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Janet is joined by Grace Lautman, a therapist and nutritionist who focuses on eating disorders, the conditions that can create and aggravate them, and how eating — or not eating — can be a symptom of mental health issues. She writes: “My hope has always been to provide accepting spaces for all individuals and bodies to explore and honor their relationships with food, body, and self.” Janet and Grace discuss some of the early signs of eating disorders, and how our own relationship with food and body image throughout our lives can affect our children beginning in the early years.
Transcript of “Eating Disorders, Healthy Body Image: What Parents Need to Know (with Grace Lautman, CN, LMHC)”
Hi, this is Janet Lansbury. Welcome to Unruffled.
I’ve been looking forward to this opportunity to hear from Grace Lautman. She’s a therapist, an eating disorder clinician, and trauma specialist who’s with me today to talk about our kids’ healthy body image and the treatment and prevention of eating disorders. She mostly works with preteens, teens, and adults, so I’m hoping she’ll share how we can get on track early to be able to influence our children positively in regard to their relationships with food and feelings about their bodies from the time that they’re young. And maybe we can catch early signs of tendencies that our kids might have.
On Grace’s website, honornutritioncounseling.com, that’s honor, H-O-N-O-R, nutritioncounseling.com, she states that her team appreciates “the bravery and energy it takes our clients to reach out and invest in their own healing, as well as their children’s, and we are honored to be trusted as a resource.”
Let’s get to it! Hi, Grace. Welcome.
Grace Lautman: Thank you so much for having me.
Janet Lansbury: I would like to start right away with hearing about your work, the issues that families bring to you. What’s happening for you these days? What do you see families concerned with?
Grace Lautman: My work primarily is with the prevention and then also the treatment of eating disorders. I work with kids as young as about 11, and I work with parents, obviously, because of that, and adults. So a lot of my work centers around an eating disorder that is already present in a family. But in addition to that, there’s a lot of prevention work, especially in my work with adults who already have an eating disorder and maybe a parent that is unpacking that while parenting, to try not to put that harm onto their kid.
Janet Lansbury: Does that happen, that if we have a disorder in regard to eating, that our child has one? How much of it do you think is genetic and how much is environmental, and what is our influence in terms of helping children to not struggle the way that we did?
Grace Lautman: I feel like it’s absolutely genetics plus environment, as so many things are, so many pieces and so many experiences disorders are. But we do have influence. In working with parents—and in being a parent myself, since I became a parent, I feel this even more strongly now—how important it is to acknowledge the genetic aspect of that. We know from the research that this is a brain difference, it’s a difference in your brain. And so genetically, we know from twin studies that this is something that we totally pass down genetically. And there are a lot of things that we can come into parenting with and even pull back and redo and recreate in our families to sort of establish the family culture around this stuff that can be more preventative.
So I always tell parents, you don’t just cause an eating disorder, it’s not all your fault. We’re not here to blame parents for an eating disorder. And that’s a very, very important part because we’re all human trying to navigate through so much in these conversations around food and body with our kids.
Janet Lansbury: Exactly. There are certain genetic tendencies that we all have for different things, and there’s nothing helpful in getting down on ourselves either for these things.
Grace Lautman: Totally. And I think with food, part of unpacking some of this stuff in our families and in ourselves to set our kids up well and treat an eating disorder if somebody gets into that position in a family, is really about reducing the shame around it and getting out of the blamey, black and white thinking and controlling. It’s like, yeah, this stuff happens and we can always redo how we’re doing it and have these more nuanced conversations in our families and just approach it from a more nuanced lens and compassionate lens.
Janet Lansbury: And are there certain dynamics that we could see in our children very early or certain aspects to their psychology or ways that we see them handling situations that might be a sign that something like this might be happening? And at that point, what would you do anyway? I would really love to hear what you talk about in terms of prevention. I think that’s really important.
Grace Lautman: The prevention is, I’ll maybe name a couple of the big topics within the prevention. It’s normalizing puberty and growth in childhood and throughout childhood. Normalizing fat and weight gain as a part of that, because our culture tends to be very fear-based around growth because growth typically does, especially in childhood, mean weight gain. So part of what happens in those preteen and teen years is that a lot of fat deposits happen, a lot of fat growth and weight growth happens.
