Episode 11: Understanding Eating Disorders with Dr. Gail Post

In this episode of the Exceptional Girls Podcast, host Julie Withrow sits down with clinical psychologist and author Dr. Gail Post to unpack the complex relationship between neurodivergence and eating disorders. 

Drawing from decades of experience, Gail offers professional insights and practical advice for parents and caregivers navigating these challenges.

🔑 Listen in as Gail shares:

• The surprising connections between autism, ADHD, and various eating disorders, and how neurodivergence may contribute to disordered eating patterns.
• The key signs and symptoms parents should look for if they suspect their child is struggling with an eating disorder.
• Actionable strategies for supporting your child, including how to approach difficult conversations and when to seek professional help.

About Dr. Gail Post, PhD
Dr. Gail Post is a Clinical Psychologist, a Clinical Associate Professor of Psychiatry at the University of Pennsylvania School of Medicine, and author of the 2022 book The Gifted Parenting Journey: A Guide to Self-discovery and Support for Families of Gifted Children. Gail has worked in the gifted field for over 20 years, has written widely, provided workshops and parenting consultations, and advocates for the needs of the gifted. 

Over her 35 year career, Gail has also worked extensively with individuals with eating disorders. Her experience includes serving as the director of psychological services for a hospital-based obesity treatment program, the director of group psychotherapy at a residential eating disorder treatment center, and the president of the Philadelphia chapter of the American Anorexia and Bulimia Association. To learn more:

• Website: www.gailpost.com
• Facebook: https://www.facebook.com/GiftedChallenges/ 
• Substack: https://psychologyperspective.substack.com/

About the Exceptional Girls Podcast
If you know and care deeply about a girl who learns, thinks, and experiences the world differently, I invite you to journey with me as we learn how we as parents, adults, and role models can help her understand, self-advocate, accept, and love herself — just as she is. To learn more, visit www.exceptionalgirlspodcast.com.

Transcript

Host, Julie Withrow:

You are listening to the Exceptional Girls Podcast, and I'm your host Julie Withrow. As a mom who raised a twice exceptional young daughter, I know both the joys and the challenges of parenting a child who thinks, learns and experiences the world differently. I also know how lonely it can feel and how long it can take to get answers. I created this podcast to increase awareness, understanding, and acceptance of female neurodivergence. In doing so, I hope to smooth the path for other families. Please join me for expert interviews and candid conversations about giftedness A DHD, autism, dyslexia, and more. Let's learn together how we can make sure our exceptional girls feel seen, supported, and celebrated.

In this episode of The Exceptional Girls Podcast, you'll hear from Dr. Gail Post as we explore the intersection of neurodivergence and eating disorders. I first learned there may be a connection between the two several years ago from the book Autism and Heals by Jennifer O'Toole. In the book, O'Toole Recounts many experiences as a female going through life with undiagnosed Asperger's. Among these, she talks about how she managed overwhelming feelings of being a fraud and failure through controlling her body, working out for hours and severely limiting her food intake. This was one of those aha moments for me. It was the first time I'd heard someone connect the dots of neurodivergence and disordered eating, but it made perfect sense to me and it also struck a very personal cord as I too have had my own struggles with food. I knew I needed to tackle this sensitive topic, and I couldn't think of anyone better than Dr.

Gail Post to call upon. You may remember Gail from episode seven. She's a clinical psychologist, a clinical associate professor of psychiatry at the University of Pennsylvania School of Medicine, and author of the 2022 book, the Gifted Parenting Journey, A Guide to Self-Discovery and Support for Families of Gifted Children. Gail has worked in the gifted field for over 20 years, has written widely provided workshops and parenting consultations and advocates for the needs of the gifted over her 35 year career. Gail has also worked extensively with individuals with eating disorders. Her experience includes serving as the director of psychological services for a hospital-based obesity treatment program, the director of group psychotherapy at a residential eating disorder treatment center, and the president of the Philadelphia chapter of the American Anorexia and Bulimia Association. So without further ado, let's listen in as Gail shares the different types of disordered eating, the signs to pay attention to and how to support your child if you suspect an eating disorder. Hi, Gail. Welcome back to the Exceptional Girls Podcast.

