Anthony Hartcher 0:01
Hello, welcome to another episode of Me&My health up. I'm your host Anthony Hartcher, a clinical nutritionist and lifestyle medicine specialist. This is an exciting episode as we are celebrating our first birthday of this podcast with our first guest on the podcast, Nina Kingsford Smith. Intriguingly, this podcast was born when Sydney was first in COVID lockdown, and today's episode is being recorded in our second lockdown. The intent was to help others with expert health and wellness tips and today the purpose has not changed. We still inspire to enhance and enlighten the well-being of others and today we'll be discussing self-love and good health with clinical nutritionist and disordered eating specialist Nina Kingsford Smith. So welcome, Nina, How are you coping with his second lockdown?
Nina Kingsford-Smith 0:58
Thank you. Um, first of all, happy birthday. That's very exciting to have the one-year mark. Look, to be honest, I'm coping quite fine with that. I think sort of with nutrition consults, we can easily switch online very luckily and you know, apart from work, I've just been spending more time with my little doggo, which has been nice having some more time with him. So yeah, I've been going quite well with that very grateful to say.
Anthony Hartcher 1:25
And remember last time we chatted, we were talking about being present when you're doing dog walks. Yeah. Are you doing that?
Nina Kingsford-Smith 1:34
Yeah, I have been I've been enjoying walking with him and just sort of, in general, being more present with him. I find animals in general are a great way to be more present. So it's lovely.
Anthony Hartcher 1:46
Yeah, because it's so present themselves and that just rubs off on us doesn't this just in the moment and I find the same with kids too, kids will bring you into the present moment because they always are leaving that present moment so it's really nice. Yeah, so just, you know, for listeners that may not have listened to our first recording episode one on disordered eating, and then a follow-up episode, we actually did Episode 23, which was on body image. Just please share some, some of you know some more about yourself and the great work you're doing around disordered eating?
Nina Kingsford-Smith 2:25
Yeah, of course. Yeah. So I'm a clinical nutritionist, I work one on one with clients in my private practice and I practice from what's called a nondiet perspective and so that's really about encouraging clients to shut out all of the external noise and confusion that there is about food and wellness and health, and to really tune into their internal cues and internal knowledge about what's best for them, and what works for them as an individual when it comes to health or food or any of those sorts of markers.
Yeah, it's really about honoring you as the expert of your own body and so I help guide them through that process of skill-building and knowledge building about how to do that and so very much what comes hand in hand with that is also working with Yes, disordered eating, eating disorders, body image concerns, that's really my area of specialty of what I do.
Anthony Hartcher 3:23
And you're so good at what you do. I've learned so much from the previous two episodes, you've really educated me and secondly, it's inspired a new way of me working with clients. So I really like your approach around this nondiet approach, and more based on intuitive eating and connection with food and it certainly had a real positive influence on me, so I really, thank you.
Nina Kingsford-Smith 3:53
Really cool. That's fantastic. Yeah. Yeah, I'm so passionate about the education empowerment side of it, not only for our, like our clients but also for other healthcare practitioners as well or the nutritionists, naturopaths, dieticians to help them practice from that sort of lense as well, because I think absolutely everybody out there would benefit from seeing food and health in that way. So that's really cool. Yeah.
Anthony Hartcher 4:17
So I just thought, you know, would touch on some previous episodes, in terms of this disordered eating just to I guess, bring out the definition and when we're referring to it in this episode, so that, you know, the listeners can really understand what we're talking about. So, yeah, if you could just share, you know, the, I guess, yeah, the definition or it doesn't have to be a textbook definition but just a good brief summary of yeah.
Nina Kingsford-Smith 4:47
Disordered eating, yeah. So I think there are a lot of nuances between disordered eating and eating disorders. So an eating disorder is something that is diagnosed according to a set of criteria whereas disordered eating, I sort of say, is what happens before an eating disorder occurs. So it's a lot of the similar behaviors, thoughts, beliefs around food, but it might be to a lesser extent, or to not such an intense frequency. So for example, if we're looking at things like compensatory behaviors around food, like that might be excessive exercise, or something like that, or restrictive thoughts around food.
So really, when it comes to disordered eating, how it actually manifests, it can be in so many different ways it might be that restrictive piece so that might be actually restricting food or having restrictive thoughts around food. So for example, I shouldn't eat this, I shouldn't eat that, I should cut out gluten, I should cut out sugar, you know, picking certain food groups or ingredients, or that sort of thing to cut out. Repeated dieting is a really, really big one so just constantly trying out all the latest diets, whether it's, you know, again, sugar-free, vegan, keto, paleo, all those sorts of ones. So intermittent fasting is another really big one at the moment, there are all those sorts of things.
