Are you wanting to make a change for the better, and start the journey to recovery from an eating disorder? Who is someone that you can speak with about this? Are there people out there who understand what you are going through? In this podcast episode, Dr. Cristina Castagnini gets real in discussing her personal experience with an eating disorder.


  • Let’s get real
  • What kick-started my journey to recovery?
  • What we'll discuss

Let’s get real

I wish I’d known someone else was out there struggling just like I was, someone who was doing and thinking the same exact things as I was. So, that’s part of who I am and why I’m here doing this, because I’ve been there and I know that when you’re still in it, you need to get information.
In recovery, I was afraid to let go of my eating disorder, I did not trust the people that were telling me to eat those foods or stop exercising as much. But when I was far enough along my road towards recovery, I decided to become the therapist that I never had and to let people know that I understand these fears because I too have wholly felt them. I join you here as someone wearing two hats. One is as a specialized doctor, who can explain your symptoms, treatments, and signs to you and give you clinical information about your struggles. The other hat is for the fact that I, as a real person who struggled for far too long and spent many years trying to figure it out, can listen and understand you as the person behind your clinical diagnosis, because I was there too.

What kick-started my journey to recovery?

I was living alone at that time and I had taken herbal pills to lose water weight because the next day was my birthday and I wanted to look slim. At around 2 am in the morning I rushed to the kitchen to drink water, and the next thing I realized was that I was on the floor with the sun shining bright in my face, with throw up all over and around me and I could not move. I figured out that I had passed out and knocked my head on something on the way down. I managed to phone a close friend who took me to the hospital. They did not find anything specifically wrong on that occasion, but it was a huge wake-up call for me. I had started and stopped treatment for my eating disorder for years but now I wanted to start it and complete it in earnest. One of the nutritionists that was treating me helped me overcome my fear of certain foods, and one by one she dispelled the fear that I had of them from me. She taught me that there are nutrients and minerals in foods that my body needs to survive. Over time, I learned to change my mindset from meals as being an opportunity to harm myself to an opportunity where I could fuel my body with foods that it needed to survive. I learned then how to truly control what I ate for the wellbeing of my body. Each of us has our own journey. For me, it was about so many things feeling out of control all at once and so restricting, that what I ate gave me a false sense of control. You have your own reasons, and I want you to know that you can get on your path to recovery too.

What we'll discuss

  • What goes on behind the closed doors.
  • The cruel and compulsive thoughts and how all those things can have deep impacts in many areas in your life; your relationships, work, school, outings.
Behind the Bite is here to discuss what is behind your bite – what are the real struggles behind the eating disorder, because it is not about the food. This is about helping you understand you, and a place where you can begin your journey to healing.



