Caroline Shermer is a registered dietitian, eating disorders specialist, and many of her clients’ biggest cheerleader. She founded Meant To Eat Nutrition Counseling with one mission: to empower women to learn all that they are meant to eat and to be a part from disordered eating, excessive exercise, and body image concerns. She lives in Nashville and is passionate about pouring into her local community. Join me and Caroline discuss about the relationship of exercise and recovery, peeling back the layers of exercise addiction.

In this Episode:

• Can becoming an RD be a breeding ground for developing disordered eating?
• The importance of variety in your exercise routine 
• The role food plays into an exercise addiction
• How small changes in your routine can help with decreasing dependence 
• The power of a full exercise break during ED and HA recovery 
• Identifying the 4 different types of hunger
• The simplest thing you can do to improve body image this week
• The connection between Taylor Swift’s music and women with EDs 

Connect with Caroline

@meanttoeat   (Instagram and TikTok)

https://meanttoeat.com/ (Website)

Transcript:

Lindsey Lusson  00:00

How do you recommend to your clients that they kind of approach exercise? And how they can start to morph and change the relationship with exercise without having to completely give it up?

Caroline Shermer  00:10

I think one of the biggest reasons why people sometimes don’t get better or getting better is so slow, is because there’s this underlying negative core belief that “I can’t get better”. “I will always workout this way”, “I have to do this because it feels too hard if I don’t”. And so I really like to start with the smallest changes possible to build up this sense of courage and this sense of empowerment, of “wait a second, I can make these very small changes, and I can do so effectively”. 

Caroline Shermer  00:36

“And I do see my anxiety rising, and then I see it falling. But not because I’m acting out of alignment with my values, but because anxiety does rise and fall. Maybe I don’t have to do a 90 minute peloton ride to feel that relief.” That’s just kind of a long winded example of how I like to meet clients where they’re at. 

Lindsey Lusson  00:56

Welcome to the Period Recovery and Fertility Podcast, where we discuss the challenging warning and life changing process of recovering your period and finding freedom with food and exercise. Whether you’re hoping to regain your cycle to get your health back on track or you’re ready to become a mama, this podcast is for you. While the recovery process isn’t always rainbows and butterflies, it’s my hope to bring you both information and inspiration during your own recovery journey. I’m your host, registered dietitian and fellow HA woman, Lindsey Lusson. 

Lindsey Lusson  01:27

Caroline Shermer is a registered dietitian, eating disorders specialist, and many of her clients’ biggest cheerleader. She founded Meant To Eat Nutrition Counseling with one mission: to empower women to learn all that they are meant to eat and to be a free from disordered eating, excessive exercise, and body image concerns. She lives in Nashville and is passionate about pouring into her local community 

Lindsey Lusson  01:47

Okay, y’all, welcome back to another episode of the Period Recovery and Fertility Podcast. I have a special guest for you guys today. We have Caroline. Guess I should have asked how to pronounce your name before I just jumped in. But Shermer?

Caroline Shermer  02:00

You got it!

Lindsey Lusson  02:03

First try, awesome! Well, Caroline, we’re so happy that you’re here. I know you’re gonna have so much valuable insight. If you guys aren’t already following Caroline on Instagram, Meanttoeat all one word, right? Is your handle? Perfect. Incredible content. 

Lindsey Lusson  02:17

How did you get into the eating disorder, disordered eating space? Did you always want to be here when you became a dietitian? Or did you, like myself, kind of stumble into it by accident/purpose?

Caroline Shermer  02:31

Yeah. Honestly, both. I developed an eating disorder when I was pretty young. I was in eighth and ninth grade when I went to outpatient treatment. Actually in Texas because you live in Texas, right? Yes. So I went to treatment back in Texas, and I just loved my dietitian. I clicked with her and I loved hearing the way she talked about food. It was so not in line with my eating disorder, and it was so authentic and courageous and fun.

Caroline Shermer  02:58

I just wanted more of that. And so, because I was so young, after that, in high school, I set my sights on doing the pre med route. So that I could become a registered dietitian and do my internship and all of that. And I knew, in the midst of all of my dietetic training that I wanted to go into eating disorders and nutrition counseling. 

Lindsey Lusson  03:15

What was it like going through our similar dietetic training, knowing that a lot of the things that are taught are very weight focused, very calorie focused, grooming towards potentially developing orthorexia? I know a ton of registered dietitians that have been through a difficult time and a difficult relationship with food that they can sometimes trace back to our training. 

Lindsey Lusson  03:40

I’m curious what it was like going through all of that through like a totally different lens. Because for me, going through it, I was like, “Oh, this is, like, so validating. I can just continue to have disordered eating because I’m a dietitian and I just know better than everybody else.”

Caroline Shermer  03:52

Yeah, oh my gosh. I mean, you’re hitting it on the nail on the head. Like, truly. I think it is a breeding ground for orthorexia. One of the most unhelpful things I think they teach us is that we are the experts of nutrition. Yes, we know so much science about nutrition. But it sort of shifts this power dynamic of as dietitians, we need to tell people how to eat. 

Caroline Shermer  04:17

That’s where someone’s going to see the most triumph in their relationship with food is when it is values aligned. And it is rooted in something more than just, like, “I know this is fact, so do what I tell you to do.” Like that was one of the worst things in the program. 

Caroline Shermer  04:17

Something I’ve learned being in this field, doing the work that I do is truly, everyone’s relationship with food is so dependent on their values and their goals. And of course, there’s merit and scientific evidence of certain nutrition principles or certain health principles that matter and are valid. But it’s going to look different person to person. And we also have to honor that. 

Lindsey Lusson  04:34

Yeah, definitely. I mean, I just think back to the idea that we were told… I think this is still some dietitians probably kind of go by this. But just telling people, “oh, well, this is the right amount of calories for you based on your height, your weight, your age and your activity level”. And it’s like, no, like, the only person who knows the right amount of food for you is you.

Lindsey Lusson  05:09

I mean, granted, if you are healing from a certain disease, or you’re having to relearn how to eat because you’re in healing from an eating disorder. Your body gets to be the guide. How dare us put these kind of rules and restrictions on people to help them distrust, honestly, their own hunger.

