0:00

Next chapter with the Prim Ripka Pad is a production

0:02

of iHeartRadio. Hey, everybody.

0:05

It's Prim. Welcome to the next chapter

0:07

presented by Baron Davis, and slick

0:09

studios. For this week's

0:11

topic, we're gonna focus on a topic rather

0:13

than a Okay.

0:24

3321

0:27

The next chapter with Prim Orthopedic is a

0:29

production of iHeartRadio. Hey,

0:31

everybody. It's Prim. Welcome to

0:33

the next chapter presented by Baron Davis

0:35

and Six Studios. This week,

0:38

we're going to focus on a top thing.

0:40

And the topic is about eating disorders

0:43

and disordered eating behaviors among

0:45

adults. I'm actually

0:47

currently coauthoring a chapter

0:50

in a soon to be published book

0:52

on this topic. And one of the main contributors

0:54

is a Homer Olympic figure skater, Rachel

0:57

Flat, who is also a PhD

0:59

clinical psychology student at

1:02

UNC. Some of you probably

1:04

recall she's been a guest here on the next

1:07

chapter. And in that conversation, we talked

1:09

about her retirement experiences as

1:11

an elite app So if you haven't listened to

1:13

it, definitely check it out. But

1:16

this time around, I wanted to delve

1:18

into her developing area

1:20

of Prim, which is eating disorders

1:22

within the Flatt population. As

1:25

some of you know, this is a topic that's

1:27

very important to me because I

1:30

was one of those athletes that suffered

1:32

from an eating disorder and

1:34

one that began shortly after I suffered

1:36

a significant injury at seventeen

1:38

years old and it's one

1:40

that I battled all the way into

1:43

my early thirties actually. And

1:45

as you'll hear from Rachel, This

1:48

is one of the most difficult mental

1:50

health issues to manage

1:53

and navigate. Because cause of

1:55

how long it takes the individual to

1:57

get help and begin and

1:59

also complete that recovery process.

2:02

And so today, what I wanted to do is really

2:04

dive into this topic about athletes

2:06

and eating disorders and not only dispel

2:09

this, but educate listeners

2:11

on the learning signs of

2:14

an athlete who might be struggling with

2:16

this and also the typical course

2:18

of this illness and what coaches,

2:20

parents, and other athletic staff

2:23

could do to help rather

2:25

than harm and athlete who is

2:27

suffering from an immune disorder. Or

2:29

disorder eating behaviors. And

2:31

just so all of you know, by definition,

2:34

eating disorders are mental illnesses

2:36

because there are different

2:38

types of eating

2:39

disorders, so that's plural, mental illnesses

2:41

Flatt are typically characterized

2:44

by unhealthy eating patterns and

2:46

weight control behaviors negatively

2:49

affect one's physical health and

2:51

or cycles social functioning.

2:54

Disordered eating behaviors on the other

2:56

hand are a host or

2:59

collection of abnormal eating

3:01

patterns that are actually quite common, but

3:03

they do impair one's physical health.

3:05

But they do not meet

3:07

the clinical diagnosis of an

3:09

eating disorder. So just wanted to give you

3:11

the definitions of both terms. And

3:14

I thought it would be really helpful to talk to Rachel

3:16

not only because this is what she is researching

3:18

and centering her clinical training

3:21

around, but because she has

3:23

experience of an so

3:25

she can speak from that perspective. And

3:28

as a of the United States

3:30

Olympic and Paralympic Committee's Mental

3:32

Health Task Force, This

3:34

is clearly something she's really passionate

3:36

about and she knows a lot about. So

3:39

without further ado, Here's

3:41

Rachel Flatt. And

4:05

so here we are. You've

4:07

recovered, you're making this transition. And

4:10

I mind out so cool that,

4:13

you know, you and I have are kind of

4:15

following a similar trajectory, you

4:17

know, you're you go from Flatt sports

4:19

and then now into the field of psychology. Although,

4:22

you didn't you skipped my whole part

4:24

of spending eighteen years in media and broadcasting.

4:27

You're you're much more efficient than how you

4:29

know. It's a much more

4:31

direct route of getting towards

4:33

that. So So

4:35

how did you get there? I know that's a complex

4:37

question because you're originally Prim, but

4:39

why is psychology and why clinical is

4:41

like,

4:42

Yeah. So I had started

4:44

doing a little bit of research, my

4:46

senior year college. With

4:50

my former PIA out at Stanford,

4:52

and he did a lot of work

4:54

on digital mental

4:56

health tools with a specific focus on eating

4:58

disorders, but project that I initially started

5:00

on was this

5:02

kind of staying fit, you know

5:05

keeping at risk kids in

5:07

San Francisco physically

5:09

engage in activities, you

5:11

know, helping them build some better nutrition

5:14

habits, like sleep hygiene.

