#072: Eating Disorder: What It Is & How to Heal It | Dr. Julia Sadusky
If you or someone you know has struggled with an eating disorder, you know how painful that experience can be. It’s often an overlooked struggle that really deserves more attention and resources. But thankfully, some resources do exist to heal an eating disorder.
Today, a psychologist who specializes in treating eating disorders joins us. We discuss:
The types, symptoms, and root causes of eating disorders
Surprising statistics on the prevalence of eating disorders and how they can be lethal
How genetics play a role in developing an eating disorder and why you can’t simply think your way out of it
What a healthy relationship with food looks like
Resources and advice you can use today to begin overcoming this struggle
If you struggle with an eating disorder or know someone who does, don’t miss this episode.
Links & Resources
Full Disclaimer: If you purchase through the links on this page, your purchase will support Restored at no additional cost to you. Thank you!
To leave feedback, comment below or contact us.
Dr. Julia Sadusky
Enjoy the show?
To be notified when new episodes go live, subscribe below.
As a bonus, you’ll receive our free guide, 7 Tips to Build a Thriving and Divorce-Proof Marriage!
TRANSCRIPT
Transcript produced by artificial intelligence. Please pardon any errors!
If you or someone, you know, has ever struggled with an eating disorder, you know, how painful and debilitating that experience can be. And sadly, it's an often overlooked, struggling in our culture that really deserves more attention and more resources, but thankfully, some resources do exist to help heal an eating disorder.
Today, I speak with a psychologist who specializes in treating eating disorders. We discuss the symptoms, root causes and types of eating disorders. My guests share some surprising statistics on how so many people struggle with this issue and how an eating disorder can actually be lethal. We talk about how genetics play a role in developing an eating disorder and why you can't simply think your way.
We discussed what a healthy relationship with food looks like, and my guests share some resources and advice that you could use today to begin overcoming this struggle. Finally, sharper some tips to help a friend who's struggling with an eating disorder. And by the way, while I haven't seen any data that suggests that people who come from broken families struggle more with this problem with eating disorders.
We've certainly seen some anecdotal evidence that some of us cope with the trauma of our broken family by turning to food. So if you struggle with an eating disorder, if she knows someone who does. Welcome to the restored podcast, helping you heal and grow from the trauma of your parents' divorce, separation or broken marriage.
So you can feel whole again. I'm your host, Joey Pontarelli. Thank you so much for listening. This is episode 72. My guest today is Dr. Julia Sadusky. You might recognize her because she's been on the show before in episode 12, 13 and 14, Dr. Sadosky is an author. She's a speaker and a licensed psychologist.
She owns her own practice. It's called Luxe counseling and consulting in Littleton, Colorado, where she offers individual family and couples therapy. In addition to consultations for individuals and families around sexuality and gender. She also serves as a youth and ministry educator offering trainings and consultations to counseling centers and faith based institutions.
Her other areas of focus include work with complex trauma, eating disorders and teens and emerging adults. Dr. Sadusky has coauthored a bunch of books, which she'll tell you about at the end of the show, but her most recent book is titled gender identity in therapy, which was co-authored with Dr. Mark Yarhouse.
Dr. Julia is currently a research fellow of the sexual and gender identity Institute in Wheaton, Illinois. And she's an advisor to the center for faith, sexuality, and gender. She's also a good friend of mine. So I'm so excited for you to listen in on my conversation with Dr. Julia, which was actually recorded in her office.
Dr. Julia. Thanks for coming on the show. It's good to be with you, Joey. I think you are our most common guests or popular guests. So where you come up, you've come on the show, the mouse. So it's great to have you back. It's good to be here. I'm excited to talk about eating disorders. I know it's a heavy topic.
It's a tough topic, but I think, uh, you have so much experience in this area, so much expertise. So excuse me. I think we'll start with an obvious question, which is like, what exactly do we mean when we say an eating disorder? What is an eating disorder? Yeah, so I think a lot of people, when they hear eating disorders, they most often think of one type of eating disorder, which, you know, we can break that down in a little bit though.
They might be thinking of anorexia where a person simply doesn't eat. And yet there are several types of eating disorders. And what makes them distinct from other types of mental health concerns is that they're pretty serious ways in which a person struggles with their relationship with food. That can include things like being obsessed with food, being obsessed with your weight size shape.
And again, there's, there's different types. So there's binge eating disorder. Bulemia anorexia, which is probably the most serious, but also the least common. So it's interesting that people think of anorexia as the only eating disorder when there's several, and it's actually the least common of the. Super interesting.
Do you mind just explaining what each of those are doing? Bulemia anorexia? Hmm. So maybe I'll start with anorexia because again, that's the one that most people understand. So anorexia is really when a person really tries to reduce their food intake, pretty significantly, that leads to extremely low body weight.
And so there's this pursuit of thinness really at all costs. It doesn't matter if I'm fainting at work. It doesn't matter if I can't think clearly it doesn't matter if I have headaches every day, that pursuit of thinness becomes more important than anything else. Um, it also comes with a distorted body image, fear of gaining.
And extremely disturbed behaviors around that. It's so things like checking myself in the mirror over and over again, um, just to make sure I haven't gained weight. And so that's one type, right? And then we have bulemia, which is probably the second, most understandable that maybe listeners have heard about, which is really where a person's combining things like eating large amounts of food, um, in a short period of time.
And that's called bingeing. So eating a lot in a short time, um, and feeling out of control when you do that and then trying to do something after to compensate. So that could be exercising that could be purging, which is like vomiting using laxatives, using diuretics fasting, anything to really try to compensate for the binge is bulemia nervosa.
And so like people with anorexia, they do fear gaining. And they're unhappy with their body size or shape. So that's what they have in common. And then binge eating is really take that first part of bulemia and take out the second part. So it's really where people are recurrently, binge eating. So eating a lot in a short period of time, feeling out of control while doing it, feeling distressed about that.
Thinking a lot about through food throughout the day. But again, the bulemia follows with exercise or fasting or purging, whereas binge eating doesn't include that compensatory part. Okay. Well, thanks for making that clear and I guess a follow up question, which is related to, so you've probably answered some of it, but what are the signs and symptoms of each?
