Navigating Nutrition and Eating Disorders with Deborah Spector

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Discover invaluable insights from Deborah Spector, a seasoned dietitian with over 30 years of experience, on the complexities of food, weight management, and eating disorders. This episode covers how societal changes, including social media, influence our relationship with food, and provides practical advice on personalized nutrition strategies.
In this episode, we discuss:
The evolution of the dietitian’s role from 1990 to today, emphasizing the impact of social media and misinformation.
Key distinctions between medical professionals and non-specialists promoting nutrition advice.
The importance of individualized treatment for eating disorders like ARFID, orthorexia, and body dysmorphia.
The vital role of education in motivating sustainable lifestyle changes.
The dangers of over-reliance on medications like GLP-1s and how they impact metabolism.
The significance of balanced blood sugar management and misconceptions about fasting.
How societal issues, including family dynamics and eating habits, contribute to health challenges.
Practical tips for fostering a healthy relationship with food and body image.
The benefits of home-cooked meals and the importance of mindful eating.

00:00 Introduction to Nutrition Confusion
02:52 The Evolution of Dietetics
05:57 Understanding Eating Disorders
09:00 The Role of Registered Dietitians
11:59 The Impact of Medications on Nutrition
15:05 Metabolism Myths and Realities
17:50 Nutritional Education and Heart Health
21:01 Post-COVID Changes in Nutrition Perspectives
22:37 The Importance of Family Meals
25:45 Understanding Sodium and Health
27:02 Debra's Insights on Eating Disorders
29:20 Exploring Different Types of Eating Disorders
32:54 The Role of Registered Dietitians
35:04 Fasting: Myths and Realities
37:02 Balancing Blood Sugar Through Nutrition
39:14 Final Thoughts on Nutrition and Health

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Transcript

SPEAKER_02 0:11

Well, welcome everybody. This is Lisa Hill, and we have today on the Paul Speed podcast a wonderful guest, Deborah Spectra. You know, we hear a lot of information given to us on the food pyramid, on what to eat, what not to eat, what's best for us. And I really believe there's a lot of confusion out there. But this is a woman that's been in the industry for many, many years. I'm going to do a little bit of a background. But before that, thank you, Deborah, for joining us today on the Pulse Beat.

SPEAKER_00 0:41

And thank you so much for having me, Lisa. This is so fun. Thank you.

SPEAKER_02 0:45

Oh, absolutely. You know, again, people I think people are really, you know, struggling with obtaining a healthy weight, really, what food to eat, what not to eat. But I'm going to give our, I know it's difficult for someone like yourself that has an extremely successful and years of longevity in this industry, but I'm going to give our guests just a little peek in the background of Deborah Spectrum. Um, she's a registered dietitian, nutritionalist with over three decades of experience helping people improve their health and relationships with food. Since 1990, she's run a private practice in Camuk, New York, specializing in eating disorders, diabetes, and cardiac nutrition. So she's a perfect fit for our sponsor. Deborah has worked extensively in her community, hosting support groups, running wellness programs, and partnering with organizations like the American Heart Association. She also is an author of the book, Gotta Get the Book. Get the book. The Things I've seen people do with and without food, where she shares powerful real life stories from patients and recovery journeys. And so we're going to go into her compassion. She's going to share a little about her compassion approach to this and so on. So again, welcome, Deborah.

SPEAKER_00 1:57

Thank you so much. It's a pleasure to be here and to actually educate everybody about what we do as dietitians.

SPEAKER_02 2:04

Yeah. So maybe you can share with our audience a little bit. Has the dietitian and nutritional world changed since when you first chose to go into this field?

SPEAKER_00 2:14

What absolutely has changed significantly. Again, I started my private practice in 1990. There was no social media back in 1990 or cell phones. So I think that social media has impacted society, advertising, and what people believe or don't believe. Whereas back then, just like medical providers, which I am, if you need medical information, you go to the source of the provider. So if you have, God forbid, cancer, you go to a oncologist. If God forbid you have diabetes, you go to an endocrinologist. If you have issues with food, weight, and body image, you go to a registered dietitian. But there are so many people, Lisa, that promote health well-being that are nutrition coasts or nutritionists and really don't know any anything about the medical information that we know. Yeah.

