Speaker 1: 0:35

Welcome back to Speak Out. Stand Out. I'm Elizabeth Green and today's guest is Mallory Tenori Tarpley. Mallory is a journalism professor at the University of Texas at Austin, and she is also an author of the memoir Slip, which explores life in the middle of eating disorder recovery. So a heavy conversation we want to have today, but a very, very necessary one. So I'm glad you're listening and I'm glad, mallory, to have you here today.

Speaker 1: 0:59

Yes, thanks so much for having me, so I'm glad you're listening and I'm glad, mallory, to have you here today. Yes, thanks so much for having me. So let's just dive right in. You are obviously you have a recovering from an eating disorder, or would you say you're recovered. How just let me get the word straight on that how do we introduce you, knowing that that's what we're talking about and I know that's such an awful way to just start the conversation, but that's what we're here to talk about right?

Speaker 2: 1:19

Yes, and I appreciate that, because I think it's so important to ask people about the language that they use to describe their recovery. So I say that I'm in recovery from an eating disorder.

Speaker 1: 1:29

Okay, and so just for context sake, when did this start for you?

Speaker 2: 1:34

So I developed anorexia nervosa when I was 12 years old, after my mother died of breast cancer. She died when I was 11, and then I very quickly descended into an eating disorder. So it's something that I was in treatment for throughout my teenage years, and I'm far better than I ever imagined I would be, but I still live with the disorder's imprints, and so that's why I always say that I am in ongoing recovery from the disorder.

Speaker 1: 2:01

Okay, and one thing I think it's important to point out too, is that we think of eating disorders as always a body image, and it is part of that, right. But that's not entirely like with your scenario, right, that your mother dying was a traumatic event, right? So do you think that played a big part?

Speaker 2: 2:18

I definitely think it did. Many people do believe that eating disorders are all about people trying to stay skinny or small, and for me it was really different in that it didn't have anything to do with weight. It was more so about trying to stay small and safe. So after my mother died, I felt so far away from her and I found myself wanting to stop time and I thought that if I stayed the same size that I was when my mom was alive, I could somehow be closer to her. And so food restriction became this warped form of time travel. And of course, the irony of eating disorders is that we think they're going to give us one thing, but they end up really completely removing us from that thing. So the eating disorder really left me feeling farther away from my mother than ever before, but originally that's what I hoped it would do. Right, Just help me to remain closer to my mother.

Speaker 1: 3:11

I think that's so important for people to hear, because I think a lot of times it's easy to think, oh no, you're already tiny, you don't have an issue. You know what I mean? I think there's just there's so much judgment around it and I want to talk about that. But before we get to that, how did you find your way out of it?

Speaker 2: 3:26

So originally, when I first started restricting my food intake, I really didn't know that it was an eating disorder. I didn't have the words to describe it. As a child, I thought people with eating disorders didn't eat anything at all, and I was still eating enough to sustain myself, but I wasn't eating nearly enough. But I had all these misconceptions about what an eating disorder was. And it wasn't until I was hospitalized at Boston Children's Hospital in Massachusetts at age 13 that I got an actual diagnosis and could better understand what it was I was grappling with.

Speaker 2: 3:58

And so I ended up being hospitalized on five separate occasions, and each time I was restored in terms of my weight and I was nutritionally rehabilitated. So physically I was in a better place after each of these hospitalizations. But all of the cognitive distortions that come with an eating disorder remained, and so I was never in the hospital long enough to really address all of those cognitive issues, and so I ended up going to a residential treatment facility for a year and a half, and it was that time away from home. It was really being immersed in treatment and in therapy that really helped me to make meaningful progress forward. So that's really where the bulk of my real recovery work happened and it really laid the foundation for my recovery in the years to come.

Speaker 1: 4:48

Well, I obviously hate that you had that experience, but it's amazing that you're taking such a painful experience and putting it out there to the world. That's not an easy thing to do either, but why are you doing that?

Speaker 2: 5:07

So it's really important to me as a writer to just think about the power of sharing stories to help other people feel seen and heard, and for me, so many of the books that I read throughout the years about eating disorders were either very clinical or they were written from the perspective of people who were fully recovered. And as I made progress in recovery, I found that I was better, but I wasn't all better, and it seemed like there was this lack of a mirrored image between my own narrative and the stories I was reading in books, because I thought all of these individuals are fully recovered and I'm not. So what does that mean? And what does it mean to be in this middle place between acute sickness and full recovery? So for a long time I thought I was the only person in this place.

