Eating Disorders and Early Intervention

Dr. Tim Thayne interview Mike Gurr. Mike has appeared on Doctor Phil and The Doctor Show as an eating disorders expert. They dive into how a family unit should react, and help with someone that has an eating disorder. 

Transcript

Talmage Thayne: 0:00

Eating Disorders and early detection. This is the not by chance podcast where we discuss intentional Family Living. I'm Talmage Thayne son and podcast manager, Dr. Thayne, we'll be interviewing Mike Baker, a professional on eating disorders and how to handle it in the family.

Dr. Tim Thayne: 0:21

This is Tim Thayne with the not by chance podcast, and we're going places with my girl. I'm really grateful to have Mike here with me today for this podcast. Mike's background is he received a master's degree from the University of Utah and exercise and sports science, with an emphasis on sports psychology. He went on then to receive another master's degree from Argosy University in Phoenix, in professional counseling is currently a licensed professional counselor in the state of Arizona. I want to make particular mention of some of the areas that Mike is has been focused on lately. He's a sought after presenter on various topics such as stress management, shame, resilience, communication, leadership, forgiveness, listening, blame cycle, relationship building, and a number of other things. And we're really happy to have his experience here with us today. And also, as a part of the homeward bound team. Mike has appeared on Dr. Phil and the award winning the Dr. Show, as an eating disorders expert. And that's why we have him here today on this podcast, where we're going to be talking about eating disorders, and early detection is going to be one of the topics, Mike, because, but before we jump into that, just real quick, what got you into this field,

Mike: 1:43

into the eating disorder,

Dr. Tim Thayne: 1:44

it kind of into the eating disorders, you know, from the sport psychology and working with, with elite athletes, what got you over here.

Mike: 1:53

So there was a time where one of my friends actually owned a residential treatment center. And they wanted to do some seminars. And so she invited me to go to the seminar with parents. And it was a three day intensive seminar. And as a participant, I saw the dramatic change. And I've always wanted to work with families. So I came back and I told her, I go sign me up, like I want to do this. So I had no idea that this field even existed. But that was my initial jump into what you would call the troubled teens or the you know, the families that are in need of help. where this came from is the center that was a director app, we would have girls 13 to 19. And they would come from other treatment programs where potentially they did have an eating disorder, and they had done well with it. They come to our program. And because we were going a little bit deeper into into some of the therapeutic work, they would exhibit some of these eating disorder behaviors. And so my staff, we weren't really like, what do we do with that, and we didn't want to do the wrong thing. So I contacted a company down in Phoenix and asked, Hey, can you send somebody up to do some training? And so the meadows, had somebody come up and do a three hour training for my therapist. And after the three hour training, I thank the gentleman for coming. And as I was walking back to my office, I told myself, why would you ever work with eating disorders, and I will never work with eating disorders. Four months later, I got a call. And that same company said, Hey, we have a great position for you. So long story short, I said, Okay, went down to that company. And that's where it got really introduced to this level of eating disorders. So you never

Dr. Tim Thayne: 3:57

say never right? Don't do that. Don't do that. Well, I think it's worked out pretty well, because you're right in the thick of it, doing a lot of great stuff down there. So, you know, first question is, isn't as someone else thinks that kind of sneaks up on, you know, a parent in terms of not not being aware a lot of times that maybe one of their children has an eating disorder. This is it's kind of a sneaky kind of thing where you don't know Yeah,

Mike: 4:24

I would say really one of the hallmarks of an eating disorder is silence and secrecy. Okay. They don't want to be found out. And really what we've what we've found, with a lot of temperament testing that we have done is that there's a similar profile, no matter if you're an adolescent or an adult. If you have anorexia, bulimia or binge eating disorder, there's a very similar temperament profile and part of that profile. There's perfectionistic tendencies. They're super sensitive, and so as as information as they experience life They don't know what to do with it. And a lot of people think there's a lot of control pieces with an eating disorder. But this temperament testing shows us, there's a lot of impulsivity pieces. And so what starts to happen is they experience life, just almost this impulse jumps in, and they will go into these eating disorder behaviors. And so as they do that, the other Hallmark to that is shame. So as they go into this eating disorder behavior, then they start feeling terrible, I'm worthless, I'm no good, I'm not wanted, I'm fat, I'm ugly, whatever it is. And so they repeat that vicious cycle with shame. They don't want to be found out, they won't tell anybody, and they do an amazing job of hiding these behaviors. So a lot of times parents will not recognize that their child is in danger, that their child really has any kind of a problem. And a lot of times, the parents will think, Well, they're just picky. Or they're going through a phase, or it's not that big of a deal, or they're trying a new diet, or I mean, so there's a lot of reasons that parents won't really think more about what's happening, you know, yeah, well,

Dr. Tim Thayne: 6:07

when you say picky, I think every one of my kids has an eating disorder. Well, I mean, they have a picky,

Mike: 6:14

while. Honestly, we could probably say everybody in this world has a has disordered eating, quite honestly. Yeah.