SPEAKER_02 3:03

Well, that's a really good point. You know, I was in in medicine myself for 27 years. And, you know, I I would say our doctors at that time were somewhat healthier than some of our doctors nowadays because our food sources were different. Um, the stress was a little bit different than it is now. In addition to that, it they really didn't know, excuse me, they really, our doctors of yesterday didn't really know anything about nutrition. You know, they used to say, you know, send to the dietitian, have the dietitian come in and visit with them, you know, as I was working in the ICU. And they would come in and they would counsel them on the type of diet and so on. And so that many times is the only time that a doctor ew would mention nutrition or uh uh approach to diet or so on. So, what are you seeing today, the changes internally with medicine and its approach to nutrition?

SPEAKER_00 3:57

That's a great question, Lisa. As a matter of fact, what you stated, you know, that's being a clinical dietitian. So I worked in hospitals for for a very long time before I started my private practice. I think the problem is that most physicians, I just had a uh colleague meet and greet today, and her she's a therapist. And her biggest thing was, Deb, that why do doctors not know anything about your job and what you do and nutrition? Because they don't have medical school, it doesn't promote nutrition education, right? Just like I really don't want to know about psychotropic medication or gastroenterology, but I know the science of the stomach, the intestines, I know about medication because most of my patients are taking medication, but it's not my wheelhouse. So I think what needs to happen now moving forward in this society is that every single provider refers out to the person who's got that specialty, Lisa, because if you don't do that, we're not well-versed to know every aspect of everything. There's too much information to understand, and that's what specialties are about.

SPEAKER_02 5:07

That's amazing. What started you on the with a passion for eating disorders?

SPEAKER_00 5:15

Excellent question, also. So when I was younger, um, my family, uh, my genetic family, they all had an abnormal relationship with food weight and body image. My mom, who I love desperately, had been on every single diet that I've ever imagined from OA gray sheet, where she was back then. I don't know if you know this, Lisa, but back you're talking about the 60s and 70s, carbs are big now. People are terrified of carbs, but back then that was the biggest thing, OA gray sheet. She was on and off every diet and very obsessed with food, weight, and body image. And it brought a disproportionate role into my family dynamic. Food is very important to my family, but how as a child do you grow up in a family where there's not a normal relationship and have one yourself? So by having this specialization, I was able to do that for myself and my daughter and my son. So now I do it and educate patients about that. How do we do it? And parents. So it's it's so important because we live in a society today where we have in America too much food and too many choices, and there is too much emphasis on how we look. And it's an industry. You know that more than anybody. It's huge advertising, it's a big industry.

SPEAKER_02 6:34

Yeah. A hundred percent. You know, I had started a program for the area schools when I was working um in the hospital and doing outreach programs, and I started a program called The Best Me. At that time, it was based on what I discovered, not only as in the eating disorder um category, but also I lost one of my best friends to an eating disorder. And she was a she was a fellow, you know, she was a fellow nurse. We worked in the IC ICU together, and I watched her absolutely fade away. And she ended up passing away in our ICU. And we she was in every kind of treatment known to man. And I became very um interested and intrigued by the the challenges that people were having with eating disorders and so on. And, you know, years ago, we didn't have the emphasis we have now. And so when I would go into the schools and talk about the best me, I would ask the question about what people was anybody ever called fat? How did they see themselves? Nine out of ten of the children in the room, the boys, not hardly any of the boys. A nine out of ten of the girls would raise their hand and think that they were fat. That's right. Now, years ago, they weren't. We didn't have the obesity problem that we have today. So you're right, it's a longevity challenge, you know, that we've had. And now with social media, it's a million times worse. It really is. I mean, I just I can't imagine what some of the young, young children have to go through right now to develop a really healthy self-esteem, and like you talk about, a healthy um relationship with food. So, where do you start with someone that is, you know, having challenges with food? I know it's probably a broad question, but where would you start with someone that is maybe embarking upon this, you know, this challenge of eating disorders?

