GOOD EVENING, THANKS SO MUCH FOR WATCHING HEALTHLINE HERE ON PBS FORT WAYNE I'M YOUR HOST MARK EVANS.

A VERY IMPORTANT TOPIC THIS EVENING EATING DISORDERS AND DISORDER EATING AND WE'LL EVEN UNCOVER HOW COVID-19 HAS AFFECTED THOSE.

AND TONIGHT'S VERY SPECIAL GUEST IS DR. LAURA OIR WHO IS A PSYCHOLOGIST SPECIALIZING IN EATING DISORDERS.

DOCTOR, THANK YOU SO MUCH FOR BEING WITH US TONIGHT.

THANK YOU.

I WANT TO GO AHEAD AND TALK ABOUT THE PROVERBIAL ELEPHANT IN THE ROOM WHICH IS ALSO NAMED COVID-19.

HAVE YOU OBSERVED AN INCREASE IN EATING DISORDERS DUE TO THE PANDEMIC AND WHAT DISORDERS HAVE INCREASED OR BECOME MORE PREVALENT?

ABSOLUTELY.

SO AS A PROFESSIONAL THAT WORKS WITH EATING DISORDERS WE HAVE SEEN A REALLY LARGE INCREASE IN PEOPLE BOTH DEVELOPING EATING DISORDERS AND I WOULD ALSO SAY THOSE WHO HAVE HAD EATING DISORDERS IN THE PAST OR HAVE BEEN, YOU KNOW, A LITTLE FURTHER IN RECOVERY , A LOT OF THEM HAVE ACTUALLY HAD A LOT MORE RELAPSES RECENTLY.

I THINK THERE'S A WHOLE LOT OF CONTRIBUTING FACTORS TO THAT.

BUT YOU KNOW, SOME OF THOSE INCLUDING NOT BEING ABLE TO BE IN THE SUPPORT GROUPS HAD GONE TO GOING TO THE THERAPY THEY'VE BEEN TO OR JUST LACK OF SUPPORT AND LOVED ONES AROUND.

AND SO WE REALLY HAVE SEEN PEOPLE EITHER GOING TOWARDS FOOD OR AWAY FROM FOOD EITHER FOR THE FIRST TIME OR GOING BACK TO SOME OF THOSE BEHAVIORS THAT HAVE BEEN PRESENT FOR THEM IN THE PAST.

WELL, AND WE'RE GOING TO TAKE SOME CALLS FROM OUR AUDIENCE TONIGHT.

OF COURSE WE ALWAYS DO HERE ON HEALTHLINE.

THAT'S ONE OF OUR THINGS.

BUT 866 NINE SIX NINE TWO SEVEN TWO ZERO IS THE LINE FOR LONG DISTANCE CALLS OR LOCALLY IT'S NINE SIX NINE TWO SEVEN TWO ZERO AND WE HAVE THE NEXT HALF AN HOUR TO DISCUSS THIS TOPIC WHETHER YOU HAVE QUESTIONS AND CONCERNS ABOUT YOURSELF OR A FRIEND OR A FAMILY MEMBER, PLEASE CALL.

THAT'S WHAT WE DO HERE AND THAT'S EXACTLY WHY THE SHOW IS SERVING YOU AND THIS SUBJECT IS VERY IMPORTANT.

SO LET'S GET THOSE CALLS COMING IN AND WE'LL TAKE THOSE AS THEY DO COME IN.

SO DOCTOR, I THINK THAT ONE OF THE MESSAGES I GOT FROM YOUR EXPLANATION JUST A COUPLE OF MINUTES AGO WAS THERE SEEMS TO BE A STRESS FACTOR INVOLVED BECAUSE OF COVID-19 HAS THE STRESS OF COVID-19 DIRECTLY AFFECTED SOME FOLKS AND THEIR EATING DISORDERS.

IT HAS SO IF YOU THINK ABOUT IF YOU THINK ABOUT HOW PEOPLE FEEL ABOUT HOW YOU FEEL WHEN YOU'RE STRESSED RIGHT.

AND EAT LOTS OF THINGS BECAUSE OF STRESS, WHETHER THAT'S NOT BEING ABLE TO SEE LOVED ONES, WHETHER THAT'S FINANCIAL STRESS, WHETHER THAT'S YOU KNOW, LOTS OF THINGS CAUSES STRESS BEING AT HOME TRYING TO MANAGE LIFE AND KIDS AND JUST ALL THE THINGS AND SO WHAT HAPPENS INSIDE OF US WHEN WHEN WE ARE UNDER STRESS IS IT ACTUALLY DOES IMPACT OUR OUR DIGESTIVE TRACT AND OUR APPETITE AND SO IT CHANGES HORMONES.

IT CHANGES ALL SORTS OF THINGS INSIDE OF US AND FOR SOME PEOPLE THEY NOTICE A LOSS OF APPETITE WHEN THEY'RE STRESSED AND SO THEY MIGHT FIND THEMSELVES NOT EATING, NOT BEING ABLE TO WANT TO GO TOWARDS FOOD WHERE OTHERS FIND THAT EATING ACTUALLY MAYBE CAN PROVIDE SOME COMFORT FOR THEM OR HELPS THEM MAYBE DISTRACT OR GET AWAY FROM THOSE STRESSORS.

