On today's episode, Dr. Karen Nelson is joined by Jackie Gustafson, NP-PPC here at Melrose. Karen and Jackie will discuss the impact eating disorders can have on women and their reproductive systems, especially as they enter their childbearing years.
On today's episode, Dr. Karen Nelson is joined by Jackie Gustafson, NP-PPC here at Melrose. Karen and Jackie will discuss the impact eating disorders can have on women and their reproductive systems, especially as they enter their childbearing years.
For a transcript of this episode click here.
Dr. Karen Nelson: [00:00:00] Eating disorders thrive in secrecy and shame. It's when we create a safe space for honest conversation that we'll find the opportunity for healing. Hi there, I'm Dr. Karen Nelson, licensed clinical psychologist at Melrose Center, welcoming you to Melrose Heals, a conversation about eating disorders. A podcast designed to explore, discuss, and understand eating disorders and mental health.
On today's episode, I'm joined by Jackie Gustafson, nurse practitioner here at Melrose. Jackie and I will discuss the impact eating disorders can have on women and their reproductive systems, especially as they enter their childbearing years. Now, before I begin, I invite you to take a deep breath. And join me in this space.
Welcome to the podcast, Jackie.
Jackie Gustafson: Thanks for having me, Karen.
Dr. Karen Nelson: So [00:01:00] happy to have you here with me. Before we get started today, I would love it if you could introduce yourself and tell us about your role here at Melrose.
Jackie Gustafson: So, my name is Jackie Gustafson. I'm a nurse practitioner here with the Park Nicollet Melrose Center. I work on the medical staff and I do initial assessments into the program in our outpatient department.
Dr. Karen Nelson: Wonderful. And so we're going to be talking about specifically how eating disorders potentially impact the reproductive system in women. We just know that eating disorders impact the entire body, but we want to focus our conversation today on impacts of women during those childbearing years. Periods can be agitating. Right? They can be irritating and inconvenient at times. And so patients may say, ‘Is it a big deal, Karen, for me to lose my period?’ As a medical provider, how would we respond to that?
Jackie Gustafson: It's a very big deal. Ror a woman to be able to get their period every month, that's [00:02:00] a very big indicator of normal health. You should be able to get your period every single month.
Dr. Karen Nelson: Absolutely. So losing your period is potentially a sign of like lack of nutrition. Do we assign those to or what would you say?
Jackie Gustafson: Yes, that can be one of the causes. I mean it's really important that if you don't have your period that you meet with your primary medical provider to determine what the cause is.
Dr. Karen Nelson: So let's start with when someone loses their period. There's some kind of medical terms that we may use. Primary Amenorrhea. Help our listeners know, what does that mean?
Jackie Gustafson: So primary amenorrhea is when you don't ever start your period. So normal range for starting your period is between the ages of nine to 15-ish. And, you know, if someone's getting their period earlier than that, or, you know, later than that, you know, you need to go and see your [00:03:00] physician. Average age for starting a period is around 12.
Dr. Karen Nelson: And then secondary amenorrhea, help us know what that means.
Jackie Gustafson: So secondary amenorrhea is where your period stops and for three consecutive months – at least three consecutive months – you don't have your period. It can go on longer than that. In the eating disorder field, that's a real common thing that we see with our patients. It's, you know, generally caused by malnutrition, you know, not enough caloric intake, too much exercise, there is some type of an imbalance happening. When you don't get your period, that's because you don't have enough hormones in your body. And if you don't have enough hormones in your body, you're not going to lay down bone appropriately. You can take all the calcium and vitamin D in the world. It doesn't matter.
Dr. Karen Nelson: It doesn’t matter.
Jackie Gustafson: You have to get your period. And just another word about secondary amenorrhea. A lot of patients that don't get their period, they will [00:04:00] go to a primary care provider or a gynecologist and get put on birth control pills. Oral birth control pills, all they do is artificially induces you to get your period every month. There is no protective factor to the bones.
Dr. Karen Nelson: Wow. Wow.
