In this poignant and eye-opening episode, Dr. Cristina Castagnini sits down with author and mental health advocate Johanna Scoglio to discuss the often-overlooked realities of living with and healing from a long-term eating disorder. Johanna bravely shares how profound grief and family transitions at age 15 triggered her decades-long struggle with food restriction and compulsive exercise—a compulsion that was masked by her identity as a dedicated collegiate athlete. Together, they explore the devastating gaps in the medical system that leave patients discharged without referrals, the shame associated with non-linear recovery, and the life-changing power of a harm-reduction approach. If you’ve ever felt unseen by the system, trapped by the rigid "rules" of recovery, or struggled to separate joyful movement from punishment, Johanna’s story offers a deeply compassionate and empowering new perspective on what it means to truly heal.

    Johanna is the author of When the Water Still Holds Me: Letters Through the Tides of a Long-Term Eating Disorder, a memoir rooted in harm reduction and a compassionate, mind-body-spirit approach to healing. Drawing from her own long-term journey, she writes for those navigating eating disorder recovery, for those who support them, and for anyone moving through the ebb and flow of their own inner tides. Her work invites a more values-aligned, human approach to healing—one that makes space for complexity, imperfection, and hope. She is also the founder of A Dragonfly’s Dream, a nonprofit dedicated to community-based, compassionate support for long-term healing.        

KEY TOPICS DISCUSSED:

  • How sudden life transitions and grief can act as the underlying catalyst for an eating disorder.
  • The hidden dangers of athletic culture and how compulsive exercise is frequently praised as "dedication."
  • Why traditional medical encounters, such as ER visits, frequently fail to recognize or refer patients for eating disorder treatment.
  • The profound difference between exercising to punish the body and engaging in joyful, mindful movement.
  • How applying the principles of "harm reduction" to eating disorders can relieve the shame of perfectionism and make recovery more accessible.

KEY TAKEAWAYS:

  • Compulsive Exercise in Athletics: The dangerous intersection between eating disorders and sports culture, where extreme, punishing movement is often mislabeled and praised as elite athletic dedication.
  • Systemic Blind Spots in Medicine: The painful reality that many individuals suffering from severe physical complications of eating disorders are treated for acute symptoms in emergency rooms but discharged without any long-term mental health or specialized referrals.
  • Harm Reduction in Recovery: A compassionate, person-centered approach that shifts the focus away from rigid abstinence (such as completely stopping a behavior immediately) and instead focuses on making incremental, value-aligned progress to meet people exactly where they are.
  • Joyful Movement: The transformation from utilizing exercise as a method to earn food or burn calories to embracing movement (like swimming) as a way to connect with the body, clear the mind, and experience true embodiment.

IMPORTANT TIMECODES FROM THIS EPISODE:

  • [00:00] Introduction to the episode and today's guest, Johanna Scoglio.
  • [05:15] Johanna's early life, family transitions, and using restriction to cope with grief at age 15.
  • [08:55] The normalization of compulsive exercise and being praised as a "gym rat" in college.
  • [16:44] Frustrating encounters with the medical system and the lack of proper referrals from doctors.
  • [20:46] Finding a specialized outpatient team and the frightening but necessary transition to residential care.
  • [32:40] How meeting her husband shifted her recovery priorities and gave her a reason to choose life over her illness.
  • [34:35] Suffering a severe stress fracture, discovering the pool, and redefining her relationship with movement.
  • [41:00] The inspiration behind writing her memoir, *When the Water Still Holds Me*, as a series of letters.
  • [43:06] Demystifying "harm reduction" in the context of eating disorders and letting go of the "perfect patient" ideal.
  • [46:15] Pausing grad school to launch "A Dragonfly's Dream," a nonprofit for peer-led, harm-reduction support.

CONNECT WITH JOHANNA:

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Part of the Los Angeles Tribune Podcast Network, produced by the Tweaky Tales.

**Disclaimer:**

The content of this podcast episode is for informational and educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment. The views and experiences shared by guests are their own and do not necessarily reflect those of the host or affiliated organizations. If you have any medical or mental health concerns, please consult a qualified healthcare provider. Listener discretion is advised, especially for those sensitive to topics related to body image, weight stigma, and eating disorders.