73: Eating Disorders in Yogaland (w/Jason Nagata & Chelsea Roff)
Meat is toxic. Dairy is toxic. Eggs? As dangerous as cigarettes. Garlic stokes the hormones. Avoid nightshades at all costs. Organic or bust. Eat according to your blood type. Eat according to your chronotype. Cacao resonates with the frequency of the sun, but never, ever add sugar to it. Sugar is toxic. Juice cleanses lead you to your highest self. If you’re exhausted already, so are we. This week, Derek anchors our look at how the wellness world disguises eating disorders as purity tests and pathways to “clean” eating. He opens up about his 15-year-battle with orthorexia, an eating disorder he believes to be rampant in yoga and wellness, as well as the broader fitness world, where men hide their own eating disorders with protein shakes and ketogenic fasting. Matthew adds kitchen notes from the spiritual cult front lines. Julian talks with Chelsea Roff, founder of Eat Breathe Thrive, about her own struggles with food before discussing her decade of experience working with eating disorder victims in Yogaland. Derek then chats with Dr. Jason Nagata about the challenges of treating boys and men in clinical settings, and what to do about a phenomenon so many suffer from yet so few are able to find a language for.Show NotesThis Is What It’s Like For Men With Eating DisordersEating Disorders in Teens Have ‘Exploded’ in the PandemicEating Disorders Surged Among Adolescents in PandemicMen obsessed with building muscle mass have higher mental health risksUncovering and Destigmatizing Male Body Dysmorphia in Popular CultureDoctors alerted to dangerous dry scooping workout trendProspective health associations of drive for muscularity in young adult malesWhat Is Orthorexia?Body dysmorphic disorderFilm Theory 101 – Laura Mulvey: The Male Gaze Theory
-- -- --Support us on PatreonPre-order Conspirituality: How New Age Conspiracy Theories Became a Health Threat: America | Canada Follow us on Instagram | Twitter: Derek | Matthew | JulianOriginal music by EarthRise SoundSystem
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Conspirituality 73, Eating Disorders in Yoga Land with Jason Nagata and Chelsea Roth.
Meat is toxic.
Dairy is toxic.
Eggs?
As dangerous as cigarettes.
Garlic stokes the hormones.
Avoid nightshades at all costs.
Organic or bust.
Eat according to your blood type.
Eat according to your chronotype.
Cacao resonates with the frequency of the sun but never ever add sugar to it.
Sugar is toxic.
Juice cleanses lead you to your highest self.
If you're exhausted already, so are we.
This week, Derek anchors our look at how the wellness world disguises eating disorders as purity tests and pathways to clean eating.
And he opens up about his own 15-year battle with orthorexia.
And eating disorder he believes to be rampant in yoga and wellness as well as the broader fitness world where men hide their own eating disorders with protein shakes and ketogenic fasting.
I'll be adding some kitchen notes from the spiritual cult front food lines.
And Julian's contributions for this week is an interview with Chelsea Roth, founder of Eat, Breathe, Thrive.
They talk about her own struggles with food before discussing her decade of experience working with eating disorder victims in Yogaland.
Derek then chats with Dr. Jason Nagata about the challenges of treating boys and men in clinical settings, and what to do about a phenomenon so many suffer from, yet so few are able to find a language for.
It's one of those nights I'll never forget, standing at my kitchen counter, fervently reading the labels on every food item in my cabinets, which wasn't much.
This was soon after college in my first solo apartment, a studio above a cleaner's on a highway in Hackensack, and I was making $23,000 a year to edit crossword puzzles.
More pertinent to this story, my first love had just broken up with me and I was a mess.
I'm 6'3", but I was 159 pounds, and not really by choice, just being depressed.
And tragically, I had recently discovered the Zone Diet.
So there I am, trying to do the math.
40% carbs, 30% protein, 30% fat, when I had only graduated college thanks to a math-for-living requirement, and at this moment I'm barely able to focus to add and divide, barely living in any functional sense of the term.
Add to this the fact that I had just taken a few bong hits.
I was rushing to get some food into my body so I could make it to a concert in Hoboken within the hour, and that's when the spiral began.
I was paralyzed by indecision as what to eat, and so I chose nothing, pretending that I would be perfectly fine running on the fumes that had helped me to subsist for that day, that week, those two months leading up to this night.
As you might have guessed, I never made it to the concert.
Instead, I spend the next few hours in the emergency room at Hackensack University Medical Center, where the ambulance driver, the nurses, and the doctor all think I'm just having an adverse reaction to some unidentified drug because I won't tell them about marijuana in 1999 in New Jersey, because I know where that leads.
I can't tell them I'm having a panic attack.
The second one to put me in an ER, because the first was at age 16 and without any cannabis whatsoever.
I can't tell them because I don't yet have the language to describe panic attacks, and I certainly don't have the language to describe that the panic was coming from a burgeoning eating disorder that the weed had exploited.
I didn't discover the language of orthorexia for many years, but let's begin with a textbook definition.
Orthorexia is an unhealthy focus on eating in a healthy way.
Eating nutritious food is good, but if you have orthorexia, you obsess about it to a degree that can damage your overall well-being.
Steve Bratman, a California doctor, coined the term in 1996.
It means fixation on righteous eating.
And since then, many medical professionals have accepted the concept.
It isn't an official diagnosis, but the basic idea is that it includes eating habits that reject a variety of foods for not being quote-unquote pure enough.
Eventually, people with orthorexia begin to avoid whole meals that don't meet their standards or that they don't make themselves.
Some experts think there are similarities in orthorexia and in eating disorders like bulimia and anorexia nervosa.
So, orthorexia is not an official diagnosis, but I can tell you that it's real because I lived with it for a long time.
And I must admit, my orthorexia was certainly inspired if not sanctioned by many people I met in yoga land.
The notion of feud purity is rampant in American holistic nomenclature.
Similar to bodily purity and even purity of thought.
There's no end to the matter in which we obsessed with being pure and clean in wellness communities.
And for me, as someone who was relentlessly bullied for being the fat kid with big ears when I was growing up, my obsession centered around food.
We know that fad dieting is endless in yoga land.
Juice cleanses have only been shown to help shed water weight, and you're pumping your body full of sugar without fiber, which is the key ingredient in whole fruits that slows down the absorption of sugar in your bloodstream.
And still, this form of dieting persists and is exploited in many communities as being something healthy.
Similarly, hot yoga has been marketed as a weight loss regimen, though it has no additional benefits than any other exercise format of similar intensity, and it comes with the attendant dangers of being in heat.
The alkaline diet is another recurring fad which overlooks the fact that our blood is naturally pH balanced, unless you have kidney problems.
And of course, there's the assault of negatives.
As Matthew mentioned in the beginning, meat is toxic, eggs are toxic, dairy, nightshades.
But meanwhile, cruciferous vegetables really are toxic, but actually provoke a process called hormesis in our bodies that's healthy.
But social media leaves no room for nuance.
My eating disorder began before social media, the old way, inside of yoga studios in New Jersey and Manhattan.
I spent most of my 20s as a pescatarian and all of my 30s as a vegetarian, including two years being a vegan.
Let me preface this by saying there are plenty of healthy vegans who pursue this diet and lifestyle for health or ethical reason.
My concern in this episode isn't to denounce or champion any particular diet, because I'm not interested in those ground wars that I'm not really educated enough to discuss.
But veganism CAN be an eating disorder, as it fits the orthorexia profile for some people, and I'm putting myself into that category.
Meat became toxic in my mind, which is absurd, as is this juncture where nuanced nutritional guidance and conversations are lost.
We can talk about the myriad of issues with factory farming.
We can talk about the abundant amount of meat we consume as Americans.
We can eliminate foods for ethical reasons and still understand that veganism is not for everyone.
But we're really looking at what happens when you take it that step further and claim that meat and dairy is toxic because you're engaging in the language of orthorexia and you're creating confusion and paranoia around food.
The promise of yoga, at least to me in the mid-90s when I began my practice, was freedom, and I still believe it holds the keys to achieving the alleviation of emotional suffering.
We're still human, and we're still tribal animals, and we're certainly prone to gossip and to believing misinformation.
I've mentioned yoga instructors who've decided that they're shamans because they had a few ayahuasca ceremonies on this podcast before.
And there is precedent for the Dunning-Kruger effect when it comes to nutritional advice in the wellness industry.
Yogis who read a few books by non-certified nutritionists and suddenly believe that this or that singular diet is the right one for everyone.
It's kind of ironic, isn't it?
A culture that promotes diversity as a catchphrase, being so authoritarian when it comes to dietary decisions.
I've spoken out about my eating disorder here and there, ever since I met my wife 7 years ago and developed a much healthier relationship to food.
In fact, just last weekend while on an endurance ride with a friend who, as it happens, also suffered from orthorexia related to the keto diet, we laughed as we realized we were eating the same workout fuel as when we were kids and we actually grew up a town apart at the same time.
And that is Snickers and Gatorade.
He's not the only man I know who has suffered from an eating disorder, though at least he admits it because so few men I know do.
Food is an extremely sensitive topic for so many of us because food is so personal and because the predominant number of people who seek treatment for eating disorders are women.
Yeah, well, Julian has this great interview coming up with Chelsea Roth and she'll be giving some perspectives from that direction.
