Bigger Bodies Can Have Eating Disorders Too with Eleni Agresta, MS, RD

Welcome a Lennie, Thank you so much for having me. I'm super excited to be here. I'm so excited, and I just keep meeting amazing health professionals on Instagram like you, and you happen to be local to where I live, which is on Long Island, so even better. Hopefully we'll meet when things come down a little bit with COVID over here. But I think that it's really easy when you're on social media to get sucked down the rabbit hole of one way nutritionists perform and think that's what

nutrition is. And it's really great to know that obviously, or maybe not so obviously. The trend has become a lot more anti diet. But once you kind of foray into that world by way of Instagram, you keep finding more and more people, so it's it's such an exciting

time for sure. It's definitely um. I've been on Instagram like professionally for a few years now, but when I first started, this anti diet movement was not there, and I found as a dietitian in a larger sized body, I was definitely like I had never seen another dietitian on Instagram that wasn't a larger sized body. My original name before All Bodies Nutrition was the Curvy Dietitian, and that's how I started it, and I ended up changing it because I felt like excluded bodies that were not curvy.

So I like, on my journey of you know, wanting to promote diversity of body size, I found that I wanted to use the name that was all encompassing because we are all not meant to have the same type of body and so in general, definitely, this anti diet trends has been very prevalent for the past year, which is really great to meet other dietitians not just locally, but like across the country and even across the world who have this message in this outlook, and how it's

really changing the face of what you would think nutrition should be quote unquote. So it's super cool. Yeah, I wish we met earlier. Like like you said, I I started using Instagram professionally to speak about I don't know if I was calling it an anti diet message, but I mean it was starting to look a lot like what you hear me say today. But I too was, you know, in my sphere, the only person that was

saying it. But I was a smaller body. So it's really great to kind of I think, being juxtaposition to who you know. I think as as quote unquote hard a time as I had showing up to a platform where all dietitians we're not saying what I was saying, it was probably still more well received than perhaps you because of you know the implications of what curvy means or what bigger bodies might mean in terms of health,

which we're going to break down. What I love is that you've really been owning your own personal body for a long time, and you said specifically that when you came to Instagram, you didn't see other bodies that looked like yours as registered dietitians showing up. But I'm curious, what about in real life? Did you have any registered dietitians who were model behavior that looked like you, that

you looked up to. I would say definitely, like just going through dietetics like the DPD, which are the requirements we had to take to be able to apply for the dietetic internship, Like there were maybe one or two other girls that were in larger sized bodies. It was definitely different. I mean, I guess thankfully, like at that time,

like it wasn't something that bothered me. But throughout the years of like having interns when I used to work in clinical and I did receive interns that were in different sized bodies, they expressed to me how like hey, like how did you how did you feel? And I was like, you know, I was never treated differently by professors, but definitely when I was in my internship, certain preceptors that I had had a bias towards me, and uh,

it definitely felt not so great. But as I've gotten older, I realized, like it just comes down to their their inability to see outside of themselves and like what nutrition is supposed supposed to quote unquote look like. And you know I have to say, like, um, I went to l U Post which is on Long Island for my internship and my masters and everything, and like I was

never made to feel any different. But you know, there are times where I'm sure I saw a new patient who didn't know what I looked like and they came in to me. And this was before I was a wait inclusive dietitian, and I'm sure they had some sort of bias. But you know, that's why I do what I do to try to spread the message of like, everyone's body is different and even if we all ate the same exact things and move the same way, we

would still look completely differently. Yeah, And I mean, I think when you're talking about your preceptors, you have the preceptors if you're unfamiliar. When we go through our training to become a registered dietitian, we do an internship and it's supervised by other registered dietitians. So the dietitians that are above us, so to speak, that are training us,

are called our preceptors. And a lot of older generations as well as current generations have weight stigma, so the belief that a bigger body means that you are less healthy and therefore your behaviors are less healthy. And there's this idea that you know, you just make the healthy choices and we'll all look the same. But hopefully we're

continuing to break this down in the podcast. But there's something about your personal confidence I think that has kind of carried you through probably difficult moments that would have otherwise broken somebody else down in your same exact body.

