Episode description: In today’s podcast we talk with Gabby Salamone, LCSW, about disordered eating and body acceptance. In this episode, we talk about defining what eating disorders and disordered eating is, prevalence for eating disorders in those who struggle with anxiety and OCD, why diets don’t work, and how to start accepting our bodies and resisting diet mentality culture.
Gabby is a full-time outpatient therapist at Therapy for Women –
in Philadelphia. Gabby specializes in treating patients (women, men, and non-binary) with eating disorders, anxiety and OCD. Gabby is passionate about supporting her clients in making changes and living a life they love.
Gabby’s #1 takeaway: Anxiety and depression are common for people struggling with eating disorders and working on becoming body /weight neutral
Gabby’s favorite book: Anything Brene Brown because Brene works with shame and guilt which Gabby thinks impacts so many areas of our life and keep us stuck and feeling unworthy.
1. Daring Greatly
2. The Gifts of Imperfection
Who does Gabby like to follow on social media
• IG: livingwellwithgabrielle
• Body image with bri
• The Fuck it Diet – Caroline Dooner
People to Follow:
Jennifer Rollin – https://www.jenniferrollin.com
Podcast: The lovely becoming
Hi guys, welcome back to the show you are in for such a knowledge bomb going off today with these Philly accents that are pretty prevalent in this conversation. My guest is Abria Salamone and she is an eating disorder therapist practicing out of Philly. So I’m so excited to have her on today. Globby talks a lot about the link between eating disorders, anxiety and OCT cabbie talks about why diets don’t work. And she also shares with us how to start accepting our bodies and resisting the diet mentality. That is very prevalent in this culture that we live in. Gabby is a full-time outpatient therapist. She works at therapy for women in Philadelphia and Gabby specializes in treating patients, including women, men, and non-binary with eating disorders, anxiety and OCD. Gabby is passionate about supporting her clients and making changes and living a life that they love. And you’ll hear this passion throughout the interview. Gabby can be found at her handle on Instagram, at live well with Gabrielle and for any questions that you have, or if you want to contact Gabby, she can be reached by firstname.lastname@example.org. I’ll put all of her information in the show notes for this episode. Let’s listen. So today I have Gabby
On the show and she’s going to speak and talk to you guys a lot about this culture that we’re, you know, that we talk about Austin and these episodes and eating disorders. And we’ll talk about anxiety and OCD related to anxiety. So Gabby, thank you so much for being here. Welcome to the show. Thank you so much for having me. I’m so excited to be here and talk with you those and to share with you some of my knowledge and get the word out there that like people aren’t alone, there’s lots of stuff going on and we are here to help and support and try to address some of that’s great. I think that’s a lot of people need to hear. So, so when we first were talking about this, why don’t we first kind of dig deep into a little bit of what you do?
It sounds like your specialty, your specialty as a therapist is, um, in dealing with eating disorders, right? That’s correct. Yeah. So I am a licensed clinical social worker. I’ve been in the mental health field for over 10 years now. I have worked in a number of levels of care, like different levels of care for it with clients. And I specialize in treating clients with that have, you know, eating disorders, OCD and anxiety disorders. Those are like my big three. And I say the big three, because a lot of times we find that they are co-occurring with each other. And what that means is that a lot of people that are struggling with anxiety disorders also struggle with eating disorders or just what are they eating and people that are struggling, whether it was ed are also a lot of times struggling with eating disorders and disordered eating and vice versa. And so it’s the prevalence of them all being there in some capacity is extremely high.
When you talk about eating disorders, what are you like? Okay. So can you first clarify what you, when you’re talking in this episode with eating disorders, as opposed to just order it eating? Cause I’m guessing that they’re different.
Yeah. So eating disorders are like, you’re meeting all the, add this in here. The patriarchy likes to have us follow the DSM in terms of diagnosing clients with specific things to meet criteria, but they have to meet these, all these specific criteria. And it’s actually really oppressive because clients can have anorexia, but not meet the criteria because of weight. And so that’s just like fat phobic in and of itself. And so I say, you know, you can have an eating disorder which could be anorexia, atypical, anorexia bulemia binge purge disorders, binge eating are fed, which is wouldn’t restrictive food intake disorder. Those are like the big encompassing eating disorders in the DSM. But then when I say disordered eating, I’m also talking about orthorexia, which is the like belief or like the over consumption of healthy foods. And I’m using quotations here and there. Nobody can see me. I can see. Right. And so like, or the Rexi is like, when you develop an unhealthy unsafe obsession with healthy foods.
