Redefining Exercise After Eating Disorder Recovery, with Jenny Langley

What a joy to have Jenny Langley on the podcast. 

Since her son recovered from anorexia 20 years ago, Jenny Langley has campaigned to raise awareness of eating disorders and the impact on the whole family, and to provide practical help and support to families affected by eating disorders.  

Jenny co-authored the New Maudsley Skills-Based Training Manual and wrote of her family’s experiences in the book Boys Get Anorexia Too. 

  In this episode, we talked about recovery, empowering parents and carers as well as those struggling and here are some of our key takeaways.

What we learn in this episode:

• The gap between clinical care and real-life recovery is real
•  Recovery isn’t linear—and that includes movement
•  “Starting again” isn’t failure—it’s part of the process
•  Exercise can easily become another way to reassert control if not approached carefully. 
•  A healthy reintroduction to movement might focus on: 
  •  Curiosity over performance 
  •  Flexibility over rigidity 
  •  Internal cues over external metrics 
•  Carers carry more than just practical responsibility
•  For carers listening: 
  •  You’re often “on” all the time, even when things look stable 
  •  Your wellbeing matters too.
•  “All or nothing” thinking can sneak into exercise in recovery and how to navigate a safe return to movement.

Resources for Parents, Friends, Carers:

Caroline Toshack Counselling - Caroline has particular expertise in supporting people with a difficult or disordered relationship with food or their body. This includes eating disorders, exercise dependency and body image concerns. 

The New Maudsley Approach - A resource for professionals and carers of those with eating disorders

Beat - UK Eating Disorder Charity - Beat provide carer groups, free resources, signposting and support

Attempt to Flee Famine: Adding an Evolutionary Perspective on Anorexia Nervosa

Transcript

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Ela Law: Hello, hello! Welcome back to another episode of the Find Your Strong podcast. We had the pleasure of speaking to Jenny Langley today. Jenny is a, an amazing

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Ela Law: coach for the New Mortally approach, which is a skills, workshop series for carers of people who, struggle with eating disorders and are going through eating disorders. So, Jenny had first-hand experience with this when her son, about 20 years ago, developed anorexia.

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Ela Law: And since then, she's campaigned to raise awareness of eating disorders and the impact on the whole family. And she provides lots of practical help and support to families that are affected by eating disorders through her workshops.

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Christine Chessman: Yeah, and you know, we had a really good chat. It wasn't the shortest chat, but it is really worth listening.

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Christine Chessman: The entire episode is absolutely brilliant, and I think we both learned a lot.

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Christine Chessman: It is just also just hammering home the fact that eating disorders do not discriminate. And, you know, age, race, gender, just, you know, and I think that's what my key takeaway was, really, that…

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Christine Chessman: You know, boys get eating disorders too, men get eating disorders, you know, adults get eating disorders, people in all sizes get eating disorders, and it is just something to really think about, before we make a mass.

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Christine Chessman: assumption, but no further, I'm not going to talk anymore.

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Christine Chessman: Here's the episode, and I hope you enjoy it.


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Christine Chessman: Welcome to the podcast, Jenny. How are you?

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Jenny Langley: I'm great, thank you, it's such a delight to be here.

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Christine Chessman: Oh, we're very excited, aren't we, Ella?

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Ela Law: Super excited, yes, yeah.

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Christine Chessman: We have lots of questions for you, but as I mentioned in our email.

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Christine Chessman: We like a tangent, and we quite like just getting into a conversation, so if any of our questions lead to a long, convoluted, great conversation, then happy days, so please…

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Ela Law: BST.

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Christine Chessman: detailed in your responses. Okay.

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Jenny Langley: Happy days indeed.

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Christine Chessman: But, Jenny, we want to get straight in there, and basically ask if you can give us a brief…

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Christine Chessman: History as to how you came to this work.

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Jenny Langley: Yeah, of course.

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Christine Chessman: Yeah, just, I mean, again, as much detail as you feel comfortable giving us.

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Jenny Langley: Yeah, so, like most families, when my eldest son developed anorexia, it was such a shock. It was like a bolt out of the blue, then it felt like a bullet train running through our family. I was working in London as a city stopbroker.

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Jenny Langley: So I was juggling both to start with, and he was admitted very quickly to an inpatient unit, so I could carry on

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Jenny Langley: working while he was under their care, but I realized very quickly that when he was going to come home, I needed to be around. So, and interestingly, it was about the time that they were doing all these kind of rights for women in the city, so I managed to get all my kits at home, so that helped a little bit. But I did end up,

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Jenny Langley: finishing that to focus on the work I'm doing now, but basically what happened with my son was he had a growth spurt, and who knows, a growth spurt can trigger an eating disorder, I just didn't know that.

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Jenny Langley: But at the same time, he had a growth spurt. He started doing weight-bearing exercise, because he was so passionate about football and running, and he wanted to be the best footballer, and he wanted to win the school cross-country run. And the irony is, he would have been the best footballer, and he would have won the school cross-country run anyway. But of course, you know, the perfectionist gene, which I have big time, kicked in, and what we didn't realize was that,

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Jenny Langley: he was doing lots of repetitive exercise in his bedroom, so he was eating the same as his friends, so we didn't think it was an eating disorder to start with. We were like, what's going on? And the GP had no idea it could be an eating disorder. So we got sent off for all sorts of tests, so cancer, IBS, Crohn's disease, you name it, he was tested for it, stomach blockage. And of course they all came back negative, which was a relief.

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Jenny Langley: But through all those tests, he was eating exactly the same as his mates, probably 3,000 calories a day, because that's what

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Jenny Langley: sporty boys do, you know? So he would be eating for Britain, so it didn't even cross our minds to start with. But this was just the first 6 weeks, so he started to lose a kilo a week, because he couldn't eat enough to make up for all this secret exercise. And when we realised what he was doing, it was constant.

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Jenny Langley: You know, like, people talk about micro-pacing and things like that, don't they? He was… whenever he was in his bedroom, he was going for it, like, thousands of press-ups and push-ups and pull-ups. So, anyway, then, as we now know, what happens when your brain gets starved.

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Jenny Langley: is that then you start to, you know, your cognitions change. He was totally in denial that there was anything wrong, but he then visibly started to look very, very unwell, very pale, very withdrawn, very moody, like the tantrums. I thought, is this puberty? Because he's my eldest.

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Jenny Langley: This can't be puberty, this is, like, so extreme. And,

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Jenny Langley: So, you know, I then started saying to the GP, do you know what? I think this is an eating disorder, and Sam stopped eating as well. He really started restricting his eating, so then it was like double whammy that his weight was plummeting. So, we knew we were heading for hospital of some sort.

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Jenny Langley: And back then, so this was in 2002, they didn't hold kids in paediatric wards.

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Jenny Langley: you know, if they decided it was an eating disorder, you might have a couple of nights of stabilization, so he collapsed. He basically went green and collapsed at home. We rushed him into our local pediatric hospital, and he was there for two nights, and then he was admitted to a general CAMS unit.

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Jenny Langley: In Maidstone, but I had to fight for the bed, because the first answer that came back was, oh, we have… we have a spare East Kemp bed, we don't have a West Kemp bed. Sounds like a pop song, doesn't it? And you can imagine, I threw my toys out of the farm, and I said, well, I can't take this boy home, he's gonna die. And thankfully, they were able to…

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Jenny Langley: realize that this boy needed this place, so he did get the place, and it was an NHS general adolescent unit. They had good experience of eating disorders, they literally saved his life, so I'm eternally grateful to everything they did. But it was very female-focused. There was one other boy there, but he didn't have an eating disorder. He was 17, you can imagine, he was very depressed.