Jackie Gustafson: And so when we get patients at Melrose that come in that went on birth control pills just to regulate their period because they're underweight and they're not – or they're overexercising or whatever the reason is, we actually take them off. I mean, if you're obviously using it for contraceptive reasons or some other kind of a medical reason, no, we don't recommend that. But you have to get your period every month and it doesn't change the treatment that we do. But it's, again, a very important marker of health in females that they get their period every month. In our patient population, if you, no matter what your age, if you haven't had your period for over six months, we recommend getting a DAXA scan done so we can [00:05:00] actually see how mineralized your bones are. And it's really important that we maximize it moving forward because we want you to have healthy bones.
Dr. Karen Nelson: And then the last one that we want to talk about is, and you're going to need to help me. Cause I don't know if I can pronounce this. Hypothalamic?
Jackie Gustafson: Hypothalamic amenorrhea.
Dr. Karen Nelson: Amenorrhea. Okay. We did it together.
Jackie Gustafson: I mean, that's basically what's happening in the eating disorder population. You know, your body makes a lot of different hormones for you to be able to get your period every month and with the, you know, with the malnutrition and the caloric deprivation and the, you know, the excessive exercise, your body literally doesn't have enough energy and nutrition to make the hormones. And your body goes and, you know, it's conserving energy. And one of the things that happens is your body stops making those hormones and it shuts off your [00:06:00] menstrual cycle because it's conserving energy for other things.
Dr. Karen Nelson: I'm glad you kind of brought up cultural messages or some minimization that might happen in culture in society, right? If, again, people may think, ‘Well, it's no big deal that I don't get a period. It's irritating and I don't want it.’ As the provider to be like, ‘There's a reason why you need it.’ And just doing that education feels really important. And so, maybe, I would love to either hear some stories. Or tell us a little bit about what have you noticed with maybe patients that you've seen doing some restriction or maybe struggling to maintain a consistent period. What has that been like for them or what do you notice about that?
Jackie Gustafson: We will always tell patients that have active eating disorders that that needs to be treated and they need to be in a better place to have the best chance of getting pregnant and having a [00:07:00] baby and having a healthy pregnancy. So we focus really hard on treatment and getting them to a better place.
Dr. Karen Nelson: Absolutely. I mean, it just makes sense, right? If someone is struggling, we just know eating disorders are serious and very treatable. And so we would want you to work on recovery and working to kind of heal those urges around the eating disorder prior to exploring having a baby. I'm just wondering if someone potentially has lost their period or their period hasn't been regular for a while due to restriction, are there any impacts on fertility or what have you noticed about that?
Jackie Gustafson: There absolutely can be impacts on fertility. If you're not getting your period, you're probably not ovulating and all of those normal processes in your body aren't happening. And a lot of patients with untreated eating disorders [00:08:00] where the cause of their infertility is malnutrition, being underweight, overexercising, you know, a lot of patients will end up in fertility clinics with these very extensive and expensive workups and maybe some of that can be avoided if the cause is really being underweight and not eating enough.
Dr. Karen Nelson: Absolutely. So the potentially being underweight and wanting to conceive, improving your diet could be a potential solution to that.
Jackie Gustafson: Yes.
Dr. Karen Nelson: Wow.
Jackie Gustafson: And getting into your, what we term their goal range. So with eating disorder treatment, we look at a patient's past growth charts. Because we can genetically see from their past growth charts where somebody is supposed to be for their weight. And we set goal ranges, and it can be really misleading [00:09:00] with all of the information that's out there on what's a normal body mass index. And some people, they fall out of the range of what the quote unquote standard normal BMI is. And we say the right BMI is the BMI that your body is healthy.
Dr. Karen Nelson: That's right.
Jackie Gustafson: You have normal vital signs. You have a normal heart rate, normal EKG. Your lab work is normal. You can get your period every month. You're healthy and happy for sure, and not tortured by food.
Dr. Karen Nelson: Yes, good point.
