Episode 21: Eating Disorders
Well Dukes Podcast
Links:
HOPE Team: https://www.jmu.edu/healthcenter/TheWell/hope-multiregion.shtml
Overeaters Anonymous: https://oa.org/
NEDA: https://www.nationaleatingdisorders.org/
Transcript:
0:01 Intro: Hi there, welcome to Well Dukes, brought to you by The Well. Each week, you'll hear conversations from a variety of JMU staff and students that we hope challenge what you know, think, or do in regards to your own health and helps you be Well Dukes.
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0:21 Jordan: Hey Dukes! It's Jordan.
0:22 Mikayla: And I'm Mikayla.
0:24 Jordan: And we're back for another episode of the Well Dukes Podcast.
0:30 Mikayla: On this week's episode, AJ Levy, Graduate Assistant for The Well interviews Erin Williams from the JMU Counseling Center, and CSPA Graduate Student, Chloe Dauer to talk about eating disorders.
0:38 Jordan: Yeah, AJ has a great conversation with Erin and Chloe, and they give a brief overview of what the different eating disorders are, including the ones a lot of people really haven't heard of. And they also go into the behaviors you might notice in friends or peers that have an eating disorder.
0:55 Mikayla: So we chose this topic as this week is National Eating Disorders Awareness Week. So we wanted to highlight its awareness and share some great resources available to JMU students too.
1:05 Jordan: Alright, let's get to it.
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1:10 Aj: Hi, Chloe and Erin. Thank you so much for joining me today. Do you want to give a little bit of an introduction to yourselves about who you are and how you got interested? Or, or really began diving into the topic of eating disorders?
1:26 Chloe: Yeah, sure. I'll jump in first. Hi, everybody. I'm Chloe. I, this is the second podcast I've been on. So you might remember me from the stalking episode, but I am a practicum student in The Well. I am a first year in College Student Personnel Administration program. And I guess, body positivity and just body image research has always been something that has really been intriguing to me. I dabbled in it, I guess, a little in undergrad with some research that I did with a professor that was really passionate about eating disorder awareness and stuff like that. So I think that's kind of where I got my start. And then I started, you know, kind of curating my social media feeds and things like that to sort of suit that perspective. And I've just been, you know, more passionate about it over the course of my lifetime. So I think that's why I'm excited about our conversation today.
2:18 Erin: Yes, hello, thanks for having me today. And, again, my name is Erin Williams. And I'm one of the senior staff clinicians and clinical case managers at the JMU Counseling Center. I primarily assist students in connecting with resources off campus. When that is needed. However, I also serve on the HOPE team here, which is an interdisciplinary team made up of different people from various departments across JMU that support students who may be working through maintenance or recovering from an eating disorder. My interest in working in this area clinically, I think, stemmed from my experience in the performing arts. And then as I went into graduate school for counseling, I specialized in Creative Arts and therapy, and specifically dance movement therapy. And so that really led my interest in this topic, just knowing that there was a lot to do in terms of body work. It led me to working at an inpatient facility for treatment of eating disorders. And so I worked through many levels of care. And just really came to enjoy the work and saw how complex and how multi-layered it was. And just recognize the importance of how valuable, but also how prominent, eating disorders are, you know, everywhere.
4:13 Aj: Awesome. Well, thank you. So thank you both so much for being here. So to jump in a little bit, it may be best to define what an eating disorder is. So an eating disorder is a pattern of eating and or exercising, which is unduly influenced by distortions and body image, so how you perceive yourself, and can be caused by a variety of biological, psychological and sociocultural factors. Eating disorders affect people of all genders, ages, races, religions, body shapes and body weights. And one thing that is often missed in a lot of conversations about eating disorders, is that eating disorders don't have just one look or just one appearance or body shape. Anybody in any body shape can be experiencing an eating disorder, potentially. So it's really important to remember that kind of that “don't judge a book by its cover” adage is really applicable here. Because, regardless of what somebody looks like, they may be or may not be experiencing an eating disorder. And so now, I'm just going to briefly go into the main kind of main eating disorders that people are likely to know about or hear about. So the first thing I'm actually going to go into is not commonly thought of when the topic of eating disorders is brought up, but it's the most common eating disorder, which is binge eating disorder, which is characterized by recurrent episodes of eating large quantities of food, often very quickly and to the point of feeling sick or feeling uncomfortable. And that's what is called a binge episode, is when you just eat so much food, often in a very short amount of time. Bulimia nervosa, which is one that we often hear in conversations, is similar to binge eating disorder, in that it has those binge eating episodes, but it includes compensatory behaviors or behaviors to counteract the effects of, of binge eating, which can include purging or self-induced vomiting, or intense exercise, which again, are designed to counter those effects of binge eating.