Speaker 2: 5:49

But for the book, I ended up surveying over 700 people from around the world who have lived experience with eating disorders, and 85% of those people said that they could identify with this middle place, and yet they never really had the words to describe it, and so I thought, okay, there's something here. Right, there needs to be a greater conversation around what it means to be in this messy middle and what it means to slip and recognize that both slips and progress can coexist. So with this book I want to really broaden our scope of understanding around what it means to recover and also give people more words for describing their recovery and remove some of the shame that can come when you're not fully recovered.

Speaker 1: 6:33

Yeah, and it makes sense. I've always kind of I guess I haven't thought too much about it, but kind of pictured somebody in an active eating disorder and then fine, and there has to be so much in the middle. It's just like, if we're talking about, recovering alcoholics still go to AA meetings years after, because it's not just a simple we're just going to turn this off, regardless of what your issue is, that you're dealing with, that you're fighting.

Speaker 2: 6:58

Yes, exactly, and in the eating disorder space, we still have a long way to go in terms of just accepting the fact that many people do live out their lives in this middle place. There is a lot of black and white language in the field in terms of people are either sick or they're fully recovered, and I really understand why treatment providers push for full recovery for everyone, because some individuals do fully recover and I include their perspectives in the book but there's so many of us who are in this kind of murky territory of really living with the vulnerability of the disorder, and I think we need to have more real and honest conversations about what that looks like, similar to the way that other fields, like the addiction and substance abuse fields, have had for many years.

Speaker 1: 7:45

That makes a lot of sense. Well, one of the things we want to talk about today is empowering our listeners, moms and dads, to have hard but meaningful conversations with their kids, in hopes that their children never go down that path, but knowing that nobody is going to live a perfect life, our children are going to hit bumps along the road and so, even though we're talking specifically about eating disorders today, a lot of the things we're talking are going to talk about apply to all kinds of challenges that kids will face and teens will face, right? Yes, for sure. So let's just start with that. How do we talk to kids about body image?

Speaker 1: 8:23

And that's such a broad question, but I guess I want to preface something that we were saying before we started recording that growing up in the nineties and the early two thousands was difficult for everybody, I'm sure, and as a woman, I felt like you know, growing, your body's changing and there's pressure on you, and at that point we were just seeing the star magazines with the beautiful actresses. Now kids have social media where they're seeing People who go to school with them looking like these famous actresses, and all of this because of this heavy conviction. They have to look amazing to the world, and so I just can't imagine. I can't imagine being a teen in today's world with those challenges. But we're raising them and so we have to think about it and learn how to cope with it. But so knowing all of those things like it's such a big thing, how do we ever begin to have that conversation with our kids?

Speaker 2: 9:18

Yes. So it's such an important topic to broach and it is not an easy one to talk about. I will say that as the mother of a seven-year-old son and a nine-year-old daughter, and I fear for the time when they do begin to use social media and when they are exposed to all of this different content, and so a big part of what I think parents could benefit from doing is to really talk about how all bodies are worthy of respect. I think that that message is really important and I talk about that a lot with my kids. I say all bodies are worthy of respect, no matter how short or tall, no matter how short or tall, no matter how big or small, because I want them to realize that they are going to be exposed to messages that tell them that their worth is determined by their weight. And our society is so deeply entrenched in diet culture and in fat phobia and we receive so many messages that essentially are perpetuating the thin ideal and making us believe that it is morally bad to live in a larger body, and I think we need to really have some of these harder conversations with kids around the fact that they will be exposed to some of this messaging and they need to try to recognize it when they see it. Because I think the more we can talk with kids about some of the pernicious content that they may be seeing or that they may one day see, the more we can prepare them to be aware of it and to call it out as diet culture. Certainly, we're not going to dismantle diet culture anytime soon, but I think, personally, we can take a stand against it and say I am not going to look at skinny talk, for instance. We know that that's been banned, but there's so much content like that on social media where you have people who are talking about dieting or who are talking about wellness under the guise of unhealthy behaviors around eating. So that's one aspect of it.

Speaker 2: 11:15

Another is really just trying to avoid labels when it comes to food. I say this as someone who, at age 12, was in a health class in which a teacher was telling us about what we should and shouldn't eat and she would label foods as being good and bad or healthy and unhealthy, and she would tell us sort of what foods to avoid, and as a people pleaser and a perfectionist, I really wanted to follow what she said. So I began to believe that I would be bad if I ate those quote unquote bad foods and that I was good if I ate the good foods. And for kids those types of labels can be harmful because it's more difficult for kids to understand nuance and sometimes children will begin to ascribe these moral values to food when they hear that there are certain foods that are good or bad. So part of this is eating disorder prevention.