So I think there's something about your personal confidence that you know, really shines through or your self worth or something that has maybe not always been tied to your body tracts definitely like from my whole life, and I mean that's something that maybe we'll progress talking about, like my personal journey, which like I don't highlight on my feed anymore because it's not relevant to other people, Like what body weight my body has gone through or changes

my body has gone through has nothing to do with what anyone else's body should or should not do, and that's just you know, how my body works. But definitely self worth where I realized like I am a worthy person and I am a competent person regardless of what size I am, or what weight I am, or whether or not my stomach is flat or not. And as far as my knowledge goes of nutrition and working with clients depending on like what their situation is is totally

separate from that. That's awesome. So your work, if it hasn't come through, is really centered around eating disorders in females, specifically in larger bodies. And I love that you're targeting that because we do hear from a lot of our audience that they feel unseen and unheard either on our podcast or in real life, because they relate to everything we talked about on this podcast when it comes to overthinking about food all the time, obsessing, you know, using

exercise for the wrong reasons, rumination, guilt, dieting. But they look different than me and Amy, my co host, and some of the guests that we have on also, we try to really have all guests on that I think bring valuable information. We don't, you know, judge based on body size, but ultimately people need to see people that

look like them to understand. But essentially it boils down to the fact that yes, what we're saying speaks to them, but they still don't think they deserve to raise their hand and say I have a problem because they're still occupying a bigger body where their doctors are telling them to lose weight and their family friends are telling them to lose weight, And how could that be an eating disorder? Yeah,

for sure. And I realized prior to becoming a dietitian, I did a lot of like bonds here work dealing with eating disorders. It just so happened that the dietitian that I was previously working with, she did specialize in

working with eating disorders. So I spent many years and outpatient eating disorder program for adolescents, and a lot of the things that I saw there, I started to see in clients that were coming to me wanting to lose weight because their b m I was a certain size, or their weight was a certain size, or the doctor said they had to lose weight, whatever the thing may have been, and they were exhibiting the same symptoms as the eating just our patients that I had worked with.

And it kind of made me please and say, like, okay, regardless of your body size, if you come to me with disordered eating habits, or an eating disorder. My recommendations are going to basically be the same thing whether or not you're considered underweight by the b m I skill or overweight or obese. And that's when I really started to make that switch from not promoting intentional weight loss, because what I explained to people is that your body

is smart and it knows what to do. But if you have all these years of trauma surrounded by food, if you've been trying to lose weight your whole entire life and you're constantly on a diet, you're so out of touch with what your body is natural like hunger and satiety cues are, or what your body's natural affinity for movement is or isn't. And so if you've spent so much time and energy focusing on these things and you're still in a larger sized body, you need to

heal whatever that may be. And in the end, your body, your body weight may decline, but it may go up or may stay the same. We're not really sure, you know, But it's just healing those issues or obstacles like I like to call them. It's really the main focus. So whether it's someone who is diagnosed clinically with an eating disweater, or someone who just comes to me who had disweatered eating symptoms. And I think that that's just so important

for everyone to hear. Whatever body size you currently occupy or have occupied in the past, you are worthy of coming home to your body first and foremost. And coming home does not mean effort, force, restriction, discipline will plower. It means love, compassion, care, nourishment, um support. And it's important to know that if you're listening and you're a bigger body or you let I think it's important for also smaller all bodies to really hear this message because

we we all bring the stigma. I bring the stigma, you know, we all bring the stigma that somebody can do more. But what if they've already done the most and we don't know it and they're really hurting. So, I mean, the main takeaway I really want to be loud and clear on this podcast is that anybody, any physical body and anybody, any person can have an eating

disorder act a hundred percent. And I think it's important for us to do this work and to continue to do you know, there's a lot of research that's being done that's really reshaping how things are looked at in a clinical like hopefully it will trickle up to a clinical setting um and how it's viewed there, because right now, I haven't worked in a clinical setting in a few years now, but when I did, there's just a lot of as you know, like wait, stigma and bias, and

