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Find Your Strong Podcast
Encouraging people to find what FEELS good in terms of food, movement and their bodies. Let's challenge the wellness w*nkery and start a new conversation.
In each episode, Christine and Ela discuss their thoughts on diet and fitness fads, speak with fabulous guests about finding peace with food and movement, and interview experts so that they can share their insights and knowledge with you, the listeners.
The hope is that together we can change the narrative around fitness and nutrition, and help you find YOUR strong!
Find Your Strong Podcast
Body Image, Eating Disorder Recovery and Cake, with Dr Kamila Irvine - RE-RELEASE
We are re-releasing this to coincide with the APPG report from Dump The Scales, that was delivered to Number 10 yesterday, alongside a petition calling for an inquiry into all eating disorder deaths.
You can find the full report here
It's always humbling to speak to our amazing experts, and our conversation with Dr Kamila Irvine was no exception! Whilst she is a very senior researcher and serious advocate for weight-inclusivity, she is also incredibly good fun to chat to!
We talked about:
- How neurodivergence can impact our eating behaviours and contribute to disordered eating
- How eating disorder recovery might need a different approach in neurodivergent individuals
- How body sensations can impact our body image
- How disordered eating behaviours and intentional weight-loss have been normalised
- Kamila's amazing work with Molly Forbes at www.bodyhappyorg.com
- Kamila's Cake analogy, that she uses to illuminate the reasons why eating disorders may occur in some people and not others. Same ingredients, different quantities, different mixing skills = different cake!
Bio:
Dr Kamila Irvine is a Senior Lecturer in Body Image and Eating Disorders at the School of Psychology, Sport Science and Wellbeing at the University of Lincoln, where she teaches and researches all things body image in the context of eating disorders and beyond.
Her research work encompasses a number of multidimensional themes and interests, including intervention and prevention, LGBTQIA+, weight stigma and anti-fat bias, and perceptual body image.
Her main teaching responsibility is her module "Body image and eating disorders" for 3rd year Psychology students, and she is soon to start teaching 3rd year medical students too!
She also supervises research projects of dissertation and masters' students, as well as PhD students; and works closely with Body Happy Org and First Steps Eating Disorders charity.
Follow her or get in touch with her:
Dr. Kamila Irvine | Senior Lecturer in Body Image and Eating Disorders
BSc(Hons), MSc, PGCE PCET, PhD, FHEA
Programme Lead for BSc (Hons) Psychology with Mental Health
(she/her)
SSB4204
School of Psychology, Sport Science & Wellbeing
College of Health and Science
Email: kirvine@lincoln.ac.uk
Instagram @drkamilairvine,
Please reach out if you would like some support with your relationship to food OR movement. Ela currently has limited spaces for Intuitive Eating coaching and if you'd like to reconnect with movement, contact Christine.
WEBVTT
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Ela Law: Hello, everybody, a very warm welcome back to find your strong podcast we are very excited because we are speaking to Dr. Camilla Irvine today who is a senior lecturer in body, image, and eating disorders at the school of psychology, sports, science, and well-being at the University of Lincoln. She teaches and researches, all things body image in the context of eating disorders, and beyond there
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Ela Law: her research work encompasses a number of multidimensional themes and interests, including intervention and prevention. Lgbtqia, plus weight, stigma and anti-fat bias and perceptual body image. Her main teaching. Responsibility is her module, body image and eating disorders for 3rd year psychology students, and she is soon to start teaching 3rd year. Medical students, too.
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Ela Law: which is great news. She also supervises research, projects of dissertation. Master students as well as Phd. Students, and she works closely with body happy org and 1st steps eating disorders. Charity. Now that sounds amazing, also sounds very serious. But I promise you Camilla is anything, but she's a proper laugh, and we're really excited to have you here. Welcome, Camilla.
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Kamila_Irvine(UoL): Hi
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Ela Law: How are you coming
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Kamila_Irvine(UoL): Not very serious at all, am I
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Ela Law: Do you know what I thought was great that you teach
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Ela Law: body image and eating disorders to 3rd year psychology students, because I don't know if anyone knows this. But my undergraduate degree was in psychology way back when and we didn't even touch on that at all. We touched on eating disorders a little bit, but there's absolutely no mentioning of body image in any of that. So I think it's fabulous that things have moved on a little bit, and that that is part of
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Ela Law: the the course and the curriculum. So yeah, I'm very excited to hear that
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Kamila_Irvine(UoL): Yes, I had an elective in eating disorders when I was an undergrad, and I know that there are quite a few different institutions that do have it, and it is a quite a popular topic.
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Kamila_Irvine(UoL): But that that spin of adding body image to it. Apparently I'm the only one who's doing that.
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Ela Law: Wow!
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Kamila_Irvine(UoL): I've looked at as many universities as I could possibly do. I think I conked out about 40 or 50 universities
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Kamila_Irvine(UoL): when I was checking. Because, like, if you go to a university website, you can see this is what we are offering as part of the course. And yeah, quite often there was an elective on eating disorders, but not on body image
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Kamila_Irvine(UoL): and because my my main thing was body image, I was like, I need to involve this, and you can't really talk eating disorders without body image, and you can only talk body, image without eating disorders. So it works, in my opinion.
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Ela Law: Yeah, it needs to be. I think it needs to be in there. I mean, it's so intricately linked to eating disorders to all sorts of mental health issues. And in particular, in young people, I think it's crazy. It's not. And in terms of the starting to teach the 3rd year medical students is that similar kind of syllabus
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Kamila_Irvine(UoL): So that's currently in development. I do want to include as much as I can of not just eating this. I don't want to do this sort of
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Kamila_Irvine(UoL): learning about it that I received when I was learning about eating disorders. My module is very much focused on understanding it more broadly.
