulty with concentration. It’s been a hard lesson in knowing my limits and learning to respect my body, but life is always a work in progress!
HAES Care for Diabetes
Rebecca Scritchfield and I are working hard on a new, expanded offering of our weight-inclusive diabetes groups. Make sure to sign up on this page to be one of the first to find out when it launches.
I work with many clients who have binge eating disorder or, if not an official diagnosis, definite binge eating behaviors. All are in different stages of recovery, and many make great progress with learning to eat in an unrestricted, nourishing way that they feel good about while also ceasing binge behaviors.
My clients also come in a range of body sizes, but most typically are in larger bodies. Given our culture’s view of fat bodies, it doesn’t surprise me at all when they eventually ask, “When can I start trying to lose weight again?”
The reality is, my clients are not strangers to dieting and weight loss. They have “succeeded” at weight loss many times, always with the inevitable weight regain that we know comes with weight loss attempts. They have developed extremely disordered eating, if not an eating disorder, and struggle to know the best way to feed themselves. So of course, I know that attempting to lose weight again is a disaster waiting to happen for their health, their eating, their mental health.
But sometimes we need to hear the stories of others to fully grasp the potential impact of certain behaviors (like dieting and restriction). That’s why I was thrilled to talk to Sunny Sea Gold, author of the book Food: The Good Girl’s Drug, about her recovery from and subsequent relapse back into binge eating disorder. We are all susceptible to diet culture, even in recovery, and we need to be reminded regularly that diets aren’t the answer and that they were often the likely cause of a lot of our problems with food and weight.
One of the best things about having a podcast is that it’s a great excuse to hang out with your friends and also get to learn from them. That’s why Aaron and I were excited to have our dear friend, registered dietitian and eating disorder expert Robyn Goldberg, on the show recently to talk about progression people take in their recovery from eating disorder to intuitive eating.
Robyn talked about learning to connect with body signals, finding satisfaction with food, the challenges of being in a larger body with an ED, the resistance of health care practitioners to Health at Every Size® and more in this informative episode.
If you are in eating disorder recovery, or know someone who is, we think you’ll find this episode invaluable.
Taylor Wolfram, MS, RDN, LDN is a non-diet dietitian who, like me, teaches others to ditch restrictive diets and learn to eat intuitively. But unlike me, she is a wealth of knowledge when it comes to veganism. She suggested we swap blog posts, and since the topic of remaining vegetarian or vegan during ED recovery has come up a few times in the online spaces where I hang out, I thought we could all learn something from her approach. Enjoy! -Glenys
Hello, Dare to Not Diet readers! I am so delighted to swap guest posts with Glenys. The community of non-diet dietitians is growing and the more we can spread positive messages about food and bodies, the better! My areas of expertise include vegan nutrition as well as a non-diet approach to sustainable wellness. I help clients focus less on weight and body size and more on enjoyable lifestyle behaviors that help them feel happy and healthy. I’ve been vegan for 8 years and have been counseling vegan (and non-vegan) clients for nearly 4 years.
Unfortunately, some people wrongly assume that veganism equates to restrictive eating. I’m here to show you that veganism is about compassion, not about restriction, and that it is possible to eat intuitively without eating animals or their byproducts. It also is possible to recover from disordered eating and eating disorders while vegan. Did you know vegans who do not eat animals for ethical reasons are no more likely to have eating disorders than non-vegans? While some people with eating disorders may abstain from eating animal products as a method of restriction, veganism is not automatically a precursor for eating disorders.
To bring you feasible and effective strategies for maintaining veganism while recovering from an eating disorder, I interviewed Caitlin Martin-Wagar, MA, an eating disorder researcher and clinician who also happens to be vegan. She holds a master’s degree in clinical psychology and also is a doctoral student in Counseling Psychology at The University of Akron.
Be honest with yourself. When I first meet with vegan clients, I ask them about their journey to becoming vegan and their motivations for doing so. This helps me understand potential restrictive mindsets and also helps clients self-reflect on their own behaviors. “Make a list with two columns: one with the ethical reasons you are vegan and one with potentially eating disordered reasons you are vegan (if there are any). If you discover there are eating disordered reasons for your veganism, find ways to challenge those reasons and refocus on the ethical reasons you are vegan if you want to maintain a vegan lifestyle. For example, you can make sure you are including a wide variety of foods in your diet, including the vegan versions of non-vegan foods, like macaroni and cheese, pizza, and cupcakes,” Caitlin advises.
Have a plan. Eating disorder or not, having a general plan for eating, especially when traveling or attending events when you aren’t certain about food availability, is one of my key tips for vegan clients. Figure out your favorite packable snacks and keep them in your bag, car, desk, etc. so you don’t find yourself without food when you’re hungry. Caitlin says, “For people not in recovery, going a few extra hours without food because of a lack of availability won’t necessarily impact them psychologically. But for vegans recovering from eating disorders, accidental restriction can trigger eating disorder urges like bingeing, purging and further restriction.”
Challenge restrictive thoughts. I like to ask my clients about their favorite vegan foods and where they can get them. This helps them realize how many options they have. I also like to see if there are any foods clients may be restricting for whatever reason, such as oils, desserts and plant-based meats and cheeses. “If you notice restriction urges are triggered from not having certain foods that are not included in vegan lifestyles, remind yourself that you are not excluding these foods due to eating disordered reasons. Challenge these thoughts and show yourself you are willing to have high-fat vegan foods at times—this can help squash any concerns that you are restricting for eating disordered reasons,” Caitlin advises.
One more thing to consider: work toward becoming more accepting of diverse body shapes. Both Caitlin and I are passionate about challenging myths related to body size and health conditions in the vegan community. Having weight stigma or an attitude of health elitism is not only damaging, it strays from the compassionate core of what veganism is all about.
If you’re struggling with an eating disorder or need support through eating disorder recovery, please work with a therapist and eating disorder dietitian. Everyone’s journey is different and no blog post can substitute for individualized therapy and guidance.
Do men get eating disorders too? Long regarded as a disease of girls and women, people sometimes don’t realize that men can also be affected by eating disorders. Aaron and I talked to Andrew Whalen of The Body Image Therapy Center, a treatment center for those with eating disorders, substance abuse issues and self-harm disorders. They also happen to specialize in eating disorders for men, and that’s the subject of this podcast. Andrew shares his personal story of suffering with an eating disorder, body shame and muscle dysmorphia.