people are not getting adequate care. But at the end of the day, like, regardless of your body size, you should feel good with what you're eating, and you should feel good in the way that you move your body, and forcing yourself to do something is not going to just make a difference your your body is smart. It's always gonna end up where it's supposed to end up

as long as you're listening to it. Yeah, what are some of the stigmas that exist around eating disorders and bigger bodies, both from the healthcare practitioner, the individual, and

just society. As far as the individual who doesn't feel that they're allowed quote unquote to have an eating diswater or or have disordered eating because they are in a larger body is really dangerous because there are like medical implications of you know, whatever the habits, maybe regarding restriction or any like actual eating, diswater behaviors as far as

the practitioner goes. And I know when I was working with various physicians and like the local error gardens City Manhattan things like that, they don't look at the individual as a whole and they just say like, oh, this person is pre diabetic, so tell them to lose weight, Like that's what they would tell me. And I would say, well, what if someone comes to me and they're pre diabetic and they're at a quote unquote normal weight, what are

my recommendations done? Has nothing to do with your weight. My recommendations whether you're a normal weight or overweight or obese and you're pre diabetic, it's going to be the same thing. So doing more like health centered recommendations and not weight centered recommendations will improve patient outcomes. So this is definitely something that practitioners and physicians should be paying attention to. But it's just reframing people's understanding of like

what actual health is and it's not one size. And I mean I've had hundreds of patients back when I used to work like in a physician's office, and I would just see back to back patients people with high cholesterol, you know, not taking care of themselves, but their weight was considered normal, So what would someone's recommendation be. Then you know there's no weight recommendations for those patients. There's obviously other recommendations that will actually improve their lab values

and things like that. So just refocusing how we look at health and how to actually improve health. And you have a really unique background because you were on the track for premed transition to becoming an r D and you have PCOS where the general recommendation is to lose weight. That being said, I feel like we could sub that into an entire episode, So we're not going to dive

too deep on that just yet. But if you're listening right now and you're super interested on dealing with pcos or why doctors may say just lose weight and things will improve, join us when a Lenny comes back, which is going to be in about two weeks from this episode's air date, So just so you know, that's why I'm not diving a little bit further now, but I really want to dive into that on our second episode, where we could get a little bit more nitty gritty

into disease states managing them with weight and outcomes related to do so, So why are the symptoms of an eating disorder more important to really think about rather than just way or b AM I well weight and b M I. Both of those things are not actual habits,

and the symptoms are the habits that you form. And so what I find is a lot of individuals, whether they're quote unquote considered a normal sized body or a larger sized body, a lot of times those symptoms are encouraged like restriction, cutting out food groups, motivational Monday, let's restart, let's reset Monday, cheat days, all those things. Those are disordered habits to have, and all of those disordered habits

are geared towards shrinking your body. And so when we talk about shrinking our bodies just scientifically, like I explain to people, your body isn't just like selectively loose fat. It doesn't just say this person has a lot of fat on their body and we're just gonna use that up as energy. It's very taxing on the body to actually burn fat for fuel when you aren't giving it

adequate energy and carbohydrates. It actually may be easier for it to use your own muscle mass, which we know is important for so many different things, not just strengthen things like that, but your immune system all these different things. So when you're losing weight and you're forcing your body to shrink itself in a in a very unhealthy, disordered manner, you're lowering your b min and you're lowering your weight, but you're also lowering your lean body mass and then

your your immunity, like you said, beautifully. Yeah, So I always recommend to people like people are always so concerned with like calories and how much on burning and this and that, and the worst thing that you could do is essentially like starving your body from adequate nutrients, adequate carbohydrates, adequate protein, et cetera, and shrink your lean body mass because we know it's hard, especially as we get older,

to build up that lean body mass. So reframing what people think of in terms of weight loss and what it actually really means, some of my clients are like, Wow, I never even thought about that, because all you hear is like, oh, let's get healthy and lean and happy, and no one thinks about what it actually means and what the consequences on the body actually are. You just triggered a memory and it's a little off tangent, but

