Avsnitt
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There are many social expectations, showing up as ‘proper’ (aka neurotypical) table manners that can ultimately make eating really uncomfortable and stressful. Sit still, keep your elbows off the table, don’t talk whilst food is in your mouth, don’t slurp, hurry up, slow down, take your cap off (which my brother heard at least a million times).
Then we get the ‘healthy eating’ brigade who insist on things like eat your veggies first, carbs are bad for you, euww beige food is sooooo bad for you.
It’s no wonder folk get a complex around meal times.
And if you have sensory processing difficulties, eating food can become impossible.
In this episode, Mel explains why neurodivergent folk can struggle to eat and invites you to chuck out the rulebook that says we need to eat this way not that.
Drawing from Goldilocks and the 3 bears, and Mel sharing her own experiences, this episode will shed some light on why having high and low sensitivity is NOT being overly dramatic, rude or high maintenance. Finding safe experiences with food is trial and error. Sometimes it will be too hot, too intense or just too much. Other times it will be boring, underwhelming and disappointing.
Stay for the pick n mix when Mel will share suggestions on how to adapt and manage your eating experiences so you can find the calm or the stimulation you need, that’s just right. These nuggets are also shared below.
Also worth mentioning, because I forgot to when recording, and because there are no treatment guidelines for supporting Autistic people with sensory processing disorder or eating disorders, [BONKERS RIGHT?!]
The PEACE Pathway is an incredible resource for both practitioners and if you are living with an eating disorder and Autism yourself, or are a carer for someone who does.
GO TO www.peacepathway.org for more
Thanks for tuning in!
Resources
Here are the nuggets from the pick n mix:
OK, if you find yourself overstimulated, overwhelmed and unable to process, my advice is to work on doing (and asking others to support you in this), what helps you feel safer and more grounded, regardless (and this can be tough) what is deemed socially acceptable. I’ve worked hard on chucking out the eating rule book which has meant managing others expectations and encouraging them to respect my needs.
You may find you benefit from finding or creating a quiet space to eat. Wearing headphones or a hat can help. You may prefer to eat alone and it’s OK if you need to take your time. Alternatively, you might find you need to move about to dissipate any held anxiety and tension. So give yourself permission to get up if you need to or eat whilst standing. You might need to prepare to eat by first doing something that brings you some calm and than having something soothing to do straight after to help you decompress. There is nothing wrong with wanting beige or similarly textured foods! If they mean you can eat, eat them. They still provide loads of nutrition, so ignore the folk who say otherwise. Similarly, if you rely on pre-packaged foods, it’s not cheating, it’s helping yourself to regulate your nervous system. Predictability is necessary and should be respected. Really cold foods can be more tolerable as their taste is sometimes less intense. Keep a list of safe or same foods to show to others who may be providing your meals. Your reasons are valid. If you’re worried about not getting the right nutrition, please do get in touch, I can help.Now if you’re someone who has low sensitivity and needs meal times to be stimulating, here are some suggestions:
Again, this is where standing up and moving about whilst eating can be helpful. SO I’m giving you permission to do that when you need to. Getting stimulation and distraction from non-food items whilst you eat means watching something, having your phone with you, or listening to music can be really helpful. I know my nan and pops would turn in their grave but hey, if it means not having to experience distressed behaviours, do it! I love funky bowls and plates; different shaped ones, different colours. I like to eat with tiny spoons, novelty cutlery that I’m sure were designed for kids and chopsticks. It’s the same with glasses and water bottles - anything that helps me go ooh, I want to use that. And go with your preferences. If you enjoy crunchy, dry foods, beige foods, salty, sweet, spicy or certain flavour combinations, there are no rules written anywhere (OK maybe some dodgy opinions) that say you shouldn’t respond to what your body is asking for. -
Welcome to Season 3!
What’s it like when your brain lacks dopamine? Pretty crap to be honest. Nothing feels exciting. It takes effort to find joy in things, because it’s all BORRRINNGG.
The most mundane of tasks, like getting out of bed and having a wash have no appeal.
So it makes sense we try to find Dopamine, and it can be by any means necessary.
With ADHD, we might learn that constantly moving, whether that’s fidgeting and not being able to sit still…or needing to exercise, gives us a hit. Even though we may well be knackered, it’s worth the effort to get it. It can also look like constantly scrolling on our phones, changing hobbies and interests time and time again, starting new projects, businesses, changing jobs (or not being able to keep them), spending (too much), doing multiple things at once and the focus of this episode - eating.
What is it about eating carbs, that everyone seems to have an opinion about? That they just can’t keep to themselves? Are you eating again? Surely you’re not still hungry? Are you sure you should be having that? OMG I could never eat that.
Food is amazing at helping us get some much needed dopamine. It’s colours, textures, smells and flavours can all press our buttons…But our culture shames anyone using food, especially carbs for anything else other than fuel (oh and it must be a ‘healthy’ fuel).
So we get can get caught up in ‘I shouldn’t eat / have eaten that’ ‘I need to stop eating so much junk’. Shaming others or self depreciation does NOT help in this situation.
