207: Ask Me Anything – Number 2 | Seven Health: Eating Disorder Recovery and Anti Diet Nutritionist

Chris Sandel: Welcome to Episode 207 of Real Health Radio. You can find the links talked about as part of this episode at the show notes, which is seven-health.com/207.

Seven Health is currently taking on new clients, and there’s a handful of reasons that clients commonly come and see us. Hypothalamic amenorrhea is the first one, and this is the fancy name for not getting a period. This is often the result of undereating and over-exercising for what your body needs, and this is irrespective of your actual weight. It’s almost always coupled with body dissatisfaction and a fear of gaining weight.

At the beginning of September, we’re going to be starting with new clients again. This will be the last time that we start with clients in 2020. Client work is the core of the business and is the thing I actually enjoy the most. After working with clients for the last decade, I feel confident in saying I’m very good at what I do.

When I reflect on the clients that have sought out Seven Health over the last couple years, there’s a handful of areas that come up most. One of the biggest is helping women get their periods back, so recovery from hypothalamic amenorrhea, or HA. This is often a result of undereating and over-exercising and is almost always connected with a fear of weight gain and a focus on being ‘healthy’. I’ve had clients regain their period after being absent for 10 or even 20 years, often after being told it would never happen again, or clients becoming pregnant who had almost given up hope of it happening.

We work with clients along the disordered eating and eating disorder spectrum. Many clients wouldn’t think to use the term ‘disordered eating’ to describe themselves; they just know that things aren’t right. With these clients, there are symptoms that are commonly occurring – water retention, poor digestion, always cold, peeing all the time (especially waking multiple times in the night), no periods or bad PMS, low energy, poor sleep, low thyroid. There’s also common mental and emotional symptoms – a compulsion for exercise, a fear of certain foods, anxiety, low mood or depression, poor body image, and a fear of gaining weight.

At Seven Health, we believe in full recovery. We’ve had many clients who’ve had multiple stays at inpatient facilities where nothing worked, but through working with us, they got to a place of full recovery.

Many clients come to Seven Health because they want help transitioning out of dieting and so they can finally start to listen to their body. They’ve had years or decades of dieting, and it hasn’t worked, but they’re struggling to figure out how to eat without dieting. Many clients experience feelings of body shame and hatred. They’re determined to be a particular size, and they feel frustrated or even angry by what they see in the mirror. They want to get past this and to be able to be present and stop putting life on hold.

In all these scenarios, we use the core components of what Seven Health is about, which is science and compassion. We focus on both physiology and psychology, so understanding how the body works and how to best support it and also understanding the mental/emotional side and uncovering someone’s identity and values and priorities and traits and beliefs, and looking at how these are helping or hindering with the change process.

It’s these kind of clients that make up the bulk of the practice, and I’m very good at helping people get to places with their food and their body, and even with their life, that feel out of reach.

If any of these scenarios sound like you and you’d like help, then please get in contact. You can head over to seven-health.com/help, and there you can read about how we work with clients and apply for a free initial chat. This will be the last time we start with clients in 2020, so if you would like help, then please reach out. The link, again, is seven-health.com/help, and I’ll also include it in the show notes.

Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. This week on the show, we are doing another Ask Me Anything, or AMA episode. We did one of these recently as a way of celebrating the 200^th episode of the show, and I really loved doing it. It was great to see all the questions from you guys, and I just enjoyed the format and how it allowed me to cover a wide range of topics. I love doing the solo episodes that I do and getting to spend 40 minutes or an hour and 40 minutes covering a specific topic in a ton of detail, and it means that those shows are detailed, but they’re pretty narrow in their focus. But with the AMA, I can touch lots of topics in one show.

There’s nothing else I need to say as part of today’s intro, so let’s get on with the show. Here is AMA #2 with Drew and I answering your questions.

Hey, Drew. Welcome back to another AMA.

Drew: Hey, Chris. Good to be here.

Chris Sandel: One of the bits of feedback we got last time when we did this was that I failed to properly introduce you and that listeners didn’t really know necessarily who you were or any backstory on you – and yes, I introduced you in terms of your role at Seven Health, but that was kind of it. So I want to start this AMA by just having a little bit of an introduction with you and giving the listeners a little bit more details on who you are. So do you want to give a little bit of your backstory, your bio of who you are and what you’ve done and what you’re currently doing?

Drew: Yeah, the feedback was just “Cool podcast, who’s this random person?” [laughs]

Chris Sandel: [laughs] Yeah.

00:05:23

A bit about Drew's background

Drew: Okay, cool. I’m Drew, and I’m the Director of Marketing and Operations here. We talked about this before, but I think it’s been 3+ years. In the rest of my life, I have a really random career. I don’t really know what I would call it. I have my own online business called Chartered Wellness. I’m a nutritionist there, and I work for you, and also I work for a functional medicine doctor, helping with his podcast and his supplement line and that sort of stuff.

My business and my work has been all online for 4 or 5 years now, and I took advantage of that by moving from Seattle, where I’m from, to Bangkok, Thailand about 3 years ago with my husband – for no real reason other than just we wanted to have an adventure. We were there actually on our honeymoon, and we have some friends that live there. It was I think the day after the 2016 election, and our friends offered him a job. We hadn’t planned on moving abroad, but we were like, “I don’t know, things seem like they’re really going to shit at home. Maybe we should ride it out abroad for a while.”

So we just took the plunge and moved over there, and we spent the last 3 years having absolutely the time of our lives. We traveled everywhere. We went all over Southeast Asia, all over that side of the world, ate all the things, saw all the things, surfed all the things. It was a really incredible experience. We had a great time.

Then earlier this year, we decided to come home. My dad is getting a little bit older, and I’m an only child, so it just felt good to be closer to him. Also, we wanted to come back and make those sweet, sweet American dollars so we could save up to eventually buy a farm on Hawaii. That’s the eventual goal. We’ll see what happens. Maybe we might die of COVID first. TBD. But that’s the plan.

Chris Sandel: Nice. With you and getting into nutrition, how did that come about? What was the pull towards that area of study?

Drew: I hate telling this story because it’s like the most typical white lady thing. [laughs] Basically, I had health issues. In my past life, I was in corporate marketing. I worked for Verizon. I had a bunch of health issues and I could not get them figured out. I went to the conventional doctor and they said, “You’re fine. Just eat less and exercise more.”

That obviously didn’t put me in a very good place, so I started learning about holistic nutrition and medicine. I got actually a good amount of help from there, and it was really great – and I became a bit obsessive about it. It definitely turned into one of those things where I felt like, “I’m spending all of my time on this anyway, and I hate my current job; why don’t I just go to school and get paid for this?” I feel like this is tale as old as time.

So I quit my job and went back to school at a school called Bauman College in Berkeley, California. It was great. It was really interesting. Like any nutrition program, there are problems with it, and it’s certainly not perfect, but it was really interesting, and I am still glad I did it. I think we might’ve mentioned this last time, but I also did the Precision Nutrition Level 2 certification as well.

It’s been good. I’ve definitely worked a lot on my relationship with food since then, and I’m in the middle of trying to figure out how I marry those two things. I get a lot of people coming to me not for eating disorder stuff, not for that sort of thing; I get more people coming to me with – I tend to see a lot of people with digestive issues, and the population that I see is not a lot of disordered eaters. I’m still in the middle of figuring out how I marry the nutrition, the physiology, the stuff that I do know, with also a non-diet and Health at Every Size approach for people who are not actually looking for that because they’re not disordered eaters. But I still feel strongly about it. It’s a work in progress. I’m sort of in the messy middle.

Chris Sandel: When did you find Health at Every Size and Intuitive Eating, and what was your reaction to that stuff when you were first exposed to it?

Drew: I was living in the Bay Area. I was still in school, actually, I remember. I was living in the Bay Area, and I don’t even remember how I came across her, but I found Isabel Foxen Duke. She was my first intro to this. It was just like a lightbulb had gone on. First of all, she’s great. She’s so relatable and so well-spoken. She’s so articulate. She just says everything that you’re thinking. You’re like, “Oh, I didn’t even know I was feeling that way until you put words to it.”

So she was my introduction to going down the rabbit hole of Health at Every Size and Intuitive Eating and all that stuff. Of course, the journey has not been exactly up and to the right since then. It’s messy and windy. But it’s been so interesting, and I continue to learn about it and read more stuff and educate myself on it all the time.

Actually, Instagram has been really helpful. There’s so much good content on there. I know it’s not your favorite platform, but I’ve learned so much from it.

Chris Sandel: Nice. That’s cool. I think it was then through Isabel that you found me? Is that right? Because I did a guest talk or lecture or something as part of her program.

Drew: Yeah, you did the one on beliefs and how they’re formed. I just thought it was fascinating because I’m a nerd and you are a nerd, and it felt like kindred spirits. [laughs]

Chris Sandel: [laughs] Yeah. Is there anything else as just this little intro that we need to let listeners know? Or have we covered it?

Drew: I am a crazy dog lady, but I don’t own any dogs. But if you have any cute dog photos, please send them to me.

Chris Sandel: Cool. So everyone is now up to speed on who you are.

Drew: Cool.

