Welcome to iHeartRadio Communities, a public affairs special focusing on the biggest issues in facting you this week.
Here's many Munos and welcome to another edition of Iheartradios Communities. As you heard, I am Manny Munyo's every fifty two minutes someone dies due to an eating disorder in our country. It's one of the deadliest yet most overlooked mental health challenges, affecting over thirty million American Let's get a little bit of clarity on why this is happening and how we could help someone that might be going through this. Johanna Kandell is from the National Alliance of Eating Disorders. She
is the CEO of the organization. Joanna, thank you very much for your time.
Thank you so much for having me today.
So let's talk about Let's start off with the prevalent. How prevalent are eating disorders in the United States in this day and age.
Yeah, I think people are often surprised how many people existactly struggle with an eating disorder. So it is estimated that over twenty nine million Americans, that is one in nine Americans will have an eating disorder in their lifetime. And what people I don't think realize is that these are not disorders of choice, They're not disorders of vanity. These are serious mental illness that are biologically based and
genetic in nature. It's not something that people, you know, wake up one morning, look out the window and decide I'm going to have an eating disorder. These are serious mental health disorders.
What constitutes an eating disorder?
Yeah, absolutely so. Eating disorders are disturbances in eating and
feeding patterns. So, for example, when individuals are not able to nourish themselves in a way that can sustain livelihood, it goes from disordered eatings to eating disorders when it becomes unmanageable, when it's ruling your life, when it's the first thing that you're thinking about in the morning, the last thing that you're thinking about at night, and every other thought in between, and your life takes a serious toll on being able to show up and you know, do life.
I guess the things we most commonly think of, and I guess I'm showing my age. I'm thinking of Karen Carpenter when I think of eating disorders, is that what they are? A bolima and orexia, things of that sort.
Yeah, So there are various eating disorders like you talk about you know Karen Carpenter who struggled with anorexia nervosa, which anorexia is a self induced starvation resulting from a distorted body image and intense fear of being big. Then there's a blimia nervosa, which is when individuals binge and perge, and then binge eating disorder when individuals compulsively overeat, they nun they stuff, they escape. It's eating disorders are maladaptive
coping mechanisms. We also have another eating disorder that many people don't know about. It's called avoidant and restrictive food intake disorder, which happens to a lot of children and young adults. It's when there is a fear around the actual act of eating. So perhaps they had a trauma where they choked on food, or they don't like a specific color or texture. And oftentimes you will see our fed in individuals that are on you know, the autism spectrum.
What are the misconceptions that you run across that people have about these types of things, Because it feels like we've kind of come to a level because in part of social media where these things have really gotten out of control in our society, we're seeing it more than ever.
Yeah. Absolutely, and I'm so glad that you asked me. And I think probably the first biggest misconception is who develop seeding disorders and what they look like. I think there's this archaic stereotype that it is, you know, often female, identifying young, very thin bodied, white, upper to middle class, when we actually know that eating disorders do not discriminate between age, gender, race, class, body shape and size, sexual
orientation ability. Everyone can develop an eating disorder, and unfortunately, those stereotypes are huge barriers in individuals accessing or even getting intervention at all. For example, up to forty percent of individuals that struggle with eating disorders are male, but yet we still have this old notion that it's only females that are going to struggle. So oftentimes people are struggling in silence, and unfortunately it goes to the point
where they're losing their life. Because what a lot of people don't know is that eating disorders have the second highest death rate among all psychiatric disorders. It's only second to opioid addiction. And in this country, someone loses their life every fifty two minutes to the insidious disease.
Well, that's that's shocking. Forty are male. What what are some of the early warning signs that that a parent, a loved one, a friend would look out for.
I think first and foremost noticing a change in mood, like if someone was very extroverted, they become very introverted. Obviously, there's some idiosyncrasies around food, perhaps like they're eating less, maybe they're more focused on the type that that that
they're eating. They might have excuses as to why they aren't eating, you know, saying oh, I had a big lunch, or my stomach hurts, an uptick in movement, if they have the ability to undo this, if they're doing a lot of movement in order to you know, burn calories, you know in cases of people that are purging, like if they're using you know, the restroom after they're eating.
And then physically, like if you notice some fluctuations in weight, if you notice some fluctuation in like almost that light in their eye. There could be a myriad of changes when it comes to both physical and mental.
Depression usually associated with these eating disorders or not necessarily.
Absolutely so you hit the really the nail on the head there, because we know that eating disorders don't just live by themselves, so you always see anxiety, depression, trauma. You know, for some people substance use. About fifty percent of individuals that have eating disorders will also have a substance use disorder. But we'll see high, high high rates of depression anxiety trauma PTSD and like all of those you typically see with eating disorders.