5:16

Just kind of hear some basic skills

5:18

on how to kind of keep yourself healthy

5:20

2 kind of prevent these

5:22

higher BMI's later in

5:24

life. And and

5:27

he thought I would be great fit knowing my app. Like,

5:29

congrats. Okay. Great. Yeah. Sounds

5:31

great. You know, this sounds really fun. And And

5:33

I was a biology major, so

5:35

a lot of pieces to that

5:37

project really spoke to me. And

5:39

and so I started working on

5:41

that project and After

5:44

retiring, after graduating, I took kind

5:46

of a, I don't know, six

5:48

months, eight months kind of gap before

5:50

one of his one of the

5:52

people in his lab reached out and said, hey, we have an

5:54

opening. I know you're still on the bay and trying to

5:56

figure out what's next because I am trapped copy

5:58

with her. And I was like, hey. Guess what? I gotta find her

6:00

med school, so I don't know what I'm saying.

6:03

And and she

6:06

happened to find out that there was a position

6:08

opening. And so I kind of reentered his

6:10

his work and his

6:12

lab through more of this

6:14

digital eating disorder intervention lens

6:17

and started working on a

6:19

national institute 2 medical health funded

6:21

research project where we were

6:23

delivering kind of

6:25

the very first step care

6:28

intervention and prevention model

6:30

that was, gosh, we

6:32

I don't know, it was almost thirty schools

6:34

nationwide. There were, you know, we

6:36

screened thousands and thousands of

6:38

women and we we're

6:41

able to kind of see pretty amazing effects,

6:43

almost similar to what we would

6:45

typically see with in person

6:48

eating disorder treatment just

6:50

through this digital app. And I was like,

6:52

my mind was blown. I was so excited that

6:54

I just saw so many applications

6:58

to the the

7:00

tremendous gap in resources in the

7:02

sports world. And so

7:05

yeah. So I got really excited about that, recognize

7:07

that we could really use something like that

7:09

and in sports and especially

7:11

in skating because eating disorders and

7:13

disorder eating and poor body image

7:15

is so so common. And

7:19

and so that caught me really excited and that

7:21

kinda lit my fire again. And

7:23

so, yeah, I ended up deciding

7:25

to apply to graduate school and pursue

7:27

clinical psychology so I could balance

7:29

kind of this research and the clinical

7:32

practice and even

7:34

the advocacy work that

7:36

comes with with

7:38

this, you know, kind of

7:40

this education. And Yeah.

7:43

And it just was so interesting to me. I

7:45

loved the idea of having a multiple

7:47

multiple different career paths that

7:50

I could pursue. And, yeah,

7:52

so I jumped right in, got connected with my current

7:54

PhD advisors, and I feel like

7:57

it turns out she has a background in

7:59

skating. She's been a lifelong skater herself. And

8:01

so there were just so many overlaps for

8:03

us that I was like, yeah, I I can't

8:05

not pursue this. And here

8:07

we are five years later, I'm planning for

8:10

innership and almost done with this

8:12

process, and it's kinda hard to believe that

8:14

this has all come together. And

8:16

I'm really grateful that I went through those

8:18

experiences now because it's really

8:20

informed and motivated this

8:23

work for me, but

8:25

I Yeah. I really couldn't have

8:28

gotten to this place without having gone through

8:30

that. That's amazing. And

8:32

congratulations on all this us and work. And

8:34

I feel like it's, like, one of those weird things

8:36

where it's, like, for for us going

8:38

through the doctoral program, and I guess it's, like, one

8:40

of those things you don't really get the congrats until

8:42

your license It's such a long

8:44

process. Like, you deserve a you

8:46

deserve a congrats, like, in the middle. Like, you're

8:48

almost done and you've and

8:50

you've gone through all the

8:52

hard stuff. And the work now is hard. I know

8:54

it's stressful. But really, like, that hard

8:57

personal inner work was, like,

8:59

beforehand. And so now you're, like, off

9:01

and running, So I really want to dive

9:03

into this topic because this is one

9:05

that really hits me on a personal level.