AND SO I THINK WE CAN ALL ACKNOWLEDGE THAT NONE OF US ESCAPE THE STRESS OF COVID AND SO BECAUSE OF THAT WE ARE SEEING A LOT OF PEOPLE GOING TOWARDS OR AWAY FROM FOOD OR DOING SOME DIFFERENT THINGS WITH FOOD JUST AS AS A SYMPTOM OR A RESPONSE TO THE STRESS THAT A LOT OF US FELT OK, VERY GOOD.

AND WE DO HAVE A CALL COMING IN AND WE'D LIKE TO ADDRESS THAT AND IT'S FROM LISA AND SHE PREFERRED TO BE OFF THE AIR WHICH IS JUST FINE BUT SHE'S ASKING DIETS LEAD TO AN EATING DISORDER.

IS THERE A POSSIBILITY OF DIETS BEING A SLIPPERY AND IS THIS SOMETHING THAT THAT SHE SHOULD BE CONCERNED ABOUT?

THAT'S A GREAT QUESTION, LISA.

ABSOLUTELY.

I THINK HANDS DOWN ONE OF THE NUMBER ONE THINGS THAT I SEE WITH CLIENTS IS THEY START ON THE DIET REGARDLESS OF THEIR EATING DISORDER.

A LOT OF THEM DO START WITH DIETING AND WHETHER THAT GOES FROM DIETING AND THEN THEY FIND THEMSELVES OVERINDULGING AND BINGEING LATER OR JUST CONTINUING ON THAT DIET AND THE KIND OF OBSESSIVE ABOUT FOOD DIETING IS A REALLY IS A REALLY I GUESS YOU KNOW, KIND OF ONE OF THE FIRST DOMINOES AND THE SERIES OF DOMINOES THAT CAN KICK OFF AN EATING DISORDER AND I WANT TO GET INTO THE SPECIFIC EATING DISORDERS THAT YOU DEAL WITH PARTICULARLY AND THE ONES THAT ARE MOST COMMON.

BUT BEFORE WE GET INTO THAT, LET'S TALK ABOUT THE SPECIFIC EATING DISORDERS AND DEFINE WHAT CONSTITUTES A DIAGNOSIS FOR THEM.

ABSOLUTELY.

SO THERE ARE DIFFERENT KINDS OF EATING DISORDERS.

ONE OF THE THINGS THAT WE USE TO DIAGNOSE AN ACTUAL EATING DISORDER IS IF IT'S CAUSING IMPAIRMENT IN SOMEONE'S LIFE.

AND SO REGARDLESS OF WHAT WE'RE DOING OR NOT DOING WITH FOOD AND WE CAN TALK ABOUT THAT IN A MINUTE IF SOMEONE FINDS THEMSELVES REALLY STRUGGLING IN THE RELATIONSHIP WITH FOOD AND IT'S REALLY CAUSING THEM A LOT OF DISTRESS, MAYBE OBSESSIVE THOUGHTS, THEY CAN'T STOP THINKING ABOUT IT.

THEY FEEL LIKE THEY CAN'T STOP CERTAIN BEHAVIORS THAT REALLY DOES START TO IMPACT THEIR SOCIAL LIFE.

IT IMPACTS MAYBE THEIR THEIR COGNITIVE ABILITY.

IT IMPACTS THEIR EMOTIONAL FUNCTIONING AND SO REALLY WE LOOK AT HOW MUCH OF AN IMPACT ARE THESE BEHAVIORS CAUSING IN THE PERSON'S LIFE AND IF THERE'S IMPAIRMENT IN THOSE DIFFERENT AREAS AND SO THEN THE BEHAVIORS WE ACTUALLY LOOK AT ARE DIFFERENT THINGS.

SO SOMEONE MIGHT NOT BE EATING ENOUGH.

THEY MIGHT BE EATING TOO MUCH MORE THAN MAYBE THEIR BODY ACTUALLY NEEDS.

THEY ALSO MIGHT BE PURGING AND SO A LOT OF PEOPLE THINK VOMITING IS WHAT PEOPLE DO WITH PURGING BUT IT CAN ALSO BE OVEREXERCISING.

THEY ALSO SEE CLEAN EATING.

SO A LOT OF PEOPLE SAY OH I'M CLEAN, I'M I'M LIVING A HEALTHY LIFESTYLE BUT IT CAN GET PRETTY EXTREME FOR SOME FOLKS AND CAN BECOME OBSESSIVE AND ALL OF A SUDDEN THEY THEY ARE NO LONGER DOING THINGS THEY ACTUALLY ENJOY AND CARE ABOUT BECAUSE OF THIS PURSUIT OF THIS CLEAN EATING.

THERE'S ALSO SOME OTHER DISORDERS THAT MAYBE ARE LESS COMMONLY KNOWN ONCE CALLED PICA THAT'S WHERE YOU EAT NON NUTRITIVE SUBSTANCE AND THEN THERE'S ONE CALLED RUMINATION DISORDER WHICH MIGHT SOUND WEIRD AND STRANGE BUT IT'S WHERE FOOD ACTUALLY KIND OF COMES UP AND YOU CAN REGURGITATE IT AND PEOPLE DO IT AND SWALLOW IT AGAIN AND THAT CAN BE PRETTY DISTRESSING FOR FOLKS AS WELL.