Dr. Tim Thayne: 6:23

So what's the difference between is it kind of a series of things that you would look at and maybe picky would be a little thing in the back of your mind? To make you think, Okay, is there something more than just normal picky? You know, behaviors here?

Mike: 6:41

Well, that's a good question. Because what I would say especially like with Homeward Bound families, they're they're not at that level, to where these kids are really acute. So they're not going to probably see some of the severe pieces, right, that we can go over in a little bit. But they might see some of those pieces, right that their emotions are all over the place, they start to talk more about food, that becomes more of an interest to them, they get anxious around it, some pay, or some parents, I'll say, look at the pacing of how they eat, they may be eating too fast, and maybe going too slow. We'll be cutting their food and little pieces, they may be taking small bites. So these are things that parents can actually be aware of that a lot of times, the kids don't really even know that they're doing it, but they are. And so these are the things I would tell parents to pay more attention to, other than to some of the extreme behaviors that when you're kind of in a full blown eating disorder. So pickiness can be that that can be you know, put in there. Others might be looking at labels, they want to really like what's in this food, they might start calorie counting like is they didn't do before. So again, kind of being obsessed with everything food related. But again, I will a lot of parents will tell me this kind of this stage, if you will, it's like walking on eggshells, they become hypersensitive. So one day, you could say something to your child, and it's fine the next day, they're gonna blow up. So I've had a lot of parents tell me it feels a little bit like a roller coaster, kind of like almost bipolar. And another piece is this, they'll start to isolate themselves. So that's another thing that this kind of stage of that we're working with, I would tell parents, do you see a difference in that? Do they not want to engage in some activities that they used to? Are they not hanging out with friends like they used to? Is their anxiety going up around food? So I would say those are some of the things now that they can start looking for?

Dr. Tim Thayne: 8:39

Yeah, and I'll come back up a little bit, because my mind is stuck on this this one thought and a question I think a lot of parents would have. What would be I mean, in most things, early detection is is really helpful. I assume it is in in eating disorders, as well. What would be the benefits of detecting this early? And the second part would that be? What can be done if you've detected early?

Mike: 9:06

And so great question. The benefit for tech, for detecting it early, is the longer they are in this eating disorder, it really starts to change the electric circuitry of their brain we're doing a lot of work in that neuro component. And eating disorders itself is actually a very relatively new field if you look at the history of it and when it really started to come to fruition but so when you take a look at what what can you do, the importance of doing it early is because then they start to become so distorted and their thinking becomes very rigid, very all or nothing black or white. So it's really difficult to start to change that when they start to now see everything through this filter. Right and so that's what's really difficult at times if you let it wait, wait, wait, is now they believe these distortions are true. So whether it's about food, whether it's about body image, whether it's about self worth, they truly believe that. And so, to me, that's why it's critical, right? Because what we have found in our work and in research that there is a lot of plasticity to the brain. And so if I can get it earlier, than I can make that shift much quicker. Whereas if I've had this for 1015 20 years, it's difficult, it is very, very difficult to start making those changes that that person truly believes. So if I start to recognize it, what I would say, and I'll see depends on where you live, like, what are your resources, but at this level, you probably want to look at an outpatient team, you want to take a look at a therapists and really a dietitian. And when you take a look at that, what I would say is for the dietitian, they're going to be key. But you want to look into what's called a set rd. If you can't find a set rd, you definitely want to find a registered dietician and not a nutritionist. There's a big difference with that. When you look for a registered dietician, I would ask them first question, do you work with eating disorders, because even if you're a registered dietician, they sometimes have no idea or don't want to work with eating disorders, because it's a very unique piece, right for them of how do you do that? Same thing with a therapist. Again, if they have the CD as part of their all their initials, you're good to go. Because that takes two plus years after all the work that they've done, to even get that, so you're going to be pretty confident they know what to do. Again, if they don't have that I have a lot of questions for parents to ask a therapist, because you'll have some therapists out there saying, Yes, I work with eating disorders. And no, you don't. Right. And on their website, they may say work with eating disorder. So I will coach parents, okay, what are some questions to ask to know is this person really going to help, you know, with my son or my daughter, and the other part of the outpatient team would be a PCP or their primary care physician. But once again, what I found is I've done a lot of education, a lot of doctors have no idea. They miss an eating disorder, they don't know what to do with an eating disorder. And they make a lot of faux pas, when somebody comes into their office, they'll talk about the body, they'll they'll actually tell them what their weight is. I mean, they do all these things that you shouldn't do. Because they don't know any better. So

Dr. Tim Thayne: 12:29

interesting. Yeah, so you're talking about a team approach to this? And what's the family's role in all of that?