I have. You know, I'm pretty selective in who I follow when it comes to people what they'll say about food and bodies like I have. You know, I don't want a feed that doesn't reflect. Not that I'm not open to hearing other people's thoughts, but it can be even I wouldn't say triggering for me, but it's kind of just like, oh, I can't I can't see this,

you know. But recently I follow a trainer that I worked with one time in d C. The only time I ever saw a trainer one it is literally one time, and then I was like no, but he was a good trainer when it came to movement, functional movement. You know, we didn't talk about anything nutrition wise, and I never really heard him speak about anything nutrition wise. And he did a post recently about you know, should you intermittent

fast or not? And I thought he was going in the direction that was going to be great, and it pivoted into it's all about the calories, calories in verse, calories out, and I was really shocked because it's really shows how insidious social media can be when it comes to following health professionals because it was so posed like I was going to really like cheer him on and be proud of what he was putting out, and yet it boiled down to just old science and treating everybody

like we're the same, Like if you and I just ate the same amount, first of all, we shouldn't eat the same amount. Not that I deserve less or more than you or you more than me, but who knows, right, Like who knows what's going on in my body and what's going on in your body? That that we're just a simple math equation. And I found it so dangerous and scary that this is, you know, obviously rampant. I don't see it as much because of where my head

is at, but it's still rampant. But imagine someone who isn't you with your education and your outlook. It prays

on these individuals. And we could talk about how many different celebrities push these you know, unrealistic or even just trainers that maybe you like how they train and you like the recommendations training wise that they make, but then they are still rooted in diet culture, and you know, to send out that message to so many people just further makes it more difficult for voices like hours to like reach as many people as pos. They just don't know, right,

Like they don't know. He doesn't know that he's saturated in diet culture or that he's perhaps suffering, like I even mean it like compare, like I had to unfollow because it just I just couldn't. And I have a really high tolerance. I really don't just unfollow somebody when I disagree with them. I don't believe in that personally. But it just really upset me that this is still,

you know, going on. And I know you don't really talk, like you said, like you don't tell your personal story so much, but I did go back on your feet a little bit, and I think it's actually really helpful when you do tell parts of your personal story. And you told one story about how you were lifting at the gym and you faced some sort of stigma in doing so. Do you remember this? Which one was it? That someone was like approaching me in regard? Yeah? Oh yeah,

for sure. I mean that has definitely happened, like the fat phobia environment of a gym. So what happened exactly if you're comfortable talking about it? Yeah, So essentially I was I had been trained by my sister who is also a dietician and a personal trainer, but she had trained me for like maybe a few years prior to me just working out on my own. So not that I'm a personal trainer by any means, but I have an idea about you know, good form, and I had

a plan and all these sorts of things. I was at my gym and it had happened a few times, but that one specific, big time that you're referring to was this trainer. This was obviously pre covid um. This trainer had come up to me, and he didn't have a great bedside manner, even though he wasn't a physician, but like, you know, just the way he came up to me, it was just very abrupt in the middle of my set and was like, oh, you're working out one part of your body, but I believe I was

working out another, which was bizarre in itself. And he basically was like targeting me because I was in a larger sized body and I and I didn't want to come to that conclusion and make that judgment, but I watched him throughout my hour there, however long it was. He did not go up to anyone else and there's a bunch of other people there. So in gym's they're like meant to target. They're literally told to target people who they think could become clients for you know, weight loss.