I just want to back up a little bit to the cycling scenario, Derek.
Also, I want to talk about how difficult a story that was that you just told, but I've seen your Instagram pictures.
You're on the bike.
There's this majestic picture where you're looking out over the mountains of Tibet, I think?
That would be the valley, but sure.
Okay, right.
Well, also, listeners should know that every once in a while, usually Saturdays, I think, I get an image in Slack and it's your riding app where there's a trail that you've done.
And then I zoom in on it and I'm like, oh, that's like the periphery of Los Angeles.
Like, what is...
What's wrong with you?
And you say you're excited, you're about to, you know, do a hundred miles in one go.
And so I wanted to ask, how do you know that you have now, I mean, obviously, as you say, you have a healthier relationship with food, but I mean, over-exercise is part of what we're going to be talking about today as well.
How do you know you're not overdoing it?
That is a question that I struggle with all of the time because these things came together.
As I mentioned, up until high school, I was overweight, but I was athletic.
I played every sport.
I've been a mutt when it comes to athletics my entire life.
And so there's a part of me that without movement on a daily basis just doesn't make sense.
It's been my entire life.
It is an obsession.
The days when I don't get out, my wife will be like, oh, it's going to be a grumpy day because I didn't get on the bike or to the gym or whatever that is.
But there is that nagging sense sometimes because I probably don't do enough off days.
I don't do enough restorative yoga or just lying down and recovering as much as I should.
And it's really honestly hard for me to tease apart sometimes because exercise and orthorexia did go together for a long time.
The difference is I think I'm a much Better nutritional standing right now.
For example, what my friend and I talk about when we're consuming Snickers and Gatorades is that we are riding 75, 80, 90 miles that day.
That food is not going to cling to us.
That is pure sugar.
It's like a hummingbird I think of just for us to go.
It's a lot different if that's your regular diet and you're not exercising.
So that's what I mean about nuance being in all of this.
But sometimes it is a holistic mental struggle.
It's that rush of endorphins that I get when I get out and I exercise.
think I have a better balance now than I used to because some days it will be gentle yoga instead of anything else but most days I just it's it's that rush of endorphins that I get when I get out and I exercise so I it's very hard for me to actually separate those two things yeah I think it sounds about as complicated as my own relationship to media and writing
actually which is like both essential for the maintenance of my mental health to have a proper relationship with it and it can also really be damaging to it if I cross over a certain threshold that I can't really tell where it is but But, you know, I'm really grateful that you've shared your particular story.
I think it's going to help a lot of people, and it brings up a lot for me.
Because I also have, I think, an orthorexia story, but it has different contours.
But I'll get into that.
And I like how the definition really highlights the diversity of orthorexia, which I think our differing anecdotes will flesh out, but also that there's this through line of purity, which is this very powerful blank slate concept that can carry a whole range of anxieties with it.
And, I think we should note, given, you know, our programming, it sits right at the heart of the Conspirituality Imaginarium.
Because everyone we cover on this podcast is obsessed in one way or another with purity.
For some, the thought of purity is a way of fantasizing about living in a less modern world before all of these, you know, modern disasters happened.
For others, it's a way of fantasizing about how your perfect diet will make you invulnerable from disease.
And as we've seen, purity is also a favorite fetish of the fascist mindset.
And, like, I do have a story, but also I have to confess from the outset that I also, it's really hard for me to talk about orthorexia because I have a kind of knee-jerk, judgmental ableism that creeps into my brain on the subject.
Because, to be perfectly honest, I think My initial response to hearing about food restrictions, especially if they have a precious or religious quality to them, I think it comes from my grandparents' memories of the depression.
They're bodily memories that I have and I carry.
And so the thought that to obsess over the purity of food, that's just so, like, I say internally, that's fucking ungrateful.
You know, like, you've got food in front of you, you eat it, you eat the food, you say thank you, and so there's a poverty and a class thing there.
And also, I mean, growing up in Toronto amongst the children of Italian immigrants, if you are ever over at Nona's house and she puts a plate of food in front of you, She's yelling at you to eat it if you're not eating it fast enough and not because I mean she's proud of how wonderful his her sauce is that year But there's also this urgency to it like you don't know when you're going to eat again.
It's in front of you manja, you know Are you crazy for not eating?
So I have this deep-seated attitude that I'm sure if it were to show up in conversation, I mean, I guess I'm spilling it on a podcast, but if I was in a conversation with somebody about it, it would not help the situation at all.
Anyway, that aside, my own encounter with orthorexia, it doesn't come from the same place that you're describing of Being haunted by this history of kids bullying you about your weight.
And it's not about calorie reduction or counting nutrients or body image, which we're going to talk about later.
You're describing a panic attack prompted by doing that math.
And to this day, I still blank out when people are talking about carbohydrates and fats and proteins and the numbers like it's just totally meaningless to me.
My brain just clicks off.
I don't understand it.
So, my orthorexia comes from a different place.
It's almost entirely injected from outside spiritual slash religious sources, from cultic sources.
And it happened all at once.
It happened within a month or two when I was 26 years old.
And before that, I didn't have any problem with my body or with the food that I ate until the cults I was recruited into told me to want to change.
But with my body, it wasn't quite clear what it was supposed to change into.
I was always relatively fit.
I played a lot of sports through high school, maybe not as much as you.
You described playing a lot of different sports.
For me, it was mainly baseball and basketball.
After high school, I kept moving.
I was on my bike all the time.
I've always done really long hikes.
I still do.
When I bumped around Europe, I would eat whatever was available and just be happy with it.
But then there was something in the way that this Buddhist group that recruited me spoke about a perfected body that made me doubt the value and even the reality of my actual body as I was, as it was in general terms.
And so it wasn't that I wanted to be more slender or more attractive or more well-muscled.
Those things didn't really make sense.
And like one of the first Buddhist meditations I was taught kind of speaks to this because it was to visualize my body decomposing.
It was a death meditation in some forms of Tibetan Buddhism.
It's called Chud.
And I was supposed to visualize like the shit and the piss and the pus just leaking out of me after I had expired while my muscles crawled with maggots because the idea was that this organic body itself was nothing to be attached to.
So going to the gym was pure vanity.
And so, as I think about this now, that could have led to a more healthy or at least an ambivalent relationship with food, as in, like, we're all dead meat anyway, let's get on with it, eat what you have.
But that's not what happened, because we were taught that the rotting organic body was a kind of mask or a disguise over a potentially awakened subtle body.
And the idea was that, you know, the bodhisattva or the yogi had an energetic body that could be accessed, woken up, enlivened through purification to develop some kind of exquisite internal sensitivity and then eventually like superpowers of compassion and service.
So, my first cult leader, Michael Roach, was totally fixated on something called the rainbow body.
And he wasn't talking about gay pride or anything, but what was described in the Tibetan Book of Life and Death, like how to prepare for death by meditating on the dissolution of the elements of the body in layers that were all radiating with these particular colors.
I think five of them, but I can't remember what they were.
I was going to look them up, but then I just didn't bother.
So, if you attained a rainbow body, you would be able to offer limitless help to all sentient beings, as they said.
And so in order to support those fantasies, I was told to radically change my diet.
And so I did it.
I became vegetarian, like overnight.
I stopped drinking alcohol.
I never drank much, but I stopped.
I cut out caffeine.
It took me a long time to cut back on sugar because as I understand the chemistry of it, if you go through a shift in protein intake, you You might become protein deficient in ways that lead to sugar cravings.
I'm not sure about that.
That seems to make sense.
But, you know, the group of us were all sort of instantly religious about these changes to the point of us that a lot of us were terrified to break the diet.
And the weirdest, dumbest part of it was that I always felt worse.
In my body, like very particularly in my digestion.
And I don't know how much TMI we're doing on this episode, but for like two or three years of strict vegetarianism, I had chronic gas, probably IBS.
I never got it diagnosed.
My joints cracked, my body ached all the time.
Also, I became more of a social isolate, not just because of the gas, but because like there were just There's fewer and fewer people I could feel comfortable eating with, so I'm ashamed to say also that my dietary ideology, I used it to justify feelings of alienation from my parents.
And so cults are really effective that way, in these material ways.
So, then, you know, the last thing is that I was taught to interpret this clear decline in health in the same way that many of our favorite conspiritualists were taught to interpret getting sick with COVID, which is, this is a purification.
It's a test of character, a dark night of the soul that would lead you to transformation.
It was totally insane.
Since we're sharing, I dealt with IBS as well, and we'll leave it at that, but it changed when I went from being vegan to eating meat again, and I haven't had those issues.
It's quite tremendous, and that was actually why I changed, because I had chronic bowel issues for a number of years, and I had heard some podcasts where people talked about the shift in the diet, which I did, which helped to Cure that.
I don't know if you want to say cure, but stop that.
And it's been, what, six or seven years now without any issues that I used to suffer from.
I also want to point out, I'm glad you brought up the fact that the grandparents in depression, because we're the same age and my grandparents went through it as well and had the same exact attitudes.
And that is another layer of what we talk about all the time when we talk about unconscious privilege in these communities.