I WOULD THINK SO NOW SINCE YOU'RE A PSYCHOLOGIST, WOULD YOU CLAIM OR WOULD YOU CATEGORIZE EATING DISORDERS AS A MENTAL ILLNESS?

YES, SO THEY THEY ARE MENTAL ILLNESSES.

WE DO DIAGNOSE THEM IN THAT WAY .

AND SO WHAT WE KNOW IS THAT THEY REALLY DO HAVE A GENETIC COMPONENT TO THEM.

SO WE SEE THEM RUNNING IN FAMILIES.

WE ALSO KNOW THAT THEY THEY ARE IMPACTED BY ENVIRONMENT AND THOSE CERTAIN CULTURES CAN WE SEE EATING DISORDERS HAPPENING MUCH MORE PREVALENT IN WESTERNIZED CULTURES?

BUT THEY REALLY ARE THEY ARE REALLY ARE MENTAL ILLNESSES.

THEY'RE NOT JUST A CHOICE PEOPLE ARE MAKING OR NOT MAKING.

THEY REALLY ARE SORT OF DEEP INGRAINED, DEEPLY SEEDED MENTAL ILLNESSES.

OK, WE HAVE ANOTHER CALL THAT JUST CAME IN AND IS ON THE LINE AND WHAT IS YOUR QUESTION FOR DR. ALL YOUR AND THANK YOU FOR CALLING, OK.

I WONDERED ABOUT PEOPLE THAT ARE OBESE OR HEAVYSET AND AFRAID TO GO TO THE DOCTOR AFRAID OF WHAT'S GETTING WEIGHED AND IT STOPS US FROM GOING AND HOW THAT AFFECTS OUR HEALTH BECAUSE WE'RE SCARED TO GO OF BEING CHASTISED AND TREATED YOU KNOW, TREATED BAD A LOT OF TIMES.

SO I WONDER WHAT YOU THOUGHT ABOUT THAT AND WHAT CAN WE DO ABOUT IT SO PETRIFIED TO GET ON THE SCALE AT THE DOCTOR'S OFFICE.

YES.

YES, ABSOLUTELY.

I THINK I THINK THERE'S A HUGE MOVEMENT CALLED HEALTH AT EVERY SIZE AND WHAT THAT MOVEMENT REALLY IS ABOUT IS LOOKING AT THE DISCRIMINATION THAT PEOPLE IN LARGER BODIES ACTUALLY DO FACE.

IT IS IT IS VERY EQUIVALENT TO RACISM LIKE THE DISCRIMINATION OF PEOPLE WHEN PEOPLE ARE IN LARGER BODIES THAT THEY FACE BOTH UNFORTUNATELY IN THE MEDICAL SETTING AND JUST IN GENERAL PUBLIC SOMETHING THAT I ENCOURAGE MY CLIENTS TO DO SOMETIMES IS JUST TO DECLINE BEING WEIGHED.

YOU CAN SOMETIMES YOU GET PUSHBACK BACK.

UNFORTUNATELY SOMETIMES NURSES DOCTORS DON'T UNDERSTAND BUT THAT IS A RIGHT PEOPLE HAVE YOU HAVE A RIGHT TO SAY I DON'T WANT TO BE WEIGHED.

I DON'T WANT TO BE SHAMED ABOUT MY WEIGHT.

I DON'T WANT TO BE I DON'T WANT TO DO THAT.

AND WHEN YOU HAVE A RIGHT TO DO THAT, SOMETIMES THERE'S MEDICAL PROCEDURES YOU MIGHT NEED TO GET PAID FOR FOR CERTAIN MEDICATION DOSAGES.

BUT IN GENERAL THAT IS SOMETHING THAT PEOPLE HAVE A RIGHT TO DO AND THEY DON'T ACTUALLY KNOW THAT THEY HAVE THAT RIGHT.

SO I THINK THAT IS SOMETHING YOU MIGHT CONSIDER OK AND THANK FOR THAT DOCTOR.

WHAT GENDER AND WHAT SPECIFIC AGE GROUPS SEEM TO BE AFFLICTED WITH EATING DISORDERS MORE THAN OTHERS.

SO MOST PEOPLE THINK THAT IT REALLY IS JUST AN ADOLESCENT PROBLEM BUT THAT IN AIR QUOTES AND WE DO SEE THAT THAT A LOT OF EATING DISORDERS DO START OR PEOPLE MIGHT EXPERIENCE THE BEGINNINGS OF WHAT ADOLESCENCE BUT WE REALLY SEE THEM RIGHT NOW GO THROUGHOUT THE ENTIRE LIFESPAN.

I MEAN I'VE HAD PEOPLE IN THEIR 80S COMING IN FOR TREATMENT WHO MAYBE HAVE HAD IT FOR A WHILE BUT HAVE NEVER SOUGHT TREATMENT BEFORE.