Mike: 12:38

This is huge. Because what I have found is, I'll always ask, and I'll ask you, if your son or daughter stopped eating, and you saw that you really saw them stop eating, or your son or daughter, you knew that after every time they ate, they would go and just throw it up, or after they ate, they would go and exercise for hours upon hours. What would you tell him?

Dr. Tim Thayne: 13:04

What would I tell? I think I would probably I want to understand what's going on inside them. You know, what is it that's causing this, this behavior?

Mike: 13:18

Well, you're a unique individual, because most parents will not say that, right? Because most parents will see that behavior as a threat to their child's life. And I will say that they will have what I call a JUST DO IT approach. Right? Stop it, just do this. Don't do that. Right? I'd start

Dr. Tim Thayne: 13:36

there. And I get to this.

Mike: 13:40

Because really, that's what I'll see parents do as they see their their children not eating, or getting rid of what they have eaten, or quite honestly over eating. Their thought is, what's the solution? If you're not eating, and that keeps happening, you're gonna die. So their thought is to do what? Let's fix it. Yeah, here's the problem, I'm going to fix it. And the solution is just eat, just eat, right? Or stop exercising or stop throwing up. And what I really need to educate parents on is the thing that we think is the approach that's gonna, quote, save their life is the very thing that will kill them. Right? It's the very thing that will drive the eating disorder even more. Yeah, how

Dr. Tim Thayne: 14:23

does that kind of cycle work? You got a parent who's saying, well then just eat. On one side, what's going on with the young person who's got the eating disorder?

Mike: 14:34

Number one, they don't feel understood. Number one, they feel broken. They feel like you don't love me because you see me as some as an object to be fixed. And again, they're very sensitive to how people perceive them. They're afraid of being judged. And so if you just tell me to do something, I'm doing it wrong. They interpret that as I am bad, I am broken. I need to be fixed and that again with that sensitivity Eat, that puts them more into that shame spiral. And with that temperament again, what we know is they don't know how to handle that. And so as that comes at them, guess what they're going to do set impulsive behavior threats, I'm going to jump right back into that eating disorder. So not

Dr. Tim Thayne: 15:13

so much control. You're saying maybe it's maybe somewhere out there saying, Well, my mom and dad are saying not to I'm or to not, you know, purge, I'm going to do it anyway. But you're saying more, it's more likely an impulsive.

Mike: 15:27

Act. Yeah, when we've done we've probably done about 1300 of those temperament tests. And I would say probably eight out of 10. And again, on this scale of self discipline, and impulsivity, eight out of 10 are scoring on that impulsivity, there are a few that are controlled, and it's depends on the eating disorder and some other things, but really eight out of 10, there's an impulse piece. And so what I will tell the parents is, this has become a habit for them. If you talk to a kid that's truly in an eating disorder, they're not thinking anymore, about oh, I'm just gonna restrict or Oh, I'm gonna go exercise I'm going to throw up. It's just something they're just doing right here it comes, the impulse here comes to stimulate at them. And I don't even think about it. I'm just gonna get you

Dr. Tim Thayne: 16:08

know, what's interesting about this, Mike, this, this relates to a podcast we did before with Sherry Murray, on ascribing this idea of they're trying to control versus something deeper, right. And in that case, it was needing to have a predictable kind of outcome with ASD, you know, kids and anxiety. And you're saying the deeper issue here and most of the time, is really this impulse. That's not thought out. I'm trying to control most of the time, it's this pattern.

Mike: 16:44

And I would say, to go deeper, right? There's there's going to be a hallmark is comparison. A hallmark is body image issues. A hallmark is trauma. So there are definitely things that are what I would call a function behind that. And what I've told parents is that when you see eating disorder behavior, that should be a trigger for you to say that there's something there's a struggle, right, that do not define them from this behavior, they are more than the behavior, and that that behavior is telling you as a parent, that there's some struggle, and I try to teach them, how do I support struggle, because if I can do that, that kind of calms the sensitive, this causes anxiety, and then if I can help them with that, I don't necessarily have to engage as much into the eating disorder. And so we really, parents have to completely change their role. And a lot of times, I will fire them as the food police, I will fire them from that role. That's not their role anymore. That's the team's role. Right? So dietitian, therapists, you know, that's their role, your role as a parent, right, is to understand to be supported to have empathy, that's going to be your new role.

