Beyond Picky: Autism, ARFID & Gut Health with Lucinda Miller

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Autism, ARFID & Gut Health

Speaker 1  0:03 

Becky. Hello and welcome to the JenUp podcast. If you’re struggling with an eating disorder and feeling lost, you’ve certainly come to the right place, and so both myself and Becky stone are former sufferers of eating disorders, and we understand the challenges that you’re facing. So join us for inspiring, educational and relatable content, whether you’re seeking support guidance or just someone who understands we’re here for you. So today, we have Lucinda Miller on the show. So Lucinda Miller is the clinical lead of nature doc, and has over 25 years’ worth of experience as a founding naturopath and functional medicine practitioner. She runs a UK wide team of nutritional therapists specializing in children and nutrition and neurodivergence. She is also a coach and mentor for kids with ADHD and autism. So it’s great to have you on here. We met on the neurodiversity panel celebration week a couple of weeks ago, and I thought, you know, you are so knowledgeable, and it’s so great to have you here and just to share your knowledge with everyone. So I’m very grateful for you to be on here today.

Speaker 2  1:18 

It’s great to be here. Thank you so much for inviting me on. It’s, you know, let’s hang out together again.

Speaker 1  1:23 

Yeah, definitely. I can’t wait to ask you these questions. So my first one I’m going to fire at you is all about the gut brain access. So I hear you know a lot about this. I’m really passionate about this topic. Can you explain, like, why it’s relevant to neurodiverse conditions such as ADHD and autism. I think people will find that really interesting, great question.