Speaking with Johanna Candell, CEO of the National Alliance for Eating Disorders, I want to talk to you about Eating Disorder Awareness Week in just a moment. It's part of what we're doing trying to bring some awareness to this. I would imagine something like this, like with so many of these mental health issues, early detection earlier is critical, isn't it.
Absolutely, Because the longer that someone experiences their eating disorder, the more likely it's going to be very difficult. Because you know, oftentimes when I share about my personal experience with with my eating disorder, people say, well, it sounds miserable, it sounds like a nightmare, And I say to them, it was the hardest ten years of my life. And at the same time, it's how I coped, it's how I navigated, And so for me my eating disorder. What
I'm detected for ten years. But if you notice signs, if you notice symptoms, please reach out. The Alliance can connect you with providers, with treatment centers, with groups that can help not only the person that is struggling, but as well as the family unit, the support unit, because you do not have to navigate this journey alone.
Is it does it disproportionately? These eating disorders affect younger Americans?
You know what it's we see an overconcentration of indivis younger than the age of thirty thirty five. But I will tell you that at the Alliance, we hold the National Helpline, and twenty five percent of all of our calls are for individuals over the age of forty five. So that really does shatter the idea that eating disorders
are only happening to kids. But we also have to take a look that six percent of all of our calls into our helpline are for individuals younger than the age of twelve, and twenty eight percent are for individuals between the ages of thirteen and eighteen. So again I think across the spectrum, but definitely paying attention to our kiddos, our young adults, and definitely we know that we have a huge uptick in midlife and beyond as well.
I hope this isn't offensive, and I don't mean for it to be. I'm looking at you, You're beautiful. And it reminded me of the idea that it's not how somebody views the person with the eating disorder. Is it's how the person with the eating disorder use themselves, isn't it.
That's exactly right. We talk about this, this distortion of never feeling good enough. So many individuals that are struggling with eating disorders are very perfectionistic. They're very black or white. They're very like high achieving, always excelling. And again, it doesn't really necessarily come from the outside in, it comes from the inside out. We know that the thing that causes, right, there's so many different contributors to the development of eating disorders, right,
it's genetics, it's the world, it's inherent temperaments. But we know that it starts with a negative energy balance where your body, you know, gets into like this negative energy of not getting enough enough food, enough calories, and then something will happen and then that is where that distortion happens with with sight, with hearing, with all of that, so you can have the most you know what, we would say, the most conventionally very good looking, very are
very you know, productive, very successful individual but yet they're not able to see what everyone else es.
What is the connection? And we've mentioned in a couple of times already between the fact that we live in the social media age, I would imagine celebrities and influencers maybe contribute to people's body image issues and maybe also help by sharing their stories.
Sure, absolutely so. What we believe is that, you know, sort of genetics, because we know that of all the contributing factors of the development of eating disorders, about fifty to seventy percent is genetics. So if a parent or a sibling of a parent has had an eating disorder, you have that genetically predisposition. However, the environment pulls that
proverbial trigger. And you are so right about social the constant barraging of messaging, the face tuning, the editing, the you know, we are comparing our everyday life to the highlight reel of everyone else, right, so we might be not feeling good about ourselves and we are connected at all times. On average, I think teens are on some type of a social or online five hours a day. And you know, when you think about that barrage of perfection of images of all of that, what is that
doing to us? And so you have all of those messaging and then on the flip side, though, something that is beautiful about social media is that it still does create a community where individuals can see people like you know, a content creators or humans have lived experience that turn around and say, you know, I've been struggling. I am in recovery. This is what I went through. You are
not alone. And for the person who is struggling in silence and isolation, that becomes the crack in the armor that less light and maybe it's the thing that really pushes them to call an organization like the Alliance to reach out for help.
It's a fascinating point. You mentioned that people are genetically predisposed to this, but when you consider that it's a mental health issue that contributes to it, it makes perfect sense. Talk to me about the National Alliance for Eating Disorders, where you are the CEO. How what are some of the things that you do to help these people who come seeking assistance.
Yeah, absolutely so, the National Alliance for Eating Disorders is the leading national nonprofit organization and we are there to be of service. We are there to be of help. We have a national helpline that is staffed by license and specialized clinicians, so everyone you talk to when you pick up the phone is a therapist that specialize in
the treatment to eating disorders. We are open Monday through Friday from nine a and to seven pm, and you can call us if you have concerns, if you have worries, if you're looking for connections to a therapist, a dietitian, or even a hospital that specializes in eating disorders. We also offer twenty one free weekly therapists, LEDs support groups people from all fifty states in eighty eight countries around the world. And we have different groups specifically for you know,
just a general eating disorder group for loved ones. We have a group for LGBTQ individuals, for midlife and beyond for BIPOP and these are free and they are still all led by licensed and specialized providers. We do a lot of work around advocacy ensuring that that eating disorders are viewed as serious mental illness and are part of the general mental health conversation, but more than anything, we are here to walk next to you on your journey throughout your eating disorders and into recovery.
