66. Navigating the Hidden Struggles of Midlife Eating Disorders with Nicole Cristina

When you think of eating disorders, do teenagers immediately come to mind? You might be surprised to learn that midlife women are equally, if not more, vulnerable to these struggles. Psychotherapist Nicole Cristina joins me to unravel the complexity of eating challenges in midlife, addressing the life transitions that often act as catalysts. 

Our conversation explores beyond the stereotypes, inviting listeners to understand the nuances between eating disorders and disordered eating—a distinction that could be closer to home than many realize.

Imagine trying to hold back the ocean with a broom. That's how it can feel for midlife women grappling with the need for control amidst menopause, caring for aging parents, or adjusting to an empty nest. In the episode, Nicole and I navigate this storm, discussing how the guise of dietary control can quickly become a slippery slope toward disordered eating. We share an honest look at the seductive simplicity of restrictions and the grief that often fuels the need for control, all while sparking a rebellion against the ageist norms that can shackle our self-image.

As our discussion culminates, we paint a vision of food rebellion—a world where calorie counting takes a back seat to enjoying a variety of foods and embracing life's pleasures. We celebrate resources like "Intuitive Eating" and "Body Kindness" for their wisdom in guiding us toward a more balanced, fulfilling relationship with food and self. Join us as we call for compassion and kindness, drawing on the teachings of experts like Kristin Neff, to support those embarking on the tumultuous journey through midlife and beyond.

Where to Find Nicole Christina

Nicoles Website, click HERE 

Find Nicole on IG HERE

Nicoles Podcast, Zestful Aging HERE

Books We Talked About

Intuitive Eating by Evelyn Tribole

Body Kindness by Rebecca Strichtfield

Self Compassion by Kristin Neff

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Hang out with Heather on IG @greenpalettekitchen or on FB HERE.

Let's Talk!
Whether you are looking for 1-1 nutrition coaching or kitchen coaching let's have a chat. Click HERE to reach out to Heather.

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Transcript

Speaker 1: 0:40

Hello everybody and thanks for being here today. Focusing on women in midlife and helping them make peace with their bodies and food is what I focus on Through my work as a nutrition coach, cooking instructor, and especially with this podcast. I am on a mission to dispel myths and secrets by talking out loud our stories and beliefs around food. So today I am talking with Nicole Cristina, who is a psychotherapist helping women with eating issues in midlife. Eating disorders and disordered eating are not relegated to teenagers and, as an interesting fact, most disordered eating rears its ugly head in relation to estrogen when we are going through puberty and when we are losing estrogen in menopause. Nicole and I set down to get clear on what an eating disorder is versus disordered eating, why there is a sharp increase in midlife, which has so much to do with control in our lives and how to make peace with food at a time when so much might feel out of our control. I really look forward to you listening to my conversation with Nicole. I know you will learn a lot and if you feel you grapple with making peace with food, you will know from this conversation that you are definitely not alone. So take a listen, hi everybody, and welcome back to the Real Food Stories Podcast.

Speaker 1: 2:03

Today I am with Nicole Cristina. Nicole is a psychotherapist with 32 years of practice under her belt and she has a specialty in eating disorders. Nicole is on a mission to educate people about eating disorders, which are definitely on the rise, especially in women in midlife. So welcome, cristina. I am so happy to have you on the show today because I think this topic is incredibly important. I see it with a decent amount of my clients and I see many, many women who are in midlife and I know that women are going through so much in midlife. We are empty nesting, we have aging parents, we are going through the whole menopause transition and a whole bunch of body image issues that go along with aging. So I'm glad that we can just talk about this today. It's really a goal of mine to make this less secretive and more talked about. So I wanted to first distinguish, because I know that there's a difference between eating disorders and then disordered eating, and I want to just start off just to get clarity on that, because I think that's important.

