“You don’t look like you would have an eating disorder.”

Crazier things have never been said.

Here’s the thing, eating disorders don’t have a look. It’s a myth that eating disorders are typically portrayed by a “skinny” individual. But the reality is far from that stereotype. Eating disorders can affect anyone, regardless of their outward appearance. They don't discriminate based on size, shape, or weight.

"When eating disorders were portrayed in the media, they said ‘If you don't look like this, you don't have an eating disorder’ and what's really ridiculous about that is that the majority of people who struggle with eating disorders actually don't look like that." - Rachelle Heinemann

"If we think about what an eating disorder looks like, there is no such thing." - Rachelle Heinemann

"The ultimate goal is for us to create some sort of harmony that if this is what you present on the outside, at the very least, you feel somewhat similar internally." - Rachelle Heinemann

"What is so incredible about the recovery journey is that it doesn't have to be the biggest disconnect between your insides and your outsides." - Rachelle Heinemann

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Parenthood can be both beautiful and stressful.

Firstly, it’s okay to admit that. There are no sick days, there is no PTO, you work 24/7 shifts and you get paid nothing. It’s sometimes a thankless job, and you’ll never get a break. But, it’s the toughest job you will ever love. 

If we really dive into the rut of parenting, it can feel incredibly overwhelming, and sometimes it’s enough to send someone into a downward spiral. However, it’s hard to prepare for something like this. Until you actually become a parent, you can’t really explain to someone what it’s like to be one.

In this epsiode, I'm sitting down with Dina Cohen, and discussing all things parenthood and eating disorders.

Dina Cohen, MS, RDN, CEDS-C is a nutrition therapist who specializes in pediatric nutrition and the treatment of eating disorders. She is the founder of EatWellSoon, a nutrition counseling practice in Lakewood, NJ dedicated to helping individuals and families develop lifelong healthy habits and a positive relationship with food. Dina's favorite thing to do is help prevent eating disorders before they ever happen, and she speaks in schools, pediatrician's offices, and mental health clinics about eating disorder prevention and awareness. Dina lives with her husband, four daughters, and lots of talking in Toms River, NJ, where she learns new things about food every day. 

"It's definitely true that kids are on a different timeline starting from when they're newborn." - Dina Cohen

"Recovery from an eating disorder is so, so hard, but you're really getting your bang for your buck because it's going to make other things in your life easier and better." - Dina Cohen

"I've found it pretty helpful is that beforehand, before the crisis happens, think about how you can be flexible in upcoming situations." - Rachelle Heinemann

"Sometimes we have these hangups of, I want my kids to be nourished well, I want them to have foods with lots of nutrients, a whole balanced meal, and sometimes, maybe, all the time, when you have lots of kids running around, it's really hard to do that." - Rachelle Heinemann

"If mama ain't happy, ain't nobody happy, and you have to make the time for yourself because otherwise it's not just you who's going to suffer, everybody's going to suffer." - Dina Cohen

Basics of Assessing & Treating Eating Disorders Webinar

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 You can find Dina at https://www.eatwellsoonrd.com/.

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Weight loss and Eating disorder treatments? Pft. Talk to the hand.

Okay, let me clarify. This used to be my point of view. I couldn’t quite understand how these two topics really played into each other. Now, I don’t necessarily disagree, but I do think this is a lot more complex, and it’s far from black and white.

We should be exploring questions around the perception that excessive weight is a health problem, the dangers of intentional weight loss, and the conversations that uncover this controversial topic.

"Weight is not synonymous with health; it's a significant factor but only one part of the bigger picture of someone's well-being." - Rachelle Heinemann

"If anybody so much as said the phrase weight loss and eating disorder treatment, or even just weight loss and health together, I'd just be like, talk to the hand." - Rachelle Heinemann

"Even if you're put in a position where it is imperative to lose weight for your health, going on a restrictive diet is not going to be the answer." - Rachelle Heinemann

"Your point on the BMI chart on that bell curve doesn't inherently determine your health, but it is one point. And this is the key, that weight is not synonymous with health, but weight is a very big factor in determining part of the bigger picture of someone's health." - Rachelle Heinemann

Basics of Assessing & Treating Eating Disorders Webinar

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Just last year, The American Academy of Pediatrics put out (terrible) guidelines, that in a nutshell, give the “go-ahead” to evaluate children for weight loss medication and/or surgery.

