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The pressure on young people to lose weight to measure up to unrealistic standards isn't new, but bringing understanding and light to the serious health implications of eating disorders is critical to foster change and save lives.

When we are seeing kids with eating disorders, we're often managing kids who are even in the hospital.

It can be deadly.

The second highest cause of death among youth with a mental health condition.

We'll learn about a new documentary aimed at educating athletes about eating disorders and how all of us can benefit from learning about what works to promote better health.

Right now on Alaska Insight.

Good evening.

For decades, Hollywood fashion magazines and sports have promoted a false sense of what our bodies should look like.

Impossible standards of ultra thin muscled physiques that were difficult for most average people to achieve.

But the pressure has increased once fold since the advent of social media and popular online celebrity culture that has made aspiring to look or be like someone online even more difficult.

And that can lead to eating disorders and mental health challenges.

Tonight, we'll hear from experts and advocates who are working to educate all of us on the need to change the discussion and promote healthier eating and a happier life.

The stigma around weight and athletics is something that many may be aware of but not discuss or really understand how seriously it can affect health and emotional well-being.

There's fear, shame and misunderstanding about eating disorders.

A new documentary called Winning at All Costs Breaking the Silence on Athletes and Eating Disorders will air here on Alaska Public Media Television on February 20th from 10 to 1030 in the evening.

Tonight, we're going to watch a short excerpt from that documentary, and then we'll talk with experts who put it together about their dedication to helping Alaskans have healthier relationships with food.

So my name is Yolanda Evans, and my role I am a physician and adolescent medicine specialist.

The main things that I'm helping youth with are recovering from an eating disorder, reproductive health concerns and gender.

And so mental health, including depression, anxiety, ADHD, eating disorders are really life threatening.

It is one of the higher causes of morbidity and mortality among mental health diagnoses for youth.

And so when we are seeing kids with eating disorders, we're often managing kids who are even in the hospital.

It can be deadly, the second highest cause of death among youth with a mental health condition.

Their bodies are still changing.

They have really significant nutritional needs just to continue to develop into adults.

And so when a person is malnourished, it literally affects every organ system.

Not eating enough contributes to how you think and your focus, your energy level, your stamina.

It can affect your heart and how it beats and how it functions.

Really, every part of your body is affected by not getting enough to eat.

Anybody can be at risk for an eating disorder regardless of your shape, your size, your gender identity, your socioeconomic background.

And I think we have to miss diagnosing people because in our in our medical environment, we kind of have this idea in our mind about who would be at risk for people who identify as bipoc or underrepresented minorities.

I think also gender plays a role to they may have an eating disorder that we're missing or not diagnosing.

And so they might not get picked up as soon or their behaviors might not be as obvious to others.

Looking outside as some of the other female appearing people.

So much important information just in that short clip.

Again, the full documentary will air on February 20th from 10 to 1030 in the evening.

Joining me tonight to discuss the documentary and their work to help Alaskans better understand eating disorders and how to recover from them is Beth Rose.

Beth is a co-founder and board chair of the Alaska Eating Disorder Alliance, or Akita.

Beth is also on Alaska Public Media's Board of Directors.

Two time Olympian and professional counselor Holly Brooks is also here with us this evening.

Holly is a featured expert in the documentary.

Welcome, both of you for being here tonight.

Thanks so much.

Thank you.

Thanks for covering this important topic.

It is very important.

Absolutely.

And I'm happy to have you both here.

Beth, you co-founded Akita and said that there really was nothing here in the state to provide this service.

Akita focuses on education and advocacy around eating disorders.

Give us a kind of a brief description of what's meant by both eating disorders and disordered eating.

Help us understand the distinctions.

Sure.

And I want to talk about that.

And Holly is a licensed professional counselor.

Might be able to.

Absolutely.

I want her.

To follow up.

You know, disordered eating is, I think, what a lot of our population is engaged with because we live in a we promote with this diet culture that is all around us.

So I think that the idea of disordered eating is where people may be uncomfortable around food, around their body, around what they eat or how often they exercise.

And there's a spectrum between, you know, from what you might call normal eating, disordered eating, eating disorders, and sometimes disordered eating is on the threshold of eating disorders.

And eating disorders is really a psychological condition and a medical condition.

And it impacts one's life, it overtakes one's thoughts, and it can occupy.

I've heard it said more than 100% of your time because you think about it all day long and at nighttime, it may be preventing you from sleeping as well.

So it's really something that an eating disorder does cause severe physical and psychological issues.

Clearly follow up there, Holly.

An eating disorder affects someone's ability to function, as Beth was just saying, that it's all consuming.

