[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. It is may. It is mental health awareness month, so we are kicking this off with a bang today. I'm excited. Any of you out there who are struggling with an eating disorder, or maybe don't know if you have an eating disorder, maybe have disordered eating, body image issues, or if you're a loved one who is watching someone struggle with an eating disorder, this is definitely the show for you. Today I have a guest on here who you definitely need to listen to. I'm excited. I don't want to spend too long on the intro because she has a lot to say, and I know you're going to want to take in everything that she has to say. So I'm going to tell you who she is. I'm super excited like I said. We have the founder and CEO of the National Alliance for Eating Disorders. Her name is Johanna Kandel and she's done so much to help the eating disorder field. She's the author of Life Beyond Your Eating Disorder and not only did she found the alliance after a decade long battle with various eating disorders but she's brought information and awareness about eating disorders to hundreds of thousands of individuals nationally and internationally. In addition, she facilitates weekly support groups, mentors individuals with eating disorders and their families throughout their treatment and recovery and helps thousands of people to gain information and find the help they need. She's a passionate advocate for mental health and eating disorders legislation and she spent a lot of time meeting with numerous members of Congress and was part of the first ever eating disorder round table at the white house. She's a proud member of the Interdepartment Serious Mental Health Coordinating Committee Meeting under the Department of Health and Human Services and member of the board of directors for the Eating Disorders Coalition and a member of the Eating Disorders Leadership Summit. She has received many awards for her ongoing outreach and advocacy work, including the Jefferson Award for Public Service, Academy for Eating Disorders, Mehan Hartley Leadership Award for Public Service, and Harla Enterprises more than words award. She has appeared on national television programs, including NBC Nightly News, The Today Show and profiled in the New York Times, Cosmopolitan Magazine and Glamour Magazine. Without further ado, I'm going to get right into bringing Johanna in. All right, well, Johanna, welcome to the show. [JOHANNA KANDEL] Thank you so much for having me. I'm so excited to be here. [DR. CRISTINA] Well, I'm very excited. We're going to have a great conversation. May is a mental health awareness month and you're kicking it off for the show. So with that, I'm excited just being a psychologist but also as a eating disorder specialist, I'm really excited because you're the founder and CEO for the National Alliance for Eating Disorders. I'm excited to have you on here just to discuss things and bring much more awareness to eating disorders. So I'm just wondering, could you tell us a little bit more about the National Alliance for Eating Disorders? [JOHANNA] Yes, absolutely. So the National Alliance for Eating Disorders or the Alliance, we were formally known as the Alliance for Eating Disorders Awareness, that was our little kid name, we were founded over 21 years ago and we have become the leading national nonprofit organization that does everything from education. We do a lot of educating our frontline providers, doctors, nurses, dentists on how to recognize and refer eating disorders because even though eating disorders affect millions and millions of people, about less than 20% of all healthcare providers are given any information on how to properly recognize and refer. What that means is that number one, people are struggling in silence. Number two is individuals often do not get diagnosed or it can be very unsafe for many people to go into their providers and to literally be turned away because they don't fit that stereotype of who develops seating disorders and what they look like. So that really is our goal to arm our frontline responders, doctors, nurses, dentist, teachers, on how to just recognize and refer. Our job is not to make them specialists. Other organizations that do that. We just want to give you information to not do any harm and to help with connecting to care. So that's one of our big pillars. Our second big pillar is referrals to care. So we built the largest robust, inclusive and comprehensive referral database specifically for the treatment of eating disorders. So we have findedhelp.com, which is a website that's actually separate from our Alliance website that people can go in and put in their zip code. They can put in level of care, the type of insurance and it'll generate list of providers and treatment centers that actually are helpful for them because for so many folks that I've talked to, there might be a provider that's phenomenal, or a treatment center that would be the perfect fit and yet, because it's cost prohibitive, because they might not take insurance it's not going to happen. So we really want to arm information to individuals with really good resources. On the flip side of that is we have our helpline that's manned by fully licensed and specialized clinicians. Actually, we have therapists, psychologists and dieticians that work on our phone lines. We feel that