Speaker 2: 3:28

Yeah, there's two sort of ways to look at this. Do they meet criteria through the DSM, which is the Bible of mental disorders? But my way of thinking about it, after doing this for a long time, is how much is this taking up rental space in their brain? How much is this really causing problems in their daily life? And I think that's kind of more an important way to determine this right. And the DSM is a fine starting point. But what we know is that people really jump in different categories. It's rarely like, oh, they meet criteria for anorexia or binge eating disorder and that's the end of the story. Many people will go into one into another, depending on the phase of life. So it's not as cut and dried as this statistical manual would have us believe. What I really like to assess for is is this causing you to not go to social events because you're anxious about the food? That's the kind of thing. Is it causing you to think about every morsel you put in your mouth? Is it causing you to exercise even if you're injured?

Speaker 2: 5:00

I had a client many years ago who actually was in med school at the time and we had to think about whether she could continue in training, but she would walk before her classes, which are already, as we know, quite demanding 15 miles. She would wake up and walk part of this highways in the dark with her golden retriever. After a while the golden retriever did not want to walk with her anymore because his pads were getting really abraded. That's a really good example. This is starting to boss you around and starting to become a problem in that it's so compulsive You're doing things that are really hurting the rest of your life. Of course she's exhausted. She can't really focus and concentrate on her studies. She's walking on an injury now, so she's causing further damage to her body. That's a really good example of when we know we are in big trouble.

Speaker 2: 6:15

One of the things you asked me how do we think about eating disorders and diagnosis? And then there's disorder eating, which is what we would call subclinical, is they're now at Renfrew, which is the gold standard for eating disorders in our country. There is a track just for midlifers. We know and they talk about a substantial increase in midlifers who are coming and who need focused treatment because of their phase of life. There's disorder eating, which means more you're dabbling in it, but then there's eating disorders where it's taken over your life to a degree that it's become it's like if you're partnered up or married. It's the third party in your relationship and actually becomes your primary relationship.

Speaker 1: 7:12

That's interesting, yeah, that it takes front and center with who and whatever you're doing and living your life. For me, with the women that I see, I think some of the things that I've heard over the years are I mean, every woman that I see has been on and off diets they almost they can't figure out how to eat normally quote normally without being on a diet. I mean they don't know how to if they're either on the diet or they're off the diet. They typically tell me that when they were younger they had an eating disorder. There's some obsession with eating clean or not, eating certain food groups, or being afraid of fruit or carrots or just vegetables and whatever food group of the moment. Would you describe that as disordered eating? Does that go into the disordered eating category or is that just? It almost seems like that is just normal, in a way that we're all supposed to be fearful of food and we're supposed to question things and we can't just enjoy food.

Speaker 2: 8:30

Yeah, I think you're making a great point that disordered eating has become kind of normative right. If you say to a group of like, if you go out with women, I'm not eating carbs, nobody says why, what do you? What? That sounds really weird. Or I'm not eating whites, I'm not eating white sugar, I'm not eating white flour, nobody blinks an eye. If it used to be before.

Speaker 2: 8:58

Most of many of us are remote here by the water cooler and you hear I was really good this weekend or I was really bad this weekend. What does that mean? I had a piece of birthday cake. Nobody says what are you talking about? Eating's not a moral issue. You weren't a, of course, you had a.

Speaker 2: 9:18

So I think your point is well taken that over 30% of people who are 50 and over have eating disorder symptoms. So I think it's fairer to say that most of us, as you noted, are pretty confused, and particularly around premenopause, menopause and postmenopause it really gets heightened because now we may Our bodies change and if we have daughters, the timing of nature is really cruel in that our daughters are blooming, their skin is full and glowing and all of a sudden we're like what's this stuff? It doesn't look the same, but we really, our bodies, have been around on the earth for 50 years. That takes a toll, even if you wear sunscreen, so that's bad timing for many women who have daughters. The other piece that you mentioned a lot of the things that we're grappling with. The other thing is our mortality. I mean we're seeing our loved ones, our parents, who are. They may be starting to fail, they may be ill. We may be taking care of them and once our parents die, we know we're next. I mean, we can pretend, well, I still walk five miles a day and I eat a lot of kale, but we do know we're up next.

