Ask me anything about eating disorders

Lauren Franzon-Rafter

Something that helped me to accept my changing body during recovery was thinking of all the things that I gained other than weight.

Chris Fowler:

They have found some strong genetic links to eating disorders with families. A study in 2019 found there are eight genes that can influence anorexia.

Anila Azhar:

Those who have a family member with an eating disorder, are seven to twelve times more likely to develop an eating disorder.

Dominik Wilkowski:

You need to replace it. There’s a skill that you have to learn, a coping mechanism that you have to acquire in order to replace it.

Sam Ikin:

This is a special episode of the Butterfly Podcast, your national voice for body image issues and eating disorders. I’m Sam Ikin. And in this episode, we’re going to answer some of the questions that we get from you, our beloved audience. I’m not going to be answering them for you. I’ve pulled together a team of experts and people with lived experience who know a whole lot more than me.

Sam:

But what I can tell you, is one of the things that’s become extremely evident to me since I’ve been creating this show, is how effective talking can be. Hearing from people with a lived experience talk about their successes, their struggles, and even their failures has helped me relate to my own struggles with an eating disorder and all the longstanding body image issues that go with it or come before it, or whatever the case may be.

Sam:

I still have an eating disorder, but I’m really hopeful that recovery is the place that I’m heading. Making this show puts me in contact with some amazing people who’ve already been there along with some of the country’s top experts and I’m just so grateful that this is something that I do. Anyways, it’s enough about me. Let’s get on with the show.

Dominik:

Hi, my name is Dominik. I used to have an eating disorder and I often go to support groups. I guess… I don’t exactly know how to introduce myself!

Sam:

Dominik is an old friend of the podcast. He helped us back in episode seven, navigating the festive season, and we’re really thrilled to have him back to help answer your questions.

Dominik:

I had an eating disorder probably about 15 years ago. Something that I found out much later, I didn’t realize at a time that it was going down a path that was probably not very healthy. I have been going to support groups and therapy for this for a couple of years and feel like I’ve completely recovered, to the point where I don’t really think about food anymore when I eat or when I don’t eat.

Sam:

The first question comes from Steph. She got in touch with us through Twitter and she says, “Why do I sometimes feel like I miss my eating disorder?” And I’ve heard this from a few people. One of our guests even said that she grieved the eating disorder.

Dominik:

That’s a very common thing and I really like this question because it shows it… it goes into the mechanics of eating disorders very deeply. I think it helps other people that may have never had an eating disorder, have never heard of it, to understand it a little bit better. An eating disorder is something that helps you cope with your emotions, with something that is uncomfortable. So you want to… you need to replace it, there’s a skill that you have to learn, a coping mechanism that you have to acquire in order to replace it. That’s a learning thing and learning is hard. Learning a new thing is always hard. So we often grieve. We often miss the eating disorder because it was simple. It is something that we’ve done for years to use, to cope with something that we didn’t know how to handle any other way.

Dominik:

And it’s a really important period in the recovery of someone who’s recovering from eating disorders that you have to look out for as a carer or as you yourself, as the affected person, because it can often lead into somewhat of a dark hole. I’ve seen it where people become depressed or other things bubble up because in the void that has been created by us taking the eating disorder away, you’re helpless, you’re swimming in an ocean, never learned how to swim.

Chris:

When it comes to perhaps using behaviors as a way of coping with stress or managing stress.

Sam:

So I’m bringing in an expert. Now, this is Chris, who has worked with the Butterfly Helpline for years.

Chris:

I started at Butterfly about six years ago now as a supervising counselor and the helpline. Previous to that, I worked at an age, sort of inpatient setting, and I guess that’s where my interest in and passion, I guess sort of grew, I guess, in terms of supporting people and helping people in their recovery journey.

Sam:

All right. So, onto to the next question and Sky who sent us an email asks a really interesting question. She says, “She’s been diagnosed with an eating disorder, but she can see a lot of similar behaviors in her Mom, but the Mom’s never had a diagnosis.” Is there a genetic link to eating disorders or I guess alternatively, are these behavior patterns something that you can learn from a young age?

Chris:

Yeah. Good question. I guess that can be certainly a bit of both then. There’s actually a lot of research being done into the genetic links of eating disorders and a lot of research done in Australia. Andthey have found some strong genetic links to eating disorders with families. A study in 2019 found there are eight genes that can influence anorexia.

