GLP-1 Medications, Exercise & Disordered Eating: What You Need to Know

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GLP-1 Medications, Exercise & Disordered Eating

Jenny Tomei  00:04

Hello, everyone, and welcome back to the JenUp podcast. If you’re struggling with an eating disorder and feeling lost, you’ve certainly come to the right place. 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, relatable content. Whether you’re seeking support, guidance, or just someone who understands, we’re here for you. And yes, sorry, Becky couldn’t actually be here today, but hopefully she’s going to be here for the next one. So, but I’m really excited to have Stephanie Van Shaik on the podcast. She is a licensed mental health counsellor and the founder of State of Balance Mental Health Counseling Services, where she provides virtual therapy to clients across New York and Florida. She is a certified delectable behavioural therapist, as well as a certified integrative mental health practitioner. She specialises in eating disorder recovery, body image work, trauma and perfectionism, and helping high achieving individuals break free from cycles of control, shame and self criticism. So thank you so much for coming on, Stephanie. And it’ll be great to. So in your bio you talked about so DBT. Would you be able to explain what that is just quickly to our audience? And I think I yeah

Speaker 1  01:29

dialectical perfect and thank you first of all thank you for having me on. I’m really excited to have this conversation with you today. And yeah, so one of my certifications is dialectical behavioural therapy, which most people recognise as DBT, and essentially the heart of it, there it’s really helpful to. A lot of times we can come up with dialectical thinking, or I’m sorry, dichotomous thinking. Rather, we think a lot of times in black and white, and dialectical behavioural therapy really helps to have incorporate multiple thoughts at once to make it where okay this might be true but it doesn’t make this not true and hopefully through our conversation it’ll make it a little bit more concrete as opposed to that abstract concept and if you guys are familiar it also breaks down into four like skill sets essentially where we’re working on interpersonal effectiveness, distress tolerance, emotional regulation, and mindfulness. Those are the four categories that it breaks down to.

Jenny Tomei  02:30

Okay, amazing. And so you work with obviously clients in America, like New York followers that are struggling with eating disorders, all types of eating disorders that you work with.

Speaker 1  02:39

Yeah. So the entire span, of course, binge eating disorder, bulimia, anorexia, ARFID, orthorexia, which isn’t technically diagnosis yet, but I expect that the next DSM it probably will be. So yeah, the the all across the mill, all I do.

Jenny Tomei  02:56

Amazing. And what sort of what are you seeing coming to your clinic at the moment? Like kind of what’s the what’s on the rise, especially might be different. Yeah. So

Stephanie  03:05

yeah, yeah. So I think it’s a really interesting conversation to have, and I am sure that this is impacting the UK very similarly to how it’s impacting here, where we had GLP ones recently come on the scene hard, where it’s being used for maybe weight manipulation, as opposed to where it originally started in the treatment of diabetes, and because it is so commonly prescribed and easily accessible, there’s a lot of people who might have otherwise benefited more by seeking treatment for disordered eating or an eating disorder rather than moving to the GLP-1, so that’s kind of complicating things and making it really hard for people who are struggling to navigate wanting and being on GLP-1s potentially or wanting to be on them and dealing with all the the other effects of having a disordered relationship with food.

Jenny Tomei  04:05

Okay, so so are you saying that people obviously may have an eating disorder and they’re going on this weight loss drug, so they’re not obviously getting down to the root cause here, not sorting the psychological side, right?

Speaker 1  04:16

Yeah. So we have seen this a lot in previous years. I would say actually it’s way more now though. But when we had more so gastric bypass, there were a lot of people who, in theory, you were supposed to get most of the time, at least from the gastroenterologist and people who work with that. That I that I connected with would say that they normally needed like mental health clearance at that point before doing that, because you know, unfortunately, when you are maybe doing something to physically change yourself without addressing the the mental health side of things and what might be perpetuating these behaviours that might you know contribute to that, you know, unfortunately, we’re not actually dealing with the. Issues and now I think it’s so much more common that people are ready and willing to go on GLP ones way more than we ever saw with gastric bypass, and even people who might not, you know, be at the place that that’s probably the healthiest choice for them.

Jenny Tomei  05:17

Okay, that’s really interesting that you’re seeing a lot of that in your clinic, okay. It

Speaker 1  05:23

makes it really hard too. Like when we’re dealing with separating out the the noise. Like I know that we’re hearing a lot with the GLP ones that it’s helpful for the food noise, which is one of the selling points for a lot of people who are struggling with their relationship with food, like oh, I can I can deal with it better. But unfortunately, usually what happens is that once you are no longer on the GLP ones, which ultimately is going to be the goal at some point, that all comes back. If you’re not actually dealing with the underlying things that have fuelled the behaviours that made it difficult for you in the first place, then as soon as that is taken away, we’re left back with all the emotions and the thoughts that had made it difficult your relationship with food difficult in the first place.

