March 18, 2025 • 30 mins
Eating Disorders affect more than 30-million Americans. Every 52 minutes, someone dies due to an eating disorder—one of the deadliest yet most overlooked mental health challenges in the U.S. Manny Munoz discusses ED a personal journey, with Johanna Kandel from the National Alliance for Eating Disorders
AND, March is Colorectal Cancer Awareness Month. As Dr. Roberto Rodriguez-Ruesga, Fellow of the American College of Surgeons, tells us it has become the leading cause of Cancer Death in Men under 50 and the second leading cause of Cancer Death in women under 50.
AND, March is Colorectal Cancer Awareness Month. As Dr. Roberto Rodriguez-Ruesga, Fellow of the American College of Surgeons, tells us it has become the leading cause of Cancer Death in Men under 50 and the second leading cause of Cancer Death in women under 50.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week.
Speaker 2 (00:09):
Here's many Munos and welcome to another edition of Iheartradios Communities.
As you heard, I am Manny Munyo's every fifty two
minutes someone dies due to an eating disorder in our country.
It's one of the deadliest yet most overlooked mental health challenges,
affecting over thirty million American Let's get a little bit
(00:32):
of clarity on why this is happening and how we
could help someone that might be going through this. Johanna
Kandell is from the National Alliance of Eating Disorders. She
is the CEO of the organization. Joanna, thank you very
much for your time.
Speaker 3 (00:46):
Thank you so much for having me today.
Speaker 2 (00:47):
So let's talk about Let's start off with the prevalent.
How prevalent are eating disorders in the United States in
this day and age.
Speaker 3 (00:55):
Yeah, I think people are often surprised how many people
existactly struggle with an eating disorder. So it is estimated
that over twenty nine million Americans, that is one in
nine Americans will have an eating disorder in their lifetime.
And what people I don't think realize is that these
are not disorders of choice, They're not disorders of vanity.
(01:18):
These are serious mental illness that are biologically based and
genetic in nature. It's not something that people, you know,
wake up one morning, look out the window and decide
I'm going to have an eating disorder. These are serious
mental health disorders.
Speaker 2 (01:33):
What constitutes an eating disorder?
Speaker 3 (01:38):
Yeah, absolutely so. Eating disorders are disturbances in eating and
feeding patterns. So, for example, when individuals are not able
to nourish themselves in a way that can sustain livelihood,
it goes from disordered eatings to eating disorders when it
becomes unmanageable, when it's ruling your life, when it's the
(02:01):
first thing that you're thinking about in the morning, the
last thing that you're thinking about at night, and every
other thought in between, and your life takes a serious
toll on being able to show up and you know,
do life.
Speaker 2 (02:14):
I guess the things we most commonly think of, and
I guess I'm showing my age. I'm thinking of Karen
Carpenter when I think of eating disorders, is that what
they are? A bolima and orexia, things of that sort.
Speaker 3 (02:26):
Yeah, So there are various eating disorders like you talk
about you know Karen Carpenter who struggled with anorexia nervosa,
which anorexia is a self induced starvation resulting from a
distorted body image and intense fear of being big. Then
there's a blimia nervosa, which is when individuals binge and perge,
and then binge eating disorder when individuals compulsively overeat, they
(02:50):
nun they stuff, they escape. It's eating disorders are maladaptive
coping mechanisms. We also have another eating disorder that many
people don't know about. It's called avoidant and restrictive food
intake disorder, which happens to a lot of children and
young adults. It's when there is a fear around the
actual act of eating. So perhaps they had a trauma
(03:13):
where they choked on food, or they don't like a
specific color or texture. And oftentimes you will see our
fed in individuals that are on you know, the autism spectrum.
Speaker 2 (03:29):
What are the misconceptions that you run across that people
have about these types of things, Because it feels like
we've kind of come to a level because in part
of social media where these things have really gotten out
of control in our society, we're seeing it more than ever.
Speaker 3 (03:44):
Yeah. Absolutely, and I'm so glad that you asked me.
And I think probably the first biggest misconception is who
develop seeding disorders and what they look like. I think
there's this archaic stereotype that it is, you know, often female,
identifying young, very thin bodied, white, upper to middle class,
when we actually know that eating disorders do not discriminate
(04:07):
between age, gender, race, class, body shape and size, sexual
orientation ability. Everyone can develop an eating disorder, and unfortunately,
those stereotypes are huge barriers in individuals accessing or even
getting intervention at all. For example, up to forty percent
of individuals that struggle with eating disorders are male, but
(04:30):
yet we still have this old notion that it's only
females that are going to struggle. So oftentimes people are
struggling in silence, and unfortunately it goes to the point
where they're losing their life. Because what a lot of
people don't know is that eating disorders have the second
highest death rate among all psychiatric disorders. It's only second
(04:52):
to opioid addiction. And in this country, someone loses their
life every fifty two minutes to the insidious disease.
Speaker 2 (05:01):
Well, that's that's shocking. Forty are male. What what are
some of the early warning signs that that a parent,
a loved one, a friend would look out for.
Speaker 3 (05:12):
I think first and foremost noticing a change in mood,
like if someone was very extroverted, they become very introverted. Obviously,
there's some idiosyncrasies around food, perhaps like they're eating less,
maybe they're more focused on the type that that that
they're eating. They might have excuses as to why they
aren't eating, you know, saying oh, I had a big lunch,
(05:33):
or my stomach hurts, an uptick in movement, if they
have the ability to undo this, if they're doing a
lot of movement in order to you know, burn calories,
you know in cases of people that are purging, like
if they're using you know, the restroom after they're eating.
And then physically, like if you notice some fluctuations in weight,
(05:53):
if you notice some fluctuation in like almost that light
in their eye. There could be a myriad of changes
when it comes to both physical and mental.
