[DR. CRISTINA CASTAGNINI] Behind The Bite podcast is part of a network of podcasts that are good for the world. Check out podcasts like the Full of Shift podcast, After the First Marriage podcast and Eating Recovery Academy over at practiceofthepractice.com/network. Welcome to Behind The Bite podcast. This podcast is about the real-life struggles women face with food, body image and weight. We're here to help you inspire and create better healthier lives. Welcome. Hello everyone. I love having a mix of guests on here, whether it be someone who is here sharing their own personal story or someone who is a professional or expert in their field. Today our guest is a seasoned professional who is sure to have you walking away from today's show with a lot of great useful information. I'm excited to get our conversation started. So I'm just going to tell you a little bit about her and then we're going to jump right into it. Dr. Jen has been specializing in working with women with eating issues for over the last 20 years. She created the FAB program to empower women to break through those barriers and to live a joyful and meaningful life. Well, Dr. Jen, welcome to the show. [DR. JENNIFER NARDOZZI] Hi, thanks so much for having me. [DR. CRISTINA] So tell us about the FAB program, how it got started, like more about it. What is it all about? [DR. JENNIFER] Aw, well, the FAB program stands for the Food And Body program. This is really, I feel like the culmination of like really two decades, it’s hard to believe, but two decades of the work that I've done. So starting off as a psychologist, I started working at an eating disorder treatment center and quickly I was like, well, I have found my place and I just found the work so challenging, so rich, so rewarding. With the treatment center, the clients were living there, they were staying there, they were staying with us weeks and months and months sometimes at a time. So that's really where I got my early training. Then I stepped out into outpatient around 2012. I started seeing people individually in my office, in Miami. What I started finding is that people really needed and sometimes it wasn't always a treatment center, but sometimes I had to refer people onto a treatment center, but what I was finding is that there were these amazing men and women, more women I was seeing in my office, but I was seeing a couple like some really great men too. They were bright. They were go-getters. They had a lot of amazing things going on, but they were struggling so much with their food, with their body, along the spectrum of an eating disorder and many times struggling so much in isolation. The FAB program really came out of seeing that people needed more, they needed more support, more guidance, a team that really understood what was going on, a community around them. This is really what FAB is about. FAB is really about providing this integrated care in the person's home environment. So the way I'm making a little hand motion here around, like, we really wrap the treatment around somebody, but in a way that really works for their lives. We just love it. We love working together as a team and working with these incredible souls. So that's my very long explanation of what FAB is about. [DR. CRISTINA] That's fantastic. So if someone's listening and hearing what you described and saying, oh, around their home environment, do you actually work with them in their home or is it something that program where they come to you and work with a tea or how does that work? [DR. JENNIFER] A great question. So right now we're doing just about everything virtual, so just the way that we're here and we work with people from all over on Zoom. I'm based in Miami and so is our nutritionist. Sometimes people choose that they want to do some in-person with me or the nutritionist and they can do that. That's an option as well, but our groups are support groups, our educational groups, all of that is on Zoom, but it's in this live forma. It's not recorded. People are interacting in real time and in live time. [DR. CRISTINA] Okay. So is it more people who have more disordered eating and body image issues versus like someone who's, I guess more of a need for more intense eating disorder treatment? Is that more of the population you're working with? [DR. JENNIFER] So what I would say is people fall along a spectrum. We have some people who will say, geez, I'm nowhere where I was at one point. Oh, I had to go to a treatment center, so hey, Dr. Jen, I'm not there anymore. I don't need to go into a center, but I still really need guidance and I still really need to understand why am I sometimes still struggling with my food or struggling with my body image? What I say is people are along the spectrum, some people we are working with are undereating so they're in more of the restrictive mode. Other people are dealing with restricting, but they're also dealing with emotional eating or binging or over exercising. So it can look a lot of different ways for different people, but really our mission is about helping people to transform the food body struggles so they can be living their joyful, fulfilling life. That's really what we're about. These food body issues really can sort of suck the life, the energy, the joy, your health, your wellbeing, your peace of mind, so it's really hard to sometimes then accomplish what you want when you're so focused on all of these things. [DR. CRISTINA] I really love that