It very often is tied into body image concerns, that sort of thing but I mean, there are many more causes other than that, it can be like a control thing, can be lots of different things but essentially, it's a lot of fear and anxiety around food, it can be overeating as well. So pretty much whenever there's a restriction, there's going to be overeating that at some stage follows. It's like a very much a binge restrict cycle so it can really encompass a lot of things and it is a little bit hard to define, as well, because a lot of those behaviors are actually really glorified in our society, I find, you know, it's seen as a good thing to count calories, or it's a good thing to go on a diet and that sort of stuff. But really, oftentimes, it's very detrimental, those sorts of behaviors actually and disordered Yeah.
Anthony Hartcher 7:07
What are the common trends you see, in terms of what initiates this from the very beginning? Notice that in your clinical practice, that you've seen some common trends amongst your clients, or you know, in terms of the research you've read?
Nina Kingsford-Smith 7:25
A lot of it starts back in childhood if you actually go back to childhood and what I often do with clients is, we'll do like a dieting timeline together, or a food timeline or a body image timeline, and go back to their first memories of how they thought about food, how they related to food, and really sort of beliefs that were formed all the way back then really coming to play a really significant role in their lives now, when it comes to how they relate to food.
Other than that, it really is very varied amongst a lot of people, the types of clients, I see, I do see a lot of these social-cultural sorts of pressures when it comes down to things like, you know, social media, or media in general and body image concerns but I also think it's important to emphasize that disordered eating and eating disorders can exist completely separately from that, and they don't always relate to that. Trauma is a really big one so having a history of trauma is you know, whether it's mental trauma, emotional trauma, sexual trauma, many different kinds, that can be a really, really disposing, predisposing factor as well and then, you know, depending on the exact thing that's going on, when, like, if it's a specific type of eating disorder, genetics can also play a role as well.
Anthony Hartcher 8:50
Yeah, so you've touched on a few really good points there. I'm thinking, like, as you said, it's a lot of you see stemming from childhood, and I'm thinking, you know, the way our parents behave in front of us growing up as kids and kids aspiring to be like their parents because they love and adore them. I'm thinking like, if there's a language that the parents are using around the children, or if they're if the children you know, see Mum and Dad you know, restricting their intake or you know, saying the particular thing I can't have that to me or make me fat and that I can imagine that has a lot to your certainly plays an influencing factor on how the kid behaves later on in their life.
Nina Kingsford-Smith 9:34
Yeah, massively so like yeah, as you said, if you think of the example of you know, there's a parent that is constantly on a diet, constantly trying to lose weight, saying I can't eat that, it'll make me fat or, you know, mommy can't eat that or anything along those lines. You know, unsurprisingly, it gives the child the message of okay, well, fat is bad, I shouldn't be that, I should control my eating to avoid becoming that as well and so sorts of really sort of base, you know, our brains like to simplify things in general.
Especially when you're a kid and in those formative years, when you really, really sort of cement in a lot of those beliefs, so it's, you know, it's really no surprise at all, but even like a really common one, and seems totally harmless when we're like, as parents, and we all do it, but that that concept of you have to finish everything on your plate and so that really teaches a lot of us to totally disconnect with, like hunger, fullness cues, and just to keep eating beyond the point of feet being full, because it's a really bad thing if you don't finish everything on your plate. So that's another really, really common one that I see pretty much in all clients, as well.
Anthony Hartcher 10:40
And it's incredible how it's passed on from generation because, you know, you know, the Great Depression, you know, resulted in that generation really valuing food, because it was so scarce during the Great Depression and, and, you know, that they've shared that, you know, saying, well, you know, this is the food we have, you got to eat at all, because I don't know when the next egg, but then, you know, as societies become more affluent, you know, that that trace of, as you said, genetics plays a bit to do with it and you can imagine this, as you know, being shaped into our genes, this way of bringing up children in terms of everything on your own, because I certainly personally experienced that, that you must eat everything on your plate as.
Yeah and then, so the other one she touched on was like, the trauma and, and situations that have a, you know, an influencing effect. So, you know, when I think trauma, I'm thinking, like, is food seen or restricting food as a way to deal with the trauma like after if someone's experienced trauma, you know, it's one way of coping could be going to food and eating it to make them feel better to you know, because they're not coping with it and there's that element with food that you can control what you put in your mouth, but in that, in certain circumstances in life are things that are out of our control.