Speaker 2 (06:03):
Depression usually associated with these eating disorders or not necessarily.
Speaker 3 (06:09):
Absolutely so you hit the really the nail on the
head there, because we know that eating disorders don't just
live by themselves, so you always see anxiety, depression, trauma.
You know, for some people substance use. About fifty percent
of individuals that have eating disorders will also have a
(06:29):
substance use disorder. But we'll see high, high high rates
of depression anxiety trauma PTSD and like all of those
you typically see with eating disorders.
Speaker 2 (06:40):
Speaking with Johanna Candell, CEO of the National Alliance for
Eating Disorders, I want to talk to you about Eating
Disorder Awareness Week in just a moment. It's part of
what we're doing trying to bring some awareness to this.
I would imagine something like this, like with so many
of these mental health issues, early detection earlier is critical,
(07:01):
isn't it.
Speaker 3 (07:03):
Absolutely, Because the longer that someone experiences their eating disorder,
the more likely it's going to be very difficult. Because
you know, oftentimes when I share about my personal experience
with with my eating disorder, people say, well, it sounds miserable,
it sounds like a nightmare, And I say to them,
it was the hardest ten years of my life. And
at the same time, it's how I coped, it's how
(07:25):
I navigated, And so for me my eating disorder. What
I'm detected for ten years. But if you notice signs,
if you notice symptoms, please reach out. The Alliance can
connect you with providers, with treatment centers, with groups that
can help not only the person that is struggling, but
as well as the family unit, the support unit, because
(07:47):
you do not have to navigate this journey alone.
Speaker 2 (07:49):
Is it does it disproportionately? These eating disorders affect younger Americans?
Speaker 3 (07:57):
You know what it's we see an overconcentration of indivis
younger than the age of thirty thirty five. But I
will tell you that at the Alliance, we hold the
National Helpline, and twenty five percent of all of our
calls are for individuals over the age of forty five.
So that really does shatter the idea that eating disorders
are only happening to kids. But we also have to
(08:19):
take a look that six percent of all of our
calls into our helpline are for individuals younger than the
age of twelve, and twenty eight percent are for individuals
between the ages of thirteen and eighteen. So again I
think across the spectrum, but definitely paying attention to our kiddos,
our young adults, and definitely we know that we have
(08:41):
a huge uptick in midlife and beyond as well.
Speaker 2 (08:45):
I hope this isn't offensive, and I don't mean for
it to be. I'm looking at you, You're beautiful. And
it reminded me of the idea that it's not how
somebody views the person with the eating disorder. Is it's
how the person with the eating disorder use themselves, isn't it.
Speaker 3 (09:02):
That's exactly right. We talk about this, this distortion of
never feeling good enough. So many individuals that are struggling
with eating disorders are very perfectionistic. They're very black or white.
They're very like high achieving, always excelling. And again, it
doesn't really necessarily come from the outside in, it comes
(09:22):
from the inside out. We know that the thing that causes, right,
there's so many different contributors to the development of eating disorders, right,
it's genetics, it's the world, it's inherent temperaments. But we
know that it starts with a negative energy balance where
your body, you know, gets into like this negative energy
of not getting enough enough food, enough calories, and then
(09:46):
something will happen and then that is where that distortion
happens with with sight, with hearing, with all of that,
so you can have the most you know what, we
would say, the most conventionally very good looking, very are
very you know, productive, very successful individual but yet they're
not able to see what everyone else es.
Speaker 2 (10:08):
What is the connection? And we've mentioned in a couple
of times already between the fact that we live in
the social media age, I would imagine celebrities and influencers
maybe contribute to people's body image issues and maybe also
help by sharing their stories.
Speaker 3 (10:26):
Sure, absolutely so. What we believe is that, you know,
sort of genetics, because we know that of all the
contributing factors of the development of eating disorders, about fifty
to seventy percent is genetics. So if a parent or
a sibling of a parent has had an eating disorder,
you have that genetically predisposition. However, the environment pulls that
proverbial trigger. And you are so right about social the
(10:49):
constant barraging of messaging, the face tuning, the editing, the
you know, we are comparing our everyday life to the
highlight reel of everyone else, right, so we might be
not feeling good about ourselves and we are connected at
all times. On average, I think teens are on some
type of a social or online five hours a day.
(11:10):
And you know, when you think about that barrage of
perfection of images of all of that, what is that
doing to us? And so you have all of those
messaging and then on the flip side, though, something that
is beautiful about social media is that it still does
create a community where individuals can see people like you know,
(11:31):
a content creators or humans have lived experience that turn
around and say, you know, I've been struggling. I am
in recovery. This is what I went through. You are
not alone. And for the person who is struggling in
silence and isolation, that becomes the crack in the armor
that less light and maybe it's the thing that really
pushes them to call an organization like the Alliance to
(11:54):
reach out for help.
Speaker 2 (11:55):
It's a fascinating point. You mentioned that people are genetically
predisposed to this, but when you consider that it's a
mental health issue that contributes to it, it makes perfect sense.
Talk to me about the National Alliance for Eating Disorders,
where you are the CEO. How what are some of
the things that you do to help these people who
(12:17):
come seeking assistance.
Speaker 3 (12:20):
Yeah, absolutely so, the National Alliance for Eating Disorders is
the leading national nonprofit organization and we are there to
be of service. We are there to be of help.