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Jenny Langley: suicidal ideation. So, Sam was witnessing all of the things that this young lad was doing, and then the rest of it was, like, you know, teenage girls with a whole variety of different things.

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Jenny Langley: And they… traditionally, they would keep the eating disorder patients for a long time, like 9 months.

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Jenny Langley: And I just instinctively knew that that wasn't going to be right for my son, and so I fought really hard, and of course, the inpatient psychiatrist didn't like that, because they can be very directive, can't they? So the inpatient psychiatrist was basically, you know, he's eating his way out of here, so once he'd gone through the refeeding syndrome bit and they'd started to increase his food, he would eat the food really quickly.

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Jenny Langley: And he didn't really engage in the psychotherapy, but he really engaged in group therapy and art therapy, and then there was a cognitive behavioural therapist who was a young man that would talk to him about football, so that was great. So there were… it was holistic, so there was lots of things that Sam could engage with. And so, I was very comfortable after he was there…

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Jenny Langley: just over 4 months, and I was very comfortable that he was ready to come home, and that I was ready to bring him home. And the new Maudsley approach didn't exist then, we just had to wing it, you know? We just had to work it out. And,

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Jenny Langley: I learned very quickly by getting things wrong. You know, like, the first time… I'll just tell this little story, because it's quite funny, but the first time when he was coming home, and so, of course, I took the two boys to the hairdressers, so his brother was 9, so I took them to the hairdresser.

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Jenny Langley: Sam had his hair cut first.

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Jenny Langley: And then I said, right, well, just wait, won't take long, James is going to have his hair cut. And literally, it's like 300 yards from home. And Sam was like, no, no, no, it's fine, I'll walk home. And I went, no, no, no, you can't walk home. So, of course, we had a mega argument in the middle of the hairdresser, and it was so embarrassing. And I realized afterwards how wrong I was, because what was the worst thing that was going to happen?

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Jenny Langley: down the hill 300 meters, you know? So, so I… we were on a steep learning curve when he came home, but I… I knew it was the right thing. And he was under, kind of, a Damocles sword, that if he didn't maintain his growth and his…

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Jenny Langley: So they put his weight target up immediately that he came home. So if he didn't maintain that, then he would have to go back to the hospital at weekends, which would be terrible for two reasons.

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Jenny Langley: One, because that's when all the football was, and two, because there was always skeleton staff, if that's the right word. There was always, like, the contract staff who knew nothing about eating disorders, so that would have been absolutely terrible. And thankfully, the outpatient psychiatrist had a completely opposite view to the inpatient psychiatrist, and they were actually married to each other.

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Jenny Langley: So, it was an interesting conundrum, but I've since learned that inpatient psychiatrists can be very risk-averse, whereas outpatient psychiatrists are all about helping

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Jenny Langley: the child and the family get back on track, aren't they? So, that was kind of, in a nutshell, what we went through. And I fought really hard at every stage to, you know, make sure that they were doing what I instinctively thought was right for my son. So I resisted medication for his OCD, because

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Jenny Langley: he never had obsessive behaviours before his brain was staffed. Had a bit of a fight about that, but I said, I'm not anti-medication at all, but I'm anti-it right now for my 12-year-old. And,

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Jenny Langley: then I thought really hard that he could go back to school for, you know, just for the sports, just for the… to stand on the cricket pitch with his mates.

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Jenny Langley: And I made a spreadsheet, and the inpatient psychiatrist hated my spreadsheet, and the outpatient psychiatrist loved it, you know, it was so funny. Looking back, it was quite funny, but also looking back, I remember how bad that inpatient psychiatrist made me feel.

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Jenny Langley: and how much the outpatient psychiatrist empowered me. And that was the key to what I do now, because I thought, we've learned so much.

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Jenny Langley: what can we do to support other families? And the first thing was I said to my son, how would you feel about sharing our story? Because there's no… there's no positive books out there about males and eating disorders, and he said, bless him, he said, if one other family benefits from reading our book, Mum, then it would all be worthwhile.

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Jenny Langley: So I wrote… and I'd written a very detailed diary as we were going through, because, as we all know, journaling is very cathartic, and so I'd got that.

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Jenny Langley: And I've got a really nerdy, kind of detailed brain. And also, he gave me permission to get all of his medical notes, so the first step towards giving something back was writing Boys Get Anorexia 2 and put… and creating a website for that. And then the second thing was, linking up with BEAT, which was then the Eating Disorder Association, to start a carer group in Tunbridge.

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Jenny Langley: So, and I ran that for many years. And about the time I started the Carer Support Group.

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Jenny Langley: Which was really popular. You know, the first meeting, we had one person, and then suddenly people were flooding in, so there was a real need. So that's… that was the time I was introduced to Professor Janet Treasure. So, she said, you'd be great as a guinea pig for our research into the New Mournsley approach. So I was one of the first guinea pigs.

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Jenny Langley: And went through the whole research program. And I love learning, so it was, like, an amazing learning curve.

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Jenny Langley: with an amazing team of people, and then we were… so the Maudsley was linking up with BEAT to, launch what was then called Empowering Families, which is now developing dolphins and Raising Resilience and, you know, the other carer groups they have. But I piloted it with a psychologist who actually came from Kent as well, in Adenbrooks in Cambridge, so we piloted the

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Jenny Langley: series, they went really well, and then I was the first one of these guinea pig carers to be back in the community delivering the workshops.

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Jenny Langley: So my first workshops I delivered were in 2009.

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Christine Chessman: Wow.

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Ela Law: So, way to go.

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Christine Chessman: Jenny.

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Jenny Langley: Oh, yeah, yeah, I've been doing this for 20 years.

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Ela Law: Yeah.

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Christine Chessman: Thank God for you, honestly. I'm just… it just… the whole thing resonates, sadly, quite hard with myself at the minute, with my daughter struggling with anorexia at the minute. And it really helped. Attending one of your seminars, kind of about 4 months ago, really helped, because at one point you said you're gonna have disagreements with the team.

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Jenny Langley: Totally, yeah.

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Christine Chessman: That's okay, because you… and that's stuck in my brain, because there have been, with the psychiatrists as well.

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Jenny Langley: It's healthy!

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Christine Chessman: And, it was really important to have heard that from you initially, because you doubt yourself the whole time. Yeah. You kind of think, am I doing the right thing? You blame yourself, and it was just knowing, I do know my child, and instinctively, I know, kind of.

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Christine Chessman: at this point, what she needs in terms of medication and all of that kind of stuff, so that was… that was just so valuable, so I'm really grateful to you.

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Jenny Langley: Thank you, thank you. And so many carers say that to me, that, you know, the clinicians give the prescription, whether it's FBT, or whether it's Mantra, or, you know, whatever the pathway is, and then the carer workshops

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Jenny Langley: Help the carers work out how they can do it best for their loved one.

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Ela Law: Yeah. It's a really brave thing to do, to go against the white-coated people and say, actually, I think I know better than you, and saying that, you know, I'm gonna try it my way and see how it works. One thing that's always stuck to me, and I've attended very kindly, you've offered me to, or you allowed me to join in some of the carers' workshops and sort of sit in the background.

