The Eating Disorder Recovery Podcast

The Eating Disorder Recovery Podcast header image 1

Dr G: Tummy Troubles in Eating Disorder Recovery

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Tabitha talks to Dr. Jennifer Gaudiani about all things gastrointestinal in eating disorder recovery! We talk about bowel movements, irritable bowel syndrome, delayed gastric emptying, and so much more! 

 

 

Medical Minute Videos: 
Blog Posts: 
 
 
 
 
 
 
AED Guidelines: 
September 14, 2017  

Science: Variants in neuropeptide signaling are associated with disordered eating behaviors

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In this podcast Tabitha Farrar talks to Micheal Lutter about the recently published paper titled: Novel and ultra-rare damaging variants in neuropeptide signaling are associated with disordered eating behaviors

 

From the paper:

Abstract

Objective

Eating disorders develop through a combination of genetic vulnerability and environmental stress, however the genetic basis of this risk is unknown.

Methods

To understand the genetic basis of this risk, we performed whole exome sequencing on 93 unrelated individuals with eating disorders (38 restricted-eating and 55 binge-eating) to identify novel damaging variants. Candidate genes with an excessive burden of predicted damaging variants were then prioritized based upon an unbiased, data-driven bioinformatic analysis. One top candidate pathway was empirically tested for therapeutic potential in a mouse model of binge-like eating.

Results

An excessive burden of novel damaging variants was identified in 186 genes in the restricted-eating group and 245 genes in the binge-eating group. This list is significantly enriched (OR = 4.6, p<0.0001) for genes involved in neuropeptide/neurotrophic pathways implicated in appetite regulation, including neurotensin-, glucagon-like peptide 1- and BDNF-signaling. Administration of the glucagon-like peptide 1 receptor agonist exendin-4 significantly reduced food intake in a mouse model of ‘binge-like’ eating.

Conclusions

 

These findings implicate ultra-rare and novel damaging variants in neuropeptide/neurotropic factor signaling pathways in the development of eating disorder behaviors and identify glucagon-like peptide 1-receptor agonists as a potential treatment for binge eating.

 

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0181556

 

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Anorexia Fears: Using Migration Science to Explain Fear of Eating and Weight Gain

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This week I speak to Shan Guisinger again, and this time we are talking specifically about fear in Anorexia. Fear of weight gain. Fear of eating more. How could a fear this great have possibly had an evolutionary advantage? Find out! 

 

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Anorexia recovery while managing a young family.

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Recovery from Anorexia is often a time of heightened anxiety and stress. Managing recovery while looking after a young family is a reality for many adult sufferers. In this podcast Tabitha talks to an adult in recovery, Erin, about managing recovery with young children. 

About Erin:

I am 36, and have lived in Colorado my entire life. I currently live in Highlands Ranch and have two children, 11 and 6. I have been married for 15 years. I studied sociology, philosophy and women's studies in college. I have struggled with issues around food and body image since I was a preteen. My eating disorder became severe at the age of 33. I want to help people of all ages, backgrounds, and weights understand that they can indeed develop this illness and that it is a life threatening disorder that needs to be taken seriously. I hope my experience can help others know they are not alone if they are struggling to recover while also being a parent. 

 

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Anorexia as an evolved genetic response to famine

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In this podcast we talk about the Adapt to Flee Famine Perspective of Anorexia evolution with Shan Guisinger. 

The Adapt to Flee Famine Perspective puts forward convincing evidence for the case that Anorexia is an evolved genetic response to times of famine. A migratory response that makes people with the genetic predisposition for Anorexia respond to energy deficit by wanting to exercise more and eat less. 

You can find out more about Shan Guisinger here: http://www.adaptedtofamine.com/

Paper on The Adapt To Flee Famine Perspective: https://www.ncbi.nlm.nih.gov/pubmed/14599241

 

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Anorexia Recovery: Energy Deficit | Energy Debt | Target Weights | Weight vs State Restoration

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Just me in this podcast! Responding to questions that I get frequently around Anorexia recovery and weight restoration. How to know when you are really weight restored? Let me tell you it is not something that you can calculate via a math equation or estimate via looking on a height/weight chart. 

Weight restoration is a process of gaining weight until you are within a healthy weight range (I recommend a BMI of 22 at least) and continuing to eat without restriction until you no longer fear further weight gain. This podcast fully explains my position on that weight restoration, target weights, and weight versus mental state restoration. 

 

 

 

 

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July 24, 2017  

Eating Disorders and PTSD

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Tabitha Farrar talks to writer, speaker, and songwriter Jenni Schaefer about her recovery from Anorexia, and subsequent experiences with PTSD. 

