Are you putting off admitting that you may need help? Do the opinions of others around you negatively impact your choices to seek medical advice? How can you overcome those thoughts that keep you doubting whether you are sick enough?

In this podcast episode, Dr. Cristina Castagnini speaks about not being sick enough, thoughts that hold you back, and other people's assumptions.


  • “You look healthy”
  • Thoughts that hold you back
  • Don’t let other people’s assumptions stop you

“You look healthy”

I did not believe people when they told me I looked healthy. I thought that they were pretending to compliment me, and I thought that being told I looked healthy meant that I needed to exercise more instead of slowing down.

There is an idea out there that you can tell whether someone has an eating disorder or not, just by looking at them. I am here to say that it is an absolute myth, it is not true and can be incredibly damaging and triggering to people who genuinely struggle with eating disorders when their relatives of friends make casual comments about how good they look. Those are not casual comments for people who are struggling with an eating disorder.

In the hospital where I was a clinician for several years, I had so many patients tell me that they were healthy because the doctor said so:

They were so sick and yet they were getting all of these compliments from the outside world including the medical professionals, saying ‘hey you’re great, you’re healthy, keep it up’ because the perception is ‘oh if you’re exercising and eating these “good” foods then everything must be healthy.
BMI confuses people and makes them think that they are not sick enough, or even not sick at all if they are in a certain category, or even towards the lower end.

Thoughts that hold you back

An eating disorder is not just a physical issue, but it also affects your mind. How much time do you spend thinking about food, about exercising, about countering the food you ate for lunch with enough exercise, about calories, about the next diet? These thoughts consume you and become so overwhelming and it is not good. It is also an indication that something is wrong and that you need help.

However, these thoughts, as well as the positive reinforcement people receive from doctors and their well-meaning loved ones hold people back from seeking medical assistance.

Beating yourself up for eating and having your life consumed by food is not living, it is not healthy.

Don’t let other people’s assumptions stop you

Your loved ones might assure you that you are fine, that there is nothing wrong because you may look healthy on the outside but on the inside, your body and mind are suffering. It can be difficult to move forward when everyone is giving you positive feedback, but their feedback is based on their erroneous assumptions about what is going on.

I want you to be honest with yourself because you know if you are struggling. You know if things are not what they seem, and food and dieting and achieving this ideal body are aspects that have consumed your life.

Part of getting through this is understanding what triggers you.

Learn what your triggers are and spend time developing boundaries around people who ask you pointed questions or make comments about your appearance. It is not your job or duty to educate them on eating disorders, but it is your job to protect yourself from these statements.

Set boundaries around yourself and do not be afraid to tell people not to speak to you in that way, because it harms you. If those people do not understand your boundary or don’t hold up on assuming, then you can release that and them too.

Food is fuel and nutrition and if you’re not using food for that, then really ask yourself. ‘what am I using food for?’



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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