Are We Missing the Root Causes?

Music.

And welcome to Change Your Relationship with Food, the podcast hosted by me, Kyla Holley. With many years' experience as an eating disorder and bariatric therapist, I know exactly what it takes to help you break free from your diet history and develop a more healthy relationship with food. Please follow this podcast to make sure you don't miss a thing.

Just a quick word before we start. I'm very excited to tell you that we are a nominee in the Women in Podcasting Awards, I would be so grateful if you could just take five minutes to just cast a vote for us. We're under the psychology section, but I will put a link in the episode notes today that will take you straight through it. It's just five minutes. It costs you nothing to do, and it would make a huge difference to the show.

It would enable us to get more guests on, to spend more money advertising, to make the content better. So please, five minutes of your time. I'd be so grateful. Thanks so much. Let's get on with the show today. This week, a colleague of mine put quite an interesting post up on Facebook, I believe. And he was talking about the amount of mental health prescriptions out there, specifically for depression and anxiety.

And apparently in the US, we're talking one in five. One in five people are on some sort of medication for depression or anxiety. In the UK, it's about one in six. And I've got some interesting figures on Australia as well. And that is, and this is for the year 22-23, in Australia, 45.6 million mental health-related medications were dispensed.

We also know, the figures from Australia, 4.8 million people in Australia, which is 18% of all Australians actually filed a mental health-related prescription in 22-23. And 85% of mental health-related prescriptions dispensed were dispensed by GPs. So that's in primary health care, those first people that we go to, this isn't specialists who've then decided that this person has a mental health condition. This is at GP level. So we've got to ask us lots of questions here.

If all these medications are out there and they're doing their job, they're solving the problem of depression and anxiety, does that mean that we should all be out there anxiety-free and happy, which of course we know isn't happening because those rates are going up. There's more and more mental health conditions than ever before, and that's going up year upon year.

So we either have to conclude that these medications just don't work, in which case, why are they so heavily prescribed and why is it we believe in this solution? Why is it we believe we can take a happy pill or we can take a pill and we won't be anxious anymore. Why is it and what's the belief in that? Well, about two years ago, a study came out, which sort of proved that all these medications aren't actually doing the job that we actually want them to do.

So for many decades, everybody has believed that depression is actually caused by a chemical imbalance in the brain, which is basically imbalance of a brain chemical called serotonin. This was first proposed in the 1960s, the idea that this serotonin theory of depression started.

And it was widely promoted in the pharmaceutical industry in about the 90s, when at the same time, they developed a new range of antidepressants, which are known as SSRIs, which is selective serotonin reuptake inhibitors. So alongside this development of a new breed of antidepressants, the information that we knew at the time, came out to say, well, hey, if depression is caused by this brain chemical imbalance, then here's the solution to fix it.

And the idea was endorsed by big institutions like the American Psychiatric Association. And countless doctors have just repeated this message all over the world. And people just accepted what they were told. And I suppose even in the medical profession, it was passed from one generation to the next, the fact that this is a chemical imbalance and it can be treated with medication. However.

A couple of years ago, some new research came out, which basically disproved this and said that there was very little connection, actually, to chemical imbalance and depression. The research two years ago, which investigated serotonin receptors, actually suggested that there was no difference between people with depression and people without depression, or that serotonin activity was actually increased in people with depression, which is the opposite of that whole serotonin theories prediction.

I know that a lot of people, even people listening will say, no, I swear by my antidepressants. They really do the job. I rely on them and without them, I can't cope. And so a lot of people are very, very emotionally invested in these products as well. So it does make we wonder if there is actually a proper chemical effect from some of these antidepressants or alternatively, if there's a big placebo effect. The fact that I've invested money in taking this medication.

I've been told it's going to make me feel better. So therefore, people feel better. I don't know, and I'm kind of holding my hands up as I say this. A lot of what I'm going to talk about today isn't because I have the answers necessarily. It's just the questions that I'm asking, and maybe the questions that need to be asked when we challenge this sort of thing. I remember about a year ago, I was doing an intake for a new patient that came to see me.

Quite often, I have the GP referral in front of me, and I'll look through all the sort sort of the diagnosis that that person has. I'll look through the medications that they're on just to build a story of what their life is like and what they've been through. And quite often there's an antidepressant on the list of medications that that person is on. I asked this patient about this particular antidepressant and I said, how long have you been taking this for? And she said, 35 years.

I don't know. I was a bit taken aback by that. I said, oh, that's a long time. I asked her what sort of therapy that she had experienced during that time, who she had been to see about the depression. She looked at me blankly and just said, nobody. I've never had any therapy. And that amazed me. I was thinking, how can you be medicated for a mental health condition for 35 years and never actually think to explore the origins of it. You know, why?

Why do I behave in a certain way? Why does my brain work in a certain way? That all be about? Why aren't people asking themselves these questions? And also from a GP's point of view, what I really don't understand is if a patient comes in and says, hey, I've been feeling awful. I've been feeling very, very low for a couple of months now, and it's affecting a lot of areas of my life.

And I feel that I'm not coping well at work and my family life is suffering, why does that GP not say, okay, let's send you off to a counselor or a psychologist just to kind of work out whether there's new skills you could learn that will make you cope better in those situations? Because life has its ups and downs. It just does.

And if we have the skills on board to be able to be a little bit resilient during the times that are tough, and we know that we can sort of identify when those times are coming and what skills to apply, then surely that's a better approach than just taking medication. Maybe that's just my personal opinion. I don't know.

But it's just that kind of mentality of give me a pill to sort this out and let me get on with my life rather than actually examine what's going on and what skills I can perhaps learn to make life better.