Dr. Gail Post:

Good to see you again. Thanks so much for inviting me back. Looking forward to this.

Host, Julie Withrow:

So I, this is your second time joining us on the podcast, and I'm really happy to have you here today to talk about a different topic. So we first talked back in episode seven and we were really digging into how parents can support their neurodivergent daughters, particularly as they make that often difficult transition to middle school. And today we're going to hone in more on a very specific issue, and that's eating disorders. And we're going to explore the connections between eating disorders and neurodivergence. Let's see where those connections are and how we can help our parents understand what those things, like what eating disorders look like, how they could identify if they're concerned, maybe that their daughter or child has an eating disorder. And so we're going to dig into that today, and I feel like it's a very sensitive, but also in important topic. And yeah, I'm really thrilled to have you here today to share your expertise on it.

Dr. Gail Post:

Thank you. Thanks.

Host, Julie Withrow:

So I think to start our conversation, what I'd love to do is have you start by talking about the different types of eating disorders, just so that we all have a shared understanding and a vocabulary as we move forward with our conversation.

Dr. Gail Post:

Sure, I'd be happy to do that. The whole term, even eating disorder is somewhat complicated because it covers such a wide range of eating difficulties, just like neurodivergence really covers a wide range of things. So you've got both of these somewhat amorphous terms that mean something different for each individual person. And in fact, although some statistics say about 9% of the US population has an eating disorder, the majority of that around 45% are actually what would be considered subclinical eating disorders or sometimes referred to as other specified feeding and eating disorders. So they're not the traditional ones. Most people think about anorexia or bulimia, and I want to talk about mostly those, but just to keep in mind that there's a huge range, almost like a spectrum in terms of eating behavior that most people go through. And some of it is more sensory based, whether it's about the texture or the sensations people feel with eating, which usually affects more young children or tied in with body image and self-esteem and anxiety, which is what we most usually think about as the classic eating disorders like anorexia or bulimia. So just to go over some very basic things, I'll try to be quick with this. So eating disorders, actually, they're very serious. They actually have the second highest mortality rate of any psychiatric illness behind opiate addiction. So there are a lot of medical complications that come with eating disorders, not necessarily only anorexia or bulimia, but sometimes the subsequent complications of binge eating where somebody may develop type two diabetes. So there are a range, again, it's a spectrum of different issues.

Interestingly, only about 6% of folks with eating disorders are actually considered medically underweight. So the stereotypical image of this emaciated young woman with anorexia is really a small percentage. And there are lots of folks with anorexia who are not necessarily underweight or underweight anymore, but engage in the same behavior. So just to kind of quickly go through them, anorexia is a condition where there's a lot of restriction of food intake, eating well below what we need calorically. There's an intense fear of gaining weight, a lot of body image concerns and body image distortions. You could have somebody who's 70 pounds who thinks they're overweight and cannot even look in the mirror because of what they see. Often there are physical symptoms that go along with it, in particular in women are menstrual irregularities where they stop menstruating or for younger girls, they don't even get their periods.

And there are a lot of problems with that where it can lead to early onset of osteoporosis, thinning of the bones, or even infertility. So it is very serious just in terms of their development. But again, it's tied in with this desire to be thin that goes well beyond the norm. Dieting is rampant in our society. Food concerns, eating healthy, all of that is pretty rampant, especially for women, but also men. About 10% of folks with eating disorders are men. But anorexia is kind of the classic sign that that's very serious. And later I can talk more about some of the signs and symptoms to look for with that. Probably the most common eating disorder of all is binge eating disorder, which is really having a lack of control, overeating, overeating excessively. And it's not like Thanksgiving's coming up. It's not like, gee, I'm really stuffed.