SPEAKER_00 8:23

Right. So if if a physician or therapist or colleague refers a patient to me, again, 36 years in private practice, and I do uphold a private practice on Long Island in person, besides virtual, because the adolescents and the teenagers really want to be seen in person. During COVID, there was this big disconnect with the virtual. Yeah. And as a dietitian, when I get eyes on them, right, is a very big difference than just seeing you right now, Lisa. Now all I see is the top of it. So it's very different. So the assessment that I that I give is one hour, and there are forms on my website. I have a website just like every other provider, and I take a blind, a blind height weight means that the patients don't see their height and weight. They're very triggered by their height and weight. So why would we want to trigger them? Right. And then I ask them, you know, they all bring what their intake of food is. The younger patients, I asked for a copy of their growth chart so I can see what their status of height and weight was, where they are, because it's interesting that everybody knows with eating disorders about anorexia, but other eating disorders people aren't aware of. It's it's interesting even to talk to medical people, they're not aware of it, right? So there's orthorexia, there's orphid, there's diabolemia, and there are so many multifaceted levels of eating disorders that are presented to me on an everyday basis. And it's my job to determine which direction I want to go. And I find education to be very powerful. You know, we do live in a society, you know, this in America, where education is extremely important. And what is going to motivate somebody, right? This is a rhetorical question. I said, what is going to motivate somebody to make a change with food, weight, and body image if they don't understand why it needs to happen? Okay. So I find that result and that education process to be extremely powerful with giving my patients the ability to want to sustain the change once they make it. Let's be honest. Anyone can go on Nutrisystem, Weight Watchers, Jenny Craig. Yeah. Anybody can take a GLP if they have enough money and spend medication, you know, money on medication. Anyone can go and have bariatric surgery and plastic surgery and fake eyelashes and breast implants. I mean, we live in America. But that's like almost addiction, right? Like the addiction of wanting to look good, the addiction of that's right, right? Feeling like we need to portray ourselves as looking a certain way. Like when you said, Deb, this is not just being recorded, it's videotaped. Here I am sitting in front of you. I showered today, but I didn't put makeup on. I didn't stop the fitman and go run and put makeup on. This is me.

SPEAKER_01 11:06

You're great.

SPEAKER_00 11:06

Yeah. No, but nobody cares. Nobody cares what you look like, Lisa. When you pass at your funeral, nobody's going to talk about how you look. They talk about how you make me feel. And the messages that we give our younger people, the children, adolescents, teenagers, even children in college, it's the wrong message. There's a disconnect. And the disconnect about the size of your body or your thigh gap or what you eat or don't eat or how many steps you take every day. It's it there's too much connection.

SPEAKER_02 11:39

It's an obsession. It's an absolute obsession. So you mentioned something, the GLPs. How do you feel about the GLPs? What is your stance on those?

SPEAKER_00 11:49

So I mean, it they're here, right? They're here. Um I supervise um for free a young group of dietitians starting out in the field. And one of the things I share with them is if we do not, as registered dietitians, individualize treatment care per patient, we're not doing our job. So, you know, I get patients that come to my practice already taking them. Already taking them. I get patients who come to my practice and they're like, Deb, I'm maxed out on this medication. I've lost whatever amount of weight, 60 pounds, 80 pounds. I have a patient who's lost 150 pounds on them. Wow. But you ready? What happens when you maxed out and you have to go off the medicine? That's my question. So that's a big, big question. So these patients regain their weight back unless they learn from us, the registered dietitians, how to change their relationship with food, weight, and body image to be able to sustain the weight that they've lost. Okay.

SPEAKER_02 12:54

So wouldn't it be an awesome idea of the docs when they put these, you know, they put people on the GLPs that they, you know, they have somebody like you guiding them? Because I'm seeing people, so many people that are on this. Number one, um, a lot of them are experiencing the side effects. So, you know, as a registered dietitian and a nutritionalist like you are, um, I'm sure that it's grieving you to see these people, their bodies are falling apart because they're not getting the good nutrition, but they're losing weight. So they're skinny and sick.

SPEAKER_00 13:25

That that is wow, that is a statement. I love it. They're skinny, they're sick, they're malnourished. Right, right. Because as a registered dietitian, we can read blood work. Health coaches can't read blood work. I can read blood work for these malnutrition. And it's very interesting. I have patients in larger bodies, Lisa, who are restricting their eating and actually present as being malnourished because they're not taking in the nutrition that they need. Of course. Based on fear, right? Based on fear. Deb, if I eat this, I'm gonna gain my weight back, or I'm not gonna be able to lose weight, I'm gonna starve myself, or I'm not gonna eat this food category. Okay.

