Head Inside Mental Health
Todd Weatherly, Therapeutic Consultant and behavioral health expert hosts #Head-Inside Mental Health featuring conversations about mental health and substance use treatment with experts from across the country sharing their thoughts and insights on the world of behavioral health care.
Head Inside Mental Health
Eating Disorders and Mental Health with Jennifer Stanger
Shattering misconceptions about eating disorders leads us to a profound realization: these complex conditions aren't about control—they're about safety. This conversation with Jennifer Stanger, a therapeutic consultant specializing in eating disorder treatment and intervention, reveals why traditional approaches often fail and what truly works for lasting recovery.
Drawing from both personal and professional experience, Jennifer explains how eating disorder treatment lags behind other behavioral health fields in addressing co-occurring conditions. While substance use treatment has evolved to integrate mental health approaches, eating disorder programs often work in isolation, treating symptoms without addressing underlying trauma, anxiety, depression, and family dynamics.
We dive deep into the neurological impacts, discussing how eating disorders impair the frontal cortex similar to substance use disorders, making rational decision-making nearly impossible. Our discussion brings clarity to recovery challenges, particularly the rarely-discussed physical and psychological distress of weight restoration. Join the conversation as we uncover better approaches to healing.
Hello folks, thanks for joining us today again on Head Inside Mental Health, featuring conversations about mental health and substance use treatment, with experts from across the country sharing their thoughts and insights on the world of behavioral health care. Broadcasting on WPVM 1037, the voice of Asheville independent commercial free radio, I am Todd Weatherly, your host, therapeutic consultant and behavioral health expert. Joining us today is my colleague and compatriot, and now a friend of mine for over a decade, jennifer Stanger. Jennifer is a member of the Stuckersmith and Weatherly consulting team, specializing in long-term care management and eating disorder treatment and care, as well as intervention.
Speaker 1:Jennifer initially entered the treatment and recovery field through marketing and business development roles, where I met her, but later transitioned to working with programs as a recovery coach and program manager, later evolving into therapeutic consulting, crisis intervention and long-term case management. She thrives on working with complex dynamics of families and individuals in need of treatment and support services, with her own personal recovery story, being trained in the ARISE intervention model, a prominent and internationally recognized invitational method developed by Dr Judith Landau. Jennifer specializes in interventions for both eating and substance use disorders. She is also skilled in addressing the complexities of severe and persistent mental health conditions, guiding families and loved ones through care planning and navigating the challenges that come along with a path to long-term recovery. Jennifer has a bachelor's degree in business admin from Liberty University, but, with over 15 years in the behavioral health field, her extensive experience has earned her credentials as a qualified mental health and substance abuse prevention professional, as well as a certified life coach with the International Association of Professional Career College.
Speaker 1:When she's not working, jennifer is a marathon runner. And was it the New York Marathon or the Boston Marathon? Which one did you run recently?
Speaker 2:Boston Marathon.
Speaker 1:Ran the Boston. Marathon recently Finished it. She's a fitness instructor and coach at the local YMCA and certified cat herder when she has time enough to be at home. But you know, jennifer, first of all, welcome to the show.
Speaker 2:Thank you so much. Thanks for having me. That was all a mouthful. I know the introduction.
Speaker 1:Well, the thing that I think you know you and I were going to talk about today focus in on working with those struggling with eating disorder. Just had Dr Wendy Oliver Pyatt on the show.
Speaker 2:Yes.
Speaker 1:So she's fabulous. She's fabulous and we talked a lot. We spent more time on the mental health side but talking about how oftentimes eating disorder programs, while they do a very good job of managing what is ultimately the the logistical science of managing an eating disorder calorie counts and, and you know, weight and blood, blood counts and the whole you know there's a lot of science that goes in just managing an eating disorder. But then a person you know starts to eat regularly and then they they may have cleared out the crisis of eating disorder and then they've got all the mental health stuff that starts to show up and if they discharge at that time they end up cycling back through because they haven't addressed the underlying trauma or issues that are going on and everything else. What's your take on all that? Like, tell me about the core message behind national awareness, national eating disorder awareness, and your thoughts about how the world is working with individuals who suffer from that condition.
Speaker 2:Yeah, I mean I think the awareness piece it's something that's increased, but I feel like the the eating disorder industry still lacks behind in both knowledge, understanding, treatment like it just lacks behind from substance use and mental health.