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Kamila_Irvine(UoL): not the sort of classic
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Kamila_Irvine(UoL): misconception and myths. And unfortunately, a lot of what is out there is that I'm very much focused on contextualizing it all within
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Kamila_Irvine(UoL): things like weight, stigma within the historical, sociocultural, geopolitical context of where things like like I said, weight, stigma, diet, culture, appearance, ideals, muscularity, ideals, toxic masculinity, where all of that is coming from? What is the impact of that on body image? And then how is that extended to eating disorders? And if I'm
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Kamila_Irvine(UoL): going to be teaching GPS, who are often like that 1st hurdle in getting disorder treatment, they need to have that nuanced understanding of it. And on top of that
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Kamila_Irvine(UoL): I then focus my teaching on specific groups that have been under, researched, underrepresented, not included in that kind of classic understanding of eating disorders. So, for example, with my students, we specifically focus on
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Kamila_Irvine(UoL): neurodiversity separately, we look at Lgbtqia plus populations. We look at men, we look at being bipoc. We look at
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Kamila_Irvine(UoL): older populations. So we're not just focusing on teenagers and young adults. We're looking at the impacts of things like pregnancy and menopause and life changes kind of having that starting the domino effect of potentially a person having a negative relationship with their body.
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Kamila_Irvine(UoL): And also we look at emerging trends. So things like orthorexia, we look at the impact of diabetes in and eating disorders. So yeah, we do. We do a lot. I only have a 12 week course, but we do a lot of content
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Ela Law: That's amazing, isn't it? I mean, there's so much in there. So it's all I'm eating my hair here. Sorry there's just so much important stuff that in particular GPS and psychology students need to know. And I'm so pleased that that is part of the teaching. But how? I mean, you said that in terms of psychology, students, you you haven't found any other university that teaches that module. Is that is it the same for
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Ela Law: for GPS medical students, because
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Kamila_Irvine(UoL): I haven't looked into it in that much depth. There was that paper a couple of years back by Agnes Ayton, and I can't remember the second author, sorry
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Kamila_Irvine(UoL): essentially what they were looking at was which Med schools actually teach eating disorders. But there was like no mention of body image as such, and then, when it comes to the content of what they are teaching them, I don't know what's in those electives. I do know some people that could potentially talk to. So, for example, just this week, I'm meeting with Dr. Chucks.
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Kamila_Irvine(UoL): Because when it comes to developing the course that I'm about to be delivering from autumn. I asked him, like, you know, is there anything you want to help with? And he was like, I would love to for club majority to be involved. So yeah, we are having a chat on Wednesday to find out what we can do together to kind of make a little bit more, all encompassing because I'm not a medical professional right?
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Kamila_Irvine(UoL): I don't know if I'm a Gp. What that would look like. So I do need that input from my colleagues and my friends to like. Tell me
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Kamila_Irvine(UoL): what they also need to learn about. I can tell about the psychology. But after that I do need that that help and support as well
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Christine Chessman: There's there's so much that we could touch on here. I've kind of a lot of experience with eating disorders sadly. As has my daughter, and you know some of my daughter's friends. She's 15,
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Christine Chessman: and it's kind of that. Age is very susceptible to eating disorders and body image issues. I'd love to talk to you about the correlation between body, image, and eating disorders, and I always, in my kind of limited understanding, believed I mean my body image has always been shockingly bad, and I've worked very hard on it, but I always thought I was more susceptible than other people to eating disorders, maybe due to neurodiversity. But is there a susceptibility there? So not everybody who's got
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Christine Chessman: poor body image is going to then end up with an eating disorder. So
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Christine Chessman: what is the link between? Do you do you know, I mean, is it just a I do know
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Kamila_Irvine(UoL): I'm going to tell you about flower theory of cake.
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Kamila_Irvine(UoL): All right. This, this is gonna end up being the title of my book.
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Kamila_Irvine(UoL): So basically, when my students ask me like, Oh, is it this that caused an eating disorder? Or is it this that caused an eating disorder? I always tell them this because I'm a baker. I go. If I made you a delicious chocolate cake right, and you are enjoying it, and you go. Oh, my God, this is a delicious cake! What made it so delicious?
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Kamila_Irvine(UoL): I cannot explain to you what made it delicious by focusing on explaining the type of flour that I used
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Kamila_Irvine(UoL): right.
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Kamila_Irvine(UoL): I also need to look at the other ingredients used. So I need to look at, you know. Eggs. Are they free range with the refrigerated with their room temperature. Did I use butter, or did they use margarine? Did I use bacon, powder, or baking soda, like all of these different things. Kind of come have to come together in order to make the butter.
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Kamila_Irvine(UoL): Then on top of that.
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Kamila_Irvine(UoL): what's my oven like right? Is it new and heating evenly, is it a bit old and naf? What if I made butter? And I gave some of it to you, and you put it in your oven and put it in my oven. Is it going to come out the same? What kind of skill level do we have? There is so much to consider, but at the end of it there is cake
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Kamila_Irvine(UoL): that is chocolate. We can follow the same recipe, do it at 2 different skill levels, using different ingredients using different ovens at the end. You have a cake.
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Kamila_Irvine(UoL): but it's done slightly different. It's got the same ingredients. So
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Kamila_Irvine(UoL): that's why, if you think of it like, oh, the eggs is your neurodiversity. The flower is your body image your butter is your parents, the oven is your sociocultural context, so on so forth. I quite often have that as an image when I teach my students where I have like this lovely chocolate cake, and I have all of these different ingredients, and it just has, like genes, biology, whatever you know.
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Kamila_Irvine(UoL): so chances are your body image would have made you susceptible. Right?
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Kamila_Irvine(UoL): There would have been some sort of activating event. So you have your
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Kamila_Irvine(UoL): predisposing factors that you were born with. You've got your predisposing factors that you have developed. You have your protective factors, because not everybody would react exactly the same. So we always talk about predisposing, precipitating, perpetuating, and protective factors. And all of these have to come together to make an eating disorder or to make negative body image. And everybody is going to experience uniquely because their cake is different.
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Ela Law: Wow!
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Christine Chessman: That's it. You have got to write that your book that has got to be the title of your book. That's that's I've never heard it explained that way.