It's really more about secretive, hidden eating, feeling ashamed of eating, eating way beyond the point of being full and developing rituals to make sure that that can happen without interruption. So it's something that people feel a lot of shame about and it can lead to a lot of problems down the road, one of which is bulimia. So for binge eaters, I mean, they may have what's called comorbid conditions, so other conditions associated with it like anxiety, depression, and substance abuse of folks who are binge eaters have attempted suicide. So it's a really, really complicated situation that we often don't notice because eating a lot is common in our society. Something like 94% have some other mental health symptoms. So it's pretty serious. But again, it can really be under the radar because we don't see people overeating. We may see telltale signs, which I can get into later, but we don't really see that.

And what's important is to distinguish that between obesity because there are a lot of reasons people gain weight and sometimes it's metabolic, sometimes it's just indulging in all the amazing foods that are out there that just compel us to overeat. Sometimes it's lack of exercise, sometimes it's something physical. There are a lot of reasons, it's not necessarily due to binging or compulsive overeating, but it's something to keep in mind that this is a problem. And one of the things that can happen is some folks who binge start to develop bulimia where they have these compensatory mechanisms to try to halt the potential weight gain that happens if you're constantly overeating. So that may include anything like self-induced vomiting, laxative abuse, diuretic abuse, using other medications, fasting, excessive exercise. It can involve really restricting the kinds of foods, claiming they can only eat healthy foods, something that's often labeled orthorexia, or they suddenly change from being a meat eater to being vegan.

Not that there's a problem with being vegan, but there can be reasons. And it really ties in a lot, again with feeling awful about themselves, awful about their body shape and the size, feeling ashamed of their behavior. And it also comes with a range of different physical conditions. And finally, there's a disorder that used to be considered a feeding disorder of childhood and infancy, but now it's called avoidant restrictive food intake disorder or a, and that is one that involves basically where it's not about body image, it's not about wanting to lose weight, but these folks, and again, as usually young children, although it could develop at any time, these folks have strong sensory sensitivities where certain foods are really uncomfortable for them, certain textures, sometimes there might be a fear of choking or vomiting. And so they're terrified of eating certain foods with certain textures. They often have a sense of fullness too soon where they feel too full, they feel like they can't eat. And so some of the medical consequences of low weight can happen. But again, it's not about, gee, I want to lose weight and look a certain way. Anyway, so those are just a really, really quick overview of some of the name eating disorder types.

Host, Julie Withrow:

So I know that eating disorders, they obviously have a lot of physical manifestations in terms of how a person looks and how they present themselves, things that we can see, but they really run much deeper. I mean, I think that there is this component of weight and physical appearance and all these outward aspects, but psychologically right, or emotionally, what's going on. Can you help us understand what causes people to take it to these extremes?

Dr. Gail Post:

Well, it's interesting that it's usually a perfect storm of a variety of conditions. So for some conditions like anorexia, there is actually a strong genetic component that they found. But not everybody with a family member who has anorexia develops it certainly. So it often is a combination of a range of things. It could be some propensity toward being very detail oriented, very rigid, very focused on rules, wanting to please others. It could be like

Host, Julie Withrow:

Perfectionism. Yeah, control, those types of

Dr. Gail Post:

Things.

It's really ripe for that when people have that concern. Also, sometimes trauma experiences can trigger that wanting to control your world because you felt so violated. Often though, there's also this other element in our society, especially white middle class world, where there is a lot of pressure to be thin and muscular and attractive in terms of typical norms that are out there. And so it's hard because we all have different body shapes and types, and if a teenage girl who's feeling insecure or maybe feeling they don't fit in with their friends wants to feel a sense of control, they're like, okay, maybe I'll just restrict what I'm eating and I'll cut out certain food groups, or I'll cut back on calories so I can be really thin and then maybe I'll be popular and then maybe boys will like me or whatever their goal is.