We have a national helpline that is staffed by license
and specialized clinicians, so everyone you talk to when you
pick up the phone is a therapist that specialize in
the treatment to eating disorders. We are open Monday through
(12:41):
Friday from nine a and to seven pm, and you
can call us if you have concerns, if you have worries,
if you're looking for connections to a therapist, a dietitian,
or even a hospital that specializes in eating disorders. We
also offer twenty one free weekly therapists, LEDs support groups
people from all fifty states in eighty eight countries around
(13:02):
the world. And we have different groups specifically for you know,
just a general eating disorder group for loved ones. We
have a group for LGBTQ individuals, for midlife and beyond
for BIPOP and these are free and they are still
all led by licensed and specialized providers. We do a
lot of work around advocacy ensuring that that eating disorders
(13:26):
are viewed as serious mental illness and are part of
the general mental health conversation, but more than anything, we
are here to walk next to you on your journey
throughout your eating disorders and into recovery.
Speaker 2 (13:38):
And that helpline for the National Alliance for Eating Disorders
is eight sixty six sixty six two twelve thirty five
eight six six sixty six to twelve thirty five. So a
couple final questions for you, what are the treatments for
someone with an eating disorder?
Speaker 3 (13:57):
Well, and that's really the beauty of our few is
that it is not one size fits all. There's different
modalities of like cognitive behavioral therapy, family based therapy, you know,
dialectical behavioral therapy. So typically when you're in recovery or
you're seeking recovery from an eating disorder, it takes a
treatment team. So you'll have a therapist, you'll have a
(14:19):
dietician that will help you reintegrate food because eating disorders
are not about the food, but food is the mechanism
in which right you might have a psychiatrist, and then
that is just outpatient. There's different levels of care above,
whether it's intensive outpatient all the way up to acute
medical stabilization. The one thing that I just want to
(14:41):
share with all of your listeners, and you've been so
generous with your time, and I so appreciate this conversation
so much. Is that we really need to view mental
health on the same level as physical health. If you
broke your arm, it wouldn't be up to you to
will it to heal on its own. You did not
choose to recover to struggle with this eating disorder. There
(15:02):
are people and places that can and will and want
to help you. So please reach out. Even if you
know we can't find that quote unquote perfect fit, we
will reach out and continue to seek resources until we
find an opportunity and a place for you to heal.
I say this each and every day is my recovery
(15:24):
is the hardest thing I ever did. It was painful,
it was overwhelming, and there are so many times that
I know I nearly lost my life and living beyond
my eating disorder. Now I will tell you it is
the absolute best thing that I ever did, and that
if you are someone you know is struggling, please know
that you're not alone. Please know that it can get better.
(15:45):
Please do not walk on this path by yourself. We
are here and we are ready to help.
Speaker 2 (15:51):
The helpline number is eight sixty six six six two
twelve thirty five. That's eight six six six twelve thirty
five for the National Alliance for Eating Disorders. We've been
speaking with the founder and CEO, Johanna Kandel. Thank you
for sharing your story and your struggle. Best of luck
to you every day. Thanks so much for the time
(16:12):
and everything you're doing as well.
Speaker 3 (16:14):
Thank you so so much for having this conversation.
Speaker 2 (16:17):
March is Colorectal Cancer Awareness month. Now you might ask yourself, well,
what is colorectal cancer anyway? We'll get to that, but
it has become the leading cause of cancer deaths in
men under fifty and the second leading cause of cancer
deaths in women under fifty. So let's discuss it as
we bring in doctor Roberto Rodriguez Esca. He's a fellow
(16:38):
at the American College of Surgeons. Doctor Rodriguez Resca, thanks
so much for the time.
Speaker 1 (16:43):
Thank you for the invitation. So let's to be with you.
Speaker 2 (16:46):
Let's start off with that what is colo rectal cancer? Anyway?
Speaker 1 (16:51):
Colorectal cancer is cancer of the colons, as simple as that.
The colon is the last part of the intestine that
where the stool gets collected, stored, and eliminated at appropriate times.
And it's there where the malignant cells can developed, can develop,
(17:12):
and then that's where what cool recular cancer is.
Speaker 2 (17:16):
It is on the rise in all Americans. One in
ten colorectal cancer pations now under the age of fifty,
and you're seeing an increasing diagnosis and people as early
as their twenties and thirties.
Speaker 1 (17:30):
Yes, it's an alarming statistic. For instance, people that were
born in nineteen ninety have double the risk of developing
colon cancer if you compare them to people who were
born before nineteen fifty or were born in nineteen fifty.
(17:52):
And I think that there's factors, multiple factors that contribute
to that increase in incidents and younger individuals.
Speaker 2 (18:05):
It would lead me to believe that it has something
to do with our country, the way we're living our lives,
that our diet something. Do we know the causes for it?
Speaker 1 (18:16):
Absolutely, you're uh scored one hundred on on on that.
There's no there's no specific cost. There's multiple factors, the
things that we eating, processed food, use of pesticides, furtilizers,
environmental pollution, uh, you know, sedentary lifestyle, excessive consumption, of alcohol.
(18:46):
All those things add up in over time, the strength
of the genetic structure starts to break, and all the
defense mechanisms that we have to prevent cancer start to fail,
and that's why that happens.
Speaker 2 (19:04):
Are these increases in cases of coorectal cancer something that
is unique to the United States because of our culture,
our food supply, all of those things, or are we
seeing it globally?
Speaker 1 (19:17):
Actually, we see the higher incidences of colon cancer in
highly developed countries. And I'm going to use just to
give you an example. The risk of developing cancer, corectal
cancer in Latin American countries is lower, presumably because of
(19:44):
the type of food that they're eating may be healthier.
But when those individuals migrate to the United States, the
incidence of colon cancer increases to the levels of the
United States. So it's definitely, uh, something that has to
do where where we're living. So all those things, uh
(20:12):
definitely contribute to the increased into and cancer in younger people.
Speaker 2 (20:18):
What is screening like.
