Change Your Brain Every Day - Eating Disorders: Are There Multiple Types? with Dr. Jennifer Farrell

Episode Date: January 24, 2018

In today’s media-centric society, body image is as big a topic as ever. In the second episode of a two-part series with Dr. Jennifer Farrell, Tana and her discuss the many different types of eating disorders, their common causes, and ways to take the first step towards healthier eating habits.

Welcome to the Brain Warriors Way podcast. I'm Dr. Daniel Amen. And I'm Tana Amen. Here we teach you how to win the fight for your brain to defeat anxiety, depression, memory loss, ADHD, and addictions. The Brain Warriors Way podcast is brought to you by Amen Clinics, where we've transformed lives for three decades using brain spec imaging to better target treatment and natural ways to heal the brain. For more information, visit amenclinics.com.

The Brain Warriors Way podcast is also brought to you by BrainMD, where we produce the highest quality nutraceutical products to support the health of your brain and body. For more information, visit brainmdhealth.com. Welcome to the Brain Warriors Way podcast. We're back, and I'm back with Dr. Farrell, and we're going to talk about eating disorders. So you are our addiction specialist, but you also deal a lot with eating disorders. Yes. I deal with chemical addictions, but also behavioral addiction, sex, gambling, video games, and eating disorders. I love that. So this is pervasive in our society. And I know, I mean, people tend to relate it to

women. I know it's not just a female disorder. No, it's plenty of male patients. But it does seem like we've got, I mean, I noticed because I have a 14 year old daughter and I see her friends and it's non-stop the talk about being thin about their bodies about not liking their bodies and one day they came over to my house and they had heard on saw on Instagram some tea that's supposed to be good for you. And it was a detox tea. It was titled, labeled detox tea. And they came over and they were making tea. And I came downstairs and I happened to see it. Now I tend to know these code words and I picked it up and I'm like, it was a laxative tea. Now they didn't actually even know that, but I'm just saying

it's so pervasive. It's actually scary. And it starts so young. And some of these girls don't even realize it. And they're like on the slippery slope before they even know it. And when I told Chloe that she actually freaked out because she just didn't know, you know, she was like so freaked out and so scared, but I saw even early on, like her, like discomfort starting with her body. And it's just such a, I hated my body when I was young. Oh my goodness. I mean, I think you hate your body until you hit 40 and then finally you're like, I don't care. Right, right. That's exactly what happened.

I hated my body. I used to like just beat myself up. And then I just remember I went through a lot of therapy. And I like, I remember just like finally one day going, I actually don't care what you think about me. Like, I just, I don't know what happened if it's hormonal or if it's finally just enough therapy. I'm not exactly sure. Yeah, age is magical for women. Yeah, it's wonderful. I wouldn't go back to save my life. Like there's no way. Not unless I could bring my brain with me to like my twenties and then I would just so that I could do it like

so cool. Like it'd be so cool. Exactly. We'd rule the world. Right. Yes. Um, but kids like younger teenagers and people in their twenties, you know, it's so peer driven and there's this comparison. And so that drives a lot of the body image issues. Now that's different than when we get into actual eating disorders, because it goes beyond even that, you know, here in California, it's a lot worse than in some other places. I mean, we just have- Florida's like that. Yeah. I don't know if it's because we're in bathing suits all year long or right by LA. So I think it's a lot worse in California than it is in other places. So there's this normal like aging and body image stuff that we all have to work through as young women. And a lot of men work through that too for various reasons, but that's different than actually developing an eating disorder. So there's a lot of differences.

There are a lot of different kinds of eating disorders. There are some that are characterized by restricting food intake. There are some that are characterized by just overeating and just diving into food and binging. And then there are some that people will binge and then they feel guilty and then they'll purge. They'll use laxatives. They'll use exercise or induce vomiting.

I did that horribly when I was young. So there's a lot of different ways of people trying to regulate. So we can't wait. I didn't even know. I have to just stop you for one second. I didn't know exercise bulimia was a thing until I went to the doctor one day and I had the flu and I'd gone to the gym. I literally had a fever and I'd gone to the gym and he was like, what are you doing? I'm like, I'm trying to sweat

it out. And he was like, and how often do you do that? And I'm like, well, if I'm stressed, I go to the gym. If I'm sick, I go to the gym. He's like, you have bulimia. And I was like, no, I don't. Like I was like so horrified, but I, I had all of the, I had all of the characteristics. That was my control mechanism, was to go sweat it out. And I hated my body and I had all those same issues. It was a control thing. Is that a common thing? It is. It is. And so it's hard to talk about eating disorders as one category because there are so many different types. And so lumping in anorexia with binge purging, with overeating, you know, it's difficult to have like one generalized conversation.