And then for some, they dabble in that and they're like, Hey, I can't do this. This is way too ridiculous and hard for others. It's like, yeah, wow, this gives me a sense of accomplishment. I feel better about myself. I don't have to think about some of my other troubles because I'm so focused on counting calories or fat grams or protein grams or keeping track of how many miles I've run that they don't have to think about some of the troubling things in their life. So it's one area they can control and feel good about, even though it leads to these disastrous circumstances. I mean, even with women athletes, a lot of them are like, yeah, I'm going to restrict so I can improve my time on my runs. And they actually start debilitating their body and their time is worse. So there are a lot of reasons that can lead up to it, but often it's trying to cope with some troubling emotions they're going through where they don't have the resources.

Host, Julie Withrow:

That makes a lot of sense. As you were talking, I was thinking about how I think a lot of times, particularly when kids, right, girls don't feel like they don't fit in, sometimes they might create a fantasy world, for example, that they can kind of live in to help control that. And I feel like my own child had that propensity, but I can see how this controlling your eating your appearance could have the same genesis coming from this place of just wanting to do something to fit in and feel like you're like others and they will see you like them.

Dr. Gail Post:

And another thing that's interesting, especially when people lose a lot of weight, everybody comments on like, oh my gosh, how did you do it? You're amazing. You look great. I wish I could be this controlled with my eating. They get a lot of compliments at first, but when they start to get past a certain point, especially with anorexia where they start looking bad, they look emaciated, they look like all skin and bones, then for a lot of these young women, it's a way of letting the world know that they're troubled without using their voice. So again, these are often, as you mentioned, perfectionistic folks who need a sense of control. It would be very hard and feel very vulnerable to say, I'm really sad, I'm really upset. I'm really angry. So instead, it's almost like their symptoms enact that for others to see

Host, Julie Withrow:

My limited understanding about eating disorders, I see them as another form of self-harm, kind of like hair pulling or self-injury or whatever. Is that a fair way to look at it? Do you think that that's accurate?

Dr. Gail Post:

Well, I really think so. I mean, I think for those young children with arfid, it's really more that they're out of touch with their bodily sensations or they overemphasize a sensation. If their stomach's rumbling, they think, oh, I can't eat anything, rather than, oh, maybe I'm hungry. Maybe that's why it's rumbling. So I don't see that as the same, although they're, for some, it may be that they are very out of touch and it's being sort of reenacted through these symptoms. But for the traditional eating disorders like anorexia and bulimia, it really is harmful. There's so many health risks associated with them. With anorexia in particular, in addition to the potential for osteoporosis and infertility, there's also electrolyte imbalances, lowered heart rate, kidney failure, potentially it's really serious. And they may not think they're hurting themselves. They may notice maybe having lower energy or having trouble sleeping or any of those signs, but they're in denial about it.

Years ago, I remembered ironically that for them to really look at what they were doing to themselves was hair loss. They had this beautiful head of hair and suddenly it was thinning, and they're like, oh, I can't tolerate that. So it really is. But bulimia is though really more apparent as a condition where there's the act of violently hurting your body through forcing one self to vomit or using laxatives or diuretics or exercising till they can't go any further. That is like what you're saying. It is a form of self-injury. And in addition to that, some folks with bulimia also engage in those forms. They cut themselves, they mutilate themselves, they do other self-harming behaviors. I'm not going to go through a list of them because I don't want to put them out there for people to think, oh, because sometimes when people hear about this information, they're like, oh, I haven't tried that. One of those things, what do you do?

Host, Julie Withrow:

Exactly, right. But I can see how these things can go hand in hand or how one can kind of lead to another. It makes a lot of sense. One thing I wanted to discuss with you was I believe there's a lot of misconceptions about eating disorders and being sort of a female problem only. Like you mentioned, when a lot of us picture, if we hear the term an anorexia, we tend to think about a very underweight female who looks very gaunt, but it's really not just a female issue, right?

