[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. Welcome back to the show if you're returning and welcome to the show, if this is your first time. One of the reasons I started the podcast, if any of you know, if you're returning is that I wanted to bring more information about eating disorders, body image, and just more information in general to the public about all that's going on social media and just bring awareness, give the right information because I think there's a lot of really wrong information. I think there's a lot of erroneous myths. I think that the more we can talk about the realities of eating disorders and really be open and vulnerable and discuss things that we're all going through or really struggling with, then the more normal people can feel when they're going through things themselves and the less scary things are going to feel to each of us, if we decide we want to open up and share our own stories and own struggles. And I think it'll open up doors for people to seek help or even to open up to loved ones and family and friends about things. Because I think there's a lot of, it can be scary to open up and share when you're going through something. Maybe you feel like you're going to be judged or maybe you feel like you're the only one going through something. So I really appreciate when I have guests on here who are going to bring information or going to share some things that maybe you don't know about, or maybe open your mind to some things and maybe empower you. So that's the guest we have today. She's here, she's going to share a lot of great information. Maybe some of it, maybe you don't but you know what, I just want to jump in and hopefully you can learn some things or maybe you'll hear something that inspires you. So with that, Serena Nangia is a longtime advocate for eating disorder recovery and the host of The Body Activism Podcast and founder of The Body Activists, Serena has spent close to a decade building expertise on the way body image media and eating disorders affect people's daily lives. She is a frequent public speaker on the issue of fatphobia and actively works to elevate diverse voices of people of color and fat people. Serena's inspiration comes from her sister Ellen, who struggled with an eating disorder for over a decade and is now in long-term recovery. Well, Serena, welcome to the show. [SERENA NANGIA] Thank you so much for having me. [DR. CRISTINA] I'd just like to get the audience to know who you are, so if you wouldn't mind just sharing a little bit about who you are and your background and how you got to this place and your life on being on a social platform and doing all that you're doing. [SERENA] I really appreciated you allowing me to come on. My name is Serena Nangia, I use she/her pronouns. I like to just mention a few of my identities before I start talking about things, especially on podcast people can't necessarily see. So I identify as fat. I live in a fat body. That doesn't apply to everybody who, not everybody identifies in that way, even if they live in a larger body. I'm queer, happy pride month this June. I am biracial half white, half Indian and sometimes I feel like I'm white presenting, I think I hold some privilege in that way. I also am the older sister of an eating disorder survivor. So my sister Ellen is part of where my work in the eating field started. When I was in high school, I was experiencing body image issues and a confused identity and feeling, I think some effects of weight, stigma of fatphobia, which I'll talk about in a second and just feeling a little excluded. And even though on the outside, I seemed very bubbly and reserved at sometimes, but I became more bubbly as I got older. So I was in high school and I joined this club called Rebel, which was the start of everything for me. I's a peer org peer education organization that at the time was focused on in high schools and middle schools, having people use researched curriculum, as well as their personal experiences to discuss among youth and within our schools about education on eating disorders, body image, media literacy, and all these important topics that I don't think we talk about enough at a young age. So I was in that club. I started in junior year and then I went into senior year and found out that my younger sister, Ellen had developed an eating disorder and that she had actually been struggling with it since fifth grade, since she was 10 years old. I like to mention my parents are healthcare practitioners and though they noticed, and I noticed some important factors of like finding out that she, that Ellen had an eating disorder. It took quite a long time for us. We didn't, even as healthcare practitioners, my dad's a doctor and my mom was trained as a nurse, even then it took a long time for them to notice because as we know eating disorders you can't always tell from the outside and eating disorders can come in people in all types of bodies. Ellen was, and is a successful human being that was president of her senior class and was very good academically and had a huge and big social life but at the same time underneath it all felt like she wasn't worthy, didn't feel comfortable in her body, felt like people were teasing her. People might have been teasing her, but we've talked about, Ellen has obviously given me permission to talk about her story because I wouldn't do so otherwise. One of the triggers for her eating disorder that ramped up in eighth grade was a feeling of like she was being teased and looking back, she doesn't even know if it was a real, someone actually teasing her, but it was interpreted that way because of how she already felt about herself. So I just started out as a loved one of someone who had an disorder. Ellen's now in full recovery and studying to be a doctor. She'll be one of medical doctors. There are only 6% of residency programs that require eating disorder training and so I think of Ellen is going to be one of those 6%, just because of her lived experiences depending on where she goes to school, of course, and training that will change but she's doing well. So I, but at the time I felt lost as many people who are family members of people with eating disorders feel, and I really didn't know what to do. So instead of doing much at time, I ended up