And I'd imagine I was curious about this in preparing for this interview. I'd imagine that it's possible to have an eating disorder without maybe realizing it, is that true? Absolutely. So one of the challenges with eating disorders, and this is true from, I think mental health concerns broadly is I in a particular way here, one of the symptoms actually of anorexia.
Not having good insight into the severity of the problem. So a person can say, you know, I just skip meals because I'm intermittently fasting. I think about things like, uh, fasting during certain seasons of the years, for people of faith, for instance, and people can kind of rationalize that, or it's popular.
I have today certain diets and people say, oh, I'm just doing this diet. Or I'm doing that diet. I'm restricting that type of food. And it's really easily to enable people in that. And it's also really easy to rationalize it in a culture that is really obsessed with size, shape, and weight where we, we don't know, we have an, maybe a challenge in this area, but when we zoom out and talk about our relationship with food, we may see distortions in that.
So usually when I meet with somebody, instead of saying you have an eating disorder, do you think you have an eating disorder? I'll just ask them, what's your relationship with food? Like, um, You know, what emotions do you have around food? And that's much more helpful cause it's both about the food and it's not about the food when we get down to it.
Yeah. And you said it's about their relationship with food and then not the relationship with food. It sounds to me like it's part yeah. Part that, the relationship with it. And then part of it is the relationship with themselves. That's exactly right. Yeah. When I've worked in, especially in a hospital setting for eating disorders, one of the goals that we set for people is how do you disconnect your sense of self, um, and your sense of value from this idea that I have to be a particular size, a particular shape, a particular weight, and then I'll be sufficient.
Then I'll have value, then I'll have worth in the eyes of others and in the eyes of myself. And so you're right. It's very much. About the food and then about my relationship with myself and other people and how that ultimately gets projected on food at some point. So interesting. Anything else you wanted to add about the signs and symptoms?
No, I think, I think that pretty much covers it. Great. And another question I had was, um, how big is this problem? Cause I think some people are aware of it, others. Aren't so curious. How big is it? Yeah. So when we're talking about worldwide, um, eating disorders affect at least 9% of population. So in the us, about 28.8 million Americans have an eating disorder over the course of their lifetime, you know, less than yeah.
A big number, right. A lot of people. And, and I think. Again, we will talk at probably in a little bit about the myths, but there's so much misunderstanding about eating disorders. And so again, we often think everybody with an eating disorder is underweight and only 6% of people with eating disorders are underweight.
Um, wow. So 94% don't fit into that category of people who struggle with exactly. So, so the ways in which we would typically identify a person with an eating disorder, well, let me look at you, let me look at your size, shape, and weight and let that guide whether I think you have one and even for people themselves, they think, oh, no, I'm not maybe a Macy eight.
And in the way that I've seen on a documentary will I don't have an eating disorder. And here's, what's so challenging about eating disorders is that they are among the most deadly mental illnesses. Second, only to opioid overdose. Wow. And that's getting more intention attention, the opioid crisis, but this isn't necessarily, well, not, not quite in the same way.
I mean, it really has been siloed. I think where people who will work in the eating disorder world take really seriously the challenges we're facing with, with suicide. And then also the direct complications of eating disorders on people's health and, and longevity of their lives. And so, but once you get outside of that context, I, I think a lot of people don't understand eating disorders and, um, don't think often about it being one of the most deadly mental illnesses today.
Well, w uh, in what ways is it lethal? Is it because it leads to suicide or there are other complications as well? So, so a primary way is, is certainly suicide. So about 26% of people with eating disorders attempt suicide. You know, that's at least once in every one in every five, but the other ways, and again, this is the things we don't probably fully appreciate until we start talking about it is, I mean, think about what happens when our body is not being regularly nourished.
Literally by food, but also by a water intake, many people with eating disorders will restrict water. They will also use things like laxatives diuretics that dehydrate the body. And over time, if, if a person is vomiting, for instance, four to five times a day, um, taking in let's say 400, 500 calories a day and purging all of that, taking diuretics, taking laxatives, not drinking water, um, that has such a cumulative effect on the body.
The body can't function. So we see things like failure in the kidneys, uh, you know, bone density, losses that become really making it difficult to be mobile for people. And simply if a person's restricting enough of food intake, their heart can simply stop eating. And so that's probably where. More intensive settings, come in for people where they're in a hospital and they're put on a feeding tube, but those kinds of things to literally keep them alive because that's how challenging it is for that person to get the nourishment that they need.
So sad. Yeah. My goodness. You mentioned myths. I'd like to talk about that. What are some of the most common myths that you've seen as, as a psychologist when it comes to this problem? You know, I think one of the biggest ones, and I remember I was at a dinner party and it's always awkward as a psychologist to tell people what you do and where you work.
And I said to somebody, oh, they said, what do you do for work? I'm a psychologist. Oh, well, where do you work? I said, I work at a hospital for people with eating disorders. And they said, oh gosh, these young people today, they just can't, you know, make the right choice, just eat the food. And then that tells me two myths right there.
One is, it's all about food, you know, it's that simple. And the other myth is it's about choice. And if you talk to anybody with any mental illness, whether it's depression, anxiety, bipolar, schizophrenia, eating disorders, we know that it's not merely about choice. And so to say, it's just a choice. You just have to eat the food.
Um, doesn't doesn't work because we're talking about mental illness here. And so it's not all about the food either. A lot of times it's about our relationship with ourself. Sometimes it's our relationship with our bodies, our relationships. You know what it means to be in a certain body size and the messaging we've received culturally or in our families about that.
Um, I've mentioned another one, you know, BMI, uh, there's a real obsession in our country about BMI and that BMI tells us if we're healthy. And so what we know though is that BMI is actually not a good predictor of overall wellness. Yeah. So our body mass index, um, and so when people, you know, go and stand on the scale at the doctor's office, for instance, many times, if your BMI is in a certain range, the doctor won't even ask about eating disorders and you see that in a particular way in different ethnic groups.