Jackie Gustafson: You know, it's really important if you're struggling with an eating disorder that you're working with a comprehensive team, that includes a medical provider, a dietician, a therapist, and or a psychiatrist, because that's one of the things that we look at as a team. Where is this patient supposed to be? And we don't just make those numbers up. We base that on the data of how this person grew.
Dr. Karen Nelson: So we were talking a little bit about more [00:10:00] on the restrictive aspect of eating disorders and kind of implications on fertility. Tell us a little bit about bulimia. What might we want to notice or pay attention if someone is struggling with bulimia, any potential impacts on fertility?
Jackie Gustafson: Well, the impacts on fertility are pretty similar to what we see with restriction as well and even though they're dealing with a different eating problem, you know, which is typically binging and purging. So eating large amounts of food and then purging either through vomiting, exercise, extreme restriction – we kind of can see it take all of those forms. And that is very hard on the body to do that and when patients with bulimia nervosa, we will also see a lot of menstrual irregularities with that too because just of what is [00:11:00] going on. It's so hard on the body to be doing that and it's causing a lot of physical stress. It's causing a lot of emotional stress. Emotional stress can be one of the reasons that people. don't get their period when you're under extreme stress. It's very hard on the body. It's hard on patients psychologically. With bulimia there's a lot of hiding of those behaviors. They don't want people to know this happens in secret. There's a lot of shame involved and it's hard physically and it's hard psychologically on the patients.
Dr. Karen Nelson: So we were talking about this kind of general concept of the impact of an eating disorder on fertility or pre-pregnancy. Let's say someone does become pregnant and is still struggling with eating disorder behaviors. Let's maybe focus on restriction first. Any thoughts on that?
Jackie Gustafson: I want them to come in and see us immediately.
Dr. Karen Nelson: Immediately. Absolutely.
Jackie Gustafson: We need help. There's another little person involved in this equation now and we need to get them some [00:12:00] help. You know, in early pregnancy, when patients are dealing with an eating disorder and they're dealing with a restriction, there can be a lot of malnutrition and nutritional deficiencies. And we think about the things that can happen in early pregnancy with the first trimester birth defects such as spina bifida, cleft palates. All of these things have, there can be a nutritional component to those. And that happens within the first four weeks of pregnancy. I mean, these are very early problems that happen. And ideally we want that eating disorder to be treated before somebody gets pregnant. We want them to have good nutrition and have a better weight. If not their ideal body weight. Be taking their prenatal vitamins and getting their nutrition through their food every day. We don't want patients to have miscarriages. We want that pregnancy to continue and be as healthy as possible. We don't want – when patients get further along, we don't want them to [00:13:00] have a premature delivery. And patients with untreated eating disorders that are underweight or not gaining weight appropriately are at higher risk for a preterm delivery. And there's also the development of the baby. It's so important that baby grows appropriately, gains weight appropriately, they're forming all their organs. We really worry about the brain. The brain needs to grow. We don't want these children to grow up and be born with developmental disabilities and lifelong problems that could be prevented with good nutrition and eating appropriately.
Dr. Karen Nelson: For sure. It takes a lot of energy. Yes, absolutely. Okay, so just acknowledging the kind of criticality, those very kind of early moments of pregnancy, if I'm not getting enough nutrition, the potential impact of, if a patient may be struggling still with some bulimic behaviors or binge purge behaviors [00:14:00] during pregnancy. What have you noticed?
Jackie Gustafson: You know, again, we want those patients to come in and see us right away. If they're actively binging and purging, you know, that requires a symptom interruption stay in our inpatient unit. We can help with that, but it's so important that those behaviors stop. You know, not only for your sake, but for the sake of your baby. With binging and purging behaviors, there's usually not overall good nutrition and eating habits going on in between, you know, those periods of binging and purging. And, you know, people that purge a lot, they're at risk for electrolyte abnormalities, which can be very dangerous for the patient. Particularly potassium is the one that we really worry about with purging. Potassium imbalances with purging are so dangerous because potassium kind of controls how your heart beats and your heart rhythm. And when potassium levels get really low, [00:15:00] they can cause really dangerous cardiac arrhythmias. And for those of you who have been to Melrose or know about us, we check EKGs on –
Dr. Karen Nelson: That's right. On the regular.