How if you can afford to go to, we have a market in LA called Air One which is just ridiculously expensive, and if you can afford to go there and your purity is coming from eating those $25 shakes that you're getting at Air One or you're enhancing supplements or whatever, It's really hard to tell someone the level of privilege that they're experiencing that that is their nutritional intake.
The owner of Moon Juice experienced that when she talked about her own regimen one day, her dietary regimen, and got slammed for it for that very reason.
But when you're in the middle of it, people don't recognize it.
And it also speaks to the challenges of This topic, and I've brought it up, as I said, over the years, but I've predominantly brought it up in research and occasionally sharing, but mostly about just the topic itself.
And people would say, this mostly affects women, why are you talking about it in a negative way?
I have to talk about it from a personal way because I've experienced it.
And the reality is, 1 out of every 3 eating disorders affect men, but only 1 in 20 treatments are for men.
Yeah, that's wild.
Yeah, I'll talk to Jason Nagata about that in a little while.
But this disparity is baked into our culture.
So I'm not going to pontificate on the many downward pressures that affect women and their body images, because I know that they run deep and have persisted for thousands of years and perhaps longer.
But I can speak confidently about the social pressures on men.
For years, fashion magazines were criticized for unrealistic beauty standards due to Airbrushing photographs, for example.
But now that those editing tools are available on every phone, new avenues for body dysmorphia appeared.
And that's really where women suffer from it, but men do as well.
So, again, let's get clinical about what dysmorphia is for a moment.
So, body dysmorphic disorder is a mental health disorder in which you can't stop thinking about one or more perceived defects or flaws in your appearance.
A flaw that appears minor or can't be seen by others, but you may feel so embarrassed, ashamed, and anxious that you may avoid many social situations.
When you have body dysmorphic disorder, you intensely focus on your appearance and body image, repeatedly checking the mirror, grooming, or seeking reassurance, sometimes for many hours each day.
Your perceived flaw and the repetitive behaviors cause you significant distress and impact your ability to function in your daily life.
We know how this manifests today.
Social media is not benign.
Two weeks ago, Facebook was under fire for internal reporting that revealed that teenage girls experienced increased suicidal ideation due to body dysmorphia from using Instagram.
But this, again, points to the problem.
The media focused on Senator Blumenthal's bumbling of Finsta accounts.
But we have to remember that Instagram admitted that its algorithm promotes pro-eating disorder content, despite the fact that it's supposed to be banned.
And just September 2020, TikTok also admitted to suppressing posts by ugly, poor, or disabled users, as well as promoting weight loss ads.
So, excellent reporting by the Wall Street Journal revered issues around teenage girls, yet it barely discussed teenage boys.
But some reporting by the New York Times in April noted that eating disorders in teens, often influenced by social media, has exploded since the pandemic began, another topic I'll discuss with Jason Nagata.
His team actually led the research on that topic that the Times covered.
While the focus of the reporting is again on teenage girls, I'm going to speculate that part of the reason teenage boys didn't report as high of numbers is because we still don't have the right language for eating disorders in men.
And there's no single reason for this uptick in eating disorders.
There's food insecurity, which you brought up, Matthew, during this economically tumultuous time.
Online schooling is part of it, because it's a poor replacement for the social connections kids get at actual schools.
And then there's social media when you're stuck home all day, and that is not limited to children, as we know.
But this paragraph in the New York Times reporting nails what generations of us have endured through our evolving forms of media.
And let me just note that the Dr. Austin in this quote is epidemiology professor S. Bryn Austin at the T.H.
Chan School of Public Health.
What young people find when they go looking for fitness information can be highly problematic.
They're likely to come across harmful thinspiration and fitspiration posts celebrating slim or sculpted bodies, or even sites that encourage eating disordered behavior.
Worse, algorithms record online search information and are deliberately designed to feed harmful weight loss content to users who are already struggling with body image.
Such as advertisements for dangerous diet supplements, Dr. Austin said.
Supplements.
So here we are again.
I'll get to that in a little more detail in a moment, but let's look at a little bit of data.
The Eating Recovery Center, which is a private network with 30 clinics in 7 states, experienced a 90% increase in new patient calls.
In January, February of this year compared to the previous year.
And according to one of their doctors, this includes 10-year-olds.
Dr. Nagata told me that one way this manifests has nothing to do with food, but as you mentioned, Matthew, excessive exercise.
He's had patients that spend six hours a day in the gym.
I remember in my years at Equinox that there were some members who We talked in terms of behind-the-scenes management about some of the members being a little unhealthy with how long they were there, but there was nothing we could do as a gym.
There really, again, there's no language for talking to people who are paying you to use their facilities to be like, hey, are you eating enough?
Are you working out too much?
Those conversations are really, really challenging.
And that's the exact entry point for many boys and many men to both body dysmorphia and orthorexia.
Body image disorders affect roughly 1 in 50 people, so that's nearly 6.5 million Americans.
Interestingly, the Anxiety and Depression Association of America found that body dysmorphia specifically affects more men than women, 2.5 compared to 2.2% of the American population.
But how does this manifest?
Experts note that women trend toward thinness, but men seek muscularity, and this is one reason why eating disorders are hidden in plain sight when it comes to men.
Conditions like anorexia and bulimia are easier to spot than muscular gain.
Sure, being waif-laif is often sanctioned in our culture, as is the thin waist, large hips, large breasts trend thanks to the Kardashians, but ripped abs and huge biceps are defining features of modern masculinity, and achieving those often requires an unhealthy relationship to food and massive amounts of supplementation.
And the desire for bigger muscles could fund a nation, as projected, revenue from the U.S.
protein supplement industry is predicted to reach $9.8 billion in the next four years.
This surge has led experts to consider bodybuilding addiction to be a new form of eating disorder, and this is a disorder that's woefully underreported because of lack of credible research in male psychology and body image.
Even still, 60% of boys self-report manipulating their diets to be more muscular.
And of course, big muscles also imply low body fat, which is why the ketogenic diet exploded.
Remember, this diet has been studied extensively in overweight and diabetic patients, but not in the general population.
That hasn't stopped hundreds of crafty food manufacturers from marketing their foodstuffs as keto-friendly.
Body dysmorphia not only affects muscle size.
A 2018 study from researchers at Norwegian University for Science and Technology and Harvard discovered that boys and young men obsessed with muscle mass are at higher risk for depression, weekend binge drinking, steroid use, and eating disorders.
And this drive is relentless.
While reporting on this story, I came across the dry scooping challenge, which is what my first inaugural TikTok video was about, which is this trend that some men obsessed with muscle gain are eating protein powder or pre-workout powder instead of diluting in water.
And to be fair, I've also watched a number of young women do it, either while working out or just to hop on a trend.
And I had to turn my phone off after about a dozen videos, it was that disturbing.
And since some of these pre-workout powders contain the caffeine of five cups of coffee in one scoop, reactions of swallowing undiluted dry powder include spikes in heart pressure and heart rate, which could cause heart rhythm problems and even heart attacks as happened to one young influencer, as well as lung infections and pneumonia.
Even still, the 30 top TikTok videos of dry scooping has resulted in more than 8 million likes.
So incredibly gross.
And it also I mean, the dry scoop, dry scoop, it goes back.
Historically, I think there are some antecedents for this.
We have lots of examples of strongmen doing conspicuously gross eating.
I mean, I think I've seen photos or read accounts of sumo wrestlers in front of their lunches and they're supposed to be eating, you know, conspicuously in public.
Then there's Josh Goldstein, friend of the pod, the raw meat guy.
I did a bonus episode on him.
He likes chugging a dozen raw eggs on Instagram Live.
And, but yeah, it does go back.
I remember reading about wrestlers in, I guess, pre-modern India, but I think this continues through to the present day.
They used to publicly drink like 10 liters of whole milk.
And then they would like crush a kilo of almonds into almond butter with their fists and just sort of gobble it up.
So, you know, and then they drink, like, two cups of ghee straight out of the, I don't know, out of the puja cup or whatever.
But the thing that's left out of these displays is, like, the other end.
They're eating all of this stuff, but they're not really talking about elimination.
It's not about shitting.
It's always about, like, superheroes who are consuming everything they can, and it's like they're digesting the entire world.
It's a real sort of show of force.
But the gym stuff is so amazing to me and really foreign.
I never got into it.
And the concentration on specific body parts and movements and muscle groups and so on is really specific.
I know that when guys get into this stuff, they get really, really concentrated on body fat percentages and specific muscular displays.
I've seen these IG Reels where I've come across bodybuilders doing something called the quad stomp where they just bust out the definition of their quads in competition and it's kind of like watching alien pop out of a person's body in the form of these ropey muscles.
But, you know, continuing on my slightly offbeat take here, I feel that during my period of orthorexia, the dysmorphia I had, this general feeling that my body didn't look correct or adequate, it was likewise vague and unfocused.
There was this abstract Buddhist aspect to it, but that was before... I think there was something earlier than that.
It was tangled up with this thing that was much more gendered and went back in my history, and it was related more to, I think, the male gaze that I was taught to have in the boys' school that I grew up in.
So, maybe some listeners know this term male gaze.
It's coined by the British feminist film theorist in a 1970s essay called Visual Pleasure in Narrative Cinema.
The feminist, the theorist's name is Laura Mulvey.