you're doing that work because I do outpatient work too. I find it's, you can speak to this too, but I find that there's so much more to it. People think, maybe who haven't struggled with any of this that, oh, it must just be about the food, it must just be about the behaviors, but there's so much more to it. I find that one of the biggest patterns I see with people is that they're not putting themselves first and there's these tendencies for, it's underlying what's beneath the food or their body image issues. It's like, they're avoiding lots of things about themselves, so like people pleasing or putting others first is one of these tendencies I see. I don't know if you could speak to that a little bit, if that's something you tend to see as well. [DR. JENNIFER] For sure. So first of all, I just love that you know it's about more than just the food. I always say it's more than just the food and you have to deal with the food. Sometimes I describe it like an iceberg. It's like all the behaviors are like the tip of the iceberg, but we're also trying to go deeper to understand what's really at the heart of what's going on? I think you spoke to something that I certainly see with the clients that I work with, something that I've struggled with myself. Sometimes this idea of being a giver or being selfless sometimes means we put ourselves at the bottom of our own list and that doesn't work so well. That doesn't work so well for, I think any of us as human beings and absolutely is what I see with our clients coming into FAB. Even sometimes being able to receive the treatment and saying, hey, I'm important enough, this is important enough to really make myself a priority and to really take on this guidance. So we say this thing, which is like being self, putting self first can feel selfish, but it is really your self-care, is putting your own needs as a priority in your life. [DR. CRISTINA] I know so many people struggle with that. They think like, oh gosh, if I'm putting time and effort, energy, even money towards this that's taking away from my family, my kids. Who am I to do this? This is, like you said, so selfish of me, who am I to do this? I can't do that. My kids need me. I'm needed at home. I have to do these things because if I don't do them, nobody will. It's such a struggle sometimes to get people, to actually see like if you put yourself first and take care of yourself, this is a great thing for everybody around you. So wondering how do you help people see that taking the time for themselves and getting the care is being selfless? [DR. JENNIFER] So it is that cliché metaphor that they say, when you get on those airplanes where you got to put your oxygen mask on yourself first. I think even though that seems a little cliché, there is a reason that that's being said. I mean, literally, if we're not taking care of ourselves first, we're really not doing anybody else a favor. We're not even doing our children a favor or our partners or the other people in our lives. It's like when we are filling our cup first, then we actually do have more to even give. So how do you do that? Sometimes I think it's like planting seeds, but the other thing, and this is where I think this community aspect is so important and why we are doing this work on our own individual path but then we come together in community because we start seeing ourselves in each other. So when one of our women in the group says, hey, you're, we have somebody who's, I'm thinking who's a mom and very easily can sometimes miss her meals because she's so focused on feeding her young children. She hears from another woman saying, hey, that's not going to work so well for your own care. Then she hears herself saying that, it's like, oh, I have to take my own advice. So I do think that there is something that they're hearing from us as the providers, but they're also hearing it in community from other women who really get it. Then the other thing I don't know about you, but I think I'm always practicing my own self-care. Sometimes I'm like, oh, didn't do that, like put way too many things in my schedule today. I get to the end of my day and I'm like, oh my gosh, I feel like I have nothing left to give. Even the dog, I don't want to take out for a walk. So I think we're learning by also tuning in and listening to ourselves. Another thing that I say frequently in other people on our team is like, the body has so much wisdom. Your body is also going to tell you how did you do with your self-care? Did you take care of your rest? Did you give yourself breaks? Did you actually stop and have your meals in a mindful way? Your body is going to communicate how you're really taking care of yourself. That's another thing that we say frequently, like the body has its wisdom if we're tuning in and we're listening to the wisdom, but are we always going to get it right? I mean, absolutely not. I think we're always evolving and growing and practicing with this. [DR. CRISTINA] That's so right. If you're getting into the day and you're getting exhausted, and I hear people say, oh my gosh, I found the gap in the middle of the night and now I don't want to sleep. I wat to stay up because that gives me some me. So then they skip on sleep and then it just goes into the next day. So I think that can be a clue too, like you said, listening to your body of going, oh, I need that me time and now I don't have it. So how does that relate to continuing not to take care of