Dr. Gail Post:

Yeah. Something, I mean, again, data out there is so varied, but I would say roughly about 10% are men, which is interesting. And men who become anorexic or bulimic often have the same concerns as women do, where they're looking for unconsciously looking for an outlet, a way to cope with these really troubling emotions. And if they feel like, well, I'm really struggling with school, or I'm really struggling in my relationships, but at least with this, I can have some control over things. Sometimes sports can be a trigger, whether it's someone who's a runner or a cyclist where they feel like they have to have this really thin frame

Host, Julie Withrow:

Or like a wrestler, right?

Dr. Gail Post:

Wrestler, you have to weigh in wrestling.

Exactly. Or boxing. Those are huge. And there's huge pressure. And certainly anything, I mean, certainly women, you hear about it with ballet, with dance, with ice skating that they have coaches sometimes who pressure them to lose weight, but with men, sometimes it's overt. They're told, go throw up before weigh-ins for wrestling. I mean, it's terrible. And most of them can't stand that, and they don't develop a disorder. But some continue to do that. And some also start getting very focused on protein powders and supplements and testosterone supplements. I mean, they do things to kind of beef up their body, but also to restrict the type of foods they're eating. So yeah, it can be really common. It's also common in athletes, and again, the percentages really vary, but in one study where they looked at competitive athletes, 86% met criteria for an eating disorder or a subclinical eating disorder, which is kind of shocking.

Host, Julie Withrow:

Yeah. Well, yeah, and that's definitely something to pay attention to, particularly for parents who have kids who may be very gifted in athletics and very into athletics, because you see that a lot sometimes in the gifted population particularly. And so I think it's really important to be aware of that. And that's really a great segue to talk a little bit more about what are some of the signs and symptoms, both, there's obviously some things that you've touched on already, but as a parent or as someone who cares about someone, and we may have a suspicion that maybe they might be suffering from some form of an eating disorder, what are some of the clues and symptoms that might help us be more clear that that might be what's going on?

Dr. Gail Post:

Yeah, that's a great question because most kids don't go up to their parents and say, Hey, I think I have an eating disorder, if anything, right? It's very secretive, possible to hide it,

Very secretive. So it can take a while. And a lot of parents are like, oh my gosh, this was going on for months. I didn't realize it because they hide it so well. So I'm just going to come up, talk about a list of different things to look for. One thing is if they start to change their eating, suddenly they go from eating regular family meals to being extremely rigid about I can't have that food or that food type. I can't have fats, I can't have carbs, I can't have certain products. If they start to, you notice they're hoarding food, you find lots of food wrappers or candy wrappers in their rooms. If they're developing food rituals, like eating foods in a certain way or excessive chewing, excessive chewing gum, which is often a way they try to suppress their appetite. Again, these are things that are dramatically different.

If your child always was a gum chewer, it probably doesn't mean much, but if suddenly they're doing that a lot, using a lot of condiments and artificial sweeteners just to mask foods or to even make them too spicy. So it bothers them drinking a lot of water or diet beverages or caffeine drinks, cooking food for others, but refusing to eat it, wearing clothes that are different, wearing lots of baggy clothes, wearing long sleeves in the summer, just doing things to really hide what's going on underneath, wearing a lot of layers so people don't see that they're losing weight, noticing if there's any signs of vomiting or if they're going to the bathroom always immediately after meals and spending a lot of time in there if your child has diabetes, being aware that they might be manipulating their insulin levels to address their eating, avoiding eating in public, refusing to go out to restaurants. So those could be a lot of things that start to sort of build up where you start to notice that happening. And when that happens, it's really important just to say something like, look, I notice you did X, Y, and Z, or I noticed when you were trying on clothes in the dressing room that you looked like you lost a lot of weight.

Be prepared for a very defensive response, and they're going to deny it. They're going to get mad. They're going to tell you you're meddling, they're going to do all these things. But it's really important to be persistent. Sometimes if children won't talk to the parent, one thing would be to take them to the pediatrician and give the pediatrician a heads up ahead of time that this is what I think is going on. Because sometimes hearing it from a medical doctor, an expert, they'll be more willing to listen. And it's obviously more complicated if you have an adult child with a problem, but because you can't really contact their doctor as easily. But to just be straightforward, sit down with people who love them, almost like an intervention and just say, look, I noticed this. It's really concerning to me one middle step before a lot of them were like, I'm not going to see a therapist, or There's nothing wrong would be, well, let's talk with a dietician who understands these things.