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Ela Law: And one thing that's always struck me was your approach to letting your son do the things he loved, the exercise, because that's one of the things that, you know, gets taken off the menu straight away. It's like.

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Ela Law: move. And I have a friend whose daughter is, going through anorexia at the moment, and she's not allowed to do any exercise, and they're curbing it at school, and I… because of what you said, I am…

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Ela Law: I am dubious about that, and I wonder, because she's a very active and very, sort of, sociable person, and I'm always wondering, is this the right thing for her? So, how…

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Ela Law: How did you get to that place to find that strength to say, no?

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Ela Law: I'm making.

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Jenny Langley: It's smooth.

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Ela Law: vision here.

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Jenny Langley: Yeah, it's all about medical risk, and as I mentioned earlier, the inpatient teams can be very risk-averse, and the community teams can be very risk-averse, because

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Jenny Langley: the research into family-based therapy, or FTAN, it's sometimes called, showed that if you can maximise weight gain in the first 4 weeks, that's the best prognosis for recovery. And of course.

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Jenny Langley: In theory, we all can do the maths. If there's no movement, then there's going to be more weight gain. And so that's where often the clinicians will give that very clear message. Now, if you go back to the FBT manual or the FTAN manual, it doesn't say that anywhere.

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Jenny Langley: It doesn't say anywhere that you have to stop all exercise. What it says

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Jenny Langley: is that the skilled therapist will work with the family to make sure that they're aware of medical risk. So, for sure, when Sam was first admitted, he couldn't walk up the stairs, you know, he would have had a heart attack. So, for sure, of course, when medical risk is very high. But, again, families are often in the best

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Jenny Langley: position.

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Jenny Langley: to judge how high that medical risk is. So, they can use the Mead guidelines, you know, the checklist, as kind of like a basis.

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Jenny Langley: But then they learned very quickly, like, actually, my loved one is perfectly capable of going for a little walk in Knoll Park. So I did… I did used to take Sam up to Knoll Park, so we'd drive up to Knoll Park, and then we would walk

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Jenny Langley: slowly and gently, in the park, with the birds and the squirrels and the deer, and other people, heaven forbid. We might hug a tree, you know? But doing very gentle movement out in nature is obviously

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Jenny Langley: you know, as beneficial as many medications would be, so… Yeah, so it's always a balance. So, there's a lovely website called Safe Exercise at Every Size, which… no, sorry, one thing. Safe Exercise at Every Stage.

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Jenny Langley: Right. So every stage of the treatment. And it's designed for clinicians, but I always say to carers, go and have a look at it, because it really gives you parameters

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Jenny Langley: Both around medical risk and also ideas

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Jenny Langley: of, like, a graded approach to get back to exercise. So say somebody's been a, you know, an amazing showjumper, and they love horses. They're not going to be showjumping, because if they fell off the horse, that could be really, you know, very, very damaging for them, but they can go and

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Jenny Langley: stroke the horse, and groom the horse, and be with the horse. They might coach younger children while they're in that kind of, like, graded build-up. So there's all sorts of ways. If they're an acrobatic gymnast.

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Jenny Langley: they can go and help out with the choreography to start with. So, just, you know, just so that they feel they're still part of that community. And then, you know, once medical risk is much lower, so when my son was discharged, his medical risk was pretty low.

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Jenny Langley: So he still had a bit of weight to gain. As I said, he'd grown. He still had a bit of weight to grow, but if he lost a little bit of weight, it wasn't going to be a disaster, and we could work with him. Now, the thing that I did with my son was I… I would have those difficult conversations.

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Jenny Langley: So, of course, he comes home from the hospital, he's absolutely delighted, he wants to play football straight away. And I felt he was strong enough, and the community psychiatrist said, Jenny, you know what you're doing, you know what to look out for, you know that you would step in if there was a problem.

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Jenny Langley: So I sat down with my little 12-year-old, who was desperate to go to this football camp for a whole week, having just come out of hospital.

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Jenny Langley: And I said, you know, darling, we're really excited about you going to the football camp, and I know that you're super excited, both about the football and being with your friends. And he's like, yeah, of course.

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Jenny Langley: are you saying I can't go? So he's immediately suspicious, and I'm like, well, no, not at all. Of course, we want you to go. We really want you to go. We know how much joy you're going to get. And, let's just… let's just think about how you can fuel your body to play your best football. So that's a very different message than saying, if you don't stick with your meal plan, you can't go to the football camp.

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Ela Law: Mmm.

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Jenny Langley: which would be a very instinctive, caring response, wouldn't it? So you flip it into that kind of, what do they desire, and then we're going to help you

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Jenny Langley: be your best person for what you desire, and he resisted, and resisted, and then, you know, begrudgingly, he went, yeah, okay, you're right, Mum, I'm gonna have to have a huge breakfast, I'm gonna have, you know, loads more snacks than my mates, my lunch is probably going to be three times bigger, and I'll have to have a huge dinner when I come home. And that's fine, because I want to fuel my body for football.

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Jenny Langley: So, I was always very prepared to have those difficult conversations, and that's a big feature of our workshops, is because it's so easy to turn a blind eye, isn't it, to some of the behaviours, or some of the language, or, you know, whatever's going on. And it's all about timing, but there's a time and a place when sitting down and saying, well, we do need to talk about this, darling.

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Jenny Langley: It's the right thing to do.

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Christine Chessman: I mean, this is sort of bringing me back to a point, anecdotally, we had a similar thing with Mia, because she loves to dance, and she's absolutely, every week, goes to dance several times a week, and from one day to the next, everything stops. So she was taken out of school, taken out of everything, told to sit at home, not move.

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Jenny Langley: Like being in an old people's home.

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Christine Chessman: So hard from one day to the next, just everything gone. And when we… when she was kind of in… she was in community care, but in a center at the minute, and when she was there about 4 or 5 weeks, maybe a bit more, her weight had kind of gone up.

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Christine Chessman: Like that, so it hadn't gone the way they wanted it to go.

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Christine Chessman: Like, like, immediately.

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Jenny Langley: The nice guidelines. The nice guidelines are…

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Jenny Langley: are really confusing for… for us all, because weight doesn't go on evenly, and they say very clearly, aim for a kilo a week in the inpatient and half a kilo a week in community. It just doesn't happen like that.

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Christine Chessman: And that's a.

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Jenny Langley: Again, why clinicians get very fixated on that.

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Christine Chessman: And I think there was one point where it was a really sunny day, and that particular week, Mia had gone down a tiny bit.

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Christine Chessman: And they rang and said, everybody else is going to the beach, but Mia's gonna stay and have a session with the, one of the team to talk about how important it is to eat food and not to… and I was like… I had to say, I'm sorry, I believe that's punishing, and it's not her fault that she's actually.

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Ela Law: Yeah.

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Christine Chessman: been giving her the food, and she's been eating it, and I, you know, obviously her metabolism's… and so they took it on board, and they were very nice about it, but equally said, no, I'm sorry, because…

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Ela Law: You had to put your foot down, didn't you? You had to say, this is not fair. They… it wasn't something… it wasn't an original thought from them, it was like.

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Christine Chessman: No.

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Ela Law: you had to make them aware of it.

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Christine Chessman: Their hands are tied in a way, because there was… when she arrived, there was medical risk, and…

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Ela Law: Hmm.

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Christine Chessman: It's… I understood it, so I had to… I had to sort of stand back and go, I understand.

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Ela Law: Mmm.