And she argues that women in media images are viewed from the eyes, most of the time, of a straight man and then become the passive objects of male desire.
And following from that, she argues that the female viewer may experience the image and story by identifying with that objectifying desire.
And so it puts women into this hall of mirrors in which they really are deprived of agency.
They are gazed upon.
And I believe that I was so governed by this as a boy, as an operator, as somebody doing that, and as a young man, so captured by gazing like a male or as a male, that I hardly knew what I looked like.
Like, the visual world that reflected my body in school around me was militarized and homogenized.
Like, we all wore the same uniforms.
It didn't really matter what we looked like, so much as that none of us stood out.
That was the important thing.
None of us could really look that different.
But then the visual world outside of that was completely different.
Like, just a carnival of the objectification of women's bodies.
uh, in advertisements and everything else.
Like in highbrow form, it was movies in lowbrow form.
It was, you know, the transgressive or even abusive forms of pornography.
And so I think I didn't have a clear sense of what my own body was because my attention was constantly being snatched outwards.
Uh, I was being told to gawk and obsess over outside things.
Now, I don't know if that's a form of dysmorphia, to feel like your body is nothing, like you're not even there, but it seems to blend with a theme a little bit.
And it also makes sense that when I did become orthorexic, it wasn't that I was trying to have the perfect body.
Because, as I said, I didn't really have any notion of that.
Michael Roach, for example, wasn't particularly athletic.
He was tall.
I think he was pretty muscular.
You could see that he wasn't overweight or anything, but it was also clear that he basically never slept and that his personal hygiene left a little to be desired.
So, you know, it wasn't about emulating him or anybody in a leadership position.
There was nothing in my sphere of influence that made me want to become more attractive.
In fact, the encouragements were all the other way.
They were to not think of that at all because if you were thinking about your attractiveness, you hadn't renounced pleasure or, you know, the egotism or the acquisitive self or something like that.
So then, like, what was I trying to do with this body that didn't really exist but that I needed to improve?
It's like, I was thinking about it this week, it's like I was treating my body like some kind of musical instrument and that if I could polish it and remove all of the fingerprints and make sure that none of the strings were frayed and if I could make sure that everything was tuned really well that somehow either I or some future version of myself would play that instrument and that a sound would come out that would be so like unearthly that everyone would know that I was enlightened.
So, the micromanaging actions that I was taking to purify, so you take a little spoon of herbs here, you add a little bit of ghee here, you make sure that your plate of food has all of the right colors on it, you sprinkle on this digestible herb blend.
Each one of those actions had the same kind of fiddly, micromanaged quality that you see carried out by people who are making pianos or guitars or something.
It was like I was tuning an instrument, but for somebody else to play.
When we were planning this episode, obviously I took the lead on it, but at first you said you didn't know what you'd have to contribute.
But a moment ago you were saying it's not on theme, but it really is on theme.
I'm so glad to be having this conversation because it talks about the holistic nature of the problem because we are entering this issue from two very different places and yet it's still the same issue.
I mean, we can talk about dualism and the separation of body and mind and partly how that helps facilitate issues like this, but when I was a vegan, I was working at Equinox.
I worked for them for 17 years as a group fitness instructor.
And the partner, my friend, who I created a signature program with for Equinox was vegan, and he very much influenced me to become vegan, which was fine.
It was not a bad relationship in any way.
He's still a friend.
But the what was fascinating was Equinox signature classes.
It's kind of like for a group fitness instructor.
It's Equinox saying, OK, we're giving you we're spotlighting you.
And here we're putting you on this pedestal to create your own format.
And then we're going to push this out to all of our hundred locations or whatever.
And we're going to do a lot of press around it, which, you know, as again, as as one of thousands of instructors, that's a big deal.
And it was a really cool program.
But something I noticed was interesting.
Usually when they launch them, They'll do all of the photos with the instructor structure to feature them.
And most of the instructors will be muscular and ripped or whatever.
They didn't do any photos with me or Philip.
We didn't fit that physical mold.
They didn't invite you?
No, they didn't invite me.
They invited me because it was a yoga and music and neuroscience programming class that I launched.
But physicality, we didn't fit their picture of what they put on all their advertising.
So, imagine I'm going through this dysmorphia, I'm going through orthorexia, I'm vegan at this time, and then that happens and I'm thinking, okay, I've worked here for a decade, I'm finally getting this push of being recognized for this specific niche that I've created at this organization.
And they're like, yeah, we'll take your brain, but we don't care about your body.
And that doesn't actually help with what I was going through.
Now, I want to be clear.
We talked about grandparents and stuff.
I mean, I very much grew up in a pull-yourself-up-by-the-bootstraps, I know the term is ridiculous and doesn't make sense, but that idea mentality.
And I will always put part of the weight of this on me.
That's why I'm not naming names in this episode.
It's not about that because so many people deal with it.
And I do take some responsibility for this, but the environment that I was in was not conducive for people who are in more fragile mental states, um, as I was at that time.
Uh, and that is really like part of the crossover when I hear about, you know, when you say about Michael Roche, um, you know, maybe you didn't have the designated image in your mind, but it's still that same, it's the same sort of club that you're, you have to enter just coming from different avenues.
Yeah, I mean, it's funny, like, there would have been no photo shoot in my Buddhist cult to get me into or out of a club or make me feel included or excluded, but it was this sort of feeling around the people who were doing it correctly that their bodies were somehow radiating.
With something that I was supposed to have but I couldn't really describe it So yeah, as I say, it was very fuzzy and very abstract, but it had very real-world Impacts in the sense that like on on, you know three meals a day.
I was I was Doing something that was odd to me and this is another thing that I wanted to bring up was that like I If you were to ask me what my diet is now, I wouldn't really be able to describe it very well because I've pretty much returned to what I feel I grew up with, which is... Snickers and Gatorade.
Well, no, not that so much, but I would just say sort of like a broad North American range of common foods.
I'm an omnivore now, but I guess the feeling that I have around Food is the feeling that I had when I was growing up in my parents' house, which is that this is what is being prepared, this is what is available, and it's really good to enjoy having it, and not too much if you can help it.
And so there's this sense of normalcy, like I don't really have any programming or ideology around food at all anymore.
I think that I feel very allergic around the notion that I should or that...
Or that I would pick something up like that again.
It gives me the prickles.
Well, I'm glad to see we've both kind of landed in the same place because that is my relationship.
My wife and I, predominantly my wife cooks because she's fascinating, a fantastic cook, but that's exactly where we've landed.
And I think that's the healthiest relationship.
As I said a moment ago, I'm not going to name names, but I do want to ask this of The listeners, if you're an influencer, if you follow influencers, or if on your Instagram feed you have a downline where you're selling supplements, this is really just a purely honest question.
Do you really know what's in the things that you're selling?
Do you know the research beyond whatever is on the marketing site of the company that you're shilling for?
The answer could be yes, and that's wonderful.
But do you know that if you've taken the supplement for a couple days, anytime you take a new substance or you switch diets, you're going to feel differently, right?
So, maybe it's just that placebo effect, or maybe it's a quick response, or maybe your brain was primed to think from the marketing site.
that this substance was supposed to have this effect.
And so therefore you help to promote that because the sales of supplements is the crossover that's pertinent to yoga land, the wellness industry, and the fitness industry.
If you look at the link trees, you're going to uncover discount codes to any number of amazing life transforming products, essential oils, reishi mushrooms, and with the growing microdosing industry, other mushrooms soon enough, ashwagandha, collagen.
I mean, the list is endless.
And embedded within these downlines are the notions we're returning to, which is purity and cleanliness, that this or that product will finally bring you the healing you've been waiting for.
It's going to magically remove the psychological and emotional chains that have been holding you back all along.
And embedded within that mindset is the notion that you've been doing it wrong all along and here I am to save you.
To supplement is to complete or enhance something else when added.
The vast amount of supplements sold on the market are really unnecessary for good health.
It's this time that we live in of excess, and one of them is our food supply.
There's so much food always available that we forget how fortunate we are to have this many opportunities to eat for so inexpensive a cost.
But insecure animals that we are, some of us tend to focus on what we lack instead of what we're inundated by.
The paradox of choice is the paralysis of indecision fostered by too many decisions.
And for most of history, humans didn't have a lot to say about what they ate, which is why I find both optimization and toxicity marketing around foods and supplements so frustrating.
Unless you're vegan, most diets will provide you with the necessary macronutrients and micronutrients you need to live a healthy lifestyle.
Diet is never just about the food you put into your body, but also environmental factors as I've mentioned.
Add in movement regimen, add in sleep levels, add in stress levels.
There's so many things that actually could factor into what your diet is doing to you.
When you have a world of food options available at any time, And when you're influenced by the toned person on Instagram declaring this food is impure, or this powder will make you smarter, trimmer, larger, or simply better, it's easy to understand how so many people have become so disconnected from their bodies that they'll buy into all sorts of false advertising.
Yeah, and I want to briefly add a political economy point here, which is that, you know, I think we should acknowledge that in a world that is both, like, micromanaged by technocrats and yet thoroughly beyond our understanding and control, That consumerism itself can provide this kind of facsimile of controlling one's environment and destiny.
And consumerism is about consuming, of course.