Dr. Tim Thayne: 17:53

That's fantastic. You know, you know, at Homeward Bound, of course, we're lucky enough to have you be one of our coaches as well. And, you know, let's say we're following up the the work that's been done, and maybe an intensive, either inpatient, residential, whatever treatment situation for an eating disorder. And and, you know, one of the things that's that I learned a while back is I started calling lots of different treatment providers who are covering a variety of things, because I wanted to see if a technology we're building would be helpful to them. And when I got to the eating disorder, professionals, and they realized that a lot of it was around helping the family system, right, they got excited. So there's what that tells me is they saw that the family inadvertently, that context, that world that they're in, without the education and the support, and all of that without being fired as the, you know, food, police and other things that they could inadvertently trigger a major relapse with the eating disorder. Is that Is that true? From your perspective?

Mike: 19:08

Yeah, I've worked with adults, I've worked with adolescents actually, I had one husband, say, Mike, the only thing I know how to do is to make this worse, is doesn't matter what I've done, what I do my approach, it just makes this worse. He had no idea what to do. And an eating disorder completely affects the family system completely affects it. And so when you're working with the eating disorder, the family has to be involved. Because it's been relationships have been severed. You know, what you'll start to see, as the eating disorder gets worse, there's a lot of dishonesty, you know, a lot of lying around that. So again, here goes to the trust, parents are overreacting. And again, because in eating disorders, is the highest mortality rate of any mental illness and so as it's getting worse and progressively worse, the parents that are progressively going to You amp up, this is what we need to do, you know, solve, solve, sell, fix, fix fix, which just makes it worse. So yes, the family and quite honestly, not just a family, but they need support. They need resources as they're going through this process as well.

Dr. Tim Thayne: 20:15

So Mike, let's let's talk about the do's and the don'ts so that we can get a really clear idea if we're actually trying to help with we're doing the very opposite of helping. What are the big don'ts for family?

Mike: 20:30

Don't use the H word. H. for that.

Dr. Tim Thayne: 20:37

Goal golf. I don't know why.

Mike: 20:41

So there's a we call it body talk. Don't talk. So you look healthy. Don't Don't say that word. When you say that word, they think that you say they're fat, right? So anything else say about Body Talk is going to be? Just don't do it. And food talk? Don't do it. And here's what's hard because Higgins, that sensitivity piece with their temperament, is you can be at a meal. And you can talk about oh, this is This tastes so good. Or this looks so good. It'll trigger them, right? It's a huge, huge trigger for

Dr. Tim Thayne: 21:12

they think you're lecturing them, right? Like you ought to eat more well, so there's well been valid, but also

Mike: 21:17

compare that well, why do you think it's good? Should I eat more? Should I eat less? If I eat too? I mean, so Oh, yeah, what you'll find is, again, there's so much of that distortion. And that to me is one another hallmark is they're battling with these intrusive thoughts. And so again, when you say things that you would think are very benign, they are not at all, because what I will tell people with whatever you're dealing with, let's say you have a little anxiety, right? Or maybe you're a little sensitive, when you have an eating disorder, put that on top of whatever that is, and times that by 10. That's what's happening. So if you have somebody has a little bit of anxiety, or a little bit of sensitivity anyway, and you put this angel on top of it, it just magnifies it exponentially. So these things that we would think are benign, are absolutely sends them through the roof. So really body top food talk would probably the two the two biggest things that I would say don't do. But then also the idea we talked about before this, just do it or just don't do it approach with also overly simplistic. Because there's a lot to it. Yeah, yeah. So those I would say, I mean, there's a lot, but I would say those are probably the primary, don't be careful.

Dr. Tim Thayne: 22:30

Don't do those things. This is a little bit of an aside. But if there's any parents out there listening, you made me think of the wilderness. Because out there in the wilderness, because food is different than they've ever been able to eat before they become obsessed with food in a way, you might start to think that they have a bad relationship with food out there. But I just thought that's so interesting, in different context, you end up having to kind of filter that and say, you know, they don't have an eating disorder right out there in that sense, but but they're obsessing about food, right? But let's say so you've got you've got the situation where you've kind of diagnosed, okay, my son, or my daughter is starting to, to have an eating disorder of some type. And you've taught us the don'ts. Now, what's the do's for a parent? In that situation?