For example, COVID, you know, is a situational thing that we're in at the moment, where, you know, the government says, This is what you can and can't do, and hence takes things out of our control and then we think, Well, what can I can control? Well, I can control what I put in my mouth, and that makes me feel better so is that you know, this, dealing the ways to deal with stress, so to speak, you know, some people can resort to food.
Nina Kingsford-Smith 12:38
Yeah, definitely. I think that's one of the really key ways that it plays out in terms of dealing with trauma and you know, when we're talking about trauma as well, I think we often think of it as like, it was like big T trauma. So a big event that's happened is one big traumatic event but trauma can also be little T trauma, as well. So lots of tiny little things that you might not even necessarily consciously realize has impacted you or been a traumatic experience for you, but it still has. So there's what's called aces or adverse childhood experiences from again, going back to childhood when we're growing up and they're really correlated with eating disorders.
So that could be something just like bullying and even if that's sort of low key bullying throughout all your childhood use, isolation, your parents separating when you're young, like emotional neglect, abuse, all sorts of things like that moving to, to a new state with your kid, and you don't know anybody for a while, that sort of thing, all sorts of things like that and that is actually often really related to developing eating disorders when you're growing up.
But again, yeah, for example, when you're an adult COVID is a massive one that's really actually which we can talk about but that has seen a really big spike in people seeking help for eating disorders. So yeah, I think definitely the control pieces big, as you said, so many things in our life feel like they're out of control, or they can feel like they're out of control and food is one thing that you can control, whether that is eating more, or eating less, or eating a certain type of thing. It's something that we can, we can attempt to control anyway, and then another really big factor is using food as an emotional coping mechanism.
So whether that is to help distract us while we're eating so that we don't have to deal with our emotions, just to completely numb out so sort of like a step further and just completely numbing out from anything and this is where you might see, for example, somebody with binge eating disorder, who reports that they just completely blackout like they actually blackout when they experience a binge eating episode. It can also be like a self-soothing thing so sometimes food can provide a really lovely sense of comfort and nourishment and nurturing like sort of a sweetness in your life sort of metaphorically speaking. So it can really play a lot of having different roles and in that aspect, I think it's really important to note as well that using food as an emotional coping mechanism is not a bad thing
Like emotional eating is not a bad thing. I so often see it really demonized and seeing it, you know, it's really, really bad, shouldn't do it at all. I am not a believer in that. It's not like you're going out and you're hurting anybody, you're not being violent, you're not taking illicit drugs or anything like that you're eating, it's actually quite a safe thing to do and it can be a very good coping mechanism, it's when I find that it can become tricky is when it's our only coping mechanism, or our main coping mechanism, because then you think of all the other awesome things out there that could be supporting us, that we're not giving space to, and we're not giving a chance for that to help out.
And yes, while food, it can be great, it can only do so much, it can't address all those other things as well. So that's when I really, like encourage people to look beyond, like, yes, include food as a coping mechanism, a coping mechanism, if you wish, but also look beyond that to all the other sorts of lovely self-care, things that you can be doing, as well and, like, consciously build up that sort of self-care toolkit that you've got.
Anthony Hartcher 16:14
And have you noticed anything around the lack of self-love, and whether that lack of self-love comes through what you said earlier around body imaging, when you're growing up and thinking you're not a particular body shape so therefore, who's going to love you, you know, you're not going to be wanted, and, and so that can result in that sort of, well, this disconnect, essentially, with your body and self-loathing about us. In terms of something, you can't control.
I mean, our figures are given to us, you know, we have, obviously, there's, you know, I guess to point out, you know, our skeletal structures, you know, really given to us and, and, yeah, so, have you noticed anything around that, that self-love that, then, you know, and then you people's thinking, Well, I'm not this sort of person, and, you know, no one's going to like me, because I don't fit this sort of shape. Is there something you've noticed around that in terms of like, self-love and eating disorders?
Nina Kingsford-Smith 17:19
Yeah, massively so, I think that, yeah, that's a really good example, where the eating disorders or disordered eating body image and your sense of self-worth, or self-identity really all come together and again, in many different ways, because we're all so different, right? We all have such different experiences but for example, we might really not value ourselves for whatever reason, that is, whatever past experiences we've had, whatever beliefs we hold, we might have a really low sense of self-worth.
There might even be, you know, like, that real self-hatred that we experience, and then almost using food as a form of punishment, whether that's in a really subconscious way, but sort of as self-sabotage so it might be, for example, binge eating and overeating constantly, so that you as a form of punishing yourself, because you don't feel like you're worthy of anything better and you want to keep sort of keeping yourself in that pattern, that sort of unhelpful negative pattern that that loop that keeps happening.