And it can be really, really scary for parents, especially when there’s so much fear around preventing diabetes or being in a bigger body and all this stuff. So it becomes really scary, and I just see a lot of parents feeling really afraid and then trying to control something that they don’t have as much control over in that way. That sort of thing that you talk about a lot on your podcast, which I love, which is about focusing on the relationship and what’s happening in our child and staying out of this fear-based, reactive place. And so we’re trying to slow people down, to both normalize what’s happening and also focus on the relationship.
Janet Lansbury: Yes, that fear-projection space that we can get into so easily without even knowing it. And we all do it to some extent. I don’t think there is anybody that looks at their child and watches the way they play or the way they behave and doesn’t have some little fear or red flags that come up around certain things and based on our own experience.
But how do you calm parents down about it? I want to steal some of your ideas so that I can help parents! When you work with these issues and they’re 11-year-olds and you’re obviously working with the parents as well. Are you talking to the children separately and the parents separately, are you talking to them all together, or both?
Grace Lautman: It’s so much both. Maybe we could use as a little bit of an example a pediatrician appointment. Typically, we go to the pediatrician and they take our weight, they take our growth, they look at our growth charts and see about our kids’ trends. And as an example, if the doctors are saying, “Hey, how are you doing with your fruits and your veggies?” And the caregiver makes that sort of, “Well, not very good,” and there might be a moment of the weight’s looking a little too big. These are moments where we might be unpacking some of that in my work with kids and families. Just stepping out a little bit to unlearn some of the things. There are times in the medical field where there are approaches to weight and food that are based in aspects of science and bodies that are important, but we have to look at them really critically and how that looks to be a kid in this world growing up in a body with social media, etc.
So if we’re unpacking these moments and some of the things that might have contributed to a kid getting to their preteen and teen years or that moment of, My body’s starting to grow and I have more fat on my stomach than I’ve ever had before, then it’s a moment where we’re going, Hey, nobody really told you about this, but it’s really normal to gain a lot of weight during this period, even before puberty starts. There’s a lot of reasons why we don’t get enough vegetables in sometimes, so many different pieces. You’re not doing a bad job or we’re not looking down on you for that. So we’re just reducing shame and blame.
Janet Lansbury: And giving more of an objective perspective from your clinical point of view and your experience.
Grace Lautman: That’s right.
But I think a lot of it is about normalizing puberty and growth and is also about celebrating body diversity and normalizing that. And then taking some of that fear from parents away. A lot of parents are nervous that their child is going to struggle in the same ways that they’ve struggled with their body image, but it’s from a place of fear. The kids pick up on that, you feel it. So I’ve heard a lot of teens say things in private to me like, “I never worried about my body until it was starting to be commented on.” Even larger kids have said to me, “I keep hearing my parents say something like, I just don’t want you to struggle in the way that I struggle. I don’t want you to be made fun of.” And they say, “I didn’t feel bad until it started to be discussed in our family.”
Janet Lansbury: Yes, that’s a problem.
Grace Lautman: Totally. But those are the really honest and lovely moments. And as you know, so many parents want to do so well. So it’s just that shift of giving that information, having that. And what I really want your listeners to know is just that they can back up, they can redo, they can have these conversations, and they can develop that continued listening. Really unpacking what is mine and what is my child’s and what is me looking out for their health and what is me sort of projecting this fear onto them?
Janet Lansbury: But as you said, the intention is so loving and positive and we do want to spare our kids from our own struggles, of course. So how do we put that in perspective and understand that the way it works isn’t that direct? It isn’t like, If I tell my child this, they won’t do it. It can be the opposite, that our anxiety is contagious. And when there’s anxiety around eating, we know that creates issues, whether it’s they’re not eating enough, they’re eating too much. Anxiety actually affects the appetite, it affects us physically.
Grace Lautman: Yes. And I’m also thinking about how the preventative moments are just the subtleties of everyday life. We’re eating all the time with our kids from a young age, and the subtleties in it are those moments where they say, “I want that! I want a cookie with lunch.” And you as a parent make the decision about it. And the subtlety is whether or not you go into, Well, you’ve had way too much sugar and you don’t need it and you never eat vegetables. You don’t need that. It’s just a little shift of, “Oh, that’s not on the menu right now. We’re doing something else. But cookies are so delicious, let’s have some later.” Or even in managing a health condition, if a kid has Type 1 diabetes or something like that and they can’t, it’s just really making it about what it is and not making it moral, not making it this shame-based thing. It’s just keeping the attitude of, Oh, that’s not what we’re having right now, knowing you as the parent set the stage for the family’s way of going about things. But we don’t want to attach eating to weight. We want to keep that out and we want to keep the food boundaries really kind of unruffled, if you will.