And I went to the manager and the manager wasn't there, but there was someone behind the desk and I kind of got into like a little bit of a fight with her, and I was like, listen, like this has happened before. I've never said anything before, but I just wanted to let you know, like like this is what I experienced. It made me really uncomfortable and like I'm fine and I'm happy here, and I not like doubting what I'm doing. Like if I went up to them and said like, hey, can you show me how to

do this? Or hey, would you like me to show you that, Like, it wasn't The conversation wasn't like that at all, and the woman was not very helpful and she was like, oh, well, that happened to me one time. And then I started training every day and I was like it was just such a bad experience. And I mean, thinking of other women in particular who are in larger sized bodies working out in the weightlifting area, it's not

very common, and so it just further perpetuates. Like everyone deserves to work out however they want without getting biased from other people. Like there are people who work out there who have terrible form, look like they're going to hurt their backs, and all these other things. You can go suggest things to them too. You don't just have to walk up to someone and say, oh, let me

train you. Like two things to that think. Number one is is that you felt targeted that the trainer came up to you and if I'm understanding you correct correct me if I'm wrong, but assumed that because you were at the gym, and because you were training pretty hard with weight and all of that, that your goal must

be to lose weight. So he or she inserted themselves and said, let me help you fix your form, do this, And you looked around and he wasn't going up to anyone else who was in particular, you know, bad form, and you weren't there to lose weight. You were there,

Why were you there? This dude didn't even ask me to crack my form, which it didn't need crack thing because I was very I'm very careful with what I do, not saying it's perfect but like, but if he had made some sort of suggestion, then I would have said, okay, whatever, and even if he didn't go up to anyone else, and I would have taken it a little bit better.

But it was very obvious and it wasn't super busy, so it just was like he walked around, he saw me and just like came right up to me, and it was very tired at it, and um, it's unfortunate, Like I said, it's for me, I'm fine, like I really don't care. But for other women, I don't see a lot of larger sized women at the gym that I go to. I mean, it's a diverse gym. There's a lot of different people who go, their old, young, different ethnicities and everything like that. But it's very rare

for me to see a larger sized woman. And for me, who someone who has not had such a good experience in my life with exercise when I found weightlifting and I fell in love with it, like it's my favorite thing to do, like it's the best part. Well, it

was the best part of my day pre COVID. But you know, it deters people from going and so I can only imagine how someone else who already feels maybe self conscious or like awkward in a place with like all men as is to be made to feel out of place, and a hundred percent agree that your experience is what you felt. And I'll also share that it's been a long time since I've been in a gym too,

and I'm like, very my energy is are you? Like I can try to give off good energy, but when trainers used to approach me, I find it really soliciting, Like I wouldn't say anything related to my body. But it's like I already pay a freaking expensive gym membership. I don't need to be solicited into personal training like you. I have my background and exercise physiology. I know how to work my form. I know what you're doing, you know, step off. But it really is it's like, this is

my time to be in my body. If I want a personal trainer, I'm going to ask for a personal trainer. I mean maybe other people do like when a trainer comes and helps them, but I feel like a good rule of thumb, like you said, like if anyone is self conscious, they might not want extra eyes on them, especially from a professional, you know, and as they're trying to figure out what feels good in their bodies and also asking permission if you would like to have a conversation.

I mean, when a client comes to they're coming to you. You already have that conversation. It would be the same as me going into someone's deans and just saying, hey, I could do this, like you know, how not cool that is. So it's definitely approaching the client in a way that's like open ended and saying like, hey, is there anything you'd like to be working on? You know, but definitely that experience was and even if somebody is very you know, social media has become a quote unquote

vulnerable place for a lot of young women. Even if a woman is saying I struggle with binge eating or I hate my body or blah blah blah, it's not the role of a registered dietitian I believe, or even a way inclusive one or some of the practices health at every size like you and I to say, oh, let me help you, Like yes, we will, we want to help you, but it's not our job to knock

on your door. Because there's that permission to and readiness and willingness and stages of making somebody feel comfortable that already feels singled out, whether they have been or not. I think you your confidence really comes through and everything that you do, and I'm sure it has something to do with the way you grow up. I could just imagine. But you also shared another personal post that growing up you were told to cover your stomach and your butt

and where oversized clothing. Who told you to do that? First of all, definitely like everyone in my family, Like I am Greek in a time, but I grew up mostly Greek, and the Greek community in general is pretty judgmental, and so my whole entire life, I was basically in a larger sized body from second grade, I would say, And so that kind of traveled with me throughout my life and as I got baker and larger, and you know,