The same thing with restricting food can be exactly the same thing. I don't deserve to eat, I'm not worthy of food, I'm not worthy of nourishment, I'm not worthy of, of this pleasure, because you know, food is such a pleasurable sensory experience, but some people might not believe that they're worthy of that either and then definitely, the way that we view our bodies very much plays into that because, you know, as we know, like, body image and self-worth, in our society today, pretty much goes, we're taught that it should go hand in hand, sadly, so much of how we judge ourselves and other people. If we think of celebrities and all that stuff, the first thing that we do is often pretty much judge them on how they look before anything else in Western society, anyway, yeah.
Anthony Hartcher 19:14
Very true. Very sad, in that sense because, you know, given that we've discussed of, you know, things in your control and out of your control, then you know, certain body shapes are just hereditary. You know, like, some, some women have wider hips, some women have narrow hips and there's nothing you can do about that. And I think it's, I think it's sad that if you don't fit the media image or the model image, therefore you're out.
So I'm really keen to chat about COVID and the impact COVIDS having because in Sydney, were experiencing the second lockdown and you know, coping mechanisms for the lockdown can be excessive drinking or excessive eating. Yeah, so please share this and, you know, obviously, this has been dragging on too, you know, we first started our discussion, you know, in the first lockdown when it first hit and we're still talking about COVID today. So what are you noticing, in terms of your clients and disordered eating?
Nina Kingsford-Smith 20:26
Yeah, amongst my clients, I've definitely noticed as if what I've personally seen amongst my clients is a lot of increased anxiety around COVID and therefore, using food in one way or another, to be coping with that sense of anxiety and uncertainty as well. I know, so the Butterfly Foundation, which is one of the key organizations for eating disorders and eating disorder support in Australia, they, back in September last year, they reported a 57% increase in calls to their helpline through over the course of the pandemic so that's more than doubling. So more people are reaching out for help, whether that is more people developing an eating disorder when they hadn't had it before, they hadn't had issues before, or people relapsing, because that's often the case with an eating disorder.
It's not like it just goes away, and it's gone forever. People go through these cycles of relapsing or sort of transitioning from one eating disorder to another and back to the original one and that sort of thing. So so that and a worsening of existing eating disorders. So you might still have an eating disorder, and it's just been exacerbated, the symptoms have become a lot worse so that has definitely been happening a lot throughout the course of the pandemic, and not just in Australia. But, you know, everywhere I know, England, I'm pretty sure it was also reported and almost doubling in on people seeking support for eating disorders. So I think it's related to a lot of different factors.
It is, like we said, the uncertainty, so it's, I think, very hard for us as just like humans to have that uncertainty and that lack of control, very, very tricky. The fear, the social isolation is a really, really big one and you know, all of the impacts that are going to have on our mental health, increased anxiety and depression, all that sort of stuff. It's, it's really, yeah, it's worsening our mental health and, you know, eating disorders are mental illness, right. Like, that's, that's what they're recognized as and so that really makes sense there.
I think two other really big key factors as well, is the fact that our environments have changed. So for example, when we might have been going out to work, you know, to an external workplace before, a lot of people are now locked at home a lot more, and whether that's home alone, or home with the people that they live with, but you're suddenly in a different environment when it comes to food and you know, for some people, they're now constantly surrounded by food, they're right near their kitchen, they can get food whenever they want.
There's a lack of structure in their daily routine, there's no set meal, you know, where you might have like your proper clock lunch break at work or something, there's not that anymore, there's that lack of daily structure and people feel less in control around food and around their eating habits, then you pair that with fear and anxiety and all that stuff going on and wanting to use food as a coping mechanism and that leading to binges, and then you feel guilty around the binge and so you say I'm going to you know, eat healthier, again, I'm going to diet, and then you're a strict and then you get sick of doing that so then you binge it again, and it's just this whole cycle, right?
So I think, yeah, that's sort of that changing environment, a really big one, but then also one that really grinds my gears and it happened, especially during the first when all of it was sort of first happening, the first sort of lockdown that I think it was a lot of rhetoric around the COVID 15, or the COVID-19, or something like that, but around gaining weight basically with COVID and everybody saying, well, I'm putting on the COVID kilos and all these, you know, exercise plans coming out about how to shed COVID weight and all that kind of stuff and that being incredibly, incredibly triggering for a lot of people and triggering for people who already had predisposed.
Like, already were predisposed to having issues around food and body image but also created a lot of body image concerns for people who'd previously not had any issues to do with any of that, and now suddenly felt this really big pressure, because a lot of people's bodies did change during COVID, right, like, a lot of people were eating differently, couldn't exercise as much you might not be able to go to your usual exercise classes or sports games or gyms or whatever.