it's really important so that individuals can get really supported and advised by individuals that are professionals. That's our second big tier. Then our last big tier is our support groups. We hold a lot of free therapist-led support groups for individuals experiencing eating disorders, as well as their loved ones. Again you'll see, it's a theme within the Alliance. We try to always use clinicians with everything we do just to really have that safety. Many of our clinicians are individuals a lived experience, so they also have that peer in a sense to bring to the table. So that's a little bit about what we do. [DR. CRISTINA] That's a lot. I think it's great. I know so many people I see on social media, people are saying, oh my gosh, I can't find any resources. I don't know if I have an eating disorder. So I'm wondering how come people haven't heard of the Alliance? For me, that's frustrating. I'm always referring people to you guys, but people just haven't heard of it. So I'm wondering what can we do to spread the word more? I know like the podcast, of course, that's why I'm excited to have you, but what do you think we need to do more to get people to find you and spread the word to other providers? [JOHANNA] I mean, honestly, that is the million dollar question that we are always talking about. I think when people find out everything we do they actually are taken aback because they're like, how did I not know that this resource exists? Truthfully, I think it really comes down to, I mean, I hate to say this, but the nonprofit field is just the same as a for-profit field. It's all about having the funding to be able to get the word out. So that's why we love to do things like this podcast. Like we have a very active social media channel and we just need clinicians, for example, that are on Find Ed Help, just spread the word to other fellow clinicians and say, "Hey, like it's free to be listed." One of the things that was very, very important to me is I didn't want to create like a Psychology Today type of database because as helpful as it is, it's also exclusive meaning that there's a charge to be listed. There's also advertisements on it. When I created Find Ed Help, I wanted it to be evergreen. I wanted it to be as inclusive, as possible, as unbiased as possible. We really go the extra mile to make sure that folks that are listed on Find Ed Help, actually are specialized in the treatment of eating disorders. So we're asking them screening questions, we're asking them about their experience, how much of their practice includes eating disorders. So I think just, we need our community to continue to spread the word and hopefully be able to continue to flood channels to say, "Hey, we're here and we're here to help." [DR. CRISTINA] I'm just wondering, why do you think there still lack, I guess, education in medical school and nursing school in eating disorders? Because I know for me that is a huge frustration. I came from working at a hospital for 15 years and just, oh gosh, I'm sorry. But it was so frustrating for me. I don't know, what's your take on that? [JOHANNA] I feel your frustration completely. I think it's something that was just so shocking to me and I think back, because we do a lot of work in residency programs across the country. I remember I was in new Orleans. I was speaking to 200 psychiatry residents. So we're talking about people that will absolutely be seeing eating disorders and out of the 200 people when I asked how many of you have gotten adequate training on eating disorders? Three people raised their hand out of 200. I asked how many of you had had any information whatsoever and they said just when we went over the DSM. That's it. And you think about what are they being taught and what is the DSM teaching us? What was really scary was that I think the reason why it doesn't get a lot of awareness attention, I think it's getting better, but I think the reason why is, and this might not be a very popular opinion, is that eating disorders for good or for bad, even though they do not discriminate against who they affect. They're still sort of known as a female based or female identifying based disorder. We know factually there's less funding, there's less education surrounding things that affect females. So that might be one side of it. I think the other side of it is this misinformation around that eating disorders are a disorder of choice or vanity even though we know that they are bio psychosocial illnesses, we know that they are genetically brained based illnesses. I think until we continue to do the job we're doing and pushing the needle forward and saying actually these are serious mental illness. We need to be very aware of the lethality rate, having the second highest lethality rate of all psychiatric disorders. It's not just the legality rate. It's also just how ill people get, how they cannot function in life, how much the eating disorder steals from the individual, as well as their loved ones, because eating disorders do not happen in silos. They don't just affect the person that's going through. It affects the loved as well. I think a combination of all of that, and I think a lack of, less awareness, lack of research money, all of that plays a part into it. [DR. CRISTINA] That's what I'm talking to me. Because like you said, psychiatrists are in mental health departments, at least where