[DR. CHRISTINA 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. Hi, I'm Christina Castagnini, host of Behind the Bite podcast and as always, I'm so glad to be here with you today. So I really want to talk about something that's been on my mind for the longest time. I really want to clarify what it is that eating disorder specialists like myself do, and even more important, what we don't do. I really believe that it's important and it's a relevant topic for many reasons. For one, I believe that there's this idea out there that when someone is seeking therapy or mental health treatment, all of us are the same. I think this needs to be addressed. We are not all the same. Just like with medical doctors, doctors, and mental health, we do have specialties. So if you had cancer, you would hopefully go to an oncologist, not a podiatrist. So if you're out there and you're struggling with disordered eating, have an eating disorder or a body image issues, I really do want to encourage you to seek help from a certified eating disorder specialist. So you might be asking, "Well, how do I find one?" So the International Association of Eating Disorder Professionals certifies licensed professionals after they complete a very rigorous set of criteria. So we've all gone through graduate school, we get internships, we get supervised before we're licensed and then we get licensed and then after that, we go over and beyond and get certified. So there's a lot that goes into this certification. It's not just something that people just can have or they just get this label. So I really want to encourage you to think about, okay, if you're really struggling with this, a specialist is really somebody that you want to go seek help from. A list of specialists can be found actually on the IAEDP website. I'm going to put that website on my show notes, so don't worry know about trying to go Google it yourself. It's going to be right on there because I know it's really hard to find help as it is. So I'm going to make that part really easy for you. I also want to mention this because I know when most people start searching for a therapist or for mental health treatment, the first place to go to is the list of providers on their insurance panel. From my experience, it is a very rare list that would include a certified eating disorder specialist. Many therapists or psychologists will put that they work with eating disorders, but they really don't have much experience nor do they have the certification. So please look for 'CEDS' in their credentials. That means they're certified. Another reason this is such an important topic to bring up is because I do believe many other professionals or professions refer their patients to me to help them lose weight. I say this based on experience. I cannot tell you the amount of patients who have come in to see me for an intake and flat out told me that their doctor said I could help them manage their weight. That always baffles me. Similarly, I've had several professionals try to reach out, to collaborate with me, thinking we would be a great match to work together, to help patients because they also focus on health and weight loss. And now inevitably they have some weight loss program they have their patients on, or they offer and they would like for me to be a referral to help their patients who may also need to manage any stress or struggles that come up that may hinder them from staying on track while they're on their program. Now, I have to tell you also, I found this when I was working on staff at the department of psychiatry in a hospital, and I started running the binge eating group. I got referrals from colleagues in every department. You name it, GI, OBGYN, family medicine, and each and every time I would start the first group this came up. I would start by going around and having everyone do a brief introduction, asking them to share their goals for being in the group. And I kid you not, each and every time the participants would say their goals and they were saying they were there to finally stop binging so they could finally lose weight and keep it off. I would always find that interesting. I would wonder what on earth were their doctors telling them about my group? Were they telling them this was a weight loss group? Were they telling them this was like something similar to Weight Watchers? I wasn't really sure, but I definitely knew that that's why they were there. They thought I was there to help them to lose weight. Now I'm going to get much more into that into a moment. But I want to, after I mention one more major reason why I feel this is necessary to clarify about what eating disorder specialists do. Now, another reason, and to clarify is because I'm so very well aware of the fact that most people out there who are struggling with food, body image and weight are probably really struggling with disorder eating or an eating disorder. They want to stop struggling. And maybe that's you, and this is important. Maybe it's you, and you believe that in order to stop struggling, you just need to find the right program or coach or guidance so you can finally lose weight. You know, I find a lot of people believe that once they lose weight and finally keep it off, then they'll stop struggling once in for all and they're finally just have this life and be happy. So who do I find that most people go see for that? They don't really come see somebody like me. No, they go to see personal trainers, weight loss coaches, bariatric surgeons, or people out there that are calling themselves things like emotional eating experts. I've discussed this in previous podcasts, but all of these types of professionals or people that they go see will only serve to lead someone into another diet or program that has the goal of weight loss. And that doesn't work because they're not treating the root of the problem. They're not getting to the why of why somebody is struggling. Please hear me when I say this. An eating disorder is not the problem. It is a symptom of the problem. Eating disorder specialists know this. We will treat the problem. All of this really came to mind because some things kept happening over and over again in the past couple of weeks. So I'll tell you what they were. Obviously I have this podcast and I get messages all the time from all sorts of people who think they would be a great guest to be on my show because we have so much in common. At least they think we have so much in common. They tell me how we would be great because we work with the same population and how my listeners would get a lot of value out of what they would share on the show, because we pretty much have the same philosophies and have the same goals for the people we help. However, most of these messages are from people who are the ones I just mentioned, the ones that most people go to instead of seeking help from an eating disorder specialist. Now I have to admit on the surface, the majority of the people who reach out actually do sound like they will help someone overcome their emotional eating struggles nd actually they sound pretty good to go to, initially. However, where the difference lies, this is where the difference is. They are really promoting weight loss and a way to lose weight and keep it off for good. They usually talk about how they understand the struggles because they too were once struggling with all of all those things you're struggling with, but then they found a solution and now they want to help you do the same thing, they talk about how they are so happy now that they no longer struggle with food and they don't feel lost. And then they bring up some unusually, very impressively, large amount of weight they've lost, and that they've kept it off. Now, I feel the need to bring this to your attention, because there are so many people out there who have little to know training in anything yet, say these exact same messages. You know, "I'm going to help you overcome your emotional eating, your struggles with