So, um, historically eating disorders are a Western problem, but many people of different ethnic groups. You know, African-Americans, Asian-Americans struggled with eating disorders. And what we know is that doctors will also not ask them because they assume it's a kind of a Caucasian issue. Um, and so a lot of people get undiagnosed, have different ethnic groups.
And then the last myth, I think that really irks me and it's, it's similar to the first, but you know, this is just people who want attention and that is perhaps the boost simplifying and reductive. Then you could say, yeah, the people that I meet with with eating disorders would love to not have an eating disorder.
In many cases, they would do anything including, and their life right out of desperation. I don't want to have this anymore. And so to imply that this is purely about attention seeking is so unhelpful and it only reinforces shame about the challenges that people are facing. Yeah. Wow. You made me think of any addiction really, but I've walked with people who've really struggled with pornography with less in general, and they have these unwanted behaviors.
Right. And I've heard a lot of people speak about this as if it's merely a choice. Like you said, where it's like, oh yeah, you just, just don't choose that. And it's like, oh, it'd be nice if it was that simple. But it's, that's just not the way that our brains work when we're in that situation. And it's sad that a lot of people don't understand it.
I've heard a lot of like very popular people like authors and speakers speak like this. And it it's sad to me because I think it, again, it's such an over simplification of a complex problem and the same thing applies in this case to that's right. It really doesn't give people the benefit of the doubt that they are actually actively working towards wellness.
Hmm. You know, that's certainly not always the case, as you know, with anybody, with anything compulsive going on, some people don't really want to change yet, but a lot of people do. Yeah. And they're really trying to do the best they can with what they have. And we don't do each other any favors when we minimize the severity and seriousness of what the other person's going through, because it's really about me.
Right. If I haven't figured out in my mind, it makes me feel better that it doesn't help people with eating disorders. Yeah, no, a hundred percent. It's no, it's a, it's a sad thing to simplify it like that. And you're right. I think there are people out there who don't care, right. That they're not trying to improve.
And I think that's probably what these people who are talking about this who may be shut up kind of dark light on it. If that's possible to shed a dark line on something, you know what I mean? So it's, yeah, it is sad. I, yeah. I think what I've seen is like a lot of this behavior and these compulsion's are truly unwanted.
And I think all of us can relate to that. Even if we haven't struggled in those ways, we can relate by saying that certainly there's different parts of ourselves that we don't like. Right. There's certainly there's things we do or things we say that we wish we didn't say or think or do. Right. And so I think in that way we can relate because I haven't met like a perfect person yet.
I don't know about you, but, so I think we all can relate at least on that level. There's like these dark sides to us that are certainly a part of our character that we can't just ignore, that we have to face. Admit that that's me. That's me like the good and the bad both. That's right. That's right. Yeah. I think thinking about it as different parts of us can be helpful to a degree.
And, you know, also recognizing, I know, I think last time I was on here, we talked about the function of behavior and being able to honor that everything we do has a function. There's a reason we do it. Um, we're not insane. You know, we have reasons for the things we do, even if they don't make much sense to us on day one.
Yeah. And it's much more helpful to like understand those reasons and even try to go to the root and heal the trauma or whatever is at the root than it is to purely give people tactics to manage it necessarily. Those, those that can be helpful in some scenarios. But I think it just doesn't go far enough.
Um, or to challenge people to become like masters in a way. Uh, I think there's much more that can be done by just truly understanding, uh, the root and then hopefully healing that as well. I want you to, if you would take us into the mind of someone who is struggling with this disorder, what are they thinking?
What are they feeling? I'm sure this varies from person to person, but kind of the typical person, maybe struggling with this what's going on inside them. Yeah. So there is a lot of emotion around nourishment. Um, maybe I'll start there. That's probably the easiest foundation to lay. So imagine you sit down, you know, for dinner, um, with a friend and first thing, when you sit down, you start to feel that anxiety rise in some cases, pure panic.
And what is the panic about? Well, the, the food may be represents, you know, a sign that I'm about to blow up, expand, take up too much space, too much in this relationship. And so I look at that food and I I'm having anxiety and panic and I don't want it, but I have to eat it because I'm with somebody and what's going to happen if I eat.
Hmm, and what's going to happen if I don't and what's, what is the other person going to notice? What are they gonna think of me? And all of that is happening internally. As you sit across the table from your friend talking about your day and the level of intensity of the, the anxiety. I think for many people is what really sticks out.
And, and that's why people avoid food, right? Like we avoid a lot of things that cause anxiety and stress as if I can avoid it long enough, maybe the anxiety will subside. But ultimately of course, when we avoid things, the anxiety increases over time and it reinforces that I have something to be afraid of that food is the threat.
Um, and then after eating, let's say you, you eat your meal or you eat half of your sandwich and then it's the shame and the. Oh, my gosh, I did something bad. I did something wrong. Might my eating disorder tells me never to nourish not to do that. That's bad. So now I've done that bad thing. I've eaten the food and now I feel disgusting and I feel like I'm bad.
And I feel like I'm not worthy of the food and I'm an imposter because I gave it to myself anyway. And that's where you get into to get rid of the disgust, right? People go to other behaviors to kind of purge the body, get rid of those feelings is the hope. And so that's where compensatory activities come in is to kind of release the negative emotion that comes up after nourishing.
Wow. Okay. That's so much going on inside the mind and said the heart of someone struggling with that switch people from the outside, looking. I don't know. And might even judge without knowing that, wow, I was, uh, I'm reading Dr. Meg Meeker's book, strong fathers, strong daughters. And, uh, in that she talks a little bit about eating disorders and she looked at it through the lens of like a middle school girl who, you know, wants to be admired by her peers once boys to be attracted to her once, uh, you know, look at on the sports field, like all this stuff.
And so in that example, I remember her saying. There were rewards that the girls were experiencing and she she's a pediatrician as if you don't know everyone listening. Um, so she works with like these young girls all the time, and she said, these girls experienced yeah. A reward of like, oh, I'm losing weight.
I'm looking thinner. And boys are attracted to me. People are, I'm getting attention and that light. And so I guess that that's kind of a common struggle too, that you're almost reinforcing that behavior. Absolutely. And that's the societal piece that I think we can dive into a little bit more, but just this the way in which we reinforce as a culture, uh, these ideas that young people, especially they get the message that they're.