Jenny Tomei  06:12

I mean, food noise comes from dieting and under eating anyway, doesn’t it? Like that’s you know that’s what food is. I I heard that term a lot, and I’m like, what food noise? It’s like a. It’s not. This is not a scientific term. It’s like something just being kind of that I see all the time. I’m like, what is this? But that can, as you said, it can come from diet. And as you said, like you can’t stay on this drug for life unless that is people’s intentions. But I know that it says in the here in the UK that you can only put it for two years unless you’ve got a medical sort of diagnosis going on,

Speaker 1  06:44

right, right. And what I’m seeing is it really makes it hard then too on the like when we’re talking about physical movement to like incorporate all of that because when it is taking away the food noise and essentially muting that like the hunger and all of that, we might be not nourishing properly enough to healthily move our bodies and and strength train, which I know is really important when you are on GLP ones, especially. And that that becomes a whole other issue too, physically and and then mentally, of course. For my side of it, it can be really like screwing with our mind a little bit for lack of a more intelligent way to put that.

Jenny Tomei  07:28

Yeah, because you need to eat more to exercise, especially if you want to build muscle mass. Like metabolic tissue, you have to eat more to build it, right? And to sustain it and to keep it. Yeah,

Speaker 1  07:37

it’s like food is fuel. And if we imagine, like with our with our cars, if we just like remove the gas gage, like how are we going to know that like oh my car needs needs fuel? What ultimately will happen is that you are left off stranded on the side of the road, and it’s like oh gosh, what do I do now? So it can be really pretty much pretty dangerous if you’re not, especially if you’re not working with a whole treatment team. I really hope that most people. I think probably most people would benefit from having a treatment team if they are on GLP ones. That does include not only the prescribing doctor, but a therapist and a dietitian to make sure that every part of that is kind of covered and that we are recognizing how this is impacting and making it difficult for you, and how can we work with that to make sure that we are getting you to the ultimately to a healthier point in all of those regards?

Jenny Tomei  08:30

Yeah, yeah, definitely. I know here within the UK, and tell me what it’s like in America as well. Is that if you’ve got the drug from sort of NHS sort of route, that you are entitled to some sort of program to help you with that, like nutrition and stuff like that. But if you have bought the drug privately, which most people are doing, you’re not entitled to this sort of program. You have to go seek out your own help or a nutritionist or, or something. And you’re sort of left in the dark. Then a lot of people have bought it sort of privately. And then is there sort of a waiting list for this program that you go on, and you know what are they teaching them on on this sort of program as well. So it’s, I think that’s quite scary because I’m my concern is that it that this can create that disordered relationship with the food and the exercise because they’ve lost all reality of how to fuel it because they’ve been on this appetite suppressant, and then you have to sort of learn. It’s almost like the opposite because you have to start eating more to exercise and to build muscle. So it’s a learning and a whole new way of eating again.

Speaker 1  09:34

Yeah, yeah, and unfortunately, our system works a lot differently than than yours, which I’m sure you’re somewhat familiar with, but we it’s really up to the individual doctor whether or not, or the the facility whether or not they’re going to recommend the the treatment team. And so I’m not going to say wholeheartedly no. I’m sure there’s a lot of people who are like, yeah, my doctor, my facility wants to make sure that we have all these. People and that’s great, but I’ve also seen the other side of it as well, where that’s not being recommended, and just kind of being like, “Here, this will help, and this will be your resolution,” and then you’re kind of left on your own. But it really does make it difficult too and trippy when we’re thinking about. I know a lot of us like to talk about intuitive eating, which I would not say is the the first start, first step when you are dealing with a disordered like relationship with food. Of course, we have to regulate our bodies more before we can feel trusting of our bodies, both mentally and physically, where our bodies are communicating hunger and fullness to us. But that the GLP ones make it that much more difficult because you’re not getting those those signals the same way. And then when you’re bringing in movement, a lot of times you have to because it does limit your appetite. So you’re probably needing to eat more than what you’re really physically wanting to, and that’s also then sending signals to your brain, like we don’t we ignore the fullness cues. So there’s a whole thing that we’re gonna have to work on once you’re not on there. Like how do we honour how our bodies are meant to work? Ideally, with no other foreign influence that we eat when we’re hungry, we ideally stop when we’re full or close to that.