AND SO IT IS IT IS A IS A COMMON, YOU KNOW, PITFALL I THINK OF A LOT OF PROFESSIONALS AND JUST PEOPLE IN GENERAL THINKING OK, THIS IS JUST AN ADOLESCENT PROBLEM, SOME IN THEIR TWENTIES BUT IT'S NOT IT'S A LIFE A LIFELONG DISEASE FOR A LOT OF PEOPLE AND A LOT OF PEOPLE.

THERE'S EVEN RESEARCH SHOWING THAT PEOPLE IN THEIR 40S OR 50S WHO MAYBE EITHER EXPERIENCE A LITTLE BIT OF DISORDERED EATING EARLIER IN THEIR LIFE OR NOT JUST GOING THROUGH SOME OF THESE MAJOR LIFE TRANSITIONS AND THEIR FAMILY OR CAREER THAT THEY'RE STARTING TO DEVELOP EATING DISORDERS LATER IN LIFE AS WELL.

SO IT DOESN'T DISCRIMINATE AGAINST WELL, IT'S IMPOSSIBLE FOR EATING DISORDERS TO BE INHERITED OR BE GENETICALLY BASED.

YES.

THOUGH THERE ARE SOME GENETIC PREDISPOSITION PEOPLE CAN HAVE SO YOU KNOW AND NATURE NURTURE IS THIS IS THIS A DISORDER BECAUSE IT'S GENETIC OR IS IT IS IT A DISORDER BECAUSE PEOPLE SEEING LOVED ONES DOING IT AND THE ANSWER IS YES KIND OF YES TO BOTH.

RIGHT.

BOTH OF THOSE PIECES MAKE ONE MORE MORE VULNERABLE AND PREDISPOSED TO AN EATING DISORDER.

OK, YOU TOUCHED ON A COUPLE OF THEM MORE I THINK UNCOMMON EATING DISORDERS WHICH WERE PICA AS WELL AS THE RUMINANT RUMINANT RUMINATION OR DISORDER.

THANK YOU.

YOU'RE THE DOCTOR.

I'M NOT AND SYMPTOMS FOR THAT.

BUT LET'S TALK ABOUT THE ONES THAT ARE MOST PREVALENT, THE ONES THAT I THINK THAT YOU PROBABLY SEE IN YOUR PRACTICE MORE OFTEN AND THAT IS THE ANOREXIA NERVOSA.

CAN YOU EXPLAIN JUST IN CASE SOME OF OUR AUDIENCE MEMBERS DON'T KNOW WHAT THAT IS AND WHAT ARE THE SYMPTOMS?

SURE.

SO WITH ANOREXIA NERVOSA ACTUALLY IT'S ONE OF THE LEAST COMMON EATING DISORDERS BELIEVE IT OR NOT.

IT'S THE ONE WE KNOW THE MOST ABOUT I THINK IN TERMS OF PUBLIC BUT IT IS IN TERMS OF PREVALENCE RATES IT'S ONE OF THE LEAST COMMON ONES BUT IN TERMS OF SYMPTOMS FOR THAT SO IT WOULD BE SOMEONE WHO IS CONSIDERED UNDERWEIGHT AND OR MAY BE OF NORMAL WEIGHT BUT YOU HAVE HAS LOST SOME SIGNIFICANT WEIGHT.

THEY RESTRICT THEIR DIET SO THEY ARE NOT EATING ENOUGH CALORIES.

THEY ALSO ARE REALLY FEARFUL ABOUT BODY AND GAINING WEIGHT AND THERE'S A LOT OF OBSESSIVE THOUGHTS AND INTRUSIVE AND INTRUSIVE THOUGHTS ABOUT BODY AND FOOD AND JUST JUST A FEAR OF OF EATING AND GAINING WEIGHT.

WHAT'S ALSO TRICKY I'LL THROW THIS IN THERE A LOT OF PEOPLE THERE IS YOU CAN ACTUALLY HAVE ANOREXIA NERVOSA AND STILL BINGE AND PURGE BY VOMITING OR EXERCISE.

SO SOME PEOPLE IF THEY SEE SOMEBODY THAT'S THAT'S VOMITING PURGING, THEY MAY SAY OH, THEY HAVE BULIMIA BUT YOU CAN ACTUALLY BE MORE HAVING ANOREXIA AND ALSO HAVE THOSE SYMPTOMS AS WELL.

OK, AND WE'LL TALK ABOUT BULIMIA NERVOSA HERE IN JUST A MINUTE.

BUT WE DO HAVE ANOTHER CALL COMING IN AND IT'S FROM SUE AND SHE'S ASKING WHAT ADVICE AND OR TREATMENT WOULD YOU HAVE FOR SOMEONE WHO HAS SUFFERED FROM BULIMIA FOR TWENTY FIVE YEARS AND YOU MIGHT WANT TO PREFACE THAT WITH BULIMIA IS SURE.

SO BULIMIA IS ANOTHER ONE OF THE EATING DISORDERS WE WORK WITH AND THEY IT IS PRIMARILY WHEN SOMEONE OVEREAT SO BINGE EATS MORE THAN ONE NORMALLY WOULD IN A SETTING AND THEN PURGES IN SOME WAY.