Janet Lansbury: What does that look like, unruffled food boundaries, in your opinion?
Grace Lautman: I think it’s different with every age. But in discussing preteens and teens, I always start with this vision of hand-making baby food when your baby is just starting solids at five months, and then you get to the teen years and your kid comes in with a big bag of chips and a Code Red pop from the store and you’re going, What happened?
Janet Lansbury: Yes. I mean, we don’t control someone else’s body and their cravings or anything like that. Unfortunately we don’t.
Grace Lautman: Right, but we do when they’re little and that’s part of what’s nutty about it. We do actually in that first year or so. We’re just losing control more and more over time when it comes to food and body, even clothing choices. That progression really happens.
Janet Lansbury: And I would argue that it does actually start in infancy, whether we’re using feeding to stop every single sign of discomfort that our child may have, whether we’re trying to get them to eat one more bite when they’re babies. It starts us on a track when we’re thinking that way. It’s not even so much our child, but I always think of it as the habits we’re creating for ourselves, the way that we’re seeing our role in eating as trying to get you to do this. I’ve got to put you in front of TV to get you to eat. I’ve got to follow you around the playground when you’re just walking because that’s how I’m going to get food in you.
There’s no kind of consciousness, we’re not teaching what we want to teach. And we’re not realizing that it starts in the beginning, the way all teaching starts, the way children are learning from the beginning, right from birth, they’re learning everything. They’re so ready to learn, and we’re not realizing that it’s not later that we teach this thing, it’s starting right now. The way that we expect our child to sit down and be mindful during this, it could be two seconds that they want to eat something. But for that two seconds, we’re just going to do this, so that they have a chance to have a present relationship with their bodies and what they need.
Grace Lautman: Yes, exactly. So Ellyn Satter is someone that you’re probably familiar with.
Janet Lansbury: Yes, I’ve had her on the podcast. I was actually just going to ask you what you think of her. Because she’s like, Let them eat the dessert first, things that would actually make me cringe. When she was talking to me about that, I was just like, Wow, I’m glad you’re saying this and not me.
Grace Lautman: Yes, I feel like Ellyn Satter can feel really radical when you’re unlearning the diet culture, fears of fat and whatnot, it can be really scary to really go all in on Ellyn Satter. But research-based, really standard of care for eating and developing positive relationships with food and body, she’s the go-to.
This is her division of food responsibility: The parent responsibility is the what, when, and the where, and the child’s responsibility is how much and whether. So in those early years, we’re really holding the boundaries, what can I control versus what can I not. And what I can’t, I’m just really going to let go of that fully. I’ve decided when we’re doing breakfast, lunch, and dinner, or I decided that we’re going out to ice cream today or we’re not. So if you sit down and you really aren’t eating anything, you hate everything that’s on the plate, it’s like, That’s okay, we’ll have snack in a little bit. You’re not bending over backwards and making it a big deal or making it a blame game or forcing them to stay at the table or eat this or that, because we want to give them that body autonomy. And that stays pretty true throughout all the years. And then reaching the teen years, there’s some nuances to that because sometimes we don’t get the what, when, and where all the time because they’re starting to launch into more autonomy.
Janet Lansbury: Yes, and then we find the more we’re trying to control, the more they’re trying to need to break out of that, break away from that. And it’s not working in our favor. Actually, that starts in toddler years.
Grace Lautman: Yes. I had a moment with my own daughter, who’s just about five. I was taking some time to get ready the other day for work, and we had a little gap in childcare, so I’m like, okay, I’m getting ready. And she’s out there, I’m a little distracted, she’s playing. And then I come outside and she’s sitting on the kitchen floor with a bag of chips. She had grabbed the chips from the counter and she’s just sitting there eating. And I thought, this is such a moment where I could say, “It’s 8:00 AM. What’s going on? No chips!” But what I ended up doing, from this mentality, is I just said, “Oh my gosh, are those not the best chips?” And I sat down on the floor with her and we just ate some chips at 8:00 AM. And I said, “Let’s both have one more. Here’s another for you, here’s another for me.” We giggled and then we put them back up and I said, “Okay, we’ll have a snack like we normally do, at the counter, the next time.” Had I not unpacked previously in my life some of my own controls, I’d be like, I’m not eating a chip at 8:00 AM! But just sort of zooming up a little to be like, What is the point of this moment?