Mike: 23:28

You actually modeled it perfectly, quite honestly, when I asked you, what would you do is you want to understand, you know where they're coming from and understand that behavior. Don't put judgment on it, don't be critical of it, and see them for more than that. And again, try to just listen, to learn, listen to understand. Because if they feel like you are understanding where they're coming from, you want them to be able to share with you. Because again, the hallmark is silence and secrecy shame. And so if they can come to you, and you're a safe place for them to share what they're feeling what they're thinking, that is a huge step in the direction of what you want to do for them. And the other thing is, is find help, because again, eating disorders want to isolate the person, right? They want to take them away from all their support all their friends, all their loved ones, and basically say I'm it. I'm all you have all consumed. Yep. And so if you can, again, as a parent, start connecting them with others, right? So you can focus on your role as that support, encourager understanding those types of things, and let the professionals do their job. Again, you're that that team, that team approach is a huge do

Dr. Tim Thayne: 24:51

and officers are as you know, speaking, that team and maybe this could be one of our wrap up questions here. You know, You play, you have a unique perspective because you've been involved in outpatient therapy, residential treatment. And now you're your inpatient inpatient. And also you've got this other hat that you've been a transition specialist with homeward bound. And we believe in a treatment team approach at homeward bound. And so from the coaches perspective, who's kind of looking at this from a holistic perspective, they're working with the family working with a little bit the team, they're working, collaborating with the professionals on that on that team. What do you How would you describe that special role.

Mike: 25:36

So I actually have a young woman now that I'm working with, and she had been in treatment for almost three years, and went through five different treatment centers. And previous to going into treatment she had really, they never diagnosed her with an eating disorder. But as I came into the picture, she should have been to or could have been diagnosed with bulimia. And so now she comes back home. And obviously, the mom is a single mom, and she was terrified that we're gonna go back into these behaviors. And so for the first probably three or four months, she was she was good. Doing well, granted, she was at a special high school was just basically one on one with the teacher. She finished what she needed to and she got put into a regular public high school. Well, you can probably guess what happened. with eating disorders, I will tell people, this set shift is huge for them. They don't like change. So that was huge shift for this kid. So now there's boys around here comes the comparison, here comes all of these things, right? And sure enough, she starts into some eating disorder behaviors. So immediately, I'm talking to Mom, I'm like, Okay, this is what we need to look for. Now, luckily, where they live, they have resources. And so I help mom navigate what those resources need to look like. So mom found a dietician who works with eating disorders, she found a therapist who works with eating disorders, and I was able to talk to them and say, Okay, here's kind of what's going on. You know, we're a team, and she has a primary care physician who we talked to and said, This is what I mean. So we did, we kind of brought all these people in, and she goes to groups with an eating disorder. So really, probably within a matter of two or three weeks, we were able to put this team together. And I told mom, I said, here's the perfect time for her to be in the school, because she's going to have all these set shifts happening. And what better time to have that now she can go to all of these professionals weekly, she'll see a dietitian, weekly. She's a therapist weekly, she sees her Ph or PCP monthly. But I said, this is the time, you have created an amazing team for her to now actually have these exposures, have these setbacks fall down, and she's going to learn how to get back up. And as a coach, I can help facilitate all this happening. So really now for the past three weeks, she's done wonderful. And she actually even told me, she goes, how off how much more depth to do this, like I'm doing good again, you know, I mean, so. So she's doing well.

Dr. Tim Thayne: 28:03

So she did an early detection of a relapse. Yeah. And I imagine you're also doing quite a bit of coaching with the parents to help them kind of hold their part of this.

Mike: 28:13

The mom, she's like, she goes Mike the thing and it's nice that she's recognized this she says Mike in the past, I would have gone downstairs spring, I would have overreacted completely react had been emotional with these behaviors. And she says, Now I know what to do different. Now I know how to support her, let that team do their job, and I can do my job as her as her mom. And that's been a huge, huge difference in her life.

Dr. Tim Thayne: 28:36

What an awesome thing. Great story to end on. Like that is fantastic. I should have had this conversation with you a long time ago. I think this is really educated me. I think it's gonna be really helpful to a lot of families out there. So thanks so much for being on the podcast and

Mike: 28:53

thanks for having me. Appreciate it.

Talmage Thayne: 28:57

Thank you for listening to this week's episode. In upcoming podcasts we'll be discussing the importance of family gatherings and traditions, and family values that can be found in holiday stories and origins. See you next time.