If they look a certain way and it's reinforcing and it gets right at the core of the eating disorder, um, and perpetuates that in really powerful ways. And the other way we see that if you, if you want to get into the mind of somebody is comparison, the constant, this is where body checking comes in and looking in the mirror, you know, over and over again, and comparing to friends and comparing to people you see on social media, all of that comes in here and has a really powerful influence on, on a person on a daily basis.
And as you can imagine, takes them right out of the present moment, you know, how do you stay present to yourself and other people when you're being consumed with that level of stress, it's a lot to juggle. It's a lot to handle a related question at the root of all this. What are some of the common factors that contribute to the struggle?
Um, yes. So one of the things that people don't fully appreciate with eating disorders is. Many people have genetic predispositions to them. Um, and so that's both in the, in the context of maybe how people process certain neurotransmitters in the brain, but it also has to do with family history of eating disorders, anxiety related disorders, and the way in which our genes impact our personality traits.
So things like perfectionism, for instance, in the case of anorexia for being risk averse. So people who are hesitant to take risks, uh, we see that as a common personality trait that goes along with anorexia in the case of bulemia things and binge eating sensation, seeking. So people who are looking for a rush much in the same way as you see with substance use, how that can be something that predisposes a person to an eating disorder and things like neuroticism.
So high anxiety, about a lot of different facets of life. All of those personality traits can come in and again, predispose a person to an eating disorder. And then we get into experiencial, um, aspects of eating disorders. And certainly a lot of the people that I've worked with have experiences of trauma, um, and neglect.
And I think a lot of times we think only of trauma and we don't often think of neglect. Uh, we think, oh, trauma. Yeah, that's bad, but neglect. Uh, we all have, we all get neglected a little bit and I gotta be honest. I mean, there is just no difference in severity of the impact of traumatic experiences and experiences of neglect on people.
And so those are certainly factors that can come in with eating disorders and peer rejection is another big one. I remember one client who shared with me, you know, I got told over and over again that I was fat. And so I stopped eating and then I stopped getting told I was. And that's where it started societal norms.
Fatphobia this idea that people in larger sized bodies are somehow less responsible, less disciplined, disgusting people to be avoided unattractive. All of that messaging has a really powerful impact on a person growing up in our world. And if we look at people and I use that language intentionally in larger sized bodies, as opposed to saying you're fat, because number one, the standards we have for what it means to be fat today are very unrealistic.
And also it's such a derogatory term to talk about people who, for any number of reasons are in larger sized bodies than other people. Um, and then social media portrayals of course, show us a lot of unrealistic standards specifically for women, but not exclusively for women. And that really. If you look at Western countries and countries that become more westernized, we see increases in rates of eating disorders.
That's really fascinating when you think about it, that even, I remember traveling to Ukraine in 2016 and gave a talk on eating disorders. And they said we didn't see eating disorders in our treatment facilities until we became more rest westernized and had more social media access. So the power of that on young people in a particular way is really, I think, hard to fully appreciate.
Yeah. That's not trivial. My goodness, man. There's so much there and I'm sure we can continue this conversation forever. I remember hearing, yeah, just like, you know, friends growing up saying like, oh, I'm so fat or something. And I remember, but with a snarky boy in me has a teenager at least to be like, well, if you're a fat than other people, like, you know, not like they're really struggling.
Cause yeah. I think there's this like an expectation. Yeah. We have of being like on a magazine cover and it's just so ridiculous. It's like, you don't need to have like a 2% body fat to be healthy. And so it is sad how we put so much pressure on people. And I think women in particular, I'm sure men struggle with this too, but women in particular, I think are just the recipients of this assault on femininity and a lot of ways, but just on the body in general.
That's right. And I think maybe that's another myth I didn't touch on is a lot of you asked, do people often not know they have an eating disorder and I've worked with several men. I can think of who came to see me and said, you know, I'm just tired a lot because I'm not getting enough food and. They had an eating disorder and, um, you know, all these fad diets and intermittent fasting and the Daniel's fast, I think it's called and all of these different options for people.
Yeah. Make credible, restricting our food intake and tell us that if I don't eat for a long period of time, I'm more disciplined and more virtuous in some cases. And that on men and women both, um, really just has a really detrimental effect on them. And I think a lot of times we think, oh, this is a female problem with eating disorders, but certainly, um, we see that with medicine.
Thanks for saying that. Yeah. Is it, is it more prominent in one of the other, I was across the board. Is it like a 50 50 split? I'm just curious because, thanks for saying, yeah, it's a great question. We honestly probably have under representative prevalence estimates. So because men don't often come to treatment.
Um, so even working in an eating disorder facility, I think I worked, I can count on two hands, the men that I worked with. And I think a lot of that is because it's normalized to go and work out seven days a week as a man. Even if you work out for two hours every day, everybody's cheering you on for that.
And it's a little bit different for women. Uh, in that regard, you can identify compulsive exercise a little bit more easily in women than in men. And, um, certainly all of the research we have on eating disorders is more focused on the experience of women. So it's pretty challenging for men to see themselves in the experience and to come forward and say, Hey.
I not only do I need mental health treatment, which is already difficult for men, but I have an eating disorder, which feels like a, a female problem. And that can be a challenge for them in getting help. They need. Yeah, it's kind of similar to lust. I think a lot of women think less as a man problem, a male problem, but that is just so false and it's starting to be proven to be false, like on a large scale, which I think is good so that people can get the help that they need.
So now thanks for clarifying that that's, that's really helpful. Um, I, I was curious, you mentioned genetics and being able to. Identified these predispositions. Right. And we've heard of predispositions to alcohol. I think a lot of people know about that, but I didn't know. You could tell things like perfectionism and I kind of fall into that category.
I'd be curious. Like, is there a way, are there tests out there? To tell like, oh, I have a predisposition to this or that. Yeah. So what I came across this more when I worked in, um, inpatient eating disorder work, but they, uh, they do I'm blanking right now on the name of the measure, but it's, it's a pretty substantial tests that looks at, um, traits that have been mapped on for people with eating disorders.
