The Complex Relationship Between Substance Use and Eating Disorders, with Alice Baker

ABOUT THE EPISODE:
In this episode, we delve into the complex relationship between eating disorders and substance use and how the principles of CRAFT and The Invitation to Change can apply to both.  Alice Baker, a Stream community parent who is also a licensed professional counselor, dietician and certified eating disorder specialist, guides us through these three issues.  In her high school days, Alice Baker was drawn to the world of competitive dance. The importance of body image in the sport sparked an eating disorder that would linger until she began learning about nutrition in her freshman year of college. Her new understanding of our body’s relationship to food would set her on a lifelong study of dietetics, eating disorders, and their effects on the lives of young people. 

Alice joined our Hopestream Community in 2022 when her son developed a substance use disorder, compulsively using marijuana and struggled in school. It was here that she began to realize how the principles of The Invitation to Change approach could also be employed in her field.

In this episode, we discuss the connections between substance use and eating habits, the serious dangers of “drunkorexia” and other combinations of the two, how parents can identify warning signs, and what we can change within ourselves to help our kids in their eating disorder recovery.

EPISODE RESOURCES:

When Your Teen Has An Eating Disorder (Mulheim)
How to Nourish Your Child Through an Eating Disorder: A Simple, Plate-by-Plate Approach® to Rebuilding a Healthy Relationship with Food

This podcast is part of a nonprofit called Hopestream Community
Learn about The Stream, our private online community for moms
Learn about The Woods, our private online community for dads
Find us on Instagram: @hopestreamcommunity
Download a free e-book, Worried Sick: A Compassionate Guide For Parents When Your Teen or Young Adult Child Misuses Drugs and Alcohol

Hopestream Community is a registered 501(c)3 nonprofit organization and an Amazon Associate. We may make a small commission if you purchase from our links.

Transcript

Alice: 0:02

Self awareness. I work a lot with parents on this. What is my relationship with food and my body?

Brenda: 0:08

Right.

Alice: 0:08

Am I dividing foods into good and bad? Am I, am I talking about how much I need to lose weight or saying negative things about my body? What are my eating patterns? You know, and as I begin to start to look at that and shift that, that has huge impacts on kids. As we start to change our behaviors and how we care for ourselves. Our kids notice, even if they pretend that they're not, they notice, right? And also our kids are going out into the world where that saying, eat this, don't eat that, you know, have the perfect body, look this way. And it, how refreshing it would be for them to be able to come home and not have that.

Brenda: 0:57

You're listening to HopeStream. If you're parenting a young person who misuses substances, is in a treatment program or finding their way to recovery. You're in the right place. This is your private space to learn from experts and gain encouragement and support from me, Brenda Zane, your host and fellow mom to a child who struggled. This podcast is just one of the resources we offer for parents. So, after the episode, head over to our website at hopestreamcommunity. org. I'm so glad you're here. Take a deep breath, exhale, and know that you have found your people. And now let's get into today's show. Hello, friend. I am so excited to share today's conversation with you because it's an example of how various parts of your world might start to intersect to create something truly amazing. I know for myself, I always had compartmentalized my life. I had my work, I had my family, and then I had this insane situation with my son, which I definitely kept separate from everything else. And it never occurred to me that there might be points of interconnection between any of these silos. Of course, now my work has stemmed from my experience with my son. So those parts of my world have come into alignment. And I've started to see this with some of our incredibly talented members of HopeStream community. Alice Baker is one of these examples. Alice joined us in the stream, our community space for moms, back in 2022. When her teenage son was heavily dependent on marijuana and struggling in school, you can hear a coaching session I did with her on episode 179 to hear more about that part of her life. But when Alice isn't being Jake's mom, she is a therapist who specializes in eating disorders. And over time, as Alice was learning about the craft approach and the invitation to change to use with her son here at HopeStream, she was realizing that it might be really helpful for her to use the same approach with her clients. So she got trained and certified in the invitation to change approach. And has adapted the material to use in her private practice. How cool is that? It's a silver lining she has experienced as a result of her son's struggles. And there are now lots of people who are struggling with eating disorders who are also benefiting from her work and her investment in this approach. Let me just tell you about this beautiful and passionate woman you're going to hear from. Alice Baker is a licensed professional counselor and certified eating disorder specialist who With over 27 years of experience in the field, after her own recovery journey from an eating disorder, she became passionate about supporting others and reducing the stigma that exists around eating disorders. Alice has founded two practices, joyful nutrition, which promotes peaceful relationships with food and body and courageous hearts counseling, specializing in eating disorders, trauma, and social justice. She is a treasured member of our community. And now I get to share her wisdom and experience and expertise with you with this important conversation about why people develop eating disorders, why they can be extremely challenging to treat. What parents need to look for and what's going on with boys and eating disorders, plus of course a lot more. So you've heard enough from me. Here's Alice, a therapist and eating disorder specialist, and of course a battle tested mom. Enjoy. Alice, welcome.

Alice: 5:05

So good to be here.