00:12:03

Addendum to Chris's favourite foods

Chris Sandel: Before we then jump into this week’s questions, there were two addendums that I want to add from last time, when we did the last AMA for Episode 200.

One of the questions was asking about favourite foods or foods you can’t say ‘no’ to, and I went on quite a long spiel about my love of barbequing and barbeques in general. One of the things I forgot to add, which I got off and I was like, “Oh, I really should’ve mentioned this,” is bananas that you then put a slit into and stuff with things that can be melted and cooked on the barbeque. You stuff them and then you wrap them in foil.

Normally I’ll get some chocolate and stuff it in there and have that as barbequed dessert, and then you have this nice melted chocolate with baked banana, and it is absolutely delicious. Ramsay, my two-and-a-half-year-old son, just loves them, and he has a face that is completely covered in chocolate by the end. So I feel like I definitely needed to mention that.

And the person who told me about that was Meret Boxler, who is a client of mine. You may remember her from the Life Unrestricted Podcast. She put me onto that, and my life has been better ever since. Ramsay is incredibly grateful for that bit of advice.

Drew: So it’s basically a cross between a banana split and a s’more.

Chris Sandel: Yes, and I’m trying to work out ways to stuff more things in there. I put in shredded coconut once, but I’m trying to work out the ultimate of banana, some kind of biscuity goodness, maybe some chocolate, some marshmallow – yeah, really make a full dessert on the barbeque.

Drew: I love it. We were talking before we got on the call – I’m going camping this weekend, and I was actually just looking at a recipe for these banana boats, and they look so wonderful. The ones that we were looking at have things like pecans and coconut and marshmallows and something that looks like dried cherries. I don’t know, it looks pretty outrageous. I’m going to try it this weekend for sure.

Also, I was going to say that it’s cracking me up that we did that whole podcast and you got to the end and hung up and you were like, “Oh my God, I can’t believe I didn’t talk about banana boats,” and you’ve been thinking about it for like 6 weeks. [laughs] And we get on the call and you’re like, “I have to mention this.”

Chris: It has stayed with me and it has haunted me. So yeah, I needed to mention it. Also, for anyone who’s not from the U.S., pecans are pecans!

Drew: Or if you’re in the South in the U.S., they call them pecans too.

00:15:10

Addendum to Chris's views on HAES

Chris Sandel: Cool. Then the other one – we had a question about Health at Every Size and about people’s arguments against it, and as part of that, I’d made a statement of the fact that I wasn’t 100% onboard with Health at Every Size or wasn’t 100% on board really with any movement.

I want to just clarify that, because I did get some feedback from people asking what exactly I meant or what I wasn’t on board with, with Health at Every Size. The answer is I’m on board with all of Health at Every Size. It’s not the tenets or the principles that I have a problem with; it’s the fact that with any movement, at the extreme ends of those movements, it becomes militant and reductionist and there’s a lack of nuance or lack of understanding complexity. It gets to a point where it just completely stifles conversation, and “you’re either with us or against us.” It becomes very adversarial.

That’s why I made that comment. I’m just not 100% with any movement because I’m always wary of the extreme ends of those movements and how it just shuts down conversations. I really wanted to clarify that so that people were aware.

Drew: Cool. I think it’s good to add that extra color.

Chris Sandel: Now, with all that said, we can now get on with today’s questions.

00:16:48

How can I overcome compulsive movement?

Drew: Let’s do that. We have a lot of good ones today. The first one comes from Madelon, and she wants to know what your view is on overcoming compulsive movement as part of an eating disorder.

Chris Sandel: I’m going to assume that the intention with this question was asking how to go about overcoming compulsive movement as part of an eating disorder. Is that how you’d interpreted it, Drew?

Drew: Yeah, that’s how I took it.

Chris Sandel: Cool. I think with pretty much every question I’m going to answer today, it’ll be “it depends.” But there are many different ways of being able to do this. It depends on the client I have in front of me.

For some people, we will do this incrementally. We’ll look at how much movement they’re currently doing, and for the next 2 weeks, let’s see if we can reduce it by X amount” or “let’s see if we can remove this session” or whatever it may be – and they will be the ones that are along for the journey in terms of us figuring out what the goal will be with that.

Another option is starting to remove the higher intensity end of the spectrum, where someone says “I’m going to give up the running” or “I’m going to give up the spin class” or “I’m going to give up the high intensity exercise,” but then they’re keeping some of the easier things or the things that are less stressful on the body.

In other situations, it’s have a complete break from exercise altogether, like ripping off the Band-Aid. With all of these options, it’s working out where the client is, how comfortable they feel with these different options, and making a decision based on that.

But it’s not just the exercise part of it. Alongside of that, if you’re now removing or decreasing someone’s exercise, there’s things that need to come in to make that sustainable. If someone now has this void of time, what do you enjoy spending your time on? How can we be encouraging that to come back into your life? Either what are you already doing that you enjoy and you could be doing more of, or what did you enjoy doing that has now drifted out of your life? Starting to have them spend more of their time on those things.

It’s also looking at new coping skills and ways to deal with emotions and stress in their life, because often that’s the role of exercise. So learning those other skills. It’s also doing the body acceptance and identity work, because for so many people, part of the difficulty with giving up exercise or reducing exercise is how that’s going to change their body. Or for others, it’s “How is that going to change my identity if I’m known as the fit one or I’m known as the runner?” or whatever it may be. That’s some work that needs to happen alongside it.

Also, just looking at what this is going to look like down the road as well. When someone is returning to exercise, if they’ve had a time off or they’re starting to find new ways of exercising, if there’s been some that they’ve now had to stop, can you find new ways of exercising that are connected to fun and joy instead of whatever used to be the other metrics? So instead of aesthetics or instead of a particular mileage that you were trying to do or some numbers or whatever it was connected to before, how can you find exercise or movement that fills a very different hole or fits into your life very differently to how it was before?

They’re kind of all of the things I’m thinking about when thinking of overcoming compulsive movement, and there’s probably a lot that I’ve forgotten, but they’re the things that come to mind. It’s not just about the movement. There’s so many other pieces that are connected to it.

Drew: I really like that, and I like what you said about working on new coping skills because so often – a lot of things go into it, but so often that really is a coping mechanism for when things feel out of control or they feel hard. Really working through, now when things feel hard, now when things feel out of control, what is a different thing that I can do that doesn’t involve exercising to the point where I’m hurting my body?

It actually made me think when you were talking about it that Lu, our other practitioner, wrote a great blog post about this back in March. It’s called “Developing a Healthy Coping Progression,” and basically she walks through some really helpful advice on the different types of coping and how you can work through finding new ones. Definitely something to check out.

Chris Sandel: Yeah. I would say for a lot of people, it’s only the point of when trying to remove the exercise or decrease the exercise that they only think of it or start to think of it as a coping skill. Before, they’re like, “This is just what I do. This is how I live my life. No, this isn’t how I cope.” But it’s only when that has started to be played around with that people can really start to notice how much of a big deal it is in their life and how difficult it is for them to be when that’s not around or not around to the level that it has been.

So yeah, I think the coping skills piece is quite a big one – and that’s a whole other podcast in and of itself in terms of what that means. Depending on the individual, that could mean lots of different things. That could mean going to therapy to deal with trauma. That could mean learning to play guitar. It can mean so many different things to different people.

00:23:05

What should I eat when I'm ill?

Drew: Right, exactly. Our next question, I’m going to apologize in advance because I know that I’m going to butcher this name, and I am so sorry. I even googled to see if I could figure out how to pronounce it, and I can’t. Apologies in advance, but I’m going to go with Zaprian. Zaprian’s question is: What’s the best way to deal when you get ill or sick? Some people say to just go on fruits and vegetables and to not stress your body with digestion too much, and other people recommend things like long-cooked soups and meats, things like that. What’s your take, Chris?

Chris Sandel: I don’t think there is necessarily a right answer to this question, and I think it will depend on the individual, but it will also depend on what that sickness is and how it affects someone. In one occurrence, it might be “I did really well on these things,” and then the next time they’re sick it might feel really different, and they do well on something else.

I would say in a general sense, typically people will want things that are soups or stews or things that are cooked for a while that are easy on digestion, in some situations. Other times they’ll feel like they want more plain foods – plain toast or crackers or bread, very simple, savory carbs that you would think of more maybe as a snack than a real meal.

But my tendency with this is really to just go with whatever your intuition is, because most of the time if someone’s sick – and when I’m answering the question, I’m thinking about someone who’s got a cough or a cold or they’re just feeling a little rundown, and it’s going to be 24 hours, 48 hours, maybe a week. It would be go with what your intuition is telling you with food.

Often food, from my perspective, is secondary to other things that are more important. If someone is ill, getting proper rest, having proper time off, having lots of sleep during this time – or even if you can’t sleep, at least time where you’re not having to work, where you’re able to take it as easy as possible – because I think that more than anything is going to be the thing that really helps you to get better and to recuperate.

There are times where I’ll recommend more than this. I’ve had Chris Masterjohn on the podcast before; he has a whole thing on his website – I think it’s called Cold War Chest – and he recommends some various supplements. Some of them are quite good. I like some of what he puts out. Some of it I’m not particularly into. But I’ve definitely made reference to that and sent that to some clients before.