Caroline Shermer  05:28

Right, right. And it just kind of lacked personal care. I really operate from such a relational standpoint with all of my clients that looking at just the anthropometrics or just the numbers, or just the calculations of it all loses the person ability. And honestly, why are we doing this work is to help people improve their lives.

Caroline Shermer  05:48

TheyThey don’t need a robot shoving all this nutrition information in their face. And so I’m glad to be out of such a kind of a strict program. There’s just been so much life using clinical judgment and adding relational value to the work we do. I know you practice the same.

Lindsey Lusson  06:07

Yeah, 100%. That’s the beauty of private practice. You get to (inaudible)  all of the wonderful knowledge that you’ve learned in clinical and in undergraduate and graduate. And you get to actually start to apply it and see how it applies to person to person, and how different it can be person to person. 

Caroline Shermer  06:25

Yep, exactly. 

Lindsey Lusson  06:26

Amazing. One of my favorite things that you talk about, that I feel a lot of times is not highlighted as much as I feel that it should be, especially for active women who are in recovery from eating disorders, is the relationship between exercise and eating disorders. 

Lindsey Lusson  06:43

And how exercise and this was my experience, exercise can be a big part of your eating disorder. I don’t think that’s always called out. Can you tell me a little bit more about what your experience has been in working with clients who are active but also struggling with eating disorders and kind of that tingling, confusing relationship?

Caroline Shermer  07:00

Oh my gosh, there’s so much there. I could talk about this for hours. But one of the most important points I always make to my clients is that it’s not necessarily the quantity of the movement in what you’re doing that makes it disordered. It’s the quality. And what I mean by that is person A could go on six runs a week, all different mileage, and it feels super embodied values aligned, and it doesn’t threaten their health and well being. 

Caroline Shermer  07:26

Whereas Person B could run the exact same amount at the exact same intensity, but the quality of those runs are compulsive. Meaning their self worth is dependent on running in that specific way. Or their ability to nourish the way that their body really needs is dependent on how they perceive their exercise to be. There’s so many different tidbits that affect the quality or that relationship to the movement for the worse. And so it’s not just the amount of exercise that we need to look at and get curious around. It’s how we’re moving and it’s how we’re relating to the movement. 

Caroline Shermer  07:59

And what’s tough is movement is objectively good for our bodies. I think where we can get in trouble is when we have to move to feel okay, when movement is our primary coping skill. And then lastly, where we don’t have a whole lot of variety in our movement.  For example, weeding our garden beds, that’s movement. But if you would have asked me, in my relationship with compulsive exercise, if that counted, and I’m using air quotations there, I would have laughed, right? 

Caroline Shermer  08:30

Because to me, movement was so black and white, and it was so the quality of my movement was really poor because it was so compulsive and intense. And it didn’t allow for flexibility and variety. So to kind of wrap up what I’m saying, I really think we need to pay attention to how we’re relating to our movement, and how dependent we feel on our relationship with movement. And then using our values, rather than our dysregulation, to then inform what we need to do moving forward to really heal our body. 

Caroline Shermer  09:01

That might look like having more rest days, that might look like having more variety in your movement. We talk about variety as a pillar of solid nutrition. Well, it’s a pillar of solid exercise as well. So that’s a lot of the work I do with my clients. And I think it’s really important when thinking about fertility too, is adding in that variety and adding in different adequacy when it comes to intensities of movement to we need high intensity and low intensity. 

Lindsey Lusson  09:27

And what I always tell people to get curious about is why does it have to be the orange theory fitness class, why does it have to be cross fit? Why does it have to be that seven mile loop, why does it always have to be done at a certain intensity? And I always tell people, like, hey, if it’s truly for your mental health and it’s truly for stress management, you’re going to get the same endorphin release, like, the same chemical reaction from a stroll around the park, from a hike in nature, as your 90 minute peloton ride. So why does it have to be at a certain level? 

Lindsey Lusson  10:02

Where’s the rigidity coming from? Why is that the rule? And I think people really struggle with that. Because I understand, at the end of the day, a lot of people don’t want to have to address that part of it. I see a lot of people, the clients that I work with, heal the food part of their relationship, and then they’re still exercise. And what they don’t understand is like the two, they kind of go together. We see a lot of women who are okay with eating X or eating certain amounts of food when they can exercise, and then when we start chipping away at the exercise piece, then more the eating disorder actually starts to get exposed. 

Caroline Shermer  10:37

Yep, it’s all really so blended, and it’s pretty conditional. When you can start to see if I change this one factor, then my ability to maybe eat the wider variety of food comes crashing down. Because, whoa, I didn’t realize I was so emotionally dependent on exercise to validate my food choices, and that’s kind of a shaky ground for your entire relationship with not just food and exercise, but like self to be on?

Lindsey Lusson  11:02

Yeah, definitely. Well, and I think that it can be really hard for people to objectively recognize that for themselves. I know. When I was struggling with exercise addiction, I don’t think I would have, like point blank, told you in the moment I exercise so that I can eat more, or I exercise so that I’m allowed to go have Mexican food on the weekends. It was there and it’s very easy to see that in hindsight. But I do feel like people, or I know for myself, like it was really hard for me to see that, recognize that point blank when you’re in it. 

Lindsey Lusson  11:35

What are some questions somebody might need to ask themselves if they’re trying to understand whether or not their desire to exercise or the way that they’re exercising might actually be part of an eating disorder. 

Caroline Shermer  11:47

Yeah. So just some different questions. One is, how do you feel if your plans of exercising change? Like, what if it snows and you can’t make it to the gym? What happens when a friend asks you to hang out last minute and you have to pick between going on the run and hanging out with this friend knowing you’ve exercised plenty earlier that week, right? 

Caroline Shermer  12:14

What happens when the one elliptical you always go on at the gym is taken? What happens when you want to go do squats, but all the squat racks are taken and you only have 30 minutes for a workout. Like, what is the level of dysregulation that starts? Like, does your mind start racing? Do you feel like red hot panic in your chest? Do you feel really angry, and maybe more so that kind of like fits or checks the facts. 