I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


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Podcast Transcription

[CRISTINA]: 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 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 heal, inspire and create better, healthier lives. Welcome. ________________________________________ [CRISTINA]: Well, hello, hello, and welcome to podcast number one. We're all here starting together and I love it. I love that you're here. And if you're someone who's tired of struggling with your weight, food, body image or self-esteem, and you're just ready to have it all stop consuming so much of your life, then you've come to the right place. Stick around because we're starting this journey together, where we're going to discuss all these things and get real about what's really going on. For everyone out there who's struggling, I know you don't know me. So let me tell you a little about who I am and how this podcast came to be. Like so many of you, I know firsthand what it feels like to struggle with an eating disorder. For years, every moment of every day of my life was consumed with my illness. I was so convinced that once I looked perfect, once I finally weighed my magic number, or wore the perfect size, then I'd finally be happy. I probably did and thought just about every weird, wonky, screwed up, embarrassing thing that anyone could ever imagine with food, exercise, and my body, and tried to achieve something that honestly just wasn't possible. And truly, I'm sitting here right now, so glad that those days are over, you have no idea. But I do remember them all too well. And I also know all too well that there are things, really, so many things that I wish someone had told me way back then. I wish I'd known someone else was out there struggling just like I was. Someone who was doing or thinking the same exact things that I was. So that's part of who I am and why I'm here doing this. Because I've been there and know that when you're still in it, you need to get information. You need someone to go to hear that you're not alone and hear that you can get past all of this. You need to hear that this isn't forever. I know there's a myth out there that you can't get past this, that you struggle with this forever. But I'm here to personally break that myth and tell you that you can have a life free from all this. I know that sounds impossible right now, but I'm honestly here telling you that you don't have to suffer the rest of your life like this. You're not trapped. I come to you from that perspective, as being someone who gets it, as someone who went through hell and back for years with my own eating disorder. And guess what, I'm fully recovered. But I also come to you as someone else, with a completely different perspective. I'm a licensed psychologist, and a certified eating disorder specialist with over twenty years of clinical experience. From a really young age, I knew it was my calling to help people. It's funny, even in high school, I had my own teen advice column in a local paper. My friend's dad saw an ad for the position and he suggested I apply because everyone, all my friends, were always coming to me with their problems and asking for help. So even way back then I kinda knew that was the direction I was headed. But after recovering from my eating disorder, I realized there was just one thing I wished I'd had somewhere along the way in my, honestly, many, many attempts in my treatment before I finally stuck with it. And that one thing was a therapist who could look me in the eye and tell me they understood my pain, that they understood my fear to do what they were asking me to do because they had been there themselves. None of them had. I never had that. I truly believe I dropped out of treatment so many times because I was afraid to let go of my eating disorder. I was afraid to trust anybody. They were asking me to do things. Things that scared me. And I really didn't trust that they actually knew what would happen to me if I ate the food they told me to eat or, you know, they knew what was going to happen to my body if I stopped exercising when they told me to. So once I knew I was far enough out of my recovery, and I knew I could treat someone in my office without being triggered, or bring in any of my own issues into their treatment, I decided to become that therapist that I never had. The one who can look into my patients eyes and wholeheartedly understand their fear of gaining weight, or understand the intense, unrelenting guilt after a binge. So I join you here on this podcast wearing two hats. One is a doctor who can speak to all the signs, symptoms, treatments and clinical information about your struggles. And one is a real person who struggled for far too many years trying to figure out the magic solution to having the perfect body, somehow thinking that would bring me all this happiness in the world. I'll be going back and forth giving perspectives from both the personal and the professional. But we're not going to have these normal, run of the mill discussions. We're going to discuss what you're really struggling with, what's going on behind the closed doors, all those things you're too embarrassed to talk about. All the things you would be mortified to have anybody in your life know about because you don't even like to admit them to yourself. We're going to discuss all those awful, cruel compulsive thoughts you have on your mind all the time, and how all those things affect all areas of your life, your relationships, your health, your moods, your work. Whether you know it or not, everybody in every part of your life is affected in ways you probably just, you're not even aware of right now. But keep listening and you realize just how much your life's being affected. We're gonna do that because none of those things are in the diagnostic manual I use in my work. But those are the things that consume your every minute of your every day. And you're not in this alone. So when my doctor hat needs to come on, we can discuss the real implications that all of this can have on your body and your overall health. Truthfully, there are really important things you need to know about. Things that could quite honestly save your life. This is about you understanding more about why you're struggling. This is a place to get information. And ultimately a place to begin