Jenny Tomei  11:20

Yeah, yeah, no, I couldn’t have put that better myself. I mean, I I saw this coming. I was worried about it. Like, I was just like, how are these people going to learn? Like, when they come off it, like, what’s going to happen? Like,

Speaker 1  11:31

you know, because

Jenny Tomei  11:31

I’ve seen people gone too far with it, and you know, and that’s scary, and that’s led into whole kind of like body dysmorphia, coupled with the exercise, that’s like a perfect storm. Yeah, it

Speaker 1  11:46

it is. It’s really concerning for me as well because it came on so fast to for for what it’s being used for right now, and I I’m not feeling very confident that doctors or prescribers are having full conversations about what this is going to look like long term. Like, how long are we supposed to stay on it? What should I know? People who have been prescribed it who have absolutely no idea. Like, we’re told nothing about how they how to eat. You know how important hydration is, how important protein is, and that’s a really scary thing because I’m not a medical doctor, and I’m trying my best to ethically give the information that I have and trying to give resources for that. But that’s really, I would hope that that’s where the doctor is going to, you know, put all that information and give them all that information. So I think a lot of people are kind of feeling like they’re on their own.

Jenny Tomei  12:42

Yeah. No. I mean, I I would I would agree with that completely, and it’s what worries me. And it’s it’s the sort of lack of support, as you said, what’s available there to people, and kind of understanding what happens when they come off it, because eventually they will have to come on off it. You know, and it’s as you said. It’s it’s scary, and it’s and not many people can afford to have like a you know someone private nutrient to help mentor them through this process because it’s. I don’t think it’s about having a one-off nutrition session. I think this is like mentoring someone through the process of learn how to eat again. Like under you said, your kind of like hunger hunger cues, your fullness cues, helping with the anxiety around hunger because a lot of people have anxiety like when the hunger comes back or they’re worried about that, and they’re like in this kind of fear of weight gain if they’ve gone you know too far with it, which is what happens with some people, and it’s like this anxiety and they’re stuck in this sort of loop. So that needs that needs long term attention.

Speaker 1  13:45

Yeah, absolutely. That’s why if there’s nothing else that from my end that people take away from this, I would I would hope that what’s really taken away is like get a treatment team if you can. Try your best to to have those different professionals on your team because we want to, we can use the GLP one if if you’d like as a tool while the noise is lessened a little bit. Okay, then let’s figure out the other tools so that when you come off of it, you’re going to be equipped to dealing with that in a more effective way, both nutritionally and mentally and physically, of course, as well.

Jenny Tomei  14:23

Yeah, and that’s definitely something that I’m starting to do with the clients I’m working with, and it sounds like you’re doing the same as well. With the that’s really good. Have you had good results for the clients that you’re working with as well? Like on this, are they similar

Speaker 1  14:38

processes? So if they’re seeking help, then I’m already thrilled because they are recognizing that hey, it’s not just about my body; it is way more than that. And when we can recognise that, that is already a big step in the right direction. So I’m a little biased to say that yes, it’s definitely I’m already dealing with people who are able to recognise. That at that point, my concern a lot of times is getting the people who might not recognise that to the proper channels of help. But yeah, when we are actually sitting together and trying to figure out, okay, well, what was this food’s function for you throughout the course of your life or throughout the onset of once you started recognizing that your relationship with food was off, and when we can look back and and see that, then we can also work on okay. When you’re off the GLP ones, what food noise is probably going to come back? What thoughts have been fuelling this? How do we intervene with maybe changing our our thoughts and our beliefs? How do we intervene with perhaps some coping skills to help with overwhelming feelings? How do we have the ability to kind of surf the urge when you might be inclined to overeat or binge or purge or whatever it is, and for that particular person? So if you are recognizing it and working on the tools a lot of times when we’re getting off of it, which you know we’re seeing a lot of people wanting to stay on it for a long time because, like you said, all the anxiety and the fears around that about what happens once you’re off of it. But if we are able to deal with that, I have noticed that people are feeling more confident when they are ready, or at least talking about stepping off a bit.

Jenny Tomei  16:25

Okay, that’s good. So what? So you said about some signs there. So I think it’d be useful for like someone listening to this if they’re like, “Oh gosh, this sort of resonates with me.” About what are some of the signs that within someone that you know that the relationship has become distorted with the GLP one and exercise, what can they look for that like within themselves to you know as signs?

