BODY DISCOMFORT: Key Takeaways From Eating Disorder Dietitian Tammy Beasley

AUTO GENERATED SCRIPT

Jessica Flint 0:02 Welcome to recover strong a podcast I will transform your recovery from an eating disorder by helping you go from theory to practice to mastery. This is your special time to learn new skills, tools and get the inspiration you need to recover strong. Let’s get started. Hello, my warrior friends. How are you all doing? My name is Jessica Flint. I’m the founder and CEO of recovery warriors, a multimedia resource hub for all things related to eating disorder recovery. I personally recovered from an eating disorder and I’m here to inspire you to do the same. I believe recovery is not only possible, but it’s worth it. That is why recover strong exists to help you see and connect to the potential that lies within you to find freedom from an eating disorder. Today we have a conversation with a trendsetting eating disorder dietitian in 1993. Tammy Beasley was the first registered dietitian to be certified by the International Association of eating disorder professionals, also known as Ida up. She is a sought after consultant speaker and leader in the eating disorder field, and is so passionate about living well in body, mind and soul. One thing I absolutely love about Tammy is how open she is about our personal history of an eating disorder and how she continues to use his first hand knowledge in her professional work decades later. There is a lot to learn in this episode. I hope after listening to it, you feel more connected to your body and confident that you can make real change happen in your recovery. Welcome to the show, Tammy. How are you doing?

Tammy Beasley 2:03 Thank you. I’m doing great. I’m very excited to be here. Thanks for asking.

Jessica Flint 2:08 When I think of nutrition education, I think of you Tammy Beasley, because of the extensive work you’ve done helping train other eating disorder professionals, and the ripple effect that has with the way these professionals communicate and educate their patients or clients. I’m curious to start off with how would you describe your role and approach to eating disorder education.

Tammy Beasley 2:31 So we get to plan and present educational opportunities to clinicians across the US. And I particularly will talk about eating disorders, I talk about creative nutrition therapy, how you can use creative analogies, which is one of my favorite things like real world analogies to make sense of the body, and how the body’s responding to the eating disorder before and during recovery. That’s a very powerful piece. And use a sponge, for example, a dried up sponge, compared to an actively used sponge. And that dried up sponge is visibly smaller, like crinkled crunchy, I pour a drop of water in that dried up sponge. And you’ll see it’ll spill over very quickly. It just can’t absorb it. And then where it does absorb it, it’ll just kind of poof in the middle. And that represents the gut of a client who has anorexia who has starved their gut to the point that it is basically unused and dried up and missing the digestive enzymes that would allow it to work, then you compare that to that fresh sponge, you pour the water in, and you can almost pour the entire water bottle in that sponge and it soaks it up. It doesn’t expand, it doesn’t move. It does its job. So that’s an example of kind of the education. I think, one of my roles too with the education piece, I call it taken away the surprise factor, which if you think about someone who has an eating disorder, and then they begin the recovery process, but they don’t understand their bodies to begin with. And then they’re not going to understand, like that example, why their gut is going to hurt and why it’s going to feel so uncomfortable if they don’t understand the physiology behind that. And that surprise factor is kind of headed off so that they are aware that this is what’s happening. This is why it’s going to hurt. Think about the power, they’ll have to be able to sit through that pain compared to someone who will immediately and rightfully so assuming Oh, I ate that or I drank that and it caused this to hurt so bad. So therefore it’s the food’s problem or it’s that drinks problem. Or I can’t do that because my body isn’t Isn’t handling it, it makes such a huge difference. It won’t make it an easier process. But I think that it takes away that what is going on with my body? I knew I couldn’t trust it feeling Yeah.

Jessica Flint 5:13 When did your kind of story start the development of your eating disorder? Have you been able to kind of link it to a certain period in your life or an event that kind of triggered the the development of it?