Right. Right. So it’ll be like somebody who like seems like, Oh, they’re so great. They eat some healthy, but really it’s some kind of disorder this stored it eating because it’s an obsession about eating the healthy view that it’s kind of like, I guess, like taking a toll on their life. Is that what makes it disordered?
Yeah. So like upset, like it comes like obsession with like healthy dieting and consuming, pure clean foods like assessing and following a healthy lifestyle. It can be also like intertwined with overexercising and an obsession about exercising problem is that it’s not recognized by the American psychiatric association. So it’s not in the DSM as a mental health disorder. And then like also disordered eating could be somebody that is going back and forth on diets and going in and out of diets. And, you know, one day they are, you know, just intuitively eating, but then the next day they’re following all these rules and then the next day maybe they are back to like intuitive eating or like following specific rules. So it just becomes a little there when there’s a lot of disordered eating, usually like when there’s like a lot of food rules.
So when you talk about eating disorders and I know that you did a lovely, like, like introduction that eating disorders and, and anxiety and OCD are related, can you like kind of dive in a little bit more about that and kinda how that, how that presents itself and just kind of why that is.
Yeah. So we’re not really sure. Always like why that is. There’s some discussion in the field that eating disorders like are very related to anxiety disorders and like, I guess a fear syndrome. And so like the statistic actually is like up to 64% of individuals with eating disorders also have at least wanting anxiety disorder and up to 41% of these individuals also have OCD.
Oh. So they can have both anxiety and OCD. Uh, okay.
Well, you can have both at the same time, but like, so you could also, the 64% has like at least one and then like 41% have OCD. And like, there’s talk that we can view eating disorders, like as a fear disorder. So like fear of weight, gain, fear of not fitting in society, fear of food, fear of physical sensations, fear of any of the above. Right.
Do we have that because, uh, like how we grew up in society or are we having that because of anxiety and or OCD, or is it a combination that’s like, I guess diet culture makes it worse. Like how does that,
It’s kind of like a combination, right? Like we don’t know necessarily what causes eating disorders or necessarily anxiety disorders or OCD. There are some biological components to it, but it’s sometimes like eating disorders and OCD and anxiety. Like don’t just happen, like in a vacuum there’s societal, there’s hereditary. There’s, socio-cultural like, there’s, uh, that society, I’m sorry, but like, you can have it, like, there’s just general like issues going on for you at that moment. And you’re like, how do I cope? What can I do? What feels like I can have some sense of control and a lot of like, there’s times like that there’s control as a part of these disorders. And then there’s a part that sometimes it’s, there’s no rhyme or reason. There’s no rationale there. Yeah. There there’s, there’s not like, there’s not really a reason why somebody starts having excessive thoughts or intrusive thoughts.
And so then, how does that impact our relationship with our bodies in general, when we have, when we are started having these, these feelings, right? So like, what does that, how does that impact our relationship with our bodies and then how do. That’s actually, what it ends up being is like, there it’s very overwhelming. And so if we’re just saying, like, I feel anxious, right. I feel scared. I feel uncertain. I utilize specific tools that I believe are helping me, but they end up hurting me. We just kind of get in this cycle of either. It’s like, they like bingeing. So we feel all these things. And then we binge and our anxiety and all those emotions go down in the short term. And then long-term though, we ended up feeling bad about ourselves, beating ourselves up, criticizing ourselves. And then when that emotion comes around, again, we usually engage in the same exact behaviors. But I think the back to the original question here is like, how do we address it? Or like, how does it all like go forward? And some of it is like learning to get comfortable with our discomfort for all of it. Like whether you’re treating, um, treating somebody with that, you know, has anxiety, OCD, or, and we’re eating disorder. Like it’s about getting comfortable with our discomfort. And that is actually like, as a society, we have been taught that discomfort is bad instead of thinking of discomfort as growth. So I will usually say to my clients, like, I want you to get comfortable with feeling oncoming.