Speaker 1:Substance use was in that category for a while too. Right, I mean like they had to catch up. You still have substance use programs out there that are not doing as well with the mental health piece, but they've had to catch up a lot. Do you feel like eating disorder is kind of behind them?
Speaker 2:Well, it's way behind. It's way behind. I mean I think you even just realize that. You know, when we talk about co-occurring disorders, everyone you immediately think mental health and substance use. Wouldn't eating disorder, mental health be co-occurring or eating disorder substance use be co-occurring? But we don't. We don't even I mean our verbiage around it doesn't even recognize that that the eating disorder in another diagnosis is still going to be a co-occurring piece. And I think when we look at the treatment programs out there, we don't see the co-occurring. We don't see co-occurring programs addressing eating disorders and substance use, eating disorders and mental health. We have a few. I mean, thank goodness Gallant Hope is down there in South Florida that is really addressing the mental health and the eating disorders but we don't see the duly licensed, true co-occurring treatment centers for eating disorders and substance use and eating disorders and mental health. Yeah, they're so closely related.
Speaker 1:One of the things that they've done that is changing, I think, is in substance uses. You know, the substance use field again is ahead of the mark on this Mental health suffers from the same problem they don't address substance. I feel like mental health programs may address diet, exercise, lifestyle and food intake a little better, uh, than than substance use field does but definitely you know it used to be done where you have to.
Speaker 1:Let's solve this problem. You got a substance use problem. You got a mental health problem. You got an eating disorder problem. You could have all three yes let's solve this problem and then we solve that problem. We're going to go over here and solve this problem and now we're walking into the world where we realize that co-occurring disorders need co-occurring treatment.
Speaker 1:Yeah, you got to work with them both at the same time because they're not separable, and exactly you know in your mind and I know that you work a lot with these programs and and and are able to not only do treatment, placement, but also the case management and advocacy that goes as part of therapeutic consulting what's the difference between? What's the difference between a program that does, you know, kind of exclusively eating disorder and in a bit of a silo approach, and a program that does true co-occurring programming for eating disorders? What, like what's the difference between those two programs in your mind?
Speaker 2:yeah, I mean I I think there's a piece with um staffing definitely that has the ability. You know the ability to be able to work with both and to be able to address both. You know, I mean, when you think about majority of the programs are treating eating disorders in a silo and kind of what you were talking about earlier eating disorder, I think I think the reason eating disorders are so complex is because there's so many different components that are pulled into it. You're not going to have an individual with an eating disorder that doesn't have some sort of underlying trauma issues.
Speaker 1:Family dynamics.
Speaker 2:Exactly right. But you also have this medical complexity that you were talking about earlier, and so you know that's a little bit different, I guess. If you think about that, in some comparisons it's it's kind of like. It's kind of like the detox side of substance use, but with eating disorders it's significantly longer. We're not talking about just like a 7 to 10 day period, but there's all these medical acuity pieces that need to be observed and monitored around the eating disorder as well, and so there's medical complexity.
Speaker 2:There is the mental health side of things, there's the food. There's the food and the regulation side of things, and then there's these underlying issues, and so much of an eating disorder program is predominantly addressing medical and food related issues, and so what lacks is getting down to the why, right? So I think you know, if I'm talking to somebody who is dealing with substance use, one of the things I'm going to ask them is well, what does drinking do for you? Right, because it's done something positive, it's helped you deal and cope in some way, right? So what is that substance use doing for you, right? And so that should be the same question that's being asked to. The eating disorder is like what is this doing for you right, there's a positive piece to it. There once was a positive piece, and then it's taken over and it's become something significantly more. So you can't address the eating disorder in a lasting way without addressing like, well, what was it doing?
Speaker 1:Because that's starting to identify that those core issues that are going down below the eating disorder well, it's funny you say that because there dr andrew while wrote a book called the marriage of sun and moon and he kind of lists this, you know, over hundreds of years there are all these things that that people have done to alter their mind from drinking alcohol to to like excessive eating of mangoes, to use of substances and psychedelics and things like that. And one of the things that he talks about is is the act of purging, because purging vomiting triggers a region in the brain that causes endorphin release.
Speaker 2:Yes.
