[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, hi everybody. I'm so glad you're here to listen to this show because I know so many of you have questions out there about what to eat, when to eat, what's going on with what I read on the internet. These questions have been going on for so long. I know it's not just right now. So I have with us today, a special guest who is an expert dietician who's going to break through all these questions and answer so many things. You're really going to want to listen because I get all these questions a lot when I'm out not in my doing my clinical work, I even hear these questions. People are fascinated by wanting to know what's the best diet or am I eating the right foods or am I doing the right things? So I know this is on top of mind for a lot of people just in general. I want to get right to the show. I want to tell you a little bit about our guest. Her name is Jessica Setnick and she is known by eating disorder professionals like myself worldwide for bringing a new version of eating disorder care to the field. Through her training workshop, Eating Disorders Bootcamp, and hundreds of conference and community presentations, Jessica has spread her message to thousands of healthcare providers, educators, college students, and so many others. [CRISTINA] I once saw her present and I'm so thrilled to just have her on this podcast today. She is very authentic. She has provided decades of expertise and she has this unique ability to translate complicated topics into very practical tools. She really is someone who can connect with people on a deep level, whether it's from the podium or across cyberspace. So I'm so happy just to have her here on the podcast today. Well, Jessica, welcome to the show. [JESSICA SETNICK] Thank you. Glad to be here. [JESSICA] All right. So you've been doing this a long time and I'm just curious, what have you seen happen, I guess, during the pandemic, and now that we're easing out of the pandemic in terms of people's relationship to food or the questions they're coming to you with in regard to food and nutrition and all of that? What have you been seeing in terms of I guess happening in the last two years? [JESSICA] So, okay, I'll start with the big picture and then smaller. The main thing that I do now, I don't have a private practice anymore. So I work individually and in groups with dieticians who help people with eating disorders. So we talk through what's going on with their situations, whether those are patient care situations or professional or inter-professional situations. That's what I do. So I observed at the beginning of COVID was that everyone was getting really full with people needing help for their eating. There was so much big picture stress related to let's say college students who were now moving back home and not having their own independence eating anymore. There were younger kids and teenagers who were spending their day at home homeschooling or just in that isolation. There was a lot more of parents and caregivers noticing things that were going on with their eating, that they might not have noticed if they hadn't been spending all day every day in the same space. I also saw a lot of increase in people seeking treatment, probably for both of those reasons that I just mentioned, but also because one of the main objections that sometimes people have to treatment is not being able to leave school or work or sports and those things weren't happening, then that sort of opened the door for people to get more care. So there was a lot, a huge increase in the number of people seeking care for their eating. On a smaller scale level I think a lot of that had to do with the stress for sure of not knowing what was happening next. There was a lot of body anxiety. We almost immediately started hearing people say that COVID was going to cause weight gain. There was a lot of anxiety about body sizes and the weight stigma in our society, the idea that individuals who were larger were going to have a harder time with COVID. I'm not sure it is true, but we do know that the research isn't done on a variety of body sizes. So there was less information. People worried that if they did get COVID that they wouldn't be prioritized for care because of their, because of weight stigma. So many different aspects really influenced eating disorders when COVID started. I think one thing that hasn't really been talked about very well is sort of the PANS, which is pediatric acute onset neuropsychiatric syndrome, and sorry to like throw that psychobabble at you, but the idea that people can actually get, when they get a virus, after the virus, they can actually have an autoimmune reaction that causes an eating disorder. It can also cause anxiety which can also move to an eating disorder. So even though yes, we know that that's the very common effect with COVID infection of having a loss of taste and smell, which of course can affect someone's eating, there's also the possibility that can actually trigger an eating disorder. So many different things going on. It's just something to focus on me just that you couldn't get the ingredients for sourdough bread anywhere because so many people were doing that as sort of a hobby, something to do. A lot of people started growing their own food in the backyard, which is a great idea if you have that ability. But I think some of it stemmed from the idea of being scared of not being able to get things as there were sort of shortages in the stores and things like that. So they're just, I mean, it's so all encompassing all of the big picture, just people being together in small spaces and everything from the triggering of past eating disorders, to of people who had or had never experienced a food shortage or food insecurity that could trigger an eating disorder too, or be