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Christine Chessman: I feel it's for… for my daughter, it feels punishing when it's not… none of it's her fault, you know, it's not…

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Jenny Langley: So the treatment does feel like punishment, but this is where I'm so passionate about helping groups of families to work out that they can reframe it.

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Jenny Langley: Yeah. They can validate that. They can say, well, you know, it makes sense that you feel like you're being punished at the moment, because… So, validating, you know, because the clinicians have said you can't do your dance, and you can't go to the beach, and you can't do this, and you can't do that. And it won't be forever, darling. This is just a temporary phase, and we're gonna… we've really got your back, we're team family, and we really believe in you. So that's just that…

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Jenny Langley: really, really important message from the family. And you can…

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Jenny Langley: learn to soften the blow of clinicians, because I know when that kind of thing was happening with my son, all I wanted to do… I had cortisol, you know, coming out of my head, and I just wanted to go and thump the clinicians.

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Jenny Langley: So there was one nurse,

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Jenny Langley: I felt sorry for her, actually, but she was his care worker to start with, and Sam was saying, you know, very quickly, when he started to eat a little bit, he felt, you know, he felt a bit more optimistic about his ability to get through this hospital program and get home and get back to football. So he was talking about getting back to football, and she said, oh no, Sam, you definitely won't be getting back to football for 9 months, maybe a year.

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Jenny Langley: And he'd been promised to be football captain in September, so she said this to him in April.

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Jenny Langley: So you can imagine the negative impact of that. So, you know, I had to think very carefully, because I wanted to kill her, as you can imagine. I had to think very carefully about

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Jenny Langley: being diplomatic, and that's when I taught myself, like, the crack sandwich. Like, thank you so much for everything you're doing for Sam, and we're so grateful, and there's just something that has come up that I would really, really appreciate the opportunity to have a chat with you about, because I can see that, you know, that that's been very upsetting for my son for these reasons, you know, when he's a healthy boy, this is what he does.

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Jenny Langley: there is part of him that really can really hold onto that, to say, it's actually a real motivation to get back to school in September to be football captain. So, that… that was my first, kind of, experience of doing that kind of crap sandwich, that I had something really important to talk about, but always I would say, thank you so much for everything you're doing.

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Christine Chessman: Yeah.

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Jenny Langley: so grateful that, you know, that you're saving his life, basically, so… but it's really hard in the heat of the moment, isn't it?

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Christine Chessman: But, yeah.

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Jenny Langley: I did rehearse, you know?

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Christine Chessman: I think you've… you… was it a jellyfish? You talk about, a jellyfish a lot. So, Ella, that just means a bit of a…

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Ela Law: I know. On that note, Jenny, would you mind sharing a little bit about the New Mordsley Method with us and the listeners? Because I think, from what I have heard and learned in the workshops, it's amazing, and it is very,

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Ela Law: it's such a positive way of dealing with things. That's what I really like about it, because there's so much negativity, and there's so many you can't, you mustn't, you have.

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Jenny Langley: Honestly, yeah.

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Ela Law: And this is very empowering, and it is very positive, and it's very focused on the person who's going through all of this, but also, it is really… I think that the carer learns an awful lot about self-compassion through it as well. So do you mind sharing a little bit about how it sort of.

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Jenny Langley: Yeah, well, first of all, yeah, first of all, so Janet Treasure, who was working with very, very unwell, patients, predominantly with anorexia at the Maudsley, and working with families, was noticing, certain traits. Certain things came up over and over again, and she said, I can really see that it would be really, really beneficial to upskill

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Jenny Langley: these families. And when I was, you know, the guinea pig in the research, I thought, oh my goodness, every parent in the world should have these skills.

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Jenny Langley: They're just good… good skills for that

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Jenny Langley: From childhood to teenage to adult, you know?

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Jenny Langley: And it's all about keeping connected, so the communication is a core, core part validating emotions.

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Jenny Langley: So rather than ignoring emotions, you really do talk about emotions, but if you're, you know, if you're a family that has alexithymia and can't talk about emotions, you can talk about being hot or cold or a color or something like that, you know, it doesn't have to be emotions. But also that there… there will be many, many times when you feel stuck and that's normal. So, again, that's a huge validation. And I made this lovely kind of infographic

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Jenny Langley: The carers of These are things that you can do at any stage. So you can always smile.

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Jenny Langley: You know? You can always take a few minutes out. Maybe you can't take an hour off, but you can always just take a few minutes out. You can always…

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Jenny Langley: read a bit of a book, you know? Not always an eating sort of book.

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Jenny Langley: So, there's always things that you can do, and the… one of the really, really important things for me, and this is really a core, isn't it, in any trauma-informed train… training, is playfulness and joyfulness. So, you can always do something playful and joyful, however bad it is.

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Jenny Langley: So that's kind of, like, at the heart of what the new modesity approach does. So we really, really get the carers to reflect, where are they now?

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Jenny Langley: You know, what's going on for them now? If it's working, then carry on doing it.

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Jenny Langley: They don't need to make any changes. If it's not working, well, give them a toolkit. And there's many, many things in the toolkit. So, you know, carers that have been on the series of five workshops, they know it can feel really, really overwhelming, and we do that on purpose, not because we want to overwhelm the carers, but we want to give them the full picture, so that they've got that toolkit to dip in and out of. And I always say to carers, you know, you can always come back in a few months.

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Jenny Langley: Because there's some stuff that's just, this is gonna be… this isn't gonna be relevant for you right now. So coaching your loved one to make a change, for many of the carers, isn't relevant right now.

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Jenny Langley: coaching carers how to reflect on what they're doing, and if they can make any changes, is something they're much more likely to be able to do now, including putting their own oxygen mask on, and that self-compassion and self-care. So, the way that we… in a nutshell.

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Jenny Langley: The way that we deliver the model is the first workshop is kind of a little bit of psychoeducation, not too much, because we respect that carers know their loved ones best, but some relevant

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Jenny Langley: Psychoeducation about the biology of the brain, hypermetabolism kicking in, things like that.

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Jenny Langley: So a little bit of psychoeducation, helping carers to really reflect on their own emotions and validate their own emotions, and then we've got some lovely empathy exercises. So, really helping the carers to step into the shoes of their loved one, not to agree with the behaviours.

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Jenny Langley: But to be able to connect.

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Jenny Langley: So, that's where I came up with this blue balloon, red balloon metaphor.

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Christine Chessman: Yeah.

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Jenny Langley: I mean, I think everyone who knows me is very familiar with my balloons, but the blue balloon represents the well side of the person, which is still there, it's just hidden at the moment, and the red balloon represents the illness and everything that comes with the illness, and naturally, human beings are going to focus on the red balloon, because you're going to be

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Jenny Langley: terrified, you're going to want to fix the person, so that it almost reinforces the identity of the eating disorder when you're focusing all your attention on the illness. So, really thinking about what's there in the blue balloon, and that might be looking back in the past. Well, we know Jenny has always loved dancing, or football, or…

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Jenny Langley: you know, dinosaur feet, or whatever it might be. We know Jenny's always loved that. We know that she also had some desires to, you know, become a brain surgeon, or, you know, be a city stockbroker, or whatever it is. And so, really kind of pulling in on that. And then in the here and now, so that's kind of what Jenny

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Jenny Langley: had in her blue balloon in the past, what Jenny might have wanted in her blue balloon in the future, which might change, of course, but then in the here and now.