Speaker 1:Yep, and and just like, and self-harm. Self-harm is another one you know.
Speaker 2:Yes.
Speaker 1:You set yourself, the body goes into. You know you might go into mild shock.
Speaker 1:We wouldn't identify the shock because it's not a major injury, but the body goes through this process and it releases endorphins and there's a relief on the other side of being hurt that you experience and it becomes you know, what we refer to commonly as this process addiction, where a person not only experiences the relief, but they've got this way that they do it. You know, I eat this and then I purge or what have you that I purge or what have you, but there's this method to the madness that causes relief and then you throw OCD in there and this person kind of gets locked into the way that they do this, the way that they hide it. And it's really kind of fascinating to me what the brain does with this material. And one of the things that you know you've just I guess it was last year or year before the you you received the, you went and did the arise training.
Speaker 1:Um, I'd like to talk a little bit more about that. But specific to eating disorder, how do you intervene, like, with all this stuff kind of going on, co-occurring conditions and a mashup of all this symptomology, like how do you intervene with a person who's suffering from eating disorder? What's that look like? Because I think it's different than you do with substance use it is.
Speaker 2:Um, I think that with I think the challenge with intervening with eating disorders is that there is a deeper, greater sense of personalization. By personalization I mean, like your core identity being connected to it, and so if I say something to the person about like hey, I feel concerned for you. This is what I'm seeing and I'm worried. There's more of an internalization piece, like it becomes more shame based and there's a greater likelihood of the defense mechanisms going up, even more so than with substance use, if that makes sense because it's. It's almost more personal, like I'm saying something that's even more personal and just saying hey, I'm concerned about your drinking and some of these behaviors and things that you're doing while you're drinking. When we're talking about the eating disorder, individuals with eating disorders are more prone to take that on as an identity, more so than someone with a substance use Right, so I can start almost struggling with an eating disorder. I almost become that identity versus. I don't think we see that as much with the substance use Right, like it's still more of a behavioral type thing.
Speaker 1:I mean, you see it in mental health as well, especially with things like personality disorder and depression and anxiety.
Speaker 1:But you know, the thing about think about substance use is that, okay, I can quit a substance, I can't quit eating yes, yes you know, and, and I think, the biggest challenge the way that I eat, what I eat and how I and how I really you know, if you talk to anybody who does, I know that you do this too like fitness and nutrition management and those kinds of things. There's this identity with the way that I eat from like my childhood and the things that are favorites to me.
Speaker 1:And and comfort foods a great time I had with a family member or whoever that this food revolved around. Maybe from the South, I can identify with that a lot, but at any rate I mean I think anybody can but the you know, with an eating disorder you're talking about this person's. You know what they put into their body and all of that stuff that's attached to it, which a lot of times is, you know, trauma and shaming and other things that you know. The family dynamics that exist with eating disorder are a lot around weight and body image.
Speaker 2:Yeah.
Speaker 1:There's, you know, one of the co-occurring disorders with eating disorder correct me if I'm wrong is body dysmorphia, which is, like you know, a person who's 110 pounds feels like they're fat.
Speaker 2:Mm-hmm, and that's you know, it's not normal, that's not accurate. They've got a misinvolutional kind of view of themselves, so kind of. I mean we see a lot of times with, like mental health and other sorts of things, where we just start kind of overusing the term in a way that's not really appropriate, because true body dysmorphia, it's almost like a delusion disorder, right, my brain is not seeing things in reality and I think what we started using it more is kind of in just this like generalized sense of like I'm not really fat, but I think I am, and so you know, everyone, you know or I shouldn't say everyone but most people with an eating disorder are going to struggle with body image in some way and that's a normal component.
Speaker 1:It's not, I mean yeah, I don't like who I am.
Speaker 2:Yeah, exactly Exactly. That is something that I think most people struggle with in some way, shape or form. Right Like, I wish this was different about myself. And so there's this, there is this you know commonality and eating disorders, that I have a somewhat distorted perception of myself and what my body looks like, and then there's body dysmorphia right.
Speaker 2:Right, which is the only way I can describe it is it's. It's, it's almost like more of like a thought component, you're like the brain is not able to actually see. It's seeing something different than what somebody else would see, right, and so I think we've kind of overgeneralized the use of the term when there really is a significant brain disconnect, when we're talking about body dysmorphia.