Brenda: 5:06

Another episode. We, we already talked with you as mom and now we're transitioning to you as professional, which is really cool. So thanks for coming back.

Alice: 5:17

Yeah, it's my pleasure. I'm glad to be here.

Brenda: 5:20

So this is so funny because I was explaining to somebody the other day, how cool all the parents are in our group. community. And they were like, Oh, well, you know, like, what do they do? And I know, I know what some people do, but for the most part, I don't, because that's not why we're together. Like we're together because of our kids. And so then like with you, eventually, I don't even know when I learned that you're a therapist. And I was like, Oh, okay. Oh my gosh, that's so cool. So I just love like tapping into our own community. Yeah. Because no one understands these things like a professional who is also going through it. Exactly. Can I ask was that what we're going to get into eating disorders because that is your specialty, but was it difficult for you being a therapist? Was it difficult for you to reach out for help when your son was struggling or tell me what that was like? Cause I have to imagine that there's a little extra for those of you who are already trained as therapists.

Alice: 6:22

It, it actually, it wasn't I had really good training in my undergraduate and graduate and mentors and, you know, colleagues and friends that, you know, we're all human. We all go through it. We all have stuff and, and actually we can become better therapists if we, if we enter our stuff and we talk about it and we, we don't avoid it and we don't pretend it's not there. And. You know, doing our own work was, was very promoted in, in all the programs that I did. So that is one thing I feel really grateful and blessed for is I, I, I've, I had a really good community around me. This group included, by the way, this group has been incredible community to help me understand helped me understand what was going on, but, but I did have a good group of colleagues and people who, you know, rallied around and were there. And I would say if anybody's listening right now, that is a professional. It is a personal thing. How much we want to share. Some people are more open and some people are less than, and one's not better than the other. Everyone's different and, and how they want to share. However, I would say if you don't have a community around you if you're a professional working in this business and you've got some things going on and you don't have. A community around you. Find one, find one. There's so many wonderful people out there who have been like, you know, if you've lived on this earth long enough, you've been through something. Exactly. So, yeah.

Brenda: 7:51

Yeah, that's so true. Cool. Well, we are chatting today because you. are an expert in eating disorders. And it's not really, well, I guess I've had a couple of topics where I've, I've touched on eating disorders, but never really done a deep dive to understand really what that is, how it manifests, where it shows up, when it shows up. And. And then that relationship with substance use. So I'm super excited to talk about all of that. Maybe walk us back though, just to give us some context for how you got into becoming a therapist who specializes in eating disorders.

Alice: 8:30

Sure. So actually before I became a therapist and I still am a dietician as well. So my undergrad was in dietetics and I knew from the get go, I wanted to work with eating disorders. I grew up as a competitive dancer and the pressure to be thin and look a certain way was incredible. And I remember taking a nutrition class in college and it was just so freeing to me to be like, Oh, We need this much nutrients a day to function and it just opened my, and I knew immediately I wanted to work with eating disorders. And so I began studying under a dietitian that specialized in eating disorders while I was still in college. And so that was my specialty from day one. from day one. And then it was in 2014, I went back to school to get my master's in counseling. And, and that for me, I, I led groups for many, many years. And also in just working with clients, I just would naturally, we'd start to get into what's underlying and you know, what's the heart of the matter and things like that. And so. So, I knew I wanted to go back to school to, to, to really get trained, clinically trained to be able to come alongside clients in, in a more therapeutic way.

Brenda: 9:50

That is really cool. So you, you know, personally, and we always love that, right? With our kids who struggle with substances, when I hear there's a therapist or a staff member or a program owner who has that lived experience, it just makes me feel so good because. Yeah. Yeah. you know, they know. And, and I imagine that that's really helpful for your clients to, to know that, you know, what it's like to have those issues. I had a cousin with anorexia and that's as close as I've gotten to, to eating disorders. So, so maybe just bring us up to speed on, because I hear eating disorders, I hear disordered eating, I hear all these different terms. So maybe just lay the groundwork for us for what. What all that encompasses