Speaker 2  1:47 

So basically, the bacteria in our tummies, in our intestines is known as the gut microbiome, and it plays loads of different roles, and everyone’s still learning all the time. So you know, new papers are coming out every single week. The gut microbiome was actually discovered over 100 years ago, but obviously the research has really ramped up in the last 20 years. And essentially, these gut microbes can be all sorts, from bacteria to viruses, etc. But I’m going to focus in on the bacteria, because that’s what we know most about. And essentially it’s an ecosystem where you’ve got beneficial bacteria and not so good bacteria. And normally that’s in harmony. So if you’re eating a really healthy diet, if you don’t have too many gut infections, etc, etc, then you know that works in harmony, really beautifully, and everything’s really well balanced. But if, for instance, you’ve been on loads of antibiotics, maybe some reflux medication, anything that can suppress the diversity of that gut microbiome, so essentially reducing the good guys, then the bad guys can come and take over, and basically the good guys. So the good, beneficial, friendly bacteria, they help with all sorts of things. They help with digestion of milk and dairy and things like that. So that’s something that actually a lot of kids, whether they’re neurodiverse or not can’t do they also help you to make vitamins. So something called folate, which is vitamin b9 which you get from your greens, and vitamin B12, which you get from meat and eggs and fish. And these two are really key neurological vitamins. So they help to turn on lots of different pathways in the body that help you neurologically, as well as giving you energy. It’s really important for the nervous system, and things like the coatings of your nerves and things like that. So it’s really vital these beneficial bacteria also help with the immune system. And a lot of people, whether you’re neurodiverse or not, have challenges with our immune system, whether it’s colds and coughs and Tommie bugs, whether it’s autoimmunity, where the body’s fighting itself, or whether it’s allergies. So it helps to modulate that. It also helps to modulate something called inflammation. Inflammation is something we think about aches and pains and burns and things like that, but it can also mean eczema, asthma, but like exacerbations of those, when they’re really bad, when they’re dry, red, raw, you know, those sorts of aspects. But also, actually, there’s been a lot of research into the links between inflammation and the brain. So in the brain, we’ve got these wonderful housekeepers called microglia, which, every night, what they do is they kind of sweep up the brain, clear out all the crud so that that’s why you’re nice and refreshed in the morning. Now, if there’s inflammation in the body due to infections or stress or dehydration or wrong. Food Choices, or whatever that might be, then the micro glare find it bit harder to do their job. So each night, over time, things sort of build up, and that can affect the brain. So there was a really good guy. He’s called Professor Ed Balmore. He’s the head of psychiatry at Cambridge University. So he’s a pretty clever guy. He wrote a book a few years ago called the inflamed mind. He talks mainly about the link between inflammation and depression and the microglia, but he also does talk a bit about ADHD and autism and the links. It seems that autistic people, ADHDs, just generally neurodiverse people tend to find that maybe it’s genetics, maybe, you know, no one really can understand exactly why, but basically, more prone to these inflammatory pathways being upregulated, and those microglia are not quite doing such a good job. So that’s really important, why we need to work on our gut microbiome to help reduce that inflammation. And then the final thing, which actually is the thing that people can relate to most in terms of neurodiversity, is that these gut microbes are actually building blocks for our brain chemicals, or neurotransmitters. So nervous system chemicals, okay, so we’ve all heard of dopamine, ADHD and dopamine, that’s why a lot of people are drawn to the medications, and people are drawn to dopamine snacks. And, you know, dopamine hits through social media, etc, etc, etc. And so certain microbes make dopamine, other microbes help to make serotonin, and serotonin keeps us happy, helps us sleep and helps us poop, all very important things in life. It also helps to make something called GABA. And GABA keeps us cool, calm and relaxed. It helps with anxiety. It helps with sleep, it helps with risky behaviours. So ADHD is often, you know, yeah, they can indulge in things like drug drug use or alcohol use, or, you know, doing extreme sports or whatever. And equally, you know, focus and concentration is a big thing, and you know, so we want to think about that. And then there is a really important one called acetylcholine. And acetylcholine is a vital neurotransmitter in the brain, and it helps with all those aspects to neurodiversity that so many people have problems with, and that’s things like working memory and memory processing information, and it also helps with things like self-regulation and emotional regulation, which are the big things that so many people struggle with. So these are not certainly the cause of any of these kind of neurodiversity, different brilliant brains. Of course not. There’s a whole host of different aspects to this, and a lot of it’s genetics. But if your gut microbiome is out for whatever reason, then you’re gonna if you’ve got, say, genetically or quite glitchy at making dopamine or serotonin or acetylcholine or GABA or whatever it might be, and your gut microbiome is a bit smashed by, I know, taking antibiotics or eating lots of ultra processed foods or whatever it might be, then guess what it’s they’re not going to do such a good job. So the body is an incredible beast. And, you know, it’s very clever at going, Okay, this pathway is blocked. Let’s find another one round the side door. So you know it’s trying its best. But obviously, you know when you’ve got difficulties anyway, making something you can really feel low and slow or unfocused or unmotivated, or whatever it might be. If your gut microbiome is out. So that’s the sort of positive side. You know, those are the friendly bacteria. And how do you boost those up? Well, that’s why we all need to eat lots of fruits and vegetables. So we, I think a lot of people read on the internet, social media, all about eating the rainbow, eating 30 fruits and vegetables a week, blahdy, blah, and that’s because all these different fruits and vegetables contain fibre, but they which feed the gut microbes, but also they contain polyphenols, or like The different pigments. So purples, greens, oranges, reds, yellows, etc. All of these things help to feed different aspects of the beneficial bacteria. So even if a child, for instance, is hooked on carrots, they’ll only eat crunchy orange carrots. You can play a game by getting all three coloured carrots. So the purple one. The yellow ones and the orange ones. And, you know, say, Hey, you like carrots? Let’s, you know, look at these different carrots and eat them and see if they’ll try them. And if they will, then, you know, even if they’ll only eat carrots, they will actually be getting different polyphenols equally with berries. You know, the different coloured berries, or the different coloured red peppers, green peppers, yellow peppers, orange peppers, etc. So building that gut microbiome can be done through fruits and vegetables and lots of fibrous foods, but equally, you can also do it through eating live cultured fermented foods, which with kids, you start with things like live yogurt or kefir. So kefir is a little bit more bubbly, a bit more sour, so that’s where usually I go with, like a creamy yogurt. And you can always mix that with honey. And actually honey helps to boost up and help that those gut microbes to get further down the gut. So it’s actually a good idea to get the honey in. And you can mix it with berries or mango puree or whatever you want to do to make it delicious, you can put it in a smoothie, and all of those little boosts will help to boost up those great, good quality, friendly bacteria, which will help with making that folate and B 12 will help with bringing down the inflammation. Will help with the immune system and will also help to make those neurotransmitters.