So we can have our own version. Yes. Control is a big issue. And for a lot of people, the way that they grow up, there's books written on family dynamics of eating disorders. For some people, food becomes the only way they can control. And so they regulate themselves through regulation of food because they've never been allowed to control anything else in their lives before. And for other people, overindulging in food is somehow emotionally protective. I don't know if you've

ever seen this show on cable called My 600-lb Life. And it's kind of like a documentary where they follow people who are morbidly obese and weigh, you know, 500, 600 pounds plus. And they go through their various treatments when they seek help from a weight loss specialist. And so they talk about the diet and nutrition and exercise, but when you watch, you know, my compassion just overflows because most of these people who are on there have had some really deep emotional things happen to them. And they describe food as their coping strategy. And so if you don't address that and you only say, well, you have to diet and exercise, then they're not going to be able to do that because it's not a lack of... It's not that simple. Yeah. It's not really a lack of self-control. It's really they're trying to

soothe this deep anxiety and fear. It's like drugs or alcohol. Exactly. Yeah. Interesting. That's so interesting. I know anorexia, I've always heard, is one of the most devastating. I know it kills a lot of young people in our society. Isn't it like the second leading cause of death of teenage girls or something like that? You know, I'm not fabulous about statistics because it bores me, but it's up there. And there's a lot of dangers with withholding and a lot of people who are severely underweight will also purge. So we don't classify an eating disorder based on the behavior. We classify it based on weight. So someone with anorexia is below a certain percentage of a healthy body weight, regardless of whether there's binging, purging behaviors. And so we can see with these young women, so not only are they not getting their nutrients, but if there's purging behaviors and you can have electrolyte

imbalances, you can lose a lot of potassium and that's where you can have young people having heart attacks. Right. Go to cardiac arrest. Absolutely. So it is very dangerous. Yeah. It's really scary. Um, yeah, I just, I see this, this obsession that kids have with being perfect and that scares me. It actually scares me. Like you said, I mean, there comes an age, I'm not sure if it's probably always been that way to some degree. I think it's worse in our society and especially in an internet society. Um, you know, You know, it's pretty scary. I would have died if I had Facebook when I was a teenager. Like I couldn't have handled that.

Right. It's terrible. Yeah. And I see the pictures of the young girls in seventh grade on Instagram and what they're putting out there. And it's like, wow, the pressure is insane. These girls look like they're 16. And it's just crazy what they put themselves through to look like that, you know, and to put these pictures out there. I don't know what to tell

parents to help their young girls, you know, or kids in general. What advice would you have to families to help them be grounded and not be susceptible to that? Or is there? It's a complicated question because I see all sorts of patients with all sorts of different backgrounds that come in and different family dynamics. Certainly when there's kind of a family dynamic of shame around food, then that sets people up for secretive eating or trying to hide. And so, I mean, you want to start with communication if you think there's a problem, talking to your kids about it. And what do you think about this? And what do you think about what's going on with your friends at school? And just having

conversations. You know, I treat mostly adults. I don't treat young kids. So it's hard for me to kind of jump into what you would say to an eight-year-old. And so with the adults. I don't treat young kids. So it's hard for me to kind of jump into what you would say to an eight-year-old. And so with the adults that I meet, these patterns are longstanding patterns and we have to go back and figure out, well, where did this come from? So there's kind of two approaches when I'm treating is like, well, okay, we have to treat the thing. You know, we have to look at, well, what do we actually do to treat? We need to have the right nutrition. We need to kind of go through like... Yeah, I'm amazed at how often they don't really understand nutrition. Like it's gotten so mixed up in their heads. Well, nutrition, you know, we always say at the Amen Clinics, food can be your best medicine. Or your worst enemy. Yeah. Well, because they see

food, well, they see even healthy food as your worst enemy. So when we say that food can be your worst enemy, well, yes, if you're eating curly fries and fast foods and all these things. But they see all food as the enemy. Potentially, yes. I have a good friend who has struggled with anorexia the whole time I've known her. And she had such horrible anxiety. And she called me one day and said, I'm thinking about going on medication.

