Episode 44: Eating Disorders: A Journey to Recovery (Part 2)
Eating disorders are a common mental health concern, so we are pleased to have Dr. Christina Bjorndal, ND join us to discuss her mental health journey and what factors influence the development and healing process of an eating disorder in this special 2 part series.
The content of this podcast has not been evaluated by Health Canada or the FDA. It is educational in nature and should not be taken as medical advice. Always consult a qualified medical professional to see if a diet, lifestyle change, or supplement is right for you. Any supplements mentioned are not intended to diagnose, treat, cure, or prevent any disease. Please note that the opinions of the guests or hosts are their own and may not reflect those of Advanced Orthomolecular Research, Inc.
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Welcome to Supplementing Health, a podcast presented by Advanced Orthomolecular Research. We are all about applying evidence based and effective dietary, lifestyle and natural health product strategies for your optimal health. In each episode, we will feature very engaging clinicians and experts from the world of functional and naturopathic medicine to help achieve our mission to empower people to lead their best lives naturally.
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[01:10] Cassy Price: Hi and welcome back to Supplementing Health. Today we are going to be doing part two of our discussion with Dr. Christina Bjorndal about eating disorders and mental health. Welcome back Christina.
[01:22] Dr. Christina Bjorndal: Thanks for having me it’s great to be here.
[01:24] Cassy Price: I’m super looking forward to continuing this conversation so let’s dive right back in. So, then if we know that nurture plays such a huge role if we kind of flip back to that nature side of the conversation, is there a genetic component to eating disorders or that increase your risk for developing one if you do experience certain traumas?
[01:48] Dr. Christina Bjorndal: I think, for myself; you are going to find people that will say yes to that question. I personally am going to say no. I don’t subscribe to this gene theory so much. I subscribe to this theory of epigenetics. So, basically Bruce Lipton wrote an amazing book called The Biology of Belief and we want to understand that it is really to explain epigenetics. It means that the genes load the gun but lifestyle pulls the trigger. They have done studies on identical twins who have been given up for adoption and you would think that they would have the same disease expression, but they don’t. It is partly because of this epigenetic influence. The environment plays a role. I think that nurture trumps nature. The environment trumps the genetic expression because it is all about what turns the gene on or off. Does that make any sense?
[02:49] Cassy Price: Yeah. Absolutely. I agree. I think it is interesting to know our genes because it does let us know what light switches we have to turn on and off and I have seen some correlation. I know in my family we have a history of cardiovascular and cerebrovascular disease. When I have done my genetic tests, I have predispositions for that and those have been confirmed with other types of testing. Like my fatty acid profile or different types of testing that can tell you whether or not you are absorbing the nutrients, or you are doing certain things. But, at the same time all of my other markers for those things like my lipid tests and my different measurements; my blood pressure, they’re healthy, so there are different factors. Diet obviously plays a role and environment and activity and all of that. I do think it is interesting to know that blueprint or map, but I don’t think people need to take that as gospel per say and go “well I am going to die of blah blah blah anyways because I have these genetic…”
[04:08] Dr. Christina Bjorndal: That’s right. “So, I might as well have another set of french fries.” Exactly. For me because I am adopted and when I struggled with these mental health challenges and again coming back to that question why, one of the answers that I always got was that it is genetic. “You have Bipolar Disorder because it is genetic.” Well, I couldn’t look to my left or right to verify the truth of that. So, I didn’t accept it as the truth. I also think that it leaves people sometimes feeling like they are a victim like there is nothing that you can do because it is all written in your genetic code. I simply think that that does people a huge disservice, especially in the realm of mental health. I wouldn’t be sitting here talking to you today if I just said “Okay, sure, it’s genetic I’ll just take these five psychotropic drugs for the rest of my life and I’ll die at whatever age because after you’ve been on them for thirty or forty years, they also are going to kill you.” I was like “That doesn’t sound like a great plan.” I didn’t think that was helpful to hear at 27 so for me I get it. The reason my parents adopted me is because my dad is a Huntington’s carrier which is a genetic neurological disease that is devastating. It is Schizophrenia, Parkinson’s and Alzheimer’s all rolled in one. It is a tough disease to deal with. I still maintain this epigenetic idea even given that information about my dad. I look at him and his family. He is one of four. Two got Huntington’s and have passed away, my aunt and uncle, and two did not, my dad and my other aunt. I look at the differences in those four children as I just mentioned earlier, four kids can grow up in the same home and each have a completely different experience because of sibling positioning and order and many factors. It is an interesting discussion, but I want to empower people to understand that they can do something to help themselves even if they have a gene for something.