retriggered. So much anxiety about food and eating really that's sort of the overarching thing. The other thing that I saw that is, again, a big picture thing is the addressing of the biases in eating disorder care, which that was actually a good thing, long overdue, but the realization that eating disorders affect everyone and that treatment isn't accessible to everyone. So I saw a lot of that too. That was, I mean, it was just something that has to continue to be worked on, but I think wasn't even realized for a long time that it was a problem. So big picture, some things, little picture, it's the anxiety, anxiety about what to eat, when to eat, how to eat. I don't think it's the coincidence that intermittent fasting sort of came on during this COVID period, because I think people were trying to find a reason not to comfort-eat. I could go on and on there's just so much, so much that COVID did to influence our eating and our stress about eating. [CRISTINA] Yes, and you just brought up so many different topics that I think each one deserves their own podcast. Truly, I think people probably listening are going, what about that? Wait, wait, what, that? Just even, you're talking about what can happen when someone has a virus and spurring on an eating disorders, a reaction that's right there. Most people probably would be, what, wait, what. And hearing that probably wait, I want to hear more about that alone. Then other people are going, wait, I want to hear more about like food choices and intermittent fasting. They're all hot topics but I think we detour in on something because they're all interesting. But what are you seeing now as people aren't home as much now and people are getting out more? What's happening now that you're having people talk about or ask about it? [JESSICA] Sure. Two things. I think one is sort of the refocus on social eating and socializing has led people to have some distress about their body sizes and then anxiety about eating, about everything from, I'm thinking for me at 49, there's not that many first, but I had a first where I planned to cook something for dinner, went to the store and one of the ingredients was out. They just did not have it. I know that's a very privileged position to be in, to say that at 49, that was the first time I couldn't buy something at the store that I wanted. It was related to COVID and supply chain problems. So there's that effect that I think people are having, just the tear or the imbalance between, will I get enough to eat and am I eating too much? Then the other thing is just anxiety, anxiety over my choices, just this constant, am I making the right choices? Am I making the right choices? I feel like sometimes some of that is just a result of feeling like there's so much going on in the world that we can't control and we want to make the right choices on the things we can do. So I know that just if we can't even go a minute without recognizing what's going on in Ukraine and that there's violence and terrible things happening everywhere in the world. We're faced with it anytime we read the newspaper, turn on the TV and just feel so powerless. So many, I mean, the idea that our whole world is being held hostage by one man's narcissistic wounds. It just, I think there's things that we want to believe that can be more cut and dry, more specific and so for some people there's relief in focusing on food and focusing on calories and rights and wrongs and goods and bads and making everything binary because so many other things in life aren't. [CRISTINA] Absolutely. I think that's the core of the eating disorder is like, when things feel out of control, this is something I can control. I can control how many calories I'm eating. I control how many minutes I'm exercising. I can control which foods I'm eating or not eating. I know you know a lot about the topic of Orthorexia and I do want to get into that a lot because I know that's --- [JESSICA] Well, I think it's a great example of control. I do think that eating disorders are really not a method of control because they're really out of control. It's really sort of the body and the subconscious controlling rather than the purposeful conscious control. But I think that's where there's, I just want to make that distinction because I do think that some people sort of poo-poo eating disorders is like, oh, well, that's just about wanting to be in control and not recognizing that it really, there's a mental illness aspect of it where someone is not in control at all. That's the thing that they normally would never do, like lie or steal or things that are just totally against their values, but the eating disorder really drives them to do it. But the aspect of feeling out of control in life, absolutely, that can lead someone to want control their body, control their eating. I think that we've been fed sort of, oh, funny pun, we've been fed pretty steadily the idea that your body size is totally in your control and what you eat is totally in your control. Both of those things totally don't take into account the fact that there's huge inequities in financial means that there's food insecurity, that a lot of times people don't have any choices. Anyone who's a child doesn't have a credit card, they don't have any choices about what foods are brought into their home. When you talk about food deserts and food apartheids, you're talking about people who within the space of the area that they're able to access there may not be access to a lot of different foods. So it's definitely a false reality and definitely a privileged position to say, well, I can eat whatever I want. So I will make healthy choices and then that will result in my perfect body size. I think that's what actually leads to a lot of shame, is the realization that I can do everything finger holds right yet I don't have