How long may i ask?

Why am I here again, and again... and again...

"Eating Disorder in Primary Care. Myth busting, to address need for specialized information, tools in toolkit--for those that are not dietitians." //Target audience: GPs, paediatrician, psychologists, social workers, OTs, nurses, lived-experience. //Gabby Heruc, APD, works in eating disorders and mental health, a dietitian with interest in psychology and research, plays key role in private practice and those affected with an ED. "We need more info about nutritional management." //Myths, and what's the general population worried about with nutrition, and what is applicable for all--as seen in clinical practice? Problematic is, patients coming in having been told inappropriate, incorrect, inaccurate information becomes triggering, leads to new beliefs they take on--so, here, explore myths and discover the truth. Continuum of consumer confusion <--> consumer confidence. 8:35 Food RULES are driven by emotion and negative reinforcement. Founded on influencers. MYTHS 1. you need to follow Guide to Health Eating. MYTH. 10:54 It is NOT for individuals, it is "populations." From 12:30 How Patients mistakenly INTERPRET the Food Guide to fill safer, adds to their fears!, i.e. Misguided. 2. you don't need carbs at every meal. MYTH. 13:55 Carbohydrate is the ESSENTIAL macro-nutrient for fuel every day, needed in many of the body's processes, including the brain--the body cannot function without it. Brain relies on glucose, starvation mode without its soul fuel resource. Without carbs/glucose body's backup system starts making its own (conceivably robbing areas to maintain blood's required levels). Sense of satisfaction versus deprivation comes with carbs. 3. some carbs are BETTER than others. MYTH. 17:51 Carbohydrates are ALL carbohydrates. 4. a high PROTEIN diet is healthy. MYTH. 19:30 Missing out on other macro-nutrients. High protein low carbohydrate diet is linked to high mortality rate. 5. plant based diet is healthier. MYTH. Nutritional adequacy of plant diets, nutritional balance is poor with inadequate consumption of: protein, iron, B12, zinc, omega-, magnesium. Vegan study found lowest energy intake of all diets, high prevalence of B12 and iodine inadequacy. Ages 12-19 girls, massive database, shift consumption, "increasing plant-based consumption by 100%" (fibre, sugar, vit-E, iron, folate) but it decreased fat, zinc, vit D, calcium, protein intake! Developing brain and bone-health at this age, and increasing protein-rich plant foods by 100%, hardly made any difference because it was an increase from very little to more. Increasing dairy foods by 100% increase vit D, magnesium, zinc, calcium, potassium, energy, saturated-fat, protein. "is a plant-based diet healthier?" 6. Gluten could be the cause of your gut issues. MYTH. Gut issues are likely from malnutrition and anxiety. (Mal-absorption of fermentable sugars can cause gut aches. Gluten consumption lowers type 2 diabetes risk thanks to fibre). With anorexia with refeeding gut issues go away. 7. there are good and bad foods. MYTH. Variety in a person's individual needs makes all foods a potential foundation for anyone. Some people need more. There are no bad foods or good foods. 8. fun foods are not everyday foods. MYTH. Fun foods are part of a regular diet, patients learn to enjoy food again. 9. full-fat dairy is bad for you. MYTH. "no risk found from high-fat dairy for mortality, heart disease, cardio vascular disease (Guo, Astrap et al 2017)" 32:00 Patient's upset stomach is due to malnutrition and impaired gut function from disordered eating; after nutritional rehabilitation of 3-4 months of refeeding all symptoms improved (Perez, Coley et al 2013); after 2 weeks (Heruc, Little, et al 2018) gastric emptying improved, though GI had not. Which is to say, IT TAKES TIME, there is a lot of damage during malnutrition and effects of refeeding take time. 30% of your energy intake needs to come from fat and LOW fat milk doesn't contribute requiring a much larger serving of low fat than high fat dairy. 10. Calcium supplements and oral contraceptives improve bone density. MYTH. 35:17 BCP is not helpful for improving bone density. Instead, 35:34 bone density is restored by returning to a healthy weight. Monthly period is not a diagnostic criteria, certain patients at BMI 13 don't lose their period. 11. you should have 8-cups of water each day. MYTH. Instead, drink when you are thirsty, drink MORE when you sweat more, for body to take care of itself! Raw fruit and veg can be 20% of fluid intake. Tea, milk, juice. MYTH that caffeinated drink dehydrate you. Fluid needs depend on age, weight, physical activity, health, climate. 12. children that are picky eaters will grow out of it. MYTH. Of 20% at age 11, goes down to 8% after age 13 that do not "grow out of" picky eating. Picky eaters may have "ARFID" but haven't been diagnosed! ARFID, avoidant/ restrictive food intake disorder, that may involve malnutrition by not necessarily weight-loss. 13. they will eat when they are ready--let's focus on the underlying factors. MYTH. 41:40 14. if a child is overweight start them on a diet. MYTH. 15. microbiome can inform dietary intake. MYTH. Correlation is NOT causation. Commercialization promotes mis-reported results [for sales and profit]. 16. if the number on the scale goes up, body fat must have increased. MYTH. 17. patient need to be in the health range. MYTH. Robust people are healthy. //Refer patients to a dietitian to unmuddle some of the myths and beliefs that are out there.

Personal attitudes of Psychologists and Nurses are too often foundation of misguided myths for patients suffering from eating disorders. 6:45 ...! Part of misguided treatment is woven into Gabby Heruc's MYTH 13: "they will eat when they are ready--let's focus on the underlying factors," MYTH. "* Clinical psychologists and nurses ARE NO BETTER THAN THE LAY GROUP. Clinician's OWN eating attitudes are reflected as nutrition knowledge. (Cordery and Waller, 2006, UK)"; and "*Non-dietitian health professionals had similar knowledge levels to individuals with eating disorders. (Long, Soh, Walter, Touyz, 2011, AU)" */In the UK study (2006, 65 clinicians and 23 in lay group), dietitians had highest level of knowledge regarding carbohydrates, protein and fats, psychiatrists were next best-informed. Important is that clinical psychologists and nurses--that all worked in eating disorders and had ALL completed coursework for measure of nutritional content of foods--were no better informed about important nutritional insights than the lay group. In the Australian study (2011, of 111 health care professionals working with eating disorder patients; 34 people with ED; 16 controls). Personal eating attitudes informed clinician's attitudes. What "YOU" believe to be true and sharing with patients, will not help to dispel myths and beliefs patients have.*/

The challenge here too is to treat BED, BN, and AN, while also treating the obesity pandemic that has far worse outcomes than any ED. I think that's when reasonable, mindful, intuitive eating for satiety and nutritional fulfillment and energetic balance (calories in versus out) paired with exercise/activity habituation and lifestyle adoption are key.

Where can I buy your self help manual and what is it called? Thanks

Thank you, now my torturing for my friend's cock and ball is completed for perfection!

I've finally accepted I may have BED & I wanted to thank you for making this public, knowing exactly what steps can be taken to fix my issues is priceless

This is awesome. thank you so much for making it public. Good luck to those clinicians helping fight against EDs.

Very helpful. Thank you very much.

This is so helpful for family members of people with eating disorders. Exquisitely explained. Thank you.