Neurodivergent folk can have complicated and often difficult relationships with food because dopamine, one way or another, often drives a big part of the show. And the world we live in seems to have a huge problem with folk doing their own thing when it comes to eating.
Our brains are incredibly resourceful. I think it’s super smart that our brains learned food = dopamine. Sure, we probably don’t want food as our only source, but we don’t need to go cold turkey and not eat anything fun or delicious whilst we try to find other ways to get it.
In this episode, Mel explains why Dopamine is essential - WHAT it does and WHY it can affect our eating. And it’s not just about dopamine seeking behaviours, we also need to understand the folk who struggle with dopamine hypersensitivity.
Better understanding = less shame and more compassion, an ideal recipe for living an easier life.
To note: as I mentioned in this episode, I am definitely simplifying the differences that exist in neurodivergent brains. I have not mentioned genes, epigenetics or structural and developmental differences in the brain. And when I say lacking dopamine, what I really mean is lacking available and active dopamine. Neurodivergent brains can have ‘normal’ dopamine levels but there are alterations in its reuptake and breakdown. But hey, lets not get all caught up in this (I’m starting to get bored) but I hope you get the gist and my explanations make some sense and resonate with you. Thanks for listening.
Resources
Here are the nuggets from the pick n mix:
Reminders, reminders, reminders. Now I’m not a fan of rules but I am all for supportive structure. If you regularly forget to eat and you don’t feel great because of that, you’re going to need some alarms. Multiple alarms. Probably 3 or 4 for the meal you struggle with most. Set them on your phone, maybe with an image of something eating, or in whatever way is going to help prompt you to go eat when you need to. You might find visual lists of your same or safe snacks and meals that you're into at the moment on a kitchen cupboard, fridge or your phone helpful too.
What can make eating more appealing or easier? There are no rules here. If you need to eat standing up, or moving around do that. Play some music, put on a video on your phone, use your favourite plate, bowl and cutlery. Body double for accountability, even if they aren’t eating, although it often helps if they are.
Make a dopamine toolkit with activities that make you happy - mine are spending time with my husband, painting my house with lively colours, wearing bright colours, watching Brooklyn 99 (there’s a new series out on Netflix), playing with my dogs, doing jigsaws, getting in the sun, going roller skating - just discovered this one!
Focus on safety. What helps you to reduce anxiety or decompress? Is it eating beige and brown coloured foods? Eating alone or in silence? Not having your foods touch? The lights not being too bright, playing your favourite song on repeat, wearing headphones or a hat? What would need to happen for you to rebuild your body trust and do what you need to do, despite what others say…basically how can you begin to throw out the neurotypical rule book?
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Saknas det avsnitt?
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“ADHD is like being in a car that’s on autopilot. Rather than it taking you directly to your planned destination, you go on an all-day adventure to some far-off place because the name sounded interesting. Or it just stops in the middle of a busy road and refuses to move”
“It’s lying awake at night thinking of all the things you want and need to do the next day, then doing none of them”.
ADHD is a life of extremes. It can be exhilarating as neurodivergent folk speak of superpowers. But it can also be REALLY FU*KIN HARD.
Disordered eating behaviours and eating disorders are more common in the neurodivergent, compared to the neurotypical. Food preoccupation, erratic eating, binge eating, rigid and restricted eating. We need better understanding so we can be better supported.
I say we, because I (Mel) am neurodivergent.
“Oh not you as well” was what someone said to me when I got my diagnosis. “It’s trendy to have ADHD isn’t it”, said someone else. Well, it’s certainly trending – screening and diagnoses have been on the increase for years. For good reason. We need more screenings, assessments and diagnoses!
In this episode I share my experience of struggling for my whole life with undiagnosed ADHD, and then finding clarity, answers and a way forward. I’ve put my heart on my sleeve here because it’s been therapeutic for me, and because I also hope it helps someone else feel less alone.
I’ll be back in season 3 to talk more about neurodiversity and eating problems. Subscribe so you can join me!
Resources
ADHD 2.0 by Edward Hallowell & John Ratey, Audible link HERE
ADHUK website and adult self-screening tool https://adhduk.co.uk
ADHD and menopause booklet from Balance Menopause
Right to choose
If you are based in England under the NHS you now have a legal right to choose your mental healthcare provider and your choice of mental healthcare team. This means, should you decide the waiting time for an ADHD assessment is too long, then you can choose alternative providers.
ADDitude magazine
A reputable source of information if you are neurodivergent, are a parent or carer or just know someone who has a fascinating, marvellous brain.
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Healthification. See also healthified, healthifying. Adapting a recipe, meal or way of eating to improve its health value; to make it healthier.
Sounds good right? It depends on how you define health. Because if becoming pre-occupied with making food healthier causes stress and anxiety, it ain’t good. If the focus is just to achieve weight loss, it ain’t gonna be good. Especially when there is negligible evidence to prove healthification does what it sets out to. Because we live in a world that is overly weight focused, that is pro healthism, that refuses to understand the impact of weight stigma and the role of the wider determinants of health.