your journey to heal and move beyond all the pain and suffering you're experiencing right now. Behind the Bite is the name of the podcast. Yes, it's a play on words. You bite your food to eat. But what that really means is just what I said just now, we're not here to discuss you actually eating. We're here to discuss your struggles with eating. To understand more about why you are struggling with food, struggling with your body, to understand what's behind all of this, what's behind your bite? What is this all about? Because believe me, it's not about the food. None of this is, it's not. It's about the food but it's not about the food. It's an eating disorder, but it's not about the food. So maybe if I share a little bit more about me, and what was behind my own "bite", if you will, then maybe it'll make a little bit more sense. So here's a little bit more about me. You know who I miss? I miss myself as a little kid. I remember getting up so early on Saturday mornings, rushing to the TV to watch Saturday morning cartoons with my older brother. And I remember, we used to sit there in our pajamas having our bowl of Froot Loops or Lucky Charms, picking out the marshmallows, most likely, and we'd have our toasted Wonder Bread with tons of butter melted up on top. And we'd wash it down with milk that probably had a bunch of Hershey's chocolate syrup in it, or Tang or something else. And those to me were the best mornings. They were great memories. And then we'd get up and we'd go outside and we would play all day, like, all day until our mom would call us in at some point. And I think back to the little me, and I marvel at how she didn't even think about that food after she ate it. There was no obsessing about all those calories, those grams of carbs. She didn't go out to play worrying about if she played freeze tag long enough to burn off breakfast, or dare miss out on playing Marco Polo at the local pool with her friends so she could go swim laps and stop feeling guilty for eating that white bread. No. That little girl, that little me, she enjoyed food. She lived in the moment and she had fun. She was happy despite what she ate or what her body looked like. And I miss her. And I was trying to think what happened, and then I remember sixth grade happened. So I was born with a birthmark on my shoulder that I had been told by everybody used to bleed rather profusely when I was a baby to the point that shirts would stick to it. It was pretty bad from what I was told, actually. But for me, all I remember is that my mom would take me to UCSF as a child to sit in this room full of scary doctors with white coats. And they'd sit around in a dark room with bright lights that were on me. And they were staring at me and they'd take all these pictures. Now, I knew they were doing some kind of research but back then it was really, really scary. And all I remember is that when people outside of that room, like, normal people saw my shoulder and this birthmark, I got asked a ton of really intrusive, embarrassing questions. So I did everything and anything to hide my shoulder. I actually hated it. So when I was ten years old, my aunt got engaged and asked me to be her junior bridesmaid. I was really excited. But then I wasn't because I realized the dress she was going to have me wear was strapless. And we have this huge Italian family, and her wedding was going to be huge with hundreds of people there. And I realized that wearing this dress, I was going to be showing off my shoulder to hundreds of people. So I didn't want to wear it. So seeing the absolute fear in me, my parents were wonderful and consulted with a plastic surgeon and they actually allowed me to undergo this new surgical procedure at the time to reconstruct my entire shoulder. I was supposed to have this very minimal scar that I was told later I could have lasered off so I would one day just have a completely normal shoulder. I was so excited because I would finally just be like everyone else. No more staring, no more embarrassing questions. So all I had to do was have assignments sent home from my teachers during a few months of my sixth grade year so I could undergo these two major surgeries. That was fine with me, I was so ready to be free of this deformity. I was getting to that age where clothing and looks mattered. I wanted to be just like everyone else my own age. It wasn't just about the wedding. I dreamt of being able to wear tank tops and swimsuits without stressing over someone seeing me, or worrying they were talking behind my back and making fun of me. I was getting to that age, I started to become more aware of the clothes my friends were wearing, cute clothes I'd never allowed myself to wear, and then wanted to wear those things too. So long story short, the surgeries were painful and unfortunately very unsuccessful. My scar after was worse than the one I had before. And I felt horrible about myself. I hated my life and to be honest, it was awful. And so I had this awful moment, and guess what else was happening at that time? I was starting puberty. Lucky me. I was gaining weight in places that I had never had it before and I developed breast weight earlier than most of my peers. So with all these changes on top of my failed surgery, I felt my body was disgusting. And I couldn't control it, and I hated it. And then because it was puberty, acne started, and it got really bad. And then I got braces so it was even worse. I felt really insecure. And now on top of all of this, as if this could be worse, something else was going on. I had grown up in Oakland, California where I'd known everybody since I was in kindergarten. So I'd literally just walk out my front door and there were easily five to ten kids already outside, ready to play. We lived in a really kid friendly neighborhood. And so in the middle of fifth grade, right before this surgery, my family decided to move to a whole new city where we knew nobody. It was in a new track development, new homes. But our home was one of the only homes actually built at the time. The rest of the homes around us weren't actually even built yet. They were just empty lots. And there were no kids anywhere near us. So I was only in the fifth grade for a few months in this new city, which was honestly hardly enough time to make any friends before the summer break. And so I started a whole new Junior High after that summer not really