[06:16] Cassy Price: Absolutely. I think health in general can be a very empowering thing if you take that perspective of “This is just information and tools that I can use to decide where I want to go.” We are all going to die one day but we can either do it in a way where we get to enjoy our life and live it to the fullest or sit in a dark corner and just let it happen, right?
[06:42] Dr. Christina Bjorndal: I always say “Look, nobody is getting out of here alive.” You have a choice. That is the key thing in what you are saying, you have a choice. You can go and wallow in the corner or get out there and enjoy it. I’m shocked that I am even saying this because listen, I didn’t even think I would make it to 50. For me this is huge to say this because I did not think this way for at least the first 40 years of my life. I certainly did not. I thought that would never come out of my mouth.
[07:16] Cassy Price: I have heard loads of different stories, and even within my family, we have cousins and stuff that at the time of their diagnosis it’s like “You only have a couple more years to live.” And since those couple more years they have lived on 30, 40 or 50 years since. I think part of that is scientific advancements and as we learn more, we know more, we can then do more. I think a huge part is your attitude and your own perspective and mentality around your diagnosis.
[07:47] Dr. Christina Bjorndal: Understand too that nobody has a crystal ball. No doctor has a crystal ball. I really don’t think doctors should be giving people that kind of information. They do that a lot with cancer. I understand why they do it because if you do truly have that limited amount of time left on the planet then certainly there are things you need to get in order but there are lots of stories that you hear about people who have been told they have X amount of time and some people go on to live decades beyond that and other people, they die a day before or a day after that timer was given to them. It is super interesting to me. Fascinating.
[08:40] Cassy Price: So, jumping back a little bit to the eating disorders that you mentioned like specifically Anorexia and Bulimia, they are two sides of the same coin, right? One is completely restricting the intake, the other is excessive intake and then purging it all out. Either way you are really not getting the nutrients that you need from the food that you should be taking in, right? So, what are some of the long-term effects that can come from those kind of restrictive diets that come out of these eating disorders?
[09:18] Dr. Christina Bjorndal: It depends on the severity of the Bulimia. Bulimia is the frequency piece. I don’t like to talk too deep into it because I don’t like to suggest things to people. I think Anorexia in my mind and what the research shows is that it is actually more problematic for long term health. One of the things is osteoporosis and osteopenia. So, those are really important to understand that everything that you build within your body, whether it be your bones or your brain or your muscle or your digestive tissue and organs, it is all made of nutrients. That is how you build the human body. If you are devoid of that, these pieces of your health are going to suffer as a consequence. The biggest things that I see with anorexia are the osteoporosis and osteopenia but then big hormone problems. From menstruation, this when they have recovered, right? So, when you have recovered you can still have this hormone piece showing up in fertility challenges, thyroid problems, digestive concerns. There is a lot of long-term health impacts or influences. Bulimia. It depends on the severity. On a scale of one to 10, is it a 10 out of 10? Then you are going to see similar outcomes. I feel that Bulimia is much more of a gradient than Anorexia. If that is making sense.
[11:13] Cassy Price: Yeah, that does for sure. The other thing that I know that can come up sometimes, people throw these words around like said over labelling people, right? When we were younger, I had a friend who actually had a thyroid condition that hadn’t yet been diagnosed so she was very much that frail, thin, tall, skinny kind of girl. People would say she was anorexic which she wasn’t. She was very active. She ate plenty of healthy food. It actually really upset her because she had been given this label by other kids or other people that didn’t at all reflect who she was and eventually it came out that she did have this thyroid condition and she was able to get the proper help to fix the issues. Giving out those labels unnecessarily or excessively can have an impact and potentially even cause some of those little t traumas that we were previously discussing, can they not?
[12:15] Dr. Christina Bjorndal: Yes, absolutely. In your friends’ case, I have a patient that is similar in that regard. She is quite thin. Her doctor keeps telling her she has an eating disorder. She doesn’t. This is why I love naturopathic medicine because we really take the time to sit with you, to understand what is going on and try to determine what the route cause or causes can be, and thyroid is huge. It regulates metabolism so whether your hyperthyroid or hypothyroid, more commonly I see hypo functioning thyroid but understand there is a connection between that and your adrenal glands and stress. It is multifactorial. The hormones, there is many hormones in the body, and they really need to be in balance like a fine symphony. If one organ is out of tune or one violin is out of tune i.e., one hormone is out of balance it can throw the whole symphony out of balance. We want to be always looking at and listening to people like in your friends’ case and my patients case that it is not an eating disorder. I think it is insulting to them. It is hurtful. They are not being heard.