Now if you love adapting your recipes for the feel-good factor or simply love experimenting with food, carry on! But it’s all to easy to get caught up in fads and trends and lose sight of why you’re doing it.
Healthification can be a slippery slope to disordered eating. And not just for me. In this episode I share some of my stories and past efforts to better myself. And what went wrong. I talk about what we did to the poor cauliflower, problematic messaging, privilege, morals and spiralling behaviours. Check out the pick n mix at the end where I recommend some cool reading that won’t make you feel badly about yourself.
Resources
1.Food is not medicine by Dr Joshua Wolrich
https://www.amazon.co.uk/Food-Isnt-Medicine-Joshua-Wolrich/dp/1785043463/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=&sr=
2.Gentle Nutrition: A Non-Diet Approach to Healthy Eating by Rachael Hartley.
https://www.amazon.co.uk/Gentle-Nutrition-Non-Diet-Approach-Healthy/dp/1628604247/ref=sr_1_1?crid=X5KEXYPKBZIV&keywords=gentle+nutrition&qid=1675779821&s=books&sprefix=gentle+nutrition%2Cstripbooks%2C90&sr=1-1
3. The wider determinants of health (that go beyond eating and exercise) https://goinvo.com/vision/determinants-of-health/
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In part 2 of this episode, I spill what the drug trial data really shows; not the rosy-coloured-spectacle -buy-our-drugs-BS. I talk about short term weight loss and weight regain, neither of which Novo Nordisk wants you to know.
You'll hear about the other weight loss drugs that have been withdrawn AFTER launch because they were NOT SAFE. Saxenda and Wegovy are no different.
The pharmaceutical industry does not care about your health. It only cares about money. The industry that says it wants to tackle weight stigma, by stigmatising the very folk they claim to want to 'help'.
Now a weight loss drug is not something I would recommend taking, but it’s also not my decision.
Although they won’t work for everyone, all of them have side effects, and none of them are risk-free. Body autonomy is a human right.
In order to make your own decision over your own life and future, you need to have access to ALL the information. I hope this episode helps do this. But you must also look at your needs, based on your lived experience. You need to listen to the Pick N Mix at the end for help with this.
Listener discretion is advised for this episode.
Have you listened to part 1?
Resources
Saxenda Trial - A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management https://www.nejm.org/doi/full/10.1056/nejmoa1411892
Wegovy Trial - Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
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If you were offered a drug you could take just once a week, that was clinically proven to lead to sustained weight loss, without the nasty side effects, you’d be tempted right?
If you were offered a drug you had to self-inject, that would give you nausea, vomiting and upset stomach for months, that you needed to take forever (that you’ll have to pay for) otherwise weight regain would occur, that might increase your chances of developing cancer or even dying, I’m guessing you wouldn’t be so keen.
The first paragraph is what the drug company tells you.
The second paragraph is me Mel, not being paid by Big Pharma to lie, instead critically evaluating the data and telling you the truth. It’s important I do this because there are literally lives at risk. 4 of the last 6 weight loss drugs have been withdrawn, not because they didn’t work, but because they caused harm. And death.
In part 1 of this episode, I start to reveal how harmful weight loss drugs can be. It’s a bit sweary and possibly triggering. I talk about weight loss, ob*s!ty and numbers so no offence taken if you need to skip this.
I’ll explain how these drugs came about, why no one can get hold of the diabetic drugs they really need, and share some rather nasty side effects.
Part 2 will follow next where I get more into the side effects, dangers and financial persuasion and discuss the recent news of the American Academy of Paediatrics recommending these weight-loss drugs (and bariatric surgery) for kids. Don’t forget to subscribe!
Resources
Saxenda Trial - A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management https://www.nejm.org/doi/full/10.1056/nejmoa1411892
Wegovy Trial - Once-Weekly Semaglutide in Adults with Overweight or Obesity https://www.nejm.org/doi/full/10.1056/NEJMoa2032183
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It’s difficult to think of Christmas beyond the food. Indulgence is the focus, with the expectation of laughter, love and joy. But the reality is often very different. Not only is the whole experience overwhelming, but it’s also riddled with fear and guilt. How the hell do you get through all this?
In this episode, Mel helps you put a strategy in place; one that helps to remove your attention from your eating disorder, that takes the focus away from the food and helps you navigate any tricky or triggering social situations.
Hear how having a dedicated support person, using safe words, thought stopping, an creating exit plan (and more), so whatever comes your way, you have the power to choose you and decide what happens next. You’ve got this!
Resources
Mentioned in the Pick n Mix.
1.Lana’s basket – eating disorder and mental health recovery cutlery https://www.lanasbasket.com
2.How to help someone with an eating disorder handbook by Dr Pamela MacDonald https://www.amazon.co.uk/How-Help-Someone-Eating-Disorder/dp/1789561973
BEAT POD (Peer-support & Online Development) for parents and carers https://www.beateatingdisorders.org.uk/training-events/find-training/training-for-parents-and-carers
3. Dealing with diet talk blog https://www.wakemannutrition.com/blogs/mels-blog/dealing-with-diet-talk
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Using food to cope with difficult emotions, including anxiety is called being human. If you’ve ever opened up a tub of ice cream, a sharing bag of crisps you have no intention of sharing or sitting on the sofa with a whole cheesecake and one spoon, you are human.