Speaker 1:And then there's a difference between two terms and I don't think most people understand, which is the difference between dysmorphia and dysphoria. Yes, and you know dysphoria, and if we're going to give it an example, I just had Dr Michael Gurian on the show, who's a gender expert and this is used with individuals who you know they're born female but they really feel like they are a male and that's that's.
Speaker 1:That's sex dysphoria, gender dysphoria Gender is a societal construct. Sex is a science term, so this is sex dysphoria. I, I'm a, I'm a, I was born a female, I have female parts, but I feel like a male and I want to make a transition to that. Yes, Versus gender dysphoria, which is where we find the identity of a person being on a spectrum. Then, if we move from there, we go into dysmorphia, and dysmorphia is a clinical term that is about a disorder and that's the person who looks at themselves at 105 pounds in the mirror and believes that they're fat and they need to lose weight. That's dysmorphia.
Speaker 1:Yeah, and it leads to and it leads to these things that are very unhealthy, and psychiatric conditions and eating disorders that person's probably their BMI is so low they end up going to the hospital. So when you run into that back to this question about intervening it lives with you personally You're shoving your walking up into somebody's life, all up in their face essentially, but the ARISE model is an invitational model face essentially. But you know, the arise model is a is an invitational model. You know, ideally, a person to realize that they need help, um, and that you're there as a resource for them to find it. What does that look like? What does that like? Give us a, give us a case you know, if you've got one that you can share, give us something that you know, a person that you've worked with or, uh, a case that's come to you, that you walk through these pieces and this is what it looked like for that individual, like what are the features to doing intervention?
Speaker 2:Well, it's much more. You know the intervention itself, you're really taking a much more conversational approach, and so you're creating a safe space. So I think that's one of the biggest things about eating disorders is because one thing I like can't talk about eating disorders without not saying how much I hate when we say that eating disorders and anorexia are about control right they're not about control, it's about safety.
Speaker 1:Right, they're not about control, it's about safety. So why is it they say it's about control? What is like? What is it? So yeah?
Speaker 2:So I think the conversations around eating disorders being about control, I think comes from all the rituals that come out of it, Right? So you and you were talking about that a little bit right.
Speaker 2:Oh, these OCD, and I actually exactly so. I think that there's a lot of components about eating disorders and especially anorexia, that almost almost more parallel OCD, because it becomes very ritualistic. Right, I only, I can only eat that. You know, nine, 12 and 5 PM. I can only eat, you know, 700 calories at each meal. I have to use two packets of pepper and, um, I'm going to measure out my amount of food and I eat, or I drink exactly 24 ounces of water. There's all these very I cut my, I'm going to cut my piece of meat into 24, even pieces, and so we say, wow, like this is, this is control. Because now if somebody comes in and says, hey, you can't do that, I'm going to get upset, right.
Speaker 1:Right.
Speaker 2:But when you think about why? So this goes back to the like what's it doing for you? What are these rituals doing for you? Yeah, what relief are?
Speaker 1:they giving you.
Speaker 2:Yeah, so somebody who has OCD. What does you know what is counting the tiles on the ceiling doing for you? What is you know checking the lights three times doing for you?
Speaker 1:What is? Cutting the stake into 24 pieces to do for you right.
Speaker 2:Yes, it's not the control. Externally it looks like control, but internally it feels like safety. Right, so I've created this safe environment for myself. So the eating disorder becomes this bubble of safety, and the reason I don't want somebody to interrupt these rituals and this routine and what I feel like I have to do is because that feels like an intrusion, it feels unsafe. So I've created this safe space around myself and everything I do now is to protect that. So when you're coming into and part of that is also what makes it more personal and why a person's going to have the strong response to trying to speak into it because you're breaching on my area of safety.
Speaker 1:Right, right, and so when you think about it in that context. When you walk into that person's life to intervene because it's gotten unsafe, right yeah, like how, how do you? What's the delicate way in which you walk into that aspect of a person's life when you got to intervene there at the beginning of their recovery journey? Um, what does that? What does that look like?
Speaker 2:So being able to match their tone, their is almost a greater connection than with other diagnoses.