6:25 Aj: Then we have anorexia nervosa, which I think is often portrayed in the media, or in you know, TV shows and movies as an as kind of the poster for an eating disorder. It's characterized by dramatic weight loss difficulties maintaining an appropriate body weight for your height, and your age and your stature. And in many individuals, there's also a psychological or cognitive component of a distorted body image. And people with anorexia nervosa generally restrict their calorie intake and/or limit the types of foods that they eat. Though there also may be some compulsive exercising, or purging as well. And then our last two categories are a little bit more broad. So first is what we call OSFED, or other specified feeding or eating disorder. And this is a category for those who don't necessarily meet the diagnosis for anorexia, or bulimia or binge eating disorder, but they still are demonstrating disordered behaviors. And then lastly, we have ARFID, or avoidant restrictive food intake disorder, which is similar to anorexia, in that it involves limiting the amount or types of food you consume. The food does not include necessarily that distress about body shape, or a fear of gaining weight. And so I know I just went through a lot of information, but I kind of want to talk more about those signs and symptoms. When we think about eating disorders, we think about wanting to support our friends who may be experiencing them. What are some signs and symptoms that you can look out for in your friends, or that you might notice in friends, who might be experiencing an eating disorder?
8:17 Erin: I can chime in here, I think it's building off of what you just described through with the different diagnostic criteria. I think one of the important things I would add is to recognize that there's much discussion in the professional community as well as advocacy groups of recognizing that diagnostic criteria can be very exclusive, and is in some ways outdated. And so I think it is important to know that, when assessing whether or not your disordered eating or disordered body image or disordered activity level is something that is interfering with your daily functioning, to recognize that you do not necessarily need to meet the criteria for diagnosis in order to get help. Like I said, again, there's a lot of discussion in the professional community about how diagnostic criteria again is very narrowing. And you know, if someone doesn't meet all the check marks, that doesn't necessarily mean that they don't need to address their eating-- disordered eating behavior or seek help. I think going back to your question in terms of what you might see in friends, or amongst your peers, or some of the classic signs and symptoms of just an avoidance of social settings or meals, or plans, where food is involved. Sometimes peers or friends will be isolated or defensive when making plans or they're invited to eat in social settings. You might notice that friends or peers have a very strict, strict adherence to a certain diet regimen or an intake schedule. And there's a high level of unwillingness to interrupt that for any reason. Because eating disordered behavior teams really exist on a spectrum in terms of severity or how it's presented, you might see an avoidance or a hyperfocus on numbers. And by numbers, I mean things like weight, calories. You know, in this world of all of the different types of fitness apps, you know, the amount of steps that somebody takes in during the day. Additionally, you also see an avoidance or hyperfocus with body image things in terms of people looking at their reflection or avoiding reflection, people looking at and gauging how they look and how they feel in clothing, and then sometimes be avoidant of how they look or how they feel in clothing.
11:04 Chloe: Yeah, Erin, I think that was, I mean, obviously, that was a fabulous list that you were able to provide for everybody. And even some, some things that I feel like are worth mentioning, especially when you're, you know, hanging out with a group of friends or anything and just just a language that's used a lot and how often that language is used. Body checking, and, but more so than just like checking yourself out in the mirror just to like, make sure you're all gathered and everything. But even physical body checking, like the really aggressive like pinching of areas on one's body, and very, like unkind physical gestures to one's own body in a way, if that makes sense. You know, loss of your menstrual period, and things like that, or rapid decrease or irregularity in one's period is often a symptom or a result of these eating disorders. And I just think it's really important to mention, too, that while we're talking, Erin had mentioned that a lot of these definitions are very narrow. But and then at the same time, disordered eating just in general is very broad, and something that I think, a lot of people experience on a daily basis with, you know, certain media influences and diet cultures, and the imagery of what we think we're supposed to look like, and all of these things. So while one not might not be able to fit in the, like, DSM category, categorization of any of these disorders, there's a lot of disordered behavior that I think a lot of people could probably identify with or recognize in their friends. And like you mentioned there, and that that definitely, is just as much of a reason to seek help or to seek assistance in figuring out what works for you and prioritizing your well being without restricting yourself in ways that are harmful. So yeah, I really appreciate your points about kind of, just because you don't fit into any of these categories doesn't mean that you don't deserve to seek assistance or seek support in any way, especially with your friends and loved ones.