It's hard to understand that preoccupation with food.

Absolutely.

And I think one thing that I'm really excited to talk about here today is that sports are an amazing thing, part of our lives and a great way to learn life skills.

But what a lot of people don't understand is that eating disorders are actually more prevalent in the athletic population than they are in kind of the non athlete peers, right.

For high school and collegiate athletes especially, which is kind of the age range or the time when statistically eating disorders start.

But it is, as Beth said, all encompassing and I always refer to it with clients.

I always talk about the opportunity cost, right?

What else could you be doing?

What else could you be thinking about?

You know, when or if you weren't so obsessed with the thought of food, weight, shape and size.

Mm hmm.

And food restrictions affect hormone levels.

Talk about how this can affect the future lives of young, growing teens.

It seems like a really dangerous situation.

I'm really glad you brought that up.

You know, as I said, puberty is kind of the time when statistically many eating disorders start.

Puberty is also the time when, you know, people go from a young, prepubescent children and become adults.

Right.

And for example, people are building their bone mineral density for life.

And so puberty is the time where eating disorders start, but is also the time when our bodies are changing and our hormones are fluctuate eating.

And people often feel, you know, really foreign in their own bodies.

Right.

So there is this big desire to kind of fight against it.

And sometimes in sport and, you know, I come from an endurance sport background and there is actually this big fear of puberty and the impact that it might have on your performance, you know, for runners and skiers and bikers and and all of that.

And so it is it is really detrimental because what we see are either people dropping out of sports or we see people kind of fighting against the natural physiological processes that their bodies need to go to in order to create a healthy body that they're going to need for the rest of their life.

Not to mention their sustainable performance in sport.

And so, you know, ironically, we have puberty.

It's the time when most eating disorders start.

But then it's also the time where there is a lot of pressure for high school and collegiate sports.

And so it's the perfect pressure cooker, right?

So the spotlight is on for performance, but it's also the time when you know this body hatred and declaring war against your body and these natural processes begin.

It's it's such a sad thing to take in, you know, as a mother and a grandmother and as a concerned human being, the idea that young people would fear or abhor what should be an exciting time in their life, that they're transitioning from being youngsters into adults and and that there's this pressure.

Do you see a change in how high school and college coaches and and and the folks that culture?

Are there changes happening there or.

I remember when my kids were in sports.

My sons were in sports, and now my grandkids are in sports.

And, you know, trying to get into this weight class for wrestling, it seems like a lot of that pressure is still there.

But are you seeing change?

Absolutely.

I mean, the pressure is just building.

I mean, in the introduction, you mentioned social media.

You know, in there, you know, people are seeing pictures of this athletic esthetic, although.

The change isn't a positive change.

They're not getting the message.

Coaches aren't promoting.

You know, I think it it's kind of we have the two ends of the spectrum, right?

There are coaches and movements that are very progressive that are speaking out against it.

Those you know, we have the health at every size movement.

You know, we have lots of organizations and advocates speaking about this issue in a very proactive, productive way.

But at the same time, diet culture is just becoming more and more entrenched.

Entrenched.

And the pictures and your brand and your social media presence are even more important.

People are going for scholarships.

You know, the NCAA, which is, you know, kind of the organization that runs collegiate athletics, it used to be amateur and that those athletes were not paid.

But now there's this thing called nil, which is name, image and like likeness.

And it means that collegiate athletes can essentially be professional athletes so they can get sponsorships.

While who are the athletes getting the sponsorships?

The ones that meet that, the athletic esthetic.

So there's so much emphasis put on appearance, sometimes even more than how good you are at your sport.

Yeah, that's that's dismaying.

Beth Akita works to help bring things together and help educate people.

The.

The.

Do you think that people really understand how serious this is, that eating disorders have the second highest mortality rate behind opioid addiction was really shocking to me.

Are people dismissive, do you find about food issues as being a serious health threat?

Weight loss is too often considered a healthy thing by so many.

Is it difficult to get the message across?

You know, it is difficult because I think people when they when they lose weight, if they have a restrictive eating disorder, they get praised for it.

And there is a word, a four letter word in the eating disorder world.

And that's fine.

And so that somebody who may have an eating disorder may not know that they have an eating disorder, and they may just say that they're fine.

And so somebody's trying to get them help.

They may push back on that because they get praised by society, you know, for losing weight.

And eating disorders are not just about restrictive eating disorders.

You know, there's bulimia nervosa and there's binge eating disorder, which is even more common that anorexia and bulimia combined.

But what we are finding, and I have to say, I want to focus on the positive side one.