focusing on myself. I went into college and was just trying to survive college as a student. I met a ton of people who had eating disorders or who were currently in the middle of one or had to leave school to go to treatment and feeling the sense of community or wanting the sense of community that I had at the club in high school. I decided to found a club, the first collegiate chapter of that club at my college in DC. Through that was really where my activism story and advocacy story started. I was able to redirect a lot of the feelings of guilt and confusion and angst about not having been able to help my sister as much as I wished I had and channel that into helping others because at that time my sister was starting to get into recovery. It's often easier to help other people than help those closest to, I think is something I found in advocacy. It's a lot easier to have hard conversations with people who you're not close to than to people who you are, because at least this is my view, Ellen and I only sat down about a year ago and had this conversation about her eating disorder. It took so long because it's a really sensitive conversation to have with someone you know and someone who feels responsible, I felt responsible not for her eating disorder, but for just being the older sister and not being able to catch it earlier, even though it wasn't my responsibility. [DR. CRISTINA] Wow, as you're talking, if anyone out there is listening and can relate to what you're going through. I think that we often don't talk about the family members' experiences. We often talk at least on this podcast, too, I have more people sharing on here about the experiences they went through with their own eating disorder. It's not as often we hear from the siblings or the parents or the loved ones who are walking the walk parallel to someone who's going through it. That feeling of guilt you had, I just, I wonder where that came from, where that feeling of responsibility that you were expressing came from because I mean, as someone, myself who had an eating disorder and is recovered, like, I'm just thinking, gosh, there's nobody in this planet that I could even think back and go, it was them or like something. So I'm just wondering like, wow, that's big burden that you carried [SERENA] That's just a psychologist's question to ask so I appreciate your intuitiveness and thinking about that question. I mean, I've been in therapy for a long time, so I know why I felt that way. I think it's true many people who are older siblings, I also was like a third parent/second mom to my siblings. I have younger siblings that are triplets and Ellen is one of the triplets. My mom has been sick for a while and my dad was working a lot and while they were both there for us very much, I think I started to feel some sense of responsibility for the wellbeing of my siblings. That's like the deeper root of everything as I got to know a lot more people in recovery and understand eating disorders scientifically and like emotionally better, of course there's nothing that necessarily I could have done or that would've helped. I was there for Ellen as much as I could have been, but I think just being, feeling almost parent-like, and feeling like, gosh, I'm so glad she's okay but there are thousands and thousands of millions of people who don't survive eating disorders. That's where my heart goes to is like, thank God Ellen is okay and now what? So that's like where my activism starts coming in, but it's definitely been a driving factor, my younger sister having an eating disorder. It's what I talk about when I am in on advocacy days with the eating disorders coalition or talking to people and wanting them to really understand the true impact that having an eating disorder can have on a person's life and those in their community. You can say as many facts as you want, like one person dies every 52 minutes of an eating disorder, 27 million people in the US don't have access to care, even though they haven't eating disorder and 30 million people in the US will have an eating disorder in their lifetime, which is larger than the population of Australia, which is 26 million. So I think about all those facts and they're obviously astounding, but then having like a story to tell not, I tell my sister's story in relation to eating disorders, but I also tell my story which came after, a lot of it came after. I started working on helping raise awareness about eating disorders and start talking about my story, which is I am fat. I live in a fat body and the discrimination that I experience as a fat person and that enlightenment came a little bit later. I think eating disorders are a little bit more of an accessible topic, even though they are so complicated and confusing for most, for a lot of people. I can go into the rest of my story. [DR. CRISTINA] Yes, no, I mean, I'd love to hear it if you're willing to share. That's why I'm having you on because I think you have such important information and great messages to share with people that need to hear everything you have to share, so please. [SERENA] Thank you. So when I was in college, I started attending conferences. I started this club, got to know a lot more, even more people who had eating disorders, were in recovery, started reading a lot, attending webinars, just educating myself really. I attended one of the last years of school. I attended a workshop on fatphobia and it gave me a name. I was able to name this issue that I had been struggling with for my entire life. So for those who don't know fatphobia is, now I'm going to have to do it off of memory. I didn't bring up the definition. So fatphobia is discrimination based on weight or size of your body, of people's bodies which shows up interpersonally like if I was talking to another person and they said something mean about my body, but it also shows up systemically. So fat people make a dollar 25 less an hour than their thin counterparts for the same job with the same qualifications. 