food and weight, help you go down the same path I did. Look at me, I've lost all this weight. I've kept it off. I'm so happy." And yet they call themselves coaches or experts. Now this is a far cry from those of us out there who have undergone years of graduate school, clinical training, licensing exams and then, like I said, past that rigorous process to becomes certified. Now I can only imagine seeing an ad or webinar from someone like this. It's very enticing. Like I said, it sounds great. It's not a diet after all. Most of them do say that this is not a diet. This is a lifestyle change. This is for the rest of your life. And if you're sick and tired of diet, and what you're reading from this person is saying, they can finally help you without dieting, that sounds wonderful. Why wouldn't you want to do that? They also say things like now they love all the foods and they're living their best life. However, I can tell you that when I have gone on to these social media accounts of the people who reached out to me, I have been shocked. I've seen so many harmful messages. Things like, "Eat this, not that," or "How eating no sugar saved me," or lots and lots of photos, praising thin bodies and shaming larger ones, or showing themselves when they were in larger bodies and now how unhappy they were and now that they're in smaller bodies, how much happy they are. So if you listen to my last podcast, then you know that all of this is just diet culture. It's just perpetuating more of the diet culture, toxic messages. And it's just more under the radar and less in your face. It's just couched in different terms and sounds nicer. So, no, I don't have any of these people on as guests because contrary to what they say, we have absolutely nothing in common. We do not have the same philosophy. We have one thing in common. We work with the same population, but I can tell you this. If any of you do choose to work with someone who claims to be able to help you end your emotional eating, lose all the weight for good and keep it off, it is just another diet or program that will ultimately not help you overcome your struggles with food, body image or weight. Because weight loss and being thin is never going to bring you happiness, give you a sense of worth and value and ultimately treat your eating disorder. No, weight loss is not going to treat your illness. In fact, it is your illness that is erroneously telling you, and has you convinced that you will finally be happy and worthy and have a better life once you lose weight and keep it off. I know I've said this before another podcast, and I've said it here too, but I will say it again. When someone comes in for treatment and says their goal is weight loss, this is diet culture speaking. This is the eating disorder. This is the part of the struggle that needs to be addressed and treated. This is exactly why I want to clarify what it is that eating disorder specialists do and don't do, because what I hear in my office lets me know that there continues to be confusion. I hear things like, "Well, come on, doc. It just makes sense. If I stop binging, then of course I'll lose weight. So I just need you to help me figure out how to stop binge eating. That's why I'm here, to treat my binge eating." However, for their goal of treatment to really ultimately be to lose weight that tells me there's confusion about what I'm there to help them do. I don't do that. Or I will so often hear this is so frustrating. Everyone thinks this is all just a waste of time, that therapy just isn't working. I'm starting to think it is neither. I mean, I haven't lost a pound yet. I guess this is just something else I'm failing at because everyone keeps pointing out that I still look the same even though I've been in here for weeks already. When am I going to see results? So people think therapy doesn't work if there's not weight loss or a change in the body. Changes in therapy, therapy results are not evident on the outside. It's evident on the inside, but that's what people expect. It's only working if it's visible. So do we promise weight loss or even promote it? No. Weight watchers or personal trainers will I use weight loss to determine if the time you spend working with them is working. That will tell you if you are a success or a failure. And once you reach your goal, you can stop working with them. With me, weight loss will never determine if the time you spend working with me is working. When you no longer have eating disorder thoughts, feelings, or behaviors, or place your value or happiness on your size, weight or appearance, and you can eat and move your body intuitively, then your time working with me has been successful in helping you to overcome your struggles with food, body image and weight. Hey, look, you may never love your body, but being able to have a life where you accept it and no longer spend so much time and energy wishing it were different and engaging in behaviors to alter it, that is an internal shift. That is you getting your life back. That is you no longer buying into diet culture. If you're someone out there listening to this and thinking, "Okay, sure, Christina, whatever. It's so easy for you to say. I really just want to lose weight." And if someone out there has some way for me to do that, without it being another diet and without me having to go through weeks months, or even you years of expensive therapy I can afford, then I want you to ask yourself how much of your life have you already spent struggling pursuing the school of losing weight and keeping it off for good. How many hours have you been to the gym? How many times have you missed out on sleep, events or being with family or friends because you had to fit in that workout. How many times have you counted calories? How many times have you really white knuckled at trying to follow a diet or a plan? What has all of that really gotten you? As you sit here, listening now, if it worked, then I would imagine you reached your goal and you've been able to maintain it with no problem, but something tells me that's not the case. I do hear people say things like, well, what works is when I follow some very restrictive or very regimented diet or way of existing that is definitely not sustainable. How is that considered working? I really am asking you to think about that. If you only ever achieved your goal by following something really restrictive or regimented to the point that you are no longer doing it, have you ever sat back and asked yourself more about that? Or if you have never achieved your goal, have you ever sat and asked yourself if I have tried and tried and tried so many things and I have white knuckled it for so many years and I have never, ever reached my goal, what makes me think I ever will? What is suddenly going to change or be different one day? I mean, you've obviously done a lot and struggled and suffered a lot to try to change your body. How much harder can you possibly try? That's what kills me. If after so much trying and hard work, when are you going to get that your body is not meant to be at that goal that you have set for it? If it was meant to be at your goal, you would not have to struggle and suffer so much to get it there. You really just wouldn't. You are not failing. Your goal is not attainable. If you are working that hard, you are not a failure. That is just not something your body is meant to achieve. I hope there's some more clarity out there now about eating disorder specialists and how they differ from others out there who claim to want to help you overcome your issues with food. The big glaring difference is that we will never do this with the ultimate goal of helping you lose weight. We will never do this. We are licensed, certified professionals who have specialized training to help you. Help is out there and I cannot say this enough, coming from someone who has had an eating disorder herself and is recovered. Recovery is possible. 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.