Speaker 1 (20:21):
Well, the gold standard for screening is colonoscopy, where you
can detect pillets, which are the precursors of cancer and
remove them at the same time if they're small enough
and safe enough to remove, that's the gold standard. There's
other methods uh stool collection methods that can be also performed,
(20:48):
and there's few other ways. But in a way besides
the stool test, they also need, for instance, X rays
or flexible sigmadoscopy look inside the intestine to.
Speaker 2 (21:08):
Detect I'm in my mid fifties, so I've had my colonoscopy.
I believe the first one was in my late forties.
We're seeing this increased incidence of people in their twenties
or thirties demographics that would never get recommended a colonoscopy
unless they had reason to. So what are the symptoms
(21:29):
that somebody might look for if they wouldn't be in
the age bracket to get a colonoscopy.
Speaker 1 (21:36):
Yes, primarily changes about habits, blood or mucus in this tool,
abdominal pain, unexplained weight loss. Those would be the symptoms.
But the other thing that is very important that may
change the age of colonoscopy is family history. And typically
(22:03):
the standard recommendation is you take the family members age
of the one that was diagnosed and then the duct
ten years and then after offspring should be scoped. Ten
years prior to the age where that individual was diagnosed,
unless there's a genetic condition mutation that would have a
(22:28):
much higher incidence of developing phone cancer. And in those cases,
the screening age could be dropping all the way into
their twenties early twenties. So finally, history is an important
factor to consider as to when you should be screened.
Speaker 2 (22:47):
We're discussing colon Cancer Awareness Month, which is March in
colorectal cancer with doctor Roberto RODRIGUEZRWESCA. He is a fellow
at the American College of Surgeons. What are the most
most common misconceptions that you come across people have about
colorectal cancer.
Speaker 1 (23:08):
Well, I think that probably the most common misconception is
that once you get diagnosed, then you're done, and that's
not the case. This is a disease that is curable
as long as is detected at an early stage, and
(23:29):
what's even better, is totally preventable if you proceed with
screening in time. So the other that's probably the number
one misconception that you're doomed with a diagnosis, and now
(23:49):
things have advanced so much that it's not the case.
Speaker 2 (23:54):
Early detection with any type of cancer. Heart disease. Anything
else is the key, right, there's a and it's called
preventative medicine. So how do you recommend that people go
about unless they're seeing some of those symptoms we've already discussed.
Uh Are doctors changing their recommendations because we're seeing this
higher incidence of younger people contracting colorectal.
Speaker 1 (24:16):
Cancer, Well, they're all not really. I mean, the standard
recommendation is proceed with colonoscopy at age twenty five or
not colonoscopy, but other means of detecting uh CO rectal
cancer still says that we mentioned earlier, so so that
(24:37):
that's the standard recommendation. But I think the threshful to
proceed with the valuation should be very low, meaning that
as soon as you have symptoms, just go see your
physician and an exam to start with an exam uh
and and and then from there the side, what are
(24:58):
the steps to follow?
Speaker 2 (25:00):
What is treatment like?
Speaker 1 (25:03):
The treatment is dictated by the states of the cancer.
It's a very personalized approach. Not two colon cancers are
the same. So in general I can say that the
treatment could be as simple as removing a malignant public
(25:25):
colonoscopy and that's the end of it, and as complicated
as requiring chemotherapy, radiation and surgery. So the treatment is
dictated by the stage. The earlier the stage, typically the
approach is surgical removing the segment in the law. The
(25:48):
more advanced it would involve additional chemotherapy radiation depending on
the location.
Speaker 2 (25:55):
We talked about some of the causes and is clear
my understanding from what you said, UH, that it is
the way we live in our country, our culture. So
in what ways do lifestyle choges choices are changing? Rather
our lifestyle choices help us contain this or not become victims?
Speaker 1 (26:19):
Well, I think a sci fi er diet, low fat exercise,
moderate alcohol consumption, maintain a good weight, fight obesity. I
think those no smoking. I think in general those are
(26:41):
the typical standard recommendations.
Speaker 2 (26:44):
Are there socioeconomic factors that you find in in people
who contract colorectal cancer?
Speaker 1 (26:53):
Absolutely? Absolutely. I think the cost of treatment is quite impactful. Uh.
Access to care shouldn't be a problem here in the
United States compared to other places, So we're blessed from
that perspective, But some people UH may have uh less
(27:21):
access because of socio economic factors. So it's definitely important.
And then uh, the highly uh successful executive that is
diagnosed will have to have down time to get chemotherapy,
and he's not going to be as productive, you know,
(27:44):
he may not feel so well. Everybody responds different to treatments,
so I'm not I don't want to generalize, sure, but
definitely there's an impact when we're there's an impact and
not to let and not not to make the emotional
impact on the individual in the family.
Speaker 2 (28:04):
Do you find there's a higher incidence in people contracting
being diagnosed with coorectal cancer in underprivileged communities, poorer people,
or does it effect across all of those demographics.
Speaker 1 (28:20):
What I see, I think it's the same. But what
I see is unfortunately individuals with lower income present to
the physician at higher stages than in my experience.
Speaker 2 (28:37):
March, as we mentioned, happens to be Coorectal cancer Awareness month,
and usually the goal of one of these things is
to bring awareness to the issue, how it's growing in
our country and the fight against the disease. Do you
think it's accomplishing that.
Speaker 1 (28:54):
I think it is. I think we're making progress, which
is need to keep.
Speaker 2 (29:03):
Better access to screening and treatment for colorectal cancer. Is
that something that's part of the goal as well?
Speaker 1 (29:11):
Correct? That is the goal, all right?
Speaker 2 (29:15):
Uh? Doctor Roberto Rodriguez throwesca fellow at the American College
of Surgeons. If you want more information on colorectal cancer,
you could go to FACS dot org slash colorectal cancer.
