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Exploring Early Onset Eating Disorders and Diet Culture with Heather Baker from Prosperity Eating Disorders

• Hatch Compliance • Season 2 • Episode 7

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Could societal pressures and social media be sparking eating disorders in children as young as 10? Join us on Hatching Creativity as we explore this alarming trend with Heather Baker from Prosperity Eating Disorders in Virginia. Heather brings her wealth of experience to our discussion about the early onset of body image issues and the devastating impact of generational diet culture. We promise you'll gain a deep understanding of the multifaceted relationship between trauma, genetics, and societal influences in the development of eating disorders. Heather will also shed light on the comprehensive treatment programs at Prosperity Eating Disorders that help young individuals navigate these complex challenges.

Together, we shatter common misconceptions about eating disorders, such as the misguided notion that those affected simply dislike food. Heather explains how binge eating often stems from a troubling cycle of restriction and guilt, magnified by societal norms and media portrayal. We also discuss the prevalence of eating disorders among both males and females, challenging stereotypes and highlighting the importance of awareness. For parents, coaches, and concerned individuals, we offer invaluable advice on how to communicate effectively with young athletes exhibiting signs of disordered eating. Tune in for resources and guidance from experts like the National Eating Disorders Association and the Academy of Eating Disorders, ensuring you have the tools to support loved ones through their journey to health.

Speaker 1:

Welcome to Hatching Creativity. This isn't just another behavioral health podcast. This is the place where thought leaders converge to talk about real-life challenges, breakthroughs and pivotal aha moments. Hey everybody, thanks for joining us today. I'm really excited for today's guest, heather Baker from Prosperity Eating Disorders in Virginia. This is a topic that I've wanted to discuss since we started Hatching Creativity and I'm really excited to have Heather here to talk about this with us. Heather, could you give a brief introduction about yourself and Prosperity Eating Disorders?

Speaker 2:

Sure, I am a social worker, a licensed clinical social worker, and about 15 years ago I started working with people with eating disorders. I was the only one in Northern Virginia that actually was treating eating disorders and it was just a desert here. So I joined up with a family therapist and a dietician and we started treating children and teens and their families in this area, and over the course of the last 15 years we've developed a day treatment program, an evening program, two different treatment centers throughout Virginia and we've helped thousands of people from 10 years up to older adults, all types of eating disorders.

Speaker 1:

Great Thank you. Do you have people coming from other areas of the country to see you guys as types of eating disorders? Great Thank you. Do you have people coming from other areas of the country to see you guys as well?

Speaker 2:

We do. There's a lot of good programs out West, specifically Arizona, and they will send them to us and they will get an Airbnb or a hotel. Our day program usually is between six and 12 weeks, so it's a big commitment and I would say, just locally, within an hour, hour and a half drive, they'll come every day.

Speaker 1:

Excellent. One of the things I would love to get started on today, though, is talking about adolescent care, because a lot of us have kids, and when you do have a kid that is struggling, we don't always know what to do as parents, so I'd love to dig into this a little bit. On the adolescent side, and from your experience in the years that you've been doing this, heather, is there a specific age or a certain age range that you find that eating disorders tend to start?

Speaker 2:

So this will surprise you, but the ages of 10 to 12 is when I see kind of things are starting to sprout up, and it usually starts with body image. And so for females, this is typically when they're starting to develop, they're going through puberty and their body's changing and they're noticing they have women parts when they've been a kid.

Speaker 1:

Right.

Speaker 2:

And there's that transition that can be really scary, that their body is not in their control. If they develop too early, they typically get called out for it or made fun of because you look different than the other girls and some girls grow out before they grow up. People get teased for being chubby and also a lot of times parents are like oh, my daughter's getting a little bit chubby, I need to let her know to watch the sweets and watch the snacking.

Speaker 2:

And so comments start to get made or maybe you should go out and work out more, so the seeds kind of start to get planted and that's just one type of one course that could develop an eating disorder. But typically with the teenagers I work with, when I said, when did you first start thinking about your body and not liking your body? And most often they say between 10 and 12.

Speaker 1:

And this is probably going to be a question that you get all the time but are you seeing that social media has a big impact on that?

Speaker 2:

Yeah, it's interesting because I think for older adults who I work with, they're even sort of started maybe more towards late teens, early college and so and then it's just kind of getting earlier and earlier. And that could be because, say, I'm in my 40s, my generation, we didn't have social media. We had the supermodels maybe to compare ourselves to, but it wasn't, it wasn't always for body image necessarily or social media. But now that we've kind of experienced that and have allowed our kids to experience that they're getting information earlier, that's a little more adult for them to really understand. Like their logic might not be totally make sense, like as a 10 year old watching an ad for an adult right, or watching older teenagers struggle, and they're a child.