yourself? [DR. JENNIFER] Absolutely. I had a night like that, not last night, but the night before. I had my beautiful family in town and everybody was like, oh, we just all want to stay together. It sounded like such a great idea until I was on this very tiny couch and my pets were all up in arms and I was like, I slept so poorly. The next day I was like, oh gosh my body was just like, you are not feeling rested. Thank God I had sort of a later schedule and I was like, wow. my body is like I'm dragging. My energy feels off, my emotions fell off, I was really trying to be compassionate because I get my intention was let's just have everybody together. It'll be really fun. And it was really fun, but the sleeping part was not really fun. So I knew last night get to bed super early. I'm going to be in my own bed and I'm really going to take care of myself. So it's like, I think it's always a work in progress. Like if I had to do it over, would I have set it up that way? I wouldn't have. That was my learning. It sounds all great until, like I'm sleeping on a bed this big and it didn't work so well. [DR. CRISTINA] Absolutely. Thanks for sharing that. I think sometimes people think, oh doctor, therapists, they must have these perfect lives and know how to do everything perfect then like, no. [DR. JENNIFER] Oh gosh, I will tell you, I believe that we teach what we're also learning, so everything that I am saying to any of our FAB clients or anybody else I'm working with, it's what I believe but also what I'm continuing to work on. And we don't always get it but hopefully every time we "don't get it right" it's more information to learn and to say, okay, what do I get to put in? Okay that didn't work so well. Can I have compassion? Can I look at myself? Can I listen? What do I need to do now? I think that's another part, sometimes it's so easy to feel oh gosh, we didn't get it so right. Now we're beating up ourselves that we're not holding ourselves as a priority. It's like, okay, what's my next right step? I would say that even for our listeners tonight, it's like, well, self-care can look like so many different things to people. It could be more sleep. It could be more breaks. It could be more consistent eating. It can be your meditation practice, it could be your movement. So what does self-care look like for that individual and how do we just do like the next right step, put in one little thing that makes a difference? For me last night that was more sleep. [DR. CRISTINA] So if somebody is listening and they're saying how do I know if I'm being selfish or not, what would you say to them in terms of this is what selfish looks in comparison with selfless. [DR. JENNIFER] Well, what I would actually say is if you're feeling like you're being selfish, you might actually be putting yourself first in a good way. Like, I know for myself, when I started really sort of shifting how I was doing this and making myself more of a priority. Oh my gosh, I felt so selfish at first. It did not feel comfortable. It actually felt very uncomfortable. So I would also say it might be good to check it out with a really good friend, because I think you start feeling uncomfortable until you start to develop a rhythm with this. We're talking about the sleep thing, we're on the sleep thing. My partner knows for me, I go to bed early because my clock just gets up early. It's like, okay, I know we're in the middle of a movie and I got to get my sleep. He knows that about me now. I think there's also something about getting really honest about the practices that also work for us and hopefully the other people around us are really going to get like, oh, I really want to support the person, support you with that because then you're functioning at your best. But I will say in the beginning, it's not going to feel comfortable. The other thing is if you've trained everybody else around you for a long time that you give and you over-give people around you are not going to like this at first. [DR. CRISTINA] Oh my gosh. The pushback, maybe. [DR. JENNIFER] People are going to get pushback [DR. CRISTINA] Yes. That's going to be the hard part, is feeling, it's like, oh, if I say no, I think there's even a book, if I say, no, I'm going to feel guilty. How does people deal with that? Because especially if loved ones are pushing back and going how dare you say no, or you can't say no, or come on. If they keep begging and pleading, like how do people just stand their ground and keep the boundary? [DR. JENNIFER] Maybe at first, again, not going to feel comfortable. Sometimes you're going to give in. I was actually talking to a client about that today where she was really trying to be very giving to somebody she cares a lot about, but she sees where she over gave, went beyond her boundaries. Then at some point, and I know this is true for me, but it was true for this client, at some point got resentful. So it's going to come out another way, but your question's, well, how do you deal with that pushback? Again I think it is practicing. It's knowing what our limits are. I will say, I remember seeing, it was a therapist a lot of years ago and she was like, well you're allowed to have boundaries and you're allowed to say no, and you're allowed to really tune into yourself and know what your limits are. I'm like, I have no idea what my limits are. I literally, I was like, I don't even know what you're talking about. I did not even understand that concept. So