SPEAKER_02 14:04

But let's talk about that. Let's talk about the metabolism because there's many people that think that the less they eat, the more they're gonna lose. Can you share with our audience a little bit about that misnomer of metabolism?

SPEAKER_00 14:17

Absolutely. Absolutely. So it's very interesting that statement you made. I often get pediatricians and doctors who refer patients to me on Long Island. I'm known to specialize in eating disorders. So they're like, oh, Deb, can you assess this patient? So the patient comes in, lo and behold, the patient has an eating disorder. Let's say they're in the restrictive type, and then with me, I get them educated, and then they begin the process of eating more. What happens is when you are restricting for such a long period of time, the body metabolically starts to slow down and things start to slow down. Yeah. The organs start to slow down. The organs, as you're older, if you're an older person that starts restricting, the organs actually start to deteriorate. Okay. So the minute you start giving your body the nutrition that it needs, we call it refeeding. Okay. It's a slow process, but it goes forward. Sometimes, as a result of that, you eat more, the metabolic function kicks up, and then the bot the patient actually loses weight instead of gaining weight. So often I'll get a doctor that calls me and says, Deb, I referred blah, blah, blah to you. They just were in. Why is their weight lower? You told me that they're eating more. And then I'm like, well, don't you remember learning back in college about the hypermetabolic phase? And they're like, oh, I forgot about that. Oh, yeah. Oh yeah. But there are so many things that, again, I go back to each individual profession and each individual specialty, right? I'm 61 years old. I'm seeing a geriatrician now instead of a primary doctor. That doctor, ready, specializes in disease states of the elderly. It's crazy for me to say it out loud to you, but I'm in that category now.

SPEAKER_02 16:04

So it's not Well you look, you look amazing, though. You look fantastic. So whatever you're doing is working, girl.

SPEAKER_00 16:10

You're funny. You're funny without makeup. Just like they have physicians that are called pediatricians. They are doctors who specialize in pediatric health and well-being. So they're registered dietitians. All we do is promote the food science of change with micronutrients, macronutrients in the organs of the body. Beautiful. And how they work. That's what we do.

SPEAKER_02 16:34

Well, I encourage everyone that's listening, you know, the get your book. It's gonna be, it's on the bottom here. But this might be a really good chance because you spurred something when you spoke about refeeding to give our sponsor a shout out because Cardi Miracle has been based on um giving the body what it needs in whole as close to nature as possible for those that might not be able to eat right, for those that might be struggling with some health issues. And maybe they're used to taking, you know, the Flintstones and the One Days and all that kind of stuff. And so when John Hewlett, the founder of Cardi Miracle, came up with this formula, I myself was a little bit skeptical because I went, whoa, you know, there's so many nutrients in here. Are they whole food? Are they organic? Are they as close to nature as possible? Are they a lot of stimulants in it? Absolutely not. This is over 700 nutrients in the product, over 58 ingredients, um, and as again, as close to nature as possible. But the secret of this particular product is the nitric oxide promotion that it does within your veins and arteries. So we know we can't live without good blood flow. So we really appreciate John and all of his infinite wisdom putting together this product and uh Cardi Miracle.com. And we encourage everyone to go take a look at it. A lot of the doctors, and we do have a lot of dietitians and nutritionalists that are coming on board because people are struggling with how do I take enough vitamins or uh fruits, vegetables, and get my vitamins out of those fruits and vegetables. And a lot of times, even if you're, wouldn't you agree with me? If you are eating organically, if the food is being shipped over 10, 20 states and it's sitting in a in a warehouse and so on, uh, is it not true that the food loses some of the nutrient value? So unless you go and pick it out of your garden, we really aren't getting all the value that we would like to or we anticipate to. So this is a helpmate to walk with everybody on the journey. And of course, you know, what all with the solutions that you are offering as face-to-face person-to-person, that's exceptional to be able to do that. So again, thank you, Cardi Miracle, for sponsoring this. And we sure appreciate hearing uh more from Deborah on this particular um topic. Now, you also talked about be partnering with the uh American Health Heart Association. The American Health Talk a little bit about that.