90% of emergency rooms don't have equipment like scanners that can accommodate people in larger bodies and so much more there, it's like 81% of dietetic students have biases against people in fat bodies. So there's a lot of systemic issues. It's not just like, oh, I feel hurt by one person. It's my actual opportunities as a person are being lessened. I don't have as much access to opportunities economically or socially. In addition, having less access to physical spaces, not having space on airplanes to sit or feeling uncomfortable in a car or even just in booths at restaurants. So all of this, I like found out about, and as a fat person, I felt so validated. I was like, wow, it's not just something I'm feeling and I feel it's real. It's there are facts and research based on weight, stigma, fatphobia. Other people have experienced it. I found a community of other people who had experienced it. And all of this relates back to eating disorders because in my view, fat phobia as a systemic issue is very related to why a lot of people have eating disorders. The focus on the ideal body obviously eating disorders are more than just what your body looks like and it often isn't all about that, but it's more of like what psychologically have we been taught to believe that is true about fat people and what is true about not fat people? And even if it's not about the body, if someone in who has an eating sort doesn't want to be in a fat body, it might not be because they don't want to be fat based on like the physicality of it, but it might be because they see underneath all the surface, they might see how fat people are treated and not want to be treated poorly because fat people are treated really poorly in our society. So I have found that through my sister's story and now finding my place in the community through my own story, I've been able to find a place in the world that feels right for me. I'm straddling the line between teaching and educating about eating disorders, to my knowledge and sharing my sister's story as well as body liberation and fatphobia and about one of the causes I believe of eating disorders. [DR. CRISTINA] I love that you said that you found your space where you feel comfortable, because I think that a lot of people maybe listening, who can relate to lots of things that you're saying don't find a comfortable space. So I'm wondering if anyone is listening going well, how do I find that for myself, what are some suggestions you might have? [SERENA] That's a super great question. I'm not going to lie, it can be hard. If you feel like difficulty in finding a community or a place, no matter what point you are at in your life, it's really valid and it's really common. We are lucky in some ways that we have these digital platforms that can help build community and at least expose us to different types of content and different types of people. So the first thing that I did was start following a lot of people that looked like me, at least in body size. So I was surrounded by, in my virtual space, surrounded by people who were at different levels of comfortability with their bodies, but weren't bashing their bodies or making themselves feel bad, at least virtually. Of course, we all show a different side of ourselves on social media, but the first place I would do it is just the easiest. Yes, social media is the easiest way. You can go to my social media, it's at The Body Activists. You can follow people that I follow or go through those profiles and follow other people who follow someone that you already follow you and really unfollowing the people who make you feel like shit. They might not be doing anything wrong, but if they make you feel bad just by your own experiences and your own feelings about what they look like or what they're representing, it's okay to protect your space. Then in person, I really was able to connect with people from online at conferences and like retreats and that sort of thing going to, I know those are not necessarily very for everybody, but that's how I've gotten into contact with a lot of other fat activists in my community. What's really cool is that we now have Zoom that is more accessible or FaceTime. So people can just hop on a call and get to know people and be like, are you experiencing this? Like, yes, I think yes or I experience something different. Writing about it can be really helpful obviously but also not only writing about it, but sharing, writing brings people into the fold of what you're experiencing. Just spending time with people who make you feel good, like your friends and your family, if that's, who makes you feel good. If not like choosing other people or being really precious and safe and protective of your safe space, because that's something that I've been working on. I, for example, I'm probably going to be getting a new therapist, not because my therapist is bad, but because my therapist is a thin woman who doesn't necessarily relate to some of my experiences. So identity affirming, like care is really helpful. So I'm going to be looking for a fat therapist who even if they can't understand, they might be able to empathize a little bit easier and bring some new perspective to that. So those are some ideas, I think, off the bat. [DR. CRISTINA] Those are great ideas. I think it can be hard to navigate, especially just coming off the pandemic where people were more isolated. It's hard to navigate how to connect with people and community. So great information. I'm glad you're on the, I found you obviously on social platform and saw your great message out there and I wouldn't have found you otherwise. I mean as much as there are some evils of social media, there's good parts to it too. So I'm curious your saying, do you I think a lot of times there's this negative connotation or these negative thoughts about what images are out there on social media and how it perpetuates an ideal and things like that, are you finding that maybe it's shifting a little bit or getting better or what do you think? [SERENA] Oh, that's a good question. I think as individuals, like individuals are starting to, some individuals are starting to understand and be able to access a lot more diverse content, but unfortunately there are algorithms and content creators, and not only individuals, but entire systems that are like, so social media platforms that are built and make money off of pro-eating disorder content. So there's one company that is pretty well known that makes 230 million a year off of pro-eating disorder content. So in my mind that has erased some of the hope that I have but I think the