[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. Well, hello everyone. So when I started thinking about recording this podcast, I remember people asking me how on earth I was going to have things to talk about week after week. I got asked things like, "Really, Cristina, how many weeks can you just sit there and talk about food or weight? It was just those kinds of questions that made me realize just how much I really did need to talk about this. Those questions motivated me more than ever to get up and start recording. Each and every week my goal is to bring on a guest or topic that helps anyone listening to walk away with some understanding that eating disorders are not just about food or weight, far from it. So the majority of my week is spent working with patients who have eating disorders or disordered eating and I know one of the hardest things for many of them is that once they understand that their eating disorder is not about what they're eating or about their weight, they leave our sessions and go live the rest of their life in a world where they're bombarded with these very different messages, the same messages that they're trying to challenge and end up themselves. I get it, if someone sees me say for an hour a week, and then they spend the rest of that week hearing toxic diet messages from numerous sources like social media, family members, or just random conversation in passing while they're out and about, I'm really not all that surprised when they return the next session questioning if anything we discussed in treatment is real, or if they're feeling really anxious about the changes they're trying to make in therapy. Let's face it, they spend a whole heck of a lot more time and hours exposed to and steeped in those toxic messages than in challenging them in therapy. It takes a lot to start to turn a deaf ear to all of that noise. So think about it. When the world outside of therapy is promoting and phrasing the behaviors that someone is trying to change and stop engaging in during their treatment, like restricting calories or certain foods, then that can be nothing short of or difficult or confusing. I see so many people wanting to believe that what we're working on in therapy is going to help them, yet they make no observable changes for a long time. The messages and voices outside of therapy are ones that are ingrained in them and usually they've become their beliefs and have controlled their daily lives to the point that they come to see me and these beliefs held, they're held and they have such powerful promises of happiness and they tell them, look, if you do these things, you're going to look a certain way and they're really not ready to let go of them. So one of the things I most often hear is, "Doc, I really believe that I can only be happy once I lose the weight or reach my goal weight. Can't I just still have weight losses of goal therapy and still treat my eating disorder? Or can you promise me that I won't gain weight if I start treatment?" Therapy challenges these faulty beliefs and it takes people different amounts of time to start to understand that it's the illness itself that keeps their mind so focused on the need to lose weight in order to be happy. It's the eating disorder voice, if you will, that loudly screams that the therapist is wrong and that all those other people out there are right. The eating disorder tells you, tells these people that the therapist just wants to keep them from reaching their goals and being happy. The eating disorder voice tries to convince you, to convince people that they need to keep doing what they are. Because if you do what the therapist wants you to do, then all of that hard work you just did, it'll just be all and done and it would've been all for nothing. The eating disorder voice will tell people that the therapist is wrong, that you do not have an illness, that you just need to follow that program, that diet and then once you do that, you'll get ahold of everything. You just need to learn how to eat better and have more willpower, that the therapist knows nothing and that there certainly are good and bad foods and you know what, the eating disorder says, there's no way you're going to just blindly trust person in what they're saying. After all, like I said, the toxic messages have become people's beliefs and when people have their mindset to something, they say to themselves, look, all that I've done, it's worked before. I know what to do, you just need to do it. That's all. You're not sick, you don't have an illness. You don't need to waste your time or money in therapy or treatment. The eating disorder voice is loud and it doesn't want people to be in therapy and get better. Again, I get it because therapy, unlike all of those messages out there and our toxic diet culture, therapy doesn't have those lofty promises. Therapy is really unknown. Therapy could change them and their bodies in ways that scare them. And I get it. I understand why the louder sexier messages and promises of our toxic diet culture usually win out, or if they don't win out, people struggle with letting go of them. So while I'm certain anyone listening has probably been subjected to many of those messages out there today, you may not be aware that you heard them because they are so ingrained in our culture and they really are just accepted as fact. So people just don't question them. So maybe you're saying, well, what message is just a belief and something I wouldn't question. I'm going to give you an example of a message that a lot of the people I work with really struggle with. Something I often hear out there in the world and in my sessions are there are are foods that are healthy or "good" or "unhealthy or bad." I hear this all the time, and if you're out there listening and you're a patient of mine that the second one of these labels leaves your lips, you say, well, I had this good food today, or I ate good, or I ate this healthy food, I stop you and I point out that you're labeling food in this way. I don't do this to be critical or to try to make anyone feel bad. I do it solely to start to create awareness that they're doing this. Because unless someone is aware of what they're doing, they can't start to change it. So I challenge any of you listening to start to pay attention to how often foods are labeled like this. You may be asking yourself why this is a problem, or maybe you're thinking, I'm crazy to think that there aren't good or healthy or bad or unhealthy foods. You