Speaker 2:

It's just things start to get planted In addition to kind of my generation. There's always been diets, right, there's carb-free diet, there's all carb diet, there was Atkins, now it's keto, like the diets just keep changing names, and so maybe it's our kids that are watching their grandparents and their parents dieting and talking about their body and dieting, and so that's more normal for them to see that. Sure, but again, it's not all the time. It's parents are usually often not to blame, where it used to be that it was always the mom's fault and they realize that that's not the case for many people social media about I'm big and I'm proud, and you, potentially, are pushing people to be unhealthy with that too.

Speaker 1:

Have you come?

Speaker 2:

across things like that too Well. So in the eating disorder world we don't believe obesity is an eating disorder.

Speaker 1:

Okay.

Speaker 2:

So obesity is not the same as like anorexia or bulimia. Obesity is typically considered a medical condition characterized by excessive body fat. This may be genetic, environmental, behavioral, psychological, right. So the obesity is the medical issue where you can be in an eating disorder, where you can be in a bigger body and be healthy.

Speaker 1:

Right.

Speaker 2:

Right, but it's assumed that the average man or woman who goes into a doctor in a bigger body. The number one thing a doctor is going to tell them is to lose weight, and they might be coming in for a cold or an infection, but that will be the treatment and so there's judgment with that as well, which also is going to make people potentially swing the other direction. A hundred percent, and also if you're going to the doctors for being shamed. So we're all made with different body types.

Speaker 1:

With that said, it's pretty interesting because I go to the doctor and I'm pretty lean and I go to the doctor and my body mass. They use the BMI right, and the BMI tool will tell somebody that they're obese even if they're not, which will also create issues. It's created issues for me, I could tell you for sure, for somebody who may be going into a medical office and having issues like that. I mean, what are they doing? Are they coming up with something other than a BMI?

Speaker 2:

Do you know where the BMI was created by a Belgian astronomer?

Speaker 1:

Interesting.

Speaker 2:

Yeah.

Speaker 1:

So for those of you who are, listening if you're listening to this and don't know what BMI is the body mass index and that's where they look at people's height and their weight and tell you whether or not you where you are on that scale and use that to determine obesity. Sorry, heather, I didn't mean to cut you off I just wanted to make sure people understood.

Speaker 2:

So it was created in the 19th century. He wanted to find a way of quantifying the degree in different populations of obesity, and so his sample was a man's body, a normal weight man's body, and so his calculations were based on that. Like. This is the standard, which also doesn't make sense for a woman to be in that exact same quotient right. Or somebody who's a bodybuilder, right. So a bodybuilder who's just eaten his chicken and his rice and you know he's going to have a very high BMI, right? So he would be considered in the obesity category, right?

Speaker 2:

pretty interesting right yeah, so you can have somebody in a normal body that's got more muscle, that will be given told well, you need to lose weight because your BMI is too high. It also doesn't take into account children. Children's BMI is going to. You know, you can still be six feet tall and 13 years old. You can't equate that to an adult male or adult female, right? So it doesn't take into any of those factors. But insurance uses that to determine whether you're going to get care or not.

Speaker 2:

In the eating disorder field, somebody is sick and let's say they're bulimic or they're binge eater, but they're still in what's considered a normal body. A lot of times they will be not considered medically. It might not be medically necessary for them to be in treatment because their BMI is okay, but we know that there's greater problems with people who are bulimics than sometimes anorexics because of the purging, because of the restrictions electrolytes there's, there's so many things. So what happens if you go to treatment for anorexia or any other eating disorder? As soon as your weight gets to a place that insurance says, well, this is the BMI, you're healthy now they're immediately kicked out of treatment.

Speaker 1:

Really.

Speaker 2:

And so a lot of people with eating disorders have gotten this thing of like. Well, I must not be sick enough to get help, so there's shame around that.

Speaker 1:

How would somebody look at themselves and say, I think I'm at risk for an eating disorder, Maybe I have an eating disorder. Or as a parent to look at their children and to say is there a potential eating disorder here? Obviously, by what you're saying, this BMI is not the way that people should be gauging that. How should people be looking at it?

Speaker 2:

We don't even really look at that and we have to send it to for insurances to get treatment. You know insurance won't pay for it unless they have those numbers. I think we first look at some of the behaviors. You know what is different from how they used to be? So for anorexics and bingers and bulimics, they all restrict their food. They all start from restriction. What happens next depends If you see your child, your teenager, wanting to be healthier and start cutting back things.