SO THE MOST COMMON WAY MIGHT BE BY VOMITING BUT IT COULD ALSO BE BY OVEREXERCISING OR EVEN FASTING.

RESTRICTING CAN BE A WAY OF PURGING AS WELL AND SO SO IN TERMS OF TREATMENT FOR THAT THAT'S CHALLENGING BECAUSE I THINK THERE IS CHALLENGING TO ANSWER YOUR QUESTION SUCCINCTLY I SHOULD SAY IT THAT WAY BUT BUT REALLY I THINK WORKING WITH A TREATMENT TEAM WE'LL TALK ABOUT THAT I'M SURE IN A LITTLE BIT.

BUT A TREATMENT IS REALLY HELPFUL LOOKING AT THE PSYCHOLOGICAL PIECES OF IT, WORKING WITH A THERAPIST, OFTEN WORKING WITH A MEDICAL PROVIDER WHO CAN MONITOR MEDICALLY THAT THINGS ARE OK AND FUNCTIONING OK, WORKING WITH A DIETICIAN MAKING SURE THAT NUTRITIONALLY YOU'RE GETTING ENOUGH OF WHAT YOU NEED AND SOMETIMES EVEN WORKING WITH A PSYCHIATRIST IF THAT'S NEEDED TO MAYBE WORK ON MEDICATION FOR UNDERLYING OTHER DIAGNOSES LIKE ANXIETY WE SEE A LOT OF DEPRESSION OR TRAUMA, THINGS LIKE THAT.

SO IT REALLY IS TREATMENT OFTEN FOR EATING DISORDERS IS PRETTY COLLABORATIVE AND IT INVOLVES A LOT OF FOLKS BECAUSE THESE ARE PRETTY INTENSE DISORDERS THAT OFTEN GO UNTREATED FOR A LONG TIME.

OK, I'M GOING TO STOP HERE FOR JUST A SECOND AND REMIND OUR VIEWERS WHO ESPECIALLY JUST TUNED AND WE'RE OF COURSE DOING A SHOW CALLED HEALTHLINE HERE ON PBS, PBS FORT WAYNE AND THE TOPIC IS EATING DISORDERS AND DISORDER EATING IN OUR SPECIAL GUEST IS DR. LAURA AURIER WHO IS A PSYCHOLOGIST WHO SPECIALIZES IN EATING DISORDERS .

AND IT'S A PLEASURE TO HAVE YOU ON THE PROGRAM THIS EVENING.

BEFORE WE GO ON TO THE OTHER EATING DISORDERS, DR. ATTARI IS CALLED IN AND I PREFACE BEFORE THE SHOW STARTED THAT THIS IS PROBABLY GOING TO BE A HOT TOPIC.

SO WE'VE HAD A LOT OF PHONE CALLS AND I'M GLAD TO SEE THAT MATARI IS ASKING IS INTERMITTENT FASTING SAFE AND WHAT ARE YOUR THOUGHTS ON THIS AND WHAT WOULD YOU SUGGEST ABOUT IT?

OH, THAT'S A LOADED QUESTION, TERRY.

SO I'M GOING TO REALLY GENERALLY HERE I'M NOT A MEDICAL DOCTOR NOR DO I CLAIM TO BE AND SO PLEASE CONSULT A PHYSICIAN ABOUT THAT OR FOR EATING DISORDERS SPECIFICALLY.

I WILL SPEAK FOR IT THAT WAY.

IT IT IS REALLY CHALLENGING AND CAN BE VERY TRIGGERING HONESTLY LIKE I MENTIONED EARLIER IN THE SHOW, OFTENTIMES EATING DISORDERS BEGIN WITH DIETING FOR A LOT OF FOLKS AND SO FOR THOSE THAT I WORK WITH THAT THAT EATING DISORDERS ARE PART OF THEIR LIFE.

DIETING REALLY CAN BE ONE OF THE CATALYSTS FOR TRIGGERING THEIR EATING DISORDER AGAIN.

AND SO INTERMITTENT FASTING IS SOMETHING THAT I THINK CAN BE REALLY TRICKY TO TO BECOME TO BE RECOVERED FROM AN EATING DISORDER AND START THAT UP AGAIN OR TO TRY TO DO THAT IN THE MIDST OF AN EATING DISORDER BECAUSE IT EITHER TRIGGERS ONGOING FASTING OR YOU SEE WE SEE THIS REBOUND EFFECT FOR INDIVIDUALS THAT STRUGGLE WITH BULIMIA AND BINGE EATING WHERE THEY FAST FOR A WHILE.

BUT BECAUSE OF THAT DEPRIVATION AND THEIR BODY AND THEIR THEIR MIND, THEY THEN SORT OF CATAPULT THE OTHER DIRECTION ON THEMSELVES OVEREATING.

SO IT'S SOMETHING I'M VERY CAUTIOUS WITH AND I YOU KNOW, I JUST DON'T SEE IT GOING WELL OFTEN WITH THOSE WITH EATING DISORDERS.

OK, AND THANK YOU FOR ADDRESSING THAT AS BEST YOU COULD AS A PSYCHOLOGIST AND NOT A NUTRITIONAL PHYSICIAN OF SORTS.