Speaker 2: 12:07

Speak as a mother in recovery but I do tell my kids that all foods fit and I do let them eat a variety of foods. So there's no foods that are really off limits in our house because I don't want to place those restrictions on them. In some ways I think our kids are attuned to what their bodies need and are attuned to kind of fullness and hunger cues in ways that a lot of us aren't as adults, and so I try to trust that. Of course I don't want them eating Cheetos for every meal, so I intervene in some ways, but I also don't restrict them from certain foods, knowing that they are growing and they need to have a variety of foods in their diet.

Speaker 1: 12:48

So if we don't want to label things as good and bad but at the same time, we still want our kids to understand the difference between healthy and not healthy, Are those the words we should be using, or how do you approach that so that they're still learning to make good choices?

Speaker 2: 13:01

Yeah, so I think each family is going to have different verbiage, different words that they want to use. There are some eating disorder dieticians who I've talked to who have kind of used the terms growing and non-growing foods. So these are foods that are really going to give your body strength, they're really going to help you grow, and then there are other foods that we enjoy eating but they're not necessarily going to help our bodies to grow in healthy ways, and so that can be a different approach as opposed to just sort of labeling things as either good or bad. Those words tend to be just difficult to understand sometimes and people can sort of define those in different ways that could be harmful. So the growing versus non-growing foods is an approach that can be helpful for some. Okay, gotcha.

Speaker 1: 13:48

And so before we kind of turn to, what do we do if we feel like our child is struggling with something like this is there? Are there any other practical tips like that that we could use at home before we get to that stage where we have to, you know, before we're worried that there is an issue.

Speaker 2: 14:02

Yeah. So I also think it's really important to try to create community around food. So thinking about how we can involve kids in making food and making dishes and giving them a say over what foods they want this is something that I've had to really think a lot about, because one of the imprints of my own disorder is that I do tend to exert a fair amount of control in the kitchen and that I like to make the meals. I like to prepare the food for the kids. But I recently enrolled them in a cooking camp and they really took so much pleasure in just trying different foods and making the foods themselves, and it was this really important reminder that we need to empower kids to make choices around food, to see food as something that can be fun, as something that really gives our body strength and fuel. And the more we can involve them in the kitchen, the more we can sort of be together as a family at mealtimes. I think the healthier relationships we can build around food with our kids. Gotcha.

Speaker 1: 15:05

And just a side note too, my kids are a little bit older, they're 12 and 16, and they both one particularly loves to cook. Actually, I would say he loves to bake, he likes to make all the sweets and things. But as a mom, there is also something really amazing when they get to that point where you can say if you don't like what I fixed for dinner, you can fix something on your own.

Speaker 2: 15:24

That is the most freeing thing. Yes, exactly, and I think that that's really important to give them options. There is a woman named Ellen Sattler who has written some books about how we feed children, and she talks about just this approach to putting a meal on the table and then letting children kind of pick from that meal. So you're the one, as the parent, choosing what the children are eating, but then they get to serve themselves what they want and how much they want, and so it gives them a little bit more choice over that and helps them to figure out what they're wanting in any moment in time. So I think that approach can also be helpful as we think about providing good, nutritious meals for our children but also giving them some sense of autonomy over what to eat.

Speaker 1: 16:08

Absolutely. And if it helps avoid some of the dinnertime tantrums too, over foods, you know, then that's absolutely a win. I love that idea. That's a great idea. So kind of moving then towards, let's say, we're in a situation where we're worried that our child is really maybe going down a path that we don't want for them. How do we start to have those conversations in a way that they're going to listen and be open to talking to us?

Speaker 2: 16:33

Yes. So I would say that you really want to trust your gut in these situations. If you feel like something is wrong, then it's important to broach that conversation. It's also important to note that many people struggling with eating disorders, and particularly children, are often in denial, and so they may not believe that they have an eating disorder. There's often this mentality that people struggling with eating disorders think that they're not sick enough, right? They think, oh, I'm eating enough, or I'm not sick enough, I'm not skinny enough to be anorexic. So there's a fair amount of denial that comes into play here, as well as a fair amount of secrecy. So if it's gotten to the point where you are noticing behavior changes, then that means that you really need to act, because most likely, these behaviors have been going on behind closed doors and it's gotten to the point where they're prevalent enough that you're seeing them.