Janet Lansbury: Yes. And I think that’s something that works with every kind of boundary or every kind of parenting moment. It’s actually really great that you heard those voices or you felt that impulse and you were able to kind of befriend that impulse and go, All right, that’s interesting. Maybe that isn’t a big deal, but it feels like it could be. I’m going to let it go and see. And that is really powerful, because then you’re not giving power to something that really would just be a waste of your energy, it would call attention to something that your child might have to explore more.
Grace Lautman: Additionally with that too, it would be totally okay for someone to notice in themselves, I really don’t want to eat a chip right now. I’m getting ready for work. And it’s just that you would navigate it again in that unruffled, grounded way of, Oh, look at you eating chips. Let’s put it away. I’ve got to keep getting ready.
Janet Lansbury: Yes, we don’t have to do it. On that note, we don’t have to say yes to anything we don’t want our child to do. Maybe we don’t want them to have the chips out right then, or maybe they want us to get them more different food and we just don’t feel like doing that for whatever reason. We don’t have to try to please. But I think if we get hooked into that idea that our child’s intake is our responsibility, I’ve found with the parents I’ve worked with, it’s really hard to let go of that, because our child gets hooked into that too. Now their dynamic with us around eating is how they’re going to resist or give in to us. It takes eating totally away from what it needs to be, which is, I’m listening to myself.
Grace Lautman: Yes, exactly. It becomes a power struggle of, Am I my own person? Can I get this? It becomes not about the food anymore. We start trying to meet developmental needs through our eating habits as a kid.
Janet Lansbury: So how do you recommend that parents dial this back? Maybe they have been very involved in their children’s eating and they’ve been feeling that pushback and now they’re coming to you and they feel like, whereas they didn’t cause this, their attitude is not helping their child. How can they dial back all these messages that they may have already given their child? Even if it’s just us very focused on ourselves in the mirror, or “Oh, don’t wear that outfit going out. You don’t look good” or “This suits you better, your tummy is hanging out of that top.” How do we undo what we’ve done? Is it a conversation that we have with our child at some point, and at what age?
Grace Lautman: I think at any age, if there’s a big enough pivot happening, that kids respond really well to that realness of just saying, Hey, I’ve been learning some things and realizing that I’m learning some new things that I want to do differently because I think it would be better for us and that I had it wrong. And so here are some of the pieces that we’re going to be changing. So for example, with some of the families I work with, it would be, “We’re actually going to be keeping the cookies in the house here.” Or, “Instead of what I used to say, I might say something more like this.” Or, “The expectation is that we’re not taking such and such food into our room, but it’s really okay for you to have that. I’m not going to be making those same comments.”
When it’s the parent reflecting on their own modeling and their own relationship with food and body, it can be the same, especially with a preteen or teen. As all kids do, I think, but especially preteens and teens, they will sniff out your bullshit immediately.
Janet Lansbury: Totally.
Grace Lautman: Just to be able to sort of say, No surprises here, but I don’t have a great relationship with my body. That’s my own stuff and I’m going to work on that. I can imagine a lot of ways that that’s been hard. Or I’m uncomfortable with my body. I’m uncomfortable, but it’s not bad. It’s not bad, I’m not bad. I don’t want you to feel this way, so I just want to let you know that I see that and I’m going to be working to do this differently. It’s just really powerful to say I was wrong or I hadn’t unlearned this yet and I’m going to keep unlearning it, it’s going to take time.
Janet Lansbury: So really being open about your process, I love that. I love that way of sharing with anybody, whether it’s a parent sharing with the co-parent. It’s such a powerful, non-threatening way to help, by saying, This is what I’ve gone through. And what I’m thinking as I’m listening to you is it’s reframing that piece we were talking about in the beginning of, I don’t want you to be heavy like I felt, or whatever. Instead it’s like, I actually want you to have a better feeling about yourself than I had. And that’s a really positive way to use that same motivation that we have as parents, that’s so wonderful and precious and loving, and turn it into something positive, where it becomes vulnerability on our part, which children always respond to. They never step on us when we’re vulnerable because they treasure that, like in all relationships.