LET'S GET BACK TO THE EATING DISORDERS, SOME OF THE MORE COMMON ONES AND I JUST HAPPENED TO STUMBLE ACROSS THIS WHEN I DON'T MEAN TO THROW YOU A CURVE BUT I SAW ONE THAT'S CALLED AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER.

IS THAT SIMILAR TO ANOREXIA OR HOW HOW WOULD YOU DESCRIBE THAT SO SO THAT WHEN IS OFTEN SOMETIMES PEOPLE REFER TO IT AS ARPIT AVOIDANT RESTRICTIVE FOOD INTAKE DISORDER AND IT IS SIMILAR ANOREXIA WHERE SOMEONE MIGHT HAVE BEEN UNDERWEIGHT OR MALNOURISHED BUT THE UNDERLYING REASONS AS TO WHY THEY'RE AVOIDING FOOD IS DIFFERENT.

SO THEY'RE NOT SO MUCH AFRAID OF WEIGHT GAIN AND IT'S NOT EVEN ABOUT NECESSARILY WANTING TO TO LOSE WEIGHT PER SAY.

BUT USUALLY THEY'RE AVOIDING FOOD FOR SOME REASON.

SO IT MIGHT BE SENSORY ISSUES.

SOMETIMES WE SEE THIS WITH AUTISM DIAGNOSES OR JUST SENSORY PROCESSING PROBLEMS.

SO THEY'RE AVOIDING A LOT OF TYPES OF FOODS BECAUSE THEY DON'T LIKE THE TEXTURE, THE FLAVOR, THE SMELL.

WE ALSO SEE IT SOMETIMES WHEN PEOPLE HAVE GONE THROUGH CANCER TREATMENTS OR OTHER THINGS THEY JUST THINGS DON'T TASTE THE SAME EVEN COVID ACTUALLY BECAUSE THAT CHANGE HAS CHANGED PEOPLE'S TASTE AND SMELL.

THEY HAVEN'T MAYBE EATEN SO MUCH AND SO I DON'T KNOW THAT I HAVE SEEN ANY RESEARCH THAT'S CORRELATING IN ANY INCREASE IN OUR FOOD BECAUSE OF COVID ALL THESE ACRONYMS.

BUT I DO THINK THAT IT IS SOMETHING THAT YOU SEE PEOPLE SORT OF AVOIDING FOOD FOR VARIOUS REASONS BUT NOT NECESSARILY BECAUSE THE BODY IMAGE PIECE BUT IT IS CAUSING ENOUGH PROBLEMS IN THEIR HEALTH AND IN THEIR LIFE THAT IT'S DIAGNOSABLE.

OK, HERE'S THE NEXT EATING DISORDER THAT I NOT MYSELF NECESSARILY I HAVE HAD MOMENTS IN MY LIFE BUT BINGE EATING DISORDER THAT SEEMS TO BE A VERY COMMON ONE AND WHAT IS WHAT ARE YOUR THOUGHTS ON THAT AND WHAT ARE THE SYMPTOMS SO BINGE EATING DISORDER IS ONE OF THE NEWEST DIAGNOSIS THAT WE HAVE IN OUR SORT OF DIAGNOSTIC MANUAL AND BELIEVE IT OR NOT, IT'S ACTUALLY THE MOST COMMON ONE.

AND SO THIS ONE IS EQUIVALENT MEN AND WOMEN EQUALLY WE SEE IT SEE IT ACROSS ALL GENDERS AND IT'S WHEN SOMEONE IS EATING MORE THAN THEY PROBABLY WOULD NEED TO IN A NORMAL MEAL AND THAT IT'S HAPPENING MULTIPLE TIMES A WEEK AND IT'S CAUSING DISTRESS TO THEM.

SOME PEOPLE WITH WITH THIS DISORDER MIGHT BE OVERWEIGHT AND SOME PEOPLE MAY NOT BE.

AND SO THIS GOES WITH ALL EATING DISORDERS BUT JUST LOOKING AT SOMEBODY'S BODY AND THEIR AND THEIR WEIGHT, YOU CAN NEVER DIAGNOSE AN EATING DISORDER BASED ON THAT ALONE BECAUSE OFTENTIMES PEOPLE ARE OF NORMAL BODY SIZE AND WEIGHT AND STRUGGLE SEVERELY WITH THESE DISORDERS.

SO BINGE EATING AFTER OFTEN PEOPLE THINK ABOUT SOMEONE HAS TO BE OVERWEIGHT.

BUT THAT'S NOT THE CASE.

BUT YEAH, IT'S JUST IT'S JUST OVEREATING AND BINGE EATING FOOD PRETTY FREQUENTLY CAUSING IMPAIRMENT.

WELL, AND AS I ALLUDED TO, I THINK THAT WE'VE ALL HAD OUR MOMENTS WHERE WE'VE DONE A LITTLE BINGE EATING BECAUSE IT JUST TASTES SO GOOD.

BUT THERE ARE WE DO HAVE CONSEQUENCES THAT WE SUFFER FROM AND THAT IS INDIGESTION AND YOU KNOW, BELLYACHES AND THINGS LIKE THAT.