And you can see the constellation of personality traits that you have and how they might factor in to the types of behaviors. Cognitive rigidity is another one. Um, and how that can map on in pretty understandable ways. When you think about it, if I'm rigid about different aspects of life and my experience, and I may also be rigid about food and calories and, oh my gosh, no, I can only have 1400 calories and that's it.
And if I have more than that, Bad things are gonna happen and you can kind of see that rigidity play out, but it's, yeah, it's pretty fascinating when you start to realize that, you know, certainly without certain experiences that kind of put you on a trajectory, it's not to say everybody who's perfectionistic has these types of things, but to know that it does complicate our process of certain behaviors and how we manage them over time.
Okay. That makes sense. And when we, when we say tests, is this a written test? It's is it a blood draw for everyone? So it's, um, a written test. So it's kind of, you know, you pick maybe statements, how true are these statements for me or, um, those kinds of things. So more of like an academic test than a blood draw or something like that.
Cool. Okay. Good to know. Yeah. I was curious though, for people, anyone listening right now who is maybe struggling with this, or maybe they're realizing that they struggle with us listening to us right now. What resources exist to help someone like that? Who's really stuck in this fight. Yeah. So there are a couple of facets to treating an eating disorder.
Um, I think a lot of times we can obviously think of therapy first and therapy is. Wonderful and helpful and important for people with eating disorders. I will say with therapy, I would recommend you work with somebody who knows about eating disorders. Um, a lot of therapists, sadly, don't get very excellent training on eating disorders.
And so they may be just as uneducated as the average lay person. And so you really, when you're stepping into that work, especially if you're really, really struggling with an eating disorder, you don't really have time to educate your therapist. Um, and so really being able to, you know, look for providers and I can talk about organizations that help you narrow that process down in a second.
But looking for providers who know their stuff about eating disorders is really critical. Um, there's really two other pieces though, that are important with eating disorder work. And one is dietary support. And in the same way, as with a therapist, you want somebody who knows eating disorders, you would want a dietician who knows eating disorders.
So there are nutritionists out there and dieticians who can actually. Cause eating disorders in people. Wow. Um, by teaching people to restrict their food intake, for instance, to get to a certain size, shape, and weight. And so being careful about who you go and see, but I do think the dietary aspect, especially early on is really critical because you want to know, like, what does my body need to function?
And a helpful dietician can map that out, help with meal planning, help with, you know, challenging thoughts that come up around meal time and just help think through and problem solve those things, help modulate exercise and make sure movement is in a healthy way. All of those things are really critical and then psychiatry as another one I mentioned, right?
How there's these genetic predispositions and a lot of times there's anxiety, depression, other things going on. So having a psychiatrist who can help with medication management can also be really helpful. Of course, there's other neat things out there, like art therapy, movement therapy that can help people get connected to their body or externalize emotions in helpful ways.
But ultimately there's a couple of support networks that might be good for people to know. So one is the eating disorder foundation, um, called EDF for short, and they have free groups, both virtually, and sometimes in person that people can go to and meet other people who have eating disorders and get support of all kinds and it's free, which is wonderful.
Um, and then Nita and EDA, the national eating disorder association has a ton of resourcing online. Um, and they can also direct you, both of those organizations. And Nita can help you find a therapist who knows eating disorders as well. And then finally, I'll say that I mentioned hospitalization before, and you know, when a person is really trying their best to nourish and to do the things they need to do on a daily basis, and they just can't make those shifts on their own, which is true for some people and nothing to be ashamed of.
There are hospitals in place that can help you with that and can give more structure and accountability and support around meal times, especially that can help people with reducing behaviors. Yeah. And the man there's so much shame around doing something like that, which is so sad. It's like, you know, we'd never shamed someone who struggling with cancer, go to the hospital and get treatment for their cancer.
But for some reason, in our culture, at least. It's almost unthinkable to go put yourself in a hospital. And my goodness, like you really messed up. Like, that's a sad that we think of it that way that someone has this desire to overcome this struggle or to, to feel whole again, and to be in a healthy place in their life that they're just so afraid and so taboo to pursue that.
Exactly. Yeah. It's a big sacrifice people make when they take those steps in a society that still has so much stigma around mental illness. And what does it mean about you as a person that you're taking that time away to in some cases sustain your life. And I often say to parents, especially who feel mixed feelings about a young person or a young adult going and taking time off work for months at a time to go to a hospital.
And I say like, do you want your child alive? I mean, 'cause the longer you wait, the worse, this gets. And we've seen that in so many ways with mental health concerns, untreated mental health concerns get worse. They don't get better. Yeah, man, and I have so much admiration for people who take those steps, who actually go to a hospital who go to, you know, whatever program is right for them.
And they take time off work to the point where, you know, maybe a lot of people end up finding out about what they're doing, which is so hard. Um, but, but there's so much admiration there because it takes such courage to just listen to that voice inside of you that says, okay, you know, you deserve to be healthy.
You deserve to be whole, and it's okay for you to take steps that maybe other people will judge you for, but it's going to be so much better for you and for the people that you love in the long run. Like what, what a heroic action in my opinion. Yeah. A lot of people focus on what will I lose? What will I miss out on if I take this step and recovery and wellness, and I often ask my clients, what do you, what do you gain and what do you lose by not right.
And we can kind of look back and see the ways eating disorders, Rob us of life and freedom and joy and peace and confidence in our true selves, as opposed to what we look like or what we think we look like on a daily basis, giving people the opportunity to really look back and say, wow, this has taken a lot for me.
And I have the opportunity to take my life back. So again, and I think that's amazing too, for people who maybe have a hard time taking care of themselves or investing in themselves, if you overcome this or at least in a manageable place with this, and, you know, you feel so much better, you feel healthier, feel more.
Not only is it just for you, but the people around you too, you're going to inspire maybe other people who are struggling with this, or even people are struggling with something completely different. You can empathize with them and help them maybe through something that's so difficult. And it's so relatable to talk with someone who's been through pain, who's struggled, who's, you know, taking these big steps to try to be healthier and whole.