the body I want, or I don't feel good. That myth that if I do everything right, then I'll always feel good, everyone will like me, and I'll always be happy and everything will turn out, what it does is the converse, is if everything doesn't turn out right, if everyone doesn't like me, if I'm not happy, then it must be me. It must be something I've done. Doesn't really recognize the bigger systems at play. So food can become a microcosm of that. So if I don't feel good about something I ate that can sort of resolve my cognitive dissonance, where I'm feeling bad about something, and I don't know what it is. So I eat something in theory to make myself feel better, but I end up feeling worse, which actually gives me a reason to feel bad now. I think there's a lot of, I don't know what the right word is exactly, but sort of guilt about having feelings, just use an example for my own life, just because I understand that the best, but the idea that there's people suffering everywhere and yet I'm safe in my house right now. So how dare I feel lonely or sad or depressed or something like that when other people are fighting for their lives? I think our culture is really bad at having mixed feelings and saying, I can have both of those. So if I feel bad, even though my life is fine right now, then I might look for something to make me feel bad. That's what I mean by the cognitive dissonance. If I know for a fact that I'll just pick a common food that I think people sometimes villainize, if I feel like pizza's going to make me feel bad, why would I eat pizza? Well, the only explanation is if I already feel bad and I need a reason to feel bad, but this all happens subconsciously, and so it becomes a big old mess where I feel bad because I ate pizza. So then I vow not to eat pizza anymore, but I still feel bad. So whatever I eat next, I'll decide, oh, I can't eat that because it made me feel bad and we're not really dealing with the roots of the issue. So that's where I think food and feelings can get really mixed up. Orthorexia is just sort of a natural, almost out cropping of that, which is sort of eliminating any foods that in theory make me feel bad, but bad is such a huge definition, anything that makes you feel sad or angry or guilty or regretful. Then someone's eventually limited to a very small number of foods. Now I will say that orthorexia can mean different things to different people, but the sort of original definition is the idea of trying to eat the right stuff. So there's nothing wrong with trying to be healthy, absolutely nothing, but it's when that trying to eat the right stuff becomes a preoccupation, becomes an obsession, takes time away from other aspects of life or isn't recognized as being an anxiety sort of management technique. So in other words, you can eat as right as you want and still have anxieties. So if you only focus that on the food, then your anxiety is being managed in other ways. There is a handout that we'll link to in the show notes that talks about orthorexia, because I feel like the concept of how can trying to eat healthy be a problem is something that is easier to visualize when you can see it, but it absolutely can be a problem because using food to manage anxiety about other things doesn't matter. The best way to tell the difference is after you eat or don't eat something, are you still worrying? Are you still worrying that you ate the right thing, ate the wrong thing, didn't eat the right thing, didn't eat the wrong thing? If you're still worrying about that, then that tells you that it didn't solve anything. So for example, if I have, if I'm allergic to strawberries and so I see some strawberries and I don't eat them and I'm like, yes, good, that was good because I needed to stay away from strawberries. So I didn't have an allergic reaction. Great, I feel good about that. Or even if I ate pizza, I ate pizza. I'm like, good, that was nourishing. That was awesome. That pizza's great. But if you're still worrying or distressed after you eat, that's a good sign that you were still worrying or distressed beforehand and the food wasn't the solution or avoiding the food wasn't the solution. So it's hard. It's hard to separate that because a lot of feeling is like hunger, so it makes a lot of sense that we would try to fill those feelings of food, but not working. [CRISTINA] It's so interesting too, like you said, people have different definitions of these things and to your point, I think there's so much, I think I call it misinformation out there for people to grab on the internet. And it does get confusing so I can see why people are coming to the, group that you're working with asking all sorts of questions about, well, what do I eat and how do I eat? Is this the right thing? Or is this the right thing? I've been around long enough to see it comes in waves. There's always like, I call it the diet of the day or 15 minutes of fame. So nothing makes sense. Even for me going, like, how did that one get this 15 minutes of fame? It's so different from the one that had it before. So when people are coming to you saying, "Hey, is this diet the right one? Is this the one that's going to get me where I want to be or where I want to go?" Are you seeing it as more motivation for weight loss or is it really health-related? [JESSICA] Well, I think that it's hard to separate because in our culture, it's so ingrained that weight losses is always good. I even just saw a commercial on TV recently with James Gordon for a weight loss diet and the people he was talking to were like, yes, sign me up. They didn't look, to me like anyone who should even be attempting to lose weight. So it's the idea that no matter what your weight is, you have to be precautious. That's part of the fatphobia in our society, is that if weight gain is always bad, then weight loss is