And so, you know, what easier way to feel that you have some fundamental but also intimate control over your life than by shrinking your concern down to, you know, the 30 feet of digestive tract between your mouth and your butthole?
And, you know, the other thing I was thinking was that, like, when you were mentioning, I can't get this image of teenage boys in the gym for six hours at a time.
And I'm thinking about how we wouldn't have gyms were it not for the physical culture movements of the 19th century coming out of Europe and how fitness was really invented actually as a stand-in for national health and virtuous citizenship or a promotion of these virtues.
During an industrial age in which it was feared that, you know, people generally who were from the global south were going to out reproduce.
So there's a lot of weird bodybuilding physical culture stuff that's rooted in white nationalism in Europe and we've covered a lot of that.
But the thing that that physical culture always did have was some kind of social project.
Now it might have been the wrong social project.
You know, in the sense that nation building is not what we should be doing as we do our jumping jacks, but I'm just thinking that for today's Zoomer kids who are in the gym six hours a day, I wonder what that could be attached to that would give it meaning and perhaps lessen the necessity to do it.
Do you know what I mean?
Because there might be an addictive quality to the overexercise itself, bodily dysmorphia might be at play, but also it's like, What is it for?
What does it represent?
What is it building?
And is it helping you connect with people?
Because I think if those elements are gone, and the fascists were really good about that, good at that stuff, by the way, but the right kind of those connections and meanings might be really helpful.
I've always connected – no, I can't say always, actually, that's not true.
More recently, with this healthier relationship to food and my body, I've related my physical workouts with my mental processes, with my wanting to, you know, create and Spread the messages in this podcast with my full-time job and what we're doing there, like the drive to continue to get better, to self-educate, to learn, to grow, that is just as mental as physical to me.
So what is healthy, what you mentioned about Being in the gym for six hours aimlessly when the goal is only to have this sort of body that you crave after from watching other people, that is, I would argue, not the best way to go about it.
Right now, I am training to do a century, as you mentioned, 100 miles on the bike.
I made it 90 two weeks ago and I got a little bit overheated and I had to come home.
But that was a learning experience.
But what I'm saying is there's a goal here.
So I'm training specific to something that not only helps me to attain that thing, but also just helps my psychology to be able to focus for that sustained period of time.
It makes me think of how high school sports, especially in the States, well I think it's true of hockey here in Canada, but I'm thinking about how football for boys has functioned, has this social function of quote-unquote character building, and I don't know if that's part of...I'm not hearing that as being part of gym culture.
Maybe it's part of CrossFit, where there's this group activity aspect to it.
But this is part of what I'm getting at, is that a lot of the things that you're talking about seem extremely isolating and kind of halls-of-mirror-y in a way.
There's community building in every sport, I would argue.
I mean, with cycling, there are all these riding clubs in Los Angeles.
I just like riding alone or with one friend because I like to talk to them.
I'm not big on group rides, but I think it's awesome that that exists.
When I go to some of the stores, there'll be like 20-25 bikers out there getting ready, and that's wonderful.
It's a social circle.
And again, it just points to the nuance of this entire conversation.
There are many eating disorders disguised as being healthy and kind of vice versa.
I mean, there are many avenues to being healthy, but if you have dysmorphia or an eating disorder, it's not going to manifest in great mental health, which is just as important, like how your body looks or acts.
I thank you for sharing this conversation because it's a tough one to have and I'm sure that some listeners relate.
It's one of those topics where when I bring it up, people are like, yeah, that's me too.
I suffered from recurring bouts, I would say, of orthorexia for 15 years.
It wasn't there all the time, but it would flare up in a sense.
And I'm only just now developing a better language to understand what I went through in large part thanks to all of the work we've done on this podcast and really drilling down on what these spiritual ideas and these wellness and fitness ideas really mean.
My hope is that as a society we find a better language for identifying and treating eating disorders in men, which is going to be a challenge in the hypermasculine media culture we're currently immersed in.
But I also hope that we can change the language of shame around both men's and women's body on social media while also facilitating positive conversations around health.
These are not easy conversations to have, especially given how emotional the subject matter is.
We're drilling down into the core of identity when asking someone to consider their body image.
But right now, we're moving in the wrong direction in a time when there are so many other fights that need to be fought at this moment in our culture.
And to borrow from the positive language of yoga, we need strong warriors out here.
Chelsea Roth, thank you for joining me on Conspirituality Podcast.
It's good to be here with you, Julian.
Yeah, so we go back a long way, you and Derek and I, and the last time that I interviewed you for another podcast, we talked in depth about your own eating disorder history and your perspective on the intersection with yoga as a kind of a double-edged sword.
What would you like to say to new listeners just to sort of establish who you are and what you do?
Sure, yeah.
I think in terms of what I do, I'm the founder and director of a non-profit organization called Eat, Breathe, Thrive.
Our mission is to prevent and help people recover from eating disorders and we use yoga in combination with Psychoeducation and therapeutic approaches to support people in that process.
We do that work in schools, hospitals, and community settings.
Like you said, I struggle with an eating disorder in my teens, so I come to this, you know, with like inside humanistic knowledge of these issues.
So, I'm thrilled to be talking to you about this today.
I'm so glad that you're bringing it to attention on the podcast.
So as you said, you've been working with yoga as a clinical adjunct to eating disorder treatment and recovery through your nonprofit called Eat, Breathe, Thrive.
What have you learned and has anything been surprising to you during that time?
That's a good question.
What have I learned here?
You'll have to narrow that question for me a little bit.
I've learned a lot over eight years.
Well, I think in terms of narrowing it down, part of what I'm really curious about for our listeners, you know, of course, there's going to be a lot of people who are in the yoga community who listen to us, is that intersection between
Yoga and eating disorders because I know there's a way that you use it that's beneficial But I think there also have been ways that you've seen some of the sort of shadow side of that connection Yeah, I'm reminded as you were just speaking there Julian about a conversation we had in advance of recording this when you were asking about my time running the you know running courses in in treatment centers and asked if there was any
Anything surprising and one thing that I think would surprise most people about that intersection of yoga and eating disorders is yes, this practice can be tremendously beneficial as an integral part of treatment, but I mean, many clients that I see in treatment centers are not only yoga practitioners, they're yoga teachers.
And these are people dealing with, you know, life-threatening eating disorders often.
Anorexia nervosa, bulimia nervosa, and they're severe enough that they're in an inpatient treatment center.
I would invite anyone who thinks that you know going to a yoga practice or discovering the practice is going to somehow save you from an eating disorder to really consider that because I think if If that were true, we wouldn't see so many people that are deeply immersed in this practice also struggling with mental health diagnoses.
I'm curious how you then sort of differentiate the ways in which a practice like yoga could be helpful in terms of treatment and recovery versus the ways that it can be sort of folded in to the eating disorder, right?
I mean, the ways to get nailed into it, the ways that I see yoga being really helpful as a complement and as an adjunct to treatment There's some
Treatment is really treatment being you know you go up you and there's many levels of treatment you can go and get outpatient therapy for an eating disorder you can go and even do day programs where you're at a treatment center all day long but you go home and sleep in your own house or you if you're you know if you're dealing with a pretty severe eating disorder you might be hospitalized in a residential or an inpatient treatment center.
Those treatment approaches are tremendously good at I would say getting people to a point of stability where perhaps they're not engaging in behaviors that are so, so severe that they might be putting their cardiovascular health at risk, right?
Starving can throw off your heart, purging can throw off your heart, so they might kind of help you to eliminate some of the behaviors, help you to rethink some of the thought patterns, but often people get to a point as they get out of treatment Or even while they're in treatment where they're almost kind of mechanically going through treatment where they're like, okay, I'm going to apply the cognitive behavioral thinking strategies.
I'm going to follow this meal plan that tells me what to eat at 9am and then at 12pm it tells me how many calories and how many carbs to eat.
But there comes a point where it's like, okay, I've gotten to this far.
I may not be acting out in the eating disorder yet, but every part of me still wants to and I don't know how to actually reintegrate in life as a person that doesn't use food and body as a measurement of my value as a human being.
And that's where I see yoga coming in.
So many ways yoga can be useful.
I'll give you two just as kind of to give some color, some examples.
One is interoception.
Yoga, if taught with this intention in mind, can be tremendously useful in helping people sense what's happening inside of their body.
That's what I mean by interoception, right?
So we're in yoga, you invite your, you know, you're invited to take a deep breath and maybe you start to take a deep breath and it's notice what you're feeling in your right leg and your Okay, interesting.
There's a stretch there.
Oh, there's a little bit of burning there.
All of that is interception.
It's noticing what's happening inside of the body.
You can imagine for somebody who cannot sense hunger or cannot sense fullness, Because they've been ignoring those signals for years, that is really useful.
So yoga can help people rebuild hunger pathways, rebuild fullness pathways, really have a more embodied experience as they move through their day without even having to think about it.
It becomes kind of second nature with good practice.
Self-regulation is also a big part of it.
I know you well enough, Julian, to know you know what I'm talking about.
There's so many practices in the yoga tradition that can help us deal with the same very states that drive an eating disorder, panic, anxiety, low self-worth, all of that stuff.
There's so many practices, really simple practices often you can do in five, 10 minutes that can change your state enough that restricting your food, purging your food, using laxatives is no longer such a kind of attractive way to feel better.