But really, I think if it’s something that is short-lived, I wouldn’t be too over-focusing on the food side of things. I think you’re better off getting some downtime and letting the body take care of itself.

The one time I would say that it is something to focus a little more on is if I’ve got someone who is in the early stages of recovery and a decrease in calories or a decrease in eating could be really detrimental, and it could make them starting to eat again more difficult. In those situations, it could be the suggestion of, “Can you just push through a little bit more? Could you eat more now than you normally, ordinarily would if you were sick and you weren’t in recovery?” That’s not something they have to do for the rest of their life; it’s just because of where they are as part of that journey.

But that would really be the only exception, or at least the only exception that’s coming to mind.

Drew: I think that makes sense. I think there are, of course, foods you can throw in there that are supportive for your immune system like garlic or honey or some sort of other syrup, but ultimately the old adage “starve a fever, feed a cold” – I don’t know if they say that in the UK, but they say that in America. To my knowledge, that has never actually been confirmed by science. So I think your point is exactly right. If you’re hungry, eat. If you’re not, don’t.

Food and what you eat is really only one aspect of what’s going to help you get better, so really making sure you focus on things like rest – which I totally agree with you; I think that is the number one thing – and drinking lots of fluids, making sure you’re staying hydrated, and eating what feels good.

Chris Sandel: Yeah. Really, the 24 hours or the 48 hours, or however long it is, is pretty inconsequential in terms of supporting your immune system and supporting your body as part of getting over whatever is going on. It’s what goes on day to day, week to week. The things that are going to make a difference in that very short time frame are, as we said before, getting proper sleep and rest. They’re going to make a much bigger difference.

Drew: I feel like you’re a Superman. I’ve literally never been sick for only 24 hours. [laughs] When I get sick, it’s definitely like 4 or 5 days or something on the short end. I’ve never woken up sick one day and then 24 hours later been good.

Chris Sandel: Thank you for saying that, because I also think then there might be some blind spot in terms of how I’ve answered this question right now, or some bias with how I’ve answered this question. But I would say for me, when I get something, it’s pretty acute. I’m normally in bed and I need to take time off, and then within 24, 36, 48 hours, I’m better. That is definitely my experience.

But the comments I did make were in relation to other clients and advice that I’ve given them or conversations that I’ve had with them. But yeah, I definitely am at the short end of things when I do get sick.

00:29:45

Are certain foods inflammatory?

Drew: You’re lucky. That’s cool. Next question comes from Samantha, and she wants to know if you believe claims that certain foods or food groups are inflammatory.

Chris Sandel: To answer this, I think it would be useful to spend a very small amount of time thinking about this more broadly in terms of what is inflammation. I think while the word is used a lot and is instantly thought of as bad, as this question seems to be alluding to, that isn’t actually the case. Inflammation is a catchall term for many different processes in the body or many different things happening within the body.

It can be connected with the immune system, so you have the response of white blood cells. If you imagine you smash your knee into something, the white blood cells create inflammation, and that inflammation then leads to other parts of your immune system coming in there. It’s meant to be assisting as part of the recovery process. Or if you’re thinking inflammation more generally within the immune system, it’s to deal with bacteria and viruses and that sort of thing.

Oxidation is another term that comes up a lot in the same conversation when talking about inflammation. People talk about oxidative stress on the body. But again, oxidation isn’t inherently bad. Without oxidation, your thyroid gland wouldn’t be able to produce thyroid hormones. There’s been research looking at taking antioxidants with exercise and after exercise and it being worse for you to be doing that. This is potentially connected to the importance of the inflammatory process and how this stimulates the body’s own antioxidant defense system.

So things like inflammation and oxidation aren’t all bad, and they’re not only a normal part of function, but their presence is actually needed within the body. Typically when people are talking about inflammation and inflammatory foods, the cascade, or at least the way people are thinking in their mind, is inflammation really means chronic inflammation in the body, and there are supposedly certain foods that lead to this chronic inflammation.

In terms of my thoughts on are there inflammatory foods – yes, if I’m thinking more along the lines of a food that creates an allergic reaction, or if you’re celiac and you have gluten, yes, it’s going to lead to an inflammatory response. But what I see happening is basically any food that people deem as ‘unhealthy’ gets talked about as being inflammatory, as if they’re one and the same.

There has been evidence to look at certain foods having anti-inflammatory properties, but for a lot of this evidence, it’s looking at what happens in a petri dish – so when a certain substance is put in, what happens, not what’s happening in a human body. A lot of the dosages that they’re using in the petri dish, as humans we’re not going to be eating it in those quantities.

So yes, there is some science to back some of this up, but I think we start to make some real leaps as to how inflammatory or anti-inflammatory particular foods really are. I think generally, there are things you could be doing within your pattern of eating that could be helping in terms of having more fruits and vegetables in your diet. Yes, that will tend to help from an inflammatory perspective in terms of what the research is showing. But I think there’s lots of other things that will make a much bigger difference in terms of not smoking, not drinking excessively, getting adequate sleep – all of those are going to have a much bigger drive in terms of inflammation.

Also, for some people, all of those things are going to be a challenge, and that is okay. But I think there has been a lot of overblown statements about inflammation and inflammatory foods, and generally what we know about this topic is pretty small. It makes much more of a difference in terms of what you’re doing in its totality than thinking about specific foods.

Drew: I think you hit the nail on the head. I’m going to resist the urge to dive super deep into the weeds and nerd out and really just say that you nailed it. A lot of the science does look at diet as a whole – fruits and vegetables, that sort of thing – but there really isn’t a lot of rock solid data on “Is this specific food anti-inflammatory? Is this specific food pro-inflammatory?”

You actually interviewed Alan Flanagan on the podcast, and you two had a really insightful conversation about some of the challenges of nutrition science and how it really is different from medical science. That’s definitely worth a listen if you’re interested.

Chris Sandel: Definitely. It’s just because it’s so hard to pull a lot of those things apart and to separate them and to analyze them. Yeah, Alan was great at explaining this. I think we chatted a fair bit about some of the research around antioxidants, so if you want to know more about that, then definitely check out that episode.

00:35:57

Why do our bodies have inflammatory reactions?

Drew: Cool. The second part of this question, also from Samantha, who wants to know what the scientific reason is that our bodies react in an inflammatory way. If we’re used to eating ‘clean’ and we eat something that our bodies aren’t used to, like kale or pizza or something, is it a mindset reason or mindset response, or more of a biological response?

Chris Sandel: The simple answer to “What is the scientific reason?” is “I don’t know.” It’s been framed as part of this question that when you switch from eating ‘clean foods’ to having foods that are – I guess it must be implying ‘unclean’, in terms of cake and pizza – but I wouldn’t say this is what I necessarily notice with clients. I would say that it’s simply introducing new foods. If a client hasn’t been eating butternut squash or they haven’t been eating beetroot and they bring it in, that can be just as challenging as if they bring in pizza or they bring in cupcakes. There are a number of potential reasons why this can be the case.

You asked if this is mindset. I would say a big part of this is probably the nocebo effect. The nocebo effect is the opposite to the placebo effect. The placebo, you have a sugar pill or you have a sham surgery where all they do is open up your knee, they don’t actually do anything, and they close it up. It has an effect because you believe it’s going to have an effect, and because of that, your knee no longer hurts or you’re no longer feeling depressed or whatever the placebo is for the particular thing that you have.

This is a really strong effect. If you’re talking about someone who believes they’ve had knee surgery having a change to their experience in terms of pain and their ability to walk and all of those things, and the reality is nothing has happened – and there is really strong research around this – that just shows the power of the mind and how we think.

The nocebo effect is basically the opposite. It’s where someone believes that there is a certain ingredient within a food or there’s something inherently bad about a food and that then has an effect on them because they believed it was going to happen. So someone believes there was gluten in a food, they have a reaction to it, and it actually turns out that there is no gluten in the food.

If someone is going in and there’s all these fears around certain foods and then they’re eating those foods, it can be a self-fulfilling prophecy. With time, as someone learns to become okay with those foods and they don’t get the same response in terms of the fear, that starts to take care of itself.

The thing is, even from a fear perspective, if you’re in a fight or flight state, it’s pulling the blood away from your digestive system. That’s not the state that you want to be in to be digesting your food. So it’s no surprise that it can make those foods more difficult to digest. Definitely mindset and the nocebo effect.

It could be that you’re just having difficulty starting to produce different enzymes to break down the new types of food. If you’ve been in a situation where your intake has been really limited, in a sense you’ve trained your body out of eating certain foods, and it then takes time for that to start working again. And that could be not just because you’ve trained your body out of certain foods; there just hasn’t been the energy or the calories or the resources coming in to actually power digestion effectively. It could be connected to the fact that you’ve had this increase in calories or increase in the size of your meal, and your body’s just having a more challenging time keeping up with that.

Another one – and I’m thinking about this because of the two examples that have been used here in terms of cake and pizza, and knowing the climate that we’ve been living in in the last decade of the fear of carbohydrates – if you’ve gone from a situation where you’re very low in carbohydrates and then you start to reintroduce those foods, as part of that there will often be a regain of water weight.