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Jenny Langley: What would bring a little twinkle in Jenny's eye?

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Jenny Langley: What would make Jenny just giggle or have a little half-smile?

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Jenny Langley: You know, is it playing double? Is it drawing? Is it going out in the garden making daisy chains?

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Jenny Langley: Is it buying a puppy and cuddling the puppy, or looking after a Russian hamster or something, you know? It can be a teeny, teeny, tiny thing, or it might be a great big thing, but really focusing on the well side of the person, and that, of course, just goes… is in line with all the mental health charities who always say, talk to the person

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Jenny Langley: Not the illness. Yeah. So that's… that's part of the blue and red balloon, and then the other part of the blue and red balloon, which is so, so important, is that

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Jenny Langley: Helping carers to understand why their loved one, and also them, the carer, are in fight-flight all the time. So we do this exercise, popping the red balloon, you know, how would you feel if you're holding this balloon in front of your face, and I'm walking around with a pin? And you've got your eyes shut, and I'm walking around with a pin.

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Jenny Langley: it would send you into a fight-flight physiological state, wouldn't it? So, and then I pop the balloon. Isn't it amazing? It calms down really quickly, but it doesn't calm down if you're the person with the eating disorder, or it doesn't calm down if you're the carer fighting for help, because you feel like you're in fight-flight.

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Jenny Langley: all the time, and your amygdala is completely hijacked, and you cannot think straight. And I always say I remember my brain was like mushy peas for that first…

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Jenny Langley: kind of phase. So popping the balloon is, is a really visual, kind of, like, example of what

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Jenny Langley: what your loved one is feeling like all the time, not just when they're holding a balloon, which is about to be popped with a pin. And then we do a couple of other empathy exercises, but one of the most easy and valuable is thinking about saying to the carers, what would your loved one say are the benefits of their eating disorder?

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Jenny Langley: So…

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Jenny Langley: you know, and then if I've got 12 people in the room, they'll probably come up with 12 different things, and I'll say, so, okay, let's flip this. So…

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Jenny Langley: If you had something that gave you, safety, you felt in control, it was part of your identity, you'd worked very hard at it, people gave you attention, it numbed difficult feelings, you didn't have to take responsibility for tough things, how much would you want to give that up?

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Jenny Langley: So we really set the scene with the red and blue balloon and the empathy exercises, so that's in the first workshop. The second workshop, we have a light-hearted introduction, which is the animal metaphors, so that's all about

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Jenny Langley: which animal are you now? Is it working? If it's not working, then maybe try to be a little bit more of the gentle, guiding dolphin and the calm, compassionate, solid St. Bernard.

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Jenny Langley: And then, then I teach them motivational interviewing in, like, an hour, which is a lot. I'll say, imagine I'm teaching you Japanese in an hour, and I've made it very… I've made a very simple framework

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Jenny Langley: For

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Jenny Langley: And I say that this is much simpler than it looks, and some of these are going to resonate with you more than others. So, whether it's noticing the emotions, or whether it's affirmations, or whether it's finding areas of agreement, you're going to find something in this little matrix.

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Jenny Langley: that you're going to be able to start with. So just start with one or two small things first. And I think the second workshop is the hardest one, getting around that language, but it's the most important, because the language is really, really going to help them to really, really, really connect.

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Jenny Langley: With their loved one. So, simple example, pre-COVID, when I used to do the face-to-face workshops,

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Jenny Langley: I had a lady, and she said she dreaded taking her daughter to Maidstone for the weekly appointment, because she knew her daughter would come out in a really dark mood, and would be stony-faced and silent and mute all the way home.

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Jenny Langley: And sure enough, so she… so while her daughter's in the therapy session, the mum's looking through her notes from the second really difficult workshop, and anyway, her daughter comes out, sure enough, slams the door, smashes her hand on the dashboard, and says.

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Jenny Langley: And previously, the mum would have argued with logic, well, it's part of the program, you have to go, you know, she might have said, I know it's difficult, but you don't understand, they would have just been, like, complete stonewall

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Jenny Langley: on the drive home. So instead, the mum paused, and she said, do you know what, darling? It's great you can be so passionate about something. And her daughter laughed, and then told her all about the therapy session as they go home. Oh, wow. Yeah.

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Jenny Langley: We don't have a magic wand, but we have a sprinkling of fairy dust, is the way I always put it. So that's the second workshop. The third workshop is very much carer reflection, so moving on from the animal metaphors, we think about their own… their own care network, so their own herd of elephants, we call it. Like, you know, when you're in a herd of elephants.

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Jenny Langley: they all look after you. So who's in the carer herd of elephants? And then…

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Jenny Langley: we have this five-step model for change, for carers to think about, what could I change

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Jenny Langley: right now, and we use this framework, I call it the reasonable adjustment framework, because we all make reasonable adjustments, don't we? But the technical medical term is the accommodating and enabling scale, which I feel is very judgmental, because, of course you're going to make those adjustments to start with, aren't you? And it's all about timing.

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Jenny Langley: So it's all about that reflection. Is this still working? Is giving reassurance that this won't make Jenny fat? Is it working? Yeah, it's working, so I'm going to carry on giving reassurance.

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Jenny Langley: Have we now got stuck?

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Jenny Langley: hmm, there's now 50 questions, maybe now we need to, you know, break away. So we do… I send after the workshop lots and lots of examples. A big, big one is turning a blind eye to eating disorder behaviours. So, you know, there's a time and a place

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Jenny Langley: when you need to challenge that bad behaviour, or you need to notice that your loved one is binging and purging late at night. So, again, giving them lots of ideas of that. And then the fourth workshop is the same

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Jenny Langley: five-step model, but the carers can imagine that they're coaching their loved one. So when their loved one has moved into

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Jenny Langley: kind of preparation, so further through contemplation into preparation, and actually is saying, I want to go to university, I want to go to college, I want to get back to dance, I want to be in the dance competition, then you can start to coach your loved one using all of the same techniques.

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Jenny Langley: Then we have a little gap, and then the fifth workshop is very much a review and reflect, like, you know, what have we learned? What are you facing? What are the challenges? Where do things feel stuck?

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Jenny Langley: And it works! Yeah, it works.

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Jenny Langley: And I love… I love doing it.

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Ela Law: It's just an amazing place for carers to come together, and actually to…

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Ela Law: to hear that they're not on their own, that there's other people going through the exact same thing. I always find it very moving listening to everyone's stories, and, you know, yeah.

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Jenny Langley: Yeah, and they will look out for each other, you know? It's so lovely. Like, if there's a… if there's a carer of a very young child, then obviously the group will kind of, like, be drawn to that, to support that mum. And as a facilitator, I need to make sure that's not too much.

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Jenny Langley: Because that wouldn't be healthy. So if they're… say there's a husband.

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Jenny Langley: then I need to make sure that we include

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Jenny Langley: his perspective, his scenarios. If I've got grandparents, I need to make sure that, you know, that their perspective is included.

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Jenny Langley: Which is useful for the other carers to hear. Recently, I had two sisters in their 50s who were supporting their 80-year-old mum, who'd always had an eating… as far as they knew, she'd always had an eating disorder. And they said, we want to come because we've heard it can really help with the communication and…

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Jenny Langley: the connection. And, oh my goodness, did they lap it up? They were just like, oh my goodness, this red and blue balloon, I wish we'd known this when we were kids, you know? Oh my goodness, this way of speaking, I wish we'd known this years ago. And they realized that they were very, both kangaroo and rhino-like, so they could be overprotective of their mum, but they could also be very…

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Jenny Langley: logical and directive with their mum. And one of the things that came out, they said, well, mum loves playing really loud music, and we always tell her to turn the music down.