In this podcast we talk about:

  • Hope and ACTION in eating disorder recovery
  • Motivation to recover
  • Trauma and PTSD
  • Exercise and lower-level movement in eating disorders 
  • Recognising the symptoms of PTSD
  • The importance of finding treatment suited to you as an individual

 

 

 

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The importance of recognizing Anorexia in people in larger bodies

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In this podcast Tabitha Farrar talks to Dr. Rachel Millner about Anorexia and people in larger bodies. This podcast was inspired by an email from a mother of a patient who has Anorexia and is in a larger body. Topics discussed include:

  • The dangers associated with energy deficit in people in larger bodies
  • Problems with diagnosis and practitioner ignorance 
  • Weight stigma in the medical field
  • Parent advocacy and strength
  • Embracing weight diversity

Find out more about Dr Millner here: http://www.rachelmillner.com/ 

 

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Challenging intake guidelines — Dr Graham Redgrave

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Tabitha Farrar talks to Dr Graham Redgrave about the research done at Johns Hopkins looking into higher weights and a faster rate of refeeding patients with Anorexia in an inpatient hospital setting. The conversation includes:

  • Refeeding intakes, traditional expectations versus new developements
  • Problems with low target weights
  • Relapse prevention programs
  • Lower rate of relaspe for patients who reach higher BMIs in treatment
  • The case for higher caloric intakes once the risk of refeeding syndrome is past
  • What refeeding syndrome is, and research around this
  • How and when treatment fails patients. 
  • Why we need to challenge the current guidelines pertraining to refeeding intakes

 

 

Link to the orginal study: https://www.ncbi.nlm.nih.gov/pubmed/25625572

 

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Exercise Trackers, BMI, Obesity, and Anorexia Treatment

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In this podcast Tabitha Farrar talks to Courtney Simpson about the work that she is doing looking at fitness tracker use amoungst people with eating disorders. We cover a lot of topics in this podcast that was originally about fitness trackers and the number of people with Anoreixa who use them to count calories and exercise. 

 

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How ARFID differs from AN/BN — science of picky eating

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Tabitha Farrar talks to Hana Zickgraf about a recently published research paper titled: Adult picky eaters with symptoms of avoidant/restrictive food intake disorder: comparable distress and comorbidity but different eating behaviors compared to those with disordered eating symptoms

Link to orginal study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086050/

Study summary

Picky eaters are people who avoid many new and familiar foods because they dislike their taste, smell, texture, or appearance. When it is severe, picky eating can lead to weight loss or difficulty maintaining a healthy weight, nutritional deficiencies, dependence on supplements to get adequate nutrition or calories, or difficulty engaging in daily life because of shame, anxiety, or inconvenience. People who experience one or more of these consequences because of their picky eating can be diagnosed with Avoidant/Restrictive Food Intake Disorder (ARFID). People who restrict the amount of food they consume because they are afraid of gaining weight or being fat (and who usually engage in excessive exercise or purging behaviors to get rid of calories) are diagnosed with anorexia or bulimia when their eating leads to weight loss, nutritional problems, or interferes with life. ARFID is a new diagnosis, and in this paper, we show that 1) adults with ARFID symptoms are just as distressed, and just as likely to have symptoms of depression, anxiety, and obsessive compulsive disorder, as those with anorexia or bulimia, but that 2) adults with ARFID symptoms show very different types of eating behavior from adults with symptoms of anorexia or bulimia.

June 12, 2017  

Won’t stop or can’t stop? Science expolring habitual nature of Anorexia

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In this podcast, Tabitha Farrar talks to researcher Kathryn Coniglio about the latest study exploring the habitual aspects of Anorexia Nervosa. In the paper titled, Won't stop or can't stop? Food restriction as a habitual behavior among individuals with anorexia nervosa or atypical anorexia nervosa, the intent behind restrictive behaviours was looked at.

Link to the original paper: https://www.ncbi.nlm.nih.gov/pubmed/28388511

 


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June 5, 2017  

Eating Disorder Recovery and Pregnancy

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Tabitha Farrar talks to Brooke Mills about pregnancy in the years after recovering from an eating disorder. We talk specifically about the effects of Bulimia behaviours on pregnancy, and the importance of establishing a solid recovery before getting pregnant. 

  • Morning sickness and bulimia triggers
  • Sustaining recovery thoughout pregnancy
  • Problems that can arise when behaviours are present during pregnancy
  • Using family and friends to help in recovery

Support this podcast via Patreon!

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Dear Dietitian … what we want you to know about treating Anorexia

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In this podcast we hear from adults with Anorexia, parents of people with Anorexia, and dietiticans treating adults and children with Anorexia about their experiences with dietiticans in the field of eating disorders. This podcast is a mixture of Tabitha Farrar reading out notes sent in from listeners, and audio files from listeners that have been sent in. 


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Cynthia Bulik: Genetics of Anorexia Nervosa

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In this podcast, Tabitha Farrar talks to professor Cynthia Bulik about the research underpinning the genetic locus for Anorexia Nervosa. In this podcast we discuss:

  • Past and present research on the genetics behind Anorexia Nervosa and other eating disorders
  • Implications for treatment
  • Anorexia Nervosa and OCD links
  • History of Anorexia Nervosa back to the starving saints
  • Importance of parents and family support in eating disorders
  • Anorexia and energy deficit
  • Anorexia and money
  • Genetics of Anorexia Nervosa

Cynthia M. Bulik, Ph.D., FAED, is Distinguished Professor of Eating Disorders in the Department of Psychiatry in the School of Medicine at the University of North Carolina at Chapel Hill, where she is also Professor of Nutrition in the Gillings School of Global Public Health, and founding director of the UNC Center of Excellence for Eating Disorders. She is also Co-Director of the UNC Center for Psychiatric Genomics. Dr. Bulik is also professor of Medical Epidemiology and Biostatistics at the Karolinska Institutet in Stockholm, Sweden. She is passionate about translating science for the public.