Grace Lautman: That’s so connecting and healing. Definitely the kids and adult kids I’ve worked with who have been able to have their parent just say, I messed that up. While I had the intentions of trying to look out for you, it was the opposite. That sucks and I’m going to keep working on doing it differently. And in the times where I slip up, because I’ve been kind of at this internally for a long time with my own body, I’m open to us being called into that and me reminding you that that look I just gave you with that food, that was about me. That wasn’t actually about you.
Janet Lansbury: Yes. I’ve been looking out for the wrong things, I realized. I’ve been looking out for not the really powerful things that will help you feel good about you and me feel good about me.
Grace Lautman: One other piece I want to mention with this is that I do feel like there is a lot of pressure for body positivity, and I feel like for many parents it’s more accessible to shoot for body neutrality because we don’t always feel positive about our bodies and our kids don’t always feel positive either. And it’s okay to normalize discomfort because what we’re trying to do is we’re trying to take our body off a pedestal of, It needs to look a very specific way. We need to be super positive with it all the time.
Because what good body image is actually about—hopefully sometimes you can evaluate it positively. We want that for everybody, that’s nice. But with different body sizes and culturally different messages, that can be a really hard goal for some people, to feel like they can be positive. So just to acknowledge instead that it can be uncomfortable to be in a body. Bodies change, they’re always going to be changing, we can’t get around that. And we’re going to be able to get more comfortable with the discomfort and know that this is just one part of our experience, it’s not everything. It’s okay to be uncomfortable.
Janet Lansbury: I love that. Instead of the everything’s fine, my body’s great, I love myself, it’s the truth, it’s what’s inside. It’s getting to be all the feelings and the freedom in that and the health in that.
Grace Lautman: Right. And sort of being with our children about the challenges of that, where it’s I feel fat or I look fat. Instead of just, “No, you’re not,” it’s going towards, Tell me more about what’s coming up and what it’s like to be with these friends and your body, their body. I want to hear about it. And that’s really the shift. A really good example too, of the well-intentioned “No, you’re not!” That can be a really big shift from someone who grew up having their parent shame them for their body really directly. But we can actually take that a step further.
Janet Lansbury: I think that’s the big impulse that we all have that’s so strong, just this idea of instead of letting the feeling come and letting it be and let’s try to understand it or sit with it a little, it’s like immediately push back, push back, push back. That feeling is uncomfortable for me that you’re having, so let me push back on it. It’s so human, we’ve got to forgive ourselves for that one. But just keep an eye on it and just be aware that basically we’re invalidating something, right? And then the danger in that, of course, is that then our child doesn’t want to share it with us because they’re not going to be heard. They’re going to be argued with about it, and nobody wants that.
Grace Lautman: Right. Or that urge to kind of fix it.
Janet Lansbury: “Let’s start exercising right now!”
Grace Lautman: Yes, and that’s where it’s like, oh no! It’s so well intentioned, but there we go down this rabbit hole, especially with the genetic piece. You could be in big trouble soon.
Janet Lansbury: I work with a lot of parents where this is a really difficult subject. We’re not at the point of disordered eating yet or anything, but How do I get them to eat more? What do I do? Or I don’t want to have any boundaries around meal times in terms of what they can do, because I’m not going to end a meal with my toddler who may need to eat more. It’s hard for me to trust that them throwing food down is conscious. But you can sense that in your child if you’re paying attention at mealtime. If you’re asking them to be present and you’re present as much as possible in those moments, then you can totally read the difference between I’m just dysregulated and I can’t focus, which they probably can’t eat then anyway, or Look, is there an answer to this question about throwing food or standing up and running around and coming back? You’re just not giving me an answer!
And that’s where I think that sometimes we misdefine love as, Oh, I would never let my child go the slightest bit hungry, and at the same time, I’m just going to leave you asking all these questions about boundaries and I’m not going to give you an answer until you get me mad, and then I’m just going to be mad at you. And really, it’s not the child’s fault, it’s our fault. I’m the last person who wants to set boundaries, so that’s why I love talking about that subject. We’re afraid that our child isn’t going to get enough to eat.
Grace Lautman: It’s such an understandable and such a biologically-based urge to make sure that they’ve gotten what they wanted. And that’s where all those tricks of Just eat this or Woo, look at this, it’s an airplane! It’s so normalized.