SPEAKER_00 18:52

Yes. So back in the day when I was younger, the American Heart Association, we had to do rotations through our program, and I did bioelectrical impedance with them, and we also did cholesterol screenings in the work site. So one of the things I love, besides specializing in eating disorders, is helping patients not prevent themselves, right? Because I'm not a medical doctor from being on medication, but how can we help ourselves, nutritionally speaking, like you said with your products, stay a little bit lower with the medication and use food and the vitamins and minerals they contain as physiology to keep these things there. And that's what my role was with the American Heart Association. I did lectures, I did cholesterol screenings on site. It was wonderful. Even with my eating disorder patients, you know what's interesting to go off with the American Heart. We can't tell patients in that genre to avoid things because the minute they hear you can't eat it, it make it triggers them to want it more or to feel bad if you eat it. There's an emotional attachment. So instead, what I've learned in my years of doing this is well, what could we eat more of that will help promote heart health and get the cholesterol down? They like that better. That's so much better than you can't have this or you can't do that. That's really good to know.

SPEAKER_02 20:16

You know, those trigger words. We don't often think about that. Yes. And really what causes a person to make a decision right or wrong or left or right or what have you. Um, what are some of the other, I would say, changes that have been happening probably post-COVID that you see in your patients and you see in people out there. What are some of the changes that people have experienced or are now embracing maybe that they weren't pre-COVID?

SPEAKER_00 20:42

So I think after COVID, as we spoke of before, social media has really blown up. I think during COVID, everybody during lockdown was stuck at home with their phones and YouTube, and just social media has impacted the way we feel about ourselves, the way we compare ourselves to either our old selves or other people. And that's a problem because genetically speaking, we're all predisposed to be who we are, whether it's the texture and color of your hair, the way your eyebrows fall, the way you know your nose. It's the same with our bodies. Okay. I think also, I think also the language has shifted, where pre-COVID, it wasn't as open as saying something like, this food is good, or this food is bad, or this is healthy, this is unhealthy. When a younger person hears that, believe it or not, there's an emotion attached to that. I feel bad when I eat a bad food. I feel good when I eat a good food. So we don't really want to talk that kind of language, especially with adolescents and teenagers, because they're so right to develop eating disorders. I teach my patients how to make all foods fit, even with abnormal blood work. There's a way to make it happen where you don't feel Bad if you eat something because you have heart disease or diabetes or cancer. You have to be able to live because we live in a society. Again, this is America. There is too much food in our country and there are too many choices. I mean, you can buy a candy bar at Home Depot. Why is there candy bars being sold at a fix it store? That's true.

SPEAKER_02 22:21

I never thought about it. That's so true.

SPEAKER_00 22:24

Yeah, that's the way we are here.

SPEAKER_02 22:26

You can buy, yeah, you can buy all these candy bars that are actually smelling like fertilizer. You're absolutely right.

SPEAKER_01 22:35

That is crazy.

SPEAKER_02 22:36

Yeah. So some what are some of the other challenges that you are noticing that people are having today? I know that's a big question for you, but as you narrow that down, what are some of the nuggets that we can leave with people today, in addition to, you know, some of the challenges that you're seeing in an overabundance today versus maybe, you know, five, 10 years ago?

SPEAKER_00 22:58

Again, very big question, but some of the suggestions and ideas that I have for the answer to that, one of the biggest I think is that we're too busy rushing around. And I think that the family dinner, the family dynamic of dinner has dissipated and gone away. You know, Becky is in dance and Sam's club and this dad is working because we know we to live in New York and Long Island, at least I'm in New York, to be able to live in this socio and economic status, we have to work significantly to be able to make ends meet here, especially with the economic world today. I think that people are losing touch with eating meals together. I think that people right now also, I don't know about where you are, are not cooking anymore. I think people are uber eating. That also started during COVID. Uber eats, DoorDash. I it's ridiculous. I've never seen so many people order in food. And again, if I promote balance, and it's not just balance in the choices we make, but it's balance overall, right? So I say to my patients, it's not just each food you eat or each meal. It's the day that makes the week, the month, the year. But if you're door-dashing in your food, and that food tends to be higher in sodium, higher in saturated fat, lower in fiber, you wonder why we have so many comorbidities now more than ever before, because we're really not cooking. You know, I'm kind of old school personally myself as a registered dietitian. I practice what I preach, and I do a lot of cooking here. And I taught my two adult children to cook. And it always is cost effective too. And the family meal without connection, in other words, not sitting with your phone or not sitting in front of a laptop or not sitting in front of a TV. I really don't know if the public can even do that anymore because they don't know how to be bored. Isn't it crazy how children today at least they don't know how to be bored? It's okay to be bored.