Speaker 1  11:23 

Okay, I was just about to say, like, there’s so many things I want to ask from what you just said. So basically, obviously, to make those neuro just so everyone understands, like, to make those neurotransmitters, like, probably you need to have, like, a good, diverse gut microbiome, because if you’re not making those neurotransmitters, you could have possible dysbiosis in the gut. Maybe,

Speaker 2  11:45 

yeah. So dysbiosis is where you have too much of the bad, yeah, lead to inflammation, disrupt that ability to digest and absorb, you know, all the good stuff that I was talking about sort of gets disrupted. Now, where do these bad bugs come from? First of all, they can be infections you pick up. So, you know, we’ve all heard of salmonella, E. coli, etc. So those can temporarily, but in a sort of sensitive, delicate gut, it could actually do damage over the longer term. I’m not taking saying forever, but it takes longer to recover. You know, there’s some people they say, Oh yeah, we all got food poisoning. And one person’s gets no symptoms other than feeling a bit nauseous for a couple of days, and someone gets awful diarrhoea for four days, and the other person feels awful for weeks afterwards, and so, you know, so that’s really what it is. It’s about that person who is more susceptible and more likely to have problems with recovering from those things, right? Equally, if you are put on antibiotics, we know that we are more susceptible to the super bugs, so we’ve heard of MRSA and C difficile. So though we may not get those as such, but there are other not quite super bugs, as in, you can get rid of them, but there are other bugs that can settle in, and some of those are more toxic on the system, but not going to necessarily give you bad symptoms like diarrhoea. So you may not even know you’ve got them, other than feeling funky and low. And so those are the ones. So we at nature doc in our clinic, we do run proper gut microbiome tests, where you can get a proper understanding of where these things lie, you know, have you got enough of the friendly bacteria? Which ones are missing, which bad bugs are there? You know, is there inflammation? Does the person find it difficult to digest, etc, etc. So you can get that sort of road map, but today is all about the positive things that you can do, yeah, and essentially the what’s great is it does take a little bit longer to do, but if you focus in on those good foods, if you focus in on the cultured foods and the rainbow foods, etc, over time, even if your guts out of whack, you can crowd out the bad bugs. And there’s also things that you can take, like really garlicky pesto. For instance, garlic is really good at getting rid of, rid of the bad bugs, things like oregano, thyme, etcetera, fantastic. So you could, you know, loads of kids like pizza. So you could go kind of do an oregano kind of sauce, like a salsa verde, almost, and sort of, you know, pour it over, I know, chicken or whatever, or yeah, or combine it with garlic. So you can kind of do that through food. And there are other. Things. We often give supplements, because we’re seeing people who have invested in this, you know, they want to see faster results, etc, etc. And, you know, we’ve got that wonderful information from the tests, but this is what people can do. They can think about food, you know, on the as as, as a good thing to do.

Speaker 1  15:19 

Okay, amazing, yeah, because I’m a lot of, what I see a lot in schools is that a lot of, especially I see a lot with autism ADHD, they tend to have more of the processed foods. They lean to more eating those. And there’s challenges, you know, I get a lot of parents sort of saying, there’s challenges introducing feeds to autistic kids, because they’re eating the same thing every day because it’s routine, and then they struggle to eat, you know, variety in their diet. So how, I know you said some suggestions. But how do you, you know, motivate an autistic child to get more variety in their diet, because it’s good for their gut health. But how do you do that?