Speaker 2: 11:04

And it's a great distraction because it makes everything so manageable. It's like, okay, I don't eat white rice, all right, it gives you a little ecosystem and in some weird way it's a very elegant solution to being overwhelmed with the world and the grief that is all around us. It's sort of and I say this ironically, but it is sort of a perfect solution. The problem is it has tremendously negative side effects, but it really makes things controllable. It makes things simple, it's clear, it's manageable. Who doesn't want that in a world that Well? I live in upstate New York. In the summer we were getting and you might have too from Connecticut the wildfires were turning the sky's orange. I mean I felt like I was in a post-apocalypse. It was the most. I felt like I was on another planet. That is very disturbing, and if you don't have other coping skills, boy, it certainly makes sense. Just to say I'm not going to have toast for breakfast.

Speaker 1: 12:29

That is such a good point. I love that. That, with all that's going on with women in midlife, with aging parents, parents dying, feeling like we're next really questioning our mortality, looking at the younger generations, our daughters or sons, and just knowing that you're not going back there, right. And then we're in menopause and I get the number one line I usually get is I just look at food and I gain weight and it all feels very, very out of control. Suddenly you're not full of your body. You can't just skip a couple of meals and lose five pounds.

Speaker 1: 13:13

Walk a couple extra miles. Walk a couple extra miles, and so I think it is something to feel like you have control of in a very out of control world. So if you fast, if you just get rid of dairy, if cut out gluten, you're feeling like something feels that you can have control over.

Speaker 2: 13:38

It's so seductive. I tell people this is over-determined, especially if you have a trauma history and I don't know if we want to go down there. The other piece and I don't bring this in often, although in my podcast I talk a lot about it but we're living in a grief-illiterate society. So now we have all of this grief around us daily, right, so much grief, and we don't really know how to talk about it. We don't really know how to talk about death. So now we're left with these feelings that we don't know what to do with and that just sort of fuel on the fire, fuel on the fire of boy.

Speaker 2: 14:22

All I need to do is focus on how many carbs, how many grams of this, how many cups of this? Who wouldn't? You know? It's so easy to get sucked into and then, before you know it, the diet is controlling you and that's what we see, and I'm sure you know, in your line of work. It all starts well in tension. Nobody wakes up. No woman wakes up and says I want to have an eating disorder. Nobody wants that. It's all well in tension, like, well, let me see if I could cut out fruit or bananas are high in sugar, so no more bananas. You know I have real compassion for people who are just trying to figure out how to live a life with peace, and you know some sense of calm.

Speaker 1: 15:17

So it does give you some control, right in a world where, like, there is so much going on and you know, there is a lot of grief, and there's a lot of grief over our aging bodies, right, I mean, it is just, I think, for some women, the ultimate loss of control.

Speaker 2: 15:35

Thank you for saying that, and I find that the more you've gotten attention for your physicality. Boy, that's a hard one. I have a friend who I don't know if people will remember Isabella Rossellini. She was an Italian actress and in her prime she was just gorgeous. This woman looks like her and, of course, not so much anymore. And she was conveying a story to me where she thought a man was looking at her in the grocery store and she felt really like, wow, that hasn't happened in a while, doesn't that feel nice? And she was kind of basking in that attention and then realized he was actually looking at the woman behind her. Yeah, that's what we're dealing with.

Speaker 1: 16:24

That's. I love that example of that story because there is grief around that. You know that we're not going to be youthful, and especially in a world that reveres younger women, and you see it on social media all the time. I don't know if you ever follow older actresses or models and they are just doing everything in their power plastic surgery, whatever to look as young as possible, and that's the standard then we have to hold up against, and that is a lot of pressure that we can't in our society just say we're aging and it's okay. I have a couple wrinkles on my face, can't do exactly what I used to do, or maybe my body doesn't look like it did when I was 25, and I think there is a lot of grief around that.