Jackie Gustafson: Absolutely. Almost everybody who walks through the door. Because we want to make sure that it's normal, because that can be deadly.
Dr. Karen Nelson: Absolutely. And arrhythmias are just abnormal heart rhythms. There you go. Absolutely. And so we want to absolutely be paying attention to that. Again, it's kind of the magic of a multidisciplinary team where we are addressing the medical aspect, the psychological component, nutrition component. We have occupational therapists, physical therapists, spiritual care, that all encompassing care. It really helps people move towards recovery.
Jackie Gustafson: It does. And there's no, there's never any shame.
Dr. Karen Nelson: That's right.
Jackie Gustafson: In getting help.
Dr. Karen Nelson: Not at all. We're just here to support you, encourage you, [00:16:00] and move you towards recovery.
Jackie Gustafson: And I always tell patients, you know, when they're having a hard time sharing their stories, you know, at the assessment, you're not going to tell me anything –
Dr. Karen Nelson: That's right.
Jackie Gustafson: – I haven't heard before.
Dr. Karen Nelson: Isn't that true?
Jackie Gustafson: I've heard it all before.
Dr. Karen Nelson: We have.
Jackie Gustafson: And I just want to know what's going on.
Dr. Karen Nelson: That's right.
Jackie Gustafson: So I can help. This is a place of no judgment. And this is truly a place of caring and support and strength and we're going to help you. I always tell patients, we're not going to fix it.
Dr. Karen Nelson: That's right. We're going to show you the way and you're going to fix it.
Jackie Gustafson: We’re helpers.
Dr. Karen Nelson: That's so cool. I'm so glad you said that. I think people share that a lot with me, that kind of initial, we may get those statements like, ‘I've actually never told anybody this.’ And then they proceed with something that we've probably heard about a hundred times. We just, some of these behaviors are almost kind of commonly experienced by people who have struggled with an eating disorder.
Jackie Gustafson: Well, exactly. And they live and thrive in the dark and in the secret.
Dr. Karen Nelson: That's right.
Jackie Gustafson: I just wanted to say one thing about when patients are in the first and the second trimester: If you're still [00:17:00] really struggling with eating disorder behaviors, you can't eat appropriately, you're binging and purging, you're not gaining weight appropriately, please come and see us. Patients that are struggling with that typically need to go into our inpatient program for a short stay to get on track. It is so important for your babies development and for your physical and your mental health to treat that.
Dr. Karen Nelson: So if a woman is in treatment for an eating disorder is coming to you, Jackie, is not potentially getting a regular period. Do we have any recommendations on what we would potentially recommend prior to them getting pregnant as far as a regular period?
Jackie Gustafson: So, you know, the general recommendation is to have, you know, to get your period back and to have it consistently for six months. And, you know, I just want to say like that, you know, there's probably some caveats for, you know, people who are of [00:18:00] advanced maternal age and there's other factors going into it. You know, so I always want to check with your healthcare provider, but, you know, generally we recommend about six months if we have that time.
Dr. Karen Nelson: Absolutely. And so that kind of resuming proper nutrition to the point where I'm getting a consistent period for six months, that's a chunk of time that I'm working in recovery.
Jackie Gustafson: It is. You know, and typically with, you know, eating disorder recovery, you know, patients are able to resume their menstrual cycle when they are able to get into their goal range. You know, when we set a goal range for someone, it's not this exact number because nobody's weight stays the same every day. We give people a range and, you know, periods typically return for most people when we get them into their goal range. And that happens through good nutrition.
Dr. Karen Nelson: That's right.
Jackie Gustafson: Following your meal plan.
Dr. Karen Nelson: Let's maybe spend a moment [00:19:00] and talk about how, as a medical provider here at Melrose, Jackie, how might you support a woman who is either newly pregnant or about to be pregnant, is pregnant, and struggling with an eating disorder? How does your role as her medical provider show up?