Alice: 10:34

sure. Absolutely. So, there is a spectrum. Now there is something called the DSM five, which is sort of this diagnostic manual that gives us diagnoses, which we all as professionals, we have a love hate relationship with us. We don't, we don't like to label people and yet it helps. It gives some clarification. It, it helps people well. individuals kind of learn what is this thing that I'm struggling with, right? So, so there's pros and cons to it. But there's anorexia nervosa, there's bulimia, which is, which is restrictive, and there's different types of anorexia nervosa. There's bulimia nervosa. Which is uh, where you, you binge and then you purge and then there is binge eating disorder, which is, uh, where you binge, but you don't purge, and however, we do know with that disorder, it's often connected to restriction. So you're restricting and then your body's playing catch up by binging. That's not in the DSM 5, but, but those of us professionals know that tends to be the cycle. And then there there are some other feeding and eating disorders. One called ARFID which is a voignant restrictive food intake disorder. And basically, there's a few reasons for it. But it can, it can be if someone has really selective, palates over texture or taste. It can be if they've had a medical trauma, like maybe they, they had to be in the hospital. They fear eating, their body remembers that trauma. Maybe they have a fear of choking or a fear of vomiting. And so they'll stay away from food for that reason. Or some, another type of ARFID is they just don't want to eat. They just don't like food. They never liked food. It's annoying. They don't, they don't want to eat. So there's some different variations. There's three classifications of ARFID. It looks a little bit different, right? It's not your classic eating disorder where they're worried, where we're worried about calories or, Possibly gaining weight or, you know, those kinds of things. And so those are the diet. Those are definitive diagnosis of eating disorders. And then there's the spectrum. Disordered eating. Most of our culture has disordered eating. I mean, when I first got into dietetics in the 90s, there was a strong diet culture, but it's nothing like it is now. Now, talking about calories is so normalized. Counting calories is so normalized. Focusing on losing weight. is so normalized. Excessively exercising is normalized. It's glorified. It's a badge of honor. There's a whole spectrum. Chronic dieting is a form of disordered eating. There's a term out there. It's not a diagnosis though. People are working really hard to put this on the map called orthorexia, which is basically it was coined by a man named Stephen Bratman, who was an alternative physician. And it really is when you become So focused on eating ultra healthy, everything's organic everything has to be completely natural, made from scratch and you're, and you're, it's more focused on health, every, like, I have to have my health, you know, in, in kind of perfect order, long answer to your question that there is just a whole spectrum. That, that is out there and, and some, some is a, a bit more mild, and maybe we would just call disordered eating, and some is a bit more acute and extreme, which we would diagnose as eating disorders, though all of it deserves to be treated. One thing, you know, One, one thing that, uh, individuals who struggle with eating disorders often say is, I'm not sick enough. I'm not sick enough. I don't, I don't really deserve this treatment. I'm, I'm not sick enough. And in fact, there's a physician out there who specializes in eating disorders, Jennifer Gaudiani. She wrote a book called, Sick enough, because it's such a, it's such a common belief, individual story, they don't believe they're sick enough. So, so wherever you are in the spectrum, you deserve treatment, you deserve people to come alongside you and to heal and freedom and find freedom and find freedom with food in your body.

Brenda: 14:29

Yeah. Yeah. How did somebody know when it was actually something that you would need to see a therapist is for versus. Yeah. I fear eating because I had so many stomach issues. I was allergic to milk as a baby, you know, so there, so there's that. And I'm like, Oh, that sounds like me. Cause I don't really like to eat food because I associate it with pain. I had SIBO, which is small intestinal bacterial overgrowth. So that was a nightmare. But how would you know, like, Oh, this is to a point where I probably should seek treatment for this versus this is just an annoying thing in my life.

Alice: 15:12

The generic answer would be, how much is it impacting the functioning of your life day to day? What percentage of the day is it on your mind? How often are you thinking about either what you might eat, what you did eat, what you're going to eat, what you should eat? How often are you thinking about your body? How much, you know, how do I look? How much do I weigh? Like what percentage of the day does that take over your mind? And if it's a higher percentage of the day then that would be something to seek treatment if it's impacting the functioning of your life. Meaning it makes it harder to work harder to study at school. It's impacting relationships. You're feeling isolated because you can't go out to eat with other people. You know, so how much is it impacting? And then I also say it's a personal. So I've had clients come to me who are, are, have, have significant impact in their functioning to where it's, it's consuming them every day. And then I also have clients that come to me where it's not. They are, they, it's, it's, it's a part of their life, but they still want to start to think differently about it. There is, well, there's, there's different types of treatment that we do depending on where somebody is in their recovery journey. There's this beautiful. Paradigm called intuitive eating. It was created by two dietitians, Evelyn Triboli and Elise Resh. And it's based on that premise that we were born with the ability to eat. Uh, babies cry when they're, when they're hungry and they turn their head when they're full. And somewhere between infancy and adulthood, we lose that. And so much of it is our diet culture. You should eat this. You shouldn't eat this. Or like what you experienced, maybe medical trauma. Yeah. Where you have you get really sick and you feel really uncomfortable after you eat and then that shifts your relationship with food. The good news is, is that, is that, that knower in our body that, that knows when we're, it doesn't go away. We just get disconnected from it. And so, so, uh, they wrote a book called Intuitive Eating, which, which offers ten practices that helps you come back to that knowing. So, so for those who maybe have. You know, some disorder eating, it's not impacting their, the functioning of their life significantly, but they just still don't like it. They still want to be free. I, I might work with them. And, and, and also for those who are listening, they can get the book and, and really look at those intuitive eating principles and helping them really heal their

Brenda: 17:41

relationship with food. That's very interesting. And a lot of what you were saying kind of to me is also ringing a similar bell as what we hear about addiction, right? About how much is it impacting your life? How much is it impacting your relationships? So, First, I just wanted to ask about male versus female and or non binary, transgender, like what is the mix, because I'm hearing more like from our community and just from friends about. Okay. more men or boys, those who identify as male having eating disorders, which in my mind, this was always, I don't know why this always seemed like a girl thing to me. So what's, what is the story on that?