9:07

And I've been some I've been public about this, and

9:09

I've mentioned this in other interviews. But

9:11

for me being a tennis player and

9:13

then, you know, I experienced a Prim significant

9:16

injury. I had a couple of stress fractures at

9:18

seventeen right before I was being recruited

9:20

and it really prompted what began

9:22

as kind of an eating disorder. And although

9:24

I'd never was clinically

9:27

I was never really diagnosed,

9:29

because I wasn't mean with therapists at the time, but it's

9:31

one that affected my life

9:33

really on and off

9:35

through my late teens and then into

9:37

my twenties. And then, of course,

9:39

definitely when I retired -- Mhmm. --

9:41

it it came at a full vengeance and it

9:43

was the reason why I went to

9:45

therapy. So this is a topic that I'm very,

9:47

very passionate about. So

9:50

I'm trying to figure out where to

9:52

begin, but You and I were

9:54

in the process, were in the process of writing

9:56

and coauthoring a

9:58

chapter on athletes and eating disorders

10:00

and disordered

10:00

eating, which is so exciting. So,

10:04

you know,

10:06

the first question is, are

10:08

athletes more susceptible to

10:10

eating disorders and disordered eating

10:12

behaviors. Let's begin with that. What are your

10:15

thoughts? Sure. Well, before I

10:17

get to that, I wanna first say thank you for

10:19

being open about Bierik's experiences

10:20

2 I think that in and of itself

10:23

can normalize like getting

10:25

help, talking about mental health

10:27

publicly and privately, you

10:29

know, with people who love you most. So I just

10:31

yeah. Very appreciative that you are willing

10:33

to share that with so many

10:35

people. So,

10:37

but to answer your question, I

10:43

think athletes are

10:45

at least as susceptible to

10:47

develop a needing disorder if not more

10:49

so. And I think it's really context dependent.

10:52

There are certainly some

10:54

sports like figure skating,

10:56

like gymnastics, like long

10:59

distance running, where there

11:01

is this perception that being

11:03

thinner or even if there's a,

11:05

you know, a weight class kind of like

11:07

wrestling where there may

11:09

be very real to

11:12

maintain or lose weight. And

11:14

and so sometimes there's this

11:17

perception that, you know, being thinner may

11:19

be providing some kind

11:21

of performance enhancement

11:23

or advantage. And

11:25

when that's not always necessarily

11:27

the case. And in most cases, it's

11:29

not. I'm surprised. But

11:33

it is in those types of sports

11:35

where we tend to see much

11:37

higher levels of

11:39

eating disorders and disordered eating in

11:41

concerns about you know,

11:43

your your body and your weight and your

11:45

shape. So there's

11:47

some evidence out there

11:49

that even competing at a high level in sports

11:51

can increase that risk. It's a little bit

11:53

mixed, but I think more often than

11:55

not being at a high level

11:58

of competition and sport can increase that

12:00

risk. And, apparently, because you're you know,

12:02

you might be interfacing with a lot of different

12:04

people who are giving you a lot of different

12:06

pieces of advice. And,

12:08

you know, I think back to, like, my own skating

12:10

career where the more

12:12

I kind of rose through the Rings, the more

12:14

sure I got in the more feedback, like direct

12:16

feedback I got on how I

12:18

looked, my weight, how my

12:20

costumes looked, how I should

12:22

have used different types of

12:24

2 to hide my physique.

12:28

And and I'm, you know,

12:30

even think back to a

12:32

whole lot of experiences that I've heard

12:34

from friends and peers and athletes who

12:36

are still kind of going through that pipeline

12:38

and just amazing to me that those kinds

12:40

of comments are still put out there.

12:42

So those culture around that is

12:44

starting to change now that people are

12:46

being more open in Frank and

12:48

honest about their experiences.

12:51

But, yeah, I think there there

12:53

are certainly some sport contacts

12:55

that definitely lend themselves lend

12:57

itself to a much greater

12:59

risk of developing an eating disorder.

13:01

Howard Bauchner: Yeah, and, you know,

13:03

I didn't mean to put you on the spot. It is a

13:06

very complex answer

13:08

is a complex question.

13:10

And obviously, the research is still kind of

13:12

evolving and developing and depending on what

13:14

study you're looking at, you're gonna

13:16

get different answers. But I think, you

13:18

know, if I were just offering taking off

13:20

my, like, clinical hat and my research

13:22

hat, I do think that for

13:24

various reasons, I do think that the athlete

13:26

population is certainly very susceptible

13:29

to at least under this umbrella

13:31

of you know, eating disorders or

13:33

disordered eating behaviors for various

13:35

reasons. I think the stressors, especially

13:37

into days were landscape is so

13:39

different. There's just more eyeballs, there's social

13:41

media, there's -- Mhmm. -- social

13:43

media alone. It's just like, I mean,

13:46

just the amount of pressure and

13:48

body image. So,

13:50

you know, I wanna talk

13:52

about the the the factors and like

13:54

really stripping this this topic

13:56

down and educating

13:58

people who are coming out,

14:00

you know, from from various

14:03

aspects so we can better understand this

14:05

topic. Because I think, you

14:07

know, sharing a little bit more about

14:09

my personal experience. Sometimes there's this idea

14:11

or this perception, then it's like, okay, an eating

14:14

disorder really begins with they just wanna

14:16

lose weight. They just wanna be skinny. It's all,

14:18

you know, there's multiple

14:20

factors that can kind of play into that.