So it’s just kind of sitting in the feelings that are starting, whatever you’re feeling that you’re trying to avoid. I eating the way. And this sounds like such a silly question, but we talk a lot on here about emotional eating. So I’m guessing that emotional eating is that considered, like when we’re eating disorder, like, or just what we’re eating our guests does, it really just depend on what, what
What’s going on, how often. And so emotional eating is a part of it, right? Like eating, it brings us comfort, brings us joy. A lot of times, you know, we can’t have a full life unless we have a full belly sometimes. Right. So many of life’s joys actually revolve around food. So it’s no wonder when we are feeling icky that we want to eat. Why? Because one of our good memories are connected with food. So the problem is, is like when we just aren’t eating to feel something and we ended up overeating because we’re not listening to our bodies at all. And we’re just like, keeping, like, we just keep eating without paying attention to any of our intuitive eating or any of our bodily sensations, physical sensations and say like, Hey, you bought it off.
It’s I guess it’s like listening and being in the discomfort is the only way through it because you have to feel in order to move through it.
Yeah. Yeah. And you have to feel it too in order to move through it. So like, even just like the discomfort of feeling physical sensations in our bodies, people get wigged out by that. Right? The thing about that, it’s like, how often do you hear people say, Oh my God, I feel so fat today often. Right? My response is what actually are you feeling? Where in your body are you feeling physical sensation? Because when they say that, it usually means, I feel heaviness on my chest, feel pressure on my chest. My arms feel like led my legs feel giggly because maybe they feel anxious, anxious. Right. My stomach feels tight and tense. Those are all acquainted with heavy. Right. Not actually fat. The other thing I usually say, and this is more of like, when I work with adolescents, when they’re like, I feel so bad today, I’ll joke with them and say that, is that a feeling you have that you have fingernails? Are you a fingernail?
It’s so funny.
Saying that like, yeah. That’s so interesting because it’s almost like, again, it’s like, it’s like, you have to kind of feel the feeling. And a lot of times we’re trying to run away from them or not sit with that. Right. And so then it sounds like all of that kind of precipitates everything else, like precipitates the cycle, you keep going and going and going. And so, you know, I know that you were saying that one of the treatments is to kind of sit with it, but like, what do you do if you feel like that you’ve had this for a really long time? Or like, how did like, that’s the thing is like, for some people, right? You have people that have maybe been doing this for like 40 and 50 years. Like, how do you want to do that? Or how do you manage that? It just seems like a huge undertaking for the individual and for the therapist.
Yeah. The distress tolerance skills are helpful. Right. They’re used to help us cope and survive during crisises. And so it’s like figuring out like what actually are like short term and short, like quick distress tolerance skills for you, but also like reminding yourself that like emotion is actually less about 90 seconds, unless we’re judging and criticizing and fueling them cycling through constantly about that emotion and ourselves. And why do we have that emotion and how come we have that? And we are ridiculous for feeling that way. You need to stop it and knock it off and soon should shove it down and pretend like it’s not happening. That actually is like the problem problem. Isn’t the emotion, how we treat ourselves after slash during or while we’re having that emotion. Yeah.
So it’s like, it sounds like there’s like a loop kind of goes on, but then how do you stop it? How do you stop it when you’re in the middle of it? I mean, my God, you say stop
Actually like the big thing is, is mindfulness. So we want to work on paying attention on purpose with purpose in the present moment. And the big part of mindfulness is without judgment. So without judging ourselves, our emotions, our thoughts,
I think you do that. How do you stop it in that moment? How do you go from being like crazy into like, I’m awful. I hate myself too. Like, I feel mindful, like how does that matter
Catching yourself in the spiral? I like to call it the spiral, the shame spiral, the downward, like rabbit hole, that Ellis tumbles, right? Like we’re just falling. All this stuff is going on around you. It’s actually like pausing. I mean, like I’m talking to myself horribly right now. Like I’m spiraling, I’m shaming myself and we’re recognizing it, recognizing it is the first step. And then it’s okay, I’m doing that. So like, I need to ground myself. I need to bring myself back to the present moment. And so it’s either paying attention to your breath and doing some, you know, square breathing where you’re breathing in for five and holding it for five and then breathing out for the extended period because your breath is always with you. So you can utilize that. It might be your senses. So taking, you know, breath and putting your feet really firmly on the ground and looking around the room and saying five things, you see four things that you can physically touch and feel three things that you can hear, two things.