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Kamila_Irvine(UoL): I'm not
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Christine Chessman: Oh!
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Kamila_Irvine(UoL): I've come!
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Christine Chessman: Make a lot of sense. Everybody
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Kamila_Irvine(UoL): Say I've come up with it myself, but actually props to my husband. He he actually coined the term flower theory of cake
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Ela Law: What's up?
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Ela Law: It makes so much sense when you explain it like that, because everyone I mean not everyone. Most people will have baked a cake, and most people know that sometimes the cake turns out okay. Sometimes it doesn't. Sometimes we don't have the right ingredients. And sometimes, you know, there's there's all sorts of variables and factors in there.
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Kamila_Irvine(UoL): That's and if you're not into cake, maybe a bread, maybe a soup or a stew, or whatever I don't care. It could be a casserole, just
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Kamila_Irvine(UoL): Some like it literally works so well, and because it's food on top of that, it just amuses.
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Kamila_Irvine(UoL): It's me so much
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Ela Law: Yeah, that's great.
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Christine Chessman: Yeah, that's fine.
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Christine Chessman: It's just a complex thing. It's, you know, it's not. There's a lot. There's been a lot of sort of talking about sort of diets. And you know the research around. If you diet, you're much more likely to then develop an eating disorder. You're 7 times where there's lots of different stats around that you never quite know which one is the correct one, or how much research has actually been done. But it's it's never that simple, is it?
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Kamila_Irvine(UoL): No.
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Christine Chessman: He's never that simple
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Kamila_Irvine(UoL): It's interesting, because, like, I know, people who basically
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Kamila_Irvine(UoL): seem to enjoy dieting, I think they enjoy the rules that come with the diet. And then I kind of immediately go, are we neurodivergent?
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Kamila_Irvine(UoL): But
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Kamila_Irvine(UoL): the thing with dieting, like I always say, like, I'm not anti weight loss as such. Right sometimes, if you choose to lose the weight, because I don't know you genuinely do want to have better flexibility, and, like the fat tissue, is getting in the way you can't like.
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Kamila_Irvine(UoL): Whatever right.
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Kamila_Irvine(UoL): What I am against is the dieting part of it, because most dieting behaviors
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Kamila_Irvine(UoL): are thinly veiled, eating disorder behaviors.
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Kamila_Irvine(UoL): So not eating according to your internal cues, not eating according to your satiety, your kind of preferences, the pleasure of eating the negative
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Kamila_Irvine(UoL): thoughts that come with it that I must eat this I should eat this I cannot eat this whatever. Last night, 2 o'clock in the morning, I was having a sandwich right genuinely
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Christine Chessman: I know.
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Kamila_Irvine(UoL): There are so many people like. Oh, no, don't eat at night. Why not? I was hungry. I'm gonna respect my body, and I'm going to have a sandwich right
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Christine Chessman: And
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Kamila_Irvine(UoL): What would happen if I didn't have that sandwich? I would try to go to sleep. It would be hard to fall asleep while I'm genuinely sitting there with lying there with my belly growling.
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Kamila_Irvine(UoL): I would impact my sleep.
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Kamila_Irvine(UoL): and then I would wake up even more hungry, and chances are that then I'm going to eat way more than I would normally eat, or how much I would eat. Following the fact that I have eaten at 2 o'clock in the morning
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Ela Law: And you're slipping into weird behaviors, weird thoughts, weird guilt and shame around eating. It's very easy to slip into that, for sure.
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Kamila_Irvine(UoL): Yeah. And that's how do I feel about myself?
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Ela Law: Yeah, exactly interesting. You said that sort of slight sort of on the side remark about neurodivergence. You tell us more about the link, because that's where I met you for. Well, I met you. You didn't meet me because you were a speaker in a course that I took and you were you were talking about in particular, the link between eating disorders, disordered eating and neurodivergence? Can you tell us a little bit more about the link
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Kamila_Irvine(UoL): Yeah. So basically, this is something that I introduced in my own module, like, as a result of, I think it was Bernie's net net was another course.
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Ela Law: It was in Med, yeah.
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Kamila_Irvine(UoL): Yeah, so I introduced it on my cause, because I was on calls with with Berthy
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Ela Law: All right.
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Kamila_Irvine(UoL): And then I kind of started reading into about it more. And I was like, Oh, this, this needs to be covered like I need to have more, because, like up until then, I didn't really involve it. I was just, maybe briefly mentioning it about within the context of like afid and and things or pika. So then I was like, Oh, I need to develop some more content for this. So I started looking at it. And
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Kamila_Irvine(UoL): it's interesting that some of it could be, for example, masking right or it could be camouflaging. So like the concealment of these autistic traits could be. That the person is trying to fit in with their friends. Right?
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Kamila_Irvine(UoL): So they are dieting because everybody else is dieting. This is what should we do? They feel like. That's what I should be doing right.
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Kamila_Irvine(UoL): And then
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Kamila_Irvine(UoL): part of it is the accompanying mental health that is related to being neurodivergent. So things like predisposition for anxiety and depression and stress feelings of isolation, the emotional sensitivity, the fact that.
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Kamila_Irvine(UoL): for example, with autistic people, they are often very acutely aware of the feelings of other people because they study them so thoroughly right because they're trying to fit in. They're trying to do what is like what everybody else is doing so.
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Kamila_Irvine(UoL): they may be paying a lot of attention like what other people are doing. They are also sensitive to negative moods of others and their own as well. There's this disappointment and anxiety. That kind of
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Kamila_Irvine(UoL): can be hyper. They can be hypersensitive, sensitive to so most research is related to autism. And Adhd. So in terms of autism, there's a lot of focus on restrictive eating disorders in terms of Adhd. Oh, my God.
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Kamila_Irvine(UoL): what it is is they they tend to look at overeating and binge, eating and impulsivity and obesity like those are the kind of keywords that go together there. But essentially
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Kamila_Irvine(UoL): well.