So certain registered dieticians have a lot of training in eating disorders, and sometimes that's a great middle ground to be, okay, you're really worried about what you're eating, or you think that certain food groups are going to harm your athletic performance or whatever they're saying, let's talk to a nutritionist who's an expert at this, and that's not a nutritionist like you find at your local gym who's all about weight loss. I mean, that would be detrimental for really someone that is specialized in eating disorders. And there are ways to find folks who do that, whether it's through your family doctor, through some of the eating disorder websites like National Association for Eating Disorders. So again, you're going to meet some defensive responses, but it's so important to address this and address it early, because the more entrenched it gets, the harder it is to stop.

Host, Julie Withrow:

Yeah, for sure. So let's talk a little bit about eating disorders and where the intersection might be with neurodivergence, right? So can you talk about that a little bit more? I know you have a lot of clinical experience and you have a lot of practical experience in these areas, and I'd just love to better understand, I know that the research may not be a hundred percent conclusive about this, but in your experience, what do you think? Where are the connections? Does it, do eating disorders tend to be more prevalent among neurodivergent folks?

Dr. Gail Post:

Well, it's interesting, and again, the research is limited, and it's often complicated because some researchers look at eating disorders as a broad category, and as we can imagine, that covers a range of different concerns. So I think the verdict is not in yet about all this, but some of the studies have shown that there is a higher prevalence, certainly with folks with autism spectrum disorder or A DHD, attention deficit hyperactivity disorder when it comes to giftedness as a form of neurodivergence it. Again, there is very little out there about that. But for most folks who know gifted people, often we'll see certain level of eating disorder behavior.

Back when I used to work a lot with folks with eating disorders, looking back now, most of them were extremely bright, accomplished people, and their giftedness wasn't really addressed as part of it. But when you think about with giftedness, first of all, there is just sort of a heightened intensity, a heightened sensitivity to feelings to what's going on in the world. There's often a sense of overthinking, like overthinking things, and for some, becoming perfectionistic for others, being self-blaming, but all of that under the right conditions can really morph into an eating disorder, particularly anorexia with folks with autism. It's complicated because a lot of the studies, especially with arfid, with the feeding disorder, where it's not based on wanting to be thin and meet societal norms, some of that really ties into sensory sensitivities, which are more prevalent with folks with autism. But as we know, autism, again, it's quite a range in terms of people's level of functioning, where some people are really challenged intellectually and some are nonverbal.

There's a whole different range. And then there are the folks that used to be referred to as Asperger's, so that they are much more high functioning, and yet they can still have some of the traits of being very rigid, being very internally focused, feeling socially isolated, feeling like they don't fit in with the world. And an eating disorder is a way to challenge me, challenge channel those energies. So it's a way to put a container around them and be like, I feel like I don't fit in. I feel like I'm putting on a mask for the world. I feel so different, but this is at least something I can control, and I can do it well because I have such a great focus on details. With A DHD, it can be a little bit different. I mean, there is some clarity around the fact that there can be a higher prevalence of eating disorders and particularly bulimia or binge eating with folks with A DHD because of the impulsivity and the disin inhibition.

So they have great difficulty regulating moods at times, and they also have often encountered situations where they feel misunderstood, where folks in the school system don't really get them, or they're always telling them to sit down and not speak or whatever. I mean, they're being criticized a lot. They get in trouble a lot. And those who do not have the hyperactivity component but who are more distractible still, they feel bad about themselves. They're always criticized, why can't you focus? Why don't you pay attention? Why didn't you get your homework done? So again, it's an outlet, but for some folks with A DHD, bulimia is often a way of discharging their energy of engaging impulsively with the food, but then trying to get rid of it.