When you eat carbohydrates, some of the carbohydrates are used immediately as part of that meal and some of them are stored as a thing called glycogen. As part of the body storing glycogen, it also stores water, so when you first cut out carbohydrates, you have a real loss of water weight, and that’s why it can look like this low carb diet is so successful. But when you start to bring carbohydrates back in, you bring that water weight back in as part of the glycogen storage.

So if you’re having a situation where you’re now eating some of these foods and this has been the change, just that feeling within your body of “Oh my gosh, my clothes are feeling tighter. I’m noticing I’m feeling puffier” or whatever that experience is, that can then be interpreted as “I’m not digesting my food as well as I was before because it feels more uncomfortable than it did before.”

Or even if it’s not just the water weight, it can be you’re eating more food now, and that’s meant that you’ve put on a little bit of weight. If that weight has gone towards your abdominal, to your stomach, it could be sticking out more than it was before, and then the assumption is “My digestion isn’t working as well as it should be. I’m getting bloating, so obviously my digestion’s not so good.”

These are all potential reasons why this could be happening, and I really think it’s a mixture of mindset as well as physiological driver.

Drew: I think that was a great overview. I don’t have anything to add other than if somebody wants to dive even more into this, you wrote a blog post about this, actually, called “Digestive Issues When Reintroducing Foods.” So if you want even more details, I will link to that in the show notes.

00:42:53

How I can I heal from metabolic syndrome without restriction?

The next question comes from Jodie, and Jodie wants to know if you have any suggestions for dietary or lifestyle changes to implement to heal from metabolic syndrome without being overly restrictive and triggering – or is basically anything you do going to be too restrictive or potentially triggering, so it would maybe be a better idea to just go the medication route?

Chris Sandel: Let me just define metabolic syndrome in case people are unsure of what that means.

Metabolic syndrome is a medical term for a combination of diabetes, high blood pressure (or hypertension), and obesity. Given the area I work in or the principles that I made reference to at the start of this podcast in terms of Health at Every Size, the fact that obesity is lumped in with those two, from my perspective, I would be taking the focus off of weight and be looking at the things that are going on that are having an impact on someone’s diabetes and having an impact on their high blood pressure.

With this, I do think there can be dietary or lifestyle changes that can be implemented, but also, someone has to be cognizant or aware of where they are on that journey.

And let me just say – and it goes without saying – I’m not a doctor, so I never tell people to go on medication or come off medication. But if in the beginning someone feels really unsure with being able to tackle any of these food or lifestyle issues to start with, and all of that just feels like dieting and feels too triggering, then maybe taking the medication can be the best place to start, and then bring in some of these other things later on.

But from a dietary and lifestyle perspective, I would say – and I’m going to go through a number of different things, and pick and choose whatever you want from this list. It’s not that you have to do any of them or all of them. Just some of them could be of use.

Intuitive eating I would say would be a really important first step with this. Part of the reason I say that is it’s really hard to do a lot of this work when there’s a load of baggage around “I can’t have those foods” or “That’s too much food,” where there’s really still that dieting mentality. So really getting on board with that and learning how to listen to hunger and fullness and learning how to follow through with all the principles of intuitive eating is important.

I say that because with metabolic syndrome, often the first place that gets recommended from a doctor is, “You need to go on a diet. You need to lose weight. You need to go on a low carb diet,” and I really don’t think that is the place people need to be putting their focus. Even if it turns out in the end that you discover, “Actually, when I’m having X and Y food” – and it could be “when I’m having this higher carbohydrate food, I don’t do so well” – you’re able to get to that place because you’ve learnt how to listen to your body. You’ve learnt how to be objective in terms of looking at what happens when you have this meal versus that meal or when you’re doing this on a regular basis versus that on a regular basis.

You’re able to be unattached to the feedback that you get as opposed to feeling like “I have to do this thing that is good or not eat that food because it’s bad.” That’s why having that base of being able to be okay with having all foods is actually really important before starting on a journey of “maybe I have to look at what foods I do better or worse with.”

So there would be the intuitive eating piece, and then focusing on the gentle nutrition, which is Principle 10, as part of that, and seeing what you can notice as part of implementing some of the ideas from that principle.

I will typically use food logs with clients. It’s always a discussion of where someone’s at, how much they want to record, and with me, always stressing that I don’t care what someone eats. By that statement, I mean there’s no judgment from me. I’m not saying “Yay, you did really well because you had these foods” or “Gosh, you shouldn’t have eaten all of these foods.” It’s “Let’s have a look at what’s going on, what’s working, what’s not, and then make some decisions based on that.”

So using a log just to get a better sense of how you’re feeling with certain ways of eating or with certain things going on in your life, which can be connected to other activities – whether that be movement, whether that be sleep, whether that be stress, whether that be lots of other things that can have an impact on health. So using the log in that way.

And then some of the things I just talked about. If I was looking at how to improve these things, sleep would be one of the first things that I would think about. If someone’s getting adequate sleep or if they’re not getting adequate sleep. I would be looking at the stressors that are going on in someone’s life, because that can have a huge impact on blood sugar, it can have a huge impact on cholesterol levels.

I would also include as part of the stress, the stress of healthism, the stress of trying to do everything perfectly, to manage this thing, because that can become a stress in and of itself. So even if that wasn’t the original stressor that tis driving this, it can then become an added stressor. So definitely looking at that.

Looking at things like meditation or breathwork in support of that. Looking at someone’s trauma history and seeing if that could be connected to stress or connected to blood sugar. The thing with blood sugar is that a lot of that is driven by stress hormones. Looking at weight stigma – I know I talked at the beginning about one of the components of this diagnosis is obesity, so looking at the stigma that someone is receiving from society about their weight, but also looking at your own internalized stigma and how much that is having an impact on your body.

I had a conversation with Jeffrey Hunger about this on the podcast, where we talked a lot about weight stigma and how it impacts the body, so that can be another thing that is driving this. Looking at someone’s movement and how much time they’re spending sitting, how much time they’re spending doing low-level movement, so non-exercise activity thermogenesis, or NEAT. Those things can have an impact on blood sugar and on cholesterol. How much time someone’s spending outside in nature, what someone’s smoking or alcohol habits are.

There are just so many things that can be looked at and connected with this that can be worked on where it doesn’t have to be restrictive, and it hopefully doesn’t have to be triggering. That can make a really big impact on this without someone going on a weight loss diet.

Drew: That’s great. The only other thing I would add is that I’m assuming, Jodie, that you wrote in because maybe you’re not totally sold on the meds as your first choice and you want to see if there are other options you can explore first.

If this is the case, maybe what you could do is go through all the suggestions that Chris listed and pick everything that looks doable to you and that you feel confident won’t be triggering for you. Maybe it’s working on getting lots of sleep, working on stress management techniques, trying meditation, and spending more time in nature. Try and implement all those things and see if they help. If they do, wonderful; if they don’t, then potentially going to your doctor for meds could end up being the best choice for you personally.

Chris Sandel: Yeah.

00:51:55

How can I manage fear of weight gain during recovery?

Drew: Cool. Next question is from Julie. Julie says that she hears quite often from health professionals and also on podcasts that of course in recovery, it’s important to eat without restriction, but that it can actually be quite difficult to gain weight. So people who are really underweight and trying to recover should eat a lot and not be overly concerned about gaining weight, as metabolisms will adjust and you can usually eat a lot and weight gain won’t be as easy as people fear.

Julie says that that has not been her experience, and she wants to know if she’s the only person who gains weight very rapidly in recovery, and if you have any tips for managing fear about weight gain and having an experience that’s different from everybody else’s and different to what the experts she listens to are saying it will be.

Chris Sandel: I would say she is definitely not the only person who gains weight very rapidly in recovery. I’ve had the whole spectrum when working with clients. Yeah, at one end of the spectrum there are the people who do struggle to put on weight, and it takes a monumental effort to have that happen, and there are other people where that is definitely not their experience, and very early on they have extreme hunger, and weight gain happens very rapidly for them.

I just wanted to say to start with that if the only things that you’re hearing online are that people don’t experience rapid weight gain, I would say that that is not the case and that it happens really across a wide spectrum.

In terms of tips, remember that everyone’s journey is different and that things will happen differently from other people, and the people who are eating lots and having a real struggle to put on weight, they didn’t choose that. That’s just what their body is doing with them. For you, if you are eating and the weight’s going on quickly, the same. You didn’t choose that. That’s just what’s happening. That is just your experience.

A big part of the recovery journey and learning to be recovered and learning to be okay with your body and learning to be okay with food is acceptance. You’re just getting a really strong lesson in acceptance from the word ‘go’.

I would also say in terms of comparing, I think you’re comparing yourself to other people’s stories when you really don’t know the full experience of other people’s stories. What I often see online is someone telling their recovery journey story that maybe took them 6 months, maybe took them 2 years, maybe took them 5 years – however long that journey is – and you then get a 10-minute, 20-minute story out of it.