Well, and then one thing that you can taste and yeah. Did I say so, like, that’s like grounding yourself. So like what can you actually see around you is like the gist of it. That’s a grounding technique. It might distract you. Is that why it works? Well, it brings your mind back from all the, what ifs and the shaming and the what ifs or the anxiety and the shaming is when you’re judging yourself. And so like, that’s where, like we, you know, end up struggling a lot too, is like, we’re trying to control a lot of things and we can’t control majority of our lives. Unfortunately, unfortunately
Then when this, when we talk about like, um, I want to kind of get a little bit into like the diet part too. So I know that you and I both agree that diets don’t work. So from your perspective, can you kind of, you know, you have a really vast perspective about like why they don’t work and how they can be harmful way more than anybody. So can you kind of speak a little bit to that? Yeah. So
Diamonds don’t work because they don’t take into account. Every body is different. We all have different genetic makeups, different Heights, different, you know, when we metabolize food, different reactions to food and diets, tell us, well, you follow this, you’ll lose weight. And then you’ll look like this, you know, thin and toned and beautiful. And you know, it doesn’t really equate to though, like, what is actually beautiful? What is, you know, any of that, they’re just giving you this like ideal. That’s really based on Euro centric, appearances, and also focusing on then white abled people. And the majority of society doesn’t fall into that category. So you and I could have the same exact diet, the same exact exercises. We will not look.
And then what happens when you don’t meet that criteria or you feel like you’re doing everything and you don’t look that well, then what happens? Then
You shame spiral and you beat yourself up and you think you’re unworthy and unlovable and an outcast of society because you can’t do it right. You fail to get. And the other part about dieting that we don’t really talk much about is actually like we’re telling our bodies how to function internally without realizing like that’s their job. They know what to do with the food that we’re giving it, but we think we know better. So we are going to restrict and punish ourselves to follow this diet because our bodies aren’t doing what we wanted to do because it doesn’t fall in line with how society wants us to be.
And so then where do we, like, how, like, what do we do to resist that I culture and to, um, and then just start having body acceptance, because I feel like I’m a lot of social media platforms. It’s really hard to do that. I mean, because there’s constantly the comparison, you know, in our Facebook feeds or I feel like on Instagram, depending on who you follow, there may be pictures of people that you think look healthy, whether or not they have any disordered eating, none of that, not going to probably be publicized. Right. And so what do you do to kind of be create somewhere that balance and then also create that like self acceptance around it.
So I think like the first thing is like cleaning up your social media feed. So that means going in and fall unfollowing, all the people that do not bring you joy and cause you to feel crappy about yourself and to question like, am I doing something wrong with how I’m eating or working out or working out or whatever, clear your search history. So you start getting new content on your suggested feed page and start following people that bring you joy and help you feel better about yourself. That’s usually the first thing I encourage people to do. You know, the only thing I usually say is like, let’s Bri to remind ourselves that 95% of diets fail. So if you hear that, right, there’s only a 5% success rate with this here, diet in the long-term, it doesn’t actually make, you want to do it.
You always think that you’re going to be that 5%. Right. I’m going to be the one that does it. Maybe,
Maybe, I don’t know. Like my head always goes only 5% success rate. No, thank you. Oh, good news. 95% of people are failing. That’s like the other part, I think. And then like remembering like our bodies know what to do. We start listening and stop controlling. It knows when we’re sleeping. It knows when we’re hungry. It knows when we need a little coffee, pick me up. It knows when, you know, we want something sweet versus when we want something cool and crunchy.
So then it’s, so then you’re saying like, first you kind of start listening to what your body’s saying. Is that involved writing anything down or does that, like that part of the process? Like, okay, this is what I’m feeling, because I feel like a lot of times we’re so busy, right. That it’s not like we sit down, we might know that those thoughts exist, but we don’t actually express them to anybody or actually like verify them. So how do we do that? How do we become in tune with it?