[13:39] Cassy Price: Yeah. For sure. Now food is an essential part of life. We do need to get the nutrients into our body to properly fuel all of the difference functions that it does whether you are an active person or an inactive person your body is still working 24/7, right? So, how do you go about treating someone who has that unhealthy relationship with food and help them to correct or improve that relationship so they can then go to a party or eat and deal with stress without binging and purging or avoiding it entirely to regain that control that they are craving, I guess?
[14:19] Dr. Christina Bjorndal: I think one of the things is to understand that the relationship with food is a reflection of your relationship with yourself. So, it is the same with someone who has suicidal thoughts and wants to end their life. We have to bring two pieces to the health equation that aren’t often brought. That is love and compassion. We need to build on this relationship with yourself. A key question I ask my patients is where did you learn not to love and accept yourself? It is important to work on these beliefs and the messaging that we get, the programming that happens to shift and change these faulty beliefs to healthier ones. Also, I want people to understand that this is not an overnight recovery. It is not that one day I am struggling with anorexia or bulimia and then the next day I am fine. This is a process, and it can take decades. Some would argue that you never get over this. I think that it is important to really celebrate the really small steps that are taken when someone is recovering. These are serious conditions, and they are not treated properly in the medical world because they don’t always bring as much love and compassion to the table in my opinion and experience.
[16:06] Cassy Price: That all makes sense. It is such a complex relationship going through those stages in your life. I think I read somewhere that girls have an inherent self confidence only until the age of nine at which point, they start questioning everything and can just as easily flip to having no self confidence and all of that. It is kind of crazy that it can change just like that for people, right? That was specifically about girls, but I know boys can experience the same thing. It is not that it is strictly for females that can question if they are pretty enough or the right size or feminine enough or masculine enough or whatever it is that they happen to be questioning, right? Now nutrient deprivation can also have cognitive effects so can those cognitive effects play into your mental health concerns and issues that you are dealing with?
[17:10] Dr. Christina Bjorndal: Yeah. Cognitive effects like if you are not getting enough nutrients then you will be experiencing things like foggy thinking and brain fog or memory issues, performance issues, focus issues, inability to study and concentrate. That then feeds into the depression and anxiety and it is just a really vicious cycle.
[17:39] Cassy Price: Would body dysmorphia be classified as an eating disorder or play into eating disorders as well?
[17:49] Dr. Christina Bjorndal: So technically you would think that would be an eating disorder but technically it is actually not. It can be seen in people with eating disorders, but it is a distinctly different issue. It is classified in the DSM manual more under OCD. It is more of an obsession or preoccupation with one or more perceived flaws in their appearance. This can be not just around food, but it can be around how your hair is or your nose or any body part can be a subject of concern. It crosses over into both categories. It is a mental illness/eating disorder. It could be considered.
[18:42] Cassy Price: What should friends and family look out for in loved ones that they believe might be at risk of an eating disorder or in the early stages of an eating disorder?
[18:54] Dr. Christina Bjorndal: A book I am going to suggest for parents to read is “Hold On to Your Kids” by Parents Matter More Than Peers. This is a book by Gabor Maté and Gordon Neufeld. It is important to read when you are expecting or before your kids are the age of two and again when they are heading into those tween years so eight, nine and maybe for boy more like 11, 12. That is to help reverse and even prevent these things from happening in the first place.
[19:26] For somebody who is concerned about whether their child has an eating disorder, some of the things to look for are this obsession with weight and then talking about their body shape or that they want to look different or lose weight. If they are talking a lot about food and being healthy or having to eat clean or dieting or is constantly dieting. Those areas around weight are one thing. The second thing is the exercise piece that I mentioned. So, increases in exercise regimes like all of a sudden going and running 10 miles like in my case. That physical activity is because of wanting to compensate for the caloric intake. If they become really upset or anxious if they can’t exercise.
[20:18] Meal preparation is another one. My husband was telling me about a friend that he knew. She would make all of these wonderful meals and bake all of these cookies but would never eat it. Sometimes people hide behind the cooking. It looks like they are cooking and “oh they must be eating”, but actually that is all they are doing. They are cooking and they are not eating. Then we mentioned this word before. Control. You want to watch if they get really upset about being able to control a situation related to food or if their meal isn’t served a certain way or if you go out to eat and it comes… just watching for the reactivity around food. On that note too I want to mention the piece around you as a parent controlling the food for them as well. That can feed into an eating disorder.