Yeah.
And then in terms of the shadow side, I mean, it's easy for me to imagine that there's something about the regimented discipline and the sense of like showing up consistently on your mat and, you know, like gaining mastery over your body.
There's a way that that has probably a certain resonance for people who suffer in this way.
That's so true.
And, you know, I'll say in some ways, It's a problem and even as an organization I use that attraction to our advantage.
We have courses that we've just simply called Yoga for Eating Disorder Recovery because I'm fairly direct.
And those courses, you would not believe it, they fill up immediately.
We don't do any search engine stuff.
People with eating disorders are really attracted to the idea that yoga can be That they're allowed to do yoga, that yoga can be helpful in recovery.
Yeah.
So I try to use that kind of attraction to this practice to our advantage and then maybe deliver them something they're not expecting.
But what you're speaking about a little bit, you know, often I think that there is, I see it with our population.
There are a lot of folks with eating disorders that are really attracted to the practice of yoga.
I think part of it might be the regimented discipline.
One is quite simply, it's exercise.
So, of course, if you've got a population of people that don't feel comfortable in their body, don't feel good about themselves, want to fix and change their bodies, you know, feel any of that stuff, any type of physical exercise is going to be attractive.
Yoga also adds this elusive promise of transcendence of one's suffering.
Of self-understanding, of self-worth, self-value, self-acceptance, which of course is something they're deeply wanting in the midst of that suffering.
It was what I was deeply wanting in the midst of my suffering.
That's why I went to my first yoga class, because I wanted to flatten my abs and there was something very attractive about no longer hating myself so much.
But when I got there, of course, I found what you spoke to, which is a really disciplined practice, which kind of Yeah, so that brings us then to the question of this term orthorexia.
that really like things to be orderly.
I found detoxes and cleanses that were like, oh, just drink these juices and all that kind of stuff.
And many of those energetic imbalances will be gone and you'll have clear thinking.
And I found all of those things, which my eating disorder loved and probably were not tremendously useful in my recovery.
Yeah, so that brings us then to the question of this term orthorexia.
Do you find that orthorexia is at play in the population you work with in terms of how you understand that concept.
Yeah, it's a good question.
You know, orthorexia has become a really popular term over I'd say the past decade, if not a little longer.
It's interesting because orthorexia is not actually a kind of recognized clinical diagnosis.
It's not a diagnosis in the DSM, which is The manual psychiatrists and mental health professionals use to diagnose mental illness.
It's not in the ICD either, which is more popular abroad as a means of diagnosing illness.
But I think that term, which was actually coined in a research paper, was looking at this phenomenon of people that were very obsessive about health.
So much so that it was It was interfering with other areas of their life, their social life, their emotional life, their job life, their financial life.
They were so obsessed with being really really healthy that all of these other areas were getting quite dysfunctional.
So that's where that that term was coined.
While it's not a clinical diagnosis, I think it's a really useful term to Identify and explain a phenomenon that you and I are very familiar with, and I think anyone listening, it's why it's taken off so much.
It's like, oh, I know those people in my life, or I know that in myself.
I know what that was like for me when I was so obsessed with eating the most pure, organic, clean, you know, untouched foods possible that I couldn't go over to a friend's house and be served a dinner.
Because I was so obsessed with that.
So do I see that in the population I work with, which is eating disorders of all kinds?
Yes, definitely.
Especially in anorexia.
Especially in bulimia.
Not so much in binge eating disorder.
And I would say I see it a lot in what I would call the subclinical disordered eating.
So maybe not a diagnosed eating disorder, but people that are really struggling with their relationship with food.
And I guess last thing I'll say is I see it a whole lot in the yoga community.
And it's celebrated!
Yeah, you know, it really reminds me of times here in LA where I would go to events at like raw vegan restaurants, right?
And the whole, all of the propaganda, all of the advertising, all of the brand identification was that you're eating living food and you're radiant and you're super healthy and this is how, this is, you know, you're in touch with nature, all of that kind of thing.
But the patrons that I would see there, I'd always be like, these people look emaciated and pale and have big circles under their eyes.
And I'm not seeing this image of radiant health.
I'm seeing people who seem to me like they're starving themselves and are sort of puritanical.
Yes yeah and that you took the words right out of my mouth because that's what's what interests me about this phenomenon of orthorexia is that it's very often a disguise for real suffering and real pain.
I mean I use the word suffering often because I've got Buddhist leanings but I would say You know, often the same people that are showing up to those events and, you know, bringing raw, organic, you know, gluten-free, all of these vegan foods.
Purity qualifiers, right?
Yes, exactly, exactly.
They're being celebrated by their community and getting validation, social validation, a place in the community, all of that.
And they might even be disguising it to themselves.
Both to their community and to themselves that actually they're not getting enough to eat every day.
And actually they're thinking way more about food than about their relationships, their job, their emotional health, their physical health, if that's what's showing up for them.
That it's become sort of for fixing fixing something that feels broken within them that you know i mean i would say is probably not broken at all but that that's what worries me is that the community can glorify it and celebrate it and it may be disguising you know a real issue that can
So in terms of this somewhat broad spectrum that we're discussing here of different types of disordered eating, do you see differences in how these issues manifest between men and women?
Yes.
100%.
And I would also just point out that I also see differences in how it manifests in people who maybe don't identify in as a man or a woman or have, you know, changed gender, identify somewhere on the spectrum, or Maybe we're born as a male but identify as a female.
So, the intersection with the transgender experience is really interesting as well in terms of how disorder reading shows up.
You know, if somebody shows up in a treatment center, I'm sorry to go off on this tangent for a second, but it is important.
If let's say you have someone showing up at a treatment center that says I really want to lose weight, I've got too much fat on my body, you know all of that that can look like anorexia, it can look like a restrictive eating disorder, but for someone who who's transgender that identifies as male but maybe was born female that you have to go okay Is there something else going on here from an intersectional lens?
You've got a lot to think about in terms of gender.
I think in terms of men versus women, I think more than anything I see men not really having space to talk about it in a socially acceptable way.
It's pretty socially acceptable For women to say, I don't feel good about my body.
You know, I really want to, I really want to change the way I'm eating.
I want to go on a diet.
I want to do all of that.
I think it's less socially acceptable for men to say, I'm really struggling with how I feel about my body.
I don't know how much you interact with men in your, you know, in your work.
When you do, do you find that you use different languages to talk to men or women around these issues?
How much I interact with men in this work depends on where I'm teaching or where the program is being offered.
In clinical settings, in treatment settings, I tend to see far more men.
In yoga studios and community centers, I tend to see far fewer men.
When you say far more men, you don't mean than women.
You mean just the percentage of men that are there is more?
Oh, yes.
No, no.
I mean more than in a yoga studio, more than in a school.
Not more men than women, although I have taught programs with 50-50 before, which is I think a reflection of how good that treatment center is at ensuring there are men on staff, male psychologists, male social workers, male nutritionists, which creates more space for men to come in and be able to be open and you know I think leadership in any company creates access always.
I think that's really interesting because you're sort of in both of your in the last minute or so, you're really flagging a kind of taboo, it sounds like, around men acknowledging that this is a thing.
Yeah, well, I'm tagging a huge taboo because the second bit of that answer is anywhere we run community programs, so in yoga studios, in community centers, now online via Zoom, we collect data, we collect demographic data, and we skew between 90 and 95% women.
And we've got a big sample size, so it's a lot of women and we've talked about that data as a team a lot.
We've got male facilitators, we have men that lead our programs, so we've looked at it and one of the things that we keep hitting up against is we We can put men into leadership, although I will say the pool of men that want to become facilitators of a yoga-based program for eating disorders doesn't tend to be huge as far as I can understand it.
But we keep hitting against, I think, institutional and social barriers.
So, if we're operating in a, maybe not institutional so much, but more social-cultural barriers, if we're operating in a society in which it's really taboo for men to say, I have an eating disorder, I don't feel good about my body, I want to go to yoga to build a better relationship with my body or to improve my relationship with food, there's only so much, you know,
A man in leadership can do, so I think there are real barriers that are just taboos, social stigma, you know, not wanting to look less masculine.
And then you've also got yoga spaces that skew way female anyway, so you add eating disorders and yoga together and it's extra difficult.
Yeah, yeah, double the Yeah, just the selection bias.
Yeah, you know, it just it strikes me too that we live in this time of sort of we talk about it on the podcast as as the bro science kind of world and where where a lot of a certain type of man is drawn into biohacking and into ways of relating to food and to exercise that are that seem to have a sort of scientific legitimacy and a and and create a kind of social
That's a very good point in terms of, I don't want to make any generalizations about kind of the psyche of men because I think it was very diverse.
But I can see why kind of that bro science, this has been proven, Joe Rogan talked about it, I can hack my own health, would intersect with that sense, or that kind of additional taboo stigma idea, stereotype that men need to be strong, independent, breadwinners, do it themselves, be their own man, and I can see how that would uniquely perhaps
be predisposing to kind of an orthorexic tendency of You know, I'm going to get all the supplements, I'm going to create a diet based on everything I've read, and I'm going to do it all by myself.
What about social media?
I mean, it's sort of the topic these days, how social media makes everything worse.