It strips that story of all the details of what actually went on, so it creates this very small, nice story arc of “this is what happened, this is what happened at the midpoint, this is when things got better.” But in terms of their day to day experience of going through that, it’s a lot more detailed and potentially a lot more excruciating than you’re hearing when you’re reading their final story, if they’re telling it from a place of full recovery, or you’re hearing it as they’re going along the way, because they’re just not getting into all the details.

What I’ve discovered through this work, through working with people who’ve really struggled to put on weight through to working with people where the weight gain is really rapid, is the real struggle is in the not knowing of where the weight is going to end up. That’s regardless of how quickly it’s going on. It’s the “I don’t know where this is going to stop.” I think that for most people is the biggest concern or the thing they’re most unsure about.

The things that I would add to this in terms of helping are things more generally that I would say are quite helpful in recovery. Looking at mindfulness and the thoughts that come up – are you able to just leave those thoughts behind? A big part of mindfulness is thoughts are just thoughts. Thoughts think themselves. It doesn’t necessarily mean that the thoughts are true. So doing some of that work in terms of mindfulness or meditation.

There’s a great section in The Body Image Workbook. It’s at the start of this book, and I’ve made reference to this book before on the podcast. At the beginning, they look at a lot of different questions where you can evaluate where the body image issues are coming from. It’s just a really useful way of starting to explore “where do I need to be doing more of my work?” There’s lots of different angles that this can be affecting someone, so going through that series of questions and the different evaluation forms as part of that can be really helpful.

Compassion is a really big part of this, so reading Kristin Neff or Tara Brach or Paul Gilbert’s The Compassionate Mind website. They’ve got a ton of resources. Compassion is a really big piece that gets worked on with clients – for lots of reasons, but definitely in this area.

Diversifying your Instagram and your Facebook and your Tumblr feed. I know this is a thing that people say a lot, but I would say diversify it and then really be proactive in using this as a way of exposure therapy. It might be that for a short amount of time, you actually either unfollow accounts, or if there are accounts you don’t necessarily want to unfollow, but you think for a little while you’re best not seeing them, you can change something so that it hides those posts. That means you can set up something where you spend 15-20 minutes a day, some length of time where you’re just looking at different bodies and reading different stories that support you in starting to change how you feel about weight and how you think about weight and how you think about your body.

Another one would be untangling the idea that weight equals happiness and really exploring this. I’ve worked with plenty of people who you’d think would adore their body, and if you looked at their body you would think, “Wow, how could they ever be upset with the body that they’ve been given?”, and yet they are really struggling. So often when I’m having these conversations, it doesn’t matter where someone is sitting on the weight spectrum; we’re having the same conversation.

I think that can be an important thing to remember, because there is someone who is miserable in your ideal body and there is someone who absolutely adores the body you most fear to be in. It’s got nothing to do with their actual body. It’s got to do with the thoughts that they are thinking, what they’re telling themselves, what they’re focusing on, etc. So starting to really understand that piece and that the freedom you’re searching for comes from within and changing what’s going on in your mind as opposed to changing your body.

I think that’s everything I’m thinking of. That felt a little bit rambly, but that was all the things that came to mind.

Drew: That was good. I feel like that was helpful advice. It sounds like it’s a long game and it’s going to take a while, and it’s work, but it’s achievable for sure.

Chris Sandel: Yeah, and different things work for different people. It matters to understand a lot of where these things are coming from, which is why before digging into a lot of this stuff with clients, I’ll do that evaluation or we’ll do writing exercises so we can both be on the same page in understanding this, and then knowing what would be the remedy or the way to actually change this thing that’s going on for that person.

01:01:35

How should I eat and exercise whilst pregnant?

Drew: Next question is from Kate, and she wants to know, how should you eat and exercise while you’re pregnant?

Chris Sandel: This is another one that I’m going to start with saying it depends on the individual, but I’m a huge advocate of intuitive eating and listening to your body, so that is really where I would be starting for everyone, and getting them to be using that as the default of really being able to tune in and listen to their body.

The thing I would say with that is this can really be tested in the first trimester if there is still the dieting mindset going on. I say this because during the first trimester – and I know this through what happened with Ali, my other half, but also through working with clients over the last decade, I’ve had lots of clients who became pregnant while we’ve been working together.

It’s amazing how things shift in that first trimester where you’re just super tired and wiped out. I’m generalizing here; this is just what happens in most people that I’ve worked with or spoken with. You could be the exception that this is not going on, but the first trimester, really tired and lethargic and sleepy and difficulty concentrating.

So really low energy combined with a real change in foods that you are craving or want to eat. You used to be okay eating a real wide variety of foods and you used to be okay eating lots of fresh foods, and now all you want is fish and chips or mac and cheese or stodgy, carby, cheesy type foods. In that situation, you can either listen to your body and go with that or you can really try to rebel and be like, “No, I need to be eating ‘healthy’ and I need to be bringing in these vegetables” or whatever it may be.

That’s why I said really being able to be okay with intuitive eating and listen to your body in those instances, because what I’ve typically found is that is just a phase and if you’re able to listen and give your body what it needs and give it the rest that it needs, you come out the other side of that. And it is somewhat in a short amount of time, like a switch has been flicked. You’re suddenly like, “Wow, I’m now starting to crave things that I wasn’t craving before.”

I remember when Ali was pregnant, we had a period where if I tried to put some vegetables on the table, I was shouted at very loudly. I realised that I should not be putting any salad or I should not be putting anything vegetable-y on the table for a period of time because she could not stand to look at it. She could not stand to smell it. She could not stand for it to be in the room. That lasted for 6, 7, 8 weeks, and then that phase was over.

Really, in that first trimester, I think it can be a really good test of where someone is in terms of their intuitive eating/dieting journey, but if you’re able to listen to your body, it really doesn’t steer you wrong.

The other one I would say is eating at regular intervals. Maybe this is the one where sometimes your body is saying, “Hey, don’t eat. You’re feeling nauseous,” and having some more food coming in and eating through that can be helpful. But again, that can be something to test out, where you do try eating something and see how you are, and you try not eating something and see how you are. But for a lot of clients, having food come in on much more regular intervals than what they were doing before was helpful.

Having snacks and things available so that if in a pinch, they suddenly felt not great, they could have something. Having something on the nightstand so that if you wake up in the night or just before going to bed or first thing waking in the morning, you can have something to eat. I know that was really helpful for lots of people.

Then in terms of as the time goes on, it’s just thinking of, what would be best to be supporting a human being to grow? At a high level, that’s making sure you’re taking in enough food, making sure you’re getting enough rest, making sure you’re getting enough downtime, trying to eat a variety of different things if your digestion and your palate will let you do that.

Digestion can definitely get worse in the beginning in the first trimester, and also towards the end or the third trimester, more from a room perspective and things being all squished together. So that can make eating more challenging. In those moments or that time, it might be eating more frequently or having certain foods that you realize you’re better able to digest. You may discover that “If I have this thing that’s too greasy or too heavy in terms of cream or butter, I don’t do so well,” so having less of that then becomes better in terms of your experience.

In terms of the exercise piece, this also is a difficult one to answer because it will be person-specific. If someone has been doing more exercise, then often they’re able to keep up more exercise in their pregnancy. But that also shouldn’t be forced, and that also needs to be considered if you’re someone who has been over-exercising. Finding that balance so that you’re able to get proper rest and you’re able to get proper recovery and you’re able to be doing exercise and movement at a level that leaves enough of the calories and the energy to be able to grow a small human being inside your body.

I know there are definitely guidelines on foods that you should avoid, and I think this can differ depending on where you are. Check the recommendations locally to where you are in terms of what’s in and out. But in a lot of ways, your eating will change based on the demands of your body. It’s about listening to those demands.

I think being an intuitive eater to start with will definitely help that journey, but even if this is where you’re becoming an intuitive eater, sometimes having the fact that you are growing a human being inside you can be the motivation that someone needs to be able to drop some of the dieting and to be able to drop some of the feelings that they had before and to really embrace this and to embrace the principles and really get into it, because there’s something much bigger at stake than there was before.

Drew: Yeah, I think that’s super helpful advice about intuitive eating. I love what you said about Ali not wanting salad and really listening to her body. If you want mac and cheese but you force yourself to have a salad when you really don’t want it because it’s ‘healthy’, that’s not going to be fun and it’s going to be a stressful experience for you. And you being stressed is going to impact negatively on the baby much more than eating a bowl of mac and cheese will.

Chris Sandel: Yeah, definitely. Also, most of the time with the cravings – or at least, within my experience with Ali and with clients – there’s a level of calorie density that is accompanying those foods, definitely in the first trimester anyway. In a sense, there’s no amount of salad that you’re going to eat that’s going to be comparable to the mac and cheese or to the fish and chips or whatever it may be.

What’s invariably going to happen is you’re going to get very hungry after a meal that you’ve just eaten that was unenjoyable and unsatisfying. It’s typically not going to lead to the place you’re hoping it’s going to lead to; you’ll finish the meal and then still want the thing that you originally were craving.

01:10:48

Will there be another Writing Club?

Drew: Absolutely. For the next question, I promise I did not just make this up to make you look good. [laughs] Somebody really did send it in. It’s from Constantin, and they said that they have missed the launch of this round of the Writing Club, but they’re really interested in taking the next one with you, and they want to know if you are going to run it again and when that might be.