13:16 Erin: I think the most, the most significant indicator that this can be an important issue is just registering and taking inventory of whether or not one's relationship with food, or their body is in any way uncomfortable, or interruptive, to your daily functioning, you know, and if you meet that simplistic criteria, come and talk to somebody, or talk to someone about what you're experiencing, because it could be something that could be a precursor to something worse. And if we intervene at the right time, it could really improve the relationship, as well as the quality of your day to day functioning.
13:58 Chloe: Yeah, I would say, especially since we would assume that a lot of JMU students are going to be the audience here and thinking about the students that are in class, and these intrusive thoughts are ruining their learning experience, or their social experiences and things like that, and to everyone listening, you know, remembering that you deserve to be able to sit in the classroom and, and have enough space in your brain to just take in the information and to hang out with your friends and enjoy the time there. Without these thoughts and disorders, or sorry, these thoughts and feelings and actions, disrupting your ability to enjoy your life. And I think that Erin, what you were saying about that can, that can be the baseline that we start from when we're deciding if we need help or if our friends need support in any way for sure.
14:51 Aj: Yeah. So as we kind of wrap up this discussion and have been talking about that... I think it's really important to emphasize that there is no - there's no specific point that is like the marker for “I need to go er- I need to go, you know, get some support.” The marker is when you notice that you're engaging in some of these behaviors, it's always helpful, even just to talk to somebody about it, who might then refer you or, or point you in the direction of other resources. So what resources are available to JMU students and support, you know, for seeking support around eating disorders?
15:39 Erin: I'm coming from the Counseling Center's perspective, obviously, there are counselors available to speak with students individually, about what they're experiencing, what are their thoughts, what are their feelings, what's their day to day like? And so the Counseling Center can offer anything from individual counseling for a few sessions, we can look at connecting them with counselors to talk more long term if that's what's needed. This semester, the Counseling Center is offering an eating disorders group, where again, we're talking more along that general spectrum of disordered eating, disordered or skewed body image topics, just to help people gain an understanding about where they're at. If people are sort of in a place where their eating disorder has been, or is a little more developed, obviously, there is support through the HOPE team. And again, as I mentioned earlier, the HOPE team consists of an interdisciplinary team of people throughout JMU, which includes myself at the Counseling Center, and includes our registered dietitian, Michele Cavoto through the University Health Center. Additionally, through the UHC Dr. Etre for any medical concerns that may come up for someone struggling with an eating disorder, as well as Holly Bailey, over at UREC, to help with that element of over activity and over exercise.
17:11 Chloe: Yeah, absolutely. And I am glad you brought up Michelle, our fabulous part-time nutritionist with the university. I know when when I found out that that was even a possibility for students, I was just completely stoked, I thought that was so cool. And such a fabulous resource to have on such a populated campus. Even too, just the Well, you can stop by and visit, visit AJ and I or visit any of our amazing advocates here in the center just to start that conversation and get some guidance. Because sometimes, even though people can lay out reasons for you all day, sometimes you just don't know where to start. So if that means just taking a step into the right office and getting guided to that thing that can help you out. I think that's really great. So, The Well is full of resources, too.
18:00 Aj: Exactly. Well, thank you so much, you both for joining me today.
18:06 Erin: Thank you for having us.
18:11 Chloe: Thank you so much, Aj! This was so fun.
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18:15 Jordan: What a great episode. I'm so glad that Aj brought up some of the other eating disorders like OSFED and ARFID. Again, those are the other specified feeding or eating disorders and ARFID is avoidant restrictive food intake disorder. Because I think those are also really common in ways that we can start to see disordered eating patterns happening. But as Aj explained, they're not quite as severe to meet the diagnostic criteria. And I just don't think people had heard about them or are aware of them alive. I mean, Mikayla, did you? Were you aware of these when you were in college?