Speaker 1:Um to be able to connect and have a very compassionate conversation and so you know, in an intervention dynamic we want to, other day I was actually speaking to the Bar Association here locally yesterday and somebody asked me about intervention and I was like, first of all I don't really like the word because it looks like what it does on TV. And while there's a model out there that's like that, that's confrontive and you know letters to family members and overwhelming a person with all this kind of like.
Speaker 1:We think you need help, um, and that can't there. There are times when it works, um, but with the clientele, especially the clientele you and I work with you know, for intervening on someone not only with substitutes but pretty significant eating disorder or eating disorder and or mental health condition or both, and likely they have both, because the truth is you don't have a, you don't have a eating disorder or a substance use condition for which you need residential treatment. That doesn't come, that is not accompanied by a mental health condition, like it doesn't exist.
Speaker 2:Absolutely.
Speaker 1:You know, this compassion and this approach style and everything else that you're talking about is is pretty critical and key. I think the the intervention style model also gets in a hurry. We got to go in and this person is going to come with me right now. There's this window, whereas you're talking about a, you know, between invitational approach, but you know between invitational approach, but you know, even a rise methodology doesn't necessarily, isn't necessarily answering all the questions that I know you run into with a person with severe, you know, thought disorder or they have severe eating disorder. You've got this personal journey Like what was it like for you? How did you? I know it informs the way that you do what you do, like yeah it was a little.
Speaker 1:If you're willing to give us a little bit about your recovery story.
Speaker 2:Yeah Well, I think one of the biggest challenges, kind of like what you're saying, like how do you go into that conversation with somebody with an eating disorder and this this just came up this week at the YMCA actually and uh, a member that's I feel concerned over and have no, this significant weight loss and the biggest challenge is, uh, that's how to say something. Right, like you, you want to how do you say something?
Speaker 2:You want to say something and the reality is is there's? There's just nothing that you can say that's going to come out well, um and and I think that's one of the pieces that's so difficult um is trying to figure out, and that's something I know from experience there's just no way to speak into it and express concerns.
Speaker 2:Yeah exactly the person who's receiving this is going to be like. Oh my God, thank you so much for saying something Right. It's just not. You know it's, it's not going to happen. And I think, gosh, I my own journey to you know cause I struggled with alcohol use as well as the eating disorder, and so when we talk about this co-occurring piece not uncommon, as we know no, it's absolutely not and it's not.
Speaker 2:I think people think of them as contradictory, and here's one thing I will tell you about an eating disorder is it is a walking contradiction. It does not. It makes sense in my brain. It does not make sense to anyone else who is looking at it seeing it From the outside, not having it right and trying to understand it right, Because you're like you're restricting your calories, You're losing weight, but you're okay drinking calories Like that doesn't make sense to me, alcohol's got a lot of calories, right.
Speaker 2:Yeah, it's exactly, exactly. And yet somehow we come up with this rationalization and the rules, the rules or the rationalization, in my own brain. It can make sense and I can remember at one point in time when I did identify gee, maybe I'm drinking too much. And I stopped drinking for a couple days and I started to lose weight, more weight, and I was already underweight and my brain said, wow, see, this is why I need a drink is because if I don't drink and now I'm going to, I now I'm losing too much weight. That's going to make people more concerned.
Speaker 2:So, like my disordered, my alcoholic eating disorder, brain rationalized that's. That is why you need to continue to drink, because it keeps you at this, still a low concerning weight, but better than it dropping down low. You know what I mean. So, like it kind of like has. This justification doesn't make sense to anyone else and you also have to keep in mind you know we talk about the impact that substance use has on the frontal cortex and the significant impact that eating disorders are the same. If you look at CT scans of eating disorders and substance use or mental health, they're all very, very similar, they're impacting similar regions of the brain right.
Speaker 2:Yes, that frontal cortex. It's significantly impaired and so my ability with a severe eating disorder, my ability to make well thought out decisions is is completely impaired. So you know, when you're talking to parents of somebody with a, you know a mental health, significant mental health, and you're like hey, look like we know you want to try to understand why they're behaving in this way and you just can't rationalize.
Speaker 1:Like we're not.
Speaker 2:your brain is not going to be able to make sense out of this, but the same is really true with what's happening in that eating disorder brain.