So they like Eating Disorders Alliance started three and a half years ago.

We are getting so much positive response from the medical profession, from therapists, from dieticians, from families.

And we've had people say, where have you been?

We really need this.

And so the positive thing about this is that like all mental illnesses, eating disorders thrive in shame and secrecy.

And there's a lot of stigma around it.

Once we started this and I will share with you that Jenny Loudon, my co-founder, and I have a similar story.

We both had eating disorders when we were young, and we fortunately came out of that.

It was a dark period.

We didn't know there's a high genetic predisposition for eating disorders.

So when we had loved ones in our families who had an eating disorder, we didn't we we knew each other but didn't know we were going to the same things when we started sharing our stories.

I can't tell you how many people will now say, Oh, I went through it myself.

I have a friend, I have a parent, I have a colleague.

The stories start to come out in the open so people do trivialize it, I think, because I think it's affecting only young, female, white, affluent kids, which is not the case.

And they think it's trivial.

But as you mentioned and as was mentioned in the documentary, the second highest mortality rate of any psychiatric illness.

Are you how are you trying to get the message out to young people?

Are you using the same platforms that are so damaging, TikTok and Instagram with all these false, you know, as you said during the film, that there's filters and all these things that can make you look impossibly attractive but unrealistic.

Are you trying to reach young people on these platforms with this message?

Well, I'll start with that.

So a key to does have a presence on not on TikTok yet, but on Instagram and Facebook and Twitter.

And we have recovery focused kind of messages and we have links to resources.

And I we haven't got into TikTok, but we do promote the idea that, you know, if somebody in Holly talks about this in the film, you know, if there's messages that you're getting on, your social media fails streams get off of those.

Yeah.

And find ones that are positive and there are some pro recovery and pro, you know, positive body positivity sites.

Absolutely.

I shouldn't be so disparaging.

There are certainly good things online and lots of good content there, too.

But but it's some of the other thing, the pressures that worry us so much.

And, you know, Holly, one of the things we didn't see in the clip that we aired, but in the full documentary, you give this excellent example of body comparisons by talking about dogs.

And Alaskans love dogs.

So talk a little bit about that, that example that you gave.

Yes.

And this is one of my favorite examples to talk about, to just normalize how we all have different genetic predispositions in our bodies.

And so this concept is actually called poodle science.

And it's you know, they talk about the poodle as being the, you know, the body ideal that consumer culture all wants or benefits from having a strive for.

And it's this idea that if the poodle is the thin, muscular know, whatever it is, and then you have all these other dogs, you may have a husky, you may have a Chihuahua, you may have a Great Dane and, you know, a pug.

Right.

And you have all of these dogs, they're very diverse.

They have different, you know, genetic traits.

They have different appearances.

They have different personalities.

But what we're doing is we're asking all of those dogs to strive to become the poodle.

And when I explain it this way, people are like, Well, that's crazy, right?

Like, a pug could never become a poodle.

A Chihuahua could never become a poodle.

But ironically, that is what we are doing to ourselves.

Right.

So consumer culture wants us to all look one certain way and we are not meant to be that way.

We all have different, you know, normal genetic predispositions and weights, shapes and sizes and, you know, consumer culture is trying to sell us things, messages, products, you know, where we're trying to become that poodle.

And it's it's physically impossible.

And we are we are killing ourselves trying to do that.

How what is healthy when it comes to how people should think about their weight and about food and eating?

What what's more of a normal kind of a setting for folks?

Well, I would say that this is a good topic we consider.

I'm going to segway just a moment to say that A somebody who has an eating disorder or disordered eating would benefit from a therapist, a dietician and a doctor.

And so dieticians would talk about this a fair amount.

But just like Holly was saying about, you know, everybody has their own body type that they're born with.

It's that that person, that individual needs different kinds of nutrients and calories from one person to another.

Right.

So there's something called intuitive eating, which is that, you know, you really need to feel your hunger and your fullness.

You need to eat when you're hungry and you need to, you know, think about where you're at and maybe stop when you're full.

Generally, people say that, you know, three meals and 2 to 3 snacks a day is what people need, because about every 3 hours you start to get a little hungry.

And if you ignore those body signals, you push yourself beyond it.

There's all things that can happen.

The lack of focus, the fatigue, you know, and worse things.

Frail bones, you know, problems for the organs.

So people sometimes think like, really?

I, you know, three meals and three sex a day.

But that's kind of what a lot of people do.

And, you know, if you go through getting treatment for an eating disorder, that's the medicine.

Food is medicine.