SPEAKER_02 25:01

Oh, they panic. They panic if they're bored. And and I even know some adults that panic if they're bored. You know, they have to be constantly on that crazy wheel on going 100 miles an hour. But I also read some studies where they talked about the families that eat together, um, you know, stay together. They learn conflict resolution. Um, they speak openly at the dinner table, and that they um, you know, when food is cooked at home, we also know the energy that goes into it, right? So loving energy goes into your food, you share it one to the other. Um, and also the nutrient value is so much higher when you cook it at home. And you mentioned the sodium. There's a little bit of a mystery around sodium. Can you dig into that just a little bit? I know some people will talk about extracellular sodium and intracellular sodium. Like they go into the hospital, they get a bag of, you know, of sodium, sodium water. Sodium sodium. And then they come home and they go, but wait a minute, why can't I put all the salt in my food? I just got it in a bag in the emergency room.

SPEAKER_00 26:03

Right. It depends because most people that you're talking about in the hospital go in for dehydration or end up being dehydrated. So then they get put on IV, and most often IV is sodium chloride. They have to be because it's an electrolyte. It works with the heart muscle, right? So sodium chloride, potassium, magnesium, they all work those electrolytes with the heart muscle, whether it's intracellular, which is within the heart muscle, or extracellular, which is outside the heart muscle. And we want it to be in perfect balance. We don't want it to be irregular. I have patients who are bulimic, who throw up their food or abuse laxatives, and those can cause what we call an electrolyte imbalance, which can lead to cardiac arrest. Very, very dangerous. So at home, in the home that we live in, it depends on how you were raised. A lot of people are heavy with salt. I have patients who salt their food before they even taste it. How do they know? A lot of people do that. Absolutely. Yes, you need salt if you haven't even tasted it. Right.

SPEAKER_02 27:10

Right. That's so, so true. So true. So tell us a little bit about your book. Now we're gonna have it on the you're you can see it on the bottom where you can order her book. I would really highly suggest you do so. Yep. Um, I have it here. My book is. What prompted you to write a book? And I'm sure it's that's fantastic.

SPEAKER_00 27:25

Yeah. This is my book. It's called The Things I've Seen People Do With and Without Food. And it was, oh my God, it was from the love of just seeing the things I've seen over the years, hearing the things I've seen over the years, the struggles that people who actually have eating disorders go through that nobody knows because eating disorders are a mental health issue. It's all internal in their head. And in the book, not only do I have the relatable stories where everybody can relate to them, but I have patients in recovery who wrote, parents of patients who wrote, physicians who wrote in the book, therapists who wrote in the book, a psychiatrist. It's a it's a very different book. It's not about eating disorders. I do write about certain ones, but they're more relatable stories because most people go through it and nobody knows they're thinking the same thing. So, for instance, during COVID, I know you remember this, we all had to work virtual. The world was unlocked in. And I wrote in the book, why are we sitting at the table working virtually in the kitchen if we have an abnormal relationship with food? The kitchen cabinets are there, the refrigerator's there, the freezer is there, we should not be doing that. Does that make sense? Absolutely.

SPEAKER_02 28:39

So when you look at um, you know, society today, and I really appreciate that book, I really highly suggest everybody get that, just so that you become more informed, not from a formal standpoint, but somebody that's really been in the in the field and worked with different individuals. And also with eating disorders, what I found out working in the medical field is that they were really difficult to identify. Some of them were difficult to identify because they weren't, you know, 90 pounds dripping wet, but yet they had this overwhelming um challenge, and now we call it, of course, multiple different words or names in the eating disorder category. Um, what are some of the, I know that you we have we've talked a little bit about bulimia or anorexic. What are some of the other ones? Can you touch on those? I know body dysmorphic is another one. Right. What are some of the other ones that and how do they present themselves?