Yeah. It is sometimes about just pausing and asking ourselves, what do I want? And what do I need? A lot of times we, you know, get in this cycle where we’re not listening to ourselves at all, because we’re on autopilot so often. So some people, it helps for them to write it down. Some people, they just want to reflect on it for a couple of minutes. Some people want to go through like a whole list of, you know, what am I thinking and feeling and what do I want to eat? And like asking themselves like either or type questions, no salty, sweet, hot, cold, soft, crunchy. Right. And then, so you can kind of figure out what you want to eat. Um, if we even think about like, how often do you go to a restaurant and order, actually the thing you want or the thing that you think you quote unquote should have, because you need to good. If you’re having the thing that you should have versus what you want. You’re more than likely to obsess about that thing that you wanted and feel disappointed by that thing that you ended up like ordering, that’s not meeting your needs or desires.
And then what do we do if we’re in a place that we don’t love our bodies? Like, what if we’re like, Oh, I BB, I don’t look the same. Or maybe we have 50 pounds that we feel like are uncomfortable on our bodies or fur or whatever. Or we’re not as active as we were before. How do we get into place that we’re like, okay. You know? Cause I think what a lot of people do is like, they’re so desperate to not feel that way. And then it’s like, I’m going to do whatever I think is easier. So the quickest way to get me there. So how do you accept where you’re at at that particular moment and resist that temptation?
Yeah. It’s I think there’s like a spectrum of body image and you know, there’s different levels and we don’t always have to love our bodies. Right. We don’t always have to accept our bodies. It’s sometimes that middle ground of like, I want to just try to appreciate myself today. I want to find some peace today. I want to feel a little confident today. What we know is like, Bobby’s action really like involves like feeling like calm, like uncomfortable and not confident in our bodies. And we know that diet culture actually sells body satisfaction through like body image. And so like, it’s pretty much telling you like, Oh, you want to feel really good about your body by this year has nothing to do with body image. Body image is really like about how you view yourself, how you think about yourself, how you feel about yourself, how you engage with your body. Like what types of behaviors you engage in around your body. And even like the thoughts and beliefs. You, you have a new feel about your body and it’s not like a one size fits all. There’s not a one, like one thing we’ll fix this or that it’s body image and body like work is like shifting around, digging around in there.
So are her social media people that you’d like to follow that you feel like there’s body positivity. Are there books that you feel like kind of help guide people to kind of finding some of the answers that you’ve kind of talked about?
So I love body image with Brie and I’m actually doing her training right now. I done the be body positive training, which is another great organization that empowers young girls and young women and men also about their bodies. There’s like the it diet, which I love her. She’s amazing. She’s free. Who else do I love Jennifer Rowlands? She’s great. There’s just like so many people that I really love and enjoy and that have like great body image stuff out there.
And we, you and I had talks about Bernay Brown when it comes to shame, right. Is there a book that you love more than others of hers
Constantly torn between like going back and between the gifts of imperfection and daring greatly. Those are like, they’re never ending depths of knowledge and like insight, I think. But yeah. There’s like the become lovely becoming. She’s amazing too. I
Really love man. Her name is Mimi,
But she’s great. The lovely becoming as harp Instagram.
Oh, lovely. And then, so Kevin, one thing before we go, I wanted to just, I wanted to ask you one more question. I feel like I get asked a lot about this fit and fat mentality. So I feel like people will say, is it possible to be fit and fat? And that’s like a big thing. So can you talk a little bit about, about that? Because I know that that’s something that you’re probably much more familiar with than I am.
Yes. So fit and fat is 100% actually capable because weight has nothing to do actually with your fault.
We talked about fit or fat. We’re talking about somebody who may appear on the outside to be what overweight, obese, and then like
Operating in a larger body
Operating in an marred providing. Yes. Okay. Yes. And thank you for correcting me. And so I think there’s this perception of like, if you’re operating in the larger body, that somehow you are a responsible for that or B that you are unhealthy, that’s kind of the fitter fat mentality. Right? Correct. Okay. Now can you please clarify a little bit about that?
Yeah. So weight has nothing to do with your health. Somebody that is overweight is actually more likely to be healthier than somebody that is under weight. That like really like what has to do with determining like health is really like, what’s your blood sugars, what’s your cholesterol, what’s your blood pressure. Like that is actually are better for amateurs of our health than a number on a scale.
We’ve talked in here about like BMI and body weight and they’d really hold any weight.