again, I think how we figure it out is we start doing it. We see the feedback, we start seeing how we're feeling but look, sometimes we're also saying then no to certain people, if they're not really getting this. Like if somebody is continuously pushing our boundaries or not really wanting to support what's good for us, I think that that's another conversation, how does that person really fit in your life if they're not really supporting what you need to take care of your self-care at your highest level? That's another show probably. I'll come back [DR. CRISTINA] Yes, totally. Let's do that one. I hear a lot of people, oh gosh, if I say no, or if I don't, they're not going to like me or they're going to yell at me, there'll be conflict. I just want to, we could do another show on conflict avoidance, but that's a big fear of like, oh gosh, what's going to be the reaction. I'm just saying yes, because I don't want to deal with it. I'm afraid of conflict or somebody not liking me. But I think that's a great point. That tells you a lot about the relationship. If somebody doesn't like you, because you set a boundary for yourself and say, no, what's going on there? What's your value and worth in this relationship? What is it based on? [DR. JENNIFER] There is such a connection that I see in the work that I do. I'm thinking you do too, with speaking up, expressing your needs, being able to have your yeses really a yes and your no, really a no, because it is so connected to food in some way. When you say yes and I'm going to allow myself to nourish my body and then also tuning in and say, okay, I'm done and now I get to say no, okay, I'm done and I'm listening to my own boundary of my body and what actually feels good in my body. So this idea of asserting ourselves, being able to say yes, no, not pretending, it's a yes when it's really a no, because at some point it's always going to come out. The no's going to come out and probably it's not going to be so pretty at that point. And I will say like right before this show, I was working with a client about that. When she is not happy with something that somebody has given her feedback wise or recommendations on the team through FAB, sometimes she just sort of disappears. So I really challenged her, I would rather you say, I'm not going to do that recommendation right now. I'd rather you be truthful than sort of just go silent and basically ghost us. It's like, it's okay to say I don't feel comfortable or I don't feel ready for that step. Then we get to talk it out and dialogue about it. But I think it's also, I would also say to people listening, maybe a good place to start practicing this of saying what we need and really putting ourselves as a priority is maybe start with people who are safer and then there's the more challenging people. I don't know, maybe you're going to say no to your boss or say no to your, who knows, somebody in your life that feels a little tougher or a little scarier to risk saying what you need and saying the no. So I think a good way to practice is start with people who want to hear your no, or they really want to hear from you, whatever it is and they're going to be for you and they're going to be a yes for you. [DR. CRISTINA] Yes, if you just said boss, I could imagine people, I can't say no to my boss. I'll get fired. [DR. JENNIFER] It's a risk. That's what you were saying. It's like a risk sometimes to speak up and see what we need. Saying what we need is really our self-care, but it can be risky on the other side if we think somebody is not going to agree or there's a consequence, or they're going to judge us in a certain way, or they're going to say, oh my gosh, you're being so selfish. And think about it as women. For many of us, I'm generalizing here, but we're taught the care taking and being pleasing. So for many of us, we've gotten a lot of affirmation and accolades for those ways of being that our beautiful ways of being in balance. [DR. CRISTINA] Going along with this is not just setting a boundary of saying no and clearing out time for yourself, but also asking for help is along the same lines. That just seems so scary to people. I could never ask for help or I'm afraid they'll say no. That seems even more selfish, not even just saying no to somebody, but no, there's no way, that's a burden. I don't want to be a burden to somebody. I don't know how often you hear that, but I hear that all the time. [DR. JENNIFER] I do hear that. I sometimes tell this story of going through a period of my life. I called my own dark night of the soul. I remember I was supposed to meet two dear, dear girlfriends. I was like, we were going to a restaurant, something low key. I was like, I don't even want to drive myself. I actually want help getting my body physically out of the house. I really wanted to meet them. And I remember, I was a therapist at that point so I was always telling my clients reach out for help, reach out for help. It was no big deal. Then I remember calling my friends up, well, somebody come pick me. I mean, it was like I was asking them for a million dollars. It was something so seemingly small but I remember what made it hard was I felt so vulnerable. I felt so vulnerable. I will tell you after that, I was like, geez, I would say that to my clients all the time. it was such no big deal. And look, it can take something to really, sometimes it's not even them, the other person saying yes or no to us. It's like, I have