Alice: 18:33

So there's, there's lots of different opinions out there, but what I will say is that eating disorders, Men have struggled with eating disorders from the very beginning as well. I think culture stereotypes men and women, and, and so they, and there's also this sort of, and this is not right, but there's this stereotypical picture of, of an eating disorder that's supposed to be this, you know, young, white, thin female, right? And that's, that's, that's when you start. And, and we know now that, that that's just not true. Eating disorders come in all different genders, all different sizes, all different races. And the tragedy is that non binary and or men and or people of color often don't get the treatment that they need because they're, they might be dismissed or they're not getting the care that they need. And so, but, but it is definitely prevalent. Now, what the research shows, the research shows that men. Cover about 25 to 30 percent of those struggling with eating disorders, depending on the type of eating disorder too. Men's eating disorders often look different, right? So because of this sort of stereotypical pressure that men and women have, men often, often it can look like wanting instead of wanting to be smaller, it might be defined muscles. It also look like bigger muscles and it's never enough. I'm never like my muscles are never big enough. It could also, because men have, there's, there's more of a, this stereotypical pressure, like for women. We're supposed to, you know, not eat much and be dainty and not eat too much and, and, and only have half and, you know, all of that. Whereas men, it's cool to eat a lot, right? It's really cool. Like, Hey, we're going to get that pizza. We're going to eat it all, you know, and that kind of thing. And so sometimes with men, you might see more of a binge eating disorder or. a bulimia. It doesn't mean that men do not struggle with anorexia nervosa. They do. It is, it is, it is prevalent, uh, significantly prevalent, but you might also just see it manifested a little bit different. And that's why it's, it's missed a lot of times.

Brenda: 20:46

I, yeah, I could see that. I have four boys, so I, I'm very aware of like, The, you know, I'm always thinking like my son will say, Oh, how many calories does that have? And I'm like, Oh, it only has a hundred. And he's like, Oh, that means I got to eat three. And in my, like in my mind, I'm thinking, Oh, this is a good thing. This thing only has a hundred calories. And he's like, Oh no, like it's only got a hundred calories. Like I need to eat

Alice: 21:11

more. Right. Right. One thing I want to name just in that moment, cause I think you're bringing up such a good piece of what. It's in our culture. We're taught to think about what should I eat? So you're thinking I need to eat less than that. He's thinking I need to eat more than that. Whereas if we didn't have that pressure in our culture, wouldn't it be nice if we could just go, Hey, what am I hungry for? Like do I want one? Do I want 30? Do I want five? Do I want half a one? Right? Like what am I hungry for? What sounds good? Yeah. Instead of like, what should I do?

Brenda: 21:45

Yeah. Right. And then all of the pressure around like intermittent fasting and, Oh my gosh, I have to leave this much time in between my meals and my first meal has to be this. And then it's just, it's, it feels very engineered, like the way we are supposed to be eating and I have my way and you have your way. And it's like, Ooh, I don't know. I heard that was bad. And I have to imagine social media has played a Just wrecked havoc on this whole thing.

Alice: 22:11

It absolutely has. I mean, one, because you see all these people post these pictures of food with the lighting and all of that. And then they post filtered versions of their body. And then the pressure is on for people to see their bodies and think, Oh, I'm supposed to look like that. And as you know, like when you post, you post your highlights. So you're posting your smiles and you're posting how wonderful life is. And they're thinking, Oh, look, that's easy for them. You know? And I, and I can't do that. What's wrong with me?

Brenda: 22:42

Every once in a while, you'll, you'll find somebody who there was a gal, I wish I knew what her account was who posts the. The Instagram worthy version, like in a bikini or whatever, and then she'll post the real version . Yeah. And you're just like, whoa.

Alice: 22:57

Yeah. Looks

Brenda: 22:57

very different. So, right,

Alice: 23:00

right. Like what's real There is a, a a, a good strong recovery Instagram community out there. Mm-Hmm.. So with, with my clients, I'll usually. It's like talk about curating your media where you unfollow a lot of those those influencers that are posting like the filtered and the pictures of their bodies and things like that. And then, and, and starting to follow there's, you know, dietitians and therapists, recovery coaches that post lots of good recovery material. I have a couple of colleagues that will do live Instagram. I don't know exactly what they're called because I'm, I'm old and I don't know the knowledge of all of this, but they will, they will do Instagram live and they will like eat with their clients where, you know, or not their clients, but just people who want to, to show up to eat in a place where we're not going to talk about food. We're not going to talk about calories. We're going to just eat and talk about life and it's just a refreshing place. So there's some wonderful things that people who are struggling with this can, they can curate their media and they could do that. It requires a little bit of tasseling it all out and Well, yeah, and

Brenda: 24:11

making sure you have the right account and, Right. And so to have somebody guide them to that seems really important. Exactly. We know, you know, the folks that are listening to hope stream, our parents, their kids are struggling with a variety of things, right? Mental health and wellness substances. If a parent is seen and I want to get to substances in a minute, but I first want to back up and just think about the parent who's listening, who's noticing some things about their kiddo. Maybe they're 14, maybe they're 20. And they're just thinking, like, there's a little bell going off in the back of their head. Like, I wonder if this is an eating disorder. What kinds of things would they be noticing that would make you say, Hmm, you might want to look into that.