BMI is and that there’s made by white men.
It doesn’t, it doesn’t tell anything about like our body composition and what’s kind of going on, but it’s used as like, um, you know, it’s used to classify disease risk. Right. But then you’re you’re right. Like all the metabolic parameters that you’re talking about are going to be much more accurate and terminating what our disease state risk is. Right?
Yeah. So like actually like here’s the one in the 1940s, like met life insurance, started using BMI measurements to determine how much to charge their customers for their insurance. And then they’re the ones that came up with these like dumb, ideal charts with no scientific evidence at all, connected to them. And then they lobbied our government to store using like recognizing BMI as an indicator of mortality, which was then adopted by health workers as a way to determine a person’s health. Even though there’s no scientific evidence about it. Yeah. And then there was a point in, I think like the like nineties that they re did the charts to lower everybody’s BMI. And so like overnight millions of Americans became obese without anything actually changing about that. Actually the best indicator of the weight, like for your ideal body weight is actually your growth curve charts, which most of us don’t have from our childhood to determine what percentiles we were in for like height and weight as a kid. So if I was a hundred percentile constantly for my height, no wonder I’m five foot 10.
Yeah. That’s a tickle point. That’s so good. And so then in all of this though, like if somebody feels like that they like something, they recognize again what you were saying, or it triggered something in what you were saying, how would somebody know to seek help? And where would they go to seek help?
I would say if it’s something that’s constantly on your mind talk to a therapist therapy, is that something doesn’t have to be catastrophic wrong for you to start seeing a therapist. Right? Like they getting therapy. We believe it’s like this big, scary thing. It’s actually like showing off for ourselves once a week, once every other week, whatever we’re, we’re just focusing on ourselves. And sometimes there’d be, yes. It’s about like digging in and doing like that hard work. And sometimes it’s just talking about like all the things that you feel like you don’t have time to talk about or think about in your day-to-day life. And so like something doesn’t have to be wrong before you to show up to there.
Yeah. And I think people think, well, I’m an advocate of therapy. I’ve been gone for many, many, many years, but I think like, there’s that part too. It’s like, it’s scary. But then also it’s like, it’s the best thing that you can do for you? Most people don’t acknowledge that they feel something. And then also like, I think we rely on our friends to give therapy, but like they’re not trained to give you information and you might not even tell them anything you might not really. I think that’s the big thing of like the honesty of it. And then non-judgment because where else do you get that in your life?
Nowhere else. Right? Like you don’t get it anywhere else. If a friend is like somebody to talk to, but they’re not, uh, they’re invested in you. They’re not going to give you like, always like that feedback that you need or give you those skills that you are going to actually like help you get through something. Sometimes they just end up enabling us more than once my friends have enabled me to make a third. This is going to say like, why do you think you’re doing these same patterns of behavior? And like, make you look at it a little deeper and look back and reflect of like, Oh, I’ve done this repeatedly for a year.
And so that you can change it. But I think you made a good point, like this skill development, if you’re talking your friend, you’re not developing skills that you can utilize to move forward in your life, where talking to the therapist, you do develop those skills. And how else would you develop them if there are skills that you haven’t learned, right? Yes, exactly. Yeah. So Gabby, thank you. I cannot thank you enough for coming on. I know that everybody has just, I’m like, I sure, just this wealth of information, and I know that I think that you clarify a lot of stuff that people are either too afraid to go to a therapist to figure out. I just think it’s just been a really down to earth conversations. So if people want to reach out to you, where can they find you at? Like, what are some of your, your hands? So you can find me on Instagram. I’m live well with Gabrielle. I see clients at therapy for women in old city, Philadelphia. And that’s really that those are the big places you can find me wandering around Philadelphia.
That’s free. So I’ll come find you. I will. So thank you again. And we really, I really appreciate you being here today. Great time. We’ll have to do it again soon because clearly you have lots of stuff to talk about. If you found value in this podcast, please rate, review and subscribe on iTunes. Being a busy woman or mom doesn’t mean that we have to give up on our health, wellness or self care together. We can take tiny, imperfect steps towards creating the whole health we desire and deserve. You can find email@example.com or on Instagram at whole health empower. Thanks for listening. I’ll see you next week.
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