I worked and they're the ones who get referrals for medication, which is oftentimes part of treatment. So if they're not getting educated on eating disorders, that is a huge problem. I work with a team approach, like part of the standard of care is to send somebody to a medical provider for vitals and all sorts of things, EKGs. If they're not getting any education in this, that is also a huge problem. I don't know about you, but I've heard so many of my patients say part of what has triggered them is things that were said to them by a medical provider or a nurse that, I know they don't mean to say anything harmful, but just the education about what to say or not to say in a medical appointment and how the impact of getting weight or just certain things can really have a negative effect. [JOHANNA] Oh, it's tremendous. We're not even taught, like we haven't even touched on or incorporated like fat phobia, weight stigma within the mental health community, within the medical health community, excuse me and the mental health community too. Let's be real. But it's really terrible. I live in the south Florida area. We have a huge amount of clinicians that specialize in eating disorders down here. We have one physician, one physician that we can send to. Like I'm constantly trying to go into residency programs or young clinicians, young physicians, I should say to be like, please, can we educate you? Can you please learn because, very directly put, there's no place that's safe for a lot of our patients to go where things like they don't have to be weighed every single time they go to the doctor unless there's like a need for it. I still, to this day, as someone have lived experience, I've lived my life beyond my eating disorder. I consider myself recovered for over two decades. I still do blind weights. For me, knowing my weight, I'm not active at all in my eating disorder, but for me, knowing my weight is not going to be helpful. It's not going to do anything for me but even the things that I experience to this day is someone who is living my life without an eating disorder. I also show up with a lot of privilege, like I am embodied, I'm fully able, I'm head, I'm Caucasian. Even the amount of pushback I get, and they know what I do for a living when I'm like, they're like, well, why do you want to blind weight? It's like, and I know I can use my voice, but I think of all of the folks in our community that are not able to use their voice, and yet it happens to them and that's not fair. They did not choose to have eating disorders yet they are facing all of these obstacles every time they go to the doctor's office. [DR. CRISTINA] Absolutely. I wonder, I don't know what you think about it, but I still wonder when's the BMI going to be gone because it is so damaging and means nothing? [JOHANNA] Nothing, and it's so harmful. I remember I was working on legislation right around the Mr. Michelle Obama Let's Move stuff came up. I remember working, we were working with the FDA, we were working with the CDC and we brought up the BMI and everyone, even the World Health Organization has said, like, the BMI is bullshit. It really is, excuse my language but --- [DR. CRISTINA] No, I love that [JOHANNA] They just don't have another indicator. That's what it is. We've been using this for 200 years and we know it's terrible and it's so harmful. I think it's time for us to find something else and really continue to lean into like a health at every size approach and to realize that health is not, your weight is not equal health. There's so many other indicators. [DR. CRISTINA] Yes. I'm just thinking, yesterday on my Instagram, I had, I put a post that said just that, and I got all this pushback from people saying, of course weight and health are connected. How could it not be? What's wrong with you? I was like getting so angry so I was responding back like, "But it's so pervasive, this belief." It's like, how do we that, because as you said in this toxic diet culture we're in, that is so prevalent. It's just like, gosh, how do we overcome this? It's awful. [JOHANNA] By having conversations and changing imagery by allowing other belief systems to the table, by bringing folks that don't ordinarily get access to a microphone, to have their voices heard. The needle is moving forward. I definitely believe that. Of course, when you have no patience like I do and want everything to change overnight, it can get a little overwhelming but I think it's continuing to show up, continuing to be that voice, continuing to post exactly what you did yesterday on Instagram, because for all the voices that said, that responded maybe negatively they're people that are listening that needed to hear that, that it will change something for them. I was watching, I'm a huge fan of Test Holiday. She's done some work with the Alliance and I just happened to be watching an interview that she did several years ago. She was on the cover of Cosmo UK. I think it was an interview with like Pierce Morgan and he basically started ripping the editor-in-chief of Cosmopolitan into pieces because he's like, you're advocating for that O word and all of that and shame on you. The editor-in-chief of Cosmo turned around and she said, whatever you believe is your belief system. All I know is that for all the pushback that we're getting from you is there are so many people that saw that