Speaker 2: 17:28

Absolutely. I think you've said it beautifully. In fact, you know, as you were talking, I was thinking to age. In a way, that's not apologetic. You kind of have to be rebellious, like, yeah, this is what I look like, I got wrinkles, I got whatever. You know, my skin isn't, all, you know, tight like it used to be, whatever tone, and that is what I, that's where I'm at, and I think you almost have to be sort of spunky about it and like, you know, if you don't like that, don't look at me, or something like that, because otherwise you're gonna be really suffering.

Speaker 2: 18:16

Now there's a whole new wave that I, you know, I highlight in my work of women who are older and like yep here, you know they are all about I am a warrior and I'm doing this. I'm traveling here, I'm going into prisons, teaching hospice, I'm, you know, getting snakes out of the Everglades, you know. So I, you know, I have a bit of a balance because I'm I'm constantly talking to people who are like I wear sunscreen, I don't spend two hours contouring my face with different color, you know. So I have a bit of an advantage. But for those women who haven't yet discovered this new group of women moving forward and really challenging ageism. It's a it's a rough road.

Speaker 1: 19:16

Tell me more about that, that it's a rough road. I mean, I I think what you're saying is that that there's this rebellion piece. You know where. We're just gonna like screw it, I'm gonna enjoy food, I'm going to just get some wrinkles on my face, not gonna be obsessed with plastic surgery. You know that, yeah, that is like a minority and that does appear very rebellious. But I think what I'm hearing you say too is that there's a almost like another camp of women yes that are like I'm gonna go like live is is.

Speaker 1: 19:53

Is that a good thing or is that? Well, it depends on how you how you want to live.

Speaker 2: 19:59

I mean I. What I'd like to say about this whole thing, about you know and it sounds like you're almost asking, like how do we not get into crazy food stuff is I think we really want to discover our values at a deeper level, what really makes us, lights us up, and focus on that, and that's a really nice balance. To gee, my pants fit weird or different, or I have to buy bigger pants, or you know, I am not gonna wear a bikini or whatever. That like you can't just kind of cold turkey, you know, no pun intended, but you can't just pull that away and then say, oh here I am, nothing to focus on. What I would suggest is what would feel filling and nutritious and delicious. That is not about food. And then the food choices become less intense and worrisome.

Speaker 2: 21:12

Right, because if now I am knitting prosthetics for women who have had breast cancer, that fills us up in a different way. That gives us a sense of purpose, a sense of meaning, maybe a legacy. And now it's not all about am I gonna eat the bread on this hamburgers? Whatever? Am I going to allow myself to have the cookie? It's we're sort of trading one purpose for another, and it doesn't necessarily mean that you're never going to say, wow, there's too much fat in that I don't know what dessert. But it becomes a different kind of life. It becomes, I would argue, you know, a more substantial life. To say what, what do I have to contribute? What have I always loved to do? What? What makes sense for me? Why am I getting out of bed in the morning at this point? I've had my kids, I've had my career, I'm at the end of my career. What is the point? And I think answering the question what is the point now really helps with the food obsession. I'm not saying it's perfect, but it's a really good place to start.

Speaker 1: 22:40

Yeah, I can definitely see that, you know, because I think this is a time in midlife where women are really questioning like what is my next move in life? Like what am I doing? You know what's my purpose? What am I doing? Yeah, why am I here?

Speaker 2: 22:54

And these smart women? This is exactly it. I mean, I see a lot of teachers in New York state. They can retire pretty early, so they have given everything to their teaching career. You know, just, you know, call it in right, they're grading, they're coming to all this stuff after hours. They've raised their family and now they're like I have no idea. And I'm like, wow, you're a smart, competent, thoughtful woman. They look at me like I literally don't even know where to start, and so we start really small and I will ask them what is the eating obsession doing for you? How does it help you? And that's a different way, right, like we used to, back in the day, say you should not do that. That's very bad for you, that doesn't work, and they already know that. So what I say is I can see why you would like this, given where you are, and really try to have compassion and understanding for what makes this so seductive. Of course it makes sense.

Speaker 1: 24:10

Yeah, yeah. Well, I mean, and we talked about the right, the control right that that disordered eating might have in your life when, yeah, you retire and you're like, oh, what am I doing for the rest of my life now? And it seems so big and overwhelming that scary yeah, yeah.