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Kamila_Irvine(UoL): what we focus on in terms of looking at autism with my students is things like the hypersensitivity and hypersensitivity. So if you are hypersensitive to smells right, it could be that you cannot have particularly strong smelling food right
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Kamila_Irvine(UoL): or, on the other hand, if you particularly enjoy strong smells, you may want to have more smelly, pungent food, right? Something that smells really strong that you can smell like when you're walking down the street right
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Kamila_Irvine(UoL): same with taste.
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Kamila_Irvine(UoL): There could be dislike of certain flavors. There could be preference for bland food. There could be difficulties with
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Kamila_Irvine(UoL): texture. Stuff like that. So like you kind of go like, oh, fed, you know. Or it could be that they enjoy really strong flavors. Right?
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Kamila_Irvine(UoL): So because of that.
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Kamila_Irvine(UoL): This, the the person's interest in food can be
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Kamila_Irvine(UoL): somewhat different than of a person who is neurotypical. And then, additionally, you've got, you know, all of the things like hypersensitivity, type, hypersensitivity with other senses like tortured vision, interoception, proprioception, all of that kind of stuff.
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Kamila_Irvine(UoL): So because of the sensory processing differences.
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Kamila_Irvine(UoL): the impact that they can have is not just in terms of food, but also how they experience their bodies. So, for example, how they experience fabrics on their body, how they experience water during a shower, how they experience, hotness, coldness, that sort of thing. So
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Kamila_Irvine(UoL): these physical sensations can influence your body image.
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Kamila_Irvine(UoL): When it comes to things like social pressures and challenges in communication.
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Kamila_Irvine(UoL): It could be that it's about social norms, or these kind of expectations related to appearance, so it could make few people like feel excluded or different, so they may try to fit in.
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Kamila_Irvine(UoL): Like I said. The Comorbidities are like on top of that, so it could be like causing some anxiety or stress, you know. Like, Am I like all the other girls, you know? Maybe I should be doing this, or, like all the other boys, are doing this, I should be doing this, whatever and then also with neurodiversity, there could be like executive function.
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Kamila_Irvine(UoL): That is a little bit different in people with neurodiversity so that can affect things like self-care grooming, whatever right and that can have then an impact on the person's confidence or their hygiene body, image, that sort of stuff.
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Kamila_Irvine(UoL): So
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Kamila_Irvine(UoL): it basically boils down to like cognitive processes, thinking styles that could be like difficulty with bigger picture thinking difficulty with flexibility. Where it's like, that's the rule. That's that's how I must do it. You know. That impulsivity, especially with like Adhd, the emotion regulation, the coping mechanisms of stimming. For example. Then you have
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Kamila_Irvine(UoL): added things like the masking, the stereotypes, the social stigma.
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Kamila_Irvine(UoL): If there's medication, there might be weight, gain, or maybe weight loss. People will be commenting on that. And we all know how that goes. So there is a lot
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Kamila_Irvine(UoL): that comes with simply being neurodiverse, that is
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Kamila_Irvine(UoL): creating a potential, like risk factor or potential maintenance factor to a person's either body image or eating habits, and that can
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Kamila_Irvine(UoL): essentially, in the predisposed person, make an eating disorder kind of manifest itself or to become entrenched.
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Kamila_Irvine(UoL): So it's it's a risk factor, basically
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Ela Law: Wow!
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Kamila_Irvine(UoL): We love a tangent. Joy.
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Ela Law: Love it.
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Ela Law: but that I mean it kind of makes a lot of sense. And would you say then, the the neurodivergence is a
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Ela Law: a sort of an activating factor in the whole thing. So you have that predisposition
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Ela Law: Neurodivergence. It sounds like a huge. It's so complex, isn't it? Because there's so many different aspects of it that could then lead you down a path of very disordered eating and eating disorders doesn't have to. But I mean, from from experience of working with clients, I would say that the majority that have had eating disorders or have quite severe disordered eating. They are neurodivergent
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Kamila_Irvine(UoL): Yeah, so, yeah, it could, it could be
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Ela Law: Definitely a link. There
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Kamila_Irvine(UoL): It could be predisposing, or it could be perpetuating, it could be both.
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Kamila_Irvine(UoL): Hmm! Right? So
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Kamila_Irvine(UoL): that's why I was talking to a friend who works in private practice. and she said, especially with younger clients of hers. When she has a person
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Kamila_Irvine(UoL): presenting for treatment.
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Kamila_Irvine(UoL): and it sounds like it's a restrictive eating disorder. She always goes like, is it neurodivergence? Or is it a de facto eating disorder? So I do believe that
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Kamila_Irvine(UoL): people working in eating disorders should have good understanding of neurodivergence. Because A,
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Kamila_Irvine(UoL): if it is there, it's going to have an impact on how that eating disorder is maintained.
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Kamila_Irvine(UoL): and B is going to have an impact on the treatment because the treatment may not be suitable for a person who is neurodiverse. So you know, give a worksheet to a person who has Adhd, and they will lose it.
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Kamila_Irvine(UoL): Or you know, they may be like. That's the rules. That's how I need to be doing this, and you need to have that flexibility. Maybe you need to have more consideration for
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Kamila_Irvine(UoL): making sure that you always schedule the person at the same time, maybe, that there is, you know, that need for consistency in the person. Maybe you need to consider what your setup is like in your office like if this person is hypersensitive to lights, can I dim the lights, or can I turn them off and have a side light on, you know, to like, make this person not physically
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Kamila_Irvine(UoL): overwhelmed and stimulated, so that they can be relaxed so they can engage in that conversation with me? Do they need fidget, fidget toys. Can they sit comfortably in a chair?
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Kamila_Irvine(UoL): Or should we take it onto a sofa? The floor go to the part, like, you know
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Kamila_Irvine(UoL): within confidentiality. Bugs, of course.
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Christine Chessman: Yeah.
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Kamila_Irvine(UoL): It. It might just be, you know. What do you need in order for you to be comfortable with me in order for you to be comfortable in the situation that you are, so that we can open up and start unpacking other things that are going on
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Ela Law: Yeah, wow, yeah, complex, isn't it?