Jackie Gustafson: So, we partner with that, you know, patient's, you know, OBGYN and they need to continue all of their prenatal care because the, you know, the OBGYN will manage that. We're going to manage the eating disorder at Melrose and, you know, when someone comes in for an initial assessment we figure out what’s going on and determine the appropriate level of care. You know, we're monitoring the patient's lab work, vitals, EKG, and, you know, making sure that, you know, they're restoring weight into their goal range and also meeting, you know, the weight requirements of their pregnancy.
Dr. Karen Nelson: Absolutely. Well, I think [00:20:00] too, you know, having that medical care around the eating disorder and then having access to therapy and working with your therapist to, you know, I use the word a lot in therapy about kind of tolerating body changes. Managing emotion, when I might feel triggered to want to use the eating disorder, after an appointment. How do I manage that? So this collaborative care. You're collaborating with their OBGYN as a medical provider, and then providing this beautiful support here at Melrose to manage any eating disorder symptoms.
Jackie Gustafson: You know, absolutely. And you know, sometimes, you know, our pregnant patients need to go to our inpatient unit. And, you know, if you're binging and purging, you know, and you can't stop, you're restricting, you're not gaining weight during your pregnancy, we need to see you. We need to help you. We need to work with you and get you on track.
Dr. Karen Nelson: [00:21:00] For sure. And I think that place of the team’s commitment to each patient is making those appropriate recommendations and, you know, continuing to evolve their care based on the needs that they have as they move through.
Jackie Gustafson: Absolutely. And one of the really nice things about Melrose is we truly individualize every patient's care.
Dr. Karen Nelson: Agreed.
Jackie Gustafson:It's not putting you into box. It's figuring out what you need and, you know, getting you the help that you need.
Dr. Karen Nelson: I think it also just indicates kind of the importance and the effectiveness of having a multidisciplinary team. So as the medical provider, you can have those conversations about biology and how their body works, optimal weight, but in therapy, having spaces to process all the emotion about that. Because you're right, it often can bring up fear or anger, you know, distress or discomfort. And working with your team to kind of hold and acknowledge, sometimes in recovery we do [00:22:00]hear things that we don't want to hear.
Jackie Gustafson: Exactly.
Dr. Karen Nelson: Yeah. Absolutely.
Jackie Gustafson: Exactly. But, you know, there is help for this and there is recovery and we have seen so many patients improve their life, but you have to show up.
Dr. Karen Nelson: That’s right.
Jackie Gustafson: And you have to be present and you have to work on it and it's hard, but we are going to assist you every step of the way.
Dr. Karen Nelson: Absolutely. That place where you just so graciously and in this nurturing space, let your patients know there's nothing that you can't tell me that we can't handle. We're going to figure it out. But if you don't tell me all of it, that's where we're going to maybe have some stumbling blocks and trip up a little bit.
Jackie Gustafson: Exactly. It's really important to come in and be completely honest with us. And I always tell patients, especially patients that have struggled with eating disorders for a long time, and they've done some treatment and have fallen away from it. And I kind of tell them, like, ‘You're living on the fence. You can't have one foot [00:23:00] in both worlds. You have to let us know what's going on. And we got to move to the recovery side of the fence.’
Dr. Karen Nelson: For sure.
Jackie Gustafson: And to take that leap of faith and to let us help you because there is a different way. There's a better way.
Dr. Karen Nelson: That's right. We got you. And we get it that it's scary. But if you jump, we're going to catch you.
Jackie Gustafson: Exactly. Absolutely. You need that holistic care.
Dr. Karen Nelson: Absolutely. So we know that pregnancy and someone who potentially had been struggling with an eating disorder. There's a lot of body changes that happen with pregnancy. Obviously, we want weight gain to be happening with pregnancy. In your experience, can that be hard for women who potentially have struggled with an eating disorder?
