Eating Disorders Q&A with Deva Murphy MSW, LCSW

What are eating disorders? How do you help someone with an eating disorder? What is involved in the treatment/recovery of an eating disorder?

Video Transcript

Laurie: Hi, my name is Laurie Groh, and I'm here with Deva Murphy, and today we're going to be talking about eating disorders and very excited to learn more about what you do in your practice and to hear more about how somebody knows if they might need to come and see you. So, Deva, why don't you tell me... let's just go right into it and you can tell me a little bit about what eating disorders are.

Deva: Absolutely. And thank you for having me. I feel very passionate about the topic of eating disorders because I think it's just an ever growing struggle with many people. And I think it's... there are types of diagnoses that I think have a lot of stigma attached to them. So with eating disorders, I guess I'll just kind of give like a high level overview. You know, there is not just one type of an eating disorder. There are multiple types of eating disorders. And when you funnel them all down, essentially what it is, is just really unhealthy relationship with food, body image, weight and oftentimes exercise. And so, you know, I would kind of categorize them as the main types of eating disorder behaviors are restriction, binge eating and purging and with purging comes kind of self-induced vomiting or overexercising, and that purging oftentimes is a way to compensate for what somebody has eaten and often times it's their brain. That eating disorder has told them it's too much. So you need to compensate and do something to take care of that.

Laurie: Yeah, yeah. Sort of like almost like an equalizer, trying to get things to be equal.

Deva: Yeah. And so I would say that the common eating disorders that I think an average person might have heard of is anorexia, and that is really characterized by restriction. And I think there's this, this common thought that a person can only have anorexia if they're of a very low weight. And that really isn't true anymore. You know, somebody who might have had a higher weight on a scale can still struggle with anorexia because the main symptom of that diagnosis is just a significant level of restriction.

Laurie: Yeah that's a good thing to know, how to recognize it. Notice, though, that it doesn't always have to be what we think it looks like. Yeah.

Deva: Absolutely, and I think oftentimes if a person does struggle with that significant level of restriction and they do meet criteria for anorexia, they oftentimes might not seek treatment because then in their brain they think, oh, well, my weight isn't low enough, you know, my weight is is normal or it actually might be above what I want it to be. So anorexia would probably be one of those bubbles. A second bubble for an eating disorder would be binge eating disorder. And I would say probably over the past few years in my practice, binge eating disorder is probably the most common eating disorder that I see. And with that, it's categorized by that overeating. And then it moves to that extreme amounts of food, which I would categorize as those binge eating episodes.

Laurie: Yeah, yeah. So with that, I mean, maybe it's not something known, but do you have any thoughts on why maybe that's happening a little bit more now or that's what you're seeing more. Any thoughts on that?

Deva: I would just say I think oftentimes with our culture too, and what we see in the media, what's available to us in grocery stores, that can sometimes play a part in it. But a lot of why binge eating happens is it stems from that, 'Well, I need to lose weight or I just need to eat less or I am X amount of pounds overweight'. And so people have these intentions of trying to eat less, to lose weight. And then what happens is they're hungry and their bodies start to give them signals like these waves of saying, I need more food, I need to eat. And so then it turns into when there is access to food, people tend to overeat or then it is becomes that binge eating where it's just this large quantity of food that oftentimes can make a person feel really, really sick.

Laurie: Right, right. In the restricting portion of that. Right. Probably, too, it does something to the stomach. And so then it's tighter as well. I would imagine that it would impact you a lot more physically, with that cycle.

Deva: Yeah. So we have anorexia, we have binge eating disorder. Another really common eating disorder is bulimia. And bulimia is kind of categorized very basically as overeating component is there or sometimes the binge eating component. But then the bulimia part of it is somebody engages in purging often times where there's the self-induced vomiting to again, like you said, kind of compensate for what somebody eats. And there's a newer eating disorder that I'm seeing a lot more and it's called orthorexia. So that might not be a term that I think oftentimes is heard very much by people. But orthorexia is just this obsession with healthy, clean. Oftentimes for people it might be I only eat organic foods or I don't eat processed foods. And it just becomes this obsession that takes over their life and their eating habits where they limit themselves pretty severely as to what types of foods they can eat.

Laurie: Yeah, it sounds like a restriction is happening there. It just looks a little different in practice again and again.

Deva: That kind of comes into play with diet culture where in our diet culture we hear, oh, carbs are bad for you or don't eat processed sugar. And so when we hear these messages from all different aspects in our lives, of course, it's so understandable to just get caught up in that and truly believe that there's good food and there's bad food and I can't eat those bad foods.

Laurie: Yeah, yeah. That idea makes a lot of sense. And that's that is that pressure, I think that we're all feeling to sort of just eat you better and clean all of that. And ideally. Yes, right. But then it becomes more of when you said it kind of takes over is when it starts to become an issue, because then you plan like maybe your day around that or your life around that and then limits your social interactions or, you know, that sort of thing.

Deva: Yeah, that's a really good point. And I think that that can sometimes be a really clear indicator that somebody might need to come see me, you know, or get some help when those what I call them, food rules, that take over a person's life and they stop doing social things that involve getting together and eating with friends or family members or, you know, whenever they eat a meal, they have to carve out time after that to engage in a behavior or engage in exercising to compensate for that, so it really can take over a person's life.

Laurie: Yeah, yeah, yeah. And probably leaves that feeling of isolation, too, with that right. Of Oh, I have to then do this. So I need to step away from my people. Yeah.