Speaker 1  16:46

Yeah, yeah. So I would say a lot of the thoughts that we can recognise. I would encourage anyone to be really honest with themselves about prior to the GLP ones. Like what caused you to go on the GLP ones. What what were your beliefs around going on the GLP ones? What were you hoping to resolve with the GLP ones? So I think where we want to start is actually really being honest with yourself retrospectively. Like let’s look beforehand what what led you to that point, because that’s where I would say arguably that’s probably where the disordered eating had started, somewhere in that in that time period. Now I think that the GLP ones, once we’re on there, whether or not it was pre like previously because of disordered eating or not, I think that exacerbates it. When we’re on the the GLP ones, it can make it where then like if you’re having extreme anxiety about not being on the GLP ones, that’s a good indication that hey, there’s something off here. If you are having a belief system that once I get where I’m going to gain all this weight, or no one’s going to like me, or I’m going to have to go on another diet. Like these thoughts are very indicative that something is off. So if any of those are are feeling like those thoughts are popping up for you, or feelings, extreme feelings, that would be some helpful signs to say like, oh, this might not be the best thing. And then if you are, I think especially with physical movement, whether or not you’re on the GLP one, trying to recognise like what role it plays in your life, because a lot of times physical movement it can be. I’m a I’m a huge fan. I want to preface it by saying I think that movement is such a great thing mentally and physically for our lives, but we need to really be honest with ourselves about how it might be playing a role in a disordered eating pattern or an eating disorder where we’re using it to compensate for like eating, or if we don’t exercise, that we feel really guilty or anxious. Like all those are red flags too. Like I said, on or off the the GLP ones with that.

Jenny Tomei  19:03

Okay, that is really useful for some people to kind of whoever listened to this or knows someone that might be going through this to kind of have check a look at themselves and to kind of think, you know, am I is this going on for me right now? And knowing it’s okay, I think it’s really important to sort of say like it’s okay to like seek out for help if you’re experiencing this.

Speaker 1  19:24

Like, yeah, I would I would absolutely agree with that. And what I would say is something to to just think about for anyone. If you even believe that it’s a possibility that like maybe something’s off, there’s no shame in getting help. And I would encourage you to find help from you know a therapist who works with eating disorders or disordered eating. I honestly, I think that’s probably one of the first stops, and maybe I’m biased, but someone who works with eating disorder with eating disorders as a therapist, I also will refer to dietitians who I know. Work with eating disorders and people. That’s how we connected. You know, I know you’re not a dietitian, but I know that you work with. You’re going to be a therapist, and you work with movement. So it’s finding other professionals that are going to work well with you. So reaching out for help and letting that person work with you to figure out like maybe this is something more. There’s no, it’s it’s never too early, and the worst case scenario is that you’re just too proactive. And is that that bad? It’s better than it progressing and you never getting help or getting too late. Like not, it’s never too late to get help, but it could be you know more progressed where you’re starting fresh to try to get better.

Jenny Tomei  20:44

Yeah, you don’t want to prolong it, right? If this is going on, you don’t want to prolong that because it will just get worse. It will get stronger, like

Speaker 1  20:52

yeah, when

Jenny Tomei  20:53

it at the end of the day, and it’s

Speaker 1  20:54

right. And research consistently shows that the earlier on an eating disorder is caught and treated, the better. And I would say that it usually, pretty much all the time, is previously from disordered eating. So anytime that you’re noticing that there’s something off, the earlier the better to get help. I would encourage you to do so if that’s something that you can do, because usually that means less time, less energy, less less higher levels of care, less money, all of that.

Jenny Tomei  21:25

I mean, what about? Let’s talk about. I’m going to throw neurodiversity in the mix here. So I’ve gone on to weight loss drug, or I mean, I’ve seen this, and I don’t know. They have ADHD, or I don’t know, autism, or OCD, and you know, with ADHD, with the kind of obsessive, sort of addictive, sort of nature, the perfectionism, the results they see with that drug, I’m wondering if that that’s going to add in complications as well. Like it’s going to heighten everything.

Speaker 1  21:57

Yeah, for sure. I mean, one of the things that I talk about with eating disorders before GLP ones came on the scene in this way was that it’s a very complicated thing to treat, and it normally takes longer than most things because there’s a lot of comorbidities, meaning that often you don’t see an eating disorder in isolation. Usually, it is coupled with a mood disorder, which might be like depression or anxiety. There could be OCD in the mix. There could be trauma, a body dysmorphia, depending on you know where we are. That could be part of it. Sometimes we see, yeah, people who are struggling with autism or ADHD might be struggling in a different way. So yeah, anytime there is another diagnosis or symptom that’s there definitely makes things more complicated. So that’s all something that good, like good professionals, treatment professionals, will be able to to try to recognise and make sure that you’re getting the proper treatment and you’re being treated the proper way. So that with your particular specific situation, we know how to best intervene to help you get off the the GLP ones when you’re ready to do so, and to be optimizing yourself for success.