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Kamila_Irvine(UoL): Yeah.
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Ela Law: Christine. You look pensive.
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Christine Chessman: I know I always look pensive.
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Christine Chessman: This is my resting faith. I heard the interoceptive awareness. It's dulled a little bit in, is it. People with Adhd. I've got Adhd diagnosed.
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Christine Chessman: but you know, and it's something that I've I've sort of worked hard to be an intuitive eater, but I've always really struggled to be an intuitive eater, and I like I kind of prefer the plan and to know what I'm eating and all of that. But I've really worked hard to tune into my signals. But I did read that. If you do have, Adhd, you struggle with interoception. Is that something you know anything, or have you done anything in your research around
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Kamila_Irvine(UoL): I haven't done any like. Personally, I haven't collected data, but like I don't talk about topics that I haven't looked into thoroughly
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Kamila_Irvine(UoL): So in terms of interoception, it could be that hypersensitivity means that you do not really feel your hunger cues, that you are out of touch with your internal cues with your emotions. Maybe you also do not recognize when you are tired.
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Kamila_Irvine(UoL): So it is possible, not saying everybody who's neurodivergent has that. But certainly there are. There are plenty of people who do, or it could be the other way around. It could be that you have hypersensitivity, and you have this really strong internal, sensory awareness.
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Kamila_Irvine(UoL): So yeah, like, that should also be considered like, if if let's say you are treating a person with an eating disorder, and you are
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Kamila_Irvine(UoL): trying to get them to listen to their hunger cues that may not work if they simply cannot recognize them if they need that external prompt of like, hey? When was the last time you've eaten? Are you? Are you hydrated, you? You've not drank anything for 6 h, or like? When was the last time you had a week, you know, so
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Kamila_Irvine(UoL): that may need to be considered as part of that person's treatment plan, and, like the maintenance plan post discharge from treatment because they may simply not be able to do it.
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Christine Chessman: Yeah.
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Christine Chessman: this is just fascinating to me, all of this information. And it's, you know, when you you were talking earlier about
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Christine Chessman: broadening the scope of eating disorders are sort of that, you know. Obviously, there's a typical I'm inverted commas idea of what somebody with an eating disorder looks like. And I'm there's nothing that angers me more than this, nothing because we've had experience with Cams and lots of the mental health services that I've treated my daughter and myself.
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Christine Chessman: Many, I mean, there's there's limited resources, and people are doing their absolute best, and there's no blame from my side, but it is simply that anorexia looks like this. Your weight is stable and fine, so you don't have anorexia. You may have atypical anorexia, but you don't need to stop doing any of the behaviors you're doing. Come back when you actually tip the scale underneath that you know. That is what my friend's daughter was told
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Christine Chessman: at the moment. You don't need to stop doing anything. If your weight drops to here, then we'd need to. So what happened? Her weight dropped to there because
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Kamila_Irvine(UoL): Alright!
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Christine Chessman: She wasn't doing it well enough.
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Christine Chessman: So and it just
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Christine Chessman: it just, you know. So these are as you were saying, dieting behaviors are sort of disordered eating behaviors. And it's okay. If you if you look a certain way you can, you can involve yourself in those behaviors. That's fine. And it's
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Christine Chessman: it's just so far, not. It's so far from fine. And it's normalized everywhere, isn't it?
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Kamila_Irvine(UoL): Normalization is one of the biggest problems in
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Christine Chessman: Hmm.
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Kamila_Irvine(UoL): That we've normalized so much of it that a person losing weight rapidly will be congratulated, and it could be that they are struggling with an eating disorder could be that they have cancer. Maybe they started a new medication that is suppressing the appetite. You just don't know why that's happening.
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Kamila_Irvine(UoL): I lost a bunch of weight, and everybody was like, Oh, looking slam! And my! My reaction to that is this one. Do you not not do what I do for a living right? Because you don't say that to me
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Kamila_Irvine(UoL): 2 stress will do that to you, you know.
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Kamila_Irvine(UoL): So Hello! That is not a purposeful thing. So
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Kamila_Irvine(UoL): when it comes to that normalization of it
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Kamila_Irvine(UoL): one of the the things that we did not so long ago with one of my students.
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Kamila_Irvine(UoL): she was writing her dissertation, and she wanted to particularly speak to parents of kids who have recovered from an eating disorder. It doesn't matter what age the Kid was. Now. It would just matter like
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Kamila_Irvine(UoL): that. They were recovered at this point because we wanted for the family to kind of not be in that panicked state of you know, we need to go through treatment.
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Kamila_Irvine(UoL): So we spoke to the parents about
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Kamila_Irvine(UoL): the signs that they've missed now in hindsight. Now that you know what was going on, now that your your kid is recovered.
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Kamila_Irvine(UoL): what was it? What were the warning signs? And they all spoke pretty much about the exact same thing of, you know. It's normal for a teenage girl to be concerned about her looks. Oh, it's normal for a boy to be wants to be stronger and more muscular. You know, he's becoming a man, you know, and it's that normalization that made these parents be okay with those behaviors, and like not to say that you can't have a daughter who's concerned, and she's not doing anything additional
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Kamila_Irvine(UoL): but what they didn't know was problematic. They? They were seeing that tip of the iceberg, and they didn't see the other things they didn't see. Obviously the thoughts and the emotions that were accompanying those basics like. If your child is allowing you to see that
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Kamila_Irvine(UoL): 1st of all, they see they feel safe, knowing that you're not going to panic right about the fact that they all of a sudden like really concerned about like, I'm never eating carbs and sugar again in my life.
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Kamila_Irvine(UoL): But you may not know that your child is getting up in the middle of the night and exercising while nobody is looking right. You don't know that the lunch that you have given them is not going straight in the bin. You don't know if the money you've given them for lunch is not just getting spent on something else. Right?