And so naturally, our bodies a lot of people's bodies were changing and so there was a lot of pressure added pressure in dealing with that as well and even little things like you know, for example, being on Zoom calls more and seeing your yourself more on Zoom calls and people reported like really struggling a lot with that as well. So even lots of little things like that I think there are so many things at play, be a really big exacerbation in eating disorders and disordered eating around COVID. Yeah.
Anthony Hartcher 25:02
Thanks for sharing and they're very insightful and very insightful in terms of everything you shared, in terms of how are you helping your clients with everything you've just shared around COVID and what are they, I guess the tips that you share with your clients, you know, to help them through this time?
Nina Kingsford-Smith 25:44
A big one, which I like to do and in general, I think it's a really helpful thing to do is, and we touched on it before, but really building out what I call your self-care toolkit and so that's like this metaphorical toolkit that you've got, you can reach in there whenever you want and pull out whatever tool you need at that point in time, to help you feel whatever it is you need to feel. So you might need to want to feel more calm, you might want to feel happy, you might want to feel nourished, you might need to release some anger, you might want some creativity.
Any of those sorts of things, all your tools can go in there and either use the toolbox, when you are feeling in need of it or as sort of like a preventative thing as well. So it's like that whole analogy of keeping gloss full, don't wait till it's empty before you're like, going to do something that's a self-care thing, keep it full and top all the time and so we create this self-care toolkit together, we'll sit down, we'll write out the list and then I encourage them to physically either have it as a list on a piece of paper or on their phone, and keep it somewhere that they can refer to often and I find that is really, really helpful because if you've just started all up in your head, when you're actually in a situation, when you're quite stressed, you're overwhelmed, whatever, it's very hard to access that part of your brain, right?
It's not going to be like, Oh, go do this, that's a good idea but past you has written out this awesome list that all you need to do is pick it up, look at it and be like, yep, that looks good. that option looks good. I'm going to go and do that right now and, you know, when we're talking the sorts of things you can put on that list, it doesn't have to be all the cliched sorts of stuff around self-care, it can be whatever works for you. So it might be like a foot bath or a bubble bath, or you know if it permits going to get a massage or something like that. But it can be random things, whatever makes you happy, dancing about to the music used to love when you were a teenager for that sense of nostalgia.
Going to if you can go into a park and playing on play equipment, I find a lot of things that reconnect you to like that inner child is really beautiful. Like playing board games, it might be doing something really creative, like we said, like knitting, drawing, sewing, and pottery class, something like that. Something that gets you to laugh so watching comedy shows, watching random funny dog videos on Netflix, just calling up a friend, and having a good laugh. It can be so many different things. I think letting out anger is another really important one, we sort of shun anger in the angry feeling.
It's sort of not really accepted in our society, but it's really important to let out so whether it's screaming into a pillow, you know, dancing about to some angry music, like so many different things you can be doing and putting on your list and like we said before, food can definitely be on there and you can sometimes pair food with something else. So you know, for example, how this all plays out, you might have a really stressful day at work or you know, working from home and you would usually mindlessly go to the cupboard as soon as you log off for your zoom calls and just eat a whole bunch of food, feel really physically sick afterward, feel a lot of guilt and anxiety and shame around it and then the cycle repeats.
Whereas the alternative might be you get off that Zoom call, you can acknowledge that you're feeling really stressed and overwhelmed and you say okay, I'm going to pick up my little self-care toolkit list, I'm going to have a look at it. Oh yeah, right now, just like having a cuddle with my dog sounds really good. I'm going to do that. I actually also still feel like that chocolate bar. I'm going to do both of them and so you might sit down, you know, have your dog on your lap, have a like a cuddle with him and really mindfully eat the chocolate bar and actually enjoy the experience of it. Notice the flavor and notice how satisfying it is. notice the smoothness in your mouth, all that stuff, and actually, gain what you're seeking from it. So whether that's like that comfort and that calmness and you're gaining that from that experience.
So I find that that is a, really, really important and helpful tool. The other thing about that is also Important is identifying the sorts of triggers, whether that's people or certain circumstances, times of the day. For women, it might even be like the time of the month in regards to your menstrual cycle, could be so many different things, that things that might make you feel more of the negative emotions that make you want to reach for your self-care toolkit, and then you can just increase your level of self-awareness around it, right. So, you know, for example, you might know that going to your mother-in-law's place makes you anxious and stressed and it's not a nice experience and when you come home from that, you'll often like binge eat on something, for example. So you might be able to identify that and then so before you go over to your mother-in-law's house.