Chris Sandel: When I saw this question, I was like, this feels like it’s just a made-up softball question to get us to promote the Writing Club, which I’m glad to hear from you was not the case and that someone did genuinely ask this.

Yes, I will definitely be running this again. It has been a really great experience doing the Writing Club. Everything that I’ve done up until this point has always been one-on-one work. That is the backbone of everything that I do here at Seven Health. It’s what takes up the majority of my time. That is an area that I’ve known really well and known how it works and why it works and have been really familiar with.

Doing more of the group work end of the spectrum is something that I hadn’t done a lot of, so when starting this program, I was a little unsure as to how it would work. I’ve heard so many good things about the power of group work, and I’ve seen it in lots of other places, so it wasn’t that I doubted it; it just wasn’t something that I had personally been involved in in terms of orchestrating and running.

I’ve been really pleasantly surprised – surprised is probably not the right word, but just blown away by how useful it is and seeing the power of the group and the support that they can bring to one another.

There’s something about solving other people’s problems that is much easier than solving your own. It’s much easier when you’re hearing someone else speak to be able to have that be externalized, because it is externalized that it’s someone else telling their story, and you’re able to empathize with it, you’re able to be compassionate with it, you’re able to come up with solutions for it.

And then you’re able to reflect on, “Hang on, this person’s story is really the same as mine. I’m able to do this for this other person; I should be able to do this for myself.” There’s some real power in being able to take something that has been externalized and then being able to turn it inwards and being able to do some of that work on yourself.

Seeing people talk about the fact that they’re changing their beliefs and their biases and they’re better understanding their feelings and they’re getting new perspectives on things has been really, really amazing, and just seeing how the group has blossomed over the time. Obviously, to start off with everyone is new. No one knows anyone else’s experience. Everyone’s quite shy about sharing their own stuff and talking about what they’ve been going through.

In a very short amount of time, that has changed. There’s much more group interaction and much more people feeling more comfortable, feeling seen and heard because there’s other people going through really similar things that they are, and just really wanting each other to improve and to get better and really championing each other’s journey.

So yeah, it’s been amazing. Just before we started this, I got an email from one of the participants talking about how great they’ve been finding the group and saying how thankful she was. It just put such a smile on my face. I was already very sure that I was going to do it again, but it really cemented that for me.

What I want to do as part of it is, when it is completely over, I want to have a debrief with every one of the participants and have a conversation and find out what they liked, what they didn’t, how it can be better, what are the strengths, etc. Based on that, I’ll create the Writing Club ver. 2. With that, it will then be released again or run again I think starting sometime in September or early October, somewhere around there.

But yes, definitely doing it again. Definitely doing it again this year. It’s just about figuring out exactly when that will be, but yeah, I’m really excited about doing it again. I’m excited about it becoming a permanent thing that I do multiple times a year.

Drew: So stay tuned, and if you’re not on your email list, make sure that you head over to seven-health.com and subscribe, and we will send you updates on when it is going to run next.

01:16:06

Will Chris make a course about the menstrual cycle?

The next question is also from Constantin, and they want to know if you’ve ever considered creating a course about the menstrual cycle and things that could go wrong with it and how to optimize it best.

Chris Sandel: I actually did a course on this about 4 years ago, and then when I started doing the podcast, I pulled some of that material and made it some of the earlier episodes as part of the podcast. Subsequently to that, I think I did a second edition on one of the episodes I did about the menstrual cycle last year. I’ve also used some of that material when I’ve had conversations with Nicola Rinaldi on the podcast.

So yeah, it’s definitely an area that I’m interested in. It’s definitely an area I work a lot on with clients that I think people are often confused about or struggle with. I would love to do a course on this. I find it hard to find the time, between doing a weekly podcast show and seeing clients and doing the book club and all of that, to create courses. But it’s definitely one of the things that I want to start doing when I can find those extra hours in the day.

I know on the last AMA, someone asked a question about a non-diet nutrition course, and actually since that AMA, I’ve been thinking a lot about that as a topic and seriously thinking about putting together a course. So there are lots of ideas.

If people have suggestions on courses that they would like, then feel free to email info@seven-health.com. It is on the long list of things that I would like to do; it just hasn’t made it to the top yet. But I can fix that if I see that people are really interested in this.

Drew: Do you think that your courses would be geared more toward practitioners or more toward the general public?

Chris Sandel: To start with, more towards the general public – although I would say the course that I would make that would be aimed at the general public would also be useful for practitioners. But it would be with the public in mind that the course would be created.

01:18:45

What Chris has learned about from the civil rights movement

Drew: The next question comes from Ava, and Ava wants to know, with everything that’s been going on lately with the civil rights movement, what have you learned and how are you working on uncovering your personal biases?

Chris Sandel: It’s been a really interesting time. That’s probably not the right way to say it, but I have really been reflecting on this a lot lately and just noticing how naïve I’ve been around a lot of things and how many blind spots I have around a lot of this stuff.

If I think about growing up, I grew up in Sydney in an area and went to a school in an area where it was nearly all white. And if it was non-white, it definitely wasn’t black. So it’s something that for the first 21 years of my life, until I moved over to the UK, I really had no personal experience with in terms of in the flesh or lived experience. It was only what was seen on TV or in movies and really at a distance from what I would then experience.

Then when I moved over here to the UK, noticing that there was a lot more multiculturalism than there had been in Sydney and noticing that there are a lot of black and brown and different people that I wouldn’t have experienced prior to moving to the UK. When I moved here, the first 7 or 8 years, I worked for Islington Council. On and off, I worked for lots of different local councils when I was first over here.

When I was there, I was definitely within the minority. That was predominantly black and brown people that were working at the council, so as a white person, I was in the minority. It was where I was first exposed to Black History Month. There was a lot that I then started to become aware of, but still very much at a distance. I would go to work, I would get on really well with these people who I was working with, and in a sense I just didn’t think about it so much.

More recently, as part of all of this happening, I took Chrissy King’s Antiracism for Wellness Professionals webinar, and it was really eye-opening. It was a great webinar, and I’m really glad that I did it. I know she’s got a Diversity and Inclusion course that she’s going to be running in a couple of months, and I really want to take that and understand it more. I know here at Seven Health, we have a meeting this week to have a talk all around how to be implementing the antiracism work for wellness professionals that Chrissy talked about.

It feels like for me, up until this point, it had been much more of an intellectual exercise in terms of I intellectually understood these ideas. I’d watched the documentary The Thirteenth and I’d listened to podcasts on the topic, but it was just in a lot of ways so removed from my lived experience. By starting to focus on this, I’m seeing how much of a problem that really is and how much I need to be getting involved and starting to do things.

I took the Implicit Bias test, which I would highly recommend everyone does to really start to get a sense of how ingrained a lot of this stuff is. I’ve started to notice in terms of the guests that I had on the show and how much in a lot of ways they look like me; they’re white and they’ve had similar experiences to me, so that’s in a sense so much easier for me to go in that direction. But that also just creates more of the same, so that’s something that needs to be dealt with.

I also noticed how uncomfortable it is talking about this topic, and that shouldn’t be a reason for me not doing it. If anything, it shows me that I should be starting to explore this because it shouldn’t be as uncomfortable as this, or there should be different kinds of uncomfortableness because the uncomfortableness is not coming from the ignorance; it’s coming from starting to really understand this topic.

Even the word of ‘racism’ conjured up, or at least until previously, conjured up a lot of ideas around overt acts in terms of being a member of the KKK, but actually it can be a lot more subtle than this, and it can be applicable to many things that I wouldn’t have previously thought of labeling as racism.

I’ve ordered a copy of the book Me and White Supremacy, and that’s something that I want to start reading about and working on, and just having this be something that continues on after this time has died down. Invariably within the next couple of weeks, something else will have taken over what is going on in the media – even by the time this podcast actually comes out, there could be something else that is going on that means all of this goes back into the background. This is definitely something that I don’t want to happen. I want this to be an ongoing thing.

Drew: Yeah. I think one thing that this time has definitely emphasized or thrown into stark relief for so many white people is most white people you ask would say, “Yeah, racism is bad. I don’t want to do a racism. But I’m not really racist and I’m not actively being racist.” I think a lot of people are learning (A) that’s not necessarily true, and (B) more than just learning about it, it is our necessary responsibility to take action, every single one of us. I think that has been a real eye-opener for a lot of people, and I’m really glad to see it.

Chris Sandel: Definitely. Again, I have to say how great a job Chrissy King did. I would highly recommend people check out her work. I know we’ve had her on the podcast. Lu interviewed her. They touched a little bit on this topic, but not really touching much of it to the degree that she did as part of the webinar. She’s going to be doing some more of those and is doing the Inclusion and Diversity webinar, so I highly recommend following her on Instagram and checking out her work if you want to be finding out more.

Drew: Definitely. Chrissy’s great.

01:26:33

What can I stop comparing myself to others?

Our next question comes from Lauren, and she says, “I always feel like I’m comparing myself with other women. How can I decrease or stop this?”