14:22

So when I say that, is there

14:24

anything that comes to mind in terms of like the

14:26

contributing factors that lead to

14:28

this? Yeah. I

14:30

mean, I I agree that there

14:32

is this general sentiment out there

14:34

that the reason

14:36

eating disorders happen is because people

14:38

decide to lose weight and then

14:40

they develop kind of these

14:42

these harmful behaviors. That

14:45

lead to kind of this long sustained

14:47

eating disorder journey. And

14:50

that's certainly not always the case,

14:52

but I think the sports

14:54

environment can certainly contribute to that in

14:56

many different ways. Like I said,

14:58

you know, there's with with being

15:00

a public figure. And, you know,

15:02

even I think about this NIL deal

15:04

too with NCWA athletes,

15:06

you know, I'm so worried about what

15:08

that might mean. For

15:11

athletes who are not only

15:13

trying to physically

15:15

be in a place where their

15:17

body can form the way

15:19

they wanted 2, but they're

15:21

now also pressured to

15:24

convey a certain type of physical

15:26

appearance that would

15:28

garner them more followers, more

15:30

influence in that space.

15:32

And I really worry and

15:34

wonder about those long term effects might

15:36

be. Certainly, I think

15:38

from a financial perspective, so it can

15:40

be so helpful for a lot of fleets

15:42

and can really alleviate some of the

15:44

burdens of of that kind of

15:46

participation. But yeah, I I

15:48

mean, there's a lot of roads, we could

15:50

go down from social media

15:52

factors to both

15:54

internal and external pressures kind

15:58

of keep a certain type of

16:00

physique that is perceived to be the

16:02

ideal physique for sport.

16:05

And certainly, there may be certain types of

16:07

bodies or certain types of physics that you more

16:09

often see. You know,

16:11

me being A52 person,

16:13

not a great basketball player. You know,

16:15

that's just never that's just never gonna be

16:17

the case. Right. I'm right there with you at

16:19

five too. Yeah. But But

16:23

I think, you know, if you look at like gymnastics in this whole

16:26

revolution that they've had from

16:28

athletes who tended to fit this

16:30

certain type of mold of being really

16:33

kind of spelt

16:35

and toned. And now

16:37

you see, you know, you see powerhouses like

16:39

Alec Graceman and some mobiles and

16:42

Laura Hernandez who come through and completely

16:44

change the game to show that

16:46

actually you can even be more

16:48

successful when you're pushing against kind of the

16:50

typical

16:50

stereotype. So

16:52

it's it's I

16:53

think there's a lot of different things in the sports

16:56

environment that can contribute to

16:58

eating disorders or at least

17:00

kind of increase the risk

17:02

for

17:02

it. Yeah.

17:03

But I don't think it necessarily comes down

17:05

to just this idea around

17:08

losing weight. There's

17:10

a lot more complexity to that. Howard

17:12

Bauchner: Yeah. And you just mentioned the

17:15

societal pressures that impact,

17:17

that's kind of always evolving. You know,

17:19

compared to I mean, I

17:21

think, you know, around the eighties and nineties,

17:23

that was a period when females

17:26

and Sports was really kind of on

17:28

the rise. So I benefited from that

17:30

and then the evolution of, like, title nine

17:32

and everything. Mhmm. But and we're a

17:34

much better place than where where we were. Many

17:36

many years ago. But nonetheless, so we've

17:38

got societal pressures that

17:41

are shaping body image,

17:44

especially when female and male. Right?

17:46

Because that's another thing. There's often this

17:48

idea that eating disorders affect

17:50

just the female population, but it

17:52

definitely affects the male population. Right?

17:54

Yeah. Yeah. And that's one of

17:56

the most frustrating parts about

17:58

kind of this historical perspective

18:01

of eating disorders, right, is

18:03

that it is it only

18:05

affects women it affects

18:07

primarily white adolescent girls

18:10

or younger women,

18:12

and it just I mean, it blows

18:15

my mind. Like, I even came

18:17

into the research base kind of having

18:19

that same misperception.