Speaker 1: 24:30

And scary. And I think, on my end, as a nutritionist, I try to get women, I try to teach women how to just make peace with food and joy. Food is to be enjoyed, food is meant to be enjoyed. Now, that doesn't mean that we want to go haywire with it either. I mean, because we have health issues to consider and we want to eat healthfully. We don't have to go to those outer extremes of clean eating and you know and whatever that means.

Speaker 2: 25:08

I mean, like when you're pulling whatever that means, the garden it is not so clean, right?

Speaker 1: 25:15

Exactly Right. Things are dirty in this world. But, yeah, I know, clean eating I'm trying to think of the other like terms that have come up like over the years about you know, but it's like clean eating or you know, just eating, eliminating things makes it more clean and without any thought that if I eliminate all carbs, you know, then I'm like I'm that's not healthy.

Speaker 2: 25:46

Grouchy Right Grouchy. I'm moody, I can't make serotonin.

Speaker 1: 25:51

Exactly, right, exactly. And I suggest you know for women, after you know, maybe hearing this conversation, if they think you know what I do have, I think I do have a problem or I'm definitely something's getting out of hand for me. What's the first line of resources books to read, people to see things like that?

Speaker 2: 26:19

Well, you, won't be surprised to hear this. Helen Tribbley is a person with her co-writer wrote a book many years ago called Intuitive Eating and it was just like a new concept. People were like, what, how does that? What are you talking about? And they've revised that book Now I lose track of times. A couple of years ago I actually interviewed her and I would steer people toward Evelyn Tribbley as T-R-I-B-O-L-E and she has a website and she is a firecracker. I mean, you talk about diets and just steam comes out of her ears. I really, really love her and I know you do too, so I would look her up. The other person I really like is Rebecca Schitzfield. Could you correct me? I always have trouble with her name. She wrote a book that Body Kindness and she has a podcast.

Speaker 1: 27:24

Yes, I know exactly who you're talking about. Yeah, I have such a trouble.

Speaker 2: 27:28

I interviewed her as well, but if you look at her book Body Kindness, there's hundreds, probably thousands, of books on this subject. Right, I really. Those two stand out for me in the last few years. I would say these are my favorite. National Eating Disorder Association is NIDA N-E-D-A. You can go on their website.

Speaker 2: 28:00

People as we talked about, like the rebels in the aging world, there are also rebels in the eating world saying I am too smart and too competent and too wise to waste all of my talents and energy on how many carbs I ate.

Speaker 2: 28:15

I have too much to offer. I have, let's say, a third of my life left, or half of my life left, and damn it, it's not going to be all about worrying if I had a cookie or not. So there are podcasts and there are certainly books, there are online groups and if you go to Google and do intuitive eating, you're going to find a lot of these resources and it just makes life more balanced and I think you alluded to just so much more enjoyable, because we have to eat and if we can really enjoy it, it doesn't have to be like oh, this layer cake is delicious, which it may be, but so's a fresh salad with roasted beets and goat cheese. I mean, you know like that puts me in another orbit. There are things that are so fresh and beautiful to look at and delicious that you can enjoy. That will bring you such satisfaction. And then you can go on and volunteer at the library or be with your people who knit, or walk or travel, and your life will be so much richer.

Speaker 1: 29:36

Yeah, great points. I mean I think I like the food rebel Because I feel like that's almost where I am, not almost. That is where I am, definitely the camp I am in.

Speaker 1: 29:49

And that I just don't give food I mean I give it its place and its due but because I want to be, because my goals are to be as healthy as possible and I know that feeding myself with really good, healthy, nourishing food is my first line of defense for that. But that doesn't mean I'm on a diet. It doesn't mean it doesn't taste good.