cover and seeing someone as fabulous as Test Holiday and were able to have a sigh of relief today, that were able to be like, I can see myself. I'm represented. It's okay to be me. It's okay to look like me. So I think just continuing to have this conversation is helping move the needle forward. [DR. CRISTINA] So since you started the Alliance, have you seen change over time? [JOHANNA] Oh, a lot. I think even how readily we talk about eating disorders. I mean, 21 years ago, no one was saying the word eating disorders. I think we still have so far to go, but even the depictions of what eating disorders are and who they look like. I mean, when I started the Alliance, it was that lifetime after school movie, and that was it. Now we know that that's not true. We know that eating disorders do not discriminate between age, gender, race, class, sexual orientation, ability, neurodiversity, body shape, size. No one's immune. I think awareness, conversations, I mean, there's not a day that goes by that I don't get a ton of Google alerts that eating disorders have been discussed somewhere in the web. I think that social media has obviously contributed not so well, like we know that now with the Facebook files and all the findings that have come up, but also when you look at the flip, take a look at what social media has allowed us to do too. When the world shut down during the pandemic, I mean, the fact that there was meal support on Instagram every hour on the hour for folks around the world, that even though we were physically separated, we were still not socially isolated. So yes, I think that that's probably some of the biggest changes that I've seen. And there's a little bit more access to care. We have a long way to go though. [DR. CRISTINA] Oh, absolutely. You brought up something a little bit ago about how eating disorders don't just affect the people that have them, but their loved ones. One thing I love about the Alliance is their support for people who are, the loved ones, for people who have eating disorders and the education that you provide for those parents, siblings, significant others. So I'm wondering, could you talk a little bit more about that, because I know that's a huge resource of blacking out in the real world, the education part and the support. [JOHANNA] Yes, no, families are a huge part and families can be blood or not blood. Families can be who we bring into our lives. One thing that I know for sure is that when I was born or when I had my daughter, I never got a yellow for dummy's book that said, in case your loved one has an eating disorder read this. I never got that. So, so often, and I say this, because we have this amazing Wednesday night, 7:00 PM, Eastern time, virtual loved ones support groups. We have, like, you talked about, we have parents, we have partners, we have kids, we have siblings, we have teachers, we have the whole gamut that come to the group. It's such a beautiful space. Is that sometimes the things that we think are the most helpful end up not being so helpful. The other thing that we see all the time is like this divide between physical health and mental health. We have this family that comes to group and they have two kids. One of them unfortunately struggled with childhood cancer. The mom talks about the fact, when my daughter had cancer, I mean, there was like a meal trained. There was Casser at my door. There was like, everyone was doing everything for us and our family. Luckily the child is in remission, they're cancer-free. The other child ended up with an eating disorder and she said, there were no Casser. There were no meal trains. It was like, our family was almost shunned. Nobody wanted to do anything. So it's very lonely going through this and loved ones need as much support as the individual that's experiencing the eating disorder. So we try to be that floaty, that oxygen mask, to be able to arm them with the tools, to be able to walk alongside their journey to recovery, because it takes a support system. No one should have to recover, I would actually say no one can recover on their own and loved ones need to have the information to be able to help support their loved ones through the journey of recovery. [DR. CRISTINA] Oh my gosh, absolutely. I mean, you nailed that one so clearly. When I work with families, I just hear so much devastation, especially if somebody has to go into, like their child has to go into residential and a parent may have to go live somewhere nearby to be with them. It can really be devastating for families and just going through that, or I don't know all of what you hear, but I know holidays are so difficult for families and how to navigate those with food and celebrations and all sorts of things can be so difficult. So getting the education and support around that and how to what to say, what to serve, all sorts of questions people have, it can be really helpful to have a support group and know what to say, what to do and all because I think there are a lot of questions. [JOHANNA] Oh, for sure. For me, and it was funny, I was doing this podcast several months ago and the amazing human that was interviewing me said, it's almost like your experience became the blueprint of the Alliance, which in actuality it did. I mean, I think our experiences make us who we are for sure. For me, when I was going through my eating disorder, I just wanted