Host, Julie Withrow:

Yeah, I think that makes perfect sense to me. You and I have talked a little bit about my own experiences that way. Growing up, I never had a formally diagnosed eating disorder, and so maybe I fell into more of that subclinical category of things, but I certainly was a very impulsive eater, would eat way too much. I would binge on ice cream or generally ice cream. That was kind of my thing, and I would compensate for it by over exercising and going for a 10 mile run. And it was very much this cyclical behavior. And then just with any behavior, once you do that a few times, you're kind of forming these neural pathways and it kind of becomes

Dr. Gail Post:

Exactly,

Host, Julie Withrow:

Yeah. It just becomes part of how you operate. And so I didn't really question it for years. It worked for me in a positive way in my mind, and it wasn't really until later on that I really, and especially as an adult, once you're living in a home with another adult, with my husband, I would notice that sometimes if I were eating something indulgent and he weren't home, and I would hear him coming in the door, I would hide it or put it away real quick. And it was those kind of behaviors that kind of triggered for me these memories of how I've always had this secretive relationship around food, particularly when I'm eating for emotional reasons. You know what I mean?

Dr. Gail Post:

Right, right. Yeah, that's such a good point. And so you to share that it's really so common for people to feel like I have this special relationship with food. It comforts me, it makes me feel good, but I feel so guilty about it. I don't want anyone to know. It's very different to go out on a summer evening and get an ice cream cone with friends. That is very different than sitting down with a pint of Haagen Daaz and going to town with it. And there's all this shame like, oh, I don't deserve this. I shouldn't have it. It's wrong. Instead of just sort of owning it, yeah, it tastes good and I'm going to have it, but I'm going to try to limit my portions. But it's, again, once it becomes an emotional outlet, it's really hard to break that pattern.

Host, Julie Withrow:

And I think it also makes a lot of sense that much as I would also love for there to be a lot of research to support the intersection here because maybe it would help more people get recognized earlier. It also makes sense that the research doesn't necessarily exist. This is, I think many people would want to tease apart the various different types of neurodivergent conditions, and then are they really going to go dig in on eating disorders specifically as they relate to each one? So it is just like you started at the very beginning, just like it's very hard sometimes to tease apart different neurodivergent traits. I've always said, I feel like many of these things are one big Venn diagram with about eight petals on it that all overlap. Eating disorders are kind of the same way. And then if you put both those together, well now it's very hard to really research that in a way that you come away with some really, really clear conclusions. Plus, as we know, far too many people aren't even diagnosed to begin with, so you wouldn't even necessarily know to make that connection. Yes,

Dr. Gail Post:

Right. I think what it really comes down to is just like with neurodivergence, that each person is so different. The same thing with eating disorders. And so with your specific child, with oneself, we're all different, and we all have different triggers and things that set us off. And as a parent to be as attuned as possible to precursors to any kind of emotional condition, because a lot of times depression, anxiety, OCD, obsessive compulsive disorder, all those things can lead to an eating disorder and trigger it under certain conditions. So that combined with kind of a preventative approach, not being too pressuring on your child to succeed, trying to modify any perfectionistic patterns that start to develop. So if you see your child being very hard on themself, they don't get all A's just really trying to work with them to tone that down, kind of a prevention program, and not just about eating disorders, but about anything really in terms of emotional stability, to develop resilience, to try things that are somewhat hard for them, but not too hard where they feel like they fail to not feel like their whole sense of self rest on their accomplishments.

And in terms of eating disorders, to also just be very careful about how we talk about our own bodies, how we talk about our child's bodies, how we deal with times if our child is gaining weight, and how to address that in a way that's not shaming or too restrictive. So just to do whatever is possible. And sometimes kids start out doing things that look great on the surface, but in reality are troubling. Like a child who is super compliant and well-behaved and just sort of a parent's dream. Other people are like, how do you have such a nice kid? And in reality, they're just so people pleasing. They're stuffing down all their emotions, just trying to make the parents feel good about them and feel good about themselves. So again, to just be aware, is this something that's developmentally outside the norm? And again, as you mentioned before, it's not just in girls.