Food has the ability to soothe, comfort and numb. It can nourish mind, body and soul and it can heal, which I think is rather marvellous. To be honest, there are many worse things we could do other than eat. Although our culture will do it’s very best to shame folk for comfort eating and binge eating. The idea of eating ‘unnecessarily’ is called greedy, overindulgent, out of control and weak. Which means many folk experience anxiety with just the idea of eating, especially if it’s been labelled a ‘bad’ food [there is no bad food by the way, this is diet culture language and it’s harmful].
There is so much pressure to conform to the so-called thin ‘ideal’ thanks to cultural, medical and peer coercion. There is no consideration of genetics, environment or trauma. There is no consideration of neurodiversity. There is no consideration of mental health and needs must.
Mel is here to help release some of the shame around food being a coping tool and she’ll explain why food is a common crutch for so many . Mel will also help you understand what food issues can look like when the anxiety comes before the eating and after the eating.
And make sure you listen to the pick n mix at the end as Mel has 3 helpful free nuggets to help you break the cycle of constant worry, boost your coping strategy options and restore a sense of calm.
Oh and she’s got a lovely helpful gift for you that you can open it right now: Journaling prompts to promote healing and recovery. Free download here: https://tinyurl.com/5dmyf8n3
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There is so much stigma around diabetes, particularly type ll. A huge blame culture exists with the idea that people give themselves diabetes, by being lazy and eating the “wrong” foods. But anyone can develop type ll diabetes; in any size body, at any age, eating any kind of diet.
Fatness doesn’t cause diabetes. Sugar doesn’t cause diabetes.
But weight loss and carb cutting continues to be pushed with the promise of prevention and cure which opens the door to an increased risk of disordered eating and developing an eating disorder.
In this episode Mel gives insight into the numerous factors that affect blood sugar, sheds light on the money making behind pre-diabetes and how diabetes management recommendations and eating disorder behaviours look very similar.
And make sure you listen to the end as the pick n mix contains 9 shame free nuggets to help you look after yourself.
Extra Resources
Pick N’ Mix Tips
The difference between type 1 diabetes and type 2 diabetes is not who “caused” their diabetes and who didn’t. To explain;Type 1: is autoimmune – the immune system attacks the pancreas, so the pancreas stops making insulin.
Type 2: pancreas makes insulin, but the insulin can't connect with cells properly to do it’s job.
Either way, that's not your fault. Someone can be diagnosed with any kind of diabetes in any size body, at any age, eating any kind of diet.
Insulin does not cause weight gain. Saying it does to induce fear into patients is fat phobic and problematic. Yes, Type 1 diabetics may experience weight loss when they can’t make insulin – this is because there is something wrong, it’s not a good thing to happen. Reintroducing insulin helps keep you alive and may enable weight restoration, it doesn't mean that insulin causes weight gain in the way people tend to talk about it. Chuck your scales away. They are likely causing more problems than they are solving and Your weight tells you so little about your health and nothing about your worth. Eating ‘to be good’ at the expense of your emotional health is not healthy. Restricted eating is not healthy eating. If you are feeling all consumed by food, if you’re hyper focusing on your body and what you’re eating; that it’s taking over all your thoughts and life, please seek help – this is not what’s needed and it’s not normal. You can learn to eat intuitively and manage diabetes. It brings improvements in blood glucose independent of weight. Revisit your boundaries – stay away from anything and anyone who reinforces the idea that larger bodies are wrong, and we should do everything in our power to keep our bodies small. This further perpetuates disordered eating behaviours and body insecurity. Remember you deserve help. It might well feel uncomfortable to ask but it’s it. Check out the HAES health sheet for type 2 diabetes https://haeshealthsheets.com/type-2-diabetes/ -
Believe me when I say, recovery looks different for everyone. And that in itself can make it scary; like you’re venturing alone on a treacherous journey, but you’re not quite sure where it will end. But you are not travelling alone and this episode proves this.
In my experience recovery can bring a fear of beginning and a fear going backwards. It can feel relentless and confusing, not being sure which is your own voice and which is the old diet voice or eating disorder voice popping up. You will likely doubt yourself and wonder if one more diet could be THE answer, just to get you in a better place so you can then start properly. Oh and there is no set timeframe, you should arrive by….I’m doing a crap job of selling this recovery aren’t I?!
But seriously, it’s worth every single, difficult step. In this episode, I share with you what recovery could look like and also what it’s not going to look like. I share the positives (yay!) and in the Pick n Mix, I give a bunch of tips that are perfect if you’re just starting or you’re already in recovery.
There is far too much stigma around eating problems so we need to talk about this – the ugly, the bad and the good! It’s time to get rid of the shame and blame.