Speaker 2:

This is usually the first sign and parents always say I didn't know. I didn't know Well, because I just thought she was being healthier, I thought it was good that she was cutting out some sweets. So that's typically one change that you start to see. And then it gets more and more and they cut out more food groups. Typically one change that you start to see, and then it gets more and more and they cut out more food groups. They cut out meals. You start to see that and you're concerned but like, oh, maybe it's just a phase, maybe they'll grow out of it.

Speaker 2:

Still, nothing is said. So it's typically when they go to the doctor and the doctor's like, wow, you've lost 20 pounds this year. That's significant. You weren't overweight to begin with, right? So no teenager or child should be losing weight, because their bodies are always still growing. So when you restrict, you're taking away energy from your body to grow and develop, even if your body is bigger than your peers right?

Speaker 2:

We should never diet, and so I think it's gotten too common to allow our teenagers and young children to eat healthy or follow these special diets, because it's extremely risky For one huge group of people. Eating disorders are genetic right. Just like schizophrenia is. Just like alcoholism is. You have this biological piece. What happens is when somebody starts to diet and they've lost a certain amount of weight, their chemicals change in their brain and then something clicks in their brain and it doesn't click back. So they become more obsessive, they become more focused as they continue to lose weight, there's more anxiousness, there's more depression, and your brain is just telling you that it's your body's problem and your body can fix it.

Speaker 1:

Do you find that so, like for substance use disorder and and a lot of other kind of disordered behaviors, right, we see that you're at a higher risk if you've suffered trauma, as as a child. Is that something as a parent maybe to kind of be cognizant of as well, that if your child has been through that that, maybe that could potentially be a factor there?

Speaker 2:

I don't know the latest research. It used to be 50% of people who had an eating disorder also had trauma and I think we used to think of trauma as more of a we call big T trauma.

Speaker 2:

you know, being raped, molested, war things like that. What we're finding now is and you love to talk about attachment is when certain traumas happen it affects how we see ourselves, our safety, our protection, being bullied. I would say eight out of 10 of the clients in my program have been bullied. A lot of them have some level of autism, asperger's. They have a hard time connecting socially. So maybe if I'm thinner, maybe then I can fit in. So a lot of poor social skills. So I can control my body, but I can't control my personality or my social skills. And again, nobody chooses. You can't choose to have an eating disorder. I mean, half the world can die and nothing happens. They don't develop one. And then a certain population if they diet they lose some weight, their brain changes.

Speaker 1:

Yeah, this is really helpful for parents to be looking at some of these factors and, kind of, as a parent, also looking at the way we're talking to our kids about ourselves and about other people as well. You know, sometimes you hear people make comments or judging other people, things like that. Kids always hear that stuff. That's definitely a thing that we want to be careful of as as parents.

Speaker 2:

Well, say, you have the trauma and you have the genetic and you start to lose some weight, because I'm just going to take out some things in my diet. When you start to lose weight, how many times is somebody going to say to you wow, you look great, have you lost weight? Yep, and then boom, okay, that feels good. I can keep doing that and it becomes addictive.

Speaker 1:

Then it becomes how much can I get down to? It becomes how much can I get down to? You know, when you start looking to the scale, you start to look at those things and go if I look this good at this, what's going to happen if I'm down to X amount of pounds? Then it really just becomes a challenge for some control over that.

Speaker 2:

The most common eating disorder is actually binge eating, where most people, when they think of an eating disorder, they think anorexia.

Speaker 1:

So how would you define binge eating? Maybe for people who are not familiar with the term or haven't really given it, thought so the most common answer I get from people when I bring it up is well, I could never have an eating disorder.

Speaker 2:

I love food too much, and I usually just want to say something or do something when they say that, because people with eating disorders like food. You know, it's not like their taste buds are different, but there's a fear around food. There's shame around food. It might feel sinful in some way and then you got to repent in some way, right? So with binge eating, it always starts with restriction. I'm not going to eat much today. I might not eat at all today. But then I get home and they've either planned it it's either not planned, but they feel out of control where they start to eat and they can't stop eating, even if they wanted to. And they don't stop eating even if they feel full, and over time they have lost the ability to feel full or feel hunger. Right, they know when to stop and actually feel sick. So some people will tell me this is the only thing.

Speaker 2:

I get to look forward to this is the only like bright spot in my life is this food. And they have this relationship with food and it calms them down or it gives them some pleasure, right. But then the next day I feel so guilty and I feel kind of sick and so I'm not going to eat today.

Speaker 1:

What I like about what you're saying is that hopefully, people are listening to this and going hey, I've dealt with this before and this I'm not the only one, right, other people have have seen this, have felt this, you've seen this before. People are not anomalies or weird or broken because, right, they have these problems around consumption A lot of us have disordered eating, you know?