And that helpline for the National Alliance for Eating Disorders is eight sixty six sixty six two twelve thirty five eight six six sixty six to twelve thirty five. So a couple final questions for you, what are the treatments for someone with an eating disorder?
Well, and that's really the beauty of our few is that it is not one size fits all. There's different modalities of like cognitive behavioral therapy, family based therapy, you know, dialectical behavioral therapy. So typically when you're in recovery or you're seeking recovery from an eating disorder, it takes a
treatment team. So you'll have a therapist, you'll have a dietician that will help you reintegrate food because eating disorders are not about the food, but food is the mechanism in which right you might have a psychiatrist, and then that is just outpatient. There's different levels of care above, whether it's intensive outpatient all the way up to acute
medical stabilization. The one thing that I just want to share with all of your listeners, and you've been so generous with your time, and I so appreciate this conversation so much. Is that we really need to view mental health on the same level as physical health. If you broke your arm, it wouldn't be up to you to will it to heal on its own. You did not choose to recover to struggle with this eating disorder. There are people and places that can and will and want
to help you. So please reach out. Even if you know we can't find that quote unquote perfect fit, we will reach out and continue to seek resources until we find an opportunity and a place for you to heal. I say this each and every day is my recovery is the hardest thing I ever did. It was painful, it was overwhelming, and there are so many times that I know I nearly lost my life and living beyond
my eating disorder. Now I will tell you it is the absolute best thing that I ever did, and that if you are someone you know is struggling, please know that you're not alone. Please know that it can get better. Please do not walk on this path by yourself. We are here and we are ready to help.
The helpline number is eight sixty six six six two twelve thirty five. That's eight six six six twelve thirty five for the National Alliance for Eating Disorders. We've been speaking with the founder and CEO, Johanna Kandel. Thank you for sharing your story and your struggle. Best of luck to you every day. Thanks so much for the time and everything you're doing as well.
Thank you so so much for having this conversation.
March is Colorectal Cancer Awareness month. Now you might ask yourself, well, what is colorectal cancer anyway? We'll get to that, but it has become the leading cause of cancer deaths in men under fifty and the second leading cause of cancer deaths in women under fifty. So let's discuss it as we bring in doctor Roberto Rodriguez Esca. He's a fellow at the American College of Surgeons. Doctor Rodriguez Resca, thanks so much for the time.
Thank you for the invitation. So let's to be with you.
Let's start off with that what is colo rectal cancer? Anyway?
Colorectal cancer is cancer of the colons, as simple as that. The colon is the last part of the intestine that where the stool gets collected, stored, and eliminated at appropriate times. And it's there where the malignant cells can developed, can develop, and then that's where what cool recular cancer is.
It is on the rise in all Americans. One in ten colorectal cancer pations now under the age of fifty, and you're seeing an increasing diagnosis and people as early as their twenties and thirties.
Yes, it's an alarming statistic. For instance, people that were born in nineteen ninety have double the risk of developing colon cancer if you compare them to people who were born before nineteen fifty or were born in nineteen fifty. And I think that there's factors, multiple factors that contribute to that increase in incidents and younger individuals.
It would lead me to believe that it has something to do with our country, the way we're living our lives, that our diet something. Do we know the causes for it?
Absolutely, you're uh scored one hundred on on on that. There's no there's no specific cost. There's multiple factors, the things that we eating, processed food, use of pesticides, furtilizers, environmental pollution, uh, you know, sedentary lifestyle, excessive consumption, of alcohol. All those things add up in over time, the strength of the genetic structure starts to break, and all the defense mechanisms that we have to prevent cancer start to fail, and that's why that happens.
Are these increases in cases of coorectal cancer something that is unique to the United States because of our culture, our food supply, all of those things, or are we seeing it globally?
Actually, we see the higher incidences of colon cancer in highly developed countries. And I'm going to use just to give you an example. The risk of developing cancer, corectal cancer in Latin American countries is lower, presumably because of the type of food that they're eating may be healthier. But when those individuals migrate to the United States, the incidence of colon cancer increases to the levels of the United States. So it's definitely, uh, something that has to
do where where we're living. So all those things, uh definitely contribute to the increased into and cancer in younger people.
What is screening like.
Well, the gold standard for screening is colonoscopy, where you can detect pillets, which are the precursors of cancer and remove them at the same time if they're small enough and safe enough to remove, that's the gold standard. There's other methods uh stool collection methods that can be also performed, and there's few other ways. But in a way besides the stool test, they also need, for instance, X rays or flexible sigmadoscopy look inside the intestine to.