BUT FOR SOME PEOPLE I KNOW ONE INDIVIDUAL IN MY LIFE IN PARTICULAR WHO DOESN'T EAT AROUND OTHER PEOPLE AND I WILL SAY THAT SHE IS PROBABLY CONSIDERED AS AN OBESE PERSON DOESN'T EAT AROUND PEOPLE BUT WHAT EVERY CHANCE SHE GETS IN HIDING WHEN SHE'S ALONE SHE ADMITS THIS SHE WILL EAT PRACTICALLY EVERYTHING IN SIGHT.

SO WHAT IS CAUSING THAT THAT PARTICULAR ONE I DON'T KNOW THAT I CAN ANSWER IT EXACTLY, BUT I WOULD SAY IN GENERAL WHAT WE SEE IS THERE'S SO MUCH SHAME .

I THINK THIS GOES ACROSS THE BOARD FOR ALL EATING DISORDERS.

THERE'S SO MUCH SHAME INDIVIDUALS OFTEN FEEL LIKE SOMETHING'S WRONG WITH THEM.

THEY FEEL JUDGED.

THEY'RE OFTEN JUDGING THEMSELVES VERY HARSHLY INTERNALLY AND THEY'RE THEIR OWN WORST CRITIC.

SO TIMES BECAUSE OF THAT SHAME WE WE SEE THEM WANTING TO HIDE HIDE IN LOTS OF WAYS AND ENGAGE IN THESE BEHAVIORS OFTEN IN PRIVATE BECAUSE THERE IS SO MUCH SHAME AROUND THEM.

I THINK THOSE AGAIN IN LARGER BODIES ARE THOSE THAT STRUGGLE WITH EATING DISORDER, WITH BINGE EATING DISORDER OR AND OR IN LARGER BODIES.

I THINK THEY ALSO EXPERIENCE A LOT OF JUDGMENT AND SHAME IN SOCIAL SETTINGS EATING SO JUST TO PREVENT THAT THEY OFTEN WANT TO EAT ALONE OR IN PRIVATE BECAUSE IT JUST FEELS SAFER FOR THEM TO NOT HAVE TO BE GET THE JUDGMENTS GET GET THE THE COMMENTS THAT REALLY CAN CAUSE A LOT OF PAIN FOR THEM AND OFTEN THEN CONTINUE ON THE EATING BECAUSE USUALLY THAT'S CAUSED BY DISTRESS.

WELL AND THIS IS A PERSON WHO IS VERY CLOSE TO ME.

IN FACT IT'S ONE OF MY SIBLINGS .

SHE'S ONE OF MY SIBLINGS AND SHE HAS EVEN GONE ON WEIGHT LOSS PROGRAMS AND LOST A LOT OF WEIGHT AND THEN ESPECIALLY THROUGH THE COVID-19 CRISIS, A LOT OF THAT WEIGHT AND MORE HAS COME ON HAS COME BACK SO THAT'S VERY CONCERNING FOR OUR FAMILY AS WELL.

SO THAT HAS TO BE VERY HARD ON ONE'S BODY, WOULDN'T YOU SAY?

YEAH.

AND IT'S SO INTERESTING BECAUSE OUR DIET CULTURE AND I WOULD EVEN ARGUE ARE FAT PHOBIC CULTURE THAT REALLY IS OVERVALUES THINNESS TO TO SOME REALLY PROFOUND LEVELS.

UNFORTUNATELY WE YOU KNOW, A LOT OF FOLKS ARE PRESCRIBING ALL THESE DIFFERENT DIETS AND WEIGHT LOSS AND AND THE STATISTICS SHOW US THAT NINETY FIVE NINETY NINE PERCENT OF PEOPLE WHO LOSE WEIGHT WILL REGAIN THAT WEIGHT BACK IN ABOUT FIVE YEARS.

AND AND SO I THINK FROM A PHYSIOLOGICAL METABOLIC WE JUST DON'T UNDERSTAND, YOU KNOW, WEIGHT LIKE LIKE WE THINK WE DO AND EVEN I WOULD SAY, YOU KNOW, THE STATS EVEN SHOW US THAT ONE THIRD TO TWO THIRDS OF THOSE PEOPLE WHO LOSE WEIGHT GAIN MORE WEIGHT BACK AND SO THAT WEIGHT CYCLING THAT OFTEN HAPPENS FOR PEOPLE IS SHOWN TO BE EVEN EVEN WORSE FOR HEALTH OUTCOMES IF THEY WERE JUST TO TRY TO MAINTAIN THEIR WEIGHT AT A HIGHER WEIGHT.

AND SO IT IS REALLY TRICKY.

I THINK A LOT OF THE SCIENCE THAT WE'RE OPERATING FROM WHEN WE THINK DIET AND WEIGHT LOSS IS HEALTHY IS ACTUALLY OLD SCIENCE.

IT'S NOT MY ARGUMENT THAT SCIENCE SOMETIMES AND SO REALLY CHALLENGING PEOPLE TO KIND OF LOOK AT THEIR VALUES AROUND WEIGHT AND AND WHERE I GO IS FOCUSED MORE THE BEHAVIORS.

RIGHT.