Caroline Shermer  12:43

I think another question, kind of what you were talking about, too, is, Hey, would I eat the same today if I didn’t work out? And there’s something to be said about our nutrition needs changing from rest days to exercise days. But I think that can be more intuition led, which is a skill to be learned, rather than something that has to be so prescriptive and rigid. So those are a few questions. Which really boil down to, how flexible can I be when exercise changes, and how willing am I to change my exercise routine when my current exercise routine might challenge or threaten some of the bigger goals I have for my life.

Lindsey Lusson  13:22

You just highlighted so many habits that I know a lot of our listeners have that they may not even realize are potentially red flags. Having to be on the same elliptical machine, disruptions to your routine, missing that Friday workout knowing exactly that you’ve exercised all of the other days. Like the inability to take a spontaneous rest day, especially when it should be something else that would bring you joy. 

Lindsey Lusson  13:51

Your best friend is in town early, and she wants you to join you for lunch, but that’s going to interfere with your Friday noon spin class. Like, you should want to go hang out with your friend. You should want to skip your skin class. It’s okay, if you want to think about it. But like those are behaviors that I think a lot of our listeners have, that we’re kind of bringing to light to today. That they’ve maybe never thought about. So thanks for for kind of highlighting those. 

Lindsey Lusson  14:16

I was doing research for a podcast episode that I did last summer on exercise addiction. And I was surprised to learn that exercise addiction is not in the DSM five. And it was my understanding that the reason why exercise addiction is not in the DSM five, which is the diagnostic and statistic manual for, I think, for like all health is where. I don’t think it’s just mental health. But the reason my understanding was is because exercise addiction typically does not exist as a singular mental health issue. It is typically part of some type of eating disorder. Do you agree or disagree with that? 

Caroline Shermer  14:55

Oh, I think that’s hard. So yeah, my understanding too with the DSM five, which typically therapists are usually trained more in the DSM five. Where I don’t really remember it being a ton of our dietetic training is that a diagnosis can be excluded if the presenting issue is better explained through another diagnosis. And so why I think exercise addiction isn’t recognized is because it either meets criteria for an eating disorder. Because fear of weight gain is probably there, or rigid beliefs around food are probably there just because it is so blended. Or they meet criteria for generalized anxiety disorder, and the exercise addiction is more of a symptom of generalized anxiety disorder, would be my guess. 

Lindsey Lusson  15:42

That makes so much sense. I have worked with several clients who will come to me and say I have no issues with food. I will eat whatever you tell me to, I eat peanut butter, I eat Doritos, I eat McDonald’s. Like, I literally have no food issues. My issue is exercise addiction. And 10 times out of 10, there is still food stuff in there. 

Lindsey Lusson  16:07

I’m yet to come across somebody who doesn’t struggle with compulsive over exercise with no part of disordered eating also in there somewhere. I’m curious if that’s been your experience.

Caroline Shermer  16:19

Oh, yeah, absolutely. Because, think about it. I mean, normal sports nutrition would require us to have some sort of planning with food and exercise, like, right? What am I going to fuel with my body afterwards to maximize my efforts at the gym? Or what am I going to eat? How long before am I going to eat before I work out? It’s so blended because we are dependent on nourishment to fuel our workouts that I don’t think they can’t not be attached. Now, I think exercise could be the primary concern, but they’re too related, and that makes sense. 

Caroline Shermer  16:53

And I have so much compassion, right for like, even myself. Like, oh no, this is the issue. Not this right? Like, I have just so much compassion for that, because it would be so much simpler if it was just an exercise issue. It would be so much more simple if it was just a food issue. And the thing is, is that it’s not simple, right? Like exercise addiction, food addiction, whatever it might be, those are process addictions. We only develop a process addiction because we need it, in a sense, to cope with something we otherwise feel would be insurmountable to cope with. And so, yeah, I just have so much compassion for that. 

Lindsey Lusson  17:28

Yeah, definitely. And I think that that just, of course, we want to oversimplify things, because we just want to get to that faster. But yes, a lot of layers to peel back there. 

Lindsey Lusson  17:39

Some of the content that I really love, that you talk about, and we’re pretty aligned in this is just the idea that it doesn’t have to be all or nothing. So if you’re healing from like in our listeners situation, maybe both, maybe an eating disorder and HA or maybe just HA. I think sometimes we hear, you know, you’re gonna have to change your exercise, and people hear you can’t exercise at all. The things that you talk about is  maybe not.  Like, maybe you can still exercise and heal from your eating disorder. How do you recommend to your clients that they kind of approach exercise and how they can start to morph and change the relationship with exercise without having to completely give it up?

Caroline Shermer  18:18

Right. So even just thinking about care accessibility, in my active eating disorder, I would have been so turned off and so hopeless hearing that I would have to go from the pits of a disordered relationship with food and exercise to, completely changing everything and dropping all my behaviors at once time for covid. Like, yeah, absolutely accessible. That’s not hopeful. And so I really do believe in meeting clients where they’re at. You know, even with the same elliptical thing, just to model more curiosity instead of judgment, that’s one of the things I always talk to clients about, is, how can we add more curiosity versus judgment here? I model that to them. 

Caroline Shermer  18:54

And so how I do that is, instead of, Oh, my God, you’re exercising so much, what are you doing? It’s like, okay, let’s just see what we’re dealing with here. What would it be like for you to go to your orange theory class and go three treadmills over from your normal one? Or to go on the different elliptical, or to go on a run for 27 minutes versus 30? Like, any kind of small change there and see what comes up. And usually clients will sort of laugh and be like, Oh my gosh. Like, That’s so silly. But then when push comes to shove, it does bring things up, because that is the oftentimes with the clients I work with, that is to the degree of rigidity and specificity at which they exercise from. 

Caroline Shermer  19:37

So we can start there. I think one of the biggest reasons why people sometimes don’t get better or getting better is so slow, is because there’s this underlying negative core belief that I can’t get better. I will always work out this way, I have to do this because it feels too hard if I don’t. And so I really like to start with the smallest changes possible to build up this sense of courage and this sense of empowerment.  Wait a second, I can make these very small changes, and I can do so effectively. 