You say, okay, I'm just going to do a few deep breaths, I'm going to take an extra 10 minutes just to calm myself before I go over or to have a chat with my friend or you know, something like that and you can sort of preempt and building these sort of self-care things around those sorts of situations, because we can't just, not all the time, can we just avoid those situations completely, sometimes we still need to do them, it's just part of life doing stuff that's uncomfortable and unenjoyable, sometimes, but we can build in this sort of self-care around that, so that we then don't resort to trying to control food either in a restrictive way, or an over compensatory way, or whatever it might be and we get we've got that, that bigger level of sort of, of self-care around that. So I think that is one of the key ones that I'll always do.
Anthony Hartcher 31:30
Yeah, I love it in terms of, you know, helping the client be more self-aware of those triggers and, and you gave some great, helpful strategies in terms of, you know, prepare yourself, you know, go prepared, so that, you know, that the trigger is less or, you know, nonexistent. So that, that was fantastic and yeah, the self-care toolkit is awesome, I love the one about, you know, doing things that you do when you're a kid and you said, yeah, going to the park and playing on the swing, like I love jumping on that swing and just swinging it's, it's just therapeutic, just been going to and fro on the net there good little feeling that you have when you you know, is it tiny drops you that sort of. Yeah and then getting high on the swing and, you know, feeling that you're on top of the world.
Nina Kingsford-Smith 32:27
It's quite freeing isn't it, it feels like you're flying, especially when you're little and everything is so high off the ground and the world's a better place.
Anthony Hartcher 32:35
Yeah, yeah and I couldn't, you know, remember the thoughts I had when I was doing it as a kid was, you know, I could fly to the moon and.
Nina Kingsford-Smith 32:42
I love that, I love that so much.
Anthony Hartcher 32:48
So, yeah, really great tips, thanks for sharing them. There's a question that came through from one of the listeners and it was a great one around orthorexia. So, first of all, I'd love you too, you know, define and please share what orthorexia is and do you see it as potentially being a trigger for later on, you know, disordered eating or, you know, are you noticing this because there's orthorexia trend is new, you know, like it's, and yeah, so please, please share some wisdom around orthorexia.
Nina Kingsford-Smith 33:28
So orthorexia basically refers to an obsession or a fixation on the quality of food. So whereas a lot of eating disorders, for example, anorexia, people focus on the quantity of food, so that restricts how much they're eating. Orthorexia is more based on the quality of it so this real obsession is essential with eating healthy or quote-unquote, clean foods, and it is not technically acknowledged as an eating disorder yet. So eating disorders, that diagnosis goes according to what's called DSM five criteria, which is like the Diag.
I think it's the diagnostic and statistical manual of mental disorders, and it's what doctors and things use to diagnose mental illness. So orthorexia is not yet in that there are proposed criteria for it to be included in there and some clinicians recognize orthorexia as existing under the umbrella of one type of eating disorder called AFRID which is avoidant restrict, avoidant feeding restrictive intake disorder. I think I've got that wrong but some acknowledged under that and some acknowledge it under another umbrella of eating disorders, which is called OSFED other, otherwise specified feeding and eating disorders. So there are a lot of technicalities around is it technically an eating disorder? Is it not?
I think essentially, we can get to caught up in the technicalities of it, essentially, it is very significant I think, definitely, you can identify it as a form of disordered eating anyway but it's really significant. It has a lot of real impacts and implications on people's lives. It can be incredibly limiting, incredibly overwhelming. Um, I think it should definitely be acknowledged as a diagnosable eating disorder. What I think can also make it really really tricky with orthorexia and we sort of touched on this before is a lot of the behaviors that you'll see in Orthorexic people are glorified as healthy behaviors. So you know, cutting out food groups, eating only so-called clean ingredients, all that kind of stuff, it's seen as a healthy thing to do these days.
But then when you've got, you know, you can get to the stage where you're gluten-free and that's not because you're celiac or anything like that, you've just decided gluten is bad and you shouldn't have it, sugar-free, vegan, Paleo, doing all these different things, you know, people widdle themselves down to only being allowed to eat a few ingredients that they deem, that they personally deem as you know, safe or healthy, there might be a massive amount of anxiety and fear around if they don't have control around their food choices so for example, going out for a meal with friends, going to a party, going to a function with they can't know exactly what they're going to eat, and what exactly what exact ingredients are in that dish, they will either avoid it completely, or there will just be massive, massive anxiety and guilt and shame around it.