Jackie Gustafson: It can be really hard. And we kind of see a couple different things that happen. Of course, everybody's an individual. But, you know, one thing that we can see [00:24:00] happen is that patients who were once restrictors, the wheels come off. And they kind of flip more to a binge eating type behavior, and they engage in all of these things that were forbidden to them that I can now let myself have. And we're switching one eating disorder behavior for another, and that's not necessarily a healthy eating pattern either, and it's probably happening for the wrong reasons. ‘I'm supposed to gain weight so my baby can grow and be healthy, so I'm just going to overindulge and do all of these things.’ And usually with those patients, there's some emotional component to that eating that we want to know about and that we want to treat. One thing about eating disorders that I will say is, if you don't treat them, they don't just go away. They keep coming back and coming out in different ways. They change and evolve over time. And we see different [00:25:00] things. And during pregnancy, that big time of change, we'll see that one, sometimes that behavior comes in. I mean, for some patients, I think it just gets pushed to the back of their mind and for the reason of their baby, they're eating normally. They're doing everything that they need to do, but you still need to work on that because it isn't going to just go away. You have to work on those feelings. Eating disorders don't just go away. If you don't treat them, it's going to just keep coming out and coming back in different ways. Usually when people go through periods of some sort of stress in their life – good or bad. Other patients, they cannot handle the weight gain. It is traumatic. It is stressful and they continue to engage in restriction or purging or they're over-exercising, whatever their eating disorder symptoms are. Sometimes it [00:26:00] becomes worse. And that is very detrimental for pregnancy because you have to gain weight because your baby is growing and sometimes it helps our patients to really realize, ‘Well, think about all of the things that are changing in your body. A very small amount of that is actual, you know, fat on your body –
Dr. Karen Nelson: Right, exactly.
Jackie Gustafson: The thing that our, you know, the thing that our patients are so afraid of.
Dr. Karen Nelson: Yeah.
Jackie Gustafson: you're increasing your blood volume, you're growing another person. There's amniotic fluid. There is the placenta. There's all of these things that are happening within your body and a very small part of it is actually fat on your body. You know, in our culture we see all these celebrities who have a baby and like literally overnight –
Dr. Karen Nelson: Yeah, they've lost all the baby weight. No evidence.
Jackie Gustafson: The transformation is, I don't even know how to describe it. It's miraculous.
Dr. Karen Nelson: It's unreal.
Jackie Gustafson: But it's unrealistic.
Dr. Karen Nelson: And again, we just want to [00:27:00] acknowledge there is help and support around that. Being a new mom, I have the pleasure of having four kids. And it's just lovely and really hard. Right? I mean, those early months after the baby came, I was joking with a dear friend of mine who recently had a baby, and I was like, ‘I think about the first six weeks was one long day, and I had no idea if it was day or night,’ right? I didn't know if I was supposed to eat or sleep. I don't know if I showered for days on end. It's overwhelming.
Jackie Gustafson: It is overwhelming. It's the best part of life.
Dr. Karen Nelson: It is.
Jackie Gustafson: A new child is the best part of life, but it's a very big adjustment.
Dr. Karen Nelson: It is.
Jackie Gustafson: For you and for your family and –
Dr. Karen Nelson: Right. And, and learning all those things about that new human. And, you know, one of the things that we talk a lot about in eating disorder treatment is like the brain space eating disorders will take up. If someone is struggling with urges around restriction or binge purge, maybe disruptions in [00:28:00] their body image, feeling uncomfortable in their body, maybe obsessing about food, trying to avoid food, all of that takes brain space. And I only have a finite amount. So if my brain is occupied by all of those thoughts, then my brain also maybe isn't being able to enjoy and be present with this brand new baby. And we're never shaming that, right? We just want to acknowledge the eating disorder can feel overwhelming. And getting specialized treatment for that is very important.
Jackie Gustafson: It's never too late. And if you're a new mom with a baby and an untreated eating disorder, please come and see us.
Dr. Karen Nelson: For sure.
Jackie Gustafson: So we can help you get to a better place and enjoy that bonding time with your baby. You have to take care of yourself before you can take care of another person and be fully present for them. And we want you to bond with that baby and you know, as the child grows and gets older, be [00:29:00] present for them. Give them all the things that they need and that you want to give them, you know.