Chris Sandel: As humans, we compare. In some regards, I hear the advice of “you just need to stop comparing.” I think the reality of that is that is never going to happen. We are hardwired, we are built to constantly be judging and evaluating and comparing.

I think what is possible is looking at the things that we compare ourselves with other people on, but also, how can I minimize the impact of that? Even if that is the knee-jerk first impulse, it’s how to temper that, or how can the next impulse be then to correct that original impulse.

A couple of ideas would be flesh out the story so that you’re comparing yourself to someone’s total life. What I often see occurring is that we compare ourselves to the tiniest fraction of someone’s life, and we don’t know the full story of what’s going on. Or alongside this, we flesh it out with all of these other assumptions about someone’s life that we think is now going on.

For example, if you’re comparing yourself to someone and they’re white and they’re living in some body that you think is amazing and that you wish you could be, you’re not just comparing yourself to their body; you’re really comparing yourself to what you imagine that body then gets for that person. It’s “Wow, they must have the most amazing partner, they must have the most amazing job, they must have the most amazing sex life. They must have incredible confidence when they walk into a room. Every time they go to the shops and try on some clothes, it must be the best experience ever.”

We create this whole narrative around what it must be like being that person, and that’s what we compare ourselves to. We’re comparing ourselves to this fantasy that’s been added on top of a tiny little bit of information that we know about someone and then compare it to every bit of messiness in our life that we know about because we’re living that life.

I think it’s important to be asking the question, “How do I know that? How do I know what I’m comparing myself to is actually accurate? How do I know how they’re feeling in that moment?” Often when I see someone who is living in a body that matches up to society’s standards, my initial thought, because of this work that I’ve done, is “I wonder how happy that person really is. I wonder all the things that they have to do to be able to maintain that. I wonder how much freedom they have when they go out to a restaurant. I wonder how confident they really are when they’re in a swimsuit.”

What I’ve discovered through doing this work is that what we think is going on on the surface when we try and evaluate someone’s life is often very different to what’s going on behind closed doors.

I would also be aware of what are the things that are feeding into these feelings. I talked earlier about setting up social media so it’s challenging some of your thoughts and giving you a different feed of what you’re seeing. Where are these feelings coming from, and what are you doing that is constantly feeding these feelings? What are you looking at? What are you reading? What are you watching? What are your friends talking about? What are the things that keep perpetuating the things that you’re comparing yourself with others on? When I’ve done this with clients, there’s lots of things we could start to identify that are keeping this in play and making it worse.

I would also add working on making peace with yourself around the ideas that you compare on, because the more that you can make peace with yourself, the more it doesn’t matter what’s going on in someone else’s life.

For example, you can compare yourself to someone who’s earning a huge amount of money, but if you actually feel good about the life that you’re living and the money you’re earning, irrespective of whether you’re earning a lot of money or not – you’re just like, “You know what? I have a nice life. I have enough that allows me to enjoy myself” – when you’re then comparing yourself to someone who is a multimillionaire, yeah, you can daydream about what it might be like, but at the end of the day, you’re pretty okay with it. You’re like, “I actually enjoy what’s going on. It doesn’t bother me that I’m hearing about someone who is a multimillionaire and it feeling really triggering.”

Or think about something that you don’t care about. If you don’t have face tattoos, you don’t look at someone with face tattoos and they’ve got 15 of them and think, “Wow, my life is suffering because I don’t have that.” You’re not comparing yourself to it because that’s just not something that you’re after or you’re into or you’re thinking about.

If you’re comparing yourself to someone, it’s typically because you’re placing a huge amount of value on that thing. The way that you change that is not necessarily just stopping comparing yourself, but starting to explore, “Why is this thing so important to me? What does this really mean?” and starting to do the inner work around that.

By doing that, then the comparison will naturally start to disappear because you’re like, “What’s the point in comparing myself to those things? I don’t care about it.” Or if you do compare, it doesn’t have the same impact because there’s not all the emotions tied up in it. You can be much more objective about it, like, “That person wears a smaller set of clothes that I do” or “That person earns more money than I do,” and these are just factual statements that don’t have emotion connected to them.

Drew: Have you read the book by Brené Brown, I Thought It Was Just Me (But It Isn’t)?

Chris Sandel: I haven’t read that. I’ve read Daring Greatly, I’ve read Braving the Wilderness and Dare to Lead, but I haven’t read the other ones. I’ve listened to her vulnerability Audible, which is her talking before Daring Greatly but after The Gifts of Imperfection. That is a very longwinded way of saying no, I have not read that book. [laughs]

Drew: If you’re struggling with comparison, I would recommend it. It’s based on a bunch of years of her research and hundreds of interviews that she did basically boiling down to the truth that our imperfections are actually what connect us to each other and to our humanity, and basically helping us learn how to see that our vulnerabilities aren’t weaknesses. They’re actually these reminders to keep our hearts and our minds open to the reality that we’re all in this together. I feel like that could be a helpful resource as well.

Chris Sandel: Definitely. I’m a fan of her work. I find her writing so great, so I will second that recommendation.

01:34:59

Is full recovery possible if I have a preference for smaller bodies?

Drew: Next question is from a different Julie, and Julie #2 wants to know, is full recovery possible if you can’t overcome your preference for smaller bodies?

Chris Sandel: I think the answer to this probably is connected to the word ‘preference’ and what this actually means. If preference means “I like smaller bodies, but I’ve come to realize that it’s just one facet of life. If I had a magic wand, I would choose that body, but I don’t have a magic wand, so I’m not going to let it dictate my life,” then yeah, full recovery is possible because you can notice that there’s preference, but it’s not like that preference is in the complete driving seat of your life.

But if by preference you mean that “Unless I’m in a smaller body, recovery is not worth it,” then I would say that full recovery with that type of thinking is unlikely, because it’s going to keep you stuck.

But what someone says is their belief or the way that they see the world when dealing with an eating disorder does not mean that that’s going to be how they see the world for the rest of their life. I would say this is true even if we move out of the realm of eating disorders.

There’s a great short TED Talk by Dan Gilbert, who is a psychologist, and he’s done a lot of work on the area of forecasting, which is looking at our ability or lack of ability of being able to imagine future times and future states and our ability of being able to deal with or have emotions about that future state. He talks about the fact that human beings are works in progress that mistakenly think that they’re finished. We imagine that the person that we are right now is the person we’re going to be for the rest of time.

He has a lot of great examples around how people who think they’re going to be this one thing, when they catch up with them a decade later, have really drastically changed, and have changed in ways that they would’ve thought at the time was never going to happen.

So I think as human beings, we’re not very good at forecasting and imagining how we would be in a different scenario until it actually occurs, and this is even more the case when you layer on the fact that there are brain changes and perception changes that occur when someone is within an eating disorder. I think that’s an important thing to keep in mind, because even if you think at this stage that this is a preference that is something you’re going to be locked into for the rest of your life, I would challenge that and say there are many people who have thought that way who now think very differently. With work in this area, that can shift.

Drew: Let me know if you disagree, but I feel like call it a preference, call it whatever you want, it’s stemming from fatphobia. I feel like there’s a lot of steps that you can take to unlearn fatphobia. I think it’s not going to happen overnight, so I wouldn’t feel discouraged if you still want to be thin and you still think that the thin white ideal is the thing to aspire to. I wouldn’t necessarily feel guilty about that, but know that it can change, but it will take a while to change, and you will need to put in work.

There’s a lot of good resources out there. Virgie Tovar’s You Have the Right to Remain Fat is a great resource for starting to unlearn fatphobia. The Body Is Not an Apology by Sonya Renee Taylor, also a wonderful resource.

And we’ve mentioned it several times in the show already, but really being intentional about curating your social media feed – not only unfollowing people who make you feel bad about yourself, but really being intentional about following people who are your size or larger that you think are beautiful and that you feel inspired by. The more that you expose yourself to that, the more that will start to feel normal and the more that will potentially start to look beautiful to you.

Chris Sandel: Yeah. I also think, the more I think about this, sometimes this preference is also a protective mechanism. There’s the fear of “What’s going to happen when my body starts to change, and how am I going to have to deal with that and cope with that?”

Yes, everything within our culture tells us that there is this ideal and we’re in a sense brainwashed into thinking that things should look a certain way, but as well as that and because of that, it can then almost feel protective to hold onto this as an ideal. Like “If I was to lose this, if I was to not have this as a preference, what would occur then? How would things look?” Often that brings up a lot of fear, so it almost feels like “I’m better off keeping this preference than losing it.”

Drew: Yeah, that makes sense. We have two questions left, and they are both personal questions for you, Chris.

01:40:50

Has Chris ever tried psychedelic-assisted therapy?

The first one is from Renee, and she wants to know if you’ve ever tried psychedelic-assisted therapy.

Chris Sandel: I have not tried psychedelic-assisted therapy. This is something that I’ve talked about a couple of times on the podcast more recently. But no, I haven’t tried psychedelic-assisted therapy. I have tried psychedelics myself on many occasions. It always feels a little weird talking about this, for legal reasons, and knowing how much I want to divulge.