reason that that is so troubling for me is because no matter how much someone who is media literate and who knows how, is aware of how they feel when certain posts come up and they're like, no, thank you or they block certain places or they report diet ads or those sorts of things, no matter how much we, as individuals are able to try to protect ourselves, there are bigger powers at play that are trying harder to harm us. It feels really distant to me as far as understanding why they do that, except for the fact that they make money off of it. As it's a branch off of the diet industry of billions of dollars, it says made by the diet industry. So of course, they see how well business wise that is doing. So maybe they want to make money. But me as an activist and someone who works for a nonprofit, it's really hard to understand why anyone would do that. What gives me hope is that there are legislative, or advocacy bodies that are working with legislation statewide within certain states and then federally as well to charge and essentially fine social media companies for doing this sort of thing and making it illegal, especially for kids. There's a kids' online safety act that is currently, we're hoping to pass federally. That will fine companies that do this as well as requiring them to be able to set limits and things on social media and a bunch more things. But I find it difficult as an individual to, there is so much, what I'll say is there's so much hope in individuals. Like if I sit down and have a conversation with someone about these issues about eating disorders, and I'm like, this is what you can do to help improve your body image, or to help improve how you feel about bodies in general, by like following social media and surrounding yourself with good people and reading these books about how body image intersects with racism and fatphobia and all these things. Individuals are so beautiful and they might not listen to you right away, and they might not even agree with you, but they heard you and they might have a niggling thing in the back of their brain that, wow, this is an issue. And of course there's been an increase in plus-size models, for example, or racial diversity in companies but unfortunately what I see as a seasoned person in this catching the eye of especially body diversity is a lot of it feels very performative and doesn't logically make sense from a capitalistic standpoint of if you actually provide clothing for bigger people and you show them in your ads, it logically makes sense that because 65% of US women are considered plus-size, that you'll make more money. So I just wish, The Body Activists, my company is about bringing awareness to other companies and organizations about not only their internal practices of hiring and firing and potential discrimination or anti-discrimination based on body size, but also I'm a marketing manager at an eating sort nonprofit. What I do in marketing is analyze what is the least harmful or what it can actually be helpful to people in marginalized communities or who have been marginalized. So I would like to in the future, be someone who companies can come to talk to and who I can educate, but also direct to other people within my field who are more experienced on the impact of racism and body and gender impact of gender affirming healthcare or not having gender affirming healthcare and disability and all of those things. I hope to see a world where companies that have so much power don't harm people unintentionally or intentionally. [DR. CRISTINA] Great. I love that you're doing this work right. It's so needed. Yes, I mean, I think that's been the biggest thing is women or men, whoever, looking to add these big companies and that's perpetuates the norm and what's ideal. So if they have somebody like you, they can go to, that's where change starts. So really appreciate all this great work you're doing and all this information that you're sharing here. I'm sure most people have no idea there's all this money behind these influences, behind everything they're seeing. I mean, some awareness, but not to the extent that you just shared. I mean, that's --- [SERENA] Yes, and I just found out that 230 million number last month, and I've been telling everybody because it is really important information to know. [DR. CRISTINA] I did not even know that's, when you said that, I don't know if saw my, you can't see listening, but my jaw dropped. I mean, I knew the diet industry makes like 76 billion in profits, but that what you just shared is shocking and aggravating and all sorts of feelings I have, but blah. [SERENA] Yes, I think one of the biggest and hardest things as an activist is to recognize the systemic issues and then find power and hope in doing as much as we can and knowing that we're part of a bigger movement, not just individuals, not just small communities, not just the US, but like huge movement that has been going on for centuries or at least decades since the 1960s. We'll keep going on until people understand and actually make real change. [DR. CRISTINA] And I think there's so much power in people, like you said, sharing what they experience, because then you don't feel alone. You don't feel like you're the only one. It's like, oh, this is a thing. This is something this is not right. So I do appreciate so much you coming on here and sharing your journey, your story, and giving so much information. Now you've given more information to more people. So maybe they'll share some too and they'll hopefully come and follow you. You'll get more information out to more people that that's how it works. So so again, just to remind people, if they do come find you, follow you how can they do that? [SERENA] My name is Serena Nangia. If you want to follow me on Instagram, Facebook, Twitter, it's @The Body Activists. My website is www.thebodyactivists.com. I also love to connect with people on LinkedIn, feel free to message me. Yes, that's it. [DR. CRISTINA] Awesome. If you didn't get that, it'll be in the show notes. So don't worry. It's going to all be there with the link. So Serena, thank you so much. You are a pleasure and thank you for doing all this fantastic, wonderful work you're doing, much needed. [SERENA] Appreciate it. [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.