to be in a space. I didn't know that virtual spaces existed at that time, but I wanted to be in a space where individuals spoke my language, where I could feel seen and heard, and someone would just look at me and say, me too. I think it's important for the individual that's going through it, but also for loved ones, because it's a game changer when someone can relate to what you're going through. I am so grateful for all of our, our clinical providers out there. They are saving lives. They are the game changer. I also want to just say, there's something to be said for that person that has a lived experience, that's going through the same thing as you to be able to say, oh my gosh, I totally know how you feel. Or even things like we hear in friendly friends, it's like, I'm so frustrated with this situation. I know that they have an illness, but I'm still frustrated. Just to remind them that you would have the same frustration if they were dealing with a physical ailment. You get to be frustrated by this. It doesn't mean that you love them less. It just means that you hate that your loved one is experiencing an eating disorder, that an eating disorder happened to them. You get to be angry, you get to be tired, you get to be all of those things. [DR. CRISTINA] Oh my gosh. That's so, yes, just to normalize it, normalize the experience and not feel alone in it. I think that that's one of the biggest things about group and support group, just to be amongst people who I guess your tribe. [JOHANNA] It becomes your family. That's one of the most beautiful things that have happened since, and I mean, the silver lining of the last two years is from a Friday to a Monday, we had to shift our 26 in-person groups to virtual groups. It's just been incredible. I mean, in 2021, we had almost 19,000 participants in our support groups from all 50 states across the country in 71 countries around the world. I got an email just before this recording from one of our members of our group where another member happened to be passing through the city in which he lives in and they had coffee together. It was just, and they sent me a picture and they were like, we wanted you to see this. It sat up my computer crying because I'm like, oh my gosh, it is a game changer when you don't have to go through this alone. That's really why I still show up to our groups all the time. They fill up my cup in ways that I can never put into words. It fuels me to do the work that we do day in and day out. [DR. CRISTINA] Now I'm just thinking for someone who might be thinking about, okay, how would I get involved or join one of these groups? How can they actually do that if they're thinking, oh gosh, that sounds amazing? [JOHANNA] Yes, absolutely. Would love to share that all of our services here at the Alliance are free, because we never want them ever to be, we never want cost to be a barrier to care. So if you go to our website, which is allianceforeatingdisorders.com, or you can follow us on any of our social channels, which is at Alliance for ED, you can see the full list of groups. We have individual groups, we have an amazing pro recovery LGBTQ+ group, we have a loved ones, friends and family group. We also have a support group just for moms. It's such a wonderful, wonderful community. We're looking to add another two virtual groups and hopefully in a few months go back to in-person as well. So really looking forward to just having, one day my big dream is to have a virtual group available every single day so that no matter where you are in the world and no matter what you're going through, you can always drop in and get support. So fingers crossed it'll happen soon. [DR. CRISTINA] I'm wondering if listeners are going okay, so how would I even be able to have a voice in these groups if they're so big and I'm wondering what would the experience be like, say if I was a parent wanting support? How many people are in these groups and how do you have the ability to speak up or say something? How does that work? [JOHANNA] Yes, I mean, so when I share the number, I'm sure listeners are going to be like, oh God, I'll never go. But I promise you, it works beautifully. So some groups have 60 people in it. Some groups have 116 people in it. Last night our Monday night virtual support group had 116 people. We got through every single hands last night of folks that wanted to share. We bring up topics, so individuals submit topics to the group leader, we go through topics in the friends and family group. We do a little bit more psychoeducation just because you have individuals that literally just found out that their loved one was diagnosed with an eating disorder that day. Then you have family members that have been walking this journey for decades. So you have all levels. What's really phenomenal about support groups is the folks that have been in there for a little bit longer, can almost take on this mentoring role of like, this is what we've been through. This is what was helpful. Then of course, you have oversight from the clinicians in the group that just to make sure that the information is accurate and also safe. So we do hold a lot of rules in our group meaning, no specific numbers, rituals, diagnoses. We also ask folks to not share specific, like how long have you had an eating disorder for? Sometimes people are like, what do you mean? There's even that