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Jenny Langley: So I went, okay, so what's your reflection now that we've done the blue and red balloon?

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Jenny Langley: well, we need to dance with her, not turn the music down. We need to dance and sing with her. And, then she's got very clear political views, which they don't agree with, which often is that generational thing, isn't it? So they would… in the past, they would always say, well, we're right and you're wrong, Mum, and now they're being curious about her political views. So, their relationship is transformed.

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Jenny Langley: By coming on this little course.

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Jenny Langley: And there were no other people in the same position on this course. It was predominantly parents of, you know, teenagers and young adults, which, you know, those would be the largest number, I guess, in the workshops. But they, you know.

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Jenny Langley: You can… you can teach this to a very disparate group of carers together, because it's a toolkit, and it's a very person-centered toolkit.

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Ela Law: Yeah.

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Christine Chessman: I mean, one thing we always talk about is the fact that

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Christine Chessman: Eating disorders, you know, obviously, you… it's been brilliant, sort of, having you talk about boys get an.

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Jenny Langley: Yes.

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Christine Chessman: And because it's… it is seen as, kind of, very specific demographic, isn't it? Yeah. I think it's so important to realize that eating disorders do not discriminate.

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Jenny Langley: Totally, and also, they don't… you can't see.

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Ela Law: No.

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Jenny Langley: You can see… you can see that very stereotypical middle-class

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Jenny Langley: white Caucasian female who has anorexia, but you… do you know what the statistic is of what percentage of eating disorder patients, so people that are diagnosed, are… are medically at risk for being underweight? 6%. 6%, yeah. So…

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Christine Chessman: resin.

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Jenny Langley: Yeah.

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Christine Chessman: I'm losing.

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Jenny Langley: Yeah, because that's… that's… that's the group that the NHS will focus on, because medical risk is so high.

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Christine Chessman: Yes.

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Jenny Langley: the groups that are in that middle ground, so there might be a diagnosis of anorexia, but they're not sick enough, which is terrible in our society in this day and age, isn't it? That they're not sick enough. There's the whole cohort of people with bulimia and binge eating disorder that you can't see.

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Jenny Langley: they have bulimia and binge eating disorder. So yeah, and that's why with the topical sessions that I do, you know, the deep dive sessions, which are additive to the series, we can cover all of those things. You know, there is a binge purge session, there is.

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Ela Law: Hmm.

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Jenny Langley: you know, we talk about self-harm, we talk about, teenage brain development, things we don't have time to talk about. The latest one we did was about obsessive compulsive disorder, which is very common with people with eating disorders, and I had two lovely carers whose

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Jenny Langley: daughters have come out the other side now, and they'd got a slightly different experience to mine, so I could tell my story of

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Jenny Langley: Sam's OCT that basically came with starvation, and they could tell their story of the OCT being hijacked.

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Jenny Langley: by the eating disorder, and then, like, just spiralling out of control. And both of those families had managed to get

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Jenny Langley: OCD therapists with the knowledge of eating disorders at the later stages of the eating disorder treatment, and that had been a really successful formula. But they had different stories, you know? Then I do the rolling autism program, and I do that over a longer period, so that is additive.

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Jenny Langley: to the core series. But basically, it's, it's one a month for three months, and because

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Jenny Langley: you know, families can be neuro-spicy, can't they? So it's not just the child, yeah? And, so often I've had so much feedback from carers saying, thank you so much for spreading it out like that, because it gives us time to process and digest and think about it and reflect, and…

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Jenny Langley: you know, they're really popular, and I've got the backing of Kate Shanchuria, you know, who's the lead psychologist on the peace pathway at the Maury, so…

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Jenny Langley: Yeah, she made all of her clinical teams sign up to my email network the other day. Yeah.

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Ela Law: Amazing. Yeah, but it's so important, isn't it, to have… to have that network, to have all of these experts, sort of, feeding in, and I do… I do like… I mean, what you just said, sort of, rang a bell, because the… there's so much overlap with other things. Yeah, totally. So the OCD, the anxiety, neurodivergence, all of those things, that there is a huge amount of overlap. And the other thing…

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Ela Law: I think we really need to address is the fact that it's not always a visible thing, and very often the behaviors that are displayed are being praised.

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Ela Law: I know somebody, for example, whose daughter, if you were to diagnose her, if there was a diagnosis, would be, orthorexic, and it's one of those things that gets praised, oh, you eat so healthily.

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Ela Law: Oh, well done, you. And it's… unless she's medically underweight and there's concerns, it's like, oh, well done, you keep going.

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Ela Law: It's so dangerous, isn't it? It's so, so dangerous to kind of ignore those alarm bells only because that person isn't medically so underweight that there's a medical risk. And, you know, it's highlighting those kind of cases as well, and working with those as well.

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Jenny Langley: That's one of the flaws of the research into FBT and FTAN, is that they had very straightforward, mild anorexia patients with no comorbid conditions.

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Ela Law: Ow.

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Jenny Langley: So no wonder they start to get good results after 4 weeks. No wonder. And even with that, you know.

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Jenny Langley: quite unchallenging, if you like. I mean, obviously always challenging, but even with that cohort of mild to moderate patients, they still…

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Jenny Langley: only had about 50% kind of recovery straight away, didn't they? So… so when families are in tears, saying we're just such a failure, the clinicians think we're useless, I say, well.

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Jenny Langley: totally you're not, it's just that's first-line therapy, so the NHS has to try it, but…

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Jenny Langley: Welcome to the club of people being able to deliver it in the way it was in the research. You know, welcome to our club!

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Christine Chessman: Welcome to the club. I think, I think I'd love to, if possible, because we could go on forever, because I'm just enjoying this conversation so much.

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Christine Chessman: Ella, I would like to bring it back to exercise. Now, this is something, obviously, I'm in the exercise field, but disordered exercise behaviors and disordered eating behaviors often go hand in.

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Jenny Langley: Definitely.

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Christine Chessman: And especially when you're recovering from an eating disorder, it is… this is personal experience for me, I went from one to the other. So I went from eating disorder to disordered exercise behaviors, and trained to be a trainer, so that I could spend a whole day.

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Jenny Langley: Exercising all the time, yeah.

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Christine Chessman: as my job, and everybody, again, was like, oh, you're so healthy, you're so this, you're so… and I really wasn't healthy at all. And a number of people that I see have struggled with disordered eating behaviors and disordered exercise behaviours for years, and it's gone unnoticed, and it's, again, Ella, as you say, praised. And it is, how do we bridge that gap?

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Christine Chessman: From eating disorder recovery, getting people back to movement in a…

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Christine Chessman: In a healthy way, because it's really a mind thing. It's really hard, because especially somebody who's really enjoyed movement, it's getting them to sort of trust their bodies and get in tune with their bodies again can be really tough.

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Jenny Langley: So this brings us back to trust.

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Christine Chessman: Yes.

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Jenny Langley: all about trust. So, to start with, so if you don't trust the people around you, not to judge you or criticize you, or tell you that you can't exercise, you're not going to open up to them, are you? So, and it takes time to build that trust.