And yet I do think a lot of the messaging that we miss around this stuff is just reassuring parents that it’s okay. It’s okay to let them come to the table and not eat anything, and then to just roll with it a little bit. Sometimes you’ve got to roll with that in order for it to get back to that division of responsibility. I think we really underestimate how much we can trust bodies. I reassure parents that it’s okay, and you don’t have to do this perfectly. Culturally, we put a lot on food and body, and we know that health comes from and nourishment comes a lot messier along the way than sitting down and really eating everything on that high chair tray, right?
Janet Lansbury: Yes.
Grace Lautman: It’s just so much pressure, and so we need to relieve ourselves of that. And also, outside of food conversations, I feel like what you guide parents in is so useful because it is you yourself as the parent doing less work and being able to enjoy more and laugh more about what’s happening. And that is the benefit of some of this with eating. If your kid comes to the table and is just playing with their spoon, that’s okay. You can just watch them play with their spoon or throw it on the ground and say, Oh, okay, it looks like you might be all done. And just sort of move along.
Janet Lansbury: I want to circle back to this thing you said about trusting the body. So for me, it’s not even just trusting the body, it’s trusting our child’s ownership of their body. It’s trusting them to embody their body, that they can do this, that they have the wisdom. If we can clear away some of the noise, they have that in them already. But we can get in the way of it and we don’t want to do that. This is going to serve them for life, that they can own their body and their feelings and what they need, and it’s really easy to drown out that message that we really want them to have.
I wanted to ask you also, if there are children that develop eating disorders that actually didn’t show any sign of problematic eating when they were little. Maybe anxiety or perfectionism or something, and then it manifested as an eating disorder?
Grace Lautman: Yes, absolutely. I like to think about eating disorders as an attempt to solve a problem, a maladaptive way of solving something that otherwise is too sticky and feels like the family or that kiddo can’t figure out on their own. And an example of that would be if we have an anxiety piece coming up or something internally going on, even neurodivergence and autism, ADHD, that there becomes sometimes a need to muffle emotions or control what are otherwise extremely loud sensory experiences. And restricting food actually can be a way of solving a problem.
So sometimes an eating disorder is really not what people think, right? An eating disorder is an attempt to solve some complicated problems, and a lot of times you can’t see it early on. The things we’ve been talking about are wonderful protective factors to set up, but there’s all these other pieces that can come into play.
Janet Lansbury: And how do you help when it is serving a purpose like that? How do you help a client find another way to achieve that?
Grace Lautman: Yes. I think especially when there’s, for example, autism at play, and I definitely have worked with many clients that didn’t get a lot of support for their autism early on or didn’t get a lot of accommodations. So sometimes it’s actually just about while you’re working on some of the eating behaviors from a harm reduction place, let’s see if we can make sure we’re not causing too much harm with those things. But as we’re doing that, we’re really looking underneath the surface and saying, what can we also alleviate for you so you don’t have to rely on this restriction of eating or extreme picky eating that is really helping you solve this other problem of internal distress. So we’ll be working on these other aspects of, okay, what is happening here? What needs were not being met? That might look like addressing anxiety, it can totally look like addressing trauma. I’ve definitely worked with a lot of instances where trauma is at play, especially speaking of body autonomy and trying to control or muffle things in the body. There can be a lot that comes up around that for people too.
Janet Lansbury: Very basically, it’s about feeling the feelings and allowing for what we’re trying to control.
Grace Lautman: And different eating disorders function differently. I find a lot of times anorexia can be really common when our nervous system has functioned better with control. Anorexia is a way oftentimes of muffling a lot of the impacts of perfectionism. Whereas binge eating tends to be more of a strategy to numb, get out of an emotion. There’s different aspects of different eating experiences and disorders that actually can give us some clues to what this person is needing a little bit more or less of.
Janet Lansbury: Is perfectionism simply a fear of imperfection?
Grace Lautman: Part of the modality that I work with is called RODBT. It’s called radically open dialectical behavioral therapy. Like every therapy thing, there’s a terrible acronym that goes along with it. In this approach, when we are incorporating this, we think about this as almost a spectrum of over-control and under- control. I always think about perfectionism as, and this is almost a temperament explanation, there are folks that feel in their bodies and in their nervous systems more safety when things are more controlled. And then there are people that feel more safety in their bodies when actually there’s more flexibility and spontaneity. Perfectionism can come up for different reasons, but I think in the context of anorexia, a lot of times there’s perfectionism at play because it feels safer in the body for somebody to control and make sure that all the ducks are in a row and that they’re presenting a very specific way. And especially with different traumas at play, that can have been a really important way of protecting oneself too.