Speaker 1:I don't. Yeah, it's like I don't. Whoever the family members are right, I'm not asking you to think this makes sense. It doesn't make sense, but it makes sense to them for a series of reasons. And we've got to find this chicken in the armor. There's this place where they're vulnerable to realizing something is going wrong, and part of the work I know from my side it sounds like it's very similar is to find where that is. But you know, the other piece is that you've got this lived experience. I do not. I can walk in and say all kinds of things that make sense, right, that doesn't make a person realize that they need to get help. You know, if you're working with somebody who suffers from and we tell families this all the time, I know for a fact you and I together suffers from and we tell families this all the time, I know for a fact, you and I together. But you know you got somebody who suffers from thought disorders, like you're not going to negotiate with thought disorder or psychosis.
Speaker 2:Exactly.
Speaker 1:It's not participating in a reality that you can understand. What you can do is ignore everything that doesn't make any sense and follow their line of logic, and somewhere in there is something that they want.
Speaker 2:Yep.
Speaker 1:And if they want that, you know I want to have a job or have a girlfriend or have a life or live independently or any of these. You know, things that everybody wants. Somewhere in there is something that's normal that they want. Yeah, Well, sounds like you want this and if you want that, you probably going to have to address some of these other things, because right now, what you're doing is not working right.
Speaker 2:Exactly.
Speaker 1:Now, with a person with thought disorder, it's very difficult to even get that far along in it and they may end up in the hospital or arrested or all kinds of other things. But for a person with an eating disorder you know from what you're saying it sounds like there are a couple of things going on. One is they're trying to. They've got anxiety. They probably suffer from depression. There's probably deep trauma and they are. They have engaged in a, a process, a lifestyle that it causes them to stay away from, abate the anxiety, control the environment so that they don't come into places where they feel unsafe. And then all of a sudden you're going to walk in and you can't just go blowing that up.
Speaker 2:Yeah.
Speaker 1:This is we're going to. We're going, we're gonna, we're gonna chip away at it. We're gonna scratch at the surface with this person and and gently help them realize, which you can't do in a moment. You know that exactly. It doesn't happen in a moment. It happens. It happens when the person knows who you are, realizes they can trust you, knows that you have a shared experiences, so you have these.
Speaker 1:You know what we would call therapeutic alliances with this person yes, ready walking into the situation and then you know, I kind of I look at it this way you, you stand, you stand still but still available and wait for them to come to you, a little bit like, yeah, like you know, the scared creature in the cave, it's like, hey, I got a little something I think you want.
Speaker 1:Why don't you come out, just let's talk a little come out, a little bit um, and then ideally, you know, somewhere along in that process they can get treatment, and treatment is, you know, being surrounded by clinical professionals and teams of support and 24-hour supervision and all these pieces that help that person manage the process. Now, the other vulnerable spot that I like to talk about, and I know that you have a lot of experience with, is the other side of treatment is, you know, okay, they've gotten past the crisis, they've gone through some treatment.
Speaker 2:What comes next?
Speaker 1:What comes next Like what is? The? What is the? What is the transition out of? Out of residential treatment, out of crisis, essentially, and some of the care that goes along with that? What is that? What is coming back home being independent? What does that look like for a person?
Speaker 2:who suffers from eating disorder yeah. So I think honestly, I think that's again that's one of the most challenging areas for eating disorders and I think we also just don't have, we lack transitional programs.
Speaker 1:Oh yeah, yeah, you have a lot for substance use, right?
Speaker 2:Yes, you really lack that transitional programming that supports an eating disorder and all of our sober livings, mental health, transitional programs. We can have someone who's had a history of eating disorder, but you know they're. And even when they say you know secondary eating disorder but they're not equipped to deal with someone who's coming out of residential. Coming out of residential is way too fragile and I think you know, talking from my experience with it. I think one of the areas that we don't talk about enough with eating disorders is that place of frailty as you come out of a residential program and I think one of the things that people don't realize. It's all taught from my experience and that was going into residential significantly underweight and so one of the primary things that they're doing is weight restoration. Okay, Right.
Speaker 2:And.
Speaker 1:The science part right.
Speaker 2:Yes, yes, the science and the medical part and weight restoration is not comfortable, right? So I think we have people, we have someone who's like a normal weight and likes their food. They're like well, that's fantastic. Like you're telling me, I get to eat these. Like extra calories, like you know. Like, like you have to do this. Like great, like that sounds wonderful, right, but right. But when you've been so severely malnourished, your body is in freak out mode, so you're adding these calories to your body.