And so I think, um, maybe you stop thinking about yourself so much in a way. I know that might sound odd because it is about you and that's okay for it to be about you, but maybe think of the other people in your life who will benefit from what you benefit from that's right. Yeah. It becomes a real gift and resource.
And I don't know that all of my clients, when they come to see me on day one, think of themselves that way is kind of a model, um, a source of wisdom, but I gotta be honest, you know, the people I work with this is true in general, but I certainly see it with eating disorders are some of the people that I admire most.
The courage. It takes to be honest with yourself about where you are and to seek support and be vulnerable and to be authentic, we, we don't have much of that in our society today. And we benefit from more people coming forward and talking about what they're really going through and to your point, being able to be a resource to others as well.
Yeah. What would the world look like if we all did? Ah, Hmm. That'd be a beautiful place. What would be different than it is right now? Yeah. I can hear some people listening right now thinking, okay. What's the line between, you know, wanting to work out a lot, maybe loving food or hating food, just not having a natural, like draw towards food.
Is there a clear line between an eating disorder and someone who just. Maybe they're just really into, um, intermittent fasting. How do you decipher those two? It sounds like it might be difficult. Yeah, it is difficult. I definitely wouldn't recommend people listen to this in self-diagnosis. I mean, I, I think this is part of the role of mental health providers and the key with eating disorders is, you know, we're not going to be as the best gauge of our own illness.
And so you do need people who you can share openly. Here's what happens for me when I see a plate of food or maybe that doesn't happen. But gosh, if I don't exercise on a day that I plan to. I shamed myself and then I skip a meal or I cut corners in my snack because I don't deserve it. And, and it's, it's not a clear line because we do have a society that's has a really unhealthy relationship with our bodies.
And so there's a lot of normalization of eating disorder, talk and conversation in our culture and not everybody meets criteria for an eating disorder. Um, so I'm of the mind that I would love for there not to be anybody who meets criteria over time. And, and yet, if you have a complicated relationship with food or you do feel a lot of shame when you don't exercise, you're skipping meals, you're feeling like you have to earn your next meal.
That to me is something that's worth talking about with somebody and. Doesn't meet full criteria. Well, at least you can work on it before it does. And if it does meet full criteria, then all the more reason to get in and to really get some support. Um, but again, I think as a society, we don't have a very healthy relationship with our bodies and food.
And so that does make the line a little bit blurry between those different pieces. Yeah. And just the inherent complexity of it too. It's like, there's so many layers to this. And so that, that makes sense, but that's really helpful. Thanks for clarifying that. So for someone who wants help, who needs help or know someone who could use help like this, you mentioned the groups, uh, what someone can, what what's something that someone can do maybe today, aside from go into one of those groups or booking a therapy session, what's something that they can do, like right now, as you're listening to this, or once they put down their earphones, you know, honestly, I think the biggest next step for somebody is telling somebody you trust that you resonated with what you heard.
So, Hey, I was listening, listening to this podcast and they were talking about eating disorders and there was a lot I could relate to. I don't know if I have one or maybe I do know that I have one and I just wanted to start with telling somebody, you know, can you hold me accountable and taking the next step, even if I'm not sure what that is yet, but maybe that is going back to my therapist who I'm seeing and bringing it up, or maybe it's reaching out to a therapist or getting on ETF's website and looking for a group.
But yeah, I think that next step is tell somebody who is safe for you about what you resonate with and opening that door to vulnerability can be really relieving and really freeing. Um, and it's a really concrete step that you can take today. I love it. I've been in that situation where I've had to reveal things to people that, you know, things in my past, for example, or I've been in the receiving end of it.
And I think beforehand you're like, this is going to go horribly and I can't promise you that I will go great. I don't know. Kind of depends on who you tell, but I'm careful choose wisely. And I always say with that, like it's wise to pick someone who, you know, who's suffered a bit. Um, I find that those types of people are more empathetic, typically.
Not always, but you know, they're, they're able to kind of receive that. They have the capacity for it. Cause some people who, and this is not to put people like this down at all, but people who maybe really haven't struggled much in life or haven't suffered much in life, which I'm really happy for them in one way.
But, but on the other hand, it's like, they might not be the best person to confide in about something like this, but anything you would add to that? No, I think that's right. I mean, You know, that's why I say, you know, if you're going to share it with somebody lofted off easy, not, you know, Hey, I'm I have an eating disorder, but Hey, I heard this podcast, would you listen to it?
And it resonated with me. And, and then if it's somebody that, you know, has shown up for you in areas of vulnerability, to be as honest as you can with them, and you may be surprised. I mean, a lot of people struggle in this area more than we would realize. And so being courageous in that, and you mentioned it's, it's scary to do it.
And it's also scary, not too many people listening, know what it's like to carry a secret alone for a long time. And it's a pretty dark and scary place there too. So it's good to remember that. Yes, it's, it's scary to take that step in vulnerability. And on the other side of that can be a lot of. Amen. Yeah.
A lot of freedom. Uh that's great advice. Thank you for everything that you've shared. I want to shift gears before we end to people listening right now, who maybe they have a friend who's come to them and told them exactly what you just said, or, or they can recognize that they're struggling in one way or another and they want to help.
They want to help. What should someone not say? I want to start there, which is someone not say or not do to help someone who's struggling with an eating disorder. Yes. So the biggest thing is do not make body comments positive or negative. And this is unpopular because a lot of people say, well, gosh, aren't you just kind of being dramatic.
And we ought to think about what that signals to somebody. Like it tells somebody pretty clearly that your value and worth hinges on what you look like. And are we prepared to say that about. And you can compliment somebody smile or compliment how radiant their eyes look or cute. Gosh, like you always dress so well, that's different than saying, wow, have you lost weight or, well, have you gained weight or while your cheeks look really big, it's like not, okay.
So body comments avoid potty comments, positive or negative because a lot of times what you do when you give a positive comment, a person with an eating disorder says, oh, I shouldn't eat less. That felt good. I imagine how it would feel. If I lost five more pounds, maybe more people would notice. And if you make a negative body comment, it reinforces there's something wrong with me and I've got to change it.