Weight loss surgery is completely irreversible. So why is it being recommended?

There are many challenges that individuals will face when deciding to undergo weight loss surgery. Not only the painful physical challenges but the mental and emotional ones as well. 

Dr. Marianne has been in the mental health field for 27 years and has specialized in eating disorders for the last 12 years. She was a full-time academic for 12 years and had a part-time eating disorder practice for much of that time until she left the university and went into private practice full-time in 2018. Dr. Marianne loves working with eating disorders as a therapist and a coach. She takes a non-diet, feminist approach that helps people of all genders live empowered, authentic lives. She embraces the Health at Every Size model and is LGBTQIA+ affirming.

"This idea of weight loss surgery is that it is completely irreversible. There is no going back.” - Rachelle Heinemann

"When they come out on the other end, they still have an eating disorder." - Rachelle Heinemann

"They say this whole procedure is to make people not hungry and not feel hunger basically switch off the part of their brain that regulates hunger and fullness cues. That’s so messed up" - Dr. Marianne Miller

“Everything's fine initially, but that eating disorder is never going to go away unless it's treated.”  - Dr. Marianne Miller

“Even people who are recovered from an eating disorder, need to be in therapy throughout it [bariatric surgery].” - Dr. Marianne Miller

Follow Dr. Marianne Miller on Instagram @drmariannemiller

Visit Dr. Marianne Miller’s website https://www.drmariannemiller.com/ 

Journal prompts - https://www.subscribepage.com/r9d0a7_copy I

Interview with Jessica Setnik

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Why does it feel like everyone is anti-recovery?

It’s like we live in this world where everyone is either dieting, jumping on a health trend, or counting calories. Wanting to “feel healthy” is great, but the pressure to fall into some standard of health is overwhelming.

Everyone seems to have an opinion, you've probably encountered unsolicited advice and opinions from well-meaning (or not-so-well-meaning) friends or family.

"The number one focus needs to be on you. You are number one in this journey, this is your life, this is your relationship with food, and this is ultimately your happiness." - Rachelle Heinemann

"This is not about them. This is about you. Don't engage in conversation, even if it's an attempt to stand up for yourself." - Rachelle Heinemann

"If the comment is directed toward you... do yourself a favor and don't engage." - Rachelle Heinemann

"You are not alone, and it doesn't mean that you won't get better. You can do it. And I know that it's incredibly difficult, and I know that it poses some really complicated challenges. You can do it. You absolutely can." - Rachelle Heinemann

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As a therapist, there are so many things I wish that psychiatrists knew when it comes to eating disorders.

Now before we hash this out, here’s my caveat–I am not a prescribing provider, I never went to medical school. I am a psychotherapist and these are all of my personal thoughts but from my professional experience.

When we view mental illnesses as medical illnesses, we are going to miss the nuance that is associated with emotions and psychology.

"We can't just take a brain MRI and say, ‘this person has an eating disorder’.” - Rachelle Heinemann

"But at the end of the day, if we create too many boxes and we don't leave any room for you to be curious and for you to explore beyond the boxes, then I think we've done you a disservice. And I think that ends up becoming its own limitation." - Rachelle Heinemann

“Every single person has an intricate, complex way that their, ‘mental illness’ is developed and maintained, and it is the kind of thing that we cannot possibly insert a medication in order to fix it completely.” - Rachelle Heinemann

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Everybody has emotions.

This isn’t a new concept. However, in more recent years, we’ve started to give names to everything as a way to “label” each other or give an overall meaning to how someone may feel, act, etc. (Labels are usually meant to organize things, not necessarily bad.) So somewhere along the way, we started to label certain individuals as “highly sensitive people”.

Everyone is sensitive to a certain extent, but some are more sensitive than others, hence, highly sensitive. The question is, how did it come to be that somebody might be highly sensitive and the next person is just not?  Why do we assume people are just born this way? Is it genetic? Is it because of their personality?