Speaker 2:

and maybe how can we not? Because every time we turn on the TV, open a magazine, turn on social media, there's a diet. What is the Groupon? You know? I used to look like cheap fighting how to get my nails done really cheap there. Cheap fighting how to get my nails done really cheap there.

Speaker 2:

So I pulled it up and every one of them was a different ozempic or injection to lose weight, and that's the latest thing now and it's everywhere you go. So it's turned from let's do all protein to let's inject ourselves, and all our worries are going to go away. Now you're going to be healthy and you're going to be skinny and life is going to be great. But you stop taking it, you gain your weight back.

Speaker 2:

That's how all the diets work right Pretty much 97% of diets fail, and that's why it's one of the biggest industries, right? Because they know it's going to fail. That as soon as you stop the diet, you gain the weight back. Plus, because you've affected your metabolism in a way. Now you're more, now I've got to find another diet that's going to work, and over and over and over, and that's also why people get bigger over their lifespan.

Speaker 1:

Right, kind of the yo-yo. They would say Something else that's pretty interesting, something that I've learned not that long ago, is that the United States is the only country that allows pharmaceutical companies to advertise on TV or on the radio or on billboards and that kind of sets people up right there. We're just sending these messages over and over again and confirming those messages. You know we want to be aware of brainwashed. It can definitely be problematic. You hear eating disorders discussed so much more frequently around girls, around teenage girls or preteen girls but at the same time there are a lot of eating disorders in males. I know if you Google eating disorders, males versus females, you're going to see usually like three to one, female to male. But from your experience in the years actually running treatment, do you see those same ratios or do you see it different?

Speaker 2:

I would say in my current program, right now, three out of 10 are boys. It's occurring more and I don't know if parents are wiser. Now know what to look for. You know it's, it's pretty shameful. It's a girl's disease. There's all these stigmas around it, right? Or boys are athletes, so that's why their heart rate's low, that's why their BMI is low. Right, they're just a good athlete. So many times where a kid has anorexia, bulimia and they have a really low weight and a low blood pressure, the doctors just dismiss and say you're fine, right?

Speaker 1:

Or even doctors are contributing to that as well.

Speaker 2:

All the time. And, granted, they don't have mandatory training for eating disorders. I think the last I checked they had to get basically like one CEU or two CEUs and all their training in eating disorders. So the majority of them are not knowing, don't know the signs, don't think to even ask on a regular checkup of tell me about how you eat. You know, maybe do a 24 hour recall. If I could think about any of the boys that have my program now, they'll say well, I go to the gym three hours a day, an hour in the morning, hour, in the afternoon hour, in the evening. I eat six eggs for lunch and I do steak for dinner.

Speaker 2:

And what might the doctor think of that? Would he praise him? Wow, that takes a lot of discipline, or man, man, that seems kind of excessive for a 15-year-old boy. Then you get his blood work done and his labs are crazy right. You give him an EKG and he's got arrhythmias. And even then we had a cardiologist argue with us just a couple weeks ago, swearing that this kid was fine. We brought him into our program. He had a heart rate of 43, which you want to rush somebody to the hospital for that. And we we did? We sent him to the hospital day one, even though the cardiologist swore up and down and pressured us for us to take him.

Speaker 1:

Really. So what happened in that situation? The cardiologist was saying I have 43. Is is normal for an athlete.

Speaker 2:

He's totally cleared to come to your program, which is my program's, an outpatient program. They come eight to three every day. It's not residential or hospital. My program. We don't have a medical doctor or a nurse on site because we have to make sure they're medically cleared first. They have to have more normal of a heart rhythm, good vitals blood paneling that you know, shows that there's nothing too off. And the reason why we want doctors to sign off is one, so we're not liable if something happens. We don't want to take kids or adults that are sicker than we can treat. Most of them don't want to go to residential. They would rather do my program, but it's unethical for me to take them if they're not well enough.

Speaker 1:

I'm curious. What we see is this disparity in males versus females in the eating disorder treatment. Do you think that the actual eating disorders is much more even and it's just not as much reported in males?

Speaker 2:

I don't know if it's going to be even, but I think the lack of reporting because of the stigma, because it's a girl's disease, because you know, whatever the reason, or they're misdiagnosed, not taken to the doctor, the doctor misdiagnosis, that's probably more high, for sure.

Speaker 1:

So more of a misdiagnosis or an overworked, or Well, there's praise for praise for guys.