Caroline Shermer  20:05

And I do see my anxiety rising, and then I see it falling, but not because I’m acting out of alignment with my values, but because anxiety does rise and fall. Maybe I don’t have to do a 90 minute peloton ride to feel that relief. Maybe I could trust the process. And so that’s just kind of a long winded example of how I like to meet clients where they’re at. 

Caroline Shermer  20:30

Now, this is all said, and I know you probably say this all the time too, with medical clearance.  I think there are some cases in some instances where exercise truly, truly, truly, is not safe. And I would say largely, we’re able to usually find somewhat of a middle point rather than going black and white. Because that also models their rigidity. And I’m not about modeling that level of rigidity right back to them, and that you can’t ever work out either.

Lindsey Lusson  20:58

Definitely. And I also like to think, especially for people for period recovery. Now, typically people who are coming from a place where they’re already weight restored, and especially like a lot of our clients that have fertility goals, they’re typically able to recover pretty quickly because they’re super motivated and they’re in it in a more nourished state than somebody who might still have some weight restoration to do. So typically it doesn’t take that long, but it can feel like a long time. And I also like to, like, remind people of, like, okay, so you feel fine not exercising at all, like you’re one weekend. What if this is 12 weeks? What if it’s, what if it’s 25 weeks, right? So I like to think about, like, sustainability of the plan too.

Lindsey Lusson  21:37

With the last thing that we want to do is, is perpetuate the black and white of it’s either, running 75 miles a week or not running at all. 

Caroline Shermer  21:45

Yeah, exactly.

Lindsey Lusson  21:46

One thing that I do feel like was a misstep in my own recovery, and this could just be the fault of my team, or maybe just like a misunderstanding, but when I was going through eating disorder recovery, I never changed anything about my exercise routine. It was continually the same routes, the same amount. And my eating disorder really liked that, because I didn’t have to touch that. However, that set me up for basically living in quasi recovery. Because those things were never challenged. 

Lindsey Lusson  22:17

Do you have any opinions on would it be something that you feel like should always be talked about? Or do you feel like there are situations where it wouldn’t necessarily need to even be brought into a treatment plan? 

Caroline Shermer  22:30

So that’s a good question. I think my thought is, I think it should always be challenged or brought up or explored at least a session or two. Because I also find clients becoming pretty movement averse, and that was my own story. I swam from like compulsive exercise addiction to feeling pretty movement averse. And it wasn’t challenged, because at least I wasn’t compulsively exercising. But I had been so burned by my relationship with exercise that that wasn’t true healing like avoiding movement or avoiding high intensity movement. That’s not healed. That is, I have a lot of hard feelings, a lot of horrible memories of my relationship with exercise, so I avoid it. 

Caroline Shermer  23:11

And so I think when we just look at the behavior of, oh, this person’s not moving, or we don’t talk about it at all and assume it’s fine enough, because, oh, look at them and what they’re doing with food, cool, cool, cool. We miss so much. So I think there’s something to be said about always checking in on, kind of like, all of the different behaviors and different rituals of someone’s complex relationship with food and exercise. As a clinician, I try to do this, like, every six ish months, because I want to start every single session being like, how is…

Lindsey Lusson  23:46

Exactly. Oh, you’re doing so good here. Let’s bring up all the things that might actually still be going wrong for you.

Caroline Shermer  23:53

Right, right. Like, that’s not fun. But like, every six months, just like you would at any job, like, hey chicken. Like, let’s take this thing, macro, bird’s eye view, and just check in. Like, how are things going? Hey, we haven’t talked about exercise a lot. I know we’ve been doing a lot of body image work or whatever. Where, where are you with exercise? And just linger there. Um, I think lingering and not rushing treatment can be huge, because we can usually pull more things back.

Lindsey Lusson  24:18

Yeah. And, like, the unfortunate truth is, like healing takes time. Like it really does potentially years, right? So I know sometimes we just want to get to the end result and be done and close that chapter of our lives. But the longer that you really spend uprooting everything, the better off you’re going to be long term.

Caroline Shermer  24:35

Oh, of course, truly, truly.

Lindsey Lusson  24:37

Have you ever found for your clients and patients who struggle with compulsive over exercise, a benefit of doing a full exercise break, even if somebody is weight restored, even if it’s not out of medical concern? Have you found that, almost like a mental reset that to be helpful?

Caroline Shermer  24:54

Yeah. So if I’m just like, speaking from my bias entirely, yeah. If I can get a client to do a full break, I think it really can be so so, so healing. Will that be everyone’s journey? No. Does it have to be? No. I do think that there’s a lot of benefit to it. I remember just in my own experience one day, just like sobbing, because I wasn’t going to move my body that day, and it brought up so much, but it was one of those, like, cathartic sobs.

Caroline Shermer  25:24

 And I recognize that, like, I hit this peak emotion of not being able to use something that for so long I was dependent on. Then it lasted an hour, maybe two hours, and then by the end of it, I just through journaling and prayer and different things like that, I realized, like, wait a second, I think I’m actually okay in this moment. I think I don’t need to go run or whatever right now. And that was truly profound. I wouldn’t have had that if I was still following more of that middle ground exercise regimen that I had been. 

Lindsey Lusson  25:55

That’s definitely what I observe with a lot of my clients who do choose to take a full exercise break as they are able to get to this like, move away from the dependence a lot quicker. I’m someone who never completely gave up exercise, really voluntarily, but in the process of having three kids and how much time they take up, I did go through with my son when we were having some feeding issues where I literally didn’t have time to exercise. And it was actually the first time in my life where I, like, went multiple weeks without even walking. 

Lindsey Lusson  26:25

nd that was actually very eye opening and very healing. I think it was the first time that I realized that I didn’t have to like that I could, I could literally just sit for weeks and like all of my deepest, darkest fears weren’t going to come true. So I think more so from my mental health perspective, I’ve seen wonders happen when people can and do even if it’s just a couple of weeks or or one week even. I think it’s really healing.

Caroline Shermer  26:51

I think sometimes we can be intentional and prescriptive around like, this is something I’m going to do, and I love that you brought up that point. I think for all of us, I don’t usually like generalized statements, but I think it is true that for all of us, at a certain point of our life, no matter what that will be, we won’t have access to exercise and the way we kind of are dependent on it being accessible to us. And will almost be forced into, or circumstantially, have to succumb to taking an exercise break, and I don’t think it has to be one way or the other. But I do think if you don’t ever take an intentional break from exercise. Chances are an opportunity in your life will come up where you have to. 