Speaker 2  15:59 

Yeah, so really good question. There are sort of twofold, really. One is, I was involved as a brilliant Food Program, which is radio four, which is called eating on the spectrum, okay, released, I think, was last November, and is up from an award, because it was the most uplifting radio program you’ve ever heard. You know they had neurodiversity cafes. There was this amazing school kitchen in North London where the kids were getting really super involved. And I think the whole process of getting involved in the kitchen, cooking, you know, all those sensory aspects, touching, smelling, tasting, you know, and so forth, can make a massive difference. And so it’s that kind of, I guess, understanding the Farm to Fork journey, etc, etc. So there are so many aspects that you can work on just through exposure, whether it’s going to food markets, farmers markets at the weekends, as I said, baking at the weekends together, thinking about different ways to introduce food that is not necessarily around the kitchen table At a meal time, because that’s often a time when they’re feeling like, you know, this is a stressful thing. I don’t really like meal times. I’ve always found them stressful, and so therefore I want the same, but it’s where it’s sort of in between meals, where maybe it’s on a Saturday and it’s mid morning and you’re, I don’t know, making a fruit puree, or your baking cake, or whatever it could be, something really kind of simple, but it could be or something complicated, but it’s sort of getting them to taste licking the bowl. You know what? Kid doesn’t love to lick the bowl. So, you know, those are little sort of inroads that you can do. However, most of the kids that we work with are where you put them in the highly selective eater stroke offered camp, where they are very fearful of trying new foods. And even if they do prepare the foods, they may not even touch them or smell them or taste them, and they sometimes won’t even go into the kitchen because they get the gag reflex, even from the smells, etc. So we see really extreme cases where we’ve have kids who are having two foods a day, four foods a day, you know, maybe six, maybe 10. But you know, really, really restrictive. And that is where, actually all this sort of square peg, round hole approach is so hard on everybody. So what we tend to do is, if it’s possible, and often, especially the older kids are quite engaged in the process that they want to eat different foods. They’re fearful of them. They know they sensibly because they’re bright kids that nutritionally. They do need these nutrients, but they can’t bear to eat them. Often. They’re quite open to the idea of supplements. Just because they can’t smell them, can’t taste them, they’ve got to swallow it down. It’s either in their water or the juice, or it’s a cap, a little capsule, or whatever. And they’re actually a bit more open to that. Now, I’m not saying it’s every child’s journey, and sometimes you have to be a bit more kind of, you know, clever at getting them in because, you know, they don’t. They haven’t, sort of had that thought process yet, but essentially, what we find is the more nutritionally depleted someone is, the more that their senses get cut off, so they find sense of smell and taste is reduced. Texture is very, very important to them, but also gastric do. Tend to, again, be lower, because it’s as if their body’s sort of gone into shutdown, as it’s, you know, their fear when we’re fearful of anything, you know, we’re in a high, fight or flight state. We just don’t feel hungry. You know, those butterflies in the tummy take over. And so we tend to think about where, what to do, and there’s, there’s sort of, I guess, three supplements that we may be for, that we think about at the outset. And you would want to try one at a time. So the main one which we find is the sort of enabler, the one that gets the child from eating such a restrictive food, food intake, to being more open to trying, whether they will actually or not. You know, it can take time, but basically, over a couple of months, if you add zinc to their juice, as I said, or however you get it in, that can make a massive difference. Now, zinc can come in almost, I’m going to say they’re not tasteless, but almost tasteless. They’re a bit salty, so it’s a sort of, you know, as I said, but they’re not like a strong taste. Zinc drops can go in the water or the juice, or the pancake mix, or whatever they’ll have. And basically, zinc helps to turn on sense of smell, sense of taste, because it’s very neurological. It’s the second most abundant mineral in your central nervous system. It helps with things like it helps the whole sensory system to sort of rebalance. So that’s why the scent, why the kind of texture feels a bit better than math. It helps with it’s one of the key components of all your gastric juices. So it helps with kind of that to make you feel just hungrier. And zinc has actually been linked with things like better growth, you know, looking more robust, less skinny, less small. So and zinc also helps with the mood, and it helps with kind of fear as well. So it’s a really good one overall to start with. And, and I think most parents will be able to get one, you know, tiny little drop into something, and then slowly build up. And even if you build up to two drops after three days, and then another drop after another three days, you know, if it’s really, really gentle, then usually, as I said, often, within six to eight weeks, you’re seeing they’re happier At the table, they’re more curious, etc, etc. Occasionally we get the most sensational story. Had one the other day. Follow on Instagram, and they’ve got this child with ARFID 12 days later eating spinach and broccoli. Wow. Everyone’s dream, hey. So phenomenal. So that was just extraordinary. But, you know, so it is possible, but I’m saying it’s not the whole picture, but it’s worth trying with zinc. Okay, second one is low iron. Now, it may not be full anaemia, but iron is something that most beige crunch eaters will not be consuming, because, you know, chicken nuggets hardly have any iron, and obviously all the beige foods don’t. And iron is the most abundant mineral in your central nervous system, and you can feel like it’s quite a sore tongue, quite a sore tummy, quite a low appetite when you’re low in iron. So that’s a kind of another one that often you need to think about they, I mean, iron is a funny one. You can get it in gummies. You can get it in sprays. You know, use. I mean, it’s possible, you know, it’s not the easiest, but it’s it. I would say zinc is a little bit easier to get in than iron, if they’re hyper restrictive. So that, again, works not in the same way as zinc, but they’re very much buddies. So think of those two as kind of key, and they’re very important together. If your child has something called picker, which is another eating disorder in brackets, which is essentially where they tend to put them not particularly interested in food, but they will perpetually put their fingers or their hands in their mouth, or they’ll be putting toys or paper or stones or soil or whatever it might be in their mouth. Instead, they’re often chewing on their hoodie strings, chewing on their T shirts, and that’s a big sign that zinc and iron could well be needed. So it’s sort of a good one to look out for, rather than having to do a blood test, which they might be too scared to do at this point, especially if they’re very dysregulated. Then the third thing is to think about the probiotics. We talked about the gut microbiome earlier and often the. The Food narrowing happens having had antibiotics, so having had lots of tummy bugs or ears, nose and throat issues, and it may not be the first round of antibiotics, maybe kind of going on, because that’s an ongoing sort of like illness. Picture could be low zinc, but it could easily be that those gut bugs are not happy, and they’re not sending those right neurotransmitters to the brain to make them want to eat much. And so that’s really important.