Janet Lansbury: And where does it get into where you’re actually not seeing yourself at all anymore? I can relate to, I just want to look this certain way. As I’m aging, I could see why people will do anything to hold themselves at a certain age, physically. So I can see that. And I kind of had a little of that when I started to get middle-aged. I was like, well, I want to be at this weight. At least this I can control. But when we get into that place where we’re not even seeing what we’re doing to our face, maybe as an older person, or what we’re doing to our bodies, that we’re getting unhealthy and we can’t see clearly. How does it get to that point?
Grace Lautman: I think about normal eating being on one side of the spectrum and then an eating disorder being on the other, and disordered eating is in the middle. That also exists. Disordered eating sometimes overlaps with even dieting behaviors that are applauded societally as well. When it gets more into that eating disorder area, like anorexia, bulimia, there’s an aspect of distortion of your body image or body dysmorphia that can come into it.
I usually explain that as if you’re at one of those hotels and it has one of those mirrors in the bathroom that hyper-focuses on your face. You can see all your pores and you start to look at it and you start to think that you’re just one big pore. That’s sort of the experience that people have with body image distortions that come at that other end of the spectrum. Where it’s not just body image issues, well, I kind of wish I could alter this or I’m kind of uncomfortable because I’m starting to notice these changes and I might do this here or do that there. Yes, there’s some disorderedness to that, but it’s not really impacting too much and the person still feels like they can look at themselves in the mirror and sort of orient, Yeah, that’s me. I know what I look like. When you get further down that spectrum towards more of a severe eating disorder, you start to lose a sense of what you look like and it starts to feel really confusing and distressing to orient yourself in your body.
Janet Lansbury: Isn’t it amazing that our minds have so much power that they can cause us to just focus in on one thing without seeing anything else, like this myopic vision of yourself?
Grace Lautman: Yes, and sometimes it can be really reassuring actually for people. I always say, I’m going to use this word “delusion” in the most loving way I could use it, but there’s a delusional aspect to having an eating disorder like this. Because you have to kind of say to yourself, you know what? It’s okay. I’m not really going to see an alignment with full reality, and so I can almost step away from the mirror. I almost need to, because I know that looking is only going to make it worse. And that’s very much true when we get to one of the big signs of an eating disorder, which is it’s on your mind 24/7. There’s some level of preoccupation that just gets really high. It’s never helping to engage further with it, it’s just going to make you feel more confused. So we try to pull back from that.
Janet Lansbury: I feel for this, I feel for all of this. And I’m really glad that you’re there. When should parents consider reaching out to you or someone like you? By the way you’re reachable at honornutritioncounseling.com. Where is the line where it would be a good idea to reach out for help?
Grace Lautman: It never hurts. So if you feel a little nervous or you want to get on top of it, I feel like if you’re wondering, it doesn’t hurt to reach out and just sort of check in. Some very clear signs are on growth charts. Not BMI, I don’t recommend BMI as an indicator. But if a child is really dropping off a growth chart and line, the percentage that they’ve typically been following, that can be a moment to just check in. Alongside seeing that your child’s eating has really shifted and their mood and experience around eating and going out to dinner or trips. Usually there’s just a lot of distress that starts happening. Those are sort of the big pieces within it.
And during the pandemic, when all the waitlists were full, I created some online on-demand courses. One of them is supporting families who think their kid might have an eating disorder and the other one is for just feeding preteens and teens. It just sort of expands on some of the conversations we were having today about the mindset around it. Those are definitely places people can go. And I also am pretty active on social media these days; I have an Instagram, which is honor_nutrition_counseling. People can totally reach out if they want resources as well.
Janet Lansbury: Wonderful. So those courses are available on your website also?
Grace Lautman: They are through my website.
Janet Lansbury: Excellent. Thank you so much, Grace. This was wonderful. I could talk with you for a long time, you’ve got so much wisdom. And I feel like we’re very much on the same wavelength in our thinking, but I don’t know anything about all this stuff you’re talking about, so I love hearing your perspective.
Grace Lautman: Thank you so much and thank you for having me on. This has really been an honor for me, so thank you.
Janet Lansbury: Keep up the wonderful work and we’ll talk soon.
Grace Lautman: Sounds good, Janet. Thanks again.
Janet Lansbury: Okay, thank you. Bye-bye.
Grace Lautman: Bye.
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