18:22

Then, obviously, research

18:24

has completely blowing that up. Right?

18:26

Like, we know -- Yeah. -- affects

18:28

people across, you know,

18:30

across ages, demographics, like,

18:32

it can affect them equally, if not more so.

18:35

And certainly, with men in

18:37

particular, like, I I

18:39

did a channel a couple years ago

18:41

with a football player who throughout

18:43

most of his career had

18:45

been eating disorder. And it

18:47

was amazing to see some of the audience's

18:50

reactions. Like, oh my gosh, I can't believe a

18:52

guy let alone a football player

18:54

would deal with this. It's

18:56

like, yes, of course. You know,

18:58

we this is not something that

19:00

is unique to a very specific

19:02

type of person or type

19:04

of athlete even. So -- Mhmm. --

19:06

you know, and and for men, we're starting

19:08

to understand especially in sport that

19:10

there are different kinds of pressures. Right?

19:13

Maybe 2 instead of

19:15

lose Per se, maybe have a more muscular and

19:17

more toned body or have a very,

19:19

very small percentage of body

19:21

fat. And so those types of

19:23

pressures can feel maybe a little bit

19:25

different than what it might be for

19:27

female or women identifying

19:30

athletes. So you know, there's certainly a lot of

19:32

nuances that we're starting to 2. And

19:34

unfortunately, their research is

19:36

you know, has been to kind

19:38

of catch up with with the times to some extent,

19:40

but I think we're really starting to

19:42

realize, like, the picture is not always

19:44

the same, and it does affect

19:47

people may be equal or higher

19:49

rates, kind of depending on

19:51

your context, who you are, your environment,

19:54

your background and your experiences and

19:56

the types of pressures that you might

19:58

be receiving. And yet, we still need

20:00

to make sure that, like, these treatments

20:03

are cognizant of those

20:05

nuances and really

20:08

can be effective in

20:10

mitigating that risk and making sure that,

20:12

like, the treatment is going to set you up for

20:14

success and is going to be sustainable long

20:17

term. Yeah. Right. And

20:19

so let's take let's take the conversation

20:21

a next because a lot of it is, like,

20:23

really recognizing the science and knowing what

20:25

it looks like. Because if we don't know what we're

20:27

looking for, we're totally gonna miss it. And

20:29

that wasn't part of my experience. You

20:31

know, generally because the time that I was

20:33

going through sports and high school, I mean,

20:35

mental health was just kind of like

20:38

this. It really wasn't that much of a

20:40

conversation. And it's just when it

20:42

comes to eating disorders, you

20:44

know, I don't think a

20:46

lot of the people around me knew

20:48

what to look for. So let's

20:50

kinda go through some of them and and make sure

20:52

that we kind of are all aspects. And we're not gonna

20:54

hit all of them. I mean, we don't have a lot

20:56

of time. Right. But, you know, it's some of it's

20:58

restricted eating, some of it might

21:00

be over exercising. What are some

21:02

other ones that come to mind for you that we

21:04

should watch out for? Yeah.

21:06

So certainly, there's the behavioral

21:08

component. Right? The restriction, the

21:10

fasting, the dieting, the over

21:13

exercising. Vomiting after meals or

21:15

misusing diuretics and laxatives. There's

21:18

certainly that kind of group of

21:20

of behaviors that we can look for.

21:24

Prim an emotional standpoint,

21:27

oftentimes we'll see folks really have

21:29

dramatic changes in their mood.