SPEAKER_00 29:34

Yep. So body dysmorphia, a lot of my male patients have it. It's interesting, like when you said about women before, there are I have a lot of men and young men with eating disorders, severe body dysmorphia. You know, they there's all that cutting now, and there's all those, you know, hydro things. There's so many different things that they're doing, taking supplements, creatine in the gym. There's a new thing. I I can't remember what it's called. You can probably research it. I think it's called hydroxy cutting or something, where they just wow uh cut their bodies to the point and they would rather just look good or die. Isn't that unbelievable? Yeah. So my word. Yeah, I have patients with it's called diabolemia. They're diabetic since they're younger and they actually are missing out if they don't see a registered dietitian to help them understand that they don't need to eat not carbs. They, of course, need to eat carbohydrates. They feel bad when they eat them, so they binge on them and then they inject more insulin to cover their carbs. And that's very, very dangerous because that can cause major side effects to the diabetes at a younger age. I have patients with orthorexia now. Orthorexia has been around for a very, very long time. Um, most of my colleagues who are physicians never heard about it. I'm not sure if you did, but it gets a it gets a bad, it's a bad hype because orthorexia is my patients who eat clean or healthy or organic. Yes. No dogs in foods or farm to table only, or they won't eat out. And it's very restrictive because it's very socially isolating to be in that category. Um my biggest uh influx of patients I see now have RFID. RFID is one of my specializations. It's an acronym that stands for avoidant restrictive food intake disorder. And those are my patients. Many of them have anxiety. Um, many of them are on the spectrum, neurodivergent, ADHD, um, Asperger's, even though we know that's not a diagnosis anymore. Ridiculous. I have patients with that. Ridiculous. It's ridiculous. Exactly. It's ridiculous. But they're not picky eaters, right, Lisa? So they actually have, and again, eating disorders are mental health. So they have thoughts, very strong thoughts about, let's say, texture of a food or smell of a food or even appearance of how it works. Like I have a patient who will eat chicken nuggets from McDonald's, but will not eat chicken nuggets from Chick-fil-A. Or I have a patient who will eat goldfish that are out of the Costco box, but not goldfish out of the bag that you can get at Shopright or a grocery store. Okay. There are all different levels of RFID. And as registered dietitians, if you do specialize in this, it's our job to individualize where is this patient and how can I help this patient move forward? Because a lot of eating disorders people don't realize, they're very isolating. Think about it. Oh my goodness, yes. Right?

SPEAKER_02 32:39

Because if you have, I want our listeners, I really want our listeners to take this in because we are living in a different time right now. And everything that you're speaking of, you know, especially those that are eating clean. I mean, there's a huge movement. Um, you know, they're vegans, they they eat specific foods, and then they, you know, they fast. I'd like to get your idea on fasting as well. So they have all these different methodologies that they are putting and incorporating into their life, believing truly that that is making them healthier. And what I really appreciate about you and what you're saying and your practice and so on is that our doctors, and when they go, when they're sick and they're not well, they go into the doctors. The doctors have no idea of what you speak. So, how are they going to be able to identify, even treat those patients like you were just talking about? Because it sounds like it's so intensive and it's so overwhelming to the average doc. I can't even imagine they would even know where to start. So thank goodness that they have someone like you to send them to.

SPEAKER_00 33:42

Right. Well, I think that in America, I mean I can't speak for other countries, although I travel a lot. I think everybody should have a consult with a registered dietitian. You know, the same thing, the sad thing in our society is advertising and pharmaceuticals is a huge part of industry and it's a huge part of the economy. So it makes a lot of money, right? Whereas we, as preventative medicine, can turn around and really help people by changing your relationship with food, weight, and body image, not be taking a statin or be lowered on your blood medication or medicine for diabetes. You mentioned the GOD. What happens when you go off of them? We know that you're gonna get maxed out eventually. Yes. I know.

unknown 34:30

Yeah.

SPEAKER_02 34:30

And even, you know, something as simple as I used to run a hypertension clinic. And did you know the first couple weeks we would put everybody, we'd have them increase their water and walk 20 minutes a day, and they would come back nine out of 10 times their their systolic would be down, their diastolic would be down. I mean, it really is impressive. Something so easy, but we all believe that the answer is in a pill or syringe. So again, I just so appreciate what you're what you're doing. So again, going back to fasting, how do you feel about fasting? And what do you I know that each of your patients are different, their individual, you know, uh approaches, but people are doing intermittent fasting, fasting. What are your thoughts?