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Kamila_Irvine(UoL): So
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Kamila_Irvine(UoL): it's that normalization that's problematic. It's lack of information and kind of openness and conversation and actual healthy attitudes towards eating. Because these parents have
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Kamila_Irvine(UoL): also normalize this for themselves and internalized it where you know many of the moms when the daughter goes like oh, I want to lose weight, she goes. Oh, come with me, and like we'll do a diet together, we'll start exercising. We'll go on walks together. It's a bonding activity
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Kamila_Irvine(UoL): Or they start going to slimming wheels together. It's or weight watchers, or whatever that's horrifying.
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Christine Chessman: Terrifying.
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Kamila_Irvine(UoL): Because what they going to teach you in slimming with our weight watchers
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Kamila_Irvine(UoL): is pretty much diet culture. What you are going to learn from observing your mom, encouraging you and joining you is also potentially not the healthy way of doing that. Because if you say, Oh, I want to eat healthier.
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Kamila_Irvine(UoL): Okay, what does healthy mean? What is healthy food? Right? Is healthy food, including carbs or excluding carbs.
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Kamila_Irvine(UoL): Right? Like, that's that's 1 of those those things that I like to kind of think about or like. What about
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Kamila_Irvine(UoL): your attitude as a family towards exercise is exercise because we enjoy it. We like movement, and we spend time together.
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Kamila_Irvine(UoL): or are we exercising because we have to burn off dinner?
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Kamila_Irvine(UoL): Right? Oh, we have big dinner. We need to go and exercise. Now, what is your motivation for these things?
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Ela Law: I love.
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Ela Law: This, this normalization is actually a real
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Ela Law: a real shit stir, isn't it? Because the
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Ela Law: the whole, the whole problem, is that all of these disordered behaviors are normalized in society, but also, then we have on top of that what is normalized in our families. So we have both of those coming at us. And, as you said earlier, this kind of this whole complimenting on weight loss
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Ela Law: that's normalized, that's seen as something that we just do. Sometimes we it's almost like we can't stop ourselves, and the words tumble out. It's that kind of thing. Or talking about food. I volunteer in a cafe on a Friday, and the number of times I've heard people say, oh, no, I'm going to be good. I'm not having a cake.
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Ela Law: and the number of times I've taken them up on that. I'm like you are not murdering anybody by eating that cake. You are still good. It's crazy, but it's just so normalized that we speak like that. It's so normalized.
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Ela Law: Things like intentional weight loss are being applauded. It's so normalized that. Oh, you're skipping a meal. Well, bravo to you. It's
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Christine Chessman: Awesome.
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Ela Law: Yeah, exactly.
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Christine Chessman: If Ella, it's also in schools. So you know, yeah.
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Christine Chessman: in our in my daughter's classroom they were talking about getting rid of desserts in the schools because they're bad for us, and you know, and it just
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Ela Law: It drives me nuts.
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Christine Chessman: I'm actually she, because because I have been so vocal with her about it. She stood up and went. I think you know that you're making food into good or bad categories. I don't think you should. She kind of stood up for us
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Ela Law: You did. Oh, well done!
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Christine Chessman: Good, you know it's and I think it is just systemic, isn't it? It's absolutely everywhere.
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Kamila_Irvine(UoL): Yeah, it's it's part of the health and nutrition is part of like the Psh curriculum. But the problem is the moment you Google for health and nutrition. You are getting green food, red food.
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Kamila_Irvine(UoL): Comfort, food, good and bad. Blah, blah, blah! And it's like it's food
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Kamila_Irvine(UoL): Sorry, but like fuck off like, yeah.
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Christine Chessman: I know.
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Ela Law: Yeah, exactly, but it sorry, but I can.
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Ela Law: It's the national curriculum. It's part
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Kamila_Irvine(UoL): Yes.
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Kamila_Irvine(UoL): one of my things that I love to say I'm I'm I'm not obsessed with cake, but it's just so easy to explain things with cake. Right?
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Ela Law: I love it. Yeah.
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Kamila_Irvine(UoL): Well, why do we eat birthday cake?
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Christine Chessman: Cause it's celebration, and it's yummy, and it's
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Kamila_Irvine(UoL): You don't eat cake because you're hungry, right? You eat cake because it's celebration, because it's cultural, because it's heritage or whatever like. Oh, you know, I miss my mom. I'm going to pull out her cookies recipe, and I'm going to make it. And I'm going to think about my mom. Blah blah, right?
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Kamila_Irvine(UoL): It's not necessarily because I'm hungry, and therefore I'm gonna if if we only ate food because we are hungry, we would be eating brown sludge full of electrolytes, salts, minerals, and vitamins.
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Ela Law: Yeah.
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Kamila_Irvine(UoL): But that's not why we eat
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Ela Law: Okay.
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Kamila_Irvine(UoL): That's not why we use herbs and spices and make things look palatable and delicious and visually appealing. On top of that
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Ela Law: Yeah.
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Kamila_Irvine(UoL): Food is so much more, and people love to just mess it up for everyone like Come on.
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Ela Law: Certainly. Yeah.
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Christine Chessman: I don't know
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Ela Law: Yeah, so true. I want to use what Christine said about the school desserts and segue into your work with body happy? Or do you like what I did? There.
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Kamila_Irvine(UoL): Yeah, I mean, that's not
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Ela Law: So a little while ago we had the wonderful Molly Forbes on our pod, who shared the fantastic program that she's running for schools. So. Can you tell us a little bit about your involvement with
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Kamila_Irvine(UoL): Did you want to start it from the beginning?
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Ela Law: Yes.
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Kamila_Irvine(UoL): So I became aware of Molly via, like social media, like where her 1st book came out blah blah.
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Kamila_Irvine(UoL): and I was full on funky. I was like, Oh, my God! This is lovely right!
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Kamila_Irvine(UoL): And at the same time I had my wonderful dissertation student, Josie Binder, come to me with an idea for her dissertation.