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Jenny Langley: So, I really, I really kind of do, like, a roadmap with the self-harm topical session, where I say, right, let's look at this person who's completely in denial, let's look at this person who's in contemplation, let's look at this person who's in

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Jenny Langley: preparation, you know, how would we connect with that person? What can you do when your loved one seems to be stuck in pre-contemplation? And you know there's that, lovely term, isn't there? Anasognosia? Do you know that word?

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Ela Law: -

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Jenny Langley: Oh my goodness, so you can be in an anisognostic state of mind, okay?

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Ela Law: goodness.

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Jenny Langley: So that's basically, Christine, what you've just described with your exercise and training, yeah? So if people said to you, so if someone close to you was like, I'm not sure about this regime that Christine's doing, it's like, you know, she… there's nothing else in her life, it's become a red balloon thing.

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Jenny Langley: Like, she can't have a healthy blue balloon when she's doing all of this training and this exercise, and if they just came in with welly boots saying, I think you've got a problem.

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Jenny Langley: You'd go, well… No, I haven't. No, I haven't.

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Ela Law: Yeah.

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Jenny Langley: But when you have the… when you're in the anisognostic state, Christine, you wouldn't even know what they were talking about. So it's like if I said to you, so if anyone doesn't know, Christine has blonde hair, yeah?

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Jenny Langley: blonde straight hair. So if I said to Christine, you've got black curly hair.

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Christine Chessman: Meh.

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Ela Law: Yeah? You're like, no!

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Christine Chessman: Oh.

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Jenny Langley: You go, well, no, I don't. I say, yeah, you have.

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Jenny Langley: I know it's not how you feel, but you have got black curly hair, then,

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Jenny Langley: that you would think I'd lost the plot, and that's what happens when somebody's in that anisagnostics flame of mind. So my son was in that at the beginning. Mum, I don't know what you're talking about, you know.

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Jenny Langley: I'm healthy, you need to eat less and exercise more, look at the size of your ass. So he would throw it back at me, and he truly believed he was healthy. Mum, all the sporty boys are like this. All the sporty boys do all this exercise, all the sporty boys are watching what they're eating when he stopped eating as well. You know, he had no idea what I was talking about. So how do we connect?

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Jenny Langley: with that person

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Jenny Langley: Well, we think about how can we step into their shoes and share something with them. So, what would you be feeling, Christine, if I just kept going on and on that you have black curly hair? What would be your primary, kind of, like, emotion?

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Christine Chessman: Just, not anger, but just, frustration.

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Jenny Langley: Frustration, yeah. It must be so frustrating, darling, when you feel fine, and everyone around you thinks something else. Or it must be so confusing.

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Jenny Langley: When you think one thing, and we're saying the opposite.

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Jenny Langley: Yeah? So that frustration, confusion, it must…

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Jenny Langley: It must… it makes sense that you're feeling angry.

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Jenny Langley: Because people are trying to tell you what to do, and you don't understand why they're doing that.

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Christine Chessman: Hmm.

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Jenny Langley: You know, it makes sense that you feel angry, so you can connect on that level. And to… for somebody who's not at medical risk, who is doing something that has become very habitual, that gives them lots of benefits, so there's lots of benefits of being the trainer, of being fit and healthy, of getting all those affirmations, that's the only way in.

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Jenny Langley: Yeah. Because you're not gonna… you're not gonna… you're not gonna get in by arguing with logic.

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Jenny Langley: So, it's that softly, gently, gently approach. Now, I've had two… two amazing ladies speak at my carer Support Group. So Caroline Drummond's… she's got another part of her name, but anyway, Caroline Drummond came and spoke a couple of times.

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Jenny Langley: And she was the lady that ran, like, in her community. Oh, there's Caroline out running, you know, nobody thought anything of it. Her life was totally dictated by her exercise regime.

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Jenny Langley: And she now is an amazing life coach. Like, she's incredible. I just love her. And then Caroline Toshak just happens to be two Carolines. Caroline Toshak, just happened to be running a compulsive exercise session for Bernie Wright in the NEDI, training programs, and, at the same time that I was doing one the following week.

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Jenny Langley: So, we came to each other's, and we had so much common ground, and she also has ADHD, and I think she's all ADHD, so, she's got the perspective of autism and ADHD, which she said was part of the feature, was the regimented running.

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Jenny Langley: Was part of her daily routine, you know, her self-protection in a neurotypical world.

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Jenny Langley: But the eating disorder hijacked it. But she was never unwell enough

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Jenny Langley: that people would be challenging her. So in the end, she reflected.

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Jenny Langley: I'm feeling a bit frustrated because I've got stuck in this. I'm feeling a bit confused because

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Jenny Langley: it's… if nothing changes, nothing's ever going to change. I'm exhausted, because I'm not doing all this training, yeah. No, exactly. So, in her situation, and I think to a certain extent with Caroline, Drummond, they worked it out for themselves, but when you're supporting a loved one, you really need to

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Jenny Langley: be coming to where they're at. And if they're in that anisognostic frame of mind, you still need to come to where they're at to make that connection, and that can take months.

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Jenny Langley: Because if they're not at medical risk, there's no urgency.

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Christine Chessman: And it's, you know, it's interesting, Ella, with our training, so we're both intuitive eating counsellors, and one of the chapters, one of the principles, is movement, feeling the difference. And that was kind of my first introduction to movement, actually asking myself, how do I want to fiend when I move? How do I fiend when I move? Yeah. And just…

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Christine Chessman: Oh! I can ask myself that. That is actually… it doesn't just have to be about punishing, chore, keep going, just make… it's…

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Christine Chessman: oh, how do I feel? And just… and it takes time, I think, doesn't it? To just… I had to take a bit of a step back from running, and everything that I was doing, because I couldn't be sure why I was doing it. I couldn't be sure.

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Christine Chessman: And it really served me very well, and it's still a work in progress, in the sense.

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Jenny Langley: Yeah, yeah, of course.

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Christine Chessman: You're always adjusting and making things, but it is…

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Christine Chessman: Yeah, it's an interesting one. I find the intuitive eating approach quite… I don't know, I…

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Jenny Langley: It's not for everyone. It's absolutely not for everyone. So, you know the flea famine?

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Jenny Langley: Theory.

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Ela Law: Fleet almond.

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Jenny Langley: If we're talking about compulsive exercise, we have to talk about the flea-famine theory. So, Shan Guisinga is the author, but it's talked about all the time, and it's so relevant to the compulsive exercise component of

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Jenny Langley: eating disorders. So, 80% of people with restrictive eating disorders will engage in some form of compulsive exercise. That's huge. 60% of people with bulimia will engage in compulsive exercise. That's also huge.

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Jenny Langley: What's going on there? So the logical thought is, well, it uses calories.

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Jenny Langley: But that's too simplistic. So it's not, it's coming from within. So there's been, several studies, but the flea famine theory is…

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Jenny Langley: If we were in a tribe in the hunter-gatherer era, and there was a scarcity of food for our tribe, some of us need to be genetically predisposed to ignore the food in front of us and run like crazy to find new food sources, or the whole tribe's gonna die out. So it figures that some of us are still genetically predisposed to move more

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Jenny Langley: when we go into energy deficit, I'm one of these people. So if I've… yeah, if I've been really busy and hyper-focused on research or writing or delivering training, and I haven't eaten all day.

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Jenny Langley: I want to go for a long run. Like, I've got this…

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Ela Law: energy.