Detect I'm in my mid fifties, so I've had my colonoscopy. I believe the first one was in my late forties. We're seeing this increased incidence of people in their twenties or thirties demographics that would never get recommended a colonoscopy unless they had reason to. So what are the symptoms that somebody might look for if they wouldn't be in the age bracket to get a colonoscopy.
Yes, primarily changes about habits, blood or mucus in this tool, abdominal pain, unexplained weight loss. Those would be the symptoms. But the other thing that is very important that may change the age of colonoscopy is family history. And typically the standard recommendation is you take the family members age of the one that was diagnosed and then the duct
ten years and then after offspring should be scoped. Ten years prior to the age where that individual was diagnosed, unless there's a genetic condition mutation that would have a much higher incidence of developing phone cancer. And in those cases, the screening age could be dropping all the way into their twenties early twenties. So finally, history is an important factor to consider as to when you should be screened.
We're discussing colon Cancer Awareness Month, which is March in colorectal cancer with doctor Roberto RODRIGUEZRWESCA. He is a fellow at the American College of Surgeons. What are the most most common misconceptions that you come across people have about colorectal cancer.
Well, I think that probably the most common misconception is that once you get diagnosed, then you're done, and that's not the case. This is a disease that is curable as long as is detected at an early stage, and what's even better, is totally preventable if you proceed with screening in time. So the other that's probably the number one misconception that you're doomed with a diagnosis, and now things have advanced so much that it's not the case.
Early detection with any type of cancer. Heart disease. Anything else is the key, right, there's a and it's called preventative medicine. So how do you recommend that people go about unless they're seeing some of those symptoms we've already discussed. Uh Are doctors changing their recommendations because we're seeing this higher incidence of younger people contracting colorectal.
Cancer, Well, they're all not really. I mean, the standard recommendation is proceed with colonoscopy at age twenty five or not colonoscopy, but other means of detecting uh CO rectal cancer still says that we mentioned earlier, so so that
that's the standard recommendation. But I think the threshful to proceed with the valuation should be very low, meaning that as soon as you have symptoms, just go see your physician and an exam to start with an exam uh and and and then from there the side, what are the steps to follow?
What is treatment like?
The treatment is dictated by the states of the cancer. It's a very personalized approach. Not two colon cancers are the same. So in general I can say that the treatment could be as simple as removing a malignant public colonoscopy and that's the end of it, and as complicated as requiring chemotherapy, radiation and surgery. So the treatment is dictated by the stage. The earlier the stage, typically the
approach is surgical removing the segment in the law. The more advanced it would involve additional chemotherapy radiation depending on the location.
We talked about some of the causes and is clear my understanding from what you said, UH, that it is the way we live in our country, our culture. So in what ways do lifestyle choges choices are changing? Rather our lifestyle choices help us contain this or not become victims?
Well, I think a sci fi er diet, low fat exercise, moderate alcohol consumption, maintain a good weight, fight obesity. I think those no smoking. I think in general those are the typical standard recommendations.
Are there socioeconomic factors that you find in in people who contract colorectal cancer?
Absolutely? Absolutely. I think the cost of treatment is quite impactful. Uh. Access to care shouldn't be a problem here in the United States compared to other places, So we're blessed from that perspective, But some people UH may have uh less access because of socio economic factors. So it's definitely important. And then uh, the highly uh successful executive that is diagnosed will have to have down time to get chemotherapy, and he's not going to be as productive, you know,
he may not feel so well. Everybody responds different to treatments, so I'm not I don't want to generalize, sure, but definitely there's an impact when we're there's an impact and not to let and not not to make the emotional impact on the individual in the family.
Do you find there's a higher incidence in people contracting being diagnosed with coorectal cancer in underprivileged communities, poorer people, or does it effect across all of those demographics.
What I see, I think it's the same. But what I see is unfortunately individuals with lower income present to the physician at higher stages than in my experience.
March, as we mentioned, happens to be Coorectal cancer Awareness month, and usually the goal of one of these things is to bring awareness to the issue, how it's growing in our country and the fight against the disease. Do you think it's accomplishing that.
I think it is. I think we're making progress, which is need to keep.
Better access to screening and treatment for colorectal cancer. Is that something that's part of the goal as well?
Correct? That is the goal, all right?
Uh? Doctor Roberto Rodriguez throwesca fellow at the American College of Surgeons. If you want more information on colorectal cancer, you could go to FACS dot org slash colorectal cancer. That's FACS dot org slash colorectal cancer, doctor Rodriguez Rescot. I appreciate the time, Thank you.
So much, Thank you having good day and keep pressing on.
Thank you, And that'll do it for another edition of Iheartradios Communities. I'm Manny Muno's until next time.