to expose that I actually feel like I really need this. At that point I remember feeling, oh God, I feel so super needy right this moment but look, I also think it's really courageous when you feel that vulnerable and you're asking for something and then geez, how good it felt when my friends were like, of course we'll come pick you up. It's no big deal. Of course we want you there. It was like, it was exactly what I needed. It was like, whoa, these people love me so much. I can super count on them. I trust them to be there through this period of time for me and made all the difference in the world but whoa, was that little example I probably will never forget. [DR. CRISTINA] That's so powerful too because I can just imagine, I'm thinking of so many people I work with who go, no, they're going to talk bad about me and be like, oh my gosh, what's she thinking? That's out of my way. There's no way. Or even if, like you were in that scenario to ask and they said, no, I can't, I don't have the time, you'd be so devastated and, "I'm never going to ask again. That's horrible." But I'm so glad you had that experience where they said yes, of course. Because even if somebody does say, no, they can't at this time that doesn't mean that they're rejecting you. It could just be they really can't for whatever reason. So I would hope nobody would take it like, "Never again." That all or nothing thinking [DR. JENNIFER] That's a great point too, because even if, you know no can sometimes just mean, no I can't, or no, I'm busy. Then we sometimes add the story, like you're saying, oh, they're saying no, because they don't like me. Or they're saying no, because I'm not worth it. We add the story that then can diminish us or have us feel really bad when the person just said no. I will say, I'm really grateful in that scenario. My friend said yes, but I do think there is something when we can really start hearing other people's nos and not make it mean anything necessarily. Maybe there is also, I don't know, I'm trying to think just in terms of worth, being able to say no, but also being able, like you're making me think being able to receive a no and just like for whatever reason, it's a no. So I get to either try again with this person at another time, or maybe find somebody else that will be yes for something that I would need down the line. [DR. CRISTINA] That's a great point because if somebody's always saying no to you, that's different than you got to know here on occasion, just like you're allowed to say no, if maybe for anyone listening, I'm just thinking somebody asks you for a ride at the airport and it's like, you can't do it. You're going to feel horribly guilty rather than just giving up whatever you have going on. Because I know people-pleasers always are like, no, I'll just put aside whatever I've got going on and do it. Maybe they are able to say I can set a clear boundary and say, I would love to take you. I just can't. Maybe another time, maybe the next time you need a ride, maybe to reduce your guilt or whatever, but a no is not always just a hard no forever. It's just a, I can't right now. There's no guilt in that. [DR. JENNIFER] No, not at all. Something you just called to mind when you were telling that story, is that for people listening that do tend to be the people pleasers and just your answers usually always yes, which on one hand is so beautiful. Your tendency is just give, give, give, and it's like a beautiful tendency but at some point, if you're giving, giving, giving until you're spent, so it's good if somebody asks you or makes a request, take a pause first. Not just go into your automatic, but take the pause to really say, does this really work for me? Do I really want to do this? Can I really do it in this timeframe this person is asking this of me, but sometimes just taking the pause to be reflective and not just going into like our automatic way, because again, that's also some of the brain. The brain just can go into that pattern that it's very familiar. So sometimes we have to take the pause, really ask ourselves those questions to then make a different choice. [DR. CRISTINA] Great. For anyone listening, yes, everything she said. Now I'm just curious for you if we relate this back to food, if somebody's getting completely drained from just giving and giving and giving and the relationships with people are maybe not so connected, how do you maybe work with people and looking at how they now have this relationship with food and turning to food instead of maybe getting their needs met from connections with people? [DR. JENNIFER] That's a great question. So the way somebody is eating, like your food is a mirror for the rest of your life, your food is a mirror for the rest of your life. The cool thing about food is given that, well, for most of us, we're doing at least three meals a day depending, is you get to practice, how am I showing up to that meal each time. Am I listening to my needs? Am I honoring my needs? Am I honoring my limits? Because many times with this idea of the people pleasing and always saying yes, yes, yes, yes, yes, many times then food can be chaotic. It can look a couple different ways, one, it could be, I'm sometimes not giving to myself until the very end. That can show up looking like I'm not really taking care of myself with my food during the day, but then at some point, my body's like, I am ravenous now. Then of course, like for any of us, we're so