That's FACS dot org slash colorectal cancer, doctor Rodriguez Rescot.
(29:35):
I appreciate the time, Thank you.
Speaker 1 (29:36):
So much, Thank you having good day and keep pressing on.
Speaker 2 (29:42):
Thank you, And that'll do it for another edition of
Iheartradios Communities. I'm Manny Muno's until next time.
Welcome to iHeartRadio Communities, a public affairs special focusing on
the biggest issues in facting you this week.
Speaker 2 (00:09):
Here's many Munos and welcome to another edition of Iheartradios Communities.
As you heard, I am Manny Munyo's every fifty two
minutes someone dies due to an eating disorder in our country.
It's one of the deadliest yet most overlooked mental health challenges,
affecting over thirty million American Let's get a little bit
(00:32):
of clarity on why this is happening and how we
could help someone that might be going through this. Johanna
Kandell is from the National Alliance of Eating Disorders. She
is the CEO of the organization. Joanna, thank you very
much for your time.
Speaker 3 (00:46):
Thank you so much for having me today.
Speaker 2 (00:47):
So let's talk about Let's start off with the prevalent.
How prevalent are eating disorders in the United States in
this day and age.
Speaker 3 (00:55):
Yeah, I think people are often surprised how many people
existactly struggle with an eating disorder. So it is estimated
that over twenty nine million Americans, that is one in
nine Americans will have an eating disorder in their lifetime.
And what people I don't think realize is that these
are not disorders of choice, They're not disorders of vanity.
(01:18):
These are serious mental illness that are biologically based and
genetic in nature. It's not something that people, you know,
wake up one morning, look out the window and decide
I'm going to have an eating disorder. These are serious
mental health disorders.
Speaker 2 (01:33):
What constitutes an eating disorder?
Speaker 3 (01:38):
Yeah, absolutely so. Eating disorders are disturbances in eating and
feeding patterns. So, for example, when individuals are not able
to nourish themselves in a way that can sustain livelihood,
it goes from disordered eatings to eating disorders when it
becomes unmanageable, when it's ruling your life, when it's the
(02:01):
first thing that you're thinking about in the morning, the
last thing that you're thinking about at night, and every
other thought in between, and your life takes a serious
toll on being able to show up and you know,
do life.
Speaker 2 (02:14):
I guess the things we most commonly think of, and
I guess I'm showing my age. I'm thinking of Karen
Carpenter when I think of eating disorders, is that what
they are? A bolima and orexia, things of that sort.
Speaker 3 (02:26):
Yeah, So there are various eating disorders like you talk
about you know Karen Carpenter who struggled with anorexia nervosa,
which anorexia is a self induced starvation resulting from a
distorted body image and intense fear of being big. Then
there's a blimia nervosa, which is when individuals binge and perge,
and then binge eating disorder when individuals compulsively overeat, they
(02:50):
nun they stuff, they escape. It's eating disorders are maladaptive
coping mechanisms. We also have another eating disorder that many
people don't know about. It's called avoidant and restrictive food
intake disorder, which happens to a lot of children and
young adults. It's when there is a fear around the
actual act of eating. So perhaps they had a trauma
(03:13):
where they choked on food, or they don't like a
specific color or texture. And oftentimes you will see our
fed in individuals that are on you know, the autism spectrum.
Speaker 2 (03:29):
What are the misconceptions that you run across that people
have about these types of things, Because it feels like
we've kind of come to a level because in part
of social media where these things have really gotten out
of control in our society, we're seeing it more than ever.
Speaker 3 (03:44):
Yeah. Absolutely, and I'm so glad that you asked me.
And I think probably the first biggest misconception is who
develop seeding disorders and what they look like. I think
there's this archaic stereotype that it is, you know, often female,
identifying young, very thin bodied, white, upper to middle class,
when we actually know that eating disorders do not discriminate
(04:07):
between age, gender, race, class, body shape and size, sexual
orientation ability. Everyone can develop an eating disorder, and unfortunately,
those stereotypes are huge barriers in individuals accessing or even
getting intervention at all. For example, up to forty percent
of individuals that struggle with eating disorders are male, but
(04:30):
yet we still have this old notion that it's only
females that are going to struggle. So oftentimes people are
struggling in silence, and unfortunately it goes to the point
where they're losing their life. Because what a lot of
people don't know is that eating disorders have the second
highest death rate among all psychiatric disorders. It's only second
(04:52):
to opioid addiction. And in this country, someone loses their
life every fifty two minutes to the insidious disease.
Speaker 2 (05:01):
Well, that's that's shocking. Forty are male. What what are
some of the early warning signs that that a parent,
a loved one, a friend would look out for.
Speaker 3 (05:12):
I think first and foremost noticing a change in mood,
like if someone was very extroverted, they become very introverted. Obviously,
there's some idiosyncrasies around food, perhaps like they're eating less,
maybe they're more focused on the type that that that
they're eating. They might have excuses as to why they
aren't eating, you know, saying oh, I had a big lunch,
(05:33):
or my stomach hurts, an uptick in movement, if they
have the ability to undo this, if they're doing a
lot of movement in order to you know, burn calories,
you know in cases of people that are purging, like
if they're using you know, the restroom after they're eating.
And then physically, like if you notice some fluctuations in weight,
(05:53):
if you notice some fluctuation in like almost that light
in their eye. There could be a myriad of changes
when it comes to both physical and mental.
Speaker 2 (06:03):
Depression usually associated with these eating disorders or not necessarily.
Speaker 3 (06:09):
Absolutely so you hit the really the nail on the
head there, because we know that eating disorders don't just
live by themselves, so you always see anxiety, depression, trauma.