May 15, 2017  

Hunger in Anorexia Recovery

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Hunger is a fascinating and crucial topic in Anorexia recovery. Navigating hunger can be difficult when hunger signals are either nonexistent, sporadic, or unrelenting.

At times of under-nutrition, most people with restrictive eating disorders such as Anorexia experience a vast reduction in hunger cues — this is a very normal result of the body moving into starvation mode. When we start to eat in recovery, hunger signals can be all over the place! In this podcast, Tabitha Farrar gives some insight into hunger based on her own experience and also those of the people with whom she was worked.

 


Support this podcast via Patreon!

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May 8, 2017  

Julie Duffy Dillon on Fat Positive Attitudes to Nutritional Advice

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Tabitha talks to registered dietician Julie Duffy Dillon about:

  • Why a fat positive approach is needed
  • Eating disorder prevention
  • Food is not on a dichotomy of good and bad
  • Education and research on fat positive approaches
  • The problem with people with eating disorders becoming nutritional advisors
  • The canary in the coal mine
  • The problem with nutritional science
  • Polycystic Ovarian Syndrome and eating disorder
Instagram @FoodPeaceDietitian
My podcast Love Food: on iTunes or via my blog: http://www.juliedillonrd.com/blog/
Bio:
Julie Duffy Dillon is a Registered Dietitian, Eating Disorder Specialist, and Food Behavior Expert partnering with people on their Food Peace journey. She is trained as a mental health counselor and supervises dietitians and other health professionals to help using weight inclusive and attuned eating strategies. She owns central North Carolina’s group nutrition private practice and premier source of eating disorder treatment and prevention, BirdHouse Nutrition Therapy. Julie also produces and hosts the weekly podcast, Love Food. Learn more at JulieDillonRD.com.

Support this podcast via Patreon!

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May 3, 2017  

Carmen Cool on HAES and Community Power

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In this podcast Tabitha Farrar talks to psychotherapist Carmen Cool about the origins and evolution of Health at Every Size and the power of community when it comes to eating disorder recovery.

Carman Cool’s Website: http://www.carmencool.com


 

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April 23, 2017  

Family Based Treatment for Adults and Problems of Fat Phobia in Eating Disorder Treatment

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In this podcast Tabitha Farrar talks to Rachel Millner — psychotherapist about:

  • How to manage recovery in a society where there is a large amount of body discontent.
  • How to apply Family Based Treatment to adults in recovery from eating disorders.
  • The pros and cons of people in recovery helping other people with eating disorders.
  • How to keep the family dynamic “cool” when there is an eating disorder in the house.
  • Fat phobia within the eating disorder community.
  • The importance of a food-first approach to eating disorder recovery.
  • Recovery IS POSSIBLE and there is always hope

Dr. Millner is a licensed psychologist in the state of Pennsylvania. She graduated from the California School of Professional Psychology (now Alliant International University) in San Diego and completed an APA (American Psychological Association) approved internship at the University of Buffalo.

http://www.rachelmillner.com/


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April 17, 2017  

Professor Janet Treasure: Maudsley, Adults with Eating Disorders, and Community

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In this podcast Tabitha Farrar talks to Professor Janet Treasure about:

  • The Maudsley approach to treating eating disorders with family support and how this has progressed over the years
  • 35+ years of eating disorder treatment and research
  • The power of community support for adults with eating disorders and caregivers/spouses/family of people with eating disorders
  • Oxytocin and the importance of human interaction in recovery
  • Online support for people who are unable to access other types of support

Professor Janet Treasure, OBE PhD FRCP FRCPsych has specialised in the treatment of eating disorders at the South London and Maudsley Hospital and had an academic career at King’s College, London for the majority of her career. The Unit continues to be one of the premier European academic centres for eating disorders. In their innovative approach to training and treatment they have adopted the newest technologies including iPODs, DVDs and web-based programmes as part of their interventions. Professor Treasure has spearheaded projects that introduce recovered patients and carers into the audit and development plans for clinical services and also in the delivery of training for professionals, carers and patients.

Professor Treasure was made a Professor of Psychiatry in 2000 and awarded an OBE for her work in eating disorders in 2013. Her research has led to greater understanding of, and better treatments for, anorexia and bulimia. Much of her research focusing on the development of new treatments has been carried out collaboratively with, and often inspired by patients and their families. As well as editing professional texts, Professor Treasure has written several self-help books for people with eating disorders (Schmidt & Treasure, 1993; Treasure, 1997). Guided self-help using books such as these are recommended in the NICE guidelines as a first stage of treatment.

The Maudsley Website


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