The Eating Disorder Recovery Podcast

The Eating Disorder Recovery Podcast header image 1

Event Restriction

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In this podcast Tabitha talks about what she refers to as "event restriction." 

Event restriction is when you anticipate eating more or resting at an event or time in the future, and therefore try to create a "buffer" by restricting more or compensating more via exercise in preparation. 

Event restriction never works. Most people find that is actually makes eating and resting harder, so ironically you struggle even more when you actually get to the big day. Most commonly people event restriction in preparation for Christmas and the festive season. 

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November 30, 2017  

Fundamentalist Religion and Eating Disorders

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In this podcast Tabitha Farrar talks to Wendy Marsman (from Woman Beyond Belief) about her experience with fundentmentalist religion and the diet culture that can exiest within some church communities. 

I want to make it clear that the aim of this dicussion is not to judge religion. Rather, we are looking into how religious intent and trying to do the "right" thing by the word of God can become troublesome when eating disorders are involved. 

We get into some sticky stuff in this discussion. It is not entirely comfortable to highlight the problems with religion and the opression of women. But it is important. 

 

Wendy Marsman was raised in a strict religious home. Also, being from a fundamental religious background, she was influenced by the Biblical interpretations that women had to submit to men. A “good Christian wife” needed to be thin to please her husband. So, after she got married and had 3 children, Wendy continued to go on yo-yo diets. There were many opportunities to be part of diet groups in the church which she participated in, always aiming to be better, aiming to not be guilty of the “sin of gluttony”.
Wendy has her own podcast called Women Beyond Belief Podcast where she mainly interviews women who have left religions and cults. Many women who have grown up in a religious background have been accustomed to suppression and inequality. She hopes to provide a platform for these women to have a voice.
 
Podcast Website: http://womenbeyondbelief.com/
 
YouTube Channel: https://www.youtube.com/channel/UCizIjQrmLqBSbPy0jqkEl3A
 
Facebook: https://www.facebook.com/WomenBeyondBelief/
 
Twitter: @WBBPodcast -  https://twitter.com/WBBPodcast
 

Email: womenbeyondbelief@gmail.com

Dr G: Hormones (and how malnutrition affects them!)

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In this podcast Tabitha talks to Dr Jennifer Gaudiani from the Gaudiani Clinic in Denver about the important and interesting topic of hormones and how they are affected by restrictive eating disorders. Topics covered include:

  • How malnutrition affects the endocrine system
  • How nutritional rehabilitation affects the endocrine system
  • The thyroid, and how it is affected by malnutrition
  • Commonly mistaken diagonises
  • What doctors need to know about hormones and malnutrition
  • The menstrual cycle
  • Sex hormones, and sex drive

 

About The Gaudiani Clinic

The Gaudiani Clinic provides superb expert outpatient medical care to adolescents and adults of all sizes, shapes, and genders with eating disorders or disordered eating. The Gaudiani Clinic also offers comprehensive person-centered care to those who are recovered from an eating disorder. Through a collaborative, communicative, multi-disciplinary approach, the Clinic cares for the whole person, in the context of their values.

Under the care of Jennifer L. Gaudiani, MD, CEDS, FAED, patients receive expert medical care provided in a comfortable and highly discreet private practice setting. Dr. Gaudiani is one of the only outpatient internists in the United States who carries the Certified Eating Disorder Specialist designation and is internationally recognized as an expert in the eating disorder field. In her role as an expert outpatient medical doctor, Dr. Gaudiani can function as a patient’s primary care physician or as an expert adjunctive physician as part of a multidisciplinary team.

The Gaudiani Clinic is located in Denver, Colorado with both local and telemedicine reatment plans available.

Dr. Gaudiani also offers professional services including private and group consultation, professional webinars, and presentations.

For more information about the Gaudiani Clinic, please visit www.gaudianiclinic.com, call 720.515.2140.

 

 

 

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Dear Doctor …

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People with eating disorders, parents, and doctors share what they think doctors should know about eating disorders. 

 

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Dr G: Metabolism

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In this podcast, Tabitha talks to Dr Gaudiani on the topic of metabolism in relation to anorexia and other restrictive eating disorders. 

We talk about:

  • How the metabolism works
  • How restriction affects the metabolism
  • Mental hunger
  • Physical hunger
  • How to eat in recovery to boost your metabolism

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Defining Mental Hunger And Why It Is Important In Anorexia Recovery

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In this Podcast Tabitha talks about mental hunger. We look at:

- What mental hunger is

- What mental hunger represents

- Why responding to mental hunger is important

- Why physical hunger cues are not reliable in Anorexia recovery

- How mental hunger will naturally reduce during the refeeding process

 

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Male vs Female Treatment Experiences in Eating Disorder Treatment

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In this podcast Tabitha talks to Philipa Hay about recent research that looked into male autobiographies of eating disorders and recovery experiences. 

Link to the full research paper --> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485468/

Study Abstract

Eating disorders are increasingly recognized as a problem for men but help-seeking is low and little is known about their treatment experiences. This paper sought to determine the treatment experiences of men who have suffered from an eating disorder using autobiographical data. Inclusion criteria were autobiographies of men who had experienced an eating disorder and sought any form of treatment for this, written in the English language, published between 1995 and 2015, and available for purchase in 2016. The search resulted in six books that were thematically analyzed. Analysis of data resulted in two broad themes (1. Positive experiences; 2. Negative experiences) with sub-themes. With regards to the first theme, factors such as concern of staff members, therapist’s expertise (in treating eating disorders in men), and a collaborative treatment approach were considered favorable for treatment. In contrast to the first theme, apathy of staff members, the authors’ own negative preconceptions, treatment providers being perceived as prioritizing financial concerns, perceived as incompetent and judgmental behavior of therapist(s), and time limitations of sessions were considered unfavorable treatment experiences. In this study, the perceived success of treatment depended on therapist’s features and the form of treatment provided. Further research examining these is indicated.

 

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October 6, 2017  

Before recovery vs. after recovery

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In this podcast Tabitha answers questions about life before recovery versus life after recovery from Anorexia. 

Topics covered include:

- Dining out

- Social life

- Feeling cold

- Eating with others

 

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Defining Restriction. Defining Unrestricted Eating

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In this podcast, Tabitha talks about restriction, and unrestricted eating. Restrictive eating disorders such as Anorexia are often misrepresented as total restriction and not eating. This is often not the case. Many people with Anorexia can eat seemingly "normal" amounts of food and still be operating under rules of restriction. The key is understanding that unrestricted eating is required in order to allow the brain and body to fully exit the Anorexia response. 

Redefining how you think of restriction is often the key to understanding what unrestrictive eating means for you 

 

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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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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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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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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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