Jenny Tomei  23:08

Yeah, and I definitely I just I do think it’s going to heighten people like for neurodiverse sort of aspects. It’s going to heighten everything like the the anxiety around the weight gain, the hunger, the exercise, and I I just as you said, it adds an extra layer of complexity to the issue because are complex. There’s no, you say, there’s no one single cause. So, but you add complexity onto the mix. It’s, yeah, it’s hard.

Speaker 1  23:32

Absolutely, absolutely. But you know what? I mean, this is something that we’re there’s usually more than one thing going on at any given point, so it’s something we’re we’re used to to dealing with to try to like I said optimise success.

Jenny Tomei  23:49

Yeah, yeah. I just know myself because it’s something that I went through, and I think you know Western. I’ve told you that I’ve still had sort of anorexia, stuffed with exercise addiction, and then two years ago I got diagnosed with sort of ADHD. So you know, I ran sort of very high level, sort of running and stuff, and I got sort of very you know into that and very hyper focused, like addicted. So I know what that mindset can do with that, and I can just kind of relate to someone who’s like struggling with that, and it’s it you, it’s like a fighting battle on your head, like

Speaker 1  24:22

yeah, yeah, and and it’s so interesting that you bring up running because I see this a lot with my clients, especially runners, and and in and of itself that becomes its own struggle. It becomes an identity, and I think that’s that’s wonderful. I think it can be so so much like you are part of a group and all of that, but unfortunately, if you’re dealing with an eating disorder that, for some reason, maybe an injury, which I’ve seen a lot, that might have thrown thrown someone to where they can’t run the same way, and then it then not only disrupts their identity because what are we? We are runners, and. And that’s such a core part of their identity, which again, I don’t think in and of itself is bad. It’s just that we need to recognise the role that it plays for us and how quickly that something circumstances could change that might make it where you can no longer do that thing in the same context, at least for that period of time. Whether it’s an injury, whether it’s like your treatment team is saying we need to lay off a bit because X, Y, and Z. So yeah,

Jenny Tomei  25:27

no, I can definitely like relate to that with the running because you know in sort of early 20s I used to run at like national level and it was my life. It was my life and it was my training and obviously I got sick and kind of couldn’t go back to it. Like too many injuries and stuff. And it, I was like, oh my god, that I’ve just lost my complete. That was my identity. Like I threw everything into it. So I think anyone listening to, I think it’s so important. So like now, what I’ve tried to focus on. Obviously, I still love school and I still do all my different sports, but I have lots of different ones, and I try, you know, think like right who I am as a person, what I do. I don’t want to be too tied to that. You know, just looking at myself and who I am as a person is enough. I don’t need to have like an identity. I don’t need to be tied to something or defined by anything. I hope I’m making sense, but that’s kind of what I’m like. I’m trying to work on.

Speaker 1  26:27

Yeah, no, absolutely. I think that you’re describing something so important too. It’s like diversity in who we are as an identity. Because if one thing goes to the wayside, no matter what, like anything could be could change in an instant, and then what? So if we have other things that also define us and make up who we are, then it’s not such a culture, like such an identity shock, rather.

Jenny Tomei  26:51

Yeah, that’s exactly what I was trying to say.

Speaker 1  26:53

I got you,

Jenny Tomei  26:56

but yeah, I had to work hard on that because I was just on a kind of like tunnel vision, kind of super focus on it. It was I got very good, and it was, you know, and it just became life. But then, you know, I lost that so dramatically, and it was it was a a depression that followed after that, you know, and that was tough. Like

Speaker 1  27:15

for sure,

Jenny Tomei  27:16

um, that was that was really tough, and you know, obviously fine now. Like I’m really good. That’s why I help others sort of free this, and kind of, and that’s what I’m really passionate about. So it’s a good mix. I feel so. I