21:31

So you might know someone who,

21:34

you know, could and this is a thing that

21:36

can be really complicated with eating disorders

21:38

and certainly other you know, mental health

21:42

concerns. With the onset of

21:44

adolescence, that tends to be a time where,

21:46

yes, of course, we'll see changes in

21:48

mood. Yeah. Right? And so let's

21:50

take let's take the conversation a next step

21:52

because a lot of it is like really recognizing

21:54

the science and knowing what it looks like. Because

21:56

if we don't know what we're looking for,

21:58

we're totally gonna miss it, and that wasn't part of my

22:01

experience. You know, generally because at the

22:03

time that I was going through sports

22:05

and high school, I mean, mental health

22:07

was just kind of like this. I

22:09

it really wasn't that much of a conversation

22:11

and it's just that when it comes

22:13

to eating disorders, you

22:16

know, I don't think a lot of the people

22:18

around me knew what to look

22:20

for. So let's kinda go through some of them

22:22

and and make sure that we kind of are all

22:24

aspects. And we're not gonna hit all I mean, we don't

22:26

have a lot of time. Right. But, you know, it's some

22:28

of it's restricted eating, some of

22:30

it might be over exercising. What

22:32

are some other ones that come to mind for you

22:34

that we should watch out for? Yeah. So

22:37

certainly, there's the behavioral

22:39

component. Right? The restricted friction, the fasting,

22:41

the dieting, the over exercising,

22:44

vomiting after meals or misusing

22:46

diuretics and laxatives, There's

22:49

certainly that kind of group of

22:51

of behaviors that we can look

22:53

for. From an

22:56

emotional standpoint, oftentimes

22:58

we'll see folks really have dramatic

23:00

changes in their mood. So

23:02

you might know someone who,

23:04

you know, could and this is a thing that can

23:06

be really complicated with eating disorders and

23:09

certainly other, you know,

23:11

mental health concerns.

23:13

With the onset of adolescence, that tends to

23:15

be a time where, yes, of course, we'll

23:17

see changes in mood. Like, that's part of

23:19

being a human. And We

23:23

also see that as a really

23:25

high risk time for specifically

23:27

creating disorder onset. And so what

23:30

people might initially perceive

23:32

or think that, oh, that's just

23:34

them being a little bit more moody or

23:36

maybe they're just a little bit more shifts and, you know, kind of

23:38

recognizing what it's like to interact

23:40

with other peers, their age, and

23:42

things like that may actually

23:44

be kind of hunting

23:46

at some disorder eating and some

23:49

concerns about how,

23:51

like, their weight or their weight may

23:53

be perceived or just real

23:55

dissatisfaction and, like, distress

23:57

around how they look. So,

24:00

certainly, that's something to keep an eye

24:02

off

24:02

for. But in terms of

24:04

what people are saying and how they're thinking as

24:06

well, like, we might we see a lot

24:08

of concerns with

24:11

how people

24:11

how they're looking. Right? Especially in comparison

24:14

to others. Like I

24:16

said, there can be a lot of, like, emotional

24:18

distress around Flatt.

24:20

But in terms of how people are thinking

24:22

about it, like, sometimes I will I

24:24

will see folks who say 2 spend eighty,

24:27

ninety percent of my day thinking

24:29

about what I'm eating, how I'm looking,

24:33

and and it just is

24:35

nonstop. And so

24:37

sometimes, you know, you'll get glimpses

24:39

into 2. When people might make

24:41

cursory comments around, oh, I'm

24:43

feeling, you know, I'm feeling really heavy

24:45

today or, like, oh my gosh, my Leo just is, like,

24:47

really not fitting today. Right? And

24:50

what we might think is, like, oh, yeah. I

24:52

mean, that can kind of be a normalized comment,

24:54

especially in sport, may actually

24:56

be something that

24:58

is kind of hinting at more underlying

25:01

concerns. So it is something to take

25:03

seriously when people are talking about that and

25:05

making those kinds of comments. Certainly

25:08

not something that we Flatt to be normalizing. Right?

25:10

We want to take that seriously and

25:12

make sure that if folks are

25:15

talking about their weight or their shape and their

25:17

dissatisfaction with that, that,

25:19

you know, hopefully, it is just kind of a

25:21

one off comment and it is just kind

25:23

of you know, maybe something they might

25:25

be feeling just in that moment,

25:27

but it doesn't hold that much value.

25:29

So checking 2 with those

25:31

folks and making sure that it isn't

25:34

something bigger and it isn't something more

25:37

severe in intense is

25:39

exceptionally important. So

25:41

there's a lot of different things to look for.

25:43

You know, if there's a dramatic loss

25:45

of weight even in a short

25:47

period of time, that's something to

25:49

be really concerned about and certainly get

25:51

that checked out from either a physician or

25:54

kind of your typical

25:56

go to healthcare

25:57

professional.

25:58

So, there's a lot of different things to look 2, but --

26:01

Yeah. -- those are some of the the big ones to

26:03

keep an eye out for. I know. I

26:05

I'm putting you on the spot, aren't I? I was like,

26:07

okay. Let's listen. All the factors in minutes ago. But

26:10

yeah. I mean, I think that was you did such an

26:12

amazing job of, like, really trying to make it

26:14

as comprehensive as as possible because it's,

26:16

like, there's a behavioral element.

26:18

There's a physical psychological element. There's

26:20

an emotional element which can be really hard

26:22

to decipher. Yeah. You're right. Talking

26:24

about adolescence, I was

26:27

a disaster or as an adolescent. At least

26:29

Prim my parents perspective, I had a

26:30

meeting. Amazing adolescence. But I it was

26:32

like World War three. So I was like, yeah. Are you

26:35

gonna be able to, like, decipher between

26:37

just like a general shift in

26:39

his teenage period versus some

26:41

of the emotional evolution

26:44

of what might be going on

26:46

with the earlier signs of

26:48

an eating disorder. And it's funny when

26:50

you're mentioning about, like, the internal dialogue.