Extra Resources
Pick N’ Mix Tips
Get yourself a journal
Buy a wheat bag that pops in the microwave to help soothe when you feel tension or your stomach feels uncomfortable
Talk to others. And you may need to remind people that just because you might look OK, it doesn’t mean that everything IS OK.
Have some go to mantras / supportive statements! Things to challenge that inner voice; ‘my weight doesn’t define me, I can do hard things, it’s okay to sit in the shit, I am enough’ Here’s a bumper load more you might find helpful: https://www.canva.com/design/DAD1s--IyEI/pfeagOaX0JKh8148Lkh-Eg/view?utm_content=DAD1s--IyEI&utm_campaign=designshare&utm_medium=link2&utm_source=sharebutton
Unpack your food rules, food fears and triggers. Turn to face them and break them. Don’t be afraid t ask for help with this.
Keep eating. Always. Eat enough and eat regularly. Even if you think you ate too much yesterday
Realise it’s going to be hard and uncomfortable. Sometimes we need to find a way to embrace the pain knowing on the other side it will be amazing! Involving others will help.
Remove emotion from the food – it really is just food. It’s OK to ask for help with this too.
Look for other non-diet and recovery podcasts; learn as much as you can. Find people to follow who provide reassurance and who don’t make you feel crap.
Surround yourself with the right people, those people who believe in you when you can’t believe in yourself!
Remember you deserve help. Learn to advocate for yourself and for support. It might feel uncomfortable but it’s worth pushing for.
Make lists of your reasons for getting well and keep them to hand.
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Why would a nutritionist encourage you to buy more sweets and eat more sweets? She’s lost the plot surely, or is she just stupid?
Well, no she hasn’t and no she’s not. Do you know what the scariest thing is about this Halloween? The amount of food and body shaming going on, and yes this is aimed at kids too. Do you know more children than ever are being treated for eating disorders? And children as young as 3 are worried about getting fat.
This has nothing to do with having more access to sweets and chocolate, but more about it being the forbidden fruit. Foods that are placed off limits have increased appeal. It’s more likely you’ll overeat a food you’ve been told you can’t have and experience a loss of control.
Listen as Mel explains why so many are terrified of sugar (also listen to the previous episode about whether addiction is a thing) and explains why it’s important we give permission to eat the foods we or our kids want.
Halloween can be a triggering time for those who have an eating disorder or a difficult relationship with food so there’ll be some tips and reminders on how to find calm and safety during this time.
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Feeling full can create some challenging feelings. We've been conditioned by diet culture to associate fullness with greed and a loss of self-control. And in order to regain this control (or a sense of it anyway), we start to restrict our intake of food, avoiding that feeling of fullness at all costs.
Eventually we forget what it feels like to eat a hearty, satisfying meal and have a full tummy. This restrictive behaviour becomes our default way of living which can result in all sorts of gut issues that only go to reinforce that eating is not something good to do. And the cycle continues.
In this episode, Mel delves into that fear of fullness; where it comes from, what it means and ultimately how we can start to let go of that fear*
*Spoiler alert, it’s all good!
Resources
Mentioned in the pick n mix
Are food sensitivity and intolerance tests accurate: https://www.instagram.com/tv/COs_bQNAVUA/
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Love, hate, guilt, out of control, shame, fear, disgust, are all feelings associated with addiction. They are also associated with food, particularly sugar which is frequently described as evil, deadly and “worse than crack”. The question is, is food really an addictive substance like cocaine?
I see the word addiction being used too often when people talk about ‘bad’ and ‘unhealthy’ eating behaviours. There’s also a lot of shame and stereotyping attached to both, which certainly doesn’t help folk who are genuinely struggling.
There are many similarities in how eating disorders and addiction disorders are characterised, for example - cravings or strong desires for the substance, a persistent desire to cut down on the substance, but inability to do so and continued substance use despite social and interpersonal problems created by the substance
But for food to be addictive in the same way as a substance (like cocaine, alcohol, caffeine or nicotine), there would need to be a chemical dependency and the food would need to alter the brain chemistry and structures over time. There is a lack of consistent evidence that supports this theory.
Join Mel in this episode as she debunks some myths and unpacks some of the conflicting theories around food addiction. Sarcasm and humour also included.
Resources
These were mentioned in this episode and pick n mix.
The original study that drew comparisons between refined sugar and cocoaine on the brain (although this is not free access so you can’t see the original brain scan images nor true context) https://bjsm.bmj.com/content/52/14/910
News Headline (yes of course it’s the Daily Fail) Sugar 'is the new crack cocaine’ (warning – contains stigmatising language)
How to break up with your phone (book) by Catherine Price.
For extra info
A literature review of dopamine in binge eating: https://jeatdisord.biomedcentral.com/articles/10.1186/s40337-022-00531-y
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Picture this – you have really painful ankle. You’re not sure if you twisted it but you have been resting it when you can, applying ice and popping Neurofen for the last 3 weeks and it’s still no better. You walk into your GP’s room (yeah I know, imagine that!) and take a seat. They ask you how they can help, take a quick history and if you’re’ lucky they might even examine your ankle.