Tammy Beasley 5:27 I would say it was a process. My personality type is very driven, I’m not firstborn that you certainly would think I was. But in high school, it was one of those things that it just started creeping where the bar would be here, I would cross that bar. And I wouldn’t be okay, I had to raise the bar. So there wasn’t a moment of feeling like I’d achieved anything, I just raised the bar higher. And in that process, dealing with insecurity inside and thinking that, well, if anyone knows how afraid I am that I’m not going to make that grade, or I’m not going to achieve that accomplishment, was very, very fearful. So I actually come from a city of engineers were super smart city, and I was a female and a female in an engineering world would have been like, really awesome. So I was encouraged to go into engineering, and I hated it. Well, I didn’t know I hated it, but the pressure was huge. And so that freshman year in college, I carried all of that insecurity and playing around a little bit with trying to control the external. And then it just led to kind of a full blown year of anorexia, where I’m not even really sure when it first happened. It just all became this messy blob of my grades going down, eating, eating very little, very concerned about what I looked like, Was it okay. And then the next thing I know, I’m sitting in front of a physician, and he’s telling my mother that he really doesn’t think there’s anything wrong with me. Physically, he thinks I’m not fueling my body in that. And actually, I really greatly credit him because this was a long time ago. And this was a physician, an OB, who I went to see because I didn’t have a period. And I didn’t know why I didn’t have a period, but I didn’t have a period for a year. And so I go to see him and for him to be able to say, No, there’s nothing wrong with her reproductively. What’s wrong is, she’s underweight. And it caught me at a time that my grades also plummeted. That point, I was scared out of it, where it just kind of like, Oh, my goodness, you know, it is related to my nutrition. This has affected my grades, I’m not thinking clearly I’m not energetic, and I was able to kind of begin making changes on my own. But because I really didn’t seek the help, I needed therapeutically to really get through to the thought processes, it pops back up. I can say that that’s what led me into moving from engineering into nutrition. I saw how much nutrition impacted every part of my life. And it was such a blend of science and people to nutrition really became my passion at that point. However, I know that probably underlying it all, there was a desire to oh, if I just find out a little bit more about nutrition, I can fix myself. I know that was there, because it pops back up and it popped back up post internship after my dietetic internship. When I moved into a period of bulimia for about three years, it was a secret. And as a dietitian, practicing with a secret that big again, realizing that we didn’t get a lot of education, not that nobody was really talking about it. I didn’t really understand what was going on. I just knew that the more I tried to fix my nutrition, and the more I tried to fix my body with all my head knowledge, the less it was working. And the more depressed I was becoming, the more lost I felt in in who I was. And I think I wanted to be discovered because I had a psychologist that was a partner in business with me at the time. And I gave enough hints that I got called out and I was very grateful. And because of him stopping and asking those hard questions, you know, I’m concerned this is something’s not okay. I started going to a therapist and really digging into the roots underneath the behaviors. And honestly, to this day, I feel like that’s why I think Shane the whole discussion on shame is so important to me because I was just so covered in shame because I was a die Titian, I was able to give other people Grace where their food was concerned, I was able to tell them, they were okay in their bodies. But I could not tell it to myself. But I couldn’t tell anyone that it was a very shameful place to be professionally and personally. And just breaking that silence and saying, I have a problem. I need help. 51% of the battle, I felt like I had turned the corner. And that was just huge to me, because it was like you could the pressure of walking around with this big secret. And finally, I had someone who actually said I understand. And so when you said there’s actually hope, and there is recovery, and it is possible, was huge. It was a three year walk all the way through. It wasn’t an easy process. But it was a beautiful process. And I really honestly wouldn’t change any day of it. Because when I, I was really signed off by my therapist and was like, you go you live, you got this. It was scary. But I was ready. I met my husband to be we were married in six months, I moved to Miami, Florida. And I was dumped in a city that I didn’t have a job. I didn’t speak the language 200 nationalities. Scary. I will never forget when I called my husband at work crying, saying I just ate four cookies. And he listened. And he said, Okay, you ate four cookies. That’s okay. And I was like, that’s not a band. And he’s like, No, I think you ate four cookies. And I was like, Oh, my goodness, I just ate four cookies. So that was just this, this wonderful moment of like, ah, that’s awesome i for cookies. And I stayed. I stayed clinical in dietetics. Because I was healed. But I wasn’t sure that I needed to go into the field, which a lot of dietitians who have had an eating disorder will tell you there’s a point where you’re thinking maybe I shouldn’t do this work, since I’ve struggled struggle myself. But oh, my goodness, I got a call from a physician saying we need you to see our client and she has an eating disorder. And I was like, Are you sure you need me to see this client? They’re like, yes, we’re sure. And it was that was no turning back. That’s when I realized that you know what, I have full recovery, I believe this is possible. I fell in love with this field. And it was where I needed to be. That’s when I joined I adab. I read every book I possibly could, I could not get an app. And I had great support with a therapy team that we just worked so well together. And that’s where it all started.

Jessica Flint 12:38 And so you are an oath professional, you’re very interested in helping people diffuse the shame messages around food, but also their body and their self worth just like who they are as a person. And I can now see that is a lot because you had to carry that heavy weight of shame for so long. And it is burdensome. And it really does feel so much better when you can reach out and be vulnerable and, you know, get connected to the help you need.