Alice: 25:01

So a lot of times it starts, it starts with maybe. Watching what we're eating uh, and I'm saying quotes for the people who are listening in podcast or cutting out foods. Like they might start to just say, you know, I think I'm just going to cut out desserts. I don't really want to eat desserts anymore. And often parents are like, Oh, they're doing something healthy. This is good. Right. And they might not notice it at first because you know, they're thinking, Oh, they're doing something healthy for their body. Right. Right. Or they might start some type of new exercise routine like they'll just start running or, you know, taking classes at the gym or things like that. And then you, you start to notice that it progresses, right? I started avoiding desserts and then I don't want to eat anything without a sugar in it. And then I really wanted to just stay with the vegetables and not get any carbs. And then, so you start to see it progress. That's one sign. Another sign might be if you, after someone eats, they go to the bathroom for a long period of time, that could mean that they might be throwing up afterwards. And usually that's connected with they're really worried about their weight. They're talking about losing weight. They're talking about how uncomfortable they feel in their body. So that, that might be another sign. If they lose a lot of weight. They lose their, for, for women, if they lose their period also their mood, if you're, and, and again, if, if you're seeing this connected to their eating is decreased and also their mood has shifted, they're more irritable, they're maybe more rigid. They have to eat at certain times. They get really upset if dinner's late or get really upset if there's a last minute change in what you're having for dinner. A lot of parents will say to me like, you know, this, my kid has turned into a different person. They're so much more anxious and they're so much more worried. They get angry at me. They lash out at me and I don't know what's going on and you know, so if you see that connected to the decrease in food, decrease in weight that can be something as well.

Brenda: 27:04

Is there an age this typically starts out? So,

Alice: 27:08

It's different for everyone. So I've worked with families with young kids. But, but at like on average, it's typically around adolescent 12, 13, 14, 15 somewhere in that adolescent is typically where it starts because that's when the hormones start shifting and changing. That's when, you know, you know, men and women go through puberty at that time. So you're supposed to gain. Like 50 to 70 pounds during puberty, right? And so there's your body's changing, your body's, you know, you're, you're getting taller, you're getting bigger. And then this is also when peers become really important developmentally. So what others think of them become really important. And so it's just kind of like this perfect storm. And then we have diet culture, diet culture that tells us thinner is better or certain, the certain body type muscular for, for males is better. And so it's just, it's like this perfect combination. And if we start quote, watching what we're eating or do it, then we're, it's cool to do that. Right? It's, it's revered to do that. It's, Oh, you're, you're taking care of yourself. Right? So, so it's, it typically will start around that time. Also if kids have been bullied for their weight because we live in a culture that has a hierarchy of bodies. And so it's not uncommon for those who naturally live in larger bodies to have been bullied for their weight, or even for doctors to have told parents, you need to put them on a diet. Right? because they need to lose weight. And so that will, that starts this message. Something's wrong with your body. They're getting external feedback. Some they're experiencing weight stigma is what they're experiencing. And so then they, they might go, they might restrict and lose weight. And then it's really hard for them to even think about restoring that weight back because their body remembers. Yeah. the teasing and the bullying or the being told something's wrong with your weight from a health provider. So, so many of these things can contribute and it's typically happening around that puberty time. But we are also seeing an increase in midlife in women and, and men in midlife as well because bodies change and in midlife as well. And so that can be Also, we can, we're, we're seeing that increase.

Brenda: 29:35

Hi, I'm taking a quick break to let you know some exciting news. There are now two private online communities for supporting you through this experience with your child or children, the stream community for those who identify as moms and the woods for guys who identify as dads. Of course, this includes step parents and anyone who is caring for a young person who struggles with substance use and mental health. The stream and the woods exists completely outside of all social media. So you never have to worry about confidentiality and they're also ad free. So when you're there, you'll be able to focus on learning the latest evidence based approaches to helping people change their relationship with drugs and alcohol in both communities. We have a positive focus without triggering content or conversations. And we hope you learn to be an active participant in helping your child move towards healthier choices. You'll also experience the relief of just being able to be real, connect with other parents who know fully what you're going through and have battle tested mentors alongside. You can check out both the stream and the woods for free before committing. So there's no risk. Go to hopestreamcommunity. org to get all the details and become a member. Okay, let's get back to the show. Role does like trauma and control play in this because I've also, I just remember hearing things about, well, eating disorders are about control and you have to control something. What, what is the true story of that?