Lindsey Lusson  27:32

For sure, or like your body will push back. You’ll get a stress fracture, or you’ll lose your period, or something like that. Well, let’s switch gears real quick from exercise and talk a little bit more about food. I know that one of the biggest areas that I see my clients, especially when they are actually actively working on eating more and recovering, they really struggle with trusting their hunger. 

Lindsey Lusson  27:55

They’re so used to eating the way that they are, and after they kind of get over the whole the hump of suppressing hunger, they’ll actually start to feel hungrier, and their appetite ramps up, but they struggle with kind of believing that this is true hunger. And they kind of get stuck in this, like, really confusing spot of, oh, is it mental hunger? Is it physical hunger? And then they’re and then they’re paralyzed, and they’re not able to, like, meet their needs. Do you have any, like, tips or advice, or want to speak into that at all for anybody who’s listening and might be struggling with that? 

Caroline Shermer  28:25

Yes, absolutely. That’s a great question, Lindsey. There are four types of hunger. So there is physical hunger, which is like this physical sensation, stomach growling, feeling faint, feeling hangry, a dip in the blood glucose, which our body, like the physicality, says we need to eat. And these sensations are real in the body. I think one of the harmful messages that comes up and eating disorder recovery is like you can’t trust your body’s hunger and fullness. And I think that further disconnects people from their body when they’re already so disconnected and disassociated from your body. So the way I like to frame it to my clients is, your hunger cues might not be always the most reliable, but they are very, very, very, very real. 

Caroline Shermer  29:08

So the fact that you maybe aren’t feeling hungry isn’t necessarily so reliable in terms of you don’t need to eat. Then there’s practical hunger, this nutrition knowledge that says, Oh, I might have wonky physical hunger cues, but I know practically and scientifically, this is what my body needs. Then there’s cravings and emotional hunger as well. All four of these hungers are just as valid as the other one. And so emotional hunger isn’t worse or less valid for you than practical hunger or physical hunger. 

Caroline Shermer  29:39

I think that’s really important to name, because, yeah, your body knew this one food, let’s say Doritos, was accessible everywhere, right at the local Walmart, at your friend’s house. Maybe it was even in your pantry, because your kids can have it, but you can’t. Your brain knew this food was accessible, but yet you never eatat it. So if you’re having craving hunger and emotional hunger around these Doritos, even though you feel like you ate enough for your dietitian, you followed her meal plan already, yeah, you can still maybe very much need to go ahead and eat those Doritos for the sake of emotionally healing the lack of access to this food that maybe should have never been so hardcore restricted. 

Caroline Shermer  30:23

There’s a difference between restriction and deprivation, and it’s really hard to delineate the two. Because oftentimes a lot of my clients who are healing from HA, they’re like, Okay, I am eating enough. I’m starting to get my period back. I’m not restricting anymore, but they could still be really, really deprived. And people are going to have different sensitivities to a level of deprivation. Some people maybe never really crave Doritos, and they’re okay not eating those more processed, delicious foods. Other people are going to crave them more, and that’s not right or wrong. 

Caroline Shermer  30:56

And so there’s just so much nuance there. I would recommend working one on one with a dietitian to explore some of these things. But all in all, it’s so normal for your physical hunger cues to go all over the place. That’s why it can be helpful to really work with the dietician to get that practical nutrition knowledge. And it’s going to make sense if you have that craving and emotional hunger coming up too. Those are just as valid coming out of such a level of restriction and deprivation as those physical hunger cues. 

Lindsey Lusson  31:25

I think that’s exactly what everyone needs to hear. I feel like times people struggle to give themselves permission to honor like an emotional hunger. A lot of times, what I tell my clients is, like, it doesn’t matter, right? If you’re hungry, you should be able to eat full stop. It shouldn’t have to be this flow chart of like, since I’ve eaten, did I try to drink a glass of water? Did I try to do this? Did I try to do did I try to trick my body into being full before I actually honored it. It’s hard, but eventually it should feel very automatic and intuitive. 

Lindsey Lusson  31:59

But I love naming the different types of hunger and driving home the message that all are valid at the end of the day, even if it is, eating for pleasure.  Or like you had a hard day and maybe you just want Yes, right? Like, that’s okay. Also interesting that we tend to have more leniency towards something like alcohol over having a cookie because you had a hard day, right? 

Caroline Shermer  32:26

Yeah, that’s one of my favorite things to challenge. Just for example… I mean, I could be calling myself out in my own eating disorder, but I struggled to allow myself to have three fresh baked chocolate chip cookies, but drink a jumbo Margarita on a Friday night. Absolutely. The sugar content like [indecipherable] in there, and it’s so based on those emotions rather than the logic of it all. And so, oh yeah, I could get into a whole spiel on challenging drinking sugar and drinking our energy just for the sake of challenging it. Plus it also tastes good and refreshing sometimes too.

Lindsey Lusson  33:03

Yeah. So true. It is interesting how the more you get into it, especially when you’re working with a registered dietitian, how those food rules will start to not make any sense. Something that was coming up next session this week was about how she  ate very, very clean in college, but she would binge drink. And it’s like, okay, well, if it was truly in the name of health. It’s so interesting how we can really convince ourselves tha for whatever reason, this is the healthiest thing for me, even though, in reality we know objectively that would not be healthy for another individual.

Caroline Shermer  33:39

Absolutely. 

Lindsey Lusson  33:40

Let’s talk a little bit about body image. Hard truth, if you’re listening, I doubt this is the first time you’ve heard it, but if this is the first time you’ve heard it, your body is going to have to change. If you have HA and you want to get your period back, and you want to be healthy and you want to be fertile.  What are, Caroline, some best practices you recommend for somebody who is really struggling? Let’s start with struggling with the idea that their body might need to change to be healthy. And then we’ll talk about some practical stuff for like putting into practice when your body is changing.