26:52

I I haven't thought about this in years,

26:55

but I remember thinking at

26:57

one point, like,

26:59

as I was going through my recovery and working

27:01

with my therapist, I was like, Is

27:03

there ever gonna be a moment

27:05

in my life that I don't

27:07

think about this the

27:09

way I'm thinking about it? Like,

27:11

I was, like, I felt like,

27:14

is this ever gonna stop? Like, am

27:16

I ever just gonna have, like, a peaceful

27:19

internal dialogue where I

27:21

don't obsess about this.

27:23

And the answer to that

27:25

is like it can happen, but

27:27

it certainly takes a lot of work.

27:29

So think my next question will

27:32

be, for the people

27:34

around these individuals and

27:36

maybe kids or adults whoever, maybe

27:38

it's parents, maybe it's coaches,

27:40

support personnel. How do they

27:42

intervene? This is a really difficult part because

27:44

it's like how do you approach somebody in the

27:47

right way You may not be ready to change.

27:50

Yeah.

27:51

I that's the

27:54

that's the million dollar question. I've

27:56

been, you know, I'm I'm thinking about even

27:58

just an instance somewhat recently

28:02

with, you know, some folks who are just

28:04

trying to help

28:06

their kid get to treatment and it

28:08

has just been an

28:10

immense struggle and

28:12

fight and you know, they're still not there

28:14

yet. So,

28:16

you know, all you the the best thing

28:18

you can do is is show up with empathy and

28:21

compassion and just be there for them as a human.

28:23

One of the things we often talked

28:25

about like when we're doing

28:28

seminars for coaches and like

28:30

sports staff is,

28:32

you know, certainly approaching the you

28:34

know, in a in a

28:37

somewhat personal space rate,

28:39

so it's not more private, I should say.

28:41

So that you're not calling them out on the

28:43

training room floor being like, hey, I'm concerned about

28:45

you. You know? I've seen that before. Not

28:48

those long ago. Yeah.

28:50

So 2 with that is helpful.

28:52

But, yeah, just showing

28:54

up them and saying like, hey, recognizing that,

28:57

you know, you seem to be struggling a little bit

28:59

or, you know, I think this is really

29:01

the only time to

29:04

if someone has lost weight because you're concerned

29:06

about it. Right? Like, I've noticed you've lost a little,

29:08

like, a little weight and I'm worried

29:10

about you. Right? That's the I

29:12

think that is the only time in which your weight

29:14

should ever be mentioned. And

29:18

or if, you know, you're noticing, like, some of these

29:20

behaviors, right, that we've talked about. I'm

29:22

I'm hearing things. You know, I'm I'm

29:24

noticing that you're, like, misusing

29:26

laxatives or diet pills to try and

29:28

potentially lose weight. And I'm really worried

29:30

about you. So

29:32

starting with Flatt. And

29:34

from there, just checking in,

29:36

you know, using, like, those statements,

29:39

I'm worried being neutral and

29:42

compassionate with them. We don't wanna judge

29:44

them for that. Don't say, like, I can't believe you're

29:46

doing that. That's so stupid. Definitely

29:48

don't wanna head that direction.

29:50

But the more that you can

29:52

kind of lean into your

29:55

softness and compassion,

29:57

the better. When

30:00

you're talking with that athlete or

30:02

that person, make sure that you have

30:04

some resources in your back pocket, whether

30:06

that's even something

30:08

as simple as, like, the National EME disorders

30:11

Association. Their website. They

30:13

have hotlines. They have, you

30:15

know, recommended kind of

30:17

referrals and providers in in

30:20

local areas. Even something as simple

30:22

as that can be really helpful as a starting

30:24

place. But if you happen to be a

30:26

little bit more connected, like,

30:28

as a has an athletic department or something being

30:30

able to immediately direct that

30:32

athlete to 2 their

30:34

mental health 2, you

30:37

know, even just their their team

30:40

positions, that can be a great starting

30:42

point to get them to some

30:44

professional who has knowledge

30:46

of eating disorders or other

30:49

health and mental health concerns that

30:51

they can assess for

30:54

is essential. So be

30:56

compassionate, be empathetic, be

30:58

there for them, support them, provide

31:00

those referrals, and then

31:02

most importantly follow-up. Because we

31:05

know that it takes folks with eating

31:07

disorders many, on average,

31:09

many years to get help.