competition of like, "Well, I've had my eating disorder longer than you and I might not be that severe." No matter where you are in your journey to recovery, you're welcome in our support groups. We say to people, there's no right way to do group. If you want to share it, we would love to hear your voice. If you don't want to share, if you don't have to share, if you want to write and chat, you can write and chat. If you don't want, you use group in the manner in which works for you. [DR. CRISTINA] Okay. So what if somebody's going, I don't know if I have an eating disorder. I'm confused. I don't know if I'm just failing at dieting or if I'm just wondering, like I'm not sure. [JOHANNA] Oftentimes we'll get that question or one of the facilitators will get that question. Sometimes they will answer the question in a DM. Oftentimes we encourage them to call our toll free helpline and they can have a conversation with one of our therapists. That's one of the benefits of having therapists and dieticians answer the phone that they don't necessarily do an assessment because we are with borders and everything. We're not able to do that, but we can do a lot of heavy psychoeducation to be like, well, these, this is what individuals that experience certain types of eating disorders, this is what they'll, and then here are some names of referrals if you want to take that next step to get the diagnosis, to get more information, to get all of that. [DR. CRISTINA] So that's actually a great question. I guess that's the difference between seeing an individual for like professional help versus what you're providing. So if somebody's thinking, oh, I can call and get help from a nutritionist from the Alliance versus help from a nutritionist, say outside of the Alliance, what's the difference there? [JOHANNA] We're not giving any nutritional advice. We're not. Again, it's more education based of like here is some factual information about RFID, for example. Like here are, this is science and symptoms. This is a DSM diagnosis. We don't do any type of therapy, any type of specifics. We just do more of like that educating. I also want to stand in the fact that only 30% of individuals ever get access to treatment, so I really want to talk, I want to say that. When we're able, we are always referring out. We want to make sure that individuals can get into the practices and the treatment centers, if needed of the amazing providers that are going to help them on the journey to their recoveries. [DR. CRISTINA] That's fantastic because I think that's a great distinction to have of what you, the Alliance can and can't provide for people not to think like, oh, this is going to be in lieu of therapy or professional help. [JOHANNA] Oh no, we even say our support groups are support groups. They are not in lieu of individual therapy. They're not in lieu of, if you have access to therapeutic groups, they are an adjunct. We sort of consider ourselves part of the treatment team. We also want to stand in the fact that for many people that don't have access to care support group is all they have. So we're always, I mean, numerous times throughout the day, we are, throughout the group we're putting in our referral information, we're putting in our phone number of like we're here. I will tell you my team is incredible. My referrals team, resources team, that's headed up by Dr. Ali, they will do everything in their power to try to find care, even if it's not on find ED help, whether it's not on one of our other databases they will call into the community. They will do everything they can to try to connect to care. Unfortunately, there are times that we just can't connect, but it's few and far between because they will do everything in their power to help them. [DR. CRISTINA] I have to say personally, I've experienced you reaching out to me trying to connect me with people. I find that just amazing. So I think, but all the work you're doing is fantastic, so, like I said, I was super excited to have you on just because I was like, oh my gosh. I'm so grateful to the support you've provided to my patients, the support for their loved ones, just because I think oftentimes at least in my work it's a lot to impart the information. So it helps me to just get to the clinical work I need to get done when you are providing the education to the loved ones and the outside support to the people I'm working with. So to any clinicians listening out there. [JOHANNA] Yes, I think that's awesome. No, no, there's also something to be said how we talked about when you have, like a mom to a mom, for example. I mean we have an amazing facilitator. Her name is Sheri Monarch. She's a mom of lived experience and we talk about like refeeding. She's like if your kiddo has to be eating and forgive me for talk about specific foods, but this is such a great example, like the fettuccini chicken Alfredo, don't sit there with a dry salad, with grilled chicken on it and expect your little kiddo to try to, if you are able to, and want to show up for the fact that some of us are not able to eat certain foods, I understand, but do it with them. Watch what, and it sort of lands differently when it's a mom talking to a mom as opposed to a clinician talking to a loved one. It's definitely hard a lot. I mean, and to some extent I feel the same thing. I'm not a clinician, but someone on the experience