Caroline Shermer  34:09

Yeah. Well, I think whenever we’re talking about body image and the idea that our body will need to change, we’re coming up against body grief. And I would say largely, a lot of us struggle in grieving well. It’s not something a lot of us have  healthy grief modeled to us and like we maybe don’t even know how to grieve. Or maybe we think grief is just for when a loved pet of ours dies, or whatever, like that. But like no we can grieve our body, and we can grieve a body that we maybe should have never known in the context of health. 

Caroline Shermer  34:42

What I mean by that education I’ll provide some of my clients sometimes is, Hey, your lowest weight was an artificial weight. And what I mean by that, yes, it was real, but it was only real in the context of compulsive exercise, trauma, illness, metabolic issues coming up like whatever it is. So, I just have so much compassion for you that you’ve had to experience a body that maybe was never quite yours to have had to experience. Like, I don’t think we should, or any of us deserve, to feel and live in a body that is sick, or one that maybe we should have never known, because coming out of that can be so hard and so painful.

Caroline Shermer  35:21

So one, I think, naming the grief there, and then two, practicing so much self compassion. Then three, leaning into the knowledge of, wait a second, the only reason why I have this size body, or the only reason my weight is this, is because there are these very rigid behaviors that keep it here. That’s the only reason, and that’s a really hard truth to sit with. And I think there’s a lot there to unpack. There’s a lot of feelings, and honestly, there should be right. 

Caroline Shermer  35:53

We could get into all the messages that we receive as women about what our bodies should look like and what our bodies should be able to do and how we should move and how we should eat. And how do you reconcile all of those pressures we have from society while also trying to be fertile and get pregnant and not be so rigid and anal about our food and exercise? It’s an impossible situation, and this is hard. There should be feelings around it, because it’s hard.

Lindsey Lusson  36:22

It’s so hard. And you said something that I know is going to resonate with a lot of people, because I hear this a lot, and I felt this way too. I think deep down, everyone knows that. They know that that, but that isn’t the body size that they’re meant to be in. But it could be really hard to come to a place of captains. Oh, something I hear coming up for a lot of our clients is, but I’ve always been this size, but nobody knows me any differently. How would you encourage somebody who has maybe been undernourished for two decades, to understand that it might be okay to be in a larger body, a body larger than the one that they’re in?

Caroline Shermer  37:01

Yeah. Well, I think, like the case in point is right there. Like no one else knows me to be in a different body. Whoa, so now we’re not just talking about the physicality of I don’t want my stomach to feel away or look a certain way or on my arms to look down. We’re talking about someone’s sense of belonging or acceptance or desirability in connection with other people. And let’s face it, humans are created and designed for connection. We live in a society that we receive messages every single day that your body and how you look can threaten your acceptance or belonging or connection to other people. And that is devastating. 

Caroline Shermer  37:39

I will say there’s a degree of perceived or anticipated exclusion or disconnection that I think comes with this. And I do think it’s fair to say that there’s an actuality there too. But I will say, if your relationships shift drastically because your body’s changed, you are being objectified by yourself and by others, and that is repulsive, right? That we live in a society that objectifies bodies. And we can always come back to, well, what are your values? Yeah, I think we act in line with our values, rather than a place of objectification of self. Even though it still might be painful and grief will be there, you will feel embodied and more grounded in it 10 fold than if we live from a place of I have to sacrifice myself, make myself smaller to be accepted. Because that’s so conditional.

Lindsey Lusson  38:29

Yeah, definitely. And I do think that at the end of the day, most people would admit that, like, that’s not my core value. Like, I don’t choose my friends because they’re like, the thinnest, right? Or I didn’t choose my partner because they, like, have an eight pack. I mean, I thinkl it’s interesting when you really start asking some of the right questions. It’s like, what am I doing? Like, is this is out of alignment. And I think that those can be really beautiful breakthroughs for people struggling with, kind of getting started there. 

Lindsey Lusson  38:56

What about now, Caroline, I’m on a period recovery journey, and I’m ready to get my period back, and I have gained a very uncomfortable amount of weight. And I don’t know if I can keep going. I’m so uncomfortable in my body, this whole process has brought up a lot of feelings that I didn’t even know were there. I don’t know why I’m here. Advice for managing body image stuff as it starts to come up, as somebody is getting to a healthier weight for their individual body?

Caroline Shermer  39:24

So one thing that I have loved talking about in session a lot is this fear, tension, pain triangle. Hillary McBride, she wrote a book called The Wisdom Of Your Body, and she talks about the science and the psychology around pain. Basically when we are anticipating or fearful of pain, we’re likely to tense up in our body, which then exacerbates our sensation of pain. And so I love providing that education, because if you feel uncomfortable in your body, you’re feeling pain. That will lead to more fear, more anxiety. Which will probably lead you to tense up more or feel that much more repulsed or repelled, or distant or disconnected. Or just like your muscles might be so tense and you might not even realize it. 

Caroline Shermer  40:16

Which then leads to more pain and discomfort in your body. And so it’s just so interesting. I recommend that book to all of my clients to learn that triangle. Because part of it might be actual, yeah, you might be uncomfortable financially. You might have to buy new clothes and like, that sucks. Like, there’s so many things where it’s like, actually, yes, this is hard. But I think there’s like, a subconscious level too, that once we learn what’s happening for us and we can plot ourselves on that triangle. We’re not necessarily helpless to the discomfort. Where we can step into naming the fear and discomfort, naming what situations we feel most pain or most discomfort in our body, and offering ourselves other alternatives. 

Caroline Shermer  40:56

Like, do I need to bite it, say I’m going to spend $500 at the mall this weeken.  Give ourselves permission. Ourselves permission just to buy the flows. I was talking about this on my Instagram story today. There’s more blending here, but I feel like if there are exercise issues and food issues. I usually always see money stuff coming up with my clients as well. And like, Hey, I’m still willing to spend XYZ on gym memberships, but I’m not willing to get myself new…

Caroline Shermer  41:26

And so I asked my clients to break it down, like price per wear. So let’s say you bought a pair of jeans from Target that’s $30. Okay, you might not want to do that at first, but if you wore these jeans for the next 30 days, that’s you paying $1 a day to feel just that much more comfortable. Is that worth it? And then we could tap into exploring like, well, what is your self worth? Do you feel like that financial commitment is worth it? And there’s a whole slew of things we can talk about there. So yeah, I just like, went down my own rabbit hole of thoughts. Welcome to the inside of my brain. I hope that answered your question.

