Body Stuff with Dr. Jennifer Gaudiani
Let’s talk body stuff.
So much of what happens to someone’s body when they engage in eating disorder behavior is individualized. It’s based on genetics, as well as other factors that we don't quite understand.
The complexities of these effects are multifaceted, and to some extent, the specific causes may not matter.
In this episode, I’m joined by Jennifer Gaudiani. Jennifer L. Gaudiani, MD, CEDS-S, FAED, is the Founder and Medical Director of the Gaudiani Clinic. Board Certified in Internal Medicine, she completed her undergraduate degree at Harvard, medical school at Boston University School of Medicine, and her internal medicine residency and chief residency at Yale. Dr. Gaudiani served as the Medical Director at the ACUTE Center for Eating Disorders prior to founding the Gaudiani Clinic, which is a Denver-based outpatient medical clinic dedicated to people with eating disorders and disordered eating. The Gaudiani Clinic provides weight-inclusive and fat-positive medical care and embraces treating people of all shapes, sizes, ages, and genders. The Gaudiani Clinic is licensed to practice in 47 US states via telemedicine and offers international professional consultation and education.
Dr. Gaudiani has lectured nationally and internationally and is widely published in the scientific literature as well as on blogs. She is a Fellow of the Academy for Eating Disorders, and is a former member of the editorial board of the International Journal of Eating Disorders and the Academy for Eating Disorders Medical Care Standards Committee. Dr. Gaudiani’s first book, Sick Enough: A Guide to the Medical Complications of Eating Disorders (Routledge, 2018) is available on Amazon.
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This conversation was definitely one for the books. We delved deep into the intricacies of eating disorders, their effects on the body, and the compassionate care that Dr. Gaudiani and her team provide. So let’s highlight a few of these topics!
Embracing Individual Complexity
As I sat down with Dr. Gaudiani, she wasted no time in emphasizing the personalized and intricate nature of eating disorders. These conditions are shaped by a complex interplay of genetics and an array of factors still shrouded in mystery. Dr. Gaudiani made it clear that the web of complexities surrounding eating disorders extends far beyond our current comprehension, revealing the need for a bespoke approach to treatment.
The Importance of Patient-Centered Care
Dr. Gaudiani was unwavering in her advocacy for patient-centered care. She stressed the immeasurable worth of patient narratives and experiences, highlighting the collaborative ethos of her practice. Here, patients actively participate in shaping their care plans, breaking free from the confines of conventional, one-size-fits-all approaches.
With this patient-centered approach, Dr. Gaudiani places the lived experiences of her patients on a pedestal, valuing them over the traditional medical metrics we so often rely on, such as vitals and numerical data on the scale. The significance of behaviors and overall well-being urges us to look beyond mere numbers.
The Misconception of "Normal Numbers"
There is a huge misconception concerning "normal numbers" in the context of weight. There are many individuals with eating disorders who might assert that their numbers are within an acceptable range, often referring to their weight. Yet, this belief holds true for nearly everyone grappling with an eating disorder, casting doubt on the reliability of such numerical metrics. Dr. Gaudiani attributed this phenomenon to the astonishing capacity of the human body to balance its chemistry and maintain stability, even when faced with destructive eating habits.
The Dynamic Nature of Metabolism
There is a myth about fixed metabolisms. The metabolism is incredibly dynamic and responds to fluctuations in calorie intake. When calories are restricted, the body's metabolism slows down to preserve energy, resulting in several noteworthy physical changes.
Insights into Starvation
The physiological effects of starvation on the body bring out a survival response, called "cave person brain". It’s a mechanism that triggers various unconscious changes in response to inadequate nutrition. These changes occur irrespective of an individual's body size or shape, a revelation that underscored the universal impact of malnourishment.
Despite the psychological effects, there is also the topic of weight fluctuations during starvation. Some individuals may experience weight loss, while others may paradoxically gain weight despite engaging in restrictive eating. The key lies in the body's tireless efforts to conserve energy in response to starvation, debunking the simplistic view of weight as the sole gauge of health.
The Impact of the Binge Eating Cycle
It may sound strange, but the body can typically withstand episodes of binging. However, it can lead to swelling or edema in various parts of the body, causing physical discomfort. This is a reminder of the necessity of addressing binge eating behaviors within the framework of a comprehensive treatment plan.
Binge eating often begets a destructive cycle of restriction and binging. Individuals may skip meals following a binge, perpetuating this unhealthy pattern. Dr. Gaudiani passionately advocated for breaking free from this cycle, urging individuals to provide their bodies with consistent, adequate nourishment throughout the day. She championed the idea of focusing on foods that are both satisfying and nourishing, fostering a reconnection with one's body and a newfound joy in eating.
A Holistic Perspective on Weight and Health
So let’s take a holistic approach to weight and health. Dr. Gaudiani candidly acknowledged the link between higher body weight and specific medical conditions such as fatty liver, diabetes, sleep apnea, hypertension, and heart disease. However, weight is but one piece of the puzzle contributing to these conditions. There is a need for a holistic approach, as it brings the importance of improving overall health through adequate nourishment, mindful eating, and suitable physical activity.
Confronting the Risks of Purging
There are many risks of purging. These consequences encompass severe health issues such as an elevated risk of reflux, dental damage, and profound physical and emotional suffering. For those reasons and many more, it highlights the urgency of seeking help and support from healthcare professionals for individuals entangled in the grip of purging behaviors.
This conversation with Dr. Gaudiani was nothing short of transformative. As we navigate the intricate world of eating disorders, may we heed her call for holistic care, empathy, and unwavering support, recognizing that every individual's journey to recovery is a unique and profound odyssey.
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Tweetable Quotes
“Virtually every human experiences medical symptoms of their eating disorder, whether they're measurable by labs or vitals.” - Dr. Jennifer Gaudiani
“The medical stuff is so vital because we understand when somebody, for instance, simply cannot remain in an outpatient setting. They need to be more intensely monitored.” - Dr. Jennifer Gaudiani
“The true science is that our metabolism is unbelievably dynamic and responsive.” - Dr. Jennifer Gaudiani
“Don't tell me you're fine. Don't tell me it's not that bad. Let's talk about what change you can make this week towards nourishing yourself better.” - Dr. Jennifer Gaudiani
Resources
Sick Enough: A Guide to the Medical Complications of Eating Disorders Book
Gaudiani Clinic Website - https://www.gaudianiclinic.com/
LinkedIn - https://www.linkedin.com/in/gaudianimd
Facebook - https://www.facebook.com/gaudianiclinic/
Twitter - https://twitter.com/gaudianiclinic
Related Episodes
Episode 77. How to Accept Your Body
Episode 76. The Basics of Health at Every Size
Episode 65. 7 Tips for Positive Body Image
Episode 39. Weight Inclusive Approach to Endocrinology and Health wtih Dr. Gregory Dodell
More From Rachelle
Hey there! I’m Rachelle, the host of the Understanding Disordered Eating Podcast. As a Licensed Mental Health Counselor, I work with clients to make sense of life’s messy emotional experiences.
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