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Jenny Langley: urge to go for a long run, and I would be running on empty. So, I've learned that that's not… that's not…

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Jenny Langley: very good for me, and so I would have a chicken sandwich and then go for a long run, because I love going for a long run. But with my son, that was exactly what happened. He had a growth spurt, went into energy deficit, and he just moved more and more and more and more. So they replicated it in a rat study. So they had a group of healthy rats, sorry, all the rats were healthy, but they put them in two groups.

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Jenny Langley: One arm had a normal rat diet, and the other had a restricted rat diet, and they all had a wheel. So the rats in the normal diet ran, on average, a kilometre a day in their wheel. So guess how many kilometres the rats in the other arm ran?

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Jenny Langley: On average.

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Jenny Langley: Because not all of them would be genetically predisposed. On average, 21.

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Ela Law: What?

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Jenny Langley: Yet.

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Ela Law: Oh, I was just gonna say maybe 3 times that.

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Jenny Langley: No, no, people in the oyster's feet are 5, 21, and that's on average, so some of the rats weren't running it.

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Ela Law: Oh, wow.

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Jenny Langley: So some of the rats were literally running themselves To the ground, yeah.

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Ela Law: Wow.

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Jenny Langley: And they also, they replicated it in some pig studies as well, so there's a group of pigs called… pigs called lean pigs, and if they go into energy deficit, they start pacing, like, manically pacing.

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Jenny Langley: There's a lot of that in eating disorder services as well, don't we?

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Ela Law: That's so interesting, I wonder what the sort of biological mechanism behind that is, because it doesn't… logically doesn't make sense, does it? When you're in energy deficit, you should just be shutting down.

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Jenny Langley: I know.

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Ela Law: down and sitting down.

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Jenny Langley: You have this superpower to run more.

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Ela Law: Wow.

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Jenny Langley: Yeah. Or to pace, or to move more, even if it's the micro-movements. It's this compulsion, I have to move, and then it can be wrapped up with the OCD. So, Sam.

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Ela Law: Hmm.

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Jenny Langley: Was convinced that if he didn't do all of his repetitive exercise, something terrible would happen to the other family members.

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Ela Law: Oh, goodness.

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Christine Chessman: And you know what? It's also combined by… so I've got ADHD diagnosed, but for me, I just wake up and I just have so much anxiety, and my brain is like, so if I run, great! It just…

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Ela Law: Totally.

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Christine Chessman: And then I feel like, oh, I'm ready for the day now. Exactly. There's so many reasons that, you know, that I'm…

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Ela Law: Another reason why just taking all exercise off the menu is not a good idea.

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Jenny Langley: Too great.

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Christine Chessman: Agreed, agreed.

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Jenny Langley: There's really high medical risk. So, have I got time to tell another.

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Christine Chessman: Yeah.

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Ela Law: Yeah, yeah, sure.

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Jenny Langley: So,

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Jenny Langley: this was way back, so I'd written the Boys Get Anorexia 2 book, it was published in 2006. So, I was at a conference, and there was, a team there from Ellen Mead who always historically have treated

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Jenny Langley: Patients that have been resistant to treatment elsewhere, and they tend to keep them for much longer, and, you know, very…

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Jenny Langley: very well renowned, they've had a few issues late, you know, just recently, but don't all hospitals, sadly. But I asked the psychiatrist, I said, what's your view on movement and exercise within treatment? And she said, well, we've just changed our mind. And she said, we've changed our mind because we had this little girl, let's call her Sophie, we had this little girl, Sophie, come to our

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Jenny Langley: Unit, and she's 12 years old.

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Jenny Langley: And she can see that some patients are allowed on the running machine.

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Jenny Langley: And she doesn't meet the parameters that we have to be able to go on the running machine. So the nurses are using all their skills of, you know, motivation. Well, you know that if you stick with the meal plan, then you'll be allowed on the running machine. And Sophie just couldn't engage in… she couldn't engage in any of the treatment. So the psychiatrist sat down with her, and

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Jenny Langley: you know, was curious, gently curious. So we've noticed, Sophie, that you're really, really interested in the running machine. So without any judgement, just, we've noticed you're interested. And Sophie said, well, I love running, I've always loved running. I don't need to run all day. A little bit of running would really help me.

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Jenny Langley: So, it would make me feel, like, calmer, and it would give me some joy to think that I can get back to my running when I'm better.

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Jenny Langley: So, okay, that's… That's interesting.

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Jenny Langley: Oh, so it must be really excruciating for you to see

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Jenny Langley: other, people on the running machine. And she said, well, yeah, it's awful, I can't think about anything else, that's all I think about all day. And so the psychiatrist said, so if we could come up with a safe plan where you can start going on the running machine, would that be helpful?

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Jenny Langley: Yes, because just a little bit of running, and they started with a few minutes of walking, but she literally then had her step on the… she was… got the foot on the path.

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Jenny Langley: to get back to her joy of running. And I've seen so many clinics going through that transformation, where they're saying, hmm, okay, and that's where that safe exercise at Every Stage website is so useful.

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Jenny Langley: him, definitely.

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Ela Law: Yeah, we'll link to that in the show notes, because I think that's a really, really good resource.

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Ela Law: And also, obviously, to all of the work that you do, the New Mawardsley Method, your book, so we will put that all in the show notes, because I think that will be really, really helpful to anyone listening who has a loved one that they care for, or maybe someone who's going through it themselves.

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Jenny Langley: Simply, yeah.

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Ela Law: Yeah. Yeah.

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Christine Chessman: And so, Jenny, before you go, we need to ask you, what do you love? How do you love to move?

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Christine Chessman: What is.

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Jenny Langley: I love running, but I also love, my husband's got me into golf.

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Jenny Langley: So I quite enjoy the golf… I mean, I'm not very good, but I've got a happy cap, and I can get around a golf course. So I've got some really, really lovely girlfriends at the golf club.

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Jenny Langley: So, I'm not the biggest fan of great big, you know, loads of ladies. We've got our spring meeting next week, so, that can be a bit overwhelming, but I've got a couple of friends, we go every Friday evening, because my husband plays cricket on a Friday evening, we go every Friday evening and play golf. I love anything to do with water, so swimming, sailing…

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Jenny Langley: you know, anything on the water is great.

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Jenny Langley: I'm walking, walking in nature. I could walk all day.

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Ela Law: You need to come.

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Christine Chessman: to Brighton and do a bit of swimming in the sea.

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Jenny Langley: Yeah, well, I grew up by the sea. I grew up in a place called Pet Level, between Hastings and Rice, so yeah.

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Ela Law: Lovely!

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Jenny Langley: And it's called Pet Level because it's a petrified forest on the beach, so when the tide's out, it's all this petrified wood, it's amazing.

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Ela Law: Oh, wow. I've not heard of it, I need to go and see it.

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Jenny Langley: You do, yeah.

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Ela Law: Amazing.

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Christine Chessman: Well, thank you, Jenny. We cannot thank you enough. That's been an absolutely brilliant discussion today. My pleasure.

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Jenny Langley: For sure, I know it's been really fun talking to you, and, I love talking about this topic.

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Christine Chessman: Yeah, it's…

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Ela Law: Brilliant, thank you so, so much.

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Christine Chessman: about it.

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Ela Law: Me too.

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Christine Chessman: talking about it, but yeah, thanks again, Jenny.

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Jenny Langley: I think I've got another 20 years in me.

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Ela Law: You have to come back on the pod.

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Jenny Langley: Yeah. Like, so I'll shoot off.