Speaker 2: 30:17

A healthy salad I mean a beautiful salad can be absolutely delicious and I crave that, yes, I think the other little dirty secret which people don't want to hear is that you're eating is not the first indicator of how well you will age. We all want to believe that I have control over getting ill, I have control over bad news. It's like number three or four. The first one is, as we know, it's human connection and bonding and having loving relationships, platonic or otherwise. So we may be deluding ourselves to say, if I eat asparagus all day or kale, I'm really doing myself a favor, maybe, but there are other things to bring into your life that would be even better if you are looking to age well.

Speaker 1: 31:18

Absolutely, I think that food in my world I'm a culinary nutritionist, so in my world I'm in the world of food, but I totally agree with you that food is not the first line of defense against healthy aging. I mean, there's so many other things that are really out of our control.

Speaker 2: 31:42

Just our genetics alone.

Speaker 1: 31:43

our environment, our social connections, I mean there's a lot that also goes into it.

Speaker 2: 31:51

That's the messy truth, right? We wish we could sort of boil it all down to well, I never eat red meat. I never eat anything that's not organic. Wonderful, it's much more complicated than that.

Speaker 1: 32:05

Absolutely yeah. And I wanted to just say too, I love these books too Intuitive Eating by Evelyn Trebley and Body Kindness.

Speaker 2: 32:15

I think it's Skitchfield, I know just that. Yeah, actually.

Speaker 1: 32:20

I'll put that in the show now. It's just so people. That's great and I think in a world where there are thousands of books out there on diets and eating or ways to eat and ways to live and eat, and it's just dizzying and I think, to go back to these classics, not get caught up in because you could really go down a rabbit hole of resources and everything. So I think these two are just like classics and really great first steps, I'll add one more just to make it more.

Speaker 2: 32:57

I'm a big fan of Janine Roth. Now she's kind of veered off, but she had and I am dating myself a CD, and I don't know if it's an audio download, I don't know if you'll know what I'm talking about. She starts at saying I'm assuming you have just binged. That's where we're starting. Do you know the one I'm talking about?

Speaker 1: 33:19

I don't know if I know the specific CD, but I do know Janine Roth and I definitely used to follow her.

Speaker 2: 33:24

I haven't really connected with her in a while, but if anyone has a chance, I would also recommend her.

Speaker 1: 33:33

Great to know that she is a name from my past, but still. I mean really, I think one of the first people who set the foundation for me in regards to eating issues or just the emotional eating behind food. So, yeah, great to know. Thank you for those resources. So just to end our very engaging conversation, are there any takeaways you could give to women in midlife? Just one or two. You know, I know we talked about so much today and we did. It's been a great conversation and we can talk for hours more.

Speaker 2: 34:20

I know this is a tall order and I'm saying this knowing it's a tall order, but as much compassion as you can have with what you're struggling with and you had mentioned a divorce, it's great. Divorce is a thing, reassessing our relationships is a real thing, and so if you can come at this with like, wow, I'm struggling with my kids in college doing well or not well, you know my friends are moving, my parents are aging, my dogs are barking you can hear them. You know my body's changing, wow, wow, you know that's a lot. How, what do I need right now? How can I take the best care of myself? And I'm a big fan of Kristin Neff, who does work with self-compassion, and I think that's the only way through this. You can't like diet yourself out of this Totally agree.

Speaker 1: 35:27

I talk to my clients all the time about infusing kindness and compassion into their lives at every step of any. You know their eating journeys, because we can be so filled with criticism and rules and regulations. So great final point, and I think, and then also just to reiterate that let's talk about it. That is my mission of having this podcast is to really dispel secrets and myths and shame around eating or struggles around midlife. So we're talking about it today.

Speaker 2: 36:15

Thank you for doing that, because it is a secret and it's embarrassing for people to talk about. They think, oh, eating disorders are for teenagers, not women who are menopausal postmen, whatever at this stage, this is a teenage girl problem, so I really appreciate the opportunity to bring this to light, right, well, thank you so much, nicole, for just being on the podcast today.

Speaker 1: 36:47

This has been an amazing conversation and I know my audience is going to get a lot out of it.

Speaker 2: 36:51

So I'm glad to hear that. Thank you for having me.