Tammy Beasley 13:04 So much so much. I think that may be my mission now. And one of the ways that I think as a dietitian, we can help reduce that shame message is helping clients understand that all the changes that occur during an eating disorder, and during recovery are actually changes that the body makes trying to help not hurt. And I think that’s a very powerful thing to embrace, or at least hear and be curious about. I love the word, let’s just be curious. We don’t have to agree, we don’t have to feel all warm and fuzzy about foods. And I may share with you how your body works. And you don’t have to necessarily agree. But I want you to be curious to see if you just can sit with it for a minute and just see what happens. Just be curious about what I just said, it may be a different way of looking at what the body is doing, but hearing it as a way that the body is protecting and helping versus always that body going like One Direction and you going the other and trying to figure out why you are completely at opposite ends of the room. It helps bring you together to at least understand each other better, so that the shame piece can be neutralized. I’m not expecting my clients to just love their bodies, but to at least tolerate and be neutral and not punish that’s that’s what I’m going for first.

Jessica Flint 14:41 And I think so much of the behaviors and just really when you’re in the midst of an eating disorder is the body’s like the enemy and absolute in the mind kind of too it’s like this battlefield internal battlefield and yeah, it’s it’s not your adversary actually So you know, it’s fighting for you. It’s your advocate. And it’s really trying to help you live in, restore your vital and have your vital functions. And so yeah, I think that is important to think about.

Tammy Beasley 15:11 We know now there’s so much we know now, even over the past two or three years about the brain and the gut brain and that whole connection, but we now know that the brain isn’t fully restored for a full year after weight is restored. And we actually are even looking at some research is showing us that it may, the brain may not fully heal until the reproductive system is healed. And often you can reach a certain weight goal before a period returns or testosterone levels are stabilized. So we know the brain is the last to heal. The great news is that the brain can heal, but it can take minimum to the year after the body has restored its muscle mass. So knowing that, understanding that not being able to comprehend fully your feelings not being able to really fully embrace, I don’t know if I’m hungry, I don’t know if I’m full, because we can’t trust that yet the brain isn’t healed yet. It’s again, changing that language and changing that expectation and realizing that it is a process that the body is in the healing process. But instead of the body being faulty or full of flaws, unable to tell you whether you’re hungry or full, or you can’t trust your body, understanding that the brain is in the healing process, it’s still kind of in intensive care, and it’s still working to heal. And I think it helps the client be less judgmental to their lack of ability sometimes to make connections with their body symptoms and feelings.

Jessica Flint 16:54 Yeah, and I think that’s why Intuitive Eating isn’t something that is recommended, right? When you’re just starting the recovery process, you’re not just going to be launched into intuitive eating, oftentimes, there’s a meal plan and more structure around it. So you can get that fuel into your body at you know, a timely intervals, as opposed to just feeling it out. Because maybe you don’t have that sensation of hunger, or it’s insatiable.

Tammy Beasley 17:20 Exactly one of the main goals of the residential treatment piece is giving you a safe place where the meal pattern will be restored, that’s very important, you will be fueled every three hours, it will be a balance of energy and protein. And the purpose of that is, even though the disconnect is still happening, the purpose is recalibrating the system, setting a new pattern back the pattern that will be able to tell you whether you’re hungry or full way down the road. But initially, in that early stage of treatment, you can’t say you set up the structure and the pattern and trust the body. like training wheels, trust the body to recalibrate that and restore that so that you are able to do that, as your body was designed to do when you get in that outpatient arena. So we can talk anxiety level, you know what your anxiety level around food before you eat after up, but we try to be very careful with asking about, are you hungry? Or are you full when you’re in that residential treatment, that higher level of care, because it actually can be it can be detrimental, it can cause more anxiety because there is that disconnect, and we understand why. So we have to be very careful with that. But we again, we can ask him xiety We can ask comfort level, how comfortable are you? We can ask? When did your thoughts start turning towards the next meal? We can ask those kinds of things, but asking directly hunger and fullness in those early stages of treatment. It’s actually I think, more anxiety producing than helpful.