Deva: Yeah, absolutely. And oftentimes when a person is restricting there's actually brain chemicals that are altered in their brain up there that those levels can reduce, which oftentimes can lead to a mood disorder, something like depression. And so eating disorders, depression, anxiety, those go hand in hand a lot of the time because what's so scary with eating disorders is it's not just an emotional component. There's a physical component that really can impact how your brain operates.

Laurie: Right, right. That makes a lot of sense. So, Deva, tell me a little bit about how you help someone that's coming in for an eating disorder and needs some assistance. What are some ways you help.

Deva: Absolutely. So I think the biggest thing that I would do in the beginning is to just educate, help them be able to understand what their eating disorder looks like, what behaviors make up what they engage in and just really start to educate, like what are those behaviors? What is the eating disorder doing to you? You know, oftentimes an eating disorder comes in too late for somebody because they're not getting something where they might not feel like they have control in their life or they might not feel like they can ever let loose or let go. And so that eating disorder starts to serve that purpose for them. So education is a huge component of what I would do in the beginning and helping them then to really start to look at it as what is this eating disorder doing? What are the consequences that start to come up when I listen to that voice in my head that says I can't eat sweets or I have to limit myself to X number of calories each day.

Laurie: Mm hmm. Yeah. So what the purpose is like, there's part of it that's what's the purpose. What's it doing. And then what are some of the consequences. Yeah.

Deva: Oftentimes for people what I hear from my clients is the eating disorder is the only thing that I have in my life that makes me feel good or it gives me a sense of control or I feel powerful, I feel capable. And although I need to validate those things, it's kind of a skewed concept of what having power and control is in your life. And so really helping them, I think to just start to shift some of those thinking patterns. And using CBT cognitive behavioral therapy is a huge part of what I do. But it's really just kind of like streamlined and focused on the eating disorder.

Laurie: Yeah, and I could see, too, like how it could be that reward built in as well with the restriction of, i'm achieving something here, right? And that can be a reward. Makes sense though. Makes sense.

Deva: And I would say the other big component, if a client were to come to me and we do start to kind of delve into the eating disorder treatment, more often than not, I am recommending somebody get connected with an eating disorder specific dietitian. And what I mean by that is dietitians that are truly educated, they have knowledge working with eating disorders because it's a different approach than like a diabetic dietitian. And that's something that I have referrals, I have connections, that's something that I would really help facilitate just to re-educate somebody on what their eating habits need to look like for themselves and work to let go of comparing. Well, my mom eats like this or my friend eats like this or that actress that I see on TV, eats like this. Really focusing on what they need for their own nutrition.

Laurie: Yeah, that seems key, that education piece. And I think it takes this other part out, which is maybe some confusion that can occur and having like straightforward information can really be helpful. So that's great.

Deva: Yeah, absolutely. And so I would say between finding somebody like me, a therapist who specializes in eating disorders as well as an eating disorder dietitian, those are two really big components with that. And oftentimes working with my client's primary care physician is a huge part of that, too. Just making sure that the medical piece is stable.

Laurie: Yeah, yeah. That sounds great, though, like having that coordination of people, which I think it's really important. We all need that, we all need support and people talking to each other. We'll all be on the same page, it just makes that change a lot easier in general if our if our environment is shifting and supporting that. Yes, that's really cool. So Deva, as far as like the recovery process and what that looks like, is there anything else you want to share about that part?

Deva: Yes, I would say that the biggest thing that I teach my clients is that it is how I explain it is eating disorder/recovery is like a saw tooth pattern where it's not the straight trajectory forward. You have some wins and then you might have some struggles where you feel like you kind of take three steps forward, two steps back, and it's all about progress, not perfection, where people can get really down on themselves when after a few weeks go by and they haven't engaged in those eating disorder behaviors and all of a sudden some stress comes in their life and they restrict or they binge or they purge, there's a lot of guilt and shame attached to that. So I think the biggest piece then, too, is knowing that it's... you don't have to be perfect. The behaviors are going to come back around every so often. It's just what can you learn from that? How else can you cope with whatever that trigger was in your life instead of resorting to the eating disorder behavior.

Laurie: Yeah, yeah. And that those those things that occur. Right. Feel like setbacks. But really, really, it's all it's all going to help. It's all going to help us in the progression whenever we're trying to make the change, right.

Deva: Yeah, that's a very good point. So I would say that's the biggest piece. And oftentimes recovery can take a lot of time.

Laurie: Yeah, yeah. Because you're right. Like that process piece, we didn't we didn't just start walking. I like to think about it that way. We didn't just one day start walking. It took a lot of encouragement. Oh, you kind of you're pulling yourself up. Good job, right. Yeah. And not to infantile it, but that there is that idea within us that any time we're trying to move towards something, that there's going to be the fallbacks, there's going to be that feeling of 'oops'. And now I know I have to step up now I know I have to do this. I can do this differently. Talk to people that are in the same place as me trying to work through it can be another really great thing. Yeah. So, Deva, is there anything else you want to mention or talk about before we end today? Anything I might have missed?

Deva: No, I mean, I would say, you know, if you are someone out there that has kind of connected to any of the things that I've said today, please reach out to me, you know, and I would be happy to just do a free 20 minute consult with you if you're just kind of looking for just some sort of information or advice or a place to start. So reach out and I will be happy to help. And if I can't help, I would be happy to get you connected with any resources that I might have

Laurie: Awesome. Well, thank you, Deva. And yeah, if anyone wants to reach out, our phone number, your phone number is on our... it's going to be on the comments, but also you can look at our website at shoresidetherapies.com and reach out to me directly. Email, text, call, all of those. Correct?

Deva: Lots of ways, yep.

Laurie: Lots of ways. All right. Sounds good. Well, thanks again. And we'll talk again. Take care.

Deva: Absolutely, bye.