always good. So the whole idea of am I eating the right things is a little bit of a fallacy because there is no one right thing. We put way too much value on any individual item. To me, the question is not, is this one item good or bad for me healthy or unhealthy for me. It's really is the way I'm eating supportive to my goals, supportive to my life, because no one food can make or break you. I mean, if you eat a pencil, that's going to be really bad for your digestive system. But the majority of what we think of as food is just molecules that your body will deal with when you eat them. I mean, your body might actually even deal with a pencil, but it's not going to feel good on its way. But so the question is more is eating this pencil supportive, and I'm just using a silly example, is it supportive to my goals or not? Well, no, it's not going to give me nutrients. It's not going to feel good going down. It might actually poke my esophagus and cause damage. That's a better sort of framework of asking questions rather than is this pencil the right thing? Is it right or wrong to eat this pencil? You might have some moral judgment about whether it's right or wrong to eat a pencil. But to me, that doesn't have a place in decision making about food. If you're talking about actual foods and nutrients, there's not a lot of rights and wrongs. It's really hard for people to hear from a dietician, especially because the whole website of our professional organization is eatright.org. But there's really not a right, people really want the answers. I relate this to one time I went to a meeting where they were talking about the fashions coming up in the next season and they were talking about Capri pants were coming back. Someone in the audience said, "Well, but what length Capri pants? Above the ankle, below the knee, can you be more specific?" The person said, "Well, it depends. It depends on what's flattering to you. What's comfortable to you." Nobody wants to hear that. Everyone wants to hear get out a ruler and get your Capri pants two inches above the ankle or something. Everyone wants a very specific answer. It's the same thing with nutrition. Everybody wants to know, am I doing it right? Am I doing it right? But is so much more involved like that. It's like if I wrote you a check and said, is this the right amount to pay for my taxes, like you have no idea. You have to gather a lot of information to find out. So that's why, if you're asking that question, am I eating right, I would encourage you to talk with someone who's an expert in nutrition that can ask the questions before giving the answer. Anyone who's an influencer online, any diet that just says, is this your height and weight? Here's what you should eat. That's never going to be correct because it hasn't taken into account your whole story, your whole background, your culture, the things you like, the things you don't like. Some of the weight loss diets that as you were saying, the diets Azure, some of those actually work because they were things that people don't like, like cabbage soup. Remember the cabbage soup diet and all you're supposed to eat was cabbage soup. But no, I'm not going to say nobody likes cabbage soup, but nobody likes it every single day for sure. So it actually, yes, it made you lose weight because you just lost interest in eating until you gave up the diet. Then you gained the way fat. So is that kind of thing operates in a lot of diets. It just limits the variety and then you just get tired of eating food. So is it the right way or the wrong way? The question is it supported to your life? Is it providing the nutrients you need? Is it fulfilling your need for connection with food, your social needs? If you're able to eat things only in secret or alone, but you're not feeling comfortable eating in a social setting, then it's not about what you eat. There's more to it. Is that social anxiety, is that not feeling comfortable with your friends? Is that feeling judged. Are you judging yourself? A lot of people in larger bodies feel that way, like, "Even strangers judge me when they see me eating." There's all kinds of pressures that affect us. I feel like is it right or wrong is just way too simplistic of a question to be asking about our eating. So yes, supportive or not supportive that to me is the way I think about it or I'd encourage people to think about it. Also you can, that's flexible. So for example, if you want to just define, I'll just pick, there's some cookies sitting on my counter right now. So I'll pick cookies. If you want to define cookies as healthy or unhealthy. You want just to have that binary, are they good or bad? But the truth is a cookie, if it's good or bad, it's always good or always bad. But if you talk about being supportive, like a cookie right now is probably not supportive because it would get crumbs in my computer and it's not really the nourishment that I need when it's almost lunchtime. It's not wrong to want a cookie. Does that support my needs right now or supportive to my goals? So after we get off this interview, I'm probably going to have a sandwich or something like that. I may also have a cookie, but in this moment, right now, cookie's not supportive, but in half an hour might be supportive because a cookie might taste delicious and I won't be on the computer. So I won't be worried about the cookie crumbs. A food can actually change in its ability to be supportive or not supportive whereas a food can't change if bad's bad. If it's unhealthy, it's unhealthy. So I think those are unhelpful words to use, to describe food. [CRISTINA] I often find people will equate the emotion with the label. So if it's a bad food, then they feel bad when they eat it. If it's a good food, then they feel --- [JESSICA] That is a real danger. That is a real danger because we