SOMETIMES THE WAY IN THE NUMBER ON THE SCALE IS NOT THE PLACE TO LOOK FOR SUCCESS.

BUT LOOK AT WHAT WE'RE DOING WITH FOOD.

ARE WE ARE WE LISTENING TO OUR BODIES?

ARE WE ARE WE MAKING SURE WE ARE ACTUALLY HEALTHY IN MIND AND BODY?

AND SO THERE'S A WHOLE LOT OF THINGS I COULD SAY ON THAT PIECE BUT I THINK IT'S JUST REALLY IMPORTANT THAT THAT WE ALONE IS NOT OUR INDICATOR OF HEALTH.

OK AND BEFORE THE SHOW ENDS I WANT TO MAKE SURE WE BRING UP SOME GRAPHICS OF SOME WEBSITES THAT PEOPLE CAN GET SOME HELP OR AT LEAST SOME GUIDANCE AND DIRECTION.

BUT IN A MINUTE OR SO CAN YOU KIND OF COMB OVER HOW DISORDERS OF EATING EATING DISORDERS ARE TREATED?

SOMEONE COMES TO YOU WHAT WOULD YOU PLAN FOR THEM?

SO EVER EATING DISORDER IS LIKE A PUZZLE, A UNIQUE PUZZLE IN TERMS, YOU KNOW, THE TREATMENT AND THE THINGS THAT A PERSON MIGHT NEED IN TERMS TO RECOVER .

BUT GENERALLY SPEAKING WE USUALLY INVOLVE A THERAPIST.

WE USUALLY INVOLVE A MEDICAL PROVIDER THAT KNOWS EATING DISORDERS.

WE USUALLY INVOLVE A DIETICIAN AND SOMETIMES A PSYCHIATRIST TO ALSO WORK WITH SOME OF THE UNDERLYING ANXIETY DEPRESSION, PTSD, OTHER THINGS LIKE THAT BUT OFTEN GO ALONG WITH THESE DISORDERS.

SO IT REALLY IS IS A MULTI DISCIPLINARY TEAM.

I ALSO SHOULD SAY FAMILY THERAPY IS INVOLVED A LOT AS WELL BECAUSE EATING DISORDERS DO NOT JUST IMPACT THE ONE, IT IMPACTS THE WHOLE SYSTEM, THE WHOLE FAMILY.

SO GETTING INVOLVED IN FAMILY THERAPY IS IMPORTANT AS WELL.

SO WE REALLY TAKE A WHOLE TEAM APPROACH TO WORK WITH THIS MENTAL ILLNESS AND ARE THERE MEDICATIONS TO TO HELP RELIEVE STRESS AND SO FORTH?

THERE ARE THERE ARE VERY FEW ACTUAL MEDICATIONS FOR EATING DISORDER ALONE BUT AGAIN BECAUSE THERE'S A LOT OF ANXIETY AND DEPRESSION AND SOME OTHER THINGS, THERE'S A LOT OF MEDICATIONS THAT CAN SUPPORT AND HELP HELP THOSE PARTS OF IT.

OK, WE HAVE A COUPLE OF WEBSITES TO FEATURE AND YOU'VE BEEN SO KIND TO FIND THOSE FOR US.

IF YOU COULD START WITH ONE, WE'LL BRING THAT UP AND WE'LL BRING UP THE OTHER ONE AFTER THAT.

ABSOLUTELY.

SO THE FIRST WEBSITE IS FOR THE ALLIANCE FOR EATING DISORDER AWARENESS.

THEY'RE A NATIONAL NONPROFIT AND SO THEIR WEBSITE IS ALLIANCE FOR EATING DISORDERS DOTCOM.

THEY ALSO HAVE SOME FREE SUPPORT GROUPS AND CAN SUPPORT PEOPLE IN FINDING HELP THAT THEY MIGHT NEED WHEREVER THEY LIVE.

AND THEN THE OTHER ONE IS THE NATIONAL EATING DISORDERS ASSOCIATION AND THEIR WEBSITE IS NATIONAL EATING DISORDERS DOG AND THEY ALSO ARE HELPFUL IN GETTING PEOPLE CONNECTED TO SUPPORT AND TREATMENT THAT THEY MIGHT NEED AS WELL.

OK, DR. LAURA OIR, PSYCHOLOGIST AND SPECIALIZING IN EATING DISORDERS, WE THANK YOU SO MUCH FOR BEING ON THE SHOW TONIGHT.

WE'LL HAVE TO HAVE YOU BACK AGAIN.

THANK YOU.

WELL THANK YOU SO MUCH.

ABSOLUTELY.

AND WE'RE GOING TO BE BACK NEXT TUESDAY.

IN FACT JENNIFER BLOMQUIST WILL BE IN ERARD CHAIR.

WE'LL BE TALKING ABOUT ORTHOPEDICS AND FRAGILITY FRACTURES AND UNTIL THEN WE HOPE TO SEE YOU AND OF COURSE TAKE YOUR CALLS AND YOUR QUESTIONS AND CONCERNS HERE ON HEALTH LINE AT PBS FORT WAYNE.

UNTIL THEN, GOOD NIGHT AND GOOD HEALTH