Lindsey Lusson  42:01

I will definitely get that resource linked in the show notes. I think that that’s super, super helpful to think about more than the discomfort and kind of the self perpetuating cycle of the feelings without recognizing what’s going on with the feelings. It’s the most simplistic advice that nobody wants to take. Just sizing up like you said, if it made you feel better, wouldn’t it be worth having the size up the clothing size on the inside of the clothing so neatly tucked in that no one knows the size that you’re wearing except for you. 

Lindsey Lusson  42:37

And it is interesting, because I hear this from a lot of people, and I think at the end of the day, it’s not a financial thing. For a lot of the people I’m having conversations with about buying new clothes. I think what I hear coming up for a lot of people is what sizing up might mean. Might mean that they failed at whatever journey they were on to get fit, or that they’re no longer that size. So they’re no longer desirable. I think a lot of times people use that I don’t want to buy new clothes, almost more, as like an excuse sometimes to stay stuck. 

Caroline Shermer  43:09

Yeah, yeah, because if I feel so adamant that I’m not wanting to or willing to do this right now, how does it help keep me where I’m at? Sometimes familiar pain is more comfortable than unfamiliar pain. So maybe I’d rather stay in this discomfort right now, because what happens if I do buy bigger sizes? What then comes up for a lot of my clients is, well, then I’ll have to size up again, and I’ll never… like I just give myself too much permission to fall apart or lose myself or whatever.

Lindsey Lusson  43:40

Yes, and I do hear that a lot too. Of the well, people are gonna think that I let myself go.

Caroline Shermer  43:45

Yes, that those are the words I was looking for, Yep,

Lindsey Lusson  43:48

Yeah. I don’t want everyone to think that I let myself go. And I think the thing that I always like to circle back to is this, like, is it really letting yourself go to care for yourself? Like, if you had a friend in a similar situation, would you think that she let herself go because she decided to, take a break from the gym so that she could actually have a baby? Or she decided that, she needed to gain weight in order for her body to be hormonally healthy enough to have a period? I think sometimes we have ridiculous amounts of pressure and judgment on ourselves that we would never force on another person, let alone somebody we cared about. 

Caroline Shermer  44:23

Absolutely, absolutely. There’s so much truth there, Lindsey.

Lindsey Lusson  44:26

Caroline, I’ve been thinking about this all morning, and there’s no like smooth way to weed this into the conversation, but we said we were going to talk about Taylor Swift. We’re both Swifties here, so if you’re listening along, you might enjoy this. If you’re not, I still think that this is just an interesting connection between kind of music and kind of an emotional connection. 

Lindsey Lusson  44:49

One of your reels, you talk about a link between people who struggle with disorder eating and eating disorders, and the emotional connection that they might feel to Taylor Swift’s music. So if you’re not a Swifty, she has a lot of really deep meaning lyrics. The most surprising thing that has happened to me as a 37 year old woman is I have literally become obsessed. And it’s so fun, and my husband makes fun of me all the time, and I’m like, just let me have this like, I don’t have a whole lot of hobbies. Like, I literally, like, I think her music is incredible. Tell us a little bit more about this emotional connection and kind of what you’re explaining here.

Caroline Shermer  45:23

Well, I think Taylor Swift has made such a glorious and impressive career around storytelling and connecting with other people through emotions and feelings. And there is actual research that shows and tells us that people who have eating disorders, also feel their feelings more intensely and frequently than the general population. Yet they struggle to identify and know how to process those emotions than the general population.

Caroline Shermer  45:51

 Which just like, oh. So it’s like, I’m gonna give you this like gift of being able to feel and feel deeply, but I’m also gonna like, give you this curse of not knowing what to do with it. That is so hard. And so, yeah, I find that her music just can give us a way to express a lot of emotions that otherwise we maybe wouldn’t have known how to express or been able to name or to really even ever connect with. I just love bringing in Taylor Swift into sessions, because even some of my most disconnected or dissociated clients are the ones that really struggle with naming those feelings or expressing those feelings, they can always connect to her music. 

Caroline Shermer  46:33

And so I’ve had clients like make a Taylor Swift playlist to describe what it’s like challenging movement or whatever that week. It’s just a really beautiful way to use art to express for something that is otherwise really hard to express.

Lindsey Lusson  46:47

Yeah, and I think it also kind of takes some of the burden off of maybe even describing the way that it might feel healing from an eating disorder. Because eating disorders, we’ve come a long way. We’re having this conversation today, right? But I do still feel like for the general population, eating disorders are very taboo and very messy. And I love that just about there’s other ways to kind of express it. If you’re not an incredibly artsy person like myself, go listen to some Taylor Swift and see what comes up for you.

Caroline Shermer  47:15

Yes, and I think it uses a different part of our brain too. I know for me in my own healing journey. I can get to stuck about thinking about my feelings. Like, what is the precise word to describe my experience right now? And I’m just still in thinking brain that I never feel it. And so I love asking my clients like, oh, what Taylor Swift song? Does this feel like? Because it gets them more in relational brain, rather than just so much logic and reason. 

Lindsey Lusson  47:38

Yes. Yeah, definitely. No. I love that, beautiful. 

Caroline Shermer  47:41

Thanks. 

Lindsey Lusson  47:43

Well, to wrap this up here, another area that I think you could really help a lot of our listeners kind of understand, and maybe some of this kind of goes back to the different types of hunger that you so beautifully already described for us. But one area that I tend to get a lot of pushback from clients on is the idea that you need to eat “unhealthy foods” in order to like, actually heal from your eating disorder. 

Lindsey Lusson  48:04

What is kind of your perspective, and how do you encourage your clients to kind of reframe this, or to be able to delineate between the idea of having a type of an eating disorder, like an orthorexia, versus being like, well, I just, I really like healthy foods. Like, I just love vegetables. How do we know, and is it necessary for somebody to eat something like Doritos we’ve already talked about today? Do you actually heal from an eating disorder?