add these moral things to food. I know people have often said to me, oh, I'm so bad about what I ate. I just feel like, gosh that's just such a bad, it's just such a negative way of thinking about food. I mean, bad, what does bad even mean? But I mean, I'm thinking like, did you harm someone's pet on purpose? Bad is like these very specific things to me, like bad, oh, I didn't quite follow my meal plan or bad I ate half a Turkey sandwich instead of a whole Turkey sandwich or vice versa. It's just such a strong word to use for a choice that you may regret. You might regret a choice, but it doesn't make you a bad person. Again, that's where I feel like we're putting way too much value on basically just molecules that are clumped together into a food. [CRISTINA] This also equates to what you were talking about earlier, this fat food society we're living in of, you're so good if you lose weight and you're bad if you gain it. It's perpetuated for the medical field too, and commercial, I mean just everywhere. What if it is supportive of your body and your needs and the energy level and everything you need to eat a certain amount, but it doesn't equate in weight loss, or it doesn't equate in you having this ideal body that society's putting out there? There is all this shame and this thought of I'm doing something wrong because I'm actually eating what I enjoy and how much I need and my body's functioning great. I don't have any illnesses and I'm actually medically, physically healthy. Everything's looking great. My labs are great, but I'm being told something's wrong with me. I need to do something different. I don't know if you hear this all the time, I do, but I'm just pulling my hair, I'm going, but you're medically fine, you're physically fine, you feel great? Like what's going on here? [JESSICA] Well, the worst part is it's perpetrated by health professionals. I had a doctor's appointment yesterday. It was virtual and the doctor asked me if I knew what I weighed and I said, I don't. Also I'm not stepping on a scale because the last time I stepped on a scale is when I donated blood. I remember that the number just stuck with me for at least a week. I mean, this is what I do for a living. I totally get that. The number on the scale is just a pigment. It doesn't have any bearing on anything in my life and yet it's still, it's just a sticky thing that stuck in my mind and had an effect on what I saw when I looked in the mirror and how I felt when I put on my clothes. So this was the first time that this doc didn't hassle me, or didn't say anything about it. I just explained why I don't know my weight and leave that blank in my chart basically. That was the end of that. I know that for me, as a person who has sort of in the field, sometimes they call a straight size body sort of someone that does fit society's image of what a healthy person looks like. Wrongfully. I may not be a healthy person at all, but because that's my size. I wonder if a person who was larger than me that said to their doctor, no, I don't want to be weighed because it affects me if they would actually be allowed that privilege or really that just that basic human right of not being weighed or if they would be sort of forced or encouraged or coerced into being weighed, because it's such an important piece of your healthcare. What I really can't stand is when people go to get medical care for something very specific, like I have an ingrown toenail and they have to be weighed. Like why, why do they have to be weighed. It has nothing to do with it. And if anything, it's almost like if you went to the hairdresser and said, I need this and they said first you need to weighed. Like what does that have to do with anything? You do not need my weight. But it's such an integral part of our culture. So the idea that so much of this weight stigma and poor medical care comes from the medical community, and of course not every doctor or PA or nurse practitioner falls into this category at all. In fact, I put a lot of the blame on insurance companies who just put these blanks in forms and say, we can't pay your claim unless we have all the information. I mean, that to me is really unfortunate because it's not that important because you know someone's weight constantly. All you're really measuring if you weigh often is your hydration status, honestly. So it's not a useful parameter, but yet it's just used as such a proxy for health. So the idea that a medical professional would suggest weight loss is a cure for everything is so aggravating. I'm really glad you mentioned it. I think back really sadly on a patient, I had a long time ago and when they were no longer my patient, their wife called and said that they had died. I asked how, and she said that this person had had a lot of symptoms, had been to a lot of doctors. Everyone said, lose weight, lose weight, lose weight. Then ultimately he had to have surgery for something. I'm not, I don't remember what, so I don't want to say the wrong thing, but once he was in surgery, they saw there was, his body was riddled with cancer and they basically sewed him up to die. Because no one had ever assessed him for anything. They had just constantly said, lose weight, lose weight, lose weight, lose weight as a treatment. I felt like that is just one of many examples, that one just personally happen to someone I know, but there's, you see that thing on the internet all the time is this woman died. She said in her obituary, she just wanted the world to see her death and recognize that this was basically medical malpractice and weight stigma as the reason she died, because what she had was treatable. So I know I'm saying a lot of words, like you said about a lot of topics, but if I could, if there's one thing that people could take away from this, it's the idea that weight is not