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Kamila_Irvine(UoL): So her idea was to interview young adults who were sent to weight management as children right so usually following the Nc. And pay. People are being told that they need to go into weight management to lose weight. Obviously they call it weight management no weight loss. Now, blah blah, so
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Christine Chessman: Hmm.
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Kamila_Irvine(UoL): What happened was we did a qualitative study. We only had a handful of participants whom we interviewed about their relationship to their bodies, to food to exercise and themselves. And you know what's like long-term impact. For a few reasons, one
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Kamila_Irvine(UoL): existing studies of weight management weren't really talking about any outcome variables beyond things like
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Kamila_Irvine(UoL): weight, blood, pressure, waist, circumference, that sort of thing. There was literally 3 studies at the time that looked at overall esteem, but not like body esteem. So in terms of the impact on
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Kamila_Irvine(UoL): people's psychology, people's mental state, body image eating disorders whatever that just simply doesn't exist.
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Kamila_Irvine(UoL): Secondly, the studies are never longitudinal.
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Kamila_Irvine(UoL): I think the longest we managed to find was 2 or 5 years. I can't remember which is, you know, classic
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Kamila_Irvine(UoL): So if you are running a program
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Kamila_Irvine(UoL): with the kind of approach of
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Kamila_Irvine(UoL): we are intervening early in childhood, so that we can have healthy adults prove it.
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Kamila_Irvine(UoL): Right.
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Kamila_Irvine(UoL): And this might be my kind of personality kind of coming through where I'm a bit of a shit steer, and I'm like, prove it like, show me the data. Show me the receipts that your program is a not harmful and B effective.
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Kamila_Irvine(UoL): And I can't find the data
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Ela Law: Okay.
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Kamila_Irvine(UoL): So what we were interested in was like, let's talk to these people. Let's see what they are saying, and every single one of them.
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Kamila_Irvine(UoL): 1st of all, every single one of them called it fat club, right?
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Kamila_Irvine(UoL): Secondly, they were talking about both the really negative impact it had on them at the time the long term impact it had on them in their adulthood.
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Kamila_Irvine(UoL): including a participant who was 60 years old.
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Kamila_Irvine(UoL): Yeah.
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Kamila_Irvine(UoL): So
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Kamila_Irvine(UoL): what happened was. Josie finished her dissertation. And obviously we are still writing the paper because I need more time. I know Josh have it. I've got more pies than fingers, because everything is cake. So
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Kamila_Irvine(UoL): I contacted Molly, saying, because at the time she was running her anti Ncmp. Campaign thing right
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Kamila_Irvine(UoL): And I said, Oh, this might be of interest to you.
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Kamila_Irvine(UoL): and I sent across some information based on our study, and she said, oh, when you publish this, can you let me know? And you know, embarrassingly, I still haven't done
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Kamila_Irvine(UoL): and then.
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Kamila_Irvine(UoL): after we had a few more exchanges, and then, after a while, she was posting about the whole school. Culture change
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Kamila_Irvine(UoL): and I contacted her, saying, Hey, do you have any efficacy of this like, can you do? You have data that shows how this works that it does work. And she was like, Oh, no, we would need we don't. We would love to. We are collecting some data, but we need a scientist, and I'm like, Hello.
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Kamila_Irvine(UoL): So that's how I got involved.
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Kamila_Irvine(UoL): And since then we've done a little Mini pilot type thing in one school.
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Kamila_Irvine(UoL): But the good thing is.
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Kamila_Irvine(UoL): it's I'm really excited about this one. It's even hard to talk about because I get like emotional about it. I was successful in securing some funding
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Kamila_Irvine(UoL): from the sense. Dtp, it's an Esrc Funded doctoral training program where you apply for a project, and specifically, it's designed for that project to then be run as a Phd.
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Kamila_Irvine(UoL): so somebody is getting 4 years worth of funding and studentship, so like a monthly stipend to actually properly investigate the impact of the whole school culture change
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Kamila_Irvine(UoL): as per body. Happy
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Kamila_Irvine(UoL): starting this October so the the sorry I just realized like, I know I know who it is. I know who's gonna be offered this position, but they don't know yet, and they will find out
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Christine Chessman: It's like.
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Kamila_Irvine(UoL): Few days.
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Ela Law: Oh, woo!
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Kamila_Irvine(UoL): And it's killing me.
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Christine Chessman: That's so exciting.
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Kamila_Irvine(UoL): So, yeah, when is this coming out? Because it might be after
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Ela Law: Oh, probably. Friday.
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Kamila_Irvine(UoL): Friday, hey? I could. I could absolutely like, name the person and hope that they actually do find out on Wednesday, and then they
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Ela Law: Well, it's up to you
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Kamila_Irvine(UoL): It'll not be a spoiler. But yeah, we we interviewed a bunch of people we identified.
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Kamila_Irvine(UoL): the person that we want this to go to? And yeah, I'm I'm super jazzed. Molly is involved as our industry partner as our external supervisor. So
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Kamila_Irvine(UoL): Yeah.
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Kamila_Irvine(UoL): So jazzed
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Ela Law: That is so cool. And we really, really, really need that data, we really need to say, look, this is what works. This is what doesn't work. This is harmful. This is helpful. Without that. It's just, you know.
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Kamila_Irvine(UoL): Yeah, I mean, one of
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Ela Law: Narrative, isn't it?
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Kamila_Irvine(UoL): One of kind of my bees in the bonnet
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Kamila_Irvine(UoL): is that most interventions are short term or worn off. But that's not.
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Kamila_Irvine(UoL): That's not how change happens.
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Ela Law: -
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Kamila_Irvine(UoL): Right change takes a little bit more effort. It needs to be a bit more scaled up than that. So it's not good enough to be like, okay, year 8. This week you have 1 h on media literacy. And whatever you see on the Internet, you know, it's a highlight reel. And you know, it's a it's not realistic. And it's filters and Photoshop.