31:11

In Really? Yes.

31:15

Yeah. Yes. Gosh.

31:17

I it

31:19

is one of the mental health

31:21

concerns that can for

31:23

some people take, like, a decade to

31:25

get help -- Wow. -- because

31:27

they don't necessarily realize what's happening.

31:30

Is actually harmful to them. It's so normalized

31:32

in some of these communities,

31:34

but also because it

31:36

can be so congruent with

31:39

how they view themselves or even like their

31:41

performance. Like, they see it as something that's so

31:43

beneficial to their performance when long term.

31:45

Like, you're at much greater risk of

31:47

getting injured. You might have a

31:49

lot of long term health

31:51

consequences as a result

31:53

of this. And certainly, your mental and

31:55

physical performances will for

31:58

eventually, like, it will happen. So,

32:01

yeah, it's it's for

32:03

some reason, one of the one of the

32:05

things that just takes people a while

32:08

to

32:08

recognize, to be willing to get

32:11

help, so the earlier

32:13

that we can catch it, the better?

32:15

Yeah. It's a I

32:17

know we're running out of time here, but, yeah, I think,

32:19

you know, in terms of, like, intervening,

32:22

definitely don't want to go in blaming. There seems

32:24

to be for me, seeding

32:26

end of it. There seems to be it seems to drop

32:28

a lot of, like, internal

32:32

emotions. Mhmm. You know, sometimes, I think I'm sure

32:34

people get frustrated. It might even

32:36

bring up their own internal

32:39

issues about weight and body image.

32:41

And so when dialogue happens, you're

32:43

right. It really has to come from a neutral

32:45

compassionate perspective.

32:48

And so, you know,

32:50

if there was one

32:53

takeaway. Let me draw this question out to give you

32:55

time to think about it. If there's really one

32:57

takeaway, at least in this

32:59

juncture, of your research

33:01

evolution and clinical training. If there's really,

33:03

like, one or two 2 that you want

33:05

people to take, to absorb from

33:07

this conversation? What would that be in terms of,

33:09

like, athletes and eating disorders? Oh,

33:13

gosh. Sorry. No.

33:15

And it's funny because I've been

33:17

asked that question so many different

33:20

times, and I feel like I get answer

33:22

every time because the more you should. Yeah.

33:24

The more knowledge of perspective I have, it's like,

33:26

okay. Well, that changes and for you

33:28

today. No. I I wanna say just

33:30

needs to go to therapy. Sounds

33:32

good. But no. But III

33:35

you know, in my heart of hearts,

33:37

like, I

33:37

think the more that people

33:40

take this seriously and the more that

33:42

people become

33:43

educated, like, truly educated

33:46

from

33:46

the The more that

33:49

we can take this seriously

33:51

and become an educated community

33:53

as a whole, the

33:55

better outlook we have in terms of

33:58

changing this culture in sports. Like, for

34:00

me,

34:00

I think you know, if I could

34:03

if I could leave some

34:05

impact in in my

34:07

second career, you know, as as

34:09

a clinical clinical psychologist and

34:11

not so much as an athlete. If I could leave

34:14

any impact, it would be moving the

34:16

needle a smidge with

34:18

the culture around mental health and 2 disorders

34:21

and sport. And I think the

34:23

education piece, the

34:26

overall empathy and awareness

34:28

and compassion that we

34:31

have towards ourselves and towards

34:33

others in this community, the

34:35

better chance we have at

34:38

reducing the stigma around

34:40

these concerns and

34:42

really getting people to get help

34:44

when they need it. Yeah. Well,

34:46

the good news is, in case

34:48

you haven't already realized, that needle

34:50

you have already been moving, not only from your outreach and

34:53

involvement, but the clinical training,

34:55

the research, the writing, everything

34:57

that you're doing is truly moving the needle.

35:00

So it was fun being

35:02

able to talk with you today and also

35:04

collaborate

35:05

with that. With that chapter and I hope we can stay in

35:07

touch and continue collaborating over time, especially, you

35:09

know, two athletes in this space

35:11

is amazing. And and we need more people. So,

35:13

Rachel, thank you so much for your time. I know you've gotta run because you have so much to do, but thank

35:15

you so much for coming on and being so

35:17

open and and really sharing your story and

35:20

and educating

35:22

everybody. Say. You bet. Thank you so much again for all that you're

35:24

doing too because this is not an easy

35:26

place to be and, yeah, just very grateful

35:28

for who you are what

35:31

you're

35:31

doing. So thank you. Thank you.

35:34

Really hope you enjoyed today's conversation.

35:36

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