Speaker 1  27:32

love that, and thank God that you. It’s such a great thing that you had that experience that you can now share from that perspective to really help people, especially in the like the niche area that you are, where you’re helping people who want to learn how to move their bodies or want to introduce exercise, but in a way that isn’t such a like all or nothing type of world or potentially disordered in its own right. And I know I think that any type of like exercise can be like really wonderful if that’s something you really love to do. But unfortunately, sometimes if you have an eating disorder that’s thrown into the mix or an injury or whatever, trying to reincorporate that or figure out like the the aftermath, like if you still like I really want to run, it might not be in the cards for that person right then and there. Hopefully, and maybe maybe never potentially, but depending on the person and you know where they’re coming from. Yeah. But we can’t just go from like, okay, I am in this place with my eating disorder that I’m either not medically cleared to exercise or like it’s becoming so compulsive that I need to take a break from it in order to figure out a healthy way to reintroduce it. So like, but it can be can be really wonderful. Some people define like running out such endorphins, this and that. So it can be great for some person, but another person it can be like if I don’t make if I make it less than I did yesterday, then I’m a failure, and then that’s it can be the same thing on the outside to other people, but it could be so wildly different experiences for you know different people.

Jenny Tomei  29:11

Yeah, I mean, with the running, and obviously I suffered with red, so relative energy deficiency syndrome. So it’s a kind of energy availability, and so I had that during when I was sort of running, and it wasn’t it wasn’t spoken about right because there were other people in my group that were struggling with it. You know, you you know there were everyone that they had disordered relationship with feed or a possible eating, but no one talked about it then. So you know, no one checked in if we were having periods, you know.

Speaker 1  29:42

That’s a big, big thing

Jenny Tomei  29:45

because I wasn’t. So, and I know that some of we weren’t because, you know, I just knew because we talked about it, and it just it was that was not normal. Like that’s just not normal. Like you know, if you’ve lost, I always say if anyone loses their period, like get it. Checked out straight away because I’d wish I’d done that because I didn’t, and I ended up with a very bad hormonal imbalance as well. So, which many years to kind of like fix as well, and to kind of get it balanced, coupled with the ADHD. So, because people with ADHD tend to like experience quite big shifts in like their hormones, especially older, like progesterone, estrogen, like dopamine, it’s quite interesting sort of area. But I think it’s something that I do see a lot. Actually, to be fair, I have seen a lot of posts on social media, like kind of athletes talking about this more and kind of opening up about their stories, which is good because I’d wish that I’d seen that when I was in my sort of peak because no one talked about it then. So yeah,

Speaker 1  30:48

I agree. I think there’s definitely a shift, and I’m so grateful for that. And I hope that it continues in a healthy way for that to be more of a conversation. I know that a lot of different sports can become like competitive with themselves and with other people, and it’s like, well, if you can do this and I could do it, and it could become this whole, it can become toxic, but that is really scary. And I think that it’s such a great piece of advice that, for some reason, a woman stops getting her period for like seemingly no reason. That’s something 100% to get checked out because that is a sign that like our body is not functioning at the way that it is. Because a healthy body ideally is going to have a regular cycle, and if not, then that’s something worthwhile checking out. And that’s one of the first things that our body does to try to show something’s wrong. Please tend to me. So it’s just one of our wonderful communication systems from our bodies to to help you get the help that you need. So absolutely, yeah.

Jenny Tomei  31:55

I mean, because having enough oestrogen is really important, you know, for preventative against like cardiovascular disease. It’s not just about facility, like

Speaker 1  32:03

exactly. And our bone growth, bone density. It can, if we’re not getting a regular cycle, it can really mess with our bone density and make it where people. And I have known people in their 20s who have like been diagnosed with osteopenia later on, sometimes osteoporosis, and way too young for it, but unfortunately, because they lost their cycle for so many years, and and there was some damage that wasn’t necessarily fully reversible.

Jenny Tomei  32:30

Talking about periods, I’ve actually teamed up with someone on this sort of health psychologist, and she works with eating disorders. And we’ve created. I can send you afterwards as well when we’ve done it, we’ve created some resources on like amenorrhea, like periods and stuff. She’s doing it as part of this course that she’s doing, and I believe it’s her PhD. I believe, and yeah, we’ve put that together actually. So once I can send them to you, please

Speaker 1  32:58

do absolutely. I love that.

Jenny Tomei  33:01

Yeah, we talked about primary amenity as well when someone hasn’t their period because I up. Yeah, I’ll send you those once they’re done. There’s like one for like coaches, teachers, young people, like parents.

Speaker 1  33:14

I love that. Thank you.

Jenny Tomei  33:15

Yeah, we just sort of sort of put all that together because it’s just like information of like if you haven’t got your period, like to go on, kind of like HRT. When to consider that? Like bioidentical hormones and stuff like that. Because the GP won’t necessarily. They might want to put you on the pill, but it’s not necessarily going to protect your bone health.