Speaker 2: 17:27

So it's important to have conversations with kids, using nonjudgmental language and really approaching it with a sense of curiosity, right, and saying I've noticed, for instance, that you've been really retreating during mealtimes. It seems like you haven't really been wanting to eat. Or I've noticed that you've been going to the bathroom every time after you eat, right, which could be a sign that someone is purging and really just saying what you've been noticing, as opposed to going into the conversation in a very accusatory way and saying I can't believe that you've not been eating or what you're noticing, and then opening up avenues for storytelling where the child can begin to hopefully tell you a little bit more about what's happening right. So being able to say I've noticed these things happening and I want to talk with you about them. Can you tell me a little bit more about what you're noticing right, or what's going on for you right now? I want to be here, I want to help you and I'm concerned, right, and really stating that I think is important. The things that are not important are when you go into it with accusations or when you say why can't you just eat right? Or you're so smart, why can't you figure this out? Or step on the scale, you'll see you're losing weight.

Speaker 2: 18:51

Those were all comments that my family made to me when I was younger, and they came from a place of love, but also just real confusion over what was going on. So I think part of this, too, is doing a little bit of our own kind of psychoeducation where, even before having these conversations, we try to read up on eating disorders a little bit more, try to get a sense of them, try to kind of get more familiar with the different symptoms, so that we can just have that knowledge in our back pocket before we have these conversations. The other thing, too, is revisiting these conversations, not just having one, and if the child denies it, then just forgetting about it, and it may be that you end up needing to take your child to a medical provider just to be able to assess them and see really what's going on.

Speaker 1: 19:39

Yeah, I think that it's hard as parents hey, we want to fix things right, we want them to be healthy and happy, and when they're not, we want to fix things. And for me it is giving my youngest as an example. He's a quiet little guy and if something is upsetting him he does not want to talk about it. And I talk all the time and so it kills me when I'm like what's wrong, tell me what's wrong so I can help you. And it just pushes him farther away thing.

Speaker 1: 20:13

When we're talking about, I mean, he might be upset because he and his friend had a little tiff or something. When we're talking about something so personal and when there's a lot of shame around it, we can't expect them just to be like oh mom, I'm so glad you asked, so we just keep having these conversations. I mean, like you said, I know at some point you might have to have medical professionals intervene, but I think also that's hard for parents to do for fear that they're going to push their kid farther away by having somebody else step in again in something that's so personal. So what do you say to the mom that's worried about that?

Speaker 2: 20:50

I would say that it's worth getting that intervention, because we do know from research that the earlier a child receives treatment, the better the prognosis, and so the longer we wait to get children help, the farther they're going to descend into their disorder and the harder it gets to recover from that disorder. So ultimately you are going to feel like you're losing your child if they are kind of descending deeper into that disorder and so there is going to be this sort of feeling of separation. It's better to just be able to go to a provider, ideally one that specializes in eating disorders, so that could be an eating disorder therapist, but could also be an eating disorder dietician. And I say that because there are a lot of medical providers who really don't know a whole lot about eating disorders. The average doctor receives zero to two hours of training on eating disorders, which is mind boggling when you consider that 30 million Americans will struggle with an eating disorder in their lifetime, and I delve pretty deeply into that in the book.

Speaker 2: 21:53

But I think that that's important too right that there are instances sometimes when parents will go to medical providers who really don't know much about eating disorders, and if their child's not clinically underweight, the provider may say well, we don't really know what's going on or we don't think they have an eating disorder. So I think that that's really important. It's so unfortunate, but I've talked with countless people for whom that's been the case, and it was also the case for me when I was a child that my pediatrician did not recognize I needed help. So I think the extent to which you can find an eating disorder clinician is going to really be helpful and yes, I would say, just try to initially have those conversations with the child, but then, if that's not working and you're really still concerned, really seeking more professional help for your child.

Speaker 1: 22:40

Just as if we suspected something was going on. Maybe they had a growth on their arm or something that shouldn't be there and they're like, oh, just leave me alone, we wouldn't just ignore it. We need to go to the dermatologist and get this checked out.

Speaker 2: 22:53

It's the same thing, yes, exactly, and I think too it's also about learning what is this right or how can I help my child and providers can really assist with that.

Speaker 2: 23:03

Years ago the sort of approach was to really try to extricate the child from the home and the thinking was that mothers were to blame for children who had eating disorders.

Speaker 2: 23:13

And there's a lot less parent blaming now because we know that certainly parents can't categorically cause eating disorders. Certainly parents can have influence over their children and the way they think about food and their bodies, but we've moved away from that mother blaming and we have really sort of realized that particularly for children, it is especially helpful if we can keep them in the home and also help parents to really work closely with them. So it's not a perfect sort of mode of treatment, but now there is a treatment that was not around in the late nineties when I was struggling and it's known as family-based treatment. It is kind of research, evidence-based treatment that really tries to keep the child at home and really works very closely with the parents on helping the child and figuring out how they can be of greater assistance to the child and how they can really sort of do that in a way that doesn't strain the relationship. So I think that that's a really important sort of development and treatment in terms of how we care for kids with eating disorders.