Do you feel like social media has had an impact on this whole area?
Absolutely.
Yes.
And again, that's another thing we're trying to flip to our advantage.
So most of our people come through social media, so we're trying to infiltrate, you know, The Instagram and the TikTok with perhaps something different, but my mind immediately went to young people, Julian, when you said that.
You know, kids are getting phones at earlier and earlier ages.
We've got huge social media companies that not only are accessible to kids, they've got programs for kids.
They've got Instagram for kids that are, you know, get them online as soon as possible.
Get them creating an identity and One of the challenges there, and we saw this recently with some of the testimonies that happen in Congress around Facebook, is that there is really good evidence and research that suggests that that kind of represents your body, your identity, on a visual platform performatively, maybe not intentionally performatively, but in a way
To garner likes, garner validation, all of that, which is something that we all do when we're 10, 11, 12, 13 years old is, you know, look for social validation, craft an identity.
I think that is a formula or perfect storm for eating disorder, if not full-blown eating disorders, at least kind of the mind's eating disorder tendencies, the body image struggles, the, oh she's got a flatter stomach than I do, you know, look how ripped he is, you know, six months ago he looked like me and now I need to get my act together.
And then also for passing loads of misinformation And loads of really toxic information about food and health.
You see that with pro-anorexia.
You see that with supplements that should not even be accessible.
They have no good research behind them.
You see that with diets, ways of eating, exercise regimens, promoting things that may actually be incredibly harmful to the body but look really sexy on social media because they're attached to a before and after picture.
Okay, so last one.
What do you wish that more people in the yoga and wellness community were aware of around this topic?
Eating disorders, orthorexia, yeah, this whole area of how we relate to our bodies via food and exercise.
In the yoga community, I think I always go to this.
I think we hear the word eating disorders and we talk about orthorexia I don't think people realize just how dangerous and life-threatening these things can become.
Yes, not everybody's going to lose their life to an eating disorder.
Most people who are dealing with orthorexia or anorexia or bulimia or binge eating disorder are not going to die.
But beneath the surface, many people dealing with eating disorders are dealing with really severe physical complications.
heart conditions, mitral valve prolapse, bradycardia, electrolyte imbalances that can cause a heart attack.
I had a meeting with a client today, was doing an intake, a yoga therapy intake, asked her about history.
She's in a stable place in her recovery.
She said, "I had a heart attack at 39 "due to my eating disorder." She was at a normal weight when she had the heart attack.
And we see this over and over and over again.
So while a person may look healthy on the outside, while they may seem like relatively harmless but slightly mentally unhealthy behaviors, often there are things going on beneath the surface that you cannot see and the person cannot see.
And that person then going on a detox, a cleanse, a heated yoga class, A really intense vinyasa class.
It can do a lot of damage.
It can do a ton of damage.
So if you're a yoga teacher, just educate yourself.
Just learn a little bit.
And don't be afraid to have a conversation with somebody if you're concerned about them.
Because that in itself can be, if not life-saving, tremendously life-enriching.
That one connection.
That one person seeing you and saying something.
Dr. Jason Nagata is an Assistant Professor of Pediatrics in the Division of Adolescent and Young Adult Medicine at the University of California, San Francisco, and affiliated faculty with the Institute for Global Health Sciences and the Center for Sexual and Gender Minority Health.
Jason is also a co-founder and co-chair of the International Association for Adolescent Health Young Professionals Network.
And he's an expert in eating disorders, particularly in boys and men, which is why I wanted to talk to him this week.
His other research interests include adolescent and young adult physical activity, eating behaviors, food security, nutrition, obesity, cardiovascular disease, screen time, HIV, and LGBTQ plus health.
So his global health work has focused in Kenya and Guatemala, and he's led an adolescent health research priorities exercise for the World Health Organization.
In total, he's published over 150 academic articles in the Lancet, the Journal of the American Medical Association, otherwise known as JAMA, and in pediatrics.
He currently serves as Senior Editor for the Journal of Eating Disorders, as well as being on the International Advisory Board of the Lancet Child and Adolescent Health, and the Editorial Board of the Journal of Adolescent Health.
He does a few things.
And in fact, I talked to him the week after he finished running the San Francisco Marathon.
So it was a pleasure talking with Jason.
I really wanted to talk to someone who specifically focuses on eating disorders in boys and men and what that looks like from a clinical treatment perspective.
I know in this episode, we've talked a lot about our anecdotal experiences, about what it's like inside of yoga studios and hearing Chelsea talk about her.
Her treating clients from a coaching perspective in the yoga domain and the wellness and broader holistic worlds.
And I think this rounds out a different perspective of people who maybe don't come through those worlds, but they sometimes do, but who are suffering real problems with food, nutrition, and body dysmorphia.
Thank you, Jason, for taking time to talk to Conspirituality.
I really appreciate it.
Yeah, my pleasure.
What made you specifically want to pursue the study of eating disorders in boys and men?
This interest actually started early on when I was a medical student.
I was in a continuity clinic in the adolescent and young adult health service and I ended up being placed in a continuity clinic for young people with eating disorders.
And for whatever reason, I developed a patient panel of teenage boys who had eating disorders and I cared for them week after week over the course of a year.
After working with many of them, I realized that that's a very underserved population.
Eating disorders in young men are really under-recognized.
They often, therefore, present with more medical instability.
By the time they get referred to a physician or a specialist, they're usually more sick.
Because of that, more of them need to be hospitalized.
And also, a lot of the treatments that we have currently are really female-centric.
And so, some of the current guidelines that we have don't apply to boys and men.
And so, a lot of our patients struggled, I think, because of all of these factors.
And it really inspired me to want to dedicate a lot of my career towards research and clinical care of this underserved population.
One issue I have is that not only in treatments is it more female-centric, but in the media it is predominantly presented as a female issue.
And I want to ask about that, but first, when you say most treatments are female-centric, how do you differentiate between how you treat women and men in this regard?
Yeah, that's a great question.
Different for each individual person, and certainly there are gender or sex differences, but even beyond that, every person with an eating disorder has their own unique story and unique risk factors.
So I do think that overall we try to individualize treatments as much as possible.
But that being said, I do think that a majority of the treatment research and guidelines currently are based on female samples.
And therefore, I do think that it reflects a lot of the body image concerns that our female populations encounter more frequently.
For instance, most girls or women with restrictive eating disorders are trying to lose weight and often they engage in unhealthy weight control behaviors like vomiting or fasting for long periods of time using laxatives or diuretics or other medications that aren't prescribed by physicians to lose weight.
But That may not be the case for a lot of men with eating disorders.
A lot of men's body pressures are actually to become bigger and bulkier and more muscular, so many of them are not actually trying to lose weight.
They're certainly trying to be lean and cut while bulking up, but a lot of those behaviors that we typically think about that are associated with eating disorders are really for the purpose of weight loss and thinness, and that doesn't apply to a lot of the men with eating disorders.
And so, I do think that a lot of the treatment Modalities that we have that are really weight focused and trying to have people gain weight or restore their weight to a certain goal don't particularly apply to boys and men.
Because eating disorders are predominantly bring to mind anorexia or bulimia, the disorders that make you lose weight, do you think that a lot of boys or men even realize they have an eating disorder?
I think that eating disorders are recognized by boys and men by almost everyone, not just patients themselves but even providers.
And I do think that part of the problem is that These diagnostic criteria and the media coverage, as you mentioned, for eating disorders are really largely based on female samples and female body issues.
And to your point, one example is that the definition of anorexia nervosa, which is one of the more common or more high-profile eating disorders, is characterized by a fear of gaining weight or becoming fat.
As we mentioned, many boys with body image issues don't actually fear gaining weight or becoming fat.
Many of them actually want to gain weight.
And so, even the restrictive categories that we make, I think, are really female-centric.
It actually used to be that you used to have to have lost periods or menses in order to have a diagnosis of anorexia nervosa.
That has been modified since, but early on that really only applied to girls, but there are still many current guidelines that have loss of periods or menstrual cycles as part of the treatment protocols of eating disorders and that obviously is not applicable to many men.
BuzzFeed did an exceptional deep dive into male eating disorders earlier this year, and one of the data points that jumped out at me was that 1 out of every 3 to 4 eating disorders occur in men, yet only 1 in 20 treatments are for men.
Have you found that men or boys are more reluctant to seek treatment?
Yeah, I do think that.
There are many factors that contribute to that.
One, as we mentioned, is just the less recognition of body image issues and eating disorders in men.
I also think that there's a great amount of stigma for men with eating disorders because it's such a feminized disease to seek treatment.
And when people do seek treatment, oftentimes in the group setting, they can feel even more ostracized or stigmatized, particularly if Their program is, you know, they may be the only male in the entire program in a group of, you know, 20 plus people.
And sometimes the issues that they're facing, they don't feel like they can relate to some of the other patients or some of the treatment modalities.
And so I do think that those are all issues that do impact men being more reluctant to seek treatment.
This episode specifically, we're looking at orthorexia because I personally, as I mentioned in email, have dealt with that being in the yoga and wellness community.
having grown up overweight myself and being bullied for it.
Getting in shape later, so there was a lot that I had to deal with to go through that, but I found that orthorexia, I didn't even know what it was until my 30s and I had been experiencing it.