Speaker 1  33:33

Yes, yes, that is such an important point to make here. Yeah, I know we don’t want to like overstep the doctor or whatever, but that’s usually the first course of action for a lot of people that I hear is that they just like, well, we’ll give you the pill, but that doesn’t actually that might give you like the physical period that you could see every month, but that doesn’t actually resolve what’s underlying, and you know you’re still having those other issues, and now we don’t even have the marker to tell us when it’s going to be like when it’s in a better place. So yeah, so take that for what it’s worth.

Jenny Tomei  34:06

Yeah, I can send you that because if we’ve put together like all the information on that, on kind of like what didn’t we explain all of that? So I’ll send you that. Yeah, I’ll send you that. But yeah, I think that leads on to like kind of some sort of reflected questions that I spoke to about before we started the podcast, and like kind of, and feel free to add to these about you know if anyone’s listening to this and think, oh god, I you know, I I feel like my relationship with food, exercise, or on a weightless drive has become a little bit distorted. So I’ve just put together some sort of reflected questions and kind of think about and ask yourself. So, like, I mean, the first one is we’ll get when and why do exercise. So, exercise is there for mental health fun. It’s not there to burn off calories, right?

Speaker 1  34:55

Being honest about the reason. Yeah.

Jenny Tomei  34:58

Yeah, being honest about the reason. How do you feel if you miss workout?

Speaker 1  35:05

Yeah, big red flag if it’s a lot of anxiety or guilt. It’s definitely something to to look in, and you know, then that might be something to be like, hey, I might want to get some help for that.

Jenny Tomei  35:19

Cool, awesome. And again, this one I love this one. I wish someone asked me this was years ago. So, am I exercising because I enjoy it, or I feel like I have to?

Speaker 1  35:30

Yeah, that’s a great question to ask because if it’s something that’s being fuelled from a place of like, I love just doing this exercise. I really have a lot of fun doing it. I know I feel so great afterwards, go and do it. Assuming you’re medically cleared, of course, then that sounds like a great thing from at least from a mental health end. But if it’s like, oh man, if I don’t do this, then I’m not going to be able to have you know dinner later, or I’m not going to, I’m I’m going to have to double up tomorrow. If you are starting to compensate in that, or starting to really freak out and trying to figure out how you’re supposed to plan, or if you are starting to have some bad thoughts about yourself, like oh I’m lazy, this and that, that’s a big red flag.

Jenny Tomei  36:11

Yeah, I agree. Yeah, this part and also that’s something that’s close to my heart personally is um what emotions am I trying to manage through exercise because that was me. I used exercise as a way to escape my emotions because they always say that exercise is good for like stress and anxiety. That’s fine. I’m a personal trainer, like I say that to clients. But for someone like me, I took it way too far.

Speaker 1  36:36

Yeah, that is such a great point. My practice, as you know, is is called state of balance. Balance is like what almost all my answers ever come down to. Is that yes, it could be absolutely wonderful to move our bodies for stress and anxiety. However, someone who’s struggling with their relationship with exercise, their body, or food, that could be like you said, a way to cope. It could be a way to like kind of try to forget about the other the the issues. It could be a way to try to outrun your body image issues. It could be a way to say like, no, I’m not feeling anything else. I’m just gonna run, run, run, and ignoring your emotions, which ultimately will catch up to you. So we want to have a nice balance where we can recognise our emotions, and maybe it’s helpful to process them while we’re working while we’re working out. But if it’s not, if it’s just like an escape or something that just kind of putting our feelings aside and not actually dealing with it, then that that’s something worthwhile talking to someone about.

Jenny Tomei  37:34

Okay, amazing. And then do yourself? Do you allow yourself to rest without Feeling guilty, so and as the as an athlete or used to be athlete myself, oh god, I struggled with rest. Like,

Speaker 1  37:48

yeah, couldn’t

Jenny Tomei  37:49

rest. So, but that was put the ADHD in the mix as well. There was that making it worse, like in driving the intensity behind that. But then with the eating disorder as well, so rest is seen as not productive, you know. But it an athlete needs to rest. If you want to perform, you need to rest. Like

Speaker 1  38:10

absolutely, that’s why it’s like incorporated into a lot of workout programs, rest days for both mentally, physically, all of that, and and also to account for life happens, and sometimes we can’t can’t always be doing the workout or whatever, and when we’re able to have that flexibility in that, and also allowing ourselves to rest, because you’re absolutely right that rest is part of productivity. Not that we have to make everything about like being productive, but rest is an important thing too. If if that’s going to help you to rest, you can recognise that’s probably going to help me in the long run with whatever my goal is. But also, like you deserve rest, which might be a little bit hard. That might be a harder place to start for you. Rest is necessary. It’s not an option or just like I something that I get at like as a reward. It’s something important that we need to prioritise, and some people have a lot of thoughts that pop up that oh I’m lazy or other people are doing more than me. Yes, red flags. The

Jenny Tomei  39:12

other people that are doing more than me want.