Alice: 31:18

They are in the art, they are in the art, but trauma can be a, can be a factor. Not everybody who has an eating disorder has experienced trauma. But, but some have uh, in, in trauma, especially if it's you know, physical abuse or sexual abuse is a direct hit to the body, right? And you know, whenever we experience trauma, we tend to turn on ourselves. So for example, if you're driving, if you get in a car accident, how, how human is it to go, Oh, if I just would have seen that person when they were coming up, I just would turn the other way. Or if I wasn't running late, maybe this wouldn't have happened. Like we just. So when you have a you know, you're, you're experiencing abuse that's directed at your body or directly to your body, you, you tend to turn on your body and that creates a sense of body shame. My body is just bad. There's just something wrong with my body. Well, maybe if I lost weight, I might feel better. Maybe if I just lost a few pounds, maybe that like icky feeling in my body would just go away, right? And so, and then you lose weight, and then you get a little bit of a high from it. Right? Maybe some people go, Oh wow, you look good. You've lost weight or you feel good cause your clothes are looser or something like that. And then that starts the, the, the, the rabbit trail.

Brenda: 32:36

Yeah. That, and, and I recall when I was going through everything with my son and I, I did lose quite a bit of weight and everybody said that, Oh, you look so great. Oh, you look great. You know, like you must be two sizes smaller than you were before. And I'm thinking, well, yeah, but I don't think this is why I was supposed to be like, this is not how I was supposed to have lost weight. Right. You're right. Our culture just, you know, reinforces that that is a good thing for women in particular, the smaller you are, the better, the better you are. So then what about. young people, as we know, the parents that are listening who are also using substances or, or somehow have combined this mixture. Cause we hear this right in our community. Well, my daughter's in treatment for an eating disorder and substance use, or talk a little bit about how those two kind of interplay with each other.

Alice: 33:34

So there's a lot of interplay. Sometimes the eating disorder starts first, often the eating disorder starts first. Sometimes the eating disorder can actually be what actually kick starts the substance abuse. So, taking a stimulant, taking. Something that is going to decrease your appetite and also increase your metabolism. Many individuals have told me at times that they took speed or they took some stimulant medication, like Adderall or something like that to, to, because they didn't eat and they lost weight, right? And then they get the physiological high from that drug. And that's fabulous to them. Right. The change, it's a, it's a solution to their problem. So then that takes on a life of its own. And then the substance abuse sort of, you know, sweeps them away. And then, then they might get treatment for their substance abuse. And then the eating disorder is still there. And so often they'll come back to me and they'll say to me, like, this is the last thing I have, you know, I've quit this. I've stopped this. I'm not doing this anymore. This is the last thing I have. And. Eating disorders are diff, the recovery is so different because we can't just avoid food. We have to change our relationship with it and we have to eat it, you know, four to six times a day. And we have to eat all different kinds of foods and you know, just it's, it's, it's much more of a messy. Predicament in terms of recovery and diet culture, you know, the culture we live in, very often we have to live in ways that are very counter cultural. To stay in recovery and and it gets it gets messy, but it's it's definitely connected. There's there's a lot of individuals who have co occurring substance abuse with eating disorders. There are a few treatment centers out there that that treat it. But I've also had clients who've, who've unfortunately. You know, they, they go to an eating disorder treatment center and they say, well, you need to go get, go get treatment for your substance abuse. They go to substance abuse. Oh, well, you need to get treatment for your eating disorder. And so they sort of feel in this sort of nebulous place that's, that's starting to change because we're starting to get some, some, you know, treatment centers that are doing both. But it is difficult because with eating disorder treatment, there has to be a certain type of environment. Meals are supervised. You can't have food sitting out. Uh, bathrooms are locked after, you know, things like that happen in an eating disorder treatment center, which if someone's just struggling with substance abuse, that wouldn't make sense. So there's, you know, it's tricky to kind of, find a way to be able to treat both at a treatment center. But I would say if somebody on an outpatient level. is struggling with both substance abuse and eating disorders have at least one person on the team that specializes in eating disorders. Cause there's a lot of physiological complications that come from you know, eating disorders. There's, there's, you know, malnutrition can impact the body. Significantly purging impacts the body significantly. So having someone who's trained and understands what that can do to the body and understand sort of the counter cultural ways. that someone needs to live to be in recovery. What is, is invaluable?

Brenda: 37:04

Well, yeah, I can just see this complex web of how to treat somebody with both. Like you said, you with substances, ideally, you know, if they're a problem, especially with an adolescent, you want to cut them out entirely. You can't do that with food. And also what we also see with, you know, our, Kids with substance use issues is a lack of nutrition, right? Cause they're prioritizing whatever substance they're using. So there's already nutritional deficit. There's already issues going on because of just poor nutrition. So that is a very complex web. So if you have any resources, I'll put them in the show notes as far as. Programs that you know of that might treat both, because that sounds like a really difficult thing to do. When I think of parents who are observing this, right, you're, you're in your home, you're already confused. By a young person, whether that's a young adult or an adolescent, and then you're starting to see these different signs. It could be really hard to know. Cause I know like when my son was kind of at his worst, he was just skin and bones, but it wasn't an eating disorder. It was just cause he would never eat because he never had any money. And if he did have money, he would be buying. drugs with it. So that could also get really confusing. Like what am I actually dealing with?