I grew That's like a whole other story. But definitely like my grandmother, my mother who suffered with like disordered eating, and that kind of translated down on us my aunt and they're still to this day, like my aunt um and other family members, they still talk about things not towards me, but like about themselves. And obviously, like you absorbed what other people say are around you. So when

you're told to like, oh, pull down your shirt. I always viewed my body, whatever size it has been throughout my life as like something that I should be ashamed of it. Yeah, And as I have gone through my self love journey, which I always explained to people, like is not linear, Like it wasn't like just one day I woke up and I was like, yes, like I love everything about myself. Like, that's not what self love is. It's just giving your body the grace to know that

like it does great things for you. And wearing things that make you feel comfortable is important. So if wearing oversized things and things that cover your butt is something that makes you feel good uncomfortable, then you should do that. But I realized that I didn't have to do those things if I didn't want to. So I've had clients and I see a lot of girls and women on social media who are in smaller bodies than me that

also struggle with that same type of thing. Um, So regardless of like where you are, you know, whatever your body size is, it's a common thing that people experience. But definitely, you know, accepting myself as I am and saying like this is okay, and this is me is something that took me a really long time to come to terms with. So I wouldn't say like I'm as like out there and confident as Lizzo, but um, you know, because she's amazing and and I always love the way

she is. It's very inspiring for me, um, and for so many other women. But definitely like going against what I had usually thought was acceptable for me has been something. I love what you said that if you want to wear an oversized shirt and that's your style or what you feel comfortable in today, great, But I think it's really cool how you've it sounds like for you wearing clothing that fits you, it's more of an accurate reflection of who you are, at least right now. Then you

know what you were told to be. So it's so cool to watch you kind of take your power back and unlarned things that were ingrained within you so deeply. And I think that gives confidence for other women who were in your you know, in a similar position to you, where they were told to, you know, cover up their stomach because it wasn't flat or where a strong at the beach, or only where a one piece, Especially as we get into summer is. If that's what you want

to do, do it. But you can also slowly take your power back if you want to by doing things radically different. And again, I think that your confidence is really what comes through for me, for you. And you come off the same as Lizzo, I'll say like, really, I don't, I'm not such a compliment. Well, who knows, you know, And I bet Lizzo as her own major struggles with this stuff. You know, she's a performer. She can get on stage and maybe look like she turns

it on. And this is a huge assumption and I don't even want to, you know, speak about it further than that, but who knows what she's going on underneath that. And I think a big turning point from you was and I woke up and I realized, like I couldn't keep trying to shrink myself anymore physically, like my body and I couldn't keep going through that cycle of like dieting and restricting and then overeating and going through that whole thing, because that's what your body's natural tendency is

when you restrict something. I woke up one day and I was just like, you know what, like whatever, I am right now, it's fine, and I need to start listening to what my body is saying. And slowly but surely, that's kind of how I fell into intuitive eating. I had read the book when I was in school, but I kind of didn't even really remember that, and I just slowly started to like listen to myself. I had

never listened to myself before. But accepting the fact that if I stayed at where I am right now, whatever that may be, that's fine and that's okay. And telling myself that every day over time like helped me kind of get to that place. That's such a powerful affirmation because we're never allowed to just be and you gave it to yourself radically. So let's dive even deeper to that in our second episode. So we'll wrap up here. We're gonna put all your information in the show notes below,

and stay tuned. We're gonna have a Lennie back to discuss her own PCOS journey, more of how she kind of came to find that comfortability in her own body. Why health practitioners might be limited in their scope although their intentions may or may not be good. We'll find out and learning more about how you became a weight inclusive dietitian and what that really means. Thank you so much for having me. This is a really great conversation to just hear your feedback and hearing like you kind

of interpret things. It was definitely very insightful for me. Well, you're wonderful and we're so happy to have you. Thank you, and we'll have you back on here real soon