18:51 Mikayla: I was not. And so I will, I'll say that we definitely talked about in my health classes, like anorexia, bulimia, and those I feel like are the standalone eating disorders that we typically talk about. And those are often the ones that you see in the media. But I'll be honest, I did not know about the other categories until I started working here at The Well. I didn't realize that eating disorders, like many health topics, do lie on this spectrum, right? That we don't have these cookie cutter definitions of exactly each person's perspective or each person's experience. It can look different across a lot of different people. So, I'm hearing that, I'm happy that our students are getting that knowledge because they might hear that definition and maybe see themselves in that definition. They might see their friends in that definition. They might be seeing some of those characteristics coming up in their roommate’s behavior. So I hadn't heard of it, but I'm really glad that our students have the platform to hear it now.
19:48 Jordan: Yeah, absolutely. And exactly like you said, when I was growing up the major ones were anorexia and bulimia, right? Self starvation and I remember watching a video and middle school about the Karen Carpenter story. And that's how I learned about it. And as it was kind of highlighted, the definition itself is that restrictive food, you know, and that kind of that obsession part, but people, I think, are quick to associate being anorexic with being extremely thin and not, not considering different body types and body shapes. So it could still be someone who is engaging in those behaviors, and not looking the, you know, super thin, emaciated look.
20:34 Mikayla: And I feel like that kind of plays into a point that Chloe made in this episode is these definitions, while they're narrow in their, I guess for diagnostic reasons. It can look so different among different people. So I mean, exactly different body types, these, these eating disorders are going to look different. And so someone doesn't have to be, like you were saying, really thin to have an eating disorder. So I feel like this can impact anybody, regardless of age. And so so often, what we see is, this conversation is targeted more towards the female population. But this also impacts males, too, in this idea, regardless of what the physical attributes are, it's this idea that you have to fit into this mold that we have deemed attractive, that we have deemed appropriate, that we have deemed valuable, and if you don't fit into that, that aesthetic, then you don't fit. That you don't, that you're not attractive. And that's not that's just, it's not true, and how much stress and how much obsession that can take over somebody to just wanting to be accepted in their own peer group into what society deems as desirable. So yeah, this, it's a big topic. And I'm really happy with the way that Aj, Erin, and Chloe, just take it and tackle it. And really pinpoint the specific attributes of eating disorders. And how society really has reinforced that, hey, in order to get to this image, you have to do this. And we're here to say that that's not - that's not the case.
22:09 Jordan: Yeah, you're exactly right. It is a really, it's a big topic. And it's not as is not as easy as just telling someone like, “Oh, hey, you just need to stop doing this, right?” I mean, it is, in fact, a mental health condition. And I really like how Chloe even pointed out that we see students you know, that are in class, you know, if you are constantly having this preoccupation of your mind about your body and your eating habit. And sometimes people develop eating disorders, because it's one of the few things they feel that they can control in their life. And so then, by having this constant obsession, and thinking about it, it's hard, it takes up so much space in the brain, and it makes it harder for focus on other things. So it is, it is difficult, it is not something just as easy as, as just, you know, changing a lifestyle habit. There's a lot of work to be done. And I think this episode can also be great for people that are concerned for friends or family members or peers, that they think they might be exhibiting some of these behaviors. And so I'm just really glad that we get to work at a place and that JMU values having these resources like Erin and the Counseling Center. And so if anyone is interested in learning more about the HOPE team or how to utilize the JMU Counseling Center, links for all of those will be in the episode description.
23:34 Mikayla: And another great resource available to JMU students and the Harrisonburg community is the Overeaters Anonymous support group. So this group meets weekly, and they help people with compulsive eating, and other food behaviors as well. So, the link to their website with more information will also be available in this description.
23:54 Jordan: Yeah, as Aj pointed out, binge eating and overeating is up there and the most common eating disorders and another point that has been made multiple times is that eating sores also don't discriminate. They can affect anyone. So be sure to follow us on Instagram @JMUWellDukes because we share information and national resources on eating disorders, body image, and nutrition. Next week's episode will feature one of the members of the HOPE team dietitian Michelle Cavoto, and she's going to talk about national Nutrition Month and diet culture. If you're listening to this episode for HTH 100 credit, your passcode is “HOPE team”. That again is “HOPE team”, which is the JMU resource for students that need support in overcoming problematic eating and exercise. So remember, be well Dukes!