You’re hoping you’re going to be told what’s wrong and how they can help you……what you get is an awkward conversation that goes something like this:
Doc: have you thought about swimming?
Patient: Huh? Umm I don’t really like swimming to be honest….why?
Doc: Well you won’t be able to do much in the gym but I thought swimming could be something good to do for weight loss?
Patient: But my ankle…what do you think is wrong with it?
Doc: There’s likely a lot of pressure on your ankle…..how much do you weigh?
Patient: Oh…I’m not sure……I don’t weigh myself
Doc: Can you just jump on then please and lets see.
Patient: Errr no, I don’t want to do that, I have recovered from an eating disorder you see…
Doc: Oh, right. But you’re obviously OK now. When I know your weight I can put you in for a 12 week weight loss programme, how does that sound?
Patient: But I came in about my ankle…………
Doc: Yes and I really think weight loss is going to help you here. I’ll make an appointment for you to see the nurse as well as she can give you some healthy eating advice.
Patient walks out and doesn’t go back.
This happens far too often. In this episode, Mel shares some situations she’s directly involved with where weight stigma means her family have not being given the treatment they need and deserve. It’s often not intentional but implicit (aka unconscious) bias is rife in healthcare – the only way to change this is (1) become more aware that it exists and (2) take the necessary steps to challenge it! Press PLAY and Mel will reveal the truth and where it comes from and the adverse effects it creates.
Resources
These were mentioned in this episode and pick n mix.
HAES health sheets for weight neutral care https://haeshealthsheets.com/the-health-sheet-library
Literature on weight stigma in healthcare http://morelove.helpdocsonline.com/weight-stigma-unhealth
Please don’t weigh me cards https://more-love.org/free-dont-weigh-me-cards
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What happens when an industry promises life changing results but this comes at a price? But a price they can’t quantify for you?
Folk may opt to have surgery to help them lose weight and say they "know the risks" of the surgery, but do they?
Will they be aware there is a 5% chance of them dying? Will they acknowledge that to lose a lot of weight, they will be making a functional digestive tract, dysfunctional? Will they understand they may not lose the weight promised because of their genetics or documented side effects? Will they get that the gut may stop working sometime within 7 years of surgery? Will they agree to sticking to a diet and exercise regime for the rest of their life (only it may be more difficult than before) because their metabolism will be permanently altered? Will they accept they may suffer complications that require more surgery, that may further add to any existing complications? Will they accept the risk of rapid weight loss increasing the risk of a sudden heart attack? Will they understand they may get VERY sick with this surgery no matter what they do?I have yet to meet someone who knew all of this, even after doing their own meticulous research.
In this episode Mel shares the information bariatric surgeons should be providing for their patients to make a fully informed decision. She talks about the risks of combining eating disorders with weight loss surgery and what you need to think about in taking the best care of yourself. Weight loss is not everything.
Resources
These were mentioned in this episode and pick n mix.
Long-term Follow-up After Bariatric Surgery. A Systematic Review: https://jamanetwork.com/journals/jama/fullarticle/1900516
Internalized weight bias in patients presenting for bariatric surgery: https://www.sciencedirect.com/science/article/abs/pii/S1471015320303482
Bariatric Surgery Patients' Perceptions of Weight-Related Stigma in Healthcare Settings Impair Post-surgery Dietary Adherence: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5056165
FOOD PSYCH #139: THE TRUTH ABOUT WEIGHT-LOSS SURGERY & "FOOD ADDICTION" WITH LISA DUBREUIL: https://christyharrison.com/foodpsych/5/the-truth-about-weight-loss-surgery-with-lisa-dubreuil
Dreams on the Operating Room Table (Bariatric Surgery) Extract from Health at Every Size by Lindo Bacon: https://www.lindobacon.com/HAESbook/pdf_files/HAES_Bariatric-Surgery.pdf
Understanding Postoperative Suicide and Self-injury: https://bariatrictimes.com/understanding-postoperative-suicide-self-injury
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Eating disorders don’t just affect young folk. Treatment centres are reporting huge rises in women over 35 seeking help and a perfect storm may be building for women in midlife. Life transitions (kids leaving home, changing jobs, moving house, supporting elderly parents, relationship difficulties health concerns) combined with menopausal hormonal changes can make dealing with ‘everyday’ life very challenging. To cope, some will turn to coping strategies that don’t help in the long term. This episode, Mel talks about why midlife is a vulnerable window for developing disordered eating or an eating disorder, or for an eating disorder developed earlier in life to re-emerge; what’s going on hormonally and how society and stress can be strong driving factors.
Be gentle with yourself – remember you are human and it’s OK to ask for help.