And that’s not to say that in this [inaudible 00:06:15] situation, that this Mom has, or doesn’t have an eating disorder. Like most mental health, visible illness with genetic links, just because a family member may be impacted doesn’t mean that you will be too or vice versa. There are a lot of other factors, as you mentioned that might be related to [inaudible 00:06:32] environmental, social, psychological factors that can all create a bit of a perfect storm, I guess, which may be the catalyst for someone to develop an eating disorder.

Sam:

Now it’s time to meet another one of our experts. This is Anila, she’s a clinician who also works with Butterfly.

Anila:

I currently am the team leader for their virtual youth programs. So I’m in private practice currently. And I’m also here at Butterfly.

Sam:

The first question for Anila is one that we’ve had a lot of versions from, but the first one we got was from Deepak, who sent us an email. She wants to know what the connection is between perfectionism and eating disorders.

Anila:

There’s much research on perfectionism and its potential links to eating disorder onset. However, the difficulty is that although perfectionism and eating disorders certainly seem to be correlated, we don’t actually know if one leads to the other. So, some research suggests that people with eating disorders often display perfectionistic traits before their eating disorders began. But what we are a little bit more sure of is that perfectionism may be a risk factor. And if they’re maintaining practice over eating disorders. What we see and I certainly see this in my rooms too, is that long after recovery perfectionism remains. So I think to try and draw the links, I think it’s probably best to try and firstly define it. From what I see, perfectionism has no universally accepted definition, so that complicates it slightly. But the literature shows us that some of the behaviors that are commonly associated with perfectionism include… what you kind of traditionally see with the increasingly high and unrelenting standards, fear of failure, procrastination, reassurance seeking, and a real black and white thinking style.

Sam:

The next few questions are best answered by somebody who’s been there in the thick of it. So we’re going to go back to one of our amazing lived experience people.

Lauren:

Hi, my name’s Lauren. I’m a Social Worker. I work in mental health and I identify as having recovered from an eating disorder. My eating disorder initially developed when I was 12 years old.

Sam:

A lot people that I speak to with the lived experience, talk about regretting the time that they’ve lost, where they were caught in their eating disorder. They’d love to go back and do it differently. Of course everyone would, was your lived experience, is that something that has had a dramatic impact on your life?

Lauren:

Absolutely. I’m 30 now. So my eating disorder consumed the majority of my life to date, but I honestly wouldn’t change anything. Obviously you’d rather not have to go through that to become the person that you are today, but I’m very thankful to be who I am today. And if I hadn’t have experienced what I experienced, I wouldn’t be in the position I am now to be able to help others.

Sam:

What a lovely way to look at it. So the first question we’re going to throw at Lauren comes from Mike. And Mike, thank you for your email. Mike wants to know, is body image just about your weight?

Lauren:

In my experience, no, it’s far more complex than that. I think if it were that simple, then losing weight would improve body image, which is not the case. Body image distress can be experienced at any size. And what really makes up body image is the attitude that we have towards our body. So that’s why we can experience a bad body image day one day, and then the next day experience a good body image day. It’s not that our body drastically changes in one day, it’s the attitude that we have towards our body.

Lauren:

So I think that improving body image is not about losing weight, but shifting our focus away from the physical appearance of our body. So something that helped me to accept my changing body during recovery was thinking of all the things that I gained other than weight. So I was gaining freedom around food. I was gaining cognitive space to be able to think about things other than food and exercise. I was gaining the ability to be in the present moment with friends and family. And I think it was this shifting focus that stopped me, equating my worth with weight and actually helped to improve my body image.

Sam:

That makes a lot of sense. All right, the next question comes from Susan. She says, “How do I know if what I’m experiencing is an eating disorder?”

Lauren:

I suppose one thing I kind of want to state first is that it’s a common experience to feel that you’re not sick enough when you have an eating disorder, but this is actually a very big red flag that you are sick enough. I think that this thought is partly due to self-denial or feeling unworthy, and also the normalization of eating disorder behaviors due to diet culture.