You know, for some people substance use. About fifty percent
of individuals that have eating disorders will also have a
(06:29):
substance use disorder. But we'll see high, high high rates
of depression anxiety trauma PTSD and like all of those
you typically see with eating disorders.
Speaker 2 (06:40):
Speaking with Johanna Candell, CEO of the National Alliance for
Eating Disorders, I want to talk to you about Eating
Disorder Awareness Week in just a moment. It's part of
what we're doing trying to bring some awareness to this.
I would imagine something like this, like with so many
of these mental health issues, early detection earlier is critical,
(07:01):
isn't it.
Speaker 3 (07:03):
Absolutely, Because the longer that someone experiences their eating disorder,
the more likely it's going to be very difficult. Because
you know, oftentimes when I share about my personal experience
with with my eating disorder, people say, well, it sounds miserable,
it sounds like a nightmare, And I say to them,
it was the hardest ten years of my life. And
at the same time, it's how I coped, it's how
(07:25):
I navigated, And so for me my eating disorder. What
I'm detected for ten years. But if you notice signs,
if you notice symptoms, please reach out. The Alliance can
connect you with providers, with treatment centers, with groups that
can help not only the person that is struggling, but
as well as the family unit, the support unit, because
(07:47):
you do not have to navigate this journey alone.
Speaker 2 (07:49):
Is it does it disproportionately? These eating disorders affect younger Americans?
Speaker 3 (07:57):
You know what it's we see an overconcentration of indivis
younger than the age of thirty thirty five. But I
will tell you that at the Alliance, we hold the
National Helpline, and twenty five percent of all of our
calls are for individuals over the age of forty five.
So that really does shatter the idea that eating disorders
are only happening to kids. But we also have to
(08:19):
take a look that six percent of all of our
calls into our helpline are for individuals younger than the
age of twelve, and twenty eight percent are for individuals
between the ages of thirteen and eighteen. So again I
think across the spectrum, but definitely paying attention to our kiddos,
our young adults, and definitely we know that we have
(08:41):
a huge uptick in midlife and beyond as well.
Speaker 2 (08:45):
I hope this isn't offensive, and I don't mean for
it to be. I'm looking at you, You're beautiful. And
it reminded me of the idea that it's not how
somebody views the person with the eating disorder. Is it's
how the person with the eating disorder use themselves, isn't it.
Speaker 3 (09:02):
That's exactly right. We talk about this, this distortion of
never feeling good enough. So many individuals that are struggling
with eating disorders are very perfectionistic. They're very black or white.
They're very like high achieving, always excelling. And again, it
doesn't really necessarily come from the outside in, it comes
(09:22):
from the inside out. We know that the thing that causes, right,
there's so many different contributors to the development of eating disorders, right,
it's genetics, it's the world, it's inherent temperaments. But we
know that it starts with a negative energy balance where
your body, you know, gets into like this negative energy
of not getting enough enough food, enough calories, and then
(09:46):
something will happen and then that is where that distortion
happens with with sight, with hearing, with all of that,
so you can have the most you know what, we
would say, the most conventionally very good looking, very are
very you know, productive, very successful individual but yet they're
not able to see what everyone else es.
Speaker 2 (10:08):
What is the connection? And we've mentioned in a couple
of times already between the fact that we live in
the social media age, I would imagine celebrities and influencers
maybe contribute to people's body image issues and maybe also
help by sharing their stories.
Speaker 3 (10:26):
Sure, absolutely so. What we believe is that, you know,
sort of genetics, because we know that of all the
contributing factors of the development of eating disorders, about fifty
to seventy percent is genetics. So if a parent or
a sibling of a parent has had an eating disorder,
you have that genetically predisposition. However, the environment pulls that
proverbial trigger. And you are so right about social the
(10:49):
constant barraging of messaging, the face tuning, the editing, the
you know, we are comparing our everyday life to the
highlight reel of everyone else, right, so we might be
not feeling good about ourselves and we are connected at
all times. On average, I think teens are on some
type of a social or online five hours a day.
(11:10):
And you know, when you think about that barrage of
perfection of images of all of that, what is that
doing to us? And so you have all of those
messaging and then on the flip side, though, something that
is beautiful about social media is that it still does
create a community where individuals can see people like you know,
(11:31):
a content creators or humans have lived experience that turn
around and say, you know, I've been struggling. I am
in recovery. This is what I went through. You are
not alone. And for the person who is struggling in
silence and isolation, that becomes the crack in the armor
that less light and maybe it's the thing that really
pushes them to call an organization like the Alliance to
(11:54):
reach out for help.
Speaker 2 (11:55):
It's a fascinating point. You mentioned that people are genetically
predisposed to this, but when you consider that it's a
mental health issue that contributes to it, it makes perfect sense.
Talk to me about the National Alliance for Eating Disorders,
where you are the CEO. How what are some of
the things that you do to help these people who
(12:17):
come seeking assistance.
Speaker 3 (12:20):
Yeah, absolutely so, the National Alliance for Eating Disorders is
the leading national nonprofit organization and we are there to
be of service. We are there to be of help.
We have a national helpline that is staffed by license
and specialized clinicians, so everyone you talk to when you
pick up the phone is a therapist that specialize in
the treatment to eating disorders. We are open Monday through
(12:41):
Friday from nine a and to seven pm, and you
can call us if you have concerns, if you have worries,
if you're looking for connections to a therapist, a dietitian,
or even a hospital that specializes in eating disorders. We
also offer twenty one free weekly therapists, LEDs support groups
people from all fifty states in eighty eight countries around
(13:02):
the world. And we have different groups specifically for you know,
just a general eating disorder group for loved ones. We
have a group for LGBTQ individuals, for midlife and beyond
for BIPOP and these are free and they are still
all led by licensed and specialized providers. We do a
lot of work around advocacy ensuring that that eating disorders
(13:26):
are viewed as serious mental illness and are part of
the general mental health conversation, but more than anything, we
are here to walk next to you on your journey
throughout your eating disorders and into recovery.