Description:
Resources
Eating Disorder Symptoms and Weight and Shape Concerns in a Large Web-Based Convenience Sample of Women Ages 50 and Above: Results of the Gender and Body Image Study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459309
Ovarian hormones influence eating disorder symptom variability during the menopause transition: A pilot study https://pubmed.ncbi.nlm.nih.gov/31726420
From the Pick n Mix:
You can get further information and support about all things eating disorders form the charity BEAT https://www.beateatingdisorders.org.uk They have a national helpline. The UK National Centre for Eating disorders https://eating-disorders.org.uk provides a huge library of information and offers treatment and counselling options. Healing Minds, founded by therapist Bernie Wright who trained at the National Centre for Eating disorders and is a registered supervisor. She offers counselling, training and supervision https://www.healingminds.co For menopause information, advice and app: https://www.balance-menopause.com founded by Louise Newson who also leads the menopause and wellbeing centre in Stratford upon Avon in the UK https://www.newsonhealth.co.ukLast but not least, just as I’m writing these show notes (having recorded the episode already), I’ve just received a book called ‘The Longest Match, rallying to defeat an eating disorder in Midlife’ by Betsy Brenner – I’m off to make a start on it!
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“Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.” — Marcus Aurelius
People will talk. They always have. And they always will. No matter what you do or say, how you behave, the way you walk or dress, how you act, or the decisions you make, will always be scrutinized by others. It’s the nature of the masses. Like the herd of lions swooping in for the kill, they prey on the weak, looking for those they can taunt and torment. And it gets to us. We allow other people’s opinions to not only hurt us, but oftentimes, to define us.
But the truth is it doesn’t. Your self-worth isn’t defined by an approval rating. There’s no objective rating scale that allows another person to judge you. Others often don’t know your journey, where you’ve been or where you’re heading.
In this episode Mel explores how as humans, we create false beliefs that can determine how we see and treat ourselves. She explains how to move away from focusing on appearance, how to re-write your beliefs and how to cope with others who perhaps have the sensitivity of a boulder when it comes to mouth engaging with their brain.
Resources
Here are the 15 retorts Mel goes through in the pick n mix – if you have some more to add, drop Mel a message!
1. “I don’t get involved in food or body shaming.”
2. "I’ve been working really hard at accepting my body, and this feels like criticism. Please let’s talk about something else.”
3. “I don’t comment on things that aren't my business.”
4. “Please don’t talk about other people's bodies with me, I don't find it helpful at all and it’s just not respectful.”
5. "It sounds like you have a problem with someone being fat, do you?"
6. “What’s wrong with being fat?”
7. “I’m so sorry you feel that way about yourself.”
8. “I don’t really want to hear everything you’re doing to avoid looking like me.”
9. “Can we change the subject; I’m not feeling this one.
10. “I want to spend my time with you talking about more important things.”
11. “No more diet / body talk please.” (Repeat as necessary) and accompany with a steely look if needed
12. Laugh as if they made a joke.
13. Start a respect jar — like a swear jar — so everyone puts in £1 for every time they express hatred of their own body, questions somebody else’s or participate in diet talk
14. [I love this one] stick your fingers in your ears and run around shouting la la la la la I can't hear you!
15. Walk away if your request is not respected
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The societal focus on weight and weight loss is associated with unrealistic ideals that doom most people to failure. And for many, the pursuit of thinness causes more harm than good. What this means is weight loss behaviours increase food and body preoccupation, repeated cycles of weight loss and regain, distraction from the wider health determinants, reduced self-esteem, eating disorders, weight stigma and discrimination.
The premise of intuitive eating / not dieting / recovering from disordered eating or an eating disorder is health does not have a size so can we shift to weight-neutral outcomes (that don’t focus on weight at all), where we see clinically relevant improvements in physical and psychological health, without the harm.
Which is all well and good but when you’ve been told for such a long time that weight IS the be all and end all…when you’ve internalised the beliefs that weight loss will bring you happiness, better health, better relationships, and life success, it’s NOT easy just to switch that thinking off.
In this episode, Mel shares two ways in which you can begin to dig deeper and explore what your desire to lose really means for you. So you can begin to let go of the need to endure dieting behaviours, without fear. She also explains how letting go of this desire can feel like grieving the loss of an actual person. Mourning the behaviours you can no longer sustain, your past body or the body you never got to have is valid!
Then hear about three amazing women who are tackling diet culture head on in Mel’s Pick N Mix! Check out their accounts, my help sheet and more from this episode below!
Resources
Exploring my past diet history help sheet – this is an approach adapted from Evelyn Tribole and Elise Resch (2017). Download the help sheet here
Pick n Mix shout outs!
Mel from @my.bodyfits is a PT and kettle bell coach, helping women find mental, emotional and physical strength through all stages of menopause. No body shaming or unrealistic ideals allowed - go check out Mel’s bells!
Faye from @Effinitupfaye is a real, cow loving Disney fan who shares content that reminds us of our humanity. She cracks me up and also shares the reality of recovery from an eating disorder.
Lauren from @fillyourbowl_ is a nutritional therapy student sharing brilliant videos and reels that challenge the diet culture BS and show how to navigate the ED voice. I don’t know how she finds the time to do these!