Speaker 2  25:30 

And then the fourth one is something which really we usually uncover through our stool test, but it’s something that you can do at home by seeing what’s coming out in the loo in terms of their poo. So most poo should be lovely, brown hazelnut coloured sausages, kind of coming out in two to three pieces each time. Now, that’s not going to happen every day for anybody, but that’s generally the pattern. If you’re seeing undigested food in the stool, so you’re seeing little bits of rice or or most people get sweetcorn in there, but you know, kind of raisins or undigested bits of nut or whatever you want. Basically, it’s just looking like, or they’re incredibly bulky, like, almost like, they’ve been described as elephant poos, like, really big sort of like, that doesn’t add up. What’s coming out is way more than than they ate. You know what? I mean? It’s just doesn’t make sense. That’s often where the pancreas, which does two things, it helps with blood sugar, but it also helps to digest and absorb your nutrients. Or there’s a malabsorption in the gut, which means that that those little villi along the gut lining and not doing their job, and so that’s an indication that there’s poor digestion, which means that they’re eating, but they’re not getting all the nutrients from the food they’re eating. So they might be getting a fabulous diet, even if it’s quite restricted. You know, some kids, actually, when you drill down, they are getting the protein, the healthy fats, the iron, the veggies, but they’re quite restricted. You know, it’s three veggies, it’s two fruits, it’s, you know what I mean, it’s, you know, it’s simple, but they are getting the basics in but often they just don’t look like they’re getting those nutrients. You know, as I said, they’re small and tiny. So as a kid, I saw years ago, who I still keep in touch with, he’s phenomenal. And he was about six or seven years old, and he’d wake up in the morning saying sausages. It was the first thing he said in the morning, and he’d eat about 10 sausages for breakfast, and then he’d eat like two chicken breasts at lunch, and like three salmon steaks at dinner. I mean, he ate like a crazy person, but he was still the tiniest. He looked about three years younger than he really was, because he just was so little. And it turned out he had this problem. So he was eating phenomenally well, but he just wasn’t getting those nutrients from what he was eating. So that’s the something called digestive enzymes, which you can get. So supplements wise, just to be completely transparent, we do have our own online shop called Nature doc shop, where we stock all these supplements, and we have a service which is free, which you can email us, or you can DM me on Instagram, saying, Hello, I’ve listened to this podcast, and I’d be really interested in the zinc or the iron or the probiotics or the digestive enzymes or whatever. And we can, if you give us the age and so forth, we can give you exactly the right one to start off with that we feel would be appropriate for your child. So anyway, to go back, those digestive enzymes can really basically help to melt the food in the tummy so everything gets absorbed. And it was brilliant. Years ago, I got sent a digestive enzyme and a little bag of oats. And I thought, This is funny. And they said, basically, put some hot water in the oats and then put the enzyme in, and I promise you, it just turned to mush in about two minutes. So it just makes makes everything highly digestible. So it’s really good for the kids that have really sore tummies. You know, they’re always saying, My tummy hurts when I eat, or I get reflux, or whatever it might be, it’s just settles everything quite well. So anyway, those are the four things that I’d look at.

Speaker 1  29:28 

Okay, great.

Speaker 3  29:33 

How old would you recommend children to start taking, like the supplements?

Speaker 2  29:40 

So really, from whenever they start eating, which is usually around six months, but you usually don’t know whether there’s neurodiversity or not, tell them much later or very often. You know, we do at new shop, we do see tiny little babies who’ve got severe gut issues. Etc, etc, but most of the time we’re seeing them from probably two years old up. No, it’s

Speaker 3  30:08 

really interesting. Sorry. It’s because my grand son, we’re all a bit of a neurodiverse house, and grandson’s presenting with autism. So he’s presenting with certain behaviours, and Alfred, and he’s as soon as you said about his skin. And I was like, Ah, this makes a lot of sense. So it’s just curious of when, when they can start.