I think about a young college student I worked with recently, a male who had OCD as a child due to he was primed for it. Something happened that upset him, and so he developed some OCD about preventing it from happening again, was treated for that, was doing fine, went off to college. And although he super bright and gifted, he was struggling and he felt really bad about himself. He wasn't excelling. So he decided I'm going to become a cyclist. And he started riding his bike and then started improving his times and competing in races, and it became a huge part of his identity, but he thought, I have to be super skinny to be a good cyclist. So developed a eating disorder, and at first it started out with anorexia, then it transferred into bulimia, and he ended up having to drop out of school and take a year off to get well.

But fortunately, he had a lot of internal resources, wasn't horribly depressed. His parents were great and really involved in helping him, and he recovered. But again, it's not just girls. As you mentioned, it's widespread. It's in the L-G-B-T-Q population. It's in persons. People who are persons of color are often unidentified with an eating disorder. Something like 50% of eating disorders in persons of color are undiagnosed, and it's really widespread. But all we can do as parents is try to prevent things from escalating to really be attuned to our children, notice what they're feeling, try to help them cope with those feelings, and if something evolves to get them the help they need.

Host, Julie Withrow:

This has been such a great conversation. Normally I would end on a question to ask about your advice for parents, but I feel like you've given us such great advice already that I don't feel like I need to ask that question so much. I feel like what you've shared is really helpful, just understanding that there can be this perfect storm of conditions that can escalate to an eating disorder pretty quickly. And so I think the more you can pay attention to those and try to nip that in the bud as quickly as you can, the better. But also, you mentioned just asking questions and not being afraid to really confront some of these issues. Right? Because I do think sometimes, as I think particularly as mothers, that we have an intuition about our kids. And sometimes it may be scary to explore some of those hunches that we have, but particularly in a case like this, it's well worth that exploration because the circumstances can be very, very serious.

Dr. Gail Post:

Yeah, I guess it just really comes down to that just knowing your child and being attuned to what's going on with them and doing what you can

Host, Julie Withrow:

And

Dr. Gail Post:

Realizing that every child is different,

And even if it's a 1% of somebody who has a problem, that's your child. I mean, that's what needs to be dealt with in a way that really helps your child. So in terms of getting more information, I mean, there are a lot of national eating disorder associations. There's actually one called National, it's called, the acronym is neda, NEDA, so National Eating Disorder Association. They have lots of resources, lots of helpful tips, lots of signs to look for. It's kind of a go-to. And then there's tons of books and articles out there as well. But that's probably the best website right now to consider.

Host, Julie Withrow:

Yeah, thank you for sharing that. I was going to make sure that we included some resources if we didn't cover them here, but that's perfect. That's great. Thank you for sharing. Yeah. And just thank you for sharing your expertise on this topic. I know you have a lot of experience with this, and it's a topic I've been wanting to talk about for a while, ever since I read a book a few years ago that kind of made the connection for me that there may be some crossover between neurodivergent states, this propensity for eating disorders. So thank you for bringing your professional expertise to the conversation. You're

Dr. Gail Post:

Welcome. I'm glad to do that.

Host, Julie Withrow:

Thank you. And just sharing such great advice and resources. So again, it's been a pleasure to have you back for a second time. Maybe this won't be the last time, I hope.

Dr. Gail Post:

Right, right. Thank you.

Host, Julie Withrow:

Thanks for tuning in to the Exceptional Girls Podcast. If you liked today's episode, it would mean the world to me. If you'd subscribe, leave a rating and review and recommend it to just one other person who you think would benefit from listening. Even a small act of support helps the podcast reach more people, which in turn helps increase awareness and understanding of exceptionality in girls. And if you have suggestions for future episodes, please share them. You can connect with me—your host, Julie Withrow—through our website@exceptionalgirlspodcast.com slash contact.