"Sometimes it's like all thoughts and all logic completely go out the window because you're just seeing red or feeling so, so hurt and really impulsive."- Rachelle Heinemann

"You are just sensitive and having emotions like a human does. There's nothing wrong with you." - Rachelle Heinemann

"Everybody has emotions. Everybody is sensitive to a certain extent, even if you don't want to be." - Rachelle Heinemann

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Let’s get controversial.

Can the concept of medical assistance in dying be used for individuals who are suffering from “severe” and persistent eating disorders, as it is for patients who have terminal cancer?

Now, before we go anything further, please know that I acknowledge the sensitivity of this topic and if it feels too heavy and overwhelming, please skip it.

But the question is, why is this a controversial topic? MAID is not a new construct. It has been utilized around the world with different controversies for many years as a way of ethically,  compassionately, and humanely allowing people to have a dignified way of dying.

“Even when there are hard conversations to have or complicated emotional conversations or even technically difficult conversations, these are not black or white topics. In any way that you look at this, if you look about the ethics, if you look about even the definitions of the words that we're using, none of it is black and white.” - Rachelle Heinemann

"Higher levels of care serve a very specific and limited function. They are not going to solve all of your problems." - Dr. Anita Federici

"We have to be really clear about what you're going for and what you're not going for." - Dr. Anita Federici

"Why is this controversial? I mean, medical assistance in dying is not a new construct." - Dr. Anita Federici

"You can't separate that from the history of how eating disorder treatment has evolved and what it is and what it isn't." - Dr. Anita Federici

"The limitations of the current system can leave individuals feeling hopeless, invalidated, and blamed." - Dr. Anita Federici

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Canada MAID Policy Update: https://www.canada.ca/en/health-canada/services/health-services-benefits/medical-assistance-dying.html 

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Happy New Year!

Can I be honest? I’m not a huge fan of New Year’s resolutions. I get that there’s this idea of a “new year, new me”. There’s almost like a fantasy of having a clean slate, when in reality, it’s just another day, in a new year. However, it could be a great time to reflect on the past year and embrace what was. So, here's the deal. If you're into New Year's resolutions, go ahead and set realistic, measurable, and slightly challenging goals for yourself. If you’re not, then no big deal!

"What you're doing is hurting yourself, hurting them, and it's not even getting the intended outcome." - Rachelle Heinemann

“One week cannot possibly change your weight in a significant way." - Rachelle Heinemann

"I think one of the major things that [I] hear is, ‘I don't want to eat because I don't want to gain weight.’ and I know that I say this all the time, but you can't possibly gain weight from this one thing." - Rachelle Heinemann

"I don't want to feel obsessive. I don't want to have obsessions. I don't want to be sick. I don't want to be socially isolated. I just don't want those things." - Rachelle Heinemann

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In today's episode, we delve into a crucial discussion about the evolving landscape of traditional eating disorder treatment.

What comes to mind when you hear the term “body positivity”?

First off, it’s become a mainstream concept. Body neutrality, all foods fit, and body positivity are all terms to describe a phase of coming to terms with your body. However, we have to recognize that this approach may not resonate with everyone seeking help. While we shift towards inclusivity, we also inadvertently exclude individuals who may not be ready or comfortable with these concepts.

"I think it's really amazing the field has gotten to this place where we're like, yes, you can pursue health wherever you're at. You can get healthcare and we're incorporating size inclusion.” - Rachelle Heinemann

"Body positivity is incredible. If you can look in the mirror and be really loving your body and appreciative of your body, all that is really incredible." - Rachelle Heinemann

"Maybe one of the goals of eating disorder treatment is not body positivity for a lot of people. Maybe it is body acceptance.” - Rachelle Heinemann

“All foods are not equal.” - Rachelle Heinemann

“I don't believe anything that you say, because you're telling me that I can eat cake and salad in the same way, but it's not the same thing." - Rachelle Heinemann

"The beginning will not look like incorporating all this food. The beginning is going to look like a lot more structured." - Rachelle Heinemann

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