My doctor said, this medication, I'm crawling out of my skin. I've been doing therapy. What do you think? And I said, well, this is the right category of medication for you. You know, I think that it could be helpful. What are your goals with it? We just kind of talk through it. And, um, she called me up, she was doing really well with it. And then another conversation several weeks later, she told me she stopped it. And I said, well, I'm curious why you decided. Did you have side effects? And she said, no, actually, it was working great. My anxiety went away.

And I stopped worrying about everything I was eating. I stopped worrying about the food and counting calories. I just felt relaxed and normal. And I couldn't stand it. Oh, she's not used to normal. Yes. I learned a very important lesson from one of my patients several years ago. Change the way I practice medicine.

She had had a panic disorder and panic attacks. And I treated her. We got rid of the panic attacks. And she called me one day from school. And she said, I haven't had any panic attacks. And she said, Dr. Farrell, I miss them. Oh, my gosh. I almost fell out of my chair.

I just kind of took a deep breath and I said, oh, and I tried to sound all dignified and not surprised, you know, tell me what you mean. And inside I'm going, what? And, and she said, you know, panic attacks are horrible. You have them every day. And she said, I'd have them. And then afterward, I'd be so relieved it was over. I could get something done with my day. She said, but now I don't have that and i just feel weird and i realized it had become her mouth became a normal and as much as our brains want change we are creatures of habit and we resist change it does and so when we're looking at whether we're talking about an addiction or we're talking about an eating disorder or something i have to take that into into consideration. I'm actually really grateful that I had this conversation with her,

that I stopped and listened. Oh, that's a really good point. Because I talked to all my patients about it. As we're going along, logically you want to change. Emotionally, your brain is going to fight that. And so when you start resisting this, we need to have a conversation of what are our goals? Are we reaching our goals? Are you fighting the goal? Are you really having a side effect? Are you really uncomfortable?

Or are we hitting a home run and you're emotionally not ready to hit that home run? You made one other point, and I just want to touch on it really quickly before we sort of wrap up, is you see adults for eating disorders. And I think most people think of eating disorders as a childhood or adolescent disorder. Women have so much shame around eating disorders. They don't reach out for help. So do men. Oh, I would think men would be worse. I think men would be worse. Because they see it as a female problem. And a weakness. And I know so many women, because they reach out to me on Facebook. So, um, I always encourage everybody keep sending me your Facebook messages, but it's outside of my scope of practice. It's not because I don't love you. If I pass you on

to someone like Dr. Farrell, or I have the call center call you it's because it's irresponsible for anybody to answer your questions on Facebook, especially if they are a nurse or a coach. Um, so I always have people send me their questions, but then I try to get them the appropriate help. And it scares me that people are just giving willy nilly advice on Facebook. It is never too late to hit the reset button in life. Right. And so it doesn't matter how long someone's had an addiction, how long someone's had an eating disorder, how long someone's been in a toxic relationship or had a pattern of those things. We can always go in. We need to set some goals and figure out what are the steps we're

going to take to start reaching toward these goals. Absolutely. And it's amazing. And I've heard so many people describe this. And I remember with my own issues going through therapy, it's like, and this is a really gross analogy, it's like popping a boil. It's like terrible, terrible, terrible till you go in and you actually do it. And then you're like, oh, it's like relief, right? Am I wrong on that? Right. That is a really awful analogy. It's awful, right? But it's true. Yeah. And the fear is often worse. It can be worse. And there is a relief in doing it. But I'd say the relief kind of comes with time because it's again, that fear of the change, that fear of getting better. But once you name it, there's something of just bringing it out of the darkness

and having a partner and walking through that with you that can be really life-changing. I love that. So this is Dr. Farrell. If you know someone or you are struggling, Dr. Farrell works in our Costa Mesa clinic. You can either call our call center or you can leave me a message below. Please leave it in my private mailbox if you're going to leave your contact information. So if you want to leave your contact information in my private mailbox, we will have someone call you back. Thank you so much. Thanks for having me. Absolutely. Thank you for listening to the Brain Warriors Way podcast. Go to iTunes and leave a review and you'll automatically be entered into a drawing to get a free signed copy of the Brain Warriors Way and the Brain Warriors Way cookbook we give away every month. Thank you.