And something extra – In this episode I mentioned the impact of widening our visual diet. Here is a fascinating TED talk by Lillian Bussel: Stripping away negative body image. You can watch this on YouTube HERE
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Intuitive eating has become rather trendy. When celebrities start jumping on it, you know it’s going to pick up speed. I loved that Demi Lovato credited intuitive eating in helping her combat her disordered eating patterns but then Gwinnie ruined it (so did the author Dr Will Cole) when she promoted intuitive fasting. Dear Gwyneth (Paltrow), please stick to your vagina candles, at least they aren’t dangerous!
The problem with media coverage is things can get twisted. Intuitive eating is a weight-inclusive model you see. It was never created to be sold for weight loss or changing your appearance or shape. But this is what’s happening. The original message is at risk of getting diluted as diet culture co-opts the intuitive eating language.
So when folk say ‘but I didn’t lose weight doing intuitive eating’ or ‘it’s not working’ I wonder if they really get what intuitive eating is or asks of you? Or it hasn’t been explained what the barriers can be.
In this episode I give 5 reasons why intuitive eating might not have worked or be working for you and I can tell you now, it won’t be your fault. But what is often NOT talked about is the impact of chronic dieting, the lingering diet mentality, stress and trauma on our ability to truly listen and respond to our body. I also provide 5 resources from my Pick N Mix that may help you fill in the gaps in terms of tools to help you embrace the practice that is intuitive eating.
Content warning: I mention body weight. There is context but please be mindful if you are triggered by the language around dieting behaviours.
I hope you find the resources below helpful – all are mentioned in this episode.
Resources
Intuitive Eating: A Revolutionary Anti-Diet Approach 4th edition by Evelyn Tribole & Elise Resch. Also The Intuitive Eating Journal: Your Guided Journey for Nourishing a Healthy Relationship with Food by Elise Resch The Making Peace: 59 Anti-diet Strategies to End Chronic Dieting and Find Joy in Eating card deck by Christy Harrison and Judith Matz. Christy is author of Anti-Diet: Reclaim Your Time, Money, Well-Being and Happiness Through Intuitive Eating Judith authored (amongst others) The Diet Survivor's Handbook: 60 Lessons in Eating, Acceptance and Self-Care Anchored – how to befriend your nervous system using polyvagal theory by Deb Dana A compassionate body scan by Dr Kristen Neff Fear of weight gain by Tabitha FarrarCome and wave to CakeOverKeto on Instragram: @cakeoverketo
You’ll find Mel at www.wakemannutrition.com
Instagram: @mel_wakeman_rnutr
Patreon: patreon.com/melwakeman
or you can drop her an email at [email protected].
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If your pal hangs around like a bad smell, sucks the life out of you and doesn’t actually care about you, would you stay friends?
Health apps like My Fitness Pal are more popular than ever, particularly since the pandemic lockdown. But we have evidence to suggest that a high proportion of users (specifically those with eating disorders) perceive MyFitnessPal as contributing to their eating disorder. When we factor in the recent NHS Health Survey (2019) reported more than 2 Million adults screened positive for an eating disorder pre pandemic (with numbers now likely to be much higher post pandemic), we can’t ignore these tools can contribute to poor health outcomes in the vulnerable.
In this episode I touch on the benefits that some may experience from tracking food, exercise and weight but I focus more heavily on the downsides, and the reasons why some users find them detrimental to their health.
I also share three tips to help reduce food and number obsession….you might guess the first one?
Lastly I have a moan at Boris Johnson and Sajid Javid in my Pick n Mix about their complete lack of common sense approach with putting Calories on menus policy. Bloody hell.
I hope you find the resources below helpful too.
Content warning: I mention body weight and may mention Calories and the O word. There will always be context –but please be mindful if you are triggered by these.
Resources
Research Paper: The Use of General Health Apps Among Users with Specific Conditions: Why College Women with Disordered Eating Adopt Food Diary Apps by Elizabeth V. Eikey (2018): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371267/
Research Paper: My Fitness Pal calorie tracker usage in the eating disorders by Cheri A.Levinson (2017): https://www.sciencedirect.com/science/article/abs/pii/S1471015317301484
Mel’s Instagram guide to noticing hunger
Rating of Hunger and Fullness cues help sheet
Open letter by Hope Virgo and co: Concerns over calorie labelling on restaurant menus
Free eating disorder recovery appropriate apps:
Rise Up + Recover: An Eating Disorder Monitoring and Management Tool for Anorexia, Bulimia, Binge Eating, and EDNOS (I use this with some of my clients) Recovery Record: Eating Disorder Management. A smart companion for managing your journey to recovery from eating disorders including anorexia nervosa, bulimia nervosa, obsessive eating disorder, binge eating disorder, ARFID, and compulsive eating disorder.Please note, an eating disorder app is not a replacement for professional therapy. It can, however, be a supplemental tool to help you work through negative thoughts and behaviours as part of your recovery plan. It is best to discuss your needs with a professional to help you determine which app and approach you may benefit most from.
Come and wave to CakeOverKeto on Instragram: @cakeoverketo
You’ll find Mel at www.wakemannutrition.com
Instagram: @mel_wakeman_rnutr
Patreon: patreon.com/melwakeman
or you can drop her an email at [email protected].
- Visa fler