an appropriate proxy for health. [CRISTINA] I hear that all the time, people saying, well, I need, I need to lose weight because for my health and I say, well, what illness do you have? What diagnosis do you have? Well, I just need to, because it'll make me healthier. I've been told and well what's going on? Well, I just need to. I'm at risk for many things. I'm at I'm at higher risk if I don't. What do you say to that because I'm thinking to myself, like for what? [JESSICA] I would just say that's a really pervasive myth in our society. That weight loss is always good. Weight gain is always bad and bodies fluctuate throughout our day throughout our lives. If you are worried about it, then it makes sense to talk about it but the person to talk about it is not necessarily an influencer or a diet counselor. The person to talk about, it might be someone who can help you figure out what you're using your weight as a proxy for. For me, I know it can be related to aging. I mean, I'm 49. I'm getting close to that age where in theory women are disposable in our society. So how do you maintain your relatableness? Do you have to stay a certain look so that you are perceived as young and all that thing. Those are things to talk about with a counselor, not to lose weight over. But again, I think that's where the mix up happens, is people think if I'm starting to not feel good about myself, this must be because of this weight, the way my weight has changed, but bodies change. Bodies change all throughout life. It's hard. It's hard in our culture to see that. Even when we see someone, the media images that we see we're always comparing. So even when you see someone like a Helen Mirror where you're like, oh, that's nice to see an older woman in a cosmetics commercial, they're still in a cosmetics commercial selling you something to make you look different. So it's interesting how our consumer culture really has to find ways to fix us in order to sell us products. If we all accepted the way we look, then there would be a lot of things, products we didn't need. So what I'm saying, I guess, and answer to your question of, what do you say is just simply, can you recognize that the idea that you need to lose weight is an external idea to yourself that you don't, you may or may not choose change things about your life. That's a separate issue, but you didn't actually wake up this morning just thinking, oh, I gain weight and I need to lose it. These are ideas that have been acquainted in you in a sense all of your life and maybe even before you were born, depending on what your, the person who just gave birth to you was told when they were pregnant. There's lots of us that were, you know, if you were born in the 70's, your mom was probably told that she needed to not gain too much weight while she was pregnant, those things, those messages just, they keep being passed on intergenerationally. It's really unfortunate. So just recognizing, and that's really what my Food Fairy Tales workbook is about, is figuring out which of these messages and where they came from and then chewing as a conscious adult which ones you want to keep, which one are valuable to you, as opposed to the ones that were just passed on to you by a culture or by family, or by sort of a mythology that you made up as you grew to explain why things were happening to you and which of those things are you ready to let go of, because they're really not what you believe. [CRISTINA] So tell us about this book you're talking about. [JESSICA] Sure. So it's a workbook called Food Fairy Tales, and we'll make sure to link to it in the show notes. The idea is that people often say to me, X, Y, Z happened to me so long ago that it couldn't still be affecting me. My response was always, no, I think it's the opposite. The younger you were, when something happened to you or something was told to you, whether that was anything about you not being okay, or not being the right size or you're the skinny one, you're the pretty one, you're the fat one, any of those messages, even things that aren't about your appearance; we carry those experiences with us, even if we don't consciously recognize them. Sometimes we do remember them. They're very specific. Sometimes we minimize them, oh, that wasn't that important. But to me, the key is to look back and say that young child was really affected by those things. Even if, as an adult, I can look back and say, yes, that wasn't important, it was important at the time. So the fewer resources you had to cope with it, the younger you were, the more of your life has gone on since the event happened. In addition, you had sort of, you had less, you had a more immature personality to explain the story, the narrative that you created about that. So in other words, if a five year old is told something like oh, I cannot believe you ate five cookies, they don't have the experience to say, well, that's someone judging me and that person doesn't know how many cookies are right for me. They take it on as, wow, I eat too much cookies, too many cookies I can't be trusted or whatever their storyline is that they come up with. So that is the underlying theme that I have seen with all of my adult clients through 25 years of being a dietician, is that there's something that they believe to be true, whether it is, and when we talk about it as adults, we can see it differently. So everything from I got punished because I ate two boxes of granola bars. Well, tell me more about that. Well, were the granola bars that we were supposed to take to the after soccer snack and I ate them all. So I was punished. Well, the child might have interpreted as there's too many carbs in those granola bars so I shouldn't eat carbs anymore when really they were punished because they ate food that frustrated the parent, maybe the parent didn't