Dr. Karen Nelson: For sure.
Jackie Gustafson: But also being able to take care of yourself.
Dr. Karen Nelson: We just know that the eating disorder can be sneaky, it can occupy a lot of our brain space, it has physical and mental health implications, and we don't want that to get in the way of someone's early experiences with their baby and ongoing. Mothering's hard, right? Our kids are older now, Jackie, but it's still hard.
Jackie Gustafson: It is hard. It is hard. I mean, we do get patients that had struggled with an eating disorder when they were young and they did treatment or not. I mean, every case is different and didn't struggle for years. And then, you know, they got pregnant, they had a baby. Didn't struggle during the pregnancy and after they had the baby, here it comes in full force.
Dr. Karen Nelson: That's right.
Jackie Gustafson: And it's surprising to a lot of those patients, like, I thought I [00:30:00] was past this.
Dr. Karen Nelson: That’s right.
Jackie Gustafson: I thought that this wasn't an issue for me anymore. And, you know.
Dr. Karen Nelson: Here it is.
Jackie Gustafson: Here it is.
Dr. Karen Nelson: That's right. Really, I'm glad you brought that up. I actually have a handful of patients where that has been their exact story. Where maybe an adolescence or early teen years, struggled with an eating disorder, had done some treatment. It felt recovered and quiet. And then the pressure of just the stress, right? We know eating disorders, like you said, they're not about food, they're about emotion. There's a heck of a lot of emotion after a baby's born. Joyful and stressful, both. It just makes sense to me that the eating disorder could potentially become triggered again. And we're here to support you. If there are listeners who are tuning in today and maybe have a loved one where they're maybe a little concerned, or a partner is kind of wondering or worrying about their loved one's eating [00:31:00] behaviors, any ideas or any suggestions of gentle ways that we could talk about it, or what's your experience of how people might bring it up?
Jackie Gustafson: That's a really good question, and it's really important for support people to encourage their loved ones to come and get help. And sometimes just acknowledging that, you know, that they're struggling and that they need help is sometimes what people need to actually come in and do it. And so having an honest conversation with those loved ones of things that you're noticing, things that you're concerned about. You know, that you know that there's help and encouraging them to seek help.
Dr. Karen Nelson: So true. People who have supportive others around them, during and continuing on in recovery, they just do better. And so we know supportive others are just really important to someone's recovery. Encouraging [00:32:00] someone, like you said: ‘Come in for an assessment. If you're wondering, if you're thinking, Oh, maybe this is nothing.’ Come to the professionals. We'll assess. We'll give you recommendations. It is always appropriate to call in and start those conversations.
Jackie Gustafson: Well, and absolutely, because eating disorders, they're a disease of isolation and secrecy.
Dr. Karen Nelson: That's right.
Jackie Gustafson: And they thrive in the dark.
Dr. Karen Nelson: Yeah.
Jackie Gustafson: And we got to shine the sunlight on it. And a lot of times you need the support of your – a loved one to do that.
Dr. Karen Nelson: Jackie, thank you so much for being here today.
Jackie Gustafson: Thank you for having me.
Dr. Karen Nelson: It was just a joy being able to hear all of your wisdom and insight.
Jackie Gustafson: It was a joy chatting with you as well.
Dr. Karen Nelson: That's it for today. Thanks for joining me. We've covered a lot, so I encourage you to let it settle and filter in. And as I tell my patients at the end of every session: Take notice, pay attention, and we'll take it as it comes. I'll [00:33:00] talk to you next time. To learn more about Melrose Center, please visit MelroseHeals.com.
If you or a loved one are suffering from an eating disorder, we're here to help. Call 952 993 6200 to schedule an appointment and begin the journey towards healing and recovery. We'd love to hear your feedback on our episodes, the topics we cover and anything you'd like to hear me discuss on the show. Our email addresses melrose@parknicollet.com. I look forward to hearing from you. Melrose Heals: A Conversation About Eating Disorders was made possible by generous donations to the Park Nicollet Foundation.