Lauren:

Some warning signs that you might have an eating disorder, which I learned about as I began to educate myself on eating disorders, which I personally could relate to, were having rules and rigidity around food. So “I’m only eating this at a number of calories per day”, et cetera. Other things that I experienced was anxiety about eating food that I personally hadn’t prepared because I didn’t know what was in it. Hyper awareness of my body. Preoccupation with food, so thinking about food all the time. Engaging in body checking behaviors, so like frequently weighing yourself or looking at reflective surfaces all the time. Working out or restricting to compensate for eating or to earn your food. I think these are all warning signs that you may have an eating disorder.

Lauren:

But one thing I definitely want to say is that whether or not you experience these signs, or whether you really experience one or two of these signs. If you experience anxiety around food and eating and exercise and your body, and this anxiety is impacting your quality of life, then you need and deserve to get support regardless of if it’s a diagnosable eating disorder, you need to get support.

Sam:

The next question from Audrey came through Butterfly’s Instagram account. It’s a very good question. Is recovering from an eating disorder, like recovering from an addiction? You’re never sure if you’re ever cured and you’ll always be more susceptible to relapsing. And for this question we’ve brought in Archana, she’s the support programs coordinator and Facilitator at Butterfly.

Archana Waller:

I guess, recovery from an eating disorder, it involves overcoming physical, mental, emotion barriers, so that one can restore normative behaviors or some behaviors and habits. There is no such time for recovery from something like an eating disorder, everyone recovers at a time and at a pace that suits them. It’s very nuanced and it’s not uncommon for the process to slow down, even come to a halt completely or to encounter relapses. So, that it’s very much clear that the person can be susceptible to relapsing. While this can be really frustrating, it can help to remember that with recovery as an ultimate goal, even the setbacks can be a really valuable part of the journey. So, with the appropriate treatment and a high level of personal commitment, recovery from an eating disorder is achievable. There can be similarities because they’re also trying to recover and there are other relapses. And I guess that’s… From that eating disorder point of view, yes, recovery is not linear. In fact, no recovery is linear. You know, it’s a back-and-forth process.

Sam:

And as we’ve heard before in the podcast, it’s something that we’ve heard more and more, eating disorder Clinicians say that full recovery is possible.

Archana:

And again, given that you have that appropriate treatment, a level of commitment, there are many other factors that are also put into that space for that recovery to take place.

Sam:

While we have an expert like Archana on the line. I thought I’d ask her one of our tougher questions. We’ve said before that eating disorders like other mental illnesses rarely exist alone. And that leads us to this question from Frank. He says, “Hi, my grand-daughter has severe depression, is suicidal, has eating disorders, has body image disorders and she’s only 16. What can I do other than heaping love on her which does not appear to help, as a grandfather, can I make her better?

Archana:

It just shows, I guess, how an eating disorder or any other mental illness can impact family and extended family. It’s not just the person who’s experiencing it. So, seeing a loved one struggle with an eating disorder can be painful, can be confusing and overwhelming. Especially because there’s so much unknown around eating disorders as well. So I can understand the concern and confusion is what do I do? Am I doing the right thing? Am I not doing the right thing? Those are some of the questions we often get. And I guess the basic aspect of this is that family support is foundational to an individual’s recovery process. So, one of the things that perhaps this grandfather can do, it’s just making sure that they communicate how much they care and love their grandchild because that unconditional love is… you kind of underestimate how powerful that can be for a person who is going through their journey with the eating disorder recovery.

Dominik:

It’s heart wrenching, this question. Absolutely heart wrenching. I thoroughly believe he can help. Absolutely. And the first step is to be there and heaping love on top of that person and create spaces where they feel comfortable with themselves. That doesn’t go super far. It’s really hard and really depends on an eating disorder, depends on the granddaughter, depends on the age. 16 is also difficult with or without an eating disorder. It really helps to find these moments when someone isn’t currently in eating disordered behaviors, there are moments when you feel a little bit more at ease with yourself and these moments we usually take to not talk about it because it gives us a little bit of a pause as carers. You don’t want to bring it up because you finally don’t have to talk about it, but it is a really good moment to have a frank conversation. To say, “Hey, you know what, I am worried about you. I want the best for you. How can I help? What can I do for you?” And often people with eating disorders will open up in that moment.

Sam:

So we’ve got time for a few more questions and I think we’re going to go back to Anila for this one. Zara asks, “Can you ever get to a point of not feeling anxious around food and if so, what’s that like?”