Alice: 38:30

Yeah. And, and sometimes I, you know, some of it, it might be, you don't know until the substance abuse. Stops because I've worked with many individuals who, who, you know, as I had mentioned before, they started a stimulant and it really worked. It really made their, that, that, that part of them that wanted to be smaller, it made them really happy. Right. But because the substance, the substance abuse took over that became even in their own minds, they weren't thinking about food and weight. They were thinking about getting the next fix. And so, it isn't until they get sober that all of a sudden they're like, Oh, I'm starting to gain weight. I'm starting to eat more. How do I feel about this? And, and that's when it starts spinning. And if there's, if the, if the underlying, if there is an underlying user, it comes up after that. Uh, but. Other things might be, if you're also hearing them talk about not wanting to gain weight if they're talking a lot about good food, bad food, counting calories, if they're talking about eating too much and then you're seeing them go to the bathroom afterwards, you know, if you're seeing those sort of co occurring behaviors along with the substance abuse, that would be, those would be some flags that there, there's, there might be an an eating disorder there or disordered eating.

Brenda: 39:49

Yeah, I heard a term. I don't know if you've heard it. Alkorexia.

Alice: 39:54

Or drunkorexia.

Brenda: 39:55

Yeah, where like people will save their calories for alcohol, not eat food because they don't want to use their calories for food. They want to use it for alcohol. And then I also have heard younger girls, not wanting the calories of the alcohol. And so starting with pills because the right, don't have any calories, which is horrifying, right? Like that is so scary.

Alice: 40:21

That term drunkorexia and that pattern of behavior is so dangerous, right? Because the way alcohol impacts the body, it has calories. But it actually steals nutrients from your body and it's incredibly toxic to the liver. And so you're doing, it's like a double whammy. You're not getting enough food, which that in and of itself can create liver inflammation. And then you're drinking on top of that. So it's a double whammy. To the body and the amount of blackouts or alcoholic comas, you know, things like that passing out with alcohol when it's much, it's much more likely to happen because you don't have any nutrition in there that can help. Metabolize some of that alcohol too, right? And

Brenda: 41:11

especially for, for girls, but also boys, just the risk of sexual assault in those kinds of situations where they are blacked out or if they've passed out is so scary. And so that kind of brings me to a question about how do you have a conversation with your child about this? So if you're seeing this in your child, you're seeing some of these patterns. you know, you don't want to just come down hard with a hammer, like you have to eat because you can't force anybody to eat. How do you even start a conversation with them to start understanding what this is?

Alice: 41:50

Well, this is where invitation to change is so wonderful. Because it's, it, it really is helpful in, in coming alongside our kids with eating disorders as well. Really? Okay. I hadn't thought about that. Yeah. So when we use, we use the concepts like behaviors make sense. So we understand we live in a diet culture that promotes perfect bodies of, of whatever the culture is saying about that particular body, it's supposed to look this way, right? The hierarchy of bodies and and you know, eating less and, or dieting and, or, you know, Tons of supplements and or all of that is glorified in our culture. We behaviors make sense, right? They make sense. The behaviors make sense. And then, you know, we come alongside them with those positive communication. Skills where we ask permission, Hey, there is, you know, whenever you get a chance is I'd love to chat with you about something. And we give them maybe a couple of times, would you like to talk now or maybe this weekend? Right. And then, and then we start to, we, we begin to validate them, right? Like, Hey, like, uh, you know, we live in this culture that just promotes. diets and, and losing weight and, and things like that. And, and I just noticed that you've been eating less and I've noticed that you've lost weight. I've noticed that you get worried about food. I just wanted to check in with you. On that, you know, what maybe is open that up for you and, and, you know, what made you decide to want to start to do that and how's that impacting you, you know, things like that. Like you're just having a positive conversation with them and, and, and some might open up and some might go, I'm fine. I'm fine. Like I, I just, I just, you know, I just don't feel like eating it. I'm just, I just don't like that stuff anymore. I'm still, you know, they, they might stay shut down, but you're opening that conversation with them. You, depending on the level of severity, there is Uh, a type of therapy out there called family based treatment, FBT. And it is where parents actually plate the meals for their kids and sit with them and support them. And the parents actually have their own support system. They typically work with a therapist and or a dietitian and how to plate those meals. And, and so they'll be getting their own support. And so there might be boundaries that need to be set. A big thing we say is like life stops until you start eating, right? Like natural consequences are you know, you don't have the energy to, to play that sport because your body's just not getting enough nutrition or you don't have the energy to, you know, go to the mall with your friends because your body's just not getting that nutrition. And that's for, for maybe younger kids. older adults or young adults. Obviously, the interaction is going to be different. But so there's boundaries that we set with them, but a lot of those things, those and. Self awareness, right? Self awareness of, of what is, and, and I work a lot with parents on this. What is my relationship with food and my body?