know what, that's okay, I get it. That's the norm out there. However, these labels are problematic and really only serve to perpetuate eating disorders and I'm going to try my best to explain this. First food, all food is simply a source of fuel and nutrition for the body. It keeps us alive. Yes, there are some foods that provide more nutrition to our bodies and others, just like there are some foods that provide us with more fuel than others. I don't really know why food started to get labeled and categorized, especially because the labels really, they're so arbitrary. For instance, one diet expert may say, red meat is a "healthy" food and another will say it's "unhealthy." Or chocolate is a "good" food according to one study, but according to another, it's "bad." It's really just confusing and awful. So to try to explain why these labels are so problematic and do nothing but perpetuate an eating disorder, I'm going to share my own experience with them. So when I had my eating disorder, if I ate something that was on my "bad food" list, I was bad and when I had eaten this, I had really bad feelings that was a result of this. I felt sad, I was guilty, I was really disgusted with myself. Then I would have these really bad thoughts about myself, like, I'm such a failure, I'm disgusting. Then I would try to engage in some eating disorder behavior as a result of this, like I would go over exercise or overly restrict or binge. To me, my "bad" or unhealthy foods were those that I considered would cause me to gain weight and would make me anxious and therefore I'd be worried and I would feel like my body was out of control after I eat them. So what I would do is I would try to regain control by engaging in those eating disorder behaviors. Most of the time I would try so hard to eat only the "good foods" or "healthy foods" to avoid what I just described. That's awful. Going through that is awful. I thought that these "good foods," these were the ones that were safe and would not cause me to gain weight. So I know now that these foods were just giving me a false sense of control because I told myself, I convinced myself that if I ate these, I was in control of my body. I was in control of my weight, but I wasn't. That was not it. I was fooling myself. Like I said, it was a false sense of control because I distinctly remember being so good, eating only the good healthy foods and doing everything so right, following all the things I heard about and read about that would get me the results that everyone in the ads and magazines got; the perfect body and the happiness that I so desperately wanted. Only, the funny thing, my body never seemed to be completely doing what I wanted it to do. No matter how "good" I was, no matter how perfectly I followed whatever the diet or program and the moment was, my body never reached that goal, the goal that I was promised. So my eating disorder voice berated me and told me all sorts of nasty, horrible things like I was a failure again and again and again. So it was not about what foods I was or was not eating. I was not good or bad for eating a certain food that I labeled that way. I was just trying to find a way to control so many things in my life through my food. I wanted to feel good, perfect in control because I felt so completely opposite of those things. At the time, I truly thought I just needed to figure out how to eat better and then I would look better, and then I would finally be happy. I thought I was so in control of my food, of my life, of my body and how it looked only the reality was that the food was controlling me. How ironic. I could not eat what I wanted when I wanted to. I had to stick to my plan, my rules. If someone were to have offered me a cookie and there would've been no way I would've said yes even if I really, really would've wanted that cookie. How was that me being in control of my life if at that time I wasn't even able to eat a cookie if I wanted to? Maybe someone could argue out there that that was just me having a lot of self-control and discipline or being "good" sticking to my diet but it wasn't that. If I would've eaten that cookie, the rest of my day would've been ruined. My emotional state for the rest of that day would've been ruined. My mind would be filled with eating disorder thoughts or rating me for what I had just done, coming up with some crazy plan for how to undo it. It would've been a horrible guilt trip. I would be convinced that I had just gained a whole bunch of weight and probably started body checking incessantly. Even as I'm just saying this now, that is not having control and that is what happens when someone is sick with an eating disorder. So let's fast forward to now, when I get offered a cookie, if I want it, I'll eat it and I enjoy it and I don't think about it again and my mood or what I think about myself is not affected by it. That cookie has no impact on what I choose to eat or do later in the day because that's what happens when someone does not have an eating disorder. I understand why people say things like, why don't they just eat less or more or exercise more when they hear someone has an eaten disorder. Because on the surface it seems like an eating disorder is only about what and how someone eats in their weight or appearance. But believe me, there is so much more going on within the person that nobody can see or understand. So it is not just about food and weight. I want to encourage any of you listening today to think about your own beliefs and behaviors with food. So if you related to any of what I mentioned today about having your moods, thoughts, or behaviors affected by eating food that you have labeled as "good" or healthy or "bad" or unhealthy, I strongly encourage you to think about seeking help or at least treating more information about eating disorders. There's always my free nine-week email course on the website at behindthebitepodcast.com, where you can go get that anytime and that can help you also to understand if you may have disordered eating or an eating disorder. I know there are really so many myth and mixed messages out there, and I'm trying to get the right information out there for all of you. So if you have questions or have topic suggestions for the show, please reach out to me, let me know. I will try my best to get the topics on the podcast because really this is for you. This is for the listeners. So let me know, I'm always listening. Until next time. 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.