And I've got to manipulate caloric intake to do that. Don't police people with eating disorders and their eating habits. Okay. So if a person struggling with binge eating disorder, don't tell them, oh, you need to eat healthy. Hmm, don't criticize good food, bad food, healthy food, unhealthy food. A lot of times I hear this now and I'm sensitive to it, certainly, but people, oh, well, you know, I eat a big breakfast, so I'm going to have to skip lunch or yeah.
Thanksgivings tonight. So let's not eat anything before we got to earn it. I mean, those kinds of comments, reinforced, disordered, eating, finding things to talk about other than diets and latest fads in that you mentioned, you know, what, if somebody is fine with intermittent fasting, well, that's fine. Don't talk about it because then it becomes this kind of social commodity and it makes it out to be something different and that can have an impact on people.
I think a lot of people are pretty obsessed with this kind of health cut, conscious fitness conscious world. And I think we would do well to spend much more of our time talking about things that matter. And so don't talk about those kinds of things like food, find other. And, and let's see how our relationships improve.
Beautiful. Yeah. My, I know my friendships, my relationships always get better when I go below the surface. And I think a lot of those things you mentioned often are surface level conversations, which is sad. And, um, maybe it's more of American culture culture in the west, but I certainly know that it tends to say that our relationships tend to say that we're just so sad for so many reasons, but this being another one of them, what should someone say or do to help someone who's struggling with an eating disorder?
Yeah. So, so comment on a person's character, their qualities that you appreciate. Listen to them. Talk about the stressors of daily life, including food, like a person, being able to tell you that like Cassia I'm, I'm feeling really stressed because we're going out to dinner with colleagues at work this evening.
And I feel a lot of shame when I eat in front of. And being able to receive that. Thank you for telling me that. Wow. It means a lot that you would trust me with that. I admire your courage and being able to say that out loud, I'm encouraging people to feel their emotion. Meaning if a person's crying, if a friend is opening up and they're crying and they start to apologize, I'm sorry.
I can't believe I'm doing this. Ugh, I'm too emotional to be able to stop them and say, Hey, I'm grateful that you trust me with your tears because a lot of people with eating disorders and people, without them, we struggled to be able to get our feelings out. And so to be able to receive them is really helpful for people with eating disorders and people without them, and find ways to connect outside of exercise and food, sitting on the ground at a park and a picnic.
Instead of, if a person has an eating disorder, always walking with them or always making it about food while also letting a person know if it would ever help to have somebody to eat a meal with, or to call me while you're eating, just to have company I'm here for that honor their ability to have boundaries.
So if a person says, Hey, please, don't talk about that diet in front of me, respecting that, you know, and, and finally I'll say focus on food as nourishment and energy, rather than something that we can earn. So talking about food, that cash. Yeah. My brain is really foggy and tired. I need to eat some food as opposed to, Ugh, I, should I eat this cookie or not because I didn't run yet today.
I mean, that, that doesn't help. And so really changing our own relationship with food and nourishment and talking about it that way, as opposed to it being something that's tied to our. I want to stay there for a second. If you want to elaborate a little bit on that, like, what does it look like to have a healthy relationship with food?
You already mentioned a few things throughout this whole interview, but especially right there, but just give you an opportunity to add anything to that. Yeah. So there's an interesting philosophy right now called intuitive eating. And the idea is that our bodies are made to tell us the truth. So when I wake up in the morning, if I don't eat, my body will send me a cue.
My stomach will grow. Yeah, I'll get a headache. Those are hunger cues. And I think a healthy relationship with food involves listening to our hunger cues. And if we don't listen to our hunger cues, believe it or not, we actually stop having them. And so this is why people will say, oh my gosh, ever since I started fasting for 12 hours, I don't get hungry.
For 12 hours while your body has listened and it's gotten the message that you're not giving it what it needs. So it stops working and the way that plays out as it also then impacts fullness cues, which come next. And so that's where binge eating comes in and it's a person being able to listen to their fullness cues and to stop eating because wow, I feel Sasha.
I feel satisfied and then intuitive eating also involves like maybe, you know, on a random Tuesday night, when a person comes home from a dinner, they're craving something sweet and they can enjoy a cookie and not have guilt about that. Pap a bowl of ice cream and enjoy that. And that's the intuitive piece.
And then maybe other days I want a salad because gosh, that sounds really good to me on the menu, but it not being about good food, bad food, safe food, dangerous food, and really about what is my body one, what does it need today? Um, and being able to spontaneously respond to that and give the body what it needs on a regular basis.
Awesome. Great advice. Thank you. And fullness cues, just to tie this up, what would those look like? I think we all know what hunger cues are. Like, we've all felt those, but I don't know if people are as aware of like what fullness cues look like. Yeah, probably not. I mean, You know, what I often tell with clients about, and, um, is mindfulness in the context of eating.
So pacing myself in such a way that I can check in with myself while I'm eating and say like, how am I feeling about this meal? Like, do I want more, do I want less? And you know, as I finish up a plate of food, checking in with myself, taking a few minutes and just seeing what that feels like, and if I want more getting up and getting more, if I think I'm going to be wanting a snack in 30 minutes, that's probably a good sign.
I should eat more now. Um, and then, you know, if I'm starting to feel bloated or kind of weighed down or kind of like, I'm just eating to put food in my mouth as opposed to mindfully, like I'm hungry, this tastes good to me. Um, that's another good gauge of like, where am I at? Am I mindfully eating? Or am I just putting food in my body?
For more of an emotional reason. Yeah. No, that can be an easy thing to do, especially if you're at a party, everyone else is eating. It's like, oh, I'm just going to do that. And now that makes so much sense. It's like sign a fullness key. I've heard that before that, like when your diaphragm, when your stomach like hit your dye from the new kind of PSI, I dunno if you've heard that and maybe I'm off go, you know what?
I, I could see that I'll say that I could see that. I do think fullness cues are a little bit harder to operationalize, but I've certainly, I can tell you as I'm working with a client and we're having a, maybe a meal in the hospital setting together, and there is a moment where it's like, I feel good. I feel satiated.