and I will, sometimes clinicians will just call me up and say, will you just talk to my client for like 15 minutes or 20 minutes? I'm like, sure, what's going on? They'll tell me a little bit about, and then they'll call me a week later and say, I cannot believe what you said connected with them. We've only been talking about it for a year in session. I'm just like, it's not that I said. It's this connection of someone of lived experience that has walked in their shoes to be like, I know it sucks. I know recovery is hard and painful and it's going to be possibly the hardest thing you ever will do. I promise you, it is the best thing you will ever do. Just to having that connection is just sometimes a game changer. [DR. CRISTINA] I think sometimes hearing it from multiple sources too, can maybe just validate it. I think that's so true. Like you have a lot of clout, obviously for your position as well. You've learned experience, but I mean, look at who you are. So that must be much more meaningful too. I often say this to people too, I also am recovered and so I became a specialist because when I went through recovery, I never had a therapist who could look me in the eye and say, "Hey, I've been there," because it was scary doing all these things and being told, "Hey trust me, you do this and you'll be fine." I was like, "How do you know?" There's something to it from hearing it from somebody like yourself and saying like, you can get through this. [JOHANNA] Yes. And honestly, one of the things that I'm a little honest to a fault with folks where it's like recovery's not sunshine, bunnies and rainbows. You don't recover to utopia. You recover to life and there's some good days and there are some not good days. But I will tell you, and this is, I've heard a lot of individuals that are in recovery, recovered, healed, whatever word you connect to will say that their best day in their eating disorder was far worse than their worst day in recovery. I have to say that. I know what my recovery has given me. I know what I've been able to experience and have. I also will tell you that not every day is a great day. I don't mean I'm active in my eating disorder, just means that like, for me, it was never just my eating disorder. It was the eating disorder. It was anxiety. The last few years have not been fun on anxiety, I don't think for anyone, but particularly people that experience anxiety, but to show up with vulnerability and to show up with honesty and yes, time is a little difficult right now and I'm going to model health behavior. I'm going to do what I need to sure and see my therapist, take care of what I need to take of and I'm going to be a I'm human being. That's being human as messy as it's, but it's so worth it. [DR. CRISTINA] That's so well said. I love that. You're another voice that I've had on here that said you can reach recovery because I hate that myth out there that says like, once you have an eating disorder, there's always a part of you that's going to struggle with it. So again, anyone listening, another voice saying you can reach recovery, so please hold on to that. Don't believe in that myth that you can't ever get there because you can. I appreciate all of the information you've provided. This is such a great resource. I know we're getting close to ending here. I don't know if you have any last words for anyone who's listening. [JOHANNA] I mean, I cannot thank you enough for the last, I don't even know how long it's been. I could definitely talk to you forever. But again, just reiterating that there is help, that there is hope, that there is life beyond eating disorders. If you're an individual you don't have to go through this alone or if you're a loved one, you don't have to go through this alone. Please reach out to the Alliance. We are here for you. We're very readily accessible. Our team of providers are always here to answer your phone, your emails, your direct messages, whatever feels right. We have a lot of fun and exciting stuff coming up during mental health awareness month, ensuring that eating disorders are part of the conversation. We have an amazing four-part Instagram live series that's covering everything from eating disorders in the Asian community to male identifying folks in eating disorders to weight stigma in the medical community. So whatever we can do please know that we are here and we're just a phone call, an email, a smoke signal, however you want to reach us. We're here always. [DR. CRISTINA] Fantastic. I will have all the links to the Alliance in the show. So head over to the website after the show, if you want to get those. I also have them on all my social media. So thank you so much for everything. Thank you for being here and for doing all the work you're doing. It's fantastic. [JOHANNA] Thank you. Thank you for being another voice and another helper. I will say the last two years have given me even more gratitude for all of our clinicians that are doing the hard thing in a time that hasn't been easy. So thank you for everything that you've done for so many people. [DR. CRISTINA] This is my mission. [JOHANNA] Yes. [DR. CRISTINA] Can do anything else. So thank you again. Like I said hope lots of people go and visit the Alliance after this. I'm sure they will. [JOHANNA] Awesome. Thank you so much. Take good care. [DR. 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.