knowing anybody. I had no friends. Then I left sixth grade pretty soon thereafter to go start the surgeries. So I was really just starting seventh grade, barely knowing anybody. So I walked into this school of essential strangers feeling so self conscious about my appearance, and I felt awful. I remember thinking, this is not the way to start meeting new people in this place. I'd look at all the other girls with envy, and I thought they were all so pretty and they had such cute clothes, and they were so thin. And I'd go home and compare myself in the mirror, and I would berate myself. I remember telling myself horrible things. And I kept thinking, I had to do something, I had to do anything. I couldn't keep going to school looking like I did, there was no way. And then I remember seeing it. I saw a SlimFast commercial. And I truly could not have grabbed my allowance money fast enough, and run down the hill to the drugstore to buy it fast enough. And I remember, really, this feeling of pure joy when I felt my jeans started to feel looser. And then when I got that first compliment from somebody, when they said, wow, you look great. You lost weight. I do, I remember that, too. That was the best feeling in the world. But with that, I also remember that fear of what would happen, that fear of, oh my gosh, what if I don't keep doing this? What if I don't keep this weight off? Or what if I don't keep losing weight? I had these thoughts in my head that I had to keep up with the SlimFast and I got scared of life, like, what would happen if we all went on vacation and I couldn't have my shake for lunch? Or what if I can't have my shake because we're at a restaurant? And actually those things happened. So I didn't know what to do. I started to get desperate to find some way to make up for not sticking to my plan, for not having my shake because I had to make sure I didn't regain the weight. I had to make sure, in my mind, I had to "look great". So this led me to start figuring out what to do. Oh boy, here we go, oh, my gosh, I kept rattling in my brain what to do. And I came up with 'I can exercise to make up for what I'm eating'. So I found the solution. I realized that when I exercise to make up for what I ate, I felt calm. I felt, yep, here's this magic word, I felt in control. I knew everything was going to be okay. Only, it wasn't okay because if I couldn't fit that in either, like if I got too busy or too tired, or if we were at a family function, that was a double whammy. If we were at a family function, most of the time that was eating food and no exercise. So then I had to come up with something else. And that's when I figured out I could just eat and throw it up, then everything was okay again. But then it wasn't okay. When I started not to get compliments, when people started to say nothing, then my mind started to wander and I'd get scared. And I do, I remember thinking, oh my gosh, does this mean I look fat? Does that mean I look awful? So I needed some way to know if I looked okay, or if everything was fine. So that's when I decided I had to know if I was okay. So that's when the scale came into play. The scale would let me know for sure what was going on. If it was up even a half a pound my day was ruined. I remember that, and I somehow had failed. And if it was down, I was thrilled. I remember thinking ah, I did something right, I succeeded, and I was good. And as time went on, I continued controlling everything I put in my mouth. And I measured, and I weighed, and I calculated it, and I had to because I needed to lose weight so I could look like the girls in the magazines. Back then there wasn't the internet, there were just magazines. And there were all these magazines and I remember looking at them incessantly. And I was convinced I had to look like them because they looked happy. And I told myself if I looked like them, then I would be happy. If I look like them, then I remember thinking everything in my life would be perfect. I was already getting straight A's, I was working two jobs and I was playing three varsity sports. And this was the only thing missing. So if I could just lose weight then everything in my life would be perfect. And I'll be honest, there were times I just couldn't white knuckle it anymore. I'd find myself knee deep into an entire pint of ice cream, then I'd eat an entire loaf of bread and gummy bears. And I mean, it would just, I would eat way too much. But before I knew it, I was sitting there thinking, oh my gosh, I've just eaten so much so fast, and my mind was somewhere else that I didn't even realize what I had been doing. And I'd only stopped because I felt physically sick and in pain. And then I would feel so guilty and awful, and then I'd freak out about gaining weight. So then I'd make myself throw it all up. And this is the worst part. I remember looking at my red, swollen face after I threw up every time and I kept swearing, I'm never going to do that again. Yet I did, over and over and over again and I never understood why I kept doing it time and time again because I hated it. So I tried to do other things to avoid it. I tried laxatives, diet pills, fasts, and these all had this ultimate goal of helping me reach that weight, that appearance that I wanted, that weight I was working so hard for. I kept thinking, I'm eating so little and exercising so much and trying so hard, doing all these things, yet somehow I'm still never reaching my goal. And I could never figure out what I was doing so wrong. And one day I remember I was sitting at a stoplight in my car, I was on the way back from another workout at the gym, and I had a vision that my brain was trapped in prison walls, like, forever. And I was going to be trapped living like this and never ever getting any relief, never getting to a place where this stops. And I wanted it all to stop right at that moment. I did. I was exhausted from so many workouts. But I truly didn't know how because I really thought that if I stopped exercising or if I eat differently, I was just going to gain weight. I already felt like I was overweight at that point. So I was like, oh gosh, I can't gain more weight. So I just kept suffering and doing what I'd been doing. And I just truly wanted someone to give me this magical book that laid out everything, exactly what and how much to eat every day to give me this perfect body once and for all. And I was