[21:30] Then with Bulimia what you want to be looking for is odd behaviours before and after a meal. Is someone making frequent excuses to go to the bathroom. Do they not want to eat in front of someone? Do they take their food to their room and eat in private? That was a big thing when I was hospitalised. We were all forced to sit down and eat. I say forced quite strongly but ‘highly encouraged’ to sit and eat in everyone’s presence in the psych ward so very hard to do for someone with eating disorder issues. Then also if you notice them engaging in different rituals around food like cutting things up super small. Eating things in a certain order, I laugh at that because I do that actually. I just like to eat one thing at a time whereas my husband laughs because if there are four things on our plate, he will take a bite and his one bite includes all four. I will eat all the chicken, then all the broccoli or rice or whatever it is. So, I don’t know. I don’t think that is a huge problem personally, but it is interesting to now look at my son who has two parents who eat the opposite, one is mixing it all up and I’m…I don’t know so much about that but it is something that I came across when I was preparing for this conversation today so I thought I would just mention it.
[23:00] Cassy Price: I find that funny because we are similar in our house. My husband will jump around between different things and I’m like “okay, I am eating this piece and then I will move on.” I work to save the best for last almost.
[23:13] Dr. Christina Bjorndal: Yes exactly. I’ll tell you a funny story about that. I do that and my friend was watching me. It was my friends’ husband actually. There was this meat that he had made, and it was really delicious. Anyway, I ate most of it, but I saved two bites and I went around my plate and ate the rest and then just when I am about to eat the last piece, he grabbed it off my plate and ate it. I was like “no! no!” What I will say about that, not so much eating things in a certain order but not letting your food touch, so if the chicken is touching the…some people get really upset about that. That to me is leaning more into the OCD piece. Two more areas to be aware of is mood. Obviously, mood is a big piece of this so if your child all of a sudden seems more depressed or anxious or irritable or more fatigued this is something to look out for. I am not saying that… especially with teenagers, my son is 14 and a half he doesn’t have any mood issues but sometimes I am hearing from my friends who have girls, and I feel bad even saying this because they are both dealing with hormones, teenagers are dealing with hormones so we just want to understand that with the hormone piece that things like depression and anxiety and eating issues and sleeping and all of these things can be because hormones are out of balance. Again, we need to be careful to look at what the root of the problem is and not just label people with things vs. trying to understand why are these happenings happening to people. Then energy is another piece of that puzzle. If their energy is plummeting, that is really big with anorexia and Bulimia too. I don’t see with Bulimia, I am not saying that it doesn’t exist because some people do which again is that frequency piece, but that is why in my case I didn’t purge every meal I had. It was really around the stress piece for me. That is the last area that I am going to say for parents and family members to look out for is stress and trauma that we talked about earlier. These traumas don’t just happen under the age of 10. They can happen any time in our lives. What has been the shift in their behaviour as a result of the stress with a trauma? There are lots of things to look for, right? Be aware.
[26:09] Cassy Price: Absolutely. One last question because we are reaching the end of our time here, you had mentioned controlling your kids food and I think we all try to control it to certain degree because we want to make sure that they are getting the healthy foods and their fruits and their vegetables and that sort of thing, especially if you have a pickier eater you want to make sure that you are giving them what they need as far as nourishment goes. Do you have tips for adults or for parents that can help them to ensure that their kids are getting those nutrients that they need while giving their kids the autonomy that they are looking for?