But then they find that people find out that that's kind of what is sustains you all day long.

Absolutely.

So true.

You know, Holly, I want you to pick up there if you'd like to add some comments.

But I was thinking about something that you said in an earlier interview about how even something that is framed as a compliment can be triggering for people.

If somebody says, wow, you look really fit.

Mm hmm.

Absolutely.

And, you know, I think all the time about how intertwined diet, culture and athletic culture truly are.

And you look fit.

That's like that's that also means you've lost weight.

Right.

And what we don't know is that we are potentially complimenting someone's eating disorder or complimenting someone who is grieving or we're complimenting someone who has cancer.

Right.

You know, and but that is the ultimate compliment, which, you know, is is just I'm really trying to get people to steer away from really all comments about appearance, because there are so many better things, I think, to talk about that are more holistic and more sustainable.

But just to piggyback on the last question about what is healthy eating, the way that I describe it is being able to enjoy your food and not obsessing about it, not counting it, not, you know, chewing it slowly so that, you know, you you can savor every pet not feeling extremely guilty about what you eat or do not eat.

Right.

And, you know, I had a client the other day tell me, I can't believe that people can just go somewhere and eat whatever's there and then go on about their day.

Something that sounds so common to many of us.

It sounds so benign to a lot of us.

But, you know, people with eating disorders, that is mind blowing.

You know, they're planning, they're obsessing, they're counting.

Then they're over exercising, you know, to get rid of it.

Right.

And, you know, we also in the athletic space, we say food is fuel and yes, it is, but it's also enjoyment and culture and celebration.

And food is delicious.

Yes.

Yes, it is.

Right.

And so, you know, the people who are just really limiting themselves are just missing out on, you know, many of the joys of life.

And it's just really, really sad and in that way.

So if I think about a healthy relationship with food, I might be obsessing about food like, Oh, I can't wait to eat lunch.

It's going to be so good, right?

But it's not like, oh, I don't know if I can eat yet, you know, you know, it hasn't been this many hours since my last meal.

And my my food rules, you know, aren't going to allow me to do that.

And then if I eat that, I'm not allowed to eat anything.

The rest of the day.

Right.

It just goes on and on and on.

Yeah.

And isn't it true that if you are limiting your restricting food intake too much, that your body sort of goes into starvation mode?

Right.

I mean, it's it it is less efficient at burning calories because it's afraid it's not getting enough calories.

So isn't it kind of a bad feedback loop?

Yeah, definitely.

I mean, restricting food like that is one of the reasons that the diet industry is still around, because it tells you to restrict, restrict, restrict.

But diets don't work for 97%.

98% of people diets don't work because we're restricting unnaturally.

Our bodies need food.

I mean, when people say I'm addicted to food, I think, are you addicted to breathing?

Are you addicted to anything else your body needs to do?

Right.

So the idea of restricting that is a trigger for bingeing because your body needs food, right?

So if you're restricting so much, it becomes harmful in so many ways.

It creates a rigid thinking brain.

You know, we find people who have eating disorders and who restrict like that, sometimes isolate.

They get you know, they experience depression and anxiety, sometimes obsessive compulsive disorders.

So it's it's a it's a trigger not just for eating disorders, but for many other co-morbidities as well.

Then furthermore, I think, you know, maybe one thing you were alluding to is if you don't eat, your metabolism slows down.

Right?

And so your body almost goes into the starvation famine mode.

Right.

And then so all of a sudden, you know, maybe you're trying to change something about your body, but your body just just shuts down, right?

Because it doesn't trust that you're going to give it what it needs.

So, you know, it's it's it's really not helpful.

It's definitely not helpful.

And, you know, I'm so happy that both of you were able to be here this evening and help people better understand that this is quite serious and and much broader than folks may realize.

So thank you both so much for the work that you're doing on behalf of all Alaskans.

Thank you.

Yeah.

Eating good food in a healthy way fuels our brains, bodies and fosters our overall sense of well-being.

If thinking about food causes stress or shame, or if you suspect someone you care about may be struggling.

Remember, there are resources right here in Alaska to help aid, recovery and a happier, fuller life.

The full documentary, Winning at All Costs Breaking the Silence on Athletes and Eating Disorders, will air here on Alaska Public Media Television on February 20th from 10 to 1030 in the evening.

That's it for this edition of Alaska Insight.

Visit our website, Alaska Public dot org for breaking news and reports from our partner stations across the state.

While you're there, sign up for our Free Daily Digest so you won't miss any of Alaska's top stories of the day.

Thanks for joining us this evening.

I'm Laurie Townsend.

Good night.