Caroline Shermer  48:35

Yes, that’s such a good question. So my brain goes in a bunch of different directions. One I think that could be a good place to start is just getting again so curious. So, yeah, your taste preference might be vegetables. Great. I love that. How can we make them more energy and nutritionally dense for your medical needs, right?  Let’s say if your period is missing, that’s the whole organ system shut down right now. There is a medical need for more nutritional density. So how do we get that? 

Caroline Shermer  49:10

And I don’t think that nutritional density has to equal unhealthy foods. For example, let’s say butter or olive oil. It is going to have more nutritional density, and yet I could see someone’s eating disorder being a little bit more judgmental about foods that are higher in fat, yet they’re just more nutritionally dense. And so I love putting like my clients, eating disorders sort of in a corner, and asking them to really nail down what they mean when they’re talking about healthy and unhealthy. Because one, I treat so many different eating disorders, and every single person I work with eating disorder has different, like, nuanced, niche rules. And it’s because a lot of the time these food rules aren’t based on facts.

Caroline Shermer  49:59

It takes like a nugget of truth, and then just like, explodes into this, like, warped world of emotional dependence on these food roles to be okay. And so what I will say about this is, oftentimes, yeah, you are going to have to eat more nutritionally and energy dense foods than maybe your eating disorder, slash preference. I think there’s a lot to work out there. Then maybe you’d prefer to I don’t think that has to mean “unhealthy foods”. And also just thinking about that paying tension for your triangle, if you are fearful or anxious of “unhealthy foods”, how does that prep your body or prime your body to feel that much more worse with them when you eat them, then kind of confirming that belief system. 

Caroline Shermer  50:45

So like, by you calling them unhealthy over and over and over again, how much more does that make it so that you actually don’t want to eat those foods and they feel bad in your body. Like there’s a lot of subconscious stuff to challenge there. Now and like, the black and white, like another defensive mechanism I see come up in class sessions all the time is like, well, you only want me to eat this. I remember in my own treatment, feeling convinced my dietitian could not be happier if I ate a whole chocolate cake. Like I just felt like that was her mission. 

Caroline Shermer  51:15

Now, as a dietitian, I’m like, Caroline, she didn’t care if you ate the chocolate cake or not. She just wanted to challenge your beliefs. And like, hope you have a little more flexibility. And so I think because I’ve experienced it, I’m so comfortable calling it out. But like, hey, is there a defense mechanism here that if I get to kind of push back on, well, you just want me to eat unhealthy foods, maybe I don’t have to eat them. It’s not about that, right? We’re both working towards the same goals here, and energy dense, nutritionally dense doesn’t mean unhealthy. And what does unhealthy to you even really mean? And is that based in fact? 

Lindsey Lusson  51:50

Yeah. And I think, I mean, I think, in this day and age, it is so hard though, because you were talking about, like, the the nugget of truth, like exploded, and now it’s your whole personality. People have, like, no of Tiktok followers, oh, like followings built around stuff like that. So I feel like it’s really hard to get out of that line of thinking when it’s so well reinforced by ridiculous people on the internet that actually might be very charismatic and very believable. I just think it’s really hard too, and I see so many women struggling with shades of orthorexia that aren’t challenged because they’re so well reinforced by maybe even their job. To circle back to our whole point of dietitians, I know that was something that was really hard for me, although orthorexia circa 2011 2012 looked very different.

Lindsey Lusson  52:49

Isn’t funny, isn’t that funny? 

Caroline Shermer  52:51

Yeah, and when I’m sure it will look different for years from this moment right now. We could have a whole podcast episode on that. And yeah, you should read the post about that. Truly, Lindsey.

Lindsey Lusson  53:06

Well, and I think it’s funny, because I’ll call that out all the time about how, like, I feel like people are very aware of, like, oh, like, calorie counting, that’s, compulsive and that can lead to disordered eating. I’m like clean eating. Is that repackaged, that this is like the Gen Z version of millennial calorie counting. But I don’t think people make that connection yet, but hopefully one day they will.

Caroline Shermer  53:28

One day, maybe after listening to this podcast, we’ll have some light bulb moments.

Lindsey Lusson  53:33

Well, Caroline, you have been amazing, and I know so many people after listening to this are going to want to learn more about you. And do you want to just tell us a little bit more about how you work with clients and how people could get in touch if they want to hear more. 

Caroline Shermer  53:44

Absolutely, and thank you again for having me on, Lindsey. I’ve had so much fun talking with you today. Um, yeah. So I founded a nutrition counseling practice called Meant To Eat Nutrition Counseling. We are based in Nashville, Tennessee. We see people in person in Nashville and then nationwide as well. I take a really relational approach to nutrition counseling. So yes, while I provide a bunch of meal plans and snack ideas and structure to what I would recommend for exercise and nourishing, we really get in deep with all of the feelings and whatnot too. So that’s sort of my approach. I also founded something called the Here And Now Closet in Nashville. 

Lindsey Lusson  54:25

I love this. Yes, I’m glad we’re talking about this. 

Caroline Shermer  54:27

Yes, going back to the buying new clothes, I mean, it is really so painful. And I thought, well, this should happen in a… Or it should be accessible for this work to take place in a therapeutic environment, versus like at the mall. And so I created this donations based boutique for people to donate and then also receive clothes that fit their hair now body, and we have every single size you could imagine in this closet for people to take clothes as a free resource. And that’s been super life giving.

Lindsey Lusson  54:55

That is so amazing. I love that so much. Well, we can link your website, Instagram, like, what’s the best way for people to get in touch with you? 

Caroline Shermer  55:03

Yes, anything. So my Instagram is @meanttoeat. My Tiktok is @meanttoeat. Website is meanttoeat.com and then, yeah, my email is info@meanttoeat.com. So when in doubt, you’re meant to eat. There we go.

Lindsey Lusson  55:16

Well, thanks again, Caroline, and we can’t wait to roll this out, because there’s so so so so much great, valuable information in this episode. So thanks again.

Caroline Shermer  55:28

Thank you, Lindsey.

Connect with Lindsey Lusson: 

Instagram: @‌food.freedom.fertility
Website: www.foodfreedomandfertility.com/
Twitter: @LindseyLusson
Tiktok: @food.freedom.fertility