And you're probably thinking about now, what the hell? How does this relate to food? What's she waffling on about mental health for? But it does relate to food in the same way. In that, imagine I have a problem and my problem is, for instance, with my body. Imagine I'm thinking, oh, I weigh too much or I'm carrying too much fat, or I don't like the shape or size of my body. Well, what do I do in that situation?

And in truth, what people do is they go for the universally recognized fix for that problem, which generally is going on a diet. And even though the evidence is there that it doesn't work, just like the mental health drugs, you know, the evidence is there. Because if diets worked, we would simply go on one diet and we would never go on another one. We wouldn't need to repeat it because it works, right? And there wouldn't be a need for all these different types of diets.

There would just be one type and it would work. And because it worked, nobody would be carrying extra weight nobody would be in a larger body because diets work and that's all we need to know but obviously diets don't work because there are hundreds of thousands of them out there and most of us that have struggled with our weight over the years have been on numerous diets and made numerous attempts to try and correct that problem.

So clearly diets don't work. So why do we keep going on them despite all the evidence? And sometimes people will go on many, many diets and perhaps realize that they don't work. And then they'll go, you know what, I'll go to my GP because there must be another solution. And perhaps that solution is in medication. Perhaps it's one of the older ones like Duramine. Perhaps Perhaps it's one of the newer ones, one of the GLP-1 agonists like Wegovy or Zempik or Saxenda.

And again, we look for that fix. This must be an imbalance in my body. How can I fix it rather than me actually looking at the reasons why? And this is what I'm coming around to with this. A lot of the approach that I use is not looking at someone's weight. In fact, most of the time I don't weigh people. I certainly don't put them on a diet. What I look at is more why.

Let's have a look at this person's life and let's have a look at their relationship with food and ask the hard questions like, why is it that someone might overeat in the evenings when they're lonely or when they're bored? Why is it that people are too rushed to eat properly? Why must they rush out the door in the mornings? Why is working and dropping the kids off and doing all these jobs every day more important than nourishing that body? Why is that?

Why is it that some people crave junk food and takeaways? Why is it that some people never actually cook at home? I've got patients that eat every single meal. They'll have breakfast out on the way to work, they'll buy lunch at work and they'll order their dinner in or they'll buy dinner on the way home with the takeaway. They don't actually cook at all. And why is it that cooking for yourself feels like so much effort to some people?

Why is it that some people can't control themselves if there's chocolate in the house or if there's cake in the the house or if there's biscuits in the house. And rather than sort of looking at why and trying to find the answers so that we can have much more of a relaxed, balanced relationship with food, people don't have time to look at the why. They go, let's have a quick fix instead. And why is that? I don't know. You tell me, have a think about this. Is it because it seems too too complex?

Is it because it seems to take too long to sort out? And when you think about it, the idea that, you know, I want a quick fix, it takes too long to sort out these problems. I've had people come to see me that have dieted for 40 years. Is that a quick solution? When you've dieted for 40 years and you're actually bigger now than you were 40 years ago, go, is that the quick fix that you're looking for? Because that sounds to me like half a lifetime of finding solutions that aren't solutions at all.

And the quick fix diet doesn't work if you do it for 40 years on and off. So why? Why is it that we're not actually taking a step back and saying, what is the underlying problem here? Why is it that I do the things I do with my relationship with food? Why is it that I think the way I think? And I would really encourage you to take a step back.

And instead of going for that next quick fix, instead of now on the 3rd of September, working out how much weight you can lose to fit into an outfit for a Christmas dinner. Instead of working on that sort of short-term solution, have a step back and think of what what the long-term solution might be in this circumstance.

Maybe take a year of your life to work this stuff out and see where you are at the end of that year with no promises of huge weight loss or maybe any weight loss at all, but the solution being that you will know yourself a lot better in a year's time than you do now. Have a think about this and have a think about taking that time and rewarding yourself with that time. So where do you start? And I guess the first thing is do not concentrate on weight loss.

Forget your weight. The scales will look after themselves. They will fall into line if you concentrate on your behavior and be brutally honest with yourself.

What are you doing with food? go back and listen to a lot of these podcasts and try and piece it all together the first stage might be to create a food diary I've done a podcast on that actually examine your current behavior and look at what is okay and look at what you think you need to change and then look at why you do those things and again absolute honesty listen back to all the different podcasts on all the different subjects,

once you work out what's actually affecting your relationship with food, remember that there's a workbook and journal that accompanies this podcast as well, where you can journal your everyday thoughts and your intakes. And it also gives you an exercise or a project to do once a week. So you can put it all together. And as you go through the workbook, you can make little changes, little sustainable changes every week.

We call it a tweak a week, which is really important not to make massive changes, which you just can't sustain. And it all falls apart within a few days of starting. These are little tiny, longstanding, sustainable changes, which over time will make a massive difference to your life. Don't forget as well that I'm actually able to see people face to face or via telehealth. I've got a few people that I catch up with weekly just with a video consult, and that works surprisingly well.

So no matter where you are in the country or in the world, that could be an option for you.

Or alternatively, seek out somebody like me that is local to you, someone who looks at the big picture rather than just focusing on weight loss and dieting. Because hopefully you've realised by now that's actually not going to work for you long term. So these are just some ideas that I've come up with today. I hope it sparked a little bit of thought in your brain about something with your relationship with food.

I'm off to a conference in Melbourne tomorrow, so I'm really hoping that there'll be lots of interesting subjects covered at the conference that will inspire me for next week. See you then. Thank you so much for your company today. I would also love it if you could follow this podcast. It really does mean a lot to me. Also, we have a six-week online Change Your Relationship with Food course that you can take. Just visit www.acfeb.com and click on the ACFEB and me courses link.

There's also a journal and a workbook available on Amazon, and you'll find that link in our bio. I really hope you can join me again next week. Goodbye. Music.