convinced that this magical book existed somewhere and I just didn't have it yet. I remember looking at women I thought looked perfect. And I'd have these fantasies about having this magical power to be invisible just so I could follow them all day long for several days and see what they really ate and how much they exercised. That way I could just do exactly what they did. That way I could look like them. I figured they had this magic solution and I just needed to know what it was. I remember that feeling of desperation, just so desperate just to know what to do. So years into this, I finally had this moment. This one that turned all of this around. People ask me all the time, what was it that got you better? Well, I was living alone at the time and I recall waking up in the middle of the night after a day of taking herbal diuretics to lose water weight. These were supposedly safe, because I bought them at a health food store. And because I bought them at a health food store they were healthy, right? And I took them because I wanted to look less bloated for my birthday, which was the next day. So in the middle of the night, I ran to the kitchen, desperate for water. I just remember feeling totally thirsty and nauseous. And I remember as I got to the sink, I was looking at the digital clock on the microwave oven, which was next to the sink, and seeing that it read, like, two-something in the morning. And then the next thing I know, I'm lying on the kitchen floor with my head pounding and the sun shining on my face. And there's throw up all over and around me and I can't move. And I remember it took me a while to figure out what on earth had happened. And what had happened was I had passed out and hit my head pretty hard on something before I'd been able to get water. Somehow at two o'clock in the morning that's what happened. Now, I'll spare you the details. But the long story short is I called my friend who, thankfully, and who I'm so grateful to, because she took me to the hospital and when I was there I had a CT scan and an EKG and all these blood tests, and inevitably nothing was found wrong. But I was freaked out and that was my wake up call. That was my huge wake up call. So while I'd started and stopped treatment several times over the years, when I got out of the hospital, I finally started it again. And this time I was all in. One nutritionist on my treatment team probably saved my life. Truly, I mean that. I was so scared of so many foods by that point and she made me list them all down. She made me list all my fear foods, one by one. And what she did was she brought me to eat each of those fear foods for our sessions. And I will never forget our first one, actually, because it was pizza. And I thought she was absolutely crazy to bring me to eat pizza. I hadn't had it in probably, I don't even know how many years by that point, but it was certainly, to me, a bad food. I was sure it was going to make me fat instantaneously. I remember I had watched some show one time where some teenagers were shaming one of their friends for having eaten a piece of pizza before she put on a swimsuit. These girls were headed to a swim party and they were shaming her saying, oh, that's why none of the boys like her, because she eats pizza. And that stuck in my head. And from that point on, I never ate another piece of pizza again. So this nutritionist sat me down, she brought me a piece of pizza and she put it in front of me. And she patiently waited for me to explain why this was such a bad food. And now I had done so many years of eating disorder behavior, and so many diets, I somehow thought I had so much knowledge about food. Yes, I knew all there was to know about calories, fat grams, basically, everything there was to know about food, and logged so much, and done so many diets. And I was convinced, she certainly couldn't tell me anything I didn't know about food. But I was wrong. So very, very wrong. Because she sat there and talked me through each part of the pizza. She told me about the cheese, the tomato sauce, the crust, and she educated me about the nutrients that each of those parts of the pizza provided my body and why my body needed those, and how my body actually used them. She slowly dispelled my fears about food. And over time, food changed from something that made me fat, and that I needed to burn off, into something that I needed to stay alive and give my body to stay healthy. So over time, every meal to me became an opportunity to fuel myself and choose how to give myself health. This is where I started to feel like I was in control of my body and my health. So no longer were my eating disorder behaviors and my fears controlling me, I was starting to be in control of my food, and starting to feel I was more in control of my body. Now, there was of course a journey, you know, a journey I took to get to full recovery. And each of us has our own reasons and our own path that gets us to why we have our struggles. For me, much had to do with many things in my life feeling out of control all at once. I shared about what was going on right around sixth grade to start it all off, but my eating disorder behaviors continued because it helped me feel in control when a whole bunch of other areas of my life felt out of control as well. Now, you have your own reasons, your own path to how you got here and why you have your struggles. And you can get on your own path to recovery too. So I just encourage you - break that myth. Know you can get better and keep listening to this podcast. In fact, if you want to make it real easy to keep listening, you can subscribe to it now. I'd love it if you did that. Just keep listening. So what you can do is you can subscribe to it. I'd love if you'd rate and review it. Let me know you're out there and what you think. And for all of you listening out there, be sure to check out my website at because you can receive a free, nine-week email course to help you understand more about your own struggles with food and body image. It's a great course, it'll hopefully jumpstart some things or at least give you some more information about yourself. Okay, this has been fantastic. I really thank you for being here today. Thank you for listening. I hope you listen again. Until next time, to your health everyone. ________________________________________ [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.