hungry, we're going to then in that setting overdo it. But in some ways we haven't over done it because we haven't actually consistently and in a balanced way, eaten and nourished ourselves throughout the day. So this people pleasing thing very much shows up usually in the food and it looks like our food is out of balance. So that's where I'm saying again, like the food is a mirror for some of these other behaviors and what they look like. [DR. CRISTINA] I'm just thinking too, as you were talking you're not really connecting with people because you're just, your role with others is just to do for them and please, and hope that they like you because you're doing things for them. It's not a genuine connection. I'm just thinking sometimes people turn to food to get that connection. They get the comfort from food instead of the people around them. [DR. JENNIFER] Very much so. [DR. CRISTINA] So when you were talking earlier about the emotional eating you can see how that would be a huge thing to look at as well. [DR. JENNIFER] Yes, and how, in some way it feels like the food is taking care of us. I have many clients who will say, oh, like eating, overeating or emotional eating or binging, that moment is like my me time. This is when I finally get to sit down/ sometimes the end of the day, usually it's the end of the day or at night when everybody else has been taken care of and now I get my time and this is my time and now it's like, yes, in the moment the food feels good, but in a sustainable way, those behaviors don't tend to work so well. So people can very much use the food as like almost self-care and like you're saying connecting, oh, I feel like I'm finally connecting with myself in this way. I'm pausing, I'm stopping. Maybe in the moment, it feels like fun and exciting and then later it doesn't always feel like that. [DR. CRISTINA] No, that's a great point. So I mean much to what you've been saying this whole time. It's like, not it's about the food, but it's so not about the food. It's such a parallel process of what you're seeing. So for anyone listening it's so it's just so important to look at you're not just struggling, that we're just struggling with how you're eating. There's underlying reasons for all these things. So it is really important to look into that and take care of yourself. I'm so glad you've got this program going on. It's amazing. [DR. JENNIFER] Yes, we are just so happy with it. I will say we're just so happy with working together as a team. We do this very holistic mind, body, spirit. Like you're saying, it's not just about the food. We do have an awesome nutritionist who does more like, we call it nutrition therapy, but it really is a deeper issue. I always say that it's almost like unsealing the onion. It's like the first layer is, oh, I'm not really loving, sometimes like, oh, I'm not liking my body or I'm liking my weight, but then we keep unpeeling this onion together to get to what are all the layers? What is all this really about? This is why for most people like this idea of like the next diet, it doesn't really work because it's like one thing you're trying to do and it doesn't oftentimes have people go deeper. So this is where sometimes people start the diet and restrict, lose the weight, gain, because you're staying on one surface layer of all of this. [DR. CRISTINA] Absolutely. Well, Dr. Jen as we come to a close here, is there any last final words you'd like to impart to anyone listening today? I know you've given us so much already, but if there's any last final thing you'd like to say? [DR. JENNIFER] Well, I think one thing I would say is for people listening, just acknowledge yourself for that because they're choosing to listen and to learn something tonight and to want to take in something in a new way. So you just doing that is like something to acknowledge yourself for. Thank you for having this show and these topics that I think are so important. To me, it's like lifelong learning. It's like, do we ever just arrive at the perfect balance of self-care? It's always a work in progress. I'm a big believer that we always need our guides and that we're always evolving. Those are my final words for right now. [DR. CRISTINA] Fantastic. So if people want to find more about your program, how do they find you? [DR. JENNIFER] I would say the best way is fabprogram.com and it's pretty easy to find us. I mean, I'm sure you can find us on social media as well on Dr. Jen Nardozzi. So you can look me up that way as well. On our website fabprogram.com, there is a little self-assessment quiz that takes like two minutes and it goes through things around food and body image if you're like curious, where do I fall on the spectrum? If people want to set up a consult with me, they can do it after taking the quiz and just sign themselves up to meet with me for a few extra minutes if you want to talk more about any of this, [DR. CRISTINA] That's fantastic. Great. I'll have all that information on the show notes. So don't worry about if you didn't get it. Well, thank you so much. This has been fantastic. [DR. JENNIFER] It's been fun. Thank you. [DR. CRISTINA] This podcast is designed to provide accurate and authoritative information in regards to the subject matter covered. It is given with the understanding that neither the host, the publisher or the guests are rendering legal, accounting, clinical, or any other professional information. If you want a professional, you should find one.