Speaker 1: 24:17

Absolutely. And are we seeing more people with eating disorders these days and at younger ages than before? Is it actually growing? I mean, it seems like it should be because of what we see in our faces all the time. It is growing.

Speaker 2: 24:32

Yes, so the rate of eating disorders is increasing. We saw this particularly during the COVID-19 pandemic, where the rate of hospitalizations for eating disorders was just skyrocketing and that really got some attention at the time. I have talked with different doctors who have also confirmed this, that they are seeing more and more patients with eating disorders, and at one point I was interviewing my medical doctor who treated me years ago when I was first hospitalized, and she still treats eating disorder patients today and I said well, why do you think that the number is increasing so much? And she said well, I know why. Social media, right. And so again, we can't always just blame one thing. So we can't blame social media alone for causing eating disorders, but certainly when we think about just all of the content that children are exposed to, that teens are exposed to on social media, it's no wonder that we see more people falling into these disorders.

Speaker 1: 25:30

Well, I have just a couple more questions for you, if you have another couple minutes. This has been so enlightening so far. I wanted to ask you what do you say if the mom who's listening right now says okay, my daughter's best friend, I know she's going down this path, my daughter knows it. What do we do? I'm not the, I'm not the mom. You know I can't broach that kind of conversation. What do you say to somebody who's witnessing this? You know closely, but from afar?

Speaker 2: 25:57

So it's always tricky and of course it's going to depend on kind of the different individuals, but I would say it's really important to try to talk to the parents of that child.

Speaker 2: 26:09

I say that as someone who wishes that other people had intervened sooner with me, because there were people who noticed that I was losing weight, but I don't think they really knew what to do or what to say, or they felt like it wasn't their place and the reaction you may get may not be positive right.

Speaker 2: 26:27

The parent may come back and say who do you think you are? Or I know my child, they're not struggling, but maybe you plant the seed right that that child needs care or that child needs something. It could be too that the parent may be struggling with their own eating disorder and may feel a lot of shame around the fact that their child now is beginning to struggle. We do know that eating disorders are genetic, and so there is that likelihood that a child of a parent with an eating disorder could also end up struggling. Recognize that, then it is important to try to talk to the parents and to try to do it again from a place of real deep seated care and not from a place of you know kind of blaming the parent or shaming the parent in any way, right?

Speaker 1: 27:16

Okay, all right, and then I guess, my last question for you. You talk a lot in your book about living in this middle ground, and I'm sure there are people listening that are like, yeah, I got it, I'm there. What do you say to them? Obviously, we want them to read your book and learn so much more about how they can help themselves. But what do you say to those people?

Speaker 2: 27:35

So I would say that it is not a failure to be in the middle place, and I also think it's important for parents to recognize that the middle place is a place where you can lead a full life, because I think very often when parents think about their own kids struggling, they think, oh my gosh, is my child just going to be living with this for the rest of their lives? I want them to be fully recovered. I don't want them in this middle place. But I think it's really important to recognize that the middle place is not about settling for stagnancy, it's not about being sick for your life, but it's really about recognizing that the disorder remains a vulnerability. And so in this place, it's important to just recognize when slips happen and to know that those slips don't have to turn into uncontrollable slides. Instead of being grounds for failure, they can really be opportunities for growth.

Speaker 2: 28:28

So it's so easy to demonize slips and to just be so hard on ourself when we have a slip up, but it's just as important to look at that slip and say, okay, that happened. What can I learn from that? How do I move forward? Because if you think about that very word slip, it suggests some sort of movement, because you can't slip if you're standing still. So often, when we are making strides in our recovery, that is when we slip, because we are trying to get better and trying to do things that are challenging and that are forcing us to step outside of our comfort zone. So it's really important to celebrate those wins and those steps forward, as opposed to only fixating on the slips and the negative repercussions of them.

Speaker 1: 29:12

Yeah, that makes a lot of sense. Well, mallory, I am grateful to you for taking what obviously is a painful and a private thing and putting it out there for the world in hopes of helping other people and I'm sure that you are and if you are listening to this or watching this, we will link to Mallory's book, so it's super easy for you to check out. And, mallory, if you have any other resources or anything that we could provide to people, we can add some extra links below, or they will also link to all your social media accounts so they can connect with you as well. So, again, thank you so much for your time and