Speaker 2:Yes, and so when you're going in and you have consumed, on a regular basis for a long period of time, significantly lower calories than your average person would need in order to just maintain weight, the body's freaking out at very little calories, just to begin with.
Speaker 2:And so they're watching and they're monitoring and they're upping the calories, but the body's continuing to freak out. It doesn't know what to do with everything. The metabolism actually shuts down because what your body is saying is oh my God, you're giving me food. Hold on to it, don't process it, because I don't know when you're going to give this to me again, because that's what it's been used to, right?
Speaker 1:Wow.
Speaker 2:And so what's going to happen is, as your body starts to gain weight and especially as a female, you're going to gain all of your initial weight in the stomach area. Your body knows to protect your vital organs and your reproductive organs.
Speaker 1:So you're talking about it gives calories to the place where they're showing up, right.
Speaker 2:Yeah, yeah, so here's so, yeah, exactly, exactly. So here's this person who already struggles with body image of a severely low weight and now all my weight gain is starting in the stomach area.
Speaker 1:Oh, my gosh.
Speaker 2:And so what people don't realize, I mean one. It's incredibly uncomfortable. Like your, your, your body doesn't know what to do with it. All you feel is this distension in this incredible fullness. Internally, you're not. It's not you're. You're probably constipated, right, your body's just not operating properly and even once you reach a normal weight, where you've gained weight is not. It doesn't look normal. Um, so it takes about a year for the weight that you gain to really evenly distribute normally throughout the body, and so again you talk about what happens.
Speaker 2:You're in a residential program, say. You're in a residential program for 60 days. You discharge. The biggest challenge that I always faced was I physically feel uncomfortable, I hate the way I look and don't even try to tell me that you know, you don't, you know. Don't try to do the whole like I can barely I literally have gained.
Speaker 2:I have, we would call it the pooch right. Like you, gain this big pooch right in your stomach area and the thing is, I know how to make it go away. I feel physically uncomfortable. I know exactly how to make this go away.
Speaker 1:I can make it go away within a day.
Speaker 2:Yes, to go right back to those eating disorder behaviors, and so to me, that's one of those biggest challenges is you're discharging the person at the most vulnerable state, where not only are they still this emotional wreck, like they're physically a wreck, and so then you just go right back into your daily life and try to maintain that recovery piece and try to continue to eat in this way. That's only adding to this physical discomfort that you're in, and so that was for me, is it never took long I mean, it was always a matter of weeks before I just returned right back to those behaviors.
Speaker 1:Yeah, well, and it sounds like, for the transition piece, something that you know we've used you as a person who does this, but even a person is, you know, ideally they used you as a person who does this, but even a person is, you know, ideally they're returning to an environment that's got some supports, whether it's you know a supported living group environment though there are not many of those for eating disorder but at the very least like a good therapist.
Speaker 1:If there are medications, a good psychiatrist and a recovery coach, that's. You know, you and I, we harp on this. I know all the time with fans like get a recovery coach. You know, you and I, we harp on this. I know all the time with fans like get a recovery coach program.
Speaker 1:They're in doesn't have one. Get one to be involved, get somebody who can walk and talk with them, can show up for them in person, can see how they're doing, can determine whether or not they're kind of reengaging in some of these old patterns and need more support. That that person is really is really, really critical to their recovery.
Speaker 1:And it's a role I know that you've played many times for a lot of different people. I like using you for that because I think your personal experience causes you to be attentive in ways that others may not be.
Speaker 2:Yeah.
Speaker 1:So I'm really grateful for you as a person who is on our team and I'm grateful that you agreed to come on the show today. Jennifer, thanks so much for talking with us about eating disorder and you know we'll probably get you back on the show so we can talk some more about intervention. But this has been Head Inside Mental Health on WPBM 1037, the Voice of Asheville Our guest today, jennifer.
Speaker 2:Stanger. Jennifer, thanks for being on the show. Thanks, todd. I need a little help. I found a little help, thank you. I don't need your love. Send me a. Send me a. I don't need your love. Send me a. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home. I feel so lonely and lost in here. I need to find my way home.
Speaker 1:Find my way home.