Speaker 2 (13:38):
And that helpline for the National Alliance for Eating Disorders
is eight sixty six sixty six two twelve thirty five
eight six six sixty six to twelve thirty five. So a
couple final questions for you, what are the treatments for
someone with an eating disorder?
Speaker 3 (13:57):
Well, and that's really the beauty of our few is
that it is not one size fits all. There's different
modalities of like cognitive behavioral therapy, family based therapy, you know,
dialectical behavioral therapy. So typically when you're in recovery or
you're seeking recovery from an eating disorder, it takes a
treatment team. So you'll have a therapist, you'll have a
(14:19):
dietician that will help you reintegrate food because eating disorders
are not about the food, but food is the mechanism
in which right you might have a psychiatrist, and then
that is just outpatient. There's different levels of care above,
whether it's intensive outpatient all the way up to acute
medical stabilization. The one thing that I just want to
(14:41):
share with all of your listeners, and you've been so
generous with your time, and I so appreciate this conversation
so much. Is that we really need to view mental
health on the same level as physical health. If you
broke your arm, it wouldn't be up to you to
will it to heal on its own. You did not
choose to recover to struggle with this eating disorder. There
(15:02):
are people and places that can and will and want
to help you. So please reach out. Even if you
know we can't find that quote unquote perfect fit, we
will reach out and continue to seek resources until we
find an opportunity and a place for you to heal.
I say this each and every day is my recovery
(15:24):
is the hardest thing I ever did. It was painful,
it was overwhelming, and there are so many times that
I know I nearly lost my life and living beyond
my eating disorder. Now I will tell you it is
the absolute best thing that I ever did, and that
if you are someone you know is struggling, please know
that you're not alone. Please know that it can get better.
(15:45):
Please do not walk on this path by yourself. We
are here and we are ready to help.
Speaker 2 (15:51):
The helpline number is eight sixty six six six two
twelve thirty five. That's eight six six six twelve thirty
five for the National Alliance for Eating Disorders. We've been
speaking with the founder and CEO, Johanna Kandel. Thank you
for sharing your story and your struggle. Best of luck
to you every day. Thanks so much for the time
(16:12):
and everything you're doing as well.
Speaker 3 (16:14):
Thank you so so much for having this conversation.
Speaker 2 (16:17):
March is Colorectal Cancer Awareness month. Now you might ask yourself, well,
what is colorectal cancer anyway? We'll get to that, but
it has become the leading cause of cancer deaths in
men under fifty and the second leading cause of cancer
deaths in women under fifty. So let's discuss it as
we bring in doctor Roberto Rodriguez Esca. He's a fellow
(16:38):
at the American College of Surgeons. Doctor Rodriguez Resca, thanks
so much for the time.
Speaker 1 (16:43):
Thank you for the invitation. So let's to be with you.
Speaker 2 (16:46):
Let's start off with that what is colo rectal cancer? Anyway?
Speaker 1 (16:51):
Colorectal cancer is cancer of the colons, as simple as that.
The colon is the last part of the intestine that
where the stool gets collected, stored, and eliminated at appropriate times.
And it's there where the malignant cells can developed, can develop,
(17:12):
and then that's where what cool recular cancer is.
Speaker 2 (17:16):
It is on the rise in all Americans. One in
ten colorectal cancer pations now under the age of fifty,
and you're seeing an increasing diagnosis and people as early
as their twenties and thirties.
Speaker 1 (17:30):
Yes, it's an alarming statistic. For instance, people that were
born in nineteen ninety have double the risk of developing
colon cancer if you compare them to people who were
born before nineteen fifty or were born in nineteen fifty.
(17:52):
And I think that there's factors, multiple factors that contribute
to that increase in incidents and younger individuals.
Speaker 2 (18:05):
It would lead me to believe that it has something
to do with our country, the way we're living our lives,
that our diet something. Do we know the causes for it?
Speaker 1 (18:16):
Absolutely, you're uh scored one hundred on on on that.
There's no there's no specific cost. There's multiple factors, the
things that we eating, processed food, use of pesticides, furtilizers,
environmental pollution, uh, you know, sedentary lifestyle, excessive consumption, of alcohol.
(18:46):
All those things add up in over time, the strength
of the genetic structure starts to break, and all the
defense mechanisms that we have to prevent cancer start to fail,
and that's why that happens.
Speaker 2 (19:04):
Are these increases in cases of coorectal cancer something that
is unique to the United States because of our culture,
our food supply, all of those things, or are we
seeing it globally?
Speaker 1 (19:17):
Actually, we see the higher incidences of colon cancer in
highly developed countries. And I'm going to use just to
give you an example. The risk of developing cancer, corectal
cancer in Latin American countries is lower, presumably because of
(19:44):
the type of food that they're eating may be healthier.
But when those individuals migrate to the United States, the
incidence of colon cancer increases to the levels of the
United States. So it's definitely, uh, something that has to
do where where we're living. So all those things, uh
(20:12):
definitely contribute to the increased into and cancer in younger people.
Speaker 2 (20:18):
What is screening like.
Speaker 1 (20:21):
Well, the gold standard for screening is colonoscopy, where you
can detect pillets, which are the precursors of cancer and
remove them at the same time if they're small enough
and safe enough to remove, that's the gold standard. There's
other methods uh stool collection methods that can be also performed,
(20:48):
and there's few other ways. But in a way besides
the stool test, they also need, for instance, X rays
or flexible sigmadoscopy look inside the intestine to.
Speaker 2 (21:08):
Detect I'm in my mid fifties, so I've had my colonoscopy.