Speaker 2:

Who are these super athletes? Right? Look how dedicated you are to this diet you're on and look how hard you're working out. It's different. You need to get bigger, you need to get leaner, you need to get stronger. So the pressure to look more like a man, so to speak, is very strong. Or for a female it's to get smaller. So different pressures that can lead to the same result.

Speaker 1:

We saw something really interesting pretty recently. My middle son is 16 years old. He's on the wrestling team in high school and when I was in high school the wrestlers were losing 20, 30 pounds for a competition and they would really restrict to get ready. And what they're doing now in the high schools which I think I really praise them for this is they're doing a weight a couple times a year, that they're weighing the students and you cannot compete in a category that's more than like 10%. There's a percentage in which you can't go above or below from this baseline weight to make sure that kids are not just going out there starving themselves and then showing up to compete.

Speaker 2:

There's certain sports where you need to be a certain weight. So we see a lot of people who do crew and, you know, do sports where it's around. That not necessarily how you look right, but you've got to make this weight and there's a lot of pressure in that. So I think any sport where you have to change your natural given body to be a certain, be able to do certain things, it's going to make you try to change your genetics. You're trying to change your biology. It's going to be the same thing as somebody who's six feet tall trying to be a gymnast and shaming themselves for being that tall.

Speaker 1:

On our next episode we're going to be talking about athletes and things for athletes to be looking at and parents of athletes to be looking at, wrapping up the conversation on adolescents and parents and what we should be looking for and kind of how we should be communicating with our children. You mentioned some of the warning signs, some of the things to look at. How would you approach your child if you think that they may be at risk for having an eating disorder or if you're kind of seeing some disordered behavior? What conversation do you have with your kids about that? And then how do you approach it kindly, without judgment?

Speaker 2:

A lot of empathy and validation. So if you start to see your child reducing their food intake or taking out whole food groups, just to say, hey, I noticed that the way you're eating is changing a little bit, can you tell me about that? A bunch of my friends are trying to lose weight, so I'm going to do it with them. We're kind of doing it all together. Okay, it sounds like you're getting some peer pressure to do this, but let's talk about the effects that this is going to do to your body. So it usually starts off in some way that what's happening in society, what's kind of normalized, and it's good to start to have a conversation around that.

Speaker 2:

Sometimes it starts to happen the more the kids start to feed themselves and having less structure around food and parents don't notice what the kids are eating, not eating, especially ages 13 up.

Speaker 1:

Right. They're more independent and potentially not being looked over as much. You know, we talked about all the places that people are potentially getting bad information. Do you have any recommendations of websites or places that people can go to get good information on eating disorders as a child or as a parent?

Speaker 2:

Well, I could tell you what not to do. First is anything that talks about weight loss. There's also what people call pro-ana sites, so there's sites that tell you how to have an eating disorder, trick your treatment providers or trick your doctors. So there's a lot of stuff out there like that too. So, really honing in on what you're searching for, so being aware of where your kids are getting information from. So if they're looking to get more healthy, then we want to look at holistic you know how to increase your energy, how to get more fruits and vegetables in your diet, things like that versus weight loss. And I think that's that's true for adults too. I have three teenagers. Every once in a while, I'm going through and seeing what they're watching, what they're watching on youtube and tikt. Going through and seeing what they're watching, what they're watching on YouTube and TikTok, and just seeing what they're searching does all these algorithms. So what's popping up for them? And just educating them on that.

Speaker 1:

What would you recommend in terms of how to find good treatment? You know, just like everything in this world, right, you're going to have the good players and then you're going to have the bad.

Speaker 2:

National Eating Disorders Association or the Academy of Eating Disorders. They have some really good information. Nida, the National Eating Disorders Association, actually has sites just for coaches, just for parents, for doctors. So a lot of resources, free support groups out in the areas, edreferralcom, so it's nationwide. They might even have international, so they'll have treatment centers. They'll have therapists, dieticians that specialize. A lot of people who might have eating disorders go to say, okay, I'm gonna go see a dietician and the dietician really only knows how to do weight loss or specific ways to like, if you've got diabetes, how to help. It's actually the opposite advice of somebody who's a registered dietitian who specializes in eating disorders. Our framework is all foods fit health at every size, right? So there's no shaming or blaming. You can be healthy eating all food groups. You can eat a Snickers bar. It's like. None of that is gonna make you unhealthy, right? Just like eating an apple doesn't make you healthy, eating a Stengers Barn doesn't make you unhealthy.

Speaker 1:

Heather, this was great. I really appreciate you taking the time through this and I'm looking forward to the next one for sure. Absolutely. Thanks for tuning in to Hatching Creativity. We appreciate your support. Please don't forget to like and subscribe and tell all your friends about the show and remember it's never just about one thing.

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