Anila:

That’s such a tricky question and honestly, it’s probably one of the first things I get asked every single time someone does seek treatment. It’s a really difficult one to answer. I think the trouble is that we live in a weight obsessed worship of this thin ideal culture. It’s really tricky to eliminate the noise on it and it’s virtually inescapable. However, recovery is absolutely possible from every angle. The anxiety around food has been seen to eventually subside in time and I think that’s the key here, that just to give it some time. It is a really long-standing thing that may have been established in an individual over several years. We know that it typically starts in adolescents. So, to eliminate that anxiety can often take some time and potentially even years.

Anila:

The other part of this that’s really important to note here is that an eating disorder is usually a symptom of an underlying condition or trauma. Usually it develops to survive something else. So when we have enough distance from that thing that we are trying to survive or looking to survive, whether it be another mental health condition associated with trauma or otherwise, or other interpersonal difficulties, for instance, the symptoms tend to fall off along with it. Including the anxiety that’s associated with food. But I do find that, that is probably one of the last things to drop off.

Sam:

And the final question we’re going to throw back to Chris, and it’s a bit of a tricky one. Cody asks, “How do you approach someone you suspect might have an eating disorder or a body image problem?”

Chris:

It would be a few things to be, I guess, mindful of when you’re approaching someone. You know certainly approaching at an appropriate time is a good start. Maybe have a conversation where it isn’t at mealtimes or around food. Because they could already be sort of, I guess a stressful time for the individual. As well as, perhaps with all new conversations that person already seems emotional for whatever reason, or even stressed or tired as well. But when you are perhaps going to have a conversation where you’ve found that a good time to have that, I think trying to have the conversation, not solely about food. Coming from an open or non-judgmental place, but focusing on the general being, and their mood. As well as their physical health but trying not to make the whole focus ‘food’ because it can be quite confronting, it can be a little bit of embarrassment, or shame or guilt associated that might mean that person shuts down as well.

Chris:

Let them know that you’re concerned, you’d like to support them in that moment and that’s perhaps why you’re raising that concern. There might be defensiveness or denial because the conversation can be overwhelming. But you can always sort of say, “I can see this conversation’s a bit too much at the moment. It is something I want to bring up again or it is something that I am concerned about. We can leave it there for the moment, but I’d like to bring this up with you again.” I’m going to think those sorts of things, you should keep those sorts of things in mind. There’s no real right or wrong. And if you have made a gross sort of error in a sense, you can admit to that. Say, “Look, I’m not really sure how to approach you at this point, but I am concerned and I’m willing to be here every day, I’ll help you or support you if that’s what you are needing at this time.”

Sam:

We have so many more questions. We’ve only got to a fraction of the ones that we’ve been asked, but unfortunately we’re running out of time. And I’m sorry about that. But we will finish off with the one question that we’ve been asked the most. We’ve had many questions that are something along the lines of, “I think I have an eating disorder, where do I go to get help?”

Lauren:

Go to the Butterfly Foundation website. That would be a great place to get some education, to find out about other resources, to find out about supports in your area, because obviously it would vary between States.

Anila:

Butterfly’s helpline is an excellent resource, actually in assisting those struggling to find a suitable Practitioner in one’s area.

Sam:

To get to Butterfly’s website, go to butterfly.org.au. To get the Butterfly National Helpline, call 1800 33 46 73, that’s one 1800 ED HOPE or you can email support@butterfly.org.au. If you have any more questions, please drop a line to Butterfly’s, amazing communications team. You can get them at C-O-M-M-S it’s comms@butterfly.org.au. Don’t forget to subscribe to the Butterfly podcast and rate us five stars. And if you’ve got a minute, leave us a comment. The Butterfly podcast is an icon media production for the Butterfly Foundation. It’s written, produced, edited, and hosted by me, I’m Sam Ikin. But I don’t do it by myself, Camilla Becket and Kate Mulray provide an amazing amount of support. That theme music is from Cody Martin. Additional music is from Breakmaster Cylinder. And we’d like to thank all our guests in today’s Ask Me Anything episode, Dominik, Chris, and Anila, Lauren and Archana, thank you so much for your time. Finally, if you know someone who you think could benefit from this podcast, please share it with them. You can find it wherever you find podcasts.