[26:44] Dr. Christina Bjorndal: Yeah exactly. Picky eaters just give them what they will eat. Sometimes picky eaters… understand that your taste buds aren’t fully formed when you are three and a half years old. A lot of kids get labelled as a picky eater when they are little and I would highly encourage you not to say that in front of your child because guess what? They are hearing that. So, don’t be calling your kids picky eaters, they are eaters and they will eat what they are able to eat based on their tastebuds and how those taste buds are developing so just give them more of what they will eat within moderation obviously. If all they are going to eat is sugar, then obviously no that is not what you are going to do. You can work with a naturopathic doctor because certain nutrients, whether they are not eating enough or a broad range, can also be understood from a homeopathic perspective. There are wonderful different homeopathic remedies that can help shift the eating piece within younger children, I am talking seven and under. You can also have a nutritional analysis done with a naturopathic doctor. I remember one of my very first patients many, many, years ago brought her daughter, I think she was three at the time, very concerned about her eating and to help alleviate her concern I said, “let’s do a nutritional analysis.” I did and I showed her that “You know, your daughter is actually very healthy for what you are giving her.” Sometimes these issues are the parents’ issue. My son when he was a little baby, we are talking six months to nine months when food introduction was starting to happen, I was so stressed out as a parent about feeding him the right things. He was already under, he was in the fifth percentile when he was born and he fell off the chart, he has never been on the chart since. I took him to the paediatrician, and she told me to feed him Fruit Loops at which point I never went back. We get hung up about these numbers from the moment our kids are born, and I think we want to throw the charts out to some extent and look at the idea from a health perspective and not from a chart perspective. Breast fed babies are not as big as formula fed babies. Just moving into adolescence here, I was thinking about this with my own son. When he was a baby and I mentioned there was struggles that I was having with his eating and six months old, I had a huge “aha” moment. I was like “Oh my god, this is my issue.” He doesn’t have an issue. I have the issue. I had to work on myself. Now that he is 14 and a half, I am still finding the balance. This is tough. I am a naturopathic doctor who has had an eating disorder. I have all of this knowledge about the damaging effects of sugar and pop and processed foods and it can be a challenge and it is a challenge for me because I want to bring balance to his life, but I don’t want to bring obsession to his life. The balance point is different for every family. Both my husband and I are naturopathic doctors, so my kid had never had pop. He is 14 and a half and he has never had a pop. I am not saying this to say that I am anything, I just want you to understand that I still deal with this with my own kid and I have to be very mindful of this relationship because I don’t want him to be obsessed about sugar. In December he decided to do a sugar challenge with his buddy, and they quit sugar. It was a competition to see who could outlast the other. At first, I thought “That’s great, good for you. Way to go.” Then I started thinking “Is this a good thing? That is not super balanced, but I do think ultimately it is a good thing.” Anyway, he lost, his friend apparently beat him, but now he is back to wanting to have ice cream every night and all this sugar. Anyway, I am going on a tangent here but what I am trying to say is try to teach your children to understand nutrition and yes, we want to have some but we don’t want that to be the only thing that we eat in our diet. For me, I am okay if he has some of these things every day perhaps. Other homes may say that is appalling that I allow my kids to have a bowl of ice cream every day. I think everybody has to find the right balance point of what works for them.
[31:48] Cassy Price: It goes back to that everything in moderation on this one, right?
[31:51] Dr. Christina Bjorndal: Yeah that sort of 80-20 rule. Also teaching our children how to be emotionally intelligent is also part of this. I wasn’t emotionally intelligent as a child and I really struggled. These emotionally intelligent skills, things like compassion, empathy, resilience, and growth mindset. A colleague of mine has a programme called the Umbrella Skills. It is really important. The last thing I will say about this is also to get your kid off their phones. Social media and technology. You need to be engaging with your kids. Do not let them on social media if you can. I will tell you another little story about my son. When he was in grade seven, he was bullied, I went to the principal to get it addressed, he asked me if he was on social media. At that point my son didn’t have a phone. I said no. The Principal said to me “Keep him off it as long as you can. Do not let him go on it. My daughter is 16 and she is dealing with a lot of mental health challenges because of this. It is really bad.” So, I know it is a tough one for parents, but you really need to watch that movie that came out The Social Dilemma.
[33:19] Cassy Price: That was super intriguing. I actually watched it on the weekend, and it is mind blowing. I think this is a topic that we could probably go on about for hours honestly there is so many different paths that we can dig up and talk about and analyse and discuss. Unfortunately, we have reached the end of our time. So, if our listeners want to get a hold of you, work with you, how can they go about doing that?
[33:43] Dr. Christina Bjorndal: So my website, it’s my name, drchrisitnabjorndal.com, and the best thing I have is a Moving Beyond programme. It is a coaching programme that guides people through the ten steps that I talk about in my book Beyond the Label to help with mental wellness and regaining your mental health so that you don’t have to be at the mercy of your mind anymore you can learn how to manage it. If people want to work with me one on one that is an option too. There is an application on my website so just fill that out. I have a bit of a waiting list which is why the programme is a great option and then of course the books and social media. What else? I’m sure if you search my name you will find me.
[34:32] Cassy Price: Thank you so much for taking the time to chat with me. This has been a fantastic conversation. I think we explored a lot of different avenues and it can get people starting to think about themselves and where they are at and where they need to go. So, thanks.
[34:48] Dr. Christina Bjorndal: Thank you. Take care.
[34:49] Cassy Price: You too.
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