SPEAKER_00 35:15

Right. So I there's always some kind of fad diet or suggestion in our country and always somebody promoting behind it who's got a big sponsorship. You you know this more than anybody. And I don't believe in any of that. It's all just a fad. As a matter of fact, we talked about this earlier. When the body all of a sudden gets those little bells that go off that it's being, it's it's being fasted. The body, it's a defense mechanism is to shut things down and things don't operate as quickly as we want them to be. And that's not the way we want our human body to work. You know, I was talking to a patient, this is interesting, you'll appreciate this because of your background uh about binge eating and intermittent fasting and eating too close to bedtime. Because with intermittent fasting, I have some patients that go to bed on the earlier side because they have to get up in the morning to take the train into Manhattan. And if you're eating too close to bedtime, think of the circulatory system, right? The circulatory system you know more than anybody is the blood system. When you're sleeping, the blood system or the circulatory system wants to be in your brain, it wants to be in your cardiovascular and your respiratory system. It really doesn't want to spend some time in the GI system at all. So look, think of the competition that the human body has to try to do that. Well, it doesn't work, and then that causes poor sleep, and poor sleep decreases metabolism, which promotes weight gain. So it's kind of like a double-edged sword fasting and restricting, isn't it? Because it really doesn't work long term. Right? Yeah.

SPEAKER_02 36:50

And there's so many people. I was even surprised at all the people that were diabetics, you know, that were sometimes are fasting up to 18 hours a day. So I my question is how does a blood sugar become balanced with with food? How do how do you balance that blood sugar with food if you are on insulin or even a you know a medication?

SPEAKER_00 37:13

Right. So excellent question. So when you're looking at managing it through food, dietitians are trained to not only work with the carbohydrates, proteins, and fats, or macronutrients, those are called those, of the foods, which then produce the micronutrients, which are the vitamins and minerals from those food categories, but also time frame. We know that a typical meal is absorbed and digested. That's a balanced meal in three to five hours. So if a patient eats a meal, not just a granola bar or not just a banana, right? And not just a cookie or a cup of coffee and skips breakfast, which is the society, then the blood sugar, if they eat balance, will go up, but at least then it stays stable.

unknown 37:55

Right?

SPEAKER_00 37:56

So it's basically so instead of having what we call metabolic dysregulation or highs and lows in blood sugar, the metabolism stays stable. That keeps the blood sugar stable and it prevents those hypoglycemic or hyperglycemic reactions. Those are not the reactions we want to have happen, especially with people driving or operating machinery.

SPEAKER_01 38:20

I'm kidding. Yeah.

SPEAKER_00 38:21

Very dangerous. Very dangerous situations. Right.

SPEAKER_02 38:24

Well, I sure appreciate everything you're saying. Now, people are gonna say, Oh, I want to take her home with me so that she can she can teach me how to eat better. Your contact information is gonna be on here, and of course, everybody can see, as well as getting your book. You want everybody to get your book because easy read. Um, what are some of the nuggets, again, as we close today, that you want to share with everybody from your stance? You're very, very, you know, this is a very successful woman that's been in the field for many, many years. Um, and I believe you've seen almost seen it all.

SPEAKER_00 38:56

Thank you. I again since 1990. The thing that I want to really make sure that everybody hears at the end is that everyone should have a consult with a registered dietitian, nutritionist, not a nutritionist, not a health coach, not a not a doctor, because doctors do not, they have one course of nutrition in school. Just to bring your blood work in and your individual self, your medical history, your surgeries, what actual medications you're taking, and/or vitamins and herbs, and let that person tailor something for you individually. It it would help you feel so much better as years go by and just live your best life.

SPEAKER_02 39:38

That's one. I love this. I love this. Thank you so much. And again, we want to give a shout out to our sponsor, Cardi Miracle and Mr. John Hewlett. We thank him so much for putting this together. You know, if you're looking for a good multi, you're looking for a good nutritional base of products, um, you're gonna find no better than the Cardi Miracle product because it also is, we call it just liquid food. Not only does it have all your vitamins and your minerals, but it also encourages the nitric oxide formulation in your veins and arteries. And we know that we can't survive without increased blood flow throughout your body, tips of your toes, tip of your nose, top of your head. So we really appreciate Cardi Miracle and uh look forward to hearing from more from Deborah in the future and all that she can bring to the table. So thank you so much, Deborah, for being with us. And thank you for having me. Enjoy the day. You too. Thank you, everybody.