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Kamila_Irvine(UoL): And then they finish that class and they they go back to where they were
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Kamila_Irvine(UoL): And nothing else has changed
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Kamila_Irvine(UoL): Right. And
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Kamila_Irvine(UoL): who's to say that? You know they finish that class. They go straight to lunch, and then they are picking up what they want, and the lunch person goes like, oh, that cake's gonna go straight to your thighs. Everything's undone.
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Kamila_Irvine(UoL): Right? So we need to make sure that the environment that these kids are in from the moment they're in school till they finish that school for those formative years
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Kamila_Irvine(UoL): is respectful of their bodies, respectful of them, regardless of what they look like, that there isn't going to be any like weight based bullying that there isn't going to be a policy that tells you you cannot bring sugary snacks to school, or that you can only have organic or whatever. So the whole environment needs to be changed. So we can create this resilient young people who can then finish school and not give in to diet culture, and not
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Kamila_Irvine(UoL): have that predisposition for engaging in negative body talk and kind of
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Kamila_Irvine(UoL): behaviors that they feel might be health promoting, but aren't such as exercising out of guilt right
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Christine Chessman: Yeah, I got in touch with Molly last year, which I'm gonna I'm not going to spend much time in the story at all. But my daughter had an enrichment day at school for science, and they brought in scales and tip measures for the kids to line up and measure their Bmis.
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Christine Chessman: And in that class they had 3 kids with active eating disorders. They didn't ask us for permission. They didn't tell us that they were going to do that. They had no concept of it. I think the teachers doing Pash had more awareness.
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Christine Chessman: but they weren't in communication through the school. And so, you know we've petitioned ahead. We tried to get Molly into the school, but funding wasn't available, and so it's an uphill battle. But I was just so pleased that Molly is doing that trial in the school, and that you've got funding that just makes me so happy for a Phd student that's just fantastic.
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Christine Chessman: So that's
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Kamila_Irvine(UoL): It's horrific that basically
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Christine Chessman: Everything.
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Kamila_Irvine(UoL): Boils down to money.
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Christine Chessman: But I
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Kamila_Irvine(UoL): If you want a proper intervention in schools or preventative kind of culture change, you need money for that.
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Kamila_Irvine(UoL): You need money. If you want Nhs to be able to provide more people with support, so that they do not need to turn somebody away simply because they are not underweight, right? Because that doesn't mean that that doesn't mean that they are not under medical threat. Right? They can be malnourished. They can have starvation syndrome, whatever size
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Christine Chessman: So if we had better funding for the Nhs.
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Kamila_Irvine(UoL): and there were more services. There was more consistency across services, and there were more literally just just hands on deck doing the the work, and believe you me like.
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Kamila_Irvine(UoL): I know, plenty of undergraduate students year after year, who are more than happy to go into eating disorders. But like it's it's 1 thing to
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Kamila_Irvine(UoL): get qualified. And it's another thing to actually get the job
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Kamila_Irvine(UoL): right. Because if the positions are not created, they're gonna have to go into private or whatever right?
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Kamila_Irvine(UoL): So we need more funding. Basically
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Ela Law: Yeah. Always boils down to money, doesn't it?
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Kamila_Irvine(UoL): F,
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Ela Law: Sadly. But this is exciting. I mean you can. You can. Only you can only start somewhere right? And I think
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Ela Law: this project is going to be amazing and getting some real quality data from it is going to be so so important to maybe secure that funding that we so desperately need
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Kamila_Irvine(UoL): Yeah, we we are hoping that this would be like the 1st steps
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Ela Law: Lin.
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Kamila_Irvine(UoL): Doing this. One of the things that we want to do as part of the project is 1st of all, like review, do like a systematic review of existing interventions and preventative interventions. We want to run a like a single case. Study where each school is a a case because it's difficult to compare across schools because completely different contexts. Right?
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Kamila_Irvine(UoL): So we want to do that in at least 3 different schools.
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Kamila_Irvine(UoL): and part of that intervention is to review the policies in the school. So, for example, what's the lunch policy? What's the anti-bullying policy? All of that stuff?
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Kamila_Irvine(UoL): And then
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Kamila_Irvine(UoL): what we want to do is at the end of the delivery of the whole school culture. Change is to do a qualitative component where they hear from the teachers where they hear from the other staff, where they hear from the kids themselves. So the pupils have a voice here
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Kamila_Irvine(UoL): about like the acceptability of this. What impact did it have.
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Kamila_Irvine(UoL): and then bring all of that together and make some policy recommendations
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Kamila_Irvine(UoL): And hopefully go as far as that with
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Kamila_Irvine(UoL): With our work, because if we can make change happen on a large scale that
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Kamila_Irvine(UoL): you know, it's it's all well and good to go into individual schools. But how many schools are there like? Come on.
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Ela Law: Yeah.
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Ela Law: oh, I'm just, we're so out of time. And we've run over by like 20 min, because I couldn't, I couldn't get enough from you. Honestly, Camilla, just
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Kamila_Irvine(UoL): I can do this for hours
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Christine Chessman: I know. Well, we might have to have you back, as I've been saying to a couple of guests. I'm really interested in this research. And we'd love to just know as it progresses, just like some updates on it. But
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Ela Law: Yeah, maybe we could do that. We'll schedule in an update once you've got sort of preliminary dates
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Kamila_Irvine(UoL): Anyone update
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Ela Law: Please.
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Christine Chessman: Daniel up there
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Kamila_Irvine(UoL): Oh, yeah.
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Christine Chessman: Where
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Christine Chessman: I mean, given that your fingers are in so many pies, we appreciate us being a pie is that you know what I mean we appreciate you putting your finger in our pie
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Ela Law: That's a bit weird.
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Christine Chessman: I didn't mean that at all. Do you know what I mean?
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Kamila_Irvine(UoL): You know what you should, you should pause the recording at the point where I pulled that and use that as my picture.
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Kamila_Irvine(UoL): I need a new headshot. That headshot is like 4 years old.
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Christine Chessman: Last night.
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Christine Chessman: Every yeah, yeah, thank you so much. Camilla.
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Ela Law: We'll talk to you soon