And, and that's the question I ask people is like, where, where are you at? How full do you feel? Do you feel satiated right now? And they can check in with themselves and kind of figure that out. Sounds good. I hope everyone doesn't be like, did I just say, yeah, that's right. Yeah. That's the neurotic piece of all of us.
Am I doing it right? Uh, yeah. And, and it takes practice and our bodies, but our bodies want to be satisfied. You know, they need nourishment to function. And so trusting your body's ability, if you don't have hunger and fuel fullness cues right now to get those back over time. That's great. And I think one of the most helpful things that anyone who's struggling with this can do is to find someone to help them.
Someone who's specially trained in this, like you said before, And so I wanted to give that opportunity to tell us about your work, what you do. I know you have an expertise in treating eating disorders. Um, you've done this for years. You obviously, your practice is much bigger than that, but I would love for you to tell us about what you offer your, any books, how you do speaking.
Tell us about all of that. Yeah. So it's funny, a lot of my work and writing and speaking doesn't have a lot to do with eating disorders. So my specialty. Well, in addition to eating disorders is sexuality and gender. So if people were to look me up, a lot of my work is in those areas. So that can be sexual identity, same-sex sexuality.
Um, so LGBT experiences and gender identity, transgender experiences. So, um, that's a lot of the writing and speaking that I do, but yes, you're right. I have a specialty in eating disorders and I work with a lot of survivors of trauma who also have eating disorders. And so I have a counseling practice, uh, here in Littleton, Colorado, and it's called Lux counseling and consulting.
And I offer individual and family therapy, um, for people with a lot of different things, but including eating disorders. Um, and then I work with dieticians and psychiatrists in the area. So if people are looking for support with dietician or psychiatrist, certainly I can give referrals for those. This is a time where everybody seems to be benefiting from mental health support and a lot of people are reaching out.
And so, um, I'm not the only one out there. So if somebody was to reach out to me and I say, I have a wait list or that kind of thing, I'd be happy to connect people to other resources. But yeah, that's a little bit about what I do. Cool. Well, thank you. And is there one best way to reach out to you? Like how can people follow you and get in touch with you if they'd like to?
Yeah. So I have a website which is kind of easy, except I have a very difficult, last name to spell. So, um, it's my first and last name www.juliasadusky.com. And that's probably the best way to, to follow some of the work. I do, the writing and the speaking engagements I have, um, I have a Facebook page for, uh, Julia Sadusky Sidey that people can follow on there.
Um, so they're probably the easiest ways. Yeah. And we'll put on the, of that in the show notes. So you guys, so. Track that down. I did want to clarify one thing, you mentioned the, uh, you know, treating gender struggles. Um, you do it from a very unique perspective. I know some people listening might not understand that.
I know you personally, so I know that, but, um, yeah. What's your perspective on that? I know you work a lot with people of faith who are struggling in that area. Would you clarify that? Yeah, so, um, yeah, my specialty is really at the intersection of exploring sexual identity, exploring gender identity and, um, experiences of people, of faith.
So for a person of faith, how do I reconcile deeply held beliefs and values with experiences, challenges I have related to my experience with gender identity or sexual identity. And so I don't exclusively work with people of faith, but, um, it's kind of a niche area to work with people at that intersection.
So a lot of my writing is, is in that vein. Yeah, no, I think there's a lot of people listening right now. And a lot of people out there who would benefit from this because. You're counter-cultural, you're, you're not, you're helping people on a unique ways, which I think is like so helpful and you're not doing it in a way that a lot of people in the world are doing it.
So I just wanted to give you that plug for that. So thank you for the work that you're doing and, uh, for helping, you know, all those people who need the help. Absolutely. Yeah. If you're interested in reading more, there's, um, a couple of recent resources out there, one emerging gender identities, which probably would be the most accessible to a person listening about just what do we make of where we are at in society and how we approach and think about gender identity and what are the ways.
Specifically people of faith can better respond than we have in the past two people navigating that space. Awesome. And you wrote that. Awesome. And that can get that on Amazon and that's right on Amazon. Yep. And it coauthored it with mark Yarhouse and it's called emerging gender identities, understanding the diverse experiences of today's youth.
Amazing. Well, thank you for all these resources. Thanks for all you do. You're a hard worker. Uh, man, your life has been so busy. I'm so surprised that you're able to do everything that you do. It seems like you're like, oh, I'm writing this book and that fuck. And you have a full client load and it's just amazing.
So I admire you, uh, Dr. Julia, um, what encouragement, just in closing, I don't want to give you the last word. What encouragement would you give to anyone who's struggling with an eating disorder? I really would want somebody listening with an eating disorder to know that you do not have to be bound by the reality that you live right.
A lot of people feel in the midst of an eating disorder. Like there's no way out they're trapped and something that offered you a life of acceptance and value and worth becomes something that you are indebted to and enslave to. And just for somebody listening to know that you don't have to be a slave to it forever, and there is treatment out there and it can help even in the spaces, in places of our lives that feel really hopeless.
Um, and so don't give into despair and trust your ability more importantly than anybody. Else's your ability to work through the things that you, that you're navigating and you don't have to do that alone. So if you struggle with an eating disorder, what's one thing that you can do this week to begin healing, some idea that you maybe heard in this episode, what can you do this week to take action on that?
And if you know someone who struggles with an eating disorder, what's one thing that you can do this week that maybe you heard in this episode to offer support and help them heal. And if you want to find a counselor, we went to help her building a network of counselors that we trust and recommend. And the benefits to using our network are we're going to save you a lot of time and effort in searching for a counselor.
We'll connect you with a trained professional who can give you the help and the tools you need to heal. So you can feel whole again. So if you want a counselor, just go to restored ministry.com/coaching. Again, restored ministry.com/coaching. Just fill out the form it's really quick. And then once we find a counselor for you, we'll connect you with them again.
That's restored ministry.com/. The resources mentioned during the show notes@restoredministry.com slash 72. Thank you so much for listening. If this has been useful for you, feel free to subscribe. And if you know someone who's struggling from their parents' divorce or broken marriage, share this podcast with them, always remember you're not alone.
We're here to help you feel whole again and become the person that you were born to be.