Speaker  2  30:33 

Yeah, absolutely. Well, send us an email, and

Speaker 2  30:37 

we obviously do have proper clinical you know, we have a big clinical team where we can do all the deep dives, but we also, equally love to help people, just to get them started. And that is why I wrote brain brilliance. Again, this is a little it’s a really lovely cookbook, but it’s also got all the tips in there so that you can have a little kind of checklist of what you’re going to try and see if it’s making a difference or not, because we realise that, I mean the clinical work we love to do, but it’s not accessible to everybody, and a lot of people just want to actually build that confidence that one thing is working or Helping a bit.

Speaker 3  31:19 

It’s fascinating, really, because we’re, we’re all neurodiverse in here, so I think it is just, it’s just so important just to be aware of it

Speaker 2  31:28 

all, absolutely, absolutely. So four out of five of us in our family are neurodiverse, and we’ve got, you know, cousins and uncles and aunts and all sorts. So you know, it’s, you know, I think. But what’s interesting is, we’ve worked with a lot of families over the years, and maybe it’s just like a magnet, you know, when you feel, you know, you do draw in those families. But you know, just even at a social event, I’ll be talking to someone, I go, yeah, we’ve got four kids. One’s neurodiverse, you know. And I think it’s very rare. I mean, obviously we work with lots of families where there’s one kid and so, you know, that’s a neurodiverse kid. And they stop for whatever reason. They’re not having any more kids or whatever. But often, you know, when you’ve got these big families, there’s usually at least one, you know, I just think it’s very rare for people not to have a neurodiverse kid?

Speaker 1  32:24 

Yeah, no, definitely. Thank you. Oh, my God. I mean, that was so insightful. With everything that you said, I do find I could, I feel like this needs to be a part 2 but I do find this very insightful. I love everything about gut health. I think that I know we haven’t touched on it much, but I do you think there’s a big thing with eating disorders, like who have restrictive type eating disorders that have issues with their gut microbiome, and kind of like low gut bacteria?

Speaker 1  32:51 

I do think that’s an issue as well that I see a lot.

Speaker 2  32:54 

I think it’s something that is being explored a lot through research. And equally, there are many, many research papers looking at zinc and restrictive eating, just to share that when a child is going through pre puberty and puberty, that is the time where the body is drawing that zinc to prioritise making their hormones and turning them into an adult. And that is the time very often, where eating disorders, classical eating disorders that we we you know, we’ve known about all our lives, do kick in, and there’s a really good psychiatrist who is in America called James Greenblatt, and he’s written a specific book on this. And essentially it’s quite a big book to read. And essentially the take home is, take zinc, okay, is the vital one that, of course, it doesn’t address all the emotional issues, etc, etc. You know, there are so many aspects to eating disorders, and there’s no, of course. And you know, some people live with disorders all their lives, even if they are a healthy weight. However, the zinc, because it helps with the gastric juices, sense of smell, sense of taste, stabilises that neurological system. Those people that continue with the zinc, especially during those puberty years, so probably up until the age of 18, are the ones that end up being stronger in the long term and finding all of those demons less of an issue.

Speaker 1  34:44 

Okay, which, which form of zinc, like zinc citrate, there’s different forms. Isn’t there of zinc? So

Speaker 2  34:51 

there are lots of different forms. And some people see others, more than more than the rest, but would look out for I like. Pickling eight. I like the sulphate and but again, you know, we would be delighted to recommend, you know, dosage, etc, as long as you know the right age and stage of someone and sort of, kind of, you know, we very happy to answer a light email just to get you going, as I said, we have to be quite careful in terms of actual eating disorders offered. We can do no problem, but actually things like anorexia, we do need to be careful with. And in fact, what we say now is that that person needs to be at least six months clear from hospital and the stable weight to be able to work with them, and then we’ll work on the underlying gut microbiome and the reflux and all those other aspects that seem to be kind of plaguing them going forward,

Speaker 3  35:56 

very fascinating, especially with the work that we do, just being able to sort of guide People in the right way and then recommending them back over to you.

Speaker 1  36:03 

Thank you. Thank you. Thank you so much. Been so great to have you. And Becky will finish off.

Speaker 2  36:14 

Thank you so much, and yeah, and we will catch up really soon.

Speaker 3  36:20 

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How to get help?

Jenny Tomei is a Nutritional Therapist and Eating Disorder coach. See all her credentials on her About Jen page and then should you need help then make contact with her today. Your road to recovery can start now!