So that can be a really big one as well, that, you know, leads to things like social isolation, all of that, and is a really big predisposing factor as well for then going on to develop an actual diagnosable eating disorder because it is so nuanced, and it can occur in so many different ways, including being quite glorified in society and because there are no official diagnostic criteria, yet estimation of how many people are impacted by it in studies vary so much.
It varies anywhere from like 60 to 90% of the population being impacted by orthorexia, or orthorexic behaviors, and the number, I think the key thing to take away, the numbers are definitely on the rise, it's just getting worse and worse. So I think it's definitely something that we need to pay more attention to, in general, as the general public, to look out for in loved ones, and also definitely, for any healthcare practitioners that are listening for our practice to keep an eye on it, and to not actually be facilitating these sorts of behaviors and beliefs in our clients as well.
Anthony Hartcher 37:48
It's shocking, those statistics are so high, and I'm thinking, you know, certainly, the media, social media has got a lot to do with that, you know, in terms of publicating, publishing headlines of, you know, say, you know, coffee is bad, or gluten is bad, or you know, this is, then I can imagine this person, it's a car, it's another thing I've got to eliminate and then, as you said, you know, they go out and I think, what can I eat, there's nothing there I can eat and you know, that so they stress over and as you say that can result in that social isolation and withdrawal, which has health implications in itself.
So, yeah and, and yeah, as you said, you know, the societal sort of glorification of it is just reinforcing those behaviors, which is making worse, just on that on this restrictive eating, have you noticed any trends around food intolerances, food allergies, and later on developing disordered eating? Because certainly, what I'm seeing is more and more kids are intolerant or have allergies these days, and I'm wondering if there are any trends of that then later on in life really affecting the way they view food and their connection or lack of connection with food and potentially result? Yeah.
Nina Kingsford-Smith 39:04
Really good question. Um, in my clinical experience, I've definitely seen correlations. I think it's a complex one. I think essentially having food intolerances or food allergies, which often also means like gut issues, right? Usually, all tied together, it contributes for sure to have a more complex relationship with food and therefore, you know, increasing your risk of disordered eating or eating disorders. You know, for example, it's understandable if we have gut issues, so food intolerances, food allergies, bloating, diarrhea, whatever sorts of symptoms you might be experiencing.
It's very understandable that, that can lead us to feel anxious or disconnected from food. You know, if we are telling ourselves, this certain food I'm eating is going to impact me in a negative way, of course, there's going to be that link between yet being fearful around what we're eating will be hyper-aware of what we're eating and that sort of stuff and then also, as well, sort of which we've talked about a little bit, often well-intentioned advice from healthcare practitioners can be very restrictive.
You know, being told that certain foods, you know, good for you and bad for you that you have to be that they should be avoided, that you have to follow certain diet can lead to feeling more stressed or scared around food and, you know, it's walking a fine line, because sometimes, there are definitely medical reasons that certain foods should be avoided for certain people, you know, especially of course, if we're looking at something like anaphylaxis, and there's a food allergy there that can cause death, as well, if there's something like celiac disease, and then the lines become a bit more blurred about intolerances like how do you diet clearly diagnose an intolerance?
It's not necessarily like a life or death situation like it might be with anaphylaxis, but it still might have been having negative impacts on your health, and then so you're trying to make decisions around? You know, for example, do I want to eat this? What's a common one, pizza that's got gluten and dairy, even though I've been told that I have gluten and dairy intolerance, and I noticed that it might make me run to the bathroom, but it's at this big family dinner, and I really want to be part of the celebrations and what do I do, because I either miss out socially, or I, like I, if I do that, then I'm sacrificing. I feel like I'm sacrificing my health, and it gets very confusing and overwhelming.
So I think that definitely plays a part of it and all of that can sort of surmount to there being a lot more rules that you impose on yourself around food, so a lot more restricted eating. Yet a lot more can eat this, can't eat that, that kind of mentality, it can become a very black, or we try and make it into a very black and white thing where it's not, it's all those shades of gray. Like I just said that that example with the pizza, that's like a really good example of that and so I also we will often see somebody who is, say, for example, with certain food intolerance, they're trying not to have that thing with that, and then they get into that really restrictive mentality and then so they end up binging on that thing, because they told themselves, they can't have it, they've avoided it for a certain amount of time.
It's all they can think about and then so they end up having a really, really large amount of it in one go and that, obviously, is not beneficial at all, either mentally or for their health. So yeah, I think you know, as well, it can contribute to orthorexia, like we're talking about before that really that real fixation on you know, what's good for me what's not good for me sort of thing, quote, unquote.