Jessica Flint 19:00 Yeah, I know a lot of people who when they first start to try to incorporate new foods, maybe not new but old foods, foods that are bad or you will blacklisted fear foods, challenge groups, they often have just incessant chatter in their brain about you know, this is bad, you’re gonna get fat, this you can’t have this, you know, whatever it may be is kind of the messages around that food. How does someone get over that kind of script that’s playing in their brain and it is really just very loud,

Tammy Beasley 19:32 very loud. I think that’s certainly the combination of the role of the therapist and the dietician working together. The first piece that the dietitian can bring is is again helping to stabilize the metabolism by just the pattern of eating and helping the client trust the pattern, which is very important, but all of those thoughts and fears that are just flying around in their brain about specific foods, the education piece I mentioned, creating an education piece about just the field groups and the power those field groups and the function they have and how they work together and balance each other kind of neutralizing the messages with just education on what’s really true versus what the world has tried to convince us of. When a client comes in, we will have them take a very extensive list on safe unsafe, like dislike foods, and it helps us kind of get an idea up front, on how many of those foods are screaming at them. And is it an entire food group that they’re afraid of, and we’re able to use that gradually, as we as with education, again, it’s trusting the system in the beginning, you’re changing their mindset take some time. But in that process of looking at that safe, unsafe food list, we guide the client and helping them be able to create a list of fear foods, actually, for every for every fuel group, and make a list on what’s the least fear to most feared foods. And when the time and place is ready, when we feel like there’s been some healing of the thought processes by again, the the refueling of the body and having that steady, every three hour nutrition coming in that all is again, doing some healing of the thought process, then as the therapies working to underlie, under, you know, to dig deeper into why those thought processes are there, we can begin bringing some exposures into those foods that are very scary, but we would never start with the most scary, we would start with the least scary, it allows the client to have a have a place where they can safely deal with it with those around them who can support them in that process. There’s a quote that I love. And it’s one of the things that I use to kind of negate that food shame and to kind of set the stage to begin working with food fears. Because food fears mean change, it means going and being willing to do something different to venture out to make a change that the quote is, when patterns are broken, new worlds emerge. One of the things I love to do that is really looking at the patterns. So before we even maybe venture to that scary food, fear food exposure, we may try to do something with just a simple pattern. Like, if the client always has this always at this time, it may be what I call a lateral move, it could be as simple as always chooses a red apple, the same red apple every time the lateral move is let’s choose a green apple. And that sounds so silly. But it’s so powerful, because they may not even be aware of what’s happening at that moment. But if you can break a pattern by just the smallest, tiniest, little open window, think about what that says, if they’re able to eat a green apple, when they always have a red apple, it may not produce a lot of anxiety, but it was a change, then you can remind them, you can change it’s possible you did this. And again, keeping a a journal that those changes helping the client see the changes they’re making. And even if they come to the to a private, you know, to one of the individual sessions, and instead of sitting quietly for five minutes, they sit quietly for two minutes, and they start talking all of those ways to show that we are making change changes happening. having confidence in their ability to make a change is huge. So if we can remind them of that, and give them practice and safe ways to make change, then when we actually venture to that scary food that fear food exposure, reminding them of all the ways that they have proven that to themselves that they have changed and are capable, gets a little more confidence to sit and deal with that. That whole fear of food exposure. And then I think you can build from there. Yeah,

Jessica Flint 24:29 no, that’s definitely I think a powerful way to be able to kind of tiptoe into it, because a lot of it is just like tiptoeing, you’re not just gonna Galavan to recovery. It’s kind of stepping outside of that comfort zone. And, and oftentimes it’s little little steps and I think that there’s a lot of power in the patterns. Well, before we wrap up the show, I just want to take a minute and acknowledge you for the professional work you do you really work tirelessly to make sure that there are more eating disorder specialists out there Aaron is trained and really understanding how to treat people who are struggling with this illness that is not just about the body, but the mind and the soul. And I think it’s really great that you bring so much creativity to it as well. And these analogies, speak loudly and really help people. So that’s great that you’re doing this work.

Tammy Beasley 25:19 Thank you for all that you do. Thank you so much.

Jessica Flint 25:23 Well, my final question for you is what is your definition of recovery?

Tammy Beasley 25:29 Recovery is beautiful imperfection. And I really love that. Seeing imperfection, as beautiful is part of it. It’s pitting free from any self punishing thoughts and behaviors. It may not be loving, you know, you may not necessarily like everything about your body today. I know I don’t always do that. But being free from punishing myself for something that I may not be just wanting to love and hug and embrace is recovery. But I think beautiful imperfection.

Jessica Flint 26:05 How can other recovery warriors stay in touch with you?

Tammy Beasley 26:09 Oh, you can email me I would love to hear from you. You can always reach me through iadep tammy@iadep.com

Jessica Flint 26:16 Oh, thank you so much for sharing your story, your professional experience and just yet for being here. Thank you, Tammy.

Tammy Beasley 26:24 Thank you so much.