I believe the first one was in my late forties.
We're seeing this increased incidence of people in their twenties
or thirties demographics that would never get recommended a colonoscopy
unless they had reason to. So what are the symptoms
(21:29):
that somebody might look for if they wouldn't be in
the age bracket to get a colonoscopy.
Speaker 1 (21:36):
Yes, primarily changes about habits, blood or mucus in this tool,
abdominal pain, unexplained weight loss. Those would be the symptoms.
But the other thing that is very important that may
change the age of colonoscopy is family history. And typically
(22:03):
the standard recommendation is you take the family members age
of the one that was diagnosed and then the duct
ten years and then after offspring should be scoped. Ten
years prior to the age where that individual was diagnosed,
unless there's a genetic condition mutation that would have a
(22:28):
much higher incidence of developing phone cancer. And in those cases,
the screening age could be dropping all the way into
their twenties early twenties. So finally, history is an important
factor to consider as to when you should be screened.
Speaker 2 (22:47):
We're discussing colon Cancer Awareness Month, which is March in
colorectal cancer with doctor Roberto RODRIGUEZRWESCA. He is a fellow
at the American College of Surgeons. What are the most
most common misconceptions that you come across people have about
colorectal cancer.
Speaker 1 (23:08):
Well, I think that probably the most common misconception is
that once you get diagnosed, then you're done, and that's
not the case. This is a disease that is curable
as long as is detected at an early stage, and
(23:29):
what's even better, is totally preventable if you proceed with
screening in time. So the other that's probably the number
one misconception that you're doomed with a diagnosis, and now
(23:49):
things have advanced so much that it's not the case.
Speaker 2 (23:54):
Early detection with any type of cancer. Heart disease. Anything
else is the key, right, there's a and it's called
preventative medicine. So how do you recommend that people go
about unless they're seeing some of those symptoms we've already discussed.
Uh Are doctors changing their recommendations because we're seeing this
higher incidence of younger people contracting colorectal.
Speaker 1 (24:16):
Cancer, Well, they're all not really. I mean, the standard
recommendation is proceed with colonoscopy at age twenty five or
not colonoscopy, but other means of detecting uh CO rectal
cancer still says that we mentioned earlier, so so that
(24:37):
that's the standard recommendation. But I think the threshful to
proceed with the valuation should be very low, meaning that
as soon as you have symptoms, just go see your
physician and an exam to start with an exam uh
and and and then from there the side, what are
(24:58):
the steps to follow?
Speaker 2 (25:00):
What is treatment like?
Speaker 1 (25:03):
The treatment is dictated by the states of the cancer.
It's a very personalized approach. Not two colon cancers are
the same. So in general I can say that the
treatment could be as simple as removing a malignant public
(25:25):
colonoscopy and that's the end of it, and as complicated
as requiring chemotherapy, radiation and surgery. So the treatment is
dictated by the stage. The earlier the stage, typically the
approach is surgical removing the segment in the law. The
(25:48):
more advanced it would involve additional chemotherapy radiation depending on
the location.
Speaker 2 (25:55):
We talked about some of the causes and is clear
my understanding from what you said, UH, that it is
the way we live in our country, our culture. So
in what ways do lifestyle choges choices are changing? Rather
our lifestyle choices help us contain this or not become victims?
Speaker 1 (26:19):
Well, I think a sci fi er diet, low fat exercise,
moderate alcohol consumption, maintain a good weight, fight obesity. I
think those no smoking. I think in general those are
(26:41):
the typical standard recommendations.
Speaker 2 (26:44):
Are there socioeconomic factors that you find in in people
who contract colorectal cancer?
Speaker 1 (26:53):
Absolutely? Absolutely. I think the cost of treatment is quite impactful. Uh.
Access to care shouldn't be a problem here in the
United States compared to other places, So we're blessed from
that perspective, But some people UH may have uh less
(27:21):
access because of socio economic factors. So it's definitely important.
And then uh, the highly uh successful executive that is
diagnosed will have to have down time to get chemotherapy,
and he's not going to be as productive, you know,
(27:44):
he may not feel so well. Everybody responds different to treatments,
so I'm not I don't want to generalize, sure, but
definitely there's an impact when we're there's an impact and
not to let and not not to make the emotional
impact on the individual in the family.
Speaker 2 (28:04):
Do you find there's a higher incidence in people contracting
being diagnosed with coorectal cancer in underprivileged communities, poorer people,
or does it effect across all of those demographics.
Speaker 1 (28:20):
What I see, I think it's the same. But what
I see is unfortunately individuals with lower income present to
the physician at higher stages than in my experience.
Speaker 2 (28:37):
March, as we mentioned, happens to be Coorectal cancer Awareness month,
and usually the goal of one of these things is
to bring awareness to the issue, how it's growing in
our country and the fight against the disease. Do you
think it's accomplishing that.
Speaker 1 (28:54):
I think it is. I think we're making progress, which
is need to keep.
Speaker 2 (29:03):
Better access to screening and treatment for colorectal cancer. Is
that something that's part of the goal as well?
Speaker 1 (29:11):
Correct? That is the goal, all right?
Speaker 2 (29:15):
Uh? Doctor Roberto Rodriguez throwesca fellow at the American College
of Surgeons. If you want more information on colorectal cancer,
you could go to FACS dot org slash colorectal cancer.
That's FACS dot org slash colorectal cancer, doctor Rodriguez Rescot.
(29:35):
I appreciate the time, Thank you.
Speaker 1 (29:36):
So much, Thank you having good day and keep pressing on.
Speaker 2 (29:42):
Thank you, And that'll do it for another edition of
Iheartradios Communities. I'm Manny Muno's until next time.
Host
Manny Munoz
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