Brenda: 45:06

Right.

Alice: 45:06

Am I dividing foods into good and bad? Am I, am I talking about how much I need to lose weight or saying negative things about my body? Uh, what are my eating patterns? You know, and as I begin to start to look at that and shift that, that has huge impacts. As we start to change our behaviors and how we care for ourselves, our kids notice, even if they pretend that they're not, they notice, right? And also our kids are going out into the world where that saying, eat this, don't eat that, you know, have the perfect body look this way. And it, how refreshing it would be for them to be able to come home and not have that,

Brenda: 45:47

to have

Alice: 45:48

that sort of secure base where there are no good or bad foods. You know, we eat when we're hungry. We stop when we're full. We have nice, yummy, pleasant meals. I would say pleasure is a nutrient, right? Like, we enjoy our meals. We, we challenge diet culture, right? Like, we look at, we watch a movie and we go, isn't that interesting? Like, Why is it always that the, you know, the, the thinner people have the main roles? Like, what is that? Like, is that great representation? I'm not sure that's really good representation, right? We just start to challenge that. We start to be a place of sort of safety from that, where they don't, they're not getting all that pressure. And that can, that can have that influence. Yeah.

Brenda: 46:31

Huge. And, and literally everything you're saying is exactly what we do with substance use, right? You want to be the safe place. You want to come alongside and not, you know, not to make a pun, but not to like shove it down their throat.

Alice: 46:45

Right, right, right.

Brenda: 46:45

And so it sounds like those skills really translate, which I had really never thought about, but that's pretty cool.

Alice: 46:53

Those skills work wonderful. In fact, I, I, I went to get trained as an invitation to change provider and did their professional training because as I was learning it, I thought this is so, it's, it's so wonderful for a wonderful resource for parents to begin to learn and I will use these principles in sessions with them. with parents. Because it is those positive communication skills, taking care of ourselves, self awareness, understanding the conceptual framework and that behaviors make sense, work well in coming alongside our kids who are struggling with eating disorders.

Brenda: 47:31

Yeah, that is really, really cool. And I like the part about the, the self reflection and being aware of our own patterns, because you're stacking the deck against your kiddo. If you're Constantly dieting constantly, you know, talking about food or restricting food, or I can only eat at this time and not at this time.

Alice: 47:52

Right.

Brenda: 47:53

Yet you're expecting your child to, you know, just like have this carefree relationship with food that doesn't match up.

Alice: 48:00

It's harder. It makes it harder. However, I would also say if you are listening, And you are thinking, Oh my goodness, I do that or I've said that give yourself a break because diet culture is the water we swim in. None of us get a pass and unless we're exposed to some of this work and we hear a podcast like this or we, you know, go do our own work we're probably not going to hear it because diet culture saturates so much of our world. So you get, you know, you get to start now. And actually sometimes I think that's. more powerful to a child when they see their parents change. So I've seen parents who have been maybe following really strict diets thinking they were taking care of themselves and completely shift that and start eating what their kids are eating and change their relationship with food and their body and their language that they're using. And it makes huge impact. Cause the kids are like, Oh wow, like there's a change. We're noticing a shift and I'm seeing that and, and you know, I, I always encourage us as parents to tell in ourselves, you're right. I did do that. I did diet and that probably wasn't helpful. And I'm learning and I'm learning now and I'm learning how my own self and my own relationship with food and shifting that. You know, cause I, to me, kids respect that much more than us thinking we have to be perfect or we have to.

Brenda: 49:31

Yeah. Exactly. It's exactly what we talk about with, with substance use, just to say, Hey, I'm trying some new stuff. Right. Right. What I was doing wasn't working. I didn't realize the impact it was having on you. It is so subliminal. you know, when you think about all the messages that we get around food in particular and appearance and all of that. So, well, this has been beyond enlightening. I'm so happy that we have this conversation because I had never really tied the two together as far as substance use and what that's, what's going on there with eating disorders and just the cultural. impact that we are all bombarded with about food. And I'll put some of the books that you recommended in the show notes for people. We'll get additional links in there. If there's some programs that Alice can recommend, at least to start looking into, if you are looking for treatment for an eating disorder and, or Both eating disorders and substance use because that's a tricky ball of wax right there. It's good. You said awesome. Thank you so much. This has been amazing.

Alice: 50:46

Absolutely. It's my pleasure.

Brenda: 50:48

Okay, my friend, that's a wrap for today. Don't forget to download the new ebook, worried sick. It's totally free and will shed so much light on positive tools and strategies you can use right now to start creating conditions for change in your home. And in your relationships, it's at HopeStreamCommunity. org forward slash worried. And as always, you can find any resources mentioned during today's show at brendazane. com forward slash podcast. That is where every episode is listed and you can search by keywords, episode number or the guest name. Plus we've created playlists for you, which make it easier to find episodes grouped by topic. And those are at brendazane. com forward slash playlists. Please be extraordinarily good to yourself today. Take a deep breath. You have got this. You are not doing it alone. And I will meet you right back here next week.