But part of the reason why I’ve had the guests that I have on the podcast is because of the very positive experiences I’ve had, and having experiences in different settings and just knowing how much that has positively affected my life in lots of ways. It really helps from a mindfulness perspective in terms of seeing how much thoughts and feelings are thinking themselves and how much that can really be messed around with with a psychedelic, and seeing how much a shift can occur in a short amount of time through these substances does really make me hopeful for it.

I would love to do psychedelic-assisted therapy. I watched the Trip of Compassion documentary, which was focusing on a trial that had gone on in Israel looking at using MDMA assisted therapy for people who’d had PTSD. One of the ladies had had a severe trauma where they’d been kidnapped; another guy had been abused by his father. The documentary was the video footage of them doing the therapy sessions that were then edited as part of the documentary, and it was a real eye-opener into that.

I know when Will Siu was on the podcast – I can’t remember if we actually talked about it or I just saw it in terms of one of the articles he’d written about. He talked about couples therapy and doing couples therapy using MDMA. It sounds like a really great idea.

So yeah, I am someone who is very much in favor of this. As I’ve said, when I’ve had the guests on, I want to be cautiously optimistic about this because you never know what’s going to happen when they start to do research and see what happens when this is tried out on more and more people. But yeah, I’ve had some really positive experiences.

And look, I’ve had some not-so-positive experiences in the moment with some of these substances, but there’s still a lot that I’ve been able to take from that. So no, I’ve done nothing formal in this realm. It’s much more been self-exploring, and I’ve liked what I’ve seen.

Drew: It’s tough to categorize an experience with them as good or bad because it feels almost so much bigger than that. And either way, it’s such a deep, personal learning experience. Personally, I’ll just say I have quite extensive experience with them, and for me as well, it’s been overwhelmingly positive and helpful. I’ve really appreciated discovering them.

It’s interesting because you’ve had these people on the podcast lately talking about them, and it’s very cool. It’s stirring up a lot of interest. We get feedback after the podcast being like, “Where can I do this?”, and it’s tough because you’re hearing so much more now about psychedelic-assisted therapy, but at least in the U.S., it’s not really legal.

Chris Sandel: Same over here.

Drew: Same there. So it’s tough because it’s stirring up all this interest, but there’s not a lot to do about it. We have talked about before on the podcast how there are still risks to it. There’s definitely therapeutic potential there, and there are risks to it. So it’s tough when there’s nowhere to really recommend somebody go to have a guaranteed safe, positive experience with it.

Chris Sandel: Yeah, it is. Even when having guests on, I know with guests, it’s difficult for them to talk about it as well because they’re in the same boat around “What can I legally say? How is this going to affect me?” It feels like we’re having half a conversation.

I’ve never been big into marijuana, but it’s amazing the amount of people who are now coming out of the woodwork and happily speaking about it because of the change in the laws in the U.S. I think what we will see is the same with psychedelics. There will be a lot more people who will become much more open about this once the legal standing changes and people feel freer to be able to talk about it.

Drew: I absolutely agree. I think we’re in the messy middle right now, where there’s a lot of interest and there are a lot of people talking about it, but there’s not necessarily a clear concrete outlet for that interest.

Chris Sandel: Yeah. Even when I have consults with clients, I’m more happy to go into some of the details with them, but even still, I’m always a little unsure with these kind of conversations. I’m definitely not recommending it and pro that people should be going out and doing this on their own because, as we’ve said, there are risks. I just wish I would be able to say “Hey, there are these centers that are open all over the place and I would highly recommend it.”

Drew: Right, exactly. Then maybe we should wrap up this question by saying it is not legal. We are not recommending that you do it. Look into this at your own risk.

Chris Sandel: Definitely.

01:47:39

What is Chris reading these days?

Drew: Last question for today. It comes from Ari, and Ari wants to know, what are you reading right now?

Chris Sandel: I’m always reading many books at once. I have a habit of having different things on the go that are different topics. On some evenings I feel like one thing, on another evening I feel like another.

I’ve also recently decided to stop buying books for a little while. I don’t know how long ‘a little while’ is going to go on for, but I have a ginormous bookshelf with hundreds of books on it, and the reality is I’ve read less than 50% of them.

Drew: Wow.

Chris Sandel: So now, unless it’s a guest who’s coming on the podcast and I want to read information to support the interview I’m doing for them or like what I talked about earlier on in terms of the White Supremacy and Me book, I’ve really put an embargo on buying books. I’m going through books that were previously on my bookshelf that I haven’t pulled out. There’s three or four that I’ll mention.

One is called This Book Will Save Your Life by A. M. Holmes. A terrible title. It sounds like a self-help book, and it is not. It’s a work of fiction about a guy who lives in LA who’s going through a midlife crisis. It’s just a really easy page-turner. I don’t read anywhere near enough fiction as I should, so I wanted to read a lighter book. Prior to that I’d read Harriet Brown’s Shadow Daughter as part of having her on the podcast.

Drew: Not light. [laughs]

Chris Sandel: It is not a light book by any means. A wonderful book, but it’s not light reading. So to be able to discover this book, This Book Will Save Your Life, has been really enjoyable.

I started reading another book called They Will F*** You Up: How to Survive Family Life by Oliver James, just looking at parenting and how parents can get in the way of good child development. I’m very early on in it, but that’s been good.

I bought this book at a secondhand bookstore, or it might’ve even been at a fete where there was a book table, and it was all about Greek mythology and looking at all of the different Greek myths. So I’ve been reading that, although that hasn’t ended up being as light as I hoped it would be.

There’s definitely a part of me that wants to know more about history, and Greek mythology seems to be one of those things that is often referenced, and a lot of words or sayings come from Greek mythology. I was like, “This would be something good to bone up on and become smarter about.” So far it’s mostly been a struggle, if I’m being honest. [laughs] It’s just a lot of people whose names I don’t know how to pronounce particularly well. So that’s been a bit more of a slog.

Drew: That’s the downside of reading so many books at once. If there’s any of them that are a slog, you’re just never going to finish it.

Chris Sandel: Yeah. So that’s been one. I think that’s it. There’s other books in my pile. I’ve got a pretty big pile next to my bed that I dip into and pick from. There’s got to be others that are in there, but they’re the ones that are coming to mind at the moment.

Oh, sorry, the other one was Ramble Book, which is Adam Buxton, whose podcast I really like. He has done a book that is a memoir of sorts, so I’ve been listening to that, which has been enjoyable. But again, I’m fairly early doors with that one too. What are you reading?

Drew: First I was going to say I’m the same as you, where I am not allowed to buy any more books. I read really quickly, so I just amassed a lot of books very fast. But then especially because I kept moving – I’ve moved, oh my gosh, seven times in the last 8 years – it becomes quite a pain to lug everything around. So I’ve been on the library-only program for a while. I still buy them sometimes because there are certain people that I’d particularly like to support, but the library has been a godsend. Even now with COVID, the library is not open here in the U.S., but you can check out e-books, which has been really great.

I am reading two books right now. I’m in the middle of reading Radical Acceptance by Tara Brach, and that is very good so far. I won’t explain it because you’ve talked about it on the show a lot of times. And then I just picked up Fearing the Black Body by Sabrina Strings, which is about the racial origins of fatphobia, which I’m super excited about. I can’t report back yet because I haven’t started, but I have been wanting to read this for a long time. I’m really interested to get started.

Chris Sandel: Nice. I’d love to hear your thoughts on that when you get further in because I’ve heard her on podcasts before. It’s one of those books where I’m like, “I definitely need to get to that,” and I just haven’t got to it yet. So please report back.

Drew: I will, for sure. Those are all the questions for today. What’d you think?

Chris Sandel: That was good. The other thing I was going to say with books is off of our kitchen, we have a little room that’s mostly Ramsay’s playroom, but also is the home bookshelf library type thing, and it’s all on one wall, and it is color-coded. So part of my bind with books as well is like “Well, it’ll just add to the aesthetic display of the books that we’ve got going on.”

Drew: Yeah. It’s part book, part decoration.

Chris Sandel: It is. It is part book, part decoration.

Drew: So really it’s a good deal because you’re getting two things for one.

Chris Sandel: Yeah, exactly. That’s what’s driven some of the “Oh, I’ll just get another book. It’s fine.” But yeah, I’ve realised I need to rein that in. That is the only area where I probably have some overspending issues going on.

Drew: Well, that is everything that we have for today. I had a good time. I hope you had a good time.

Chris Sandel: Yeah, this was really good. We are going to do this again sometime soon.

Drew: Definitely. If you have a question that you would like Chris or us to answer, feel free to send us a DM on Instagram @sevenhealthcompany, or you can just email it in to info@seven-health.com, and we will get to it next time.

Chris Sandel: That is it for this episode. I hope you enjoyed it.

As I mentioned at the top, ~~we’re taking on clients for the last time this year~~. If you’re struggling with dieting, disordered eating, recovery, body image issues, or any of the topics covered as part of today’s AMA or covered as part of the podcast more generally, then please get in contact. You can go to seven-health.com/help.

I will be back next week with another show. Until then, take care of yourself, keep safe, and I will catch you soon.

Thanks so much for joining this week. Have some feedback you’d like to share? Leave a note in the comment section below!

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Here’s what we talk about in this podcast episode:

Intro