have the money to go buy more snacks, or maybe they didn't have the time to go buy more snacks. So they were mad and it can just be misinterpreted. I had this realization again about myself. I hope I'm not talking too much about myself, just using examples. When I was in kindergarten, my mom was very chronically ill. Nobody picked me up and I remember being often left alone. This was in the 70's where they would just, the teachers would just leave and say like, okay, well, I'm sure your parents will be here soon. So I would be alone and each little kindergarten room had a kitchenette and I would climb up on the counter and the cupboards until I found something I could have for snacks, crackers, or you know, something like that. And I remember that so well, but I didn't really think about how that might have affected me, but it's still affects me to this day, not necessarily with the food choices, but I do not like to be late when I'm picking anyone up from school. I have to be there on time. I had an incident earlier this year where I was on time early in fact to pick up my nephew, but it was the first time I picked him up at this new school. So he didn't see me. I didn't see him that kind thing. So it was about 10 minutes after school ended before he realized I was there and I was in a panic, not because I thought I wouldn't find him, but because I thought he might be in a panic because he thought someone wasn't coming to get him. He knows someone's always coming to get him. He wasn't worried about it at all, but I was still projecting that experience of being left alone. So there's probably ways that still affecting my eating. It definitely affects me in picking people up from school. So it's just a tiny example of how things that we think happened so long ago as an adult, we can say, if yes, turned up fine or we can minimize it, but it's still maybe affecting us in a way that we don't actually consciously realize. [JESSICA] So that's what Food Fairy Tales is about. It has all these exercises to help you come up with what are the messages that you got about food, about your body, about your self-esteem and where do they come from and were those reliable sources? It's a deep dive. I mean, I'm not going to say it's an easy workbook, but it's really helpful. If someone isn't quite ready to talk with another human about what's going on with their eating and just needs to gather their own thoughts, that's, what's really good for. [CRISTINA] That's fantastic, because I think people aren't aware of their relationship with food and it is very emotionally tied oftentimes and into things way back. There's a lot about food that people don't realize. [JESSICA] Yes. Well, and even just how self-esteem develops while you're being fed. That if the person that is nourishing you, if they are present and paying attention to you and babbling to you and saying things like, oh, you learn that you're a good person. You don't have words for that. You're totally preverbal, but you learn, like I make people happy. If the person who is feeding you is crabby, depressed, on drugs, not present, neglectful, those things, which many people are, and I'm not judging because people find a way to get through the day, however they need to, but it does impact the child that they're feeding because the child then learns again, nonverbally, pre-verbally, the child learns my needs make other people upset or anxious or depressed because you don't have the ability to understand that your caregiver could be anxious, depressed, or anything else unrelated to you. That's just not a concept that you grasp at that age. So you take away from the experience that something about me makes people unhappy. It's so weird to think about how these things happen long before we're even conscious of them, but can still be affecting us. [CRISTINA] Absolutely. I'm sure people listening are probably going in their minds like, Hmm, how do things affect me? So working some things right now. Well, Jessica, you've brought up so many things and I mean, I would love to have you back just to talk about one of them. You could come back because like I said, we could go on and on and on today, but definitely you've brought up so many great things for people to think about long after this show, after they've listened to it. So I don't know if you have any last thoughts or words for people as we come to an end here, or? [JESSICA] The main thing I would say is whatever you're doing with food that you feel ashamed of, no need to feel ashamed. I sat with people for so many years that would tell me things that they were ashamed of with their food. It made me realize everyone carries something and you're not a bad person. You do things for a reason. It's just, whatever it is that you're feeling ashamed about, tell someone, write it down, throw it away after you write it down, if you have to, but start to recognize that it's external to you, that whatever you're doing has a reason. If you don't want to do it anymore, you have to figure out the reason, but just stop blaming yourself for being a failure if the way you're eating is not supportive right now. I think shame is a killer. [CRISTINA] So if people do want to find you, get in touch with you, I'm going to have links to your handouts and your book, but how can they find you? [JESSICA] Sure. So jessicasetnick.com is my sort of umbrella website where everything is listed. Then you're of course, welcome to contact me through the website. If you, especially, if you're looking for an eating disorder professional or eating professional in your area, I would be happy to try to help you do that. So, yes, please feel free to get in touch. [CRISTINA] Well, thank you again so much. Hopefully people will be in contact with you. [JESSICA] Fabulous. [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.