Speaker 1  39:15

Yeah, yeah. If I’m resting, then everyone else is doing it. That means they’re gonna get ahead. There’s a whole lot, but these are all questions that you know. Based on some of the things that we’re talking about, you might want to get help with.

Jenny Tomei  39:29

Yeah, amazing. And I think the last one be really good. So you know, does exercise you know does it leave me feeling energised or does it leave me feeling completely exhausted?

Speaker 1  39:38

Yeah, ideally, moving our bodies should feel should feel like afterwards, like okay, I feel like a little bit of an energy spike. Even if you might feel like physically tired, there’s something that you’re getting out of it in terms of like feeling better. And if you are exercising to the point of depletion, that’s not good physically or mentally. Ultimately. We want to have something still in the tank to carry on for the rest of our day. So yeah,

Jenny Tomei  40:05

that is something that I used to do all the time. What you have just said there, I used to, and it was came from a perfectionist achieving background.

Speaker 1  40:13

Yeah, that I see that a lot with my perfectionist clients and ones who identify with perfectionism.

Jenny Tomei  40:19

Had to just push it to the max. Nothing left. Like, and I mean, as an athlete, whether you, yeah, you do have to do that. But it’s there can be a healthier way to do that. I was not doing it in. There was a point where I was like, well, if I haven’t done that, then it’s not good enough. And that’s where the relationship became bad. And that’s not healthy as well because you shouldn’t be pushing yourself to depletion all

Speaker 1  40:43

the time

Jenny Tomei  40:44

because you that you just get low glucose levels you don’t recover properly after your session because you haven’t topped up after the after the session you’ve just depleted yourself

Speaker 1  40:55

often

Jenny Tomei  40:56

like it’s I think that’s something that yeah that I struggled with for years, and it and it it took a lot of time to like work on that because, as you said, it was of working on the high achieving and the perfectionism side of myself, which I had to work on because, as you said, something was driving that.

Speaker 1  41:14

Yeah, and you’re right. I mean, we definitely want to work on like somewhere between the all or nothing. I understand that a lot of times, yeah, we do have to. We are challenging ourselves. Like it working out, it should be like somewhat of a challenge if you for certain goals. But especially strength training, I know it has to be like somewhat of a balance. But also, you normally have something left afterwards. Where sometimes, sometimes it’s going to happen. Where you’re like, oh my gosh, I could just like pass out right now. I think we all have moments that like maybe maybe we pushed it too hard, but we just want to generally more often than not just trying to be very mindful about finding that balance where we’re challenging ourselves in the way that we need to, but not overdoing it. And that’s kind of like where it’s a little bit more nuanced.

Jenny Tomei  42:01

Amazing. Honestly, I’ve really enjoyed this podcast, and I feel like it’s been so beneficial. I hope people listening to it have found it beneficial as well. And it’s been amazing to have you on. If anyone wants to kind of look at more at what you do, where can they go? Like, what’s your social media? What’s your website?

Speaker 1  42:19

Well, thank you again for having me on. I really enjoyed this conversation as well. And yeah, you could find me. You could go to my website. It’s state ofbalancementalhealthcounseling.com. I have blogs there. I have a lot of information there. You feel free to reach out if you guys have any questions or anything. Also, I have an Instagram. It’s it’s the handle is at state of balance for life. And my friend and I, who is also a therapist, we have a podcast. It’s called Quapi and Counseling Podcast. We’re currently on a break right now, but we do expect coming back. We have a lot of of episodes in the in the you know out there. So feel free to check me out there as well.

Jenny Tomei  42:55

Amazing! Thank you so much for coming on. It’s been amazing to have you. Hopefully, we’ll have you on again. I would

Speaker 1  43:01

love to. Thank you so much. I really appreciated this.

Jenny Tomei  43:04

That’s been amazing. Thank you so much for listening to the JenUp podcast. You please subscribe to this podcast, share it so other others can benefit from from it. You can find us on Facebook and on Instagram at @askjenup, or on my website for the nonprofit jenup.com, or for my sort of personal training one to one work at jennytomei.com. If you visit the website, you’ll find lots of different resources available there. Please like and subscribe and share this podcast, and thank you all for listening.

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!