Do you work with specifically, or any gender, do you work with that disorder with patients?
Yeah, I think that orthorexia, muscle dysmorphia, some of these other diagnoses that are perhaps less acknowledged formally in the medical or psychological literature.
I think part of the reason why these new phenomena are arising is that our current diagnostic criteria do not really reflect the diversity of body image and eating problems that today's population faces.
And certainly we have a lot of young people who suffer from orthorexia, which is basically a focus on healthy eating that becomes unhealthy because people with orthorexia can obsess about eating healthy healthy foods to a degree that can really overall damage their well-being.
So yeah, we have many of young people who don't fit the formal criteria for anorexia nervosa or bulimia nervosa or some of these other more formalized diagnoses, but do have a lot of issues related to body image, eating, preoccupation but do have a lot of issues related to body image, eating, preoccupation with eating that can still lead them to be hospitalized and lead to medical stability and weight changes that can be
And so yeah, we have a lot of young people who don't completely fit the picture for a formal eating disorder diagnosis but still can be really impacted in terms of their life and their physical and mental health.
I have a friend who was on the keto diet for a while and he was actually doing six days a week where he fasted 23 hours a day, ate one hour a day in his window.
He was in tremendous shape, but we even were talking about this when we were cycling yesterday because he knows that it was a problem and he fortunately no longer practices that.
But I'm wondering, when you're talking about diets, specifically in boys and men, What sort of diets, or I know you've studied supplementations for example, what are the most common forms of eating disorders specifically that men go through, either dietarily or supplementation?
Yeah, that's a great question.
I do think that because we had mentioned that the idealized body image for many boys and men is to become increasingly muscular, a lot of the disordered eating behaviors that they engage in don't particularly relate to weight loss, but some common diets could be like a high-protein diet while still trying to cut carbs and fats, use of appearance and performance-enhancing drugs and supplements.
You know, the most harmful would be anabolic steroids, but There are many people who use more benign substances like protein powders, creatine, other types of supplements, but they can use them to a degree and obsess about them to a degree that, kind of like an orthorexia, it is no longer helpful for them, but it really becomes a preoccupation, an obsession, and it really worsens their quality of life because, for instance, many of our patients
Feel like they can't go out to eat with friends because the foods that are offered in restaurants or at other people's houses aren't high enough in protein or not healthy enough and then they're not able to socialize or enjoy meals and time with other people like they used to.
And I think one other really important thing that is a little bit of a
I think that is also part of the reason why eating disorders are under-recognized in boys and men, is even the focus on the word eating and eating disorders, because I think that excessive exercise or physical activity is also a way that boys and men present, and that's not really an eating problem, but if you, you know, many of our patients will exercise for five or ten hours a day, and you know, when you do that, that really doesn't give you a lot of extra time to do other things in your life, and if you're not
meeting your appropriate nutrition needs while exerting that much physical activity, you can still get into the same energy imbalances and relative malnutrition problems that can land you in the hospital.
I taught group fitness at Equinox for 17 years and there were just some people who never seemed to leave the gym.
And that was never usually, you know, there are no parameters for people who work at the gym to sort of say anything or guidelines.
I I know you said that treatments are individual, which I think is really important.
Can you give some broad brushstrokes of how you treat boys and men both physically and psychologically when they're dealing with these issues?
Yeah, I think that that's a really important question.
I think at a high level, these are really complicated issues that affect your nutrition, physical health, and mental health.
And so, ideally, we have an interdisciplinary team to help People suffering from these issues.
So, for instance, for teenage boys who have eating disorders or muscle dysmorphia on a team, we have a therapist.
Often for a minor, the recommended modality of therapy is actually family-based treatment.
So it's therapy that not only involves the teenager, but also their parents or guardians and even other family members who are involved with helping to or around meals or helping to feed them as they recover.
Just because when somebody has a severe eating disorder, sometimes their mental state is not such that they're able to really make rational decisions about their own foods.
And so we really try to, especially for minors, involve their parents and other people to help support them, just like we would with any other disease in a minor.
So I think therapists is one part.
The medical team, like a physician or a nurse practitioner who can help to monitor vital signs, electrolytes, like other laboratory abnormalities, and make sure that the young person is medically stable enough that they can continue their therapy at an outpatient and make sure that the young person is medically stable enough And then also, ideally, a dietician who can help advising on adequate foods and nutrition to get the young person sort of back on track.
Um, So I think that in general those three components are really important to getting someone back on track from an eating disorder.
Do you have any data on recovery rates for people who come to see your organization?
That is a really great question.
I will say that for the teenagers, and I will specify that I'm a pediatrician, and so our patient population with eating disorders is generally adolescents and young adults.
I don't generally care for older adults who, you know, sometimes when people are more independent and they don't have families or they're not minors, they make their own legal decisions.
There's a slightly different model where, you know, technically you're your own decision maker.
And so it's more of like an individualized approach with individual therapy.
But I will say that the best evidence for treatment in adolescence is this interdisciplinary model that also includes family support and really getting the family to support the young person to sort of get back on track and not letting them make their own decisions at first.
And then as their brain recovers, as their physical health recovers, then allowing them a little bit more flexibility so long as they're still progressing in their treatment to, you know, make some of their own decisions about food and nutrition so long as they're progressing with the help of their parents.
I know it's common in addiction recovery, for example, for someone to get off of a substance only to find themselves addicted to something else.
And I know personally from orthorexia, I had switched diets a few times, so there was sort of different focuses on either elimination or what I should thought I should be eating at that time.
Do you find this trend in eating disorders as well, where people may start to recover from one but then start to Yeah, I do think that there is an overlap and we do have a lot of young people who suffer from eating disorders and other mental health issues and or issues with addiction and substances.
And I will also say that sometimes people can use substances towards the ends of their eating disorder.
For instance, tobacco smoking can sometimes help you to lose weight, as we mentioned.
Performance enhancing substances or supplements like steroids can also help with muscularity.
So I think there is an overlap particularly in men for using substances and eating disorders.
And I do think that there is, I have seen in many patients where they may develop other substance use disorders or mental health issues as their eating disorder progresses.
So I do think that that is Not uncommon.
As a pediatrician especially, I'm sure you've seen the Wall Street Journal reporting on Facebook and the damage that Instagram does to teens.
I know that the focus in the media was on teenage girls and body images, but there was also a data point for teenage boys in there that wasn't discussed as much, again going back to how the media covers this.
How prominent is social media in eating disorders in children and teens?
In general, people who spend more time in social media have more exposure to unattainable body ideals and more opportunities for comparison to other people's bodies.
And in boys and men in particular, there have been studies that have shown that greater social media use has been linked to higher dissatisfaction with muscles and thoughts of steroid use.
Social media is also linked to higher risk of eating disorders in men and in women.
And I do think that overall, men's bodies have been on display more through social media than they have in the past.
I do think that especially through influencer accounts, there is just idealized Physiques that can be heavily filtered that, you know, post perhaps the best of hundreds or even thousands of photos.
And so I do think that there is somewhat of a distortion that people have a perception that everyone around them is perfect and beautiful and has these unattainable body ideals.
And then, of course, the algorithms in that will, if you've looked at one image, then all the other images subsequently that you will be exposed to will be other fitness people who have, you know, perfect bodies.
And I do think that that perpetual cycle can lead to greater dissatisfaction with a boy's body and then potentially leading to the development of an eating disorder.
So I do think that there are preliminary studies that have shown links specifically in boys and men of, you know, exposure to social media and body dissatisfaction and then behaviors that could lead to an eating disorder.
You know again everyone is a little bit different so it's not that everyone who's on social media who looks at these images is going to have an eating disorder but it does seem like these people could be at higher risk and as you mentioned if you're already predisposed potentially to having an addictive behavior or personality and then you know being exposed to this medium where you're getting lots of photos you're getting likes or dislikes and stuff it can kind of add to pressures for people to
Feel like they have to look a certain way or do certain behaviors to look a certain way and then post content in a certain way that can become a self-perpetuating cycle.
During the pandemic, you led research about there being an uptick in eating disorders in children and teens when lockdowns began.
Can you talk a little bit about why that happened?
Yeah, it's been really heartbreaking to see that since the start of the pandemic.
We've seen over a doubling of teenagers who've needed to be hospitalized for eating disorders at our hospital in San Francisco.
And this is reflected nationally and internationally with trends from other hospitals all over the world.
And I do think that in general, teenagers have been really impacted by the effects of the pandemic, school closures, social isolation, and general anxiety related to Fears of infection or or the pandemic itself.
I also think that particularly earlier on in the pandemic there was a lot of concern about this quarantine 15 where people initially gained some weight and then people started to engage in behaviors to try to lose that weight.
And I do think that also with the in teenagers particular with the cancellation of Sports teams or postponement of sports seasons and then also being in zoom school where you always have a camera Basically on you all day.
I think that that has really led to different body image issues and concerns and To your point about social media and the last question, I do think that while social distancing was being implemented, social media was one of the ways that people could still feel connected to their friends and peers.
And so there was more of a reliance on social media to feel connected and then therefore exposure to more of these body image pressures.
And overall, I think that We have conducted research showing that social media use has more than doubled during the pandemic from pre-pandemic levels.