But yeah, I think there are definitely links I think it's about the thing is maybe around 25%, of a systematic review of people with gastrointestinal disorders, also exhibited disordered eating behaviors and habits and about 90% of people with anorexia or bulimia also have got symptoms and I mean, in that reverse in terms of 90% of people with anorexia or bulimia, have got symptoms, that can be due to a whole host of other factors, nutritional deficiencies, lack of fiber impacting our, our migrating motor complex, you know, all sorts of things like that, but there is definitely a correlation.
Anthony Hartcher 43:31
Yeah, I felt like, it certainly opened up a whole new can of worms in it, say it's, it's, as of, you know, a lot of open-ended sort of, I can imagine from a parent's point of view, well, how do I now help prevent this disordered eating? Because they certainly want to do the best by the kid and saying, Well, you know, you need to restrict these foods, because they're going to result in tummy discomfort, however, I don't want to then this poor child later on in life, then, you know, experiencing further eating disorders and it, is there any advice you have? I mean, I think obviously, parents should come and see you, but is it's a hard one to deal with, right? It's
Nina Kingsford-Smith 44:17
Yeah, like it like we were saying it's not black and white, there are lots of shades of gray and when I say that, I mean, you know, when it comes to like you like whoever and their child, it's, it's constantly checking in with how it's going, it's looking for all the little nuances, knowing that everybody, like you know, each child's experience is going to be completely different. I think one thing that's important to focus on is the education so really helping people understand why the suggestions might be being made.
Knowing that it is acknowledging that health is not just, for example, digestive health, it's not just our physical health, it's also that mental and emotional aspect as well. So at what point do you do try and force these? For example, just what Torpoint To what extent do you force these restrictions around food if you're trying to help their gut health, but at the expense of all these other aspects of their health as well, it's sort of, you know, really weighing up all of that and seeing the bigger picture. Also, really focusing on an abundance mentality rather than a scarcity mentality and so when I say that, I mean, if you're a parent, it's not just saying to your kid, you can't eat this, you can't eat that when you go to school like if anybody offers you food, make sure you don't have anything with that in it.
Or when you go to that birthday party don't have that, that's focusing on that real scarcity mentality, right? It's focusing on all the things they can't do, all the things they can't eat. Instead, focus on abundance mentality. So what are the things they can be having that they do want to have? What? What are some really fun alternatives?
So it might be a real encouragement of, let's you know, what about this as a fun new option, let's cook this recipe together, this sounds great, getting them involved in the cooking process and the shopping process and even growing, if you're growing like herbs, or some fruits or veggies or something like that, get them really involved in the experience of food of things that they can have and that they do enjoy as well. Not just what they can have, but things that they enjoy because there's always going to be something and there's always a way to make the experience of food a positive experience in that sense as well. So I think that's a really really key one.
Anthony Hartcher 46:41
Beautiful tips thanks so much for sharing and closing that can of worms I opened. So just wrapping up I'm sure the list I'm sure there's still parts of the can's still open so how can listeners best contact you?
Nina Kingsford-Smith 47:01
Yeah, um, so my best way to contact me would be probably my Instagram, I'm on that most often and that's healthy happenings with Nina and then from there, there's also you can get the links to my website which is Nina Kingsford Smith.com.au and my email address if you want to reach out to contact me that just contacts at ninakingsfordsmith.com.au but all the details, via my Instagram and I, 've got on my website, lots of blog posts, I've got a blog post on this self-care toolkit that we talked about before, one on, like supporting body image, more information about the nondiet approach all sorts of bits and pieces and, and lots of recipes on there as well, for people who enjoy cooking, or want to get into some cooking more maybe, especially while we're going through the lockdown period, they might enjoy that. So yeah.
Anthony Hartcher 47:55
And I second those recipes. I've seen the post pictures of them and I've actually seen her eat them and I always get jealous, they get it. You know I love some of that. So thoroughly recommend you check out Nina's website, I'll incorporate all those links in the show notes so it's easy for you to access, and thanks again I really appreciate the insights, you've given us all the great tips and fleet and the third episode actually, I haven't done three episodes with anyone so there's always a first.
Nina Kingsford-Smith 48:31
Thank you, thank you for having me back. It's always good chatting with you, I always really enjoy it.
Anthony Hartcher 48:35
Awesome and it seems fitting it's the first birthday and we've covered in another first today so yeah and thank you, listeners, for tuning in for the first birthday episode and for being so supportive of Me&My health up throughout the year, we will certainly continue to provide more insightful information around health and wellness in the years to come. So stay tuned for more insightful episodes of Me&My health up.
Transcribed by https://otter.ai