Aleta Storch, MS, RDN, LMHC joins Julie Church, RDN to discuss how ADHD (Attention Deficit Hyperactivity Disorder) can lead to different feeding and eating challenges. Her personal story highlights the benefit of understanding how the brain works for everyone, especially those desiring to heal from disordered eating and eating disorders. Listen in for a sneak peek of a few practical tips from her model of care for ADHDers and expect this episode to give you a full dose of information about the brain, ADHD and neurodivergence.
To learn more about Aleta:
Website: https://www.wiseheartnutrition.com/
Membership: https://www.wiseheartnutrition.com/neurished
Free FB Group: https://www.facebook.com/groups/eatingwithadhdofficial
@the_adhd_rd
@wiseheart_nutrition
Connect with Opal:
Thank you to our team…
Editing by David Bazzi
Music by Aaron Davidson: https://soundcloud.com/diet75/
Sound engineering by Ayesha Ubayatilaka at Jack Straw Studios
Transcription by Rev.com
Julie Church (00:06):
Welcome to the Appetite of Podcasts, brought to you by Opal Food and Body Wisdom. We are a podcast all about all things food, body movement, and mental health. And today I am your host, Julie Church, registered dietician, one of the co-founders of Opal and Director of People and Culture, as well as Nutrition director. And I am joined by Aleta Storch, dietician and owner of Wise Heart Nutrition and a more affectionately, broadly known, I think as the A DHD dietician. Aleta. I’m glad to have you here.
Aleta Storch (00:41):
I’m super excited to be here too. Julie.
Julie Church (00:43):
Yeah. So we are on screen looking at each other, but recording here in a studio. And Aleta and I haven’t seen each other in person for a while, but our paths crossed when Aleta began working at Opal years ago in a mil therapy role, as well as a primary therapy role, as well as helping us in the pandemic to launch a virtual IOPI forgot about that. That was a big project that Aleta helped us with. But today I am excited to be able to have you as listeners here al’s just wisdom and where she’s grown to be really specialized in helping individuals that struggle with food and body concerns and also identify with Neurodivergence and especially A DHD. So Aleta, what else did I miss that you would want our listeners to know about you?
Aleta Storch (01:31):
I think you hit all the big points, dietician and therapist. So yeah, the two nutrition and mental health overlap.
Julie Church (01:39):
Yes, you have that dual degree, which is a lovely kind of unique thing that you bring especially to Sure in this conversation today. Thank you. Yeah, good reminder. So where do we want to start? I want to hear and let our listeners into how you got into this specialty and where that kind of interest and passion came from. So give us a little backdrop into where you came from other than your little bits of time at Opal.
Aleta Storch (02:07):
Well, yeah, that sounds like a great place to start. So I guess kind of rewinding as a little kid, I always really struggled with food and it was mostly forgetting to eat or forgetting my lunch, being really picky eater. And so there were a lot of issues that kind of presented almost like AED avoidant, restrictive food intake disorder, but it wasn’t ever diagnosed. And then the term A DHD was kind of thrown around, but my parents were sort of like, she’ll get over it, it’ll be fine. But they were always really worried about my eating because they wanted to make sure that I was eating enough. I also grew up with intuitive eating, kind of the norm in my household. I feel really lucky for that. So I wasn’t really exposed a lot to diet culture, but then when I went to college, diet culture was sort of everywhere.
(02:57):
And essentially to be in community with other people to fit in, to be accepted, it kind of felt like I had to engage in that and be part of that. And I was already coming into college undernourished because I didn’t have my parents constantly being like, did you eat? Here’s some food, make sure you get whatever’s in the refrigerator. So then it just sort of snowballed and essentially turned into an eating disorder and I was able to get treatment for that in outpatient and help every size intuitive eating, which was really great. Fast forward to grad school, I had done so much of the healing around the diet culture piece, letting go of the food rules, body image, but I was still really struggling with food, so I was kind of in this restrict binge cycle, but it didn’t feel the same. It didn’t feel like I was intentionally restricting.
(03:49):
And so that was when it kind of came to light that it was maybe more related to the logistics piece. So I went ahead and I got assessed for A DHD got diagnosed, and those two pieces just kind of came together and I was able to just better understand my brain a little bit and understand what was getting in the way of feeding myself and develop some tools and systems. And I never would’ve been able to do that if I hadn’t come to it through the lens of neurodivergence or through the lens of A DHD because for a long time I thought it was just me like a personal failing. Right, totally. So then fast forward even longer, I graduated grad school and you all hired me as a million therapist, which is where I learned so much about eating disorders. I mean, that is the foundation of the work that I do now. And I noticed a lot of clients who struggled with similar things that I had struggled with in grad school where maybe diet culture was present, but it wasn’t the underlying motivation for restriction and just sort of seeing them struggle more on the weekends when food wasn’t served to them. And just again, struggling more with those logistics.
(05:04):
And then I started to notice that in my own clients in Wise Heart Nutrition and just started to make the connection that there is a lot of overlap between eating disorders and, and it was not being talked about at all. I tried doing lots of research and found nothing. I was like, okay, I’m going to create this model, and it seemed to really resonate with my clients. And from there it has just grown. That’s how I came to be.
Julie Church (05:34):
Love
Aleta Storch (05:34):
It. Focused on adhd. Thank
Julie Church (05:36):
You. That’s so helpful. I’m sure our listeners love hearing that personal part so much of yeah, that just inspires and helps people see the context in which you can be such a great helper and understand it. And I love that you said when you had that diagnosis of the A DHD, it did help you to grow in understanding your brain and how it worked. And I do hope that that’s kind of what comes out of this too, is just a bigger picture recognition that neurodivergence, a lot of this conversation today is just understanding that different brains work differently and then therefore what does that look like for people that struggle with food and body issues. If you could back up just wanting to make sure our listeners understand what maybe acronyms are being used, the A DHD you’ve said a few times. So if you could state what that is and maybe give a quick little spiel on that that would be helpful to make sure people understood what you were sharing about your story.
Aleta Storch (06:33):
Yeah, absolutely. So A DHD is attention deficit hyperactivity disorder, and it used to be called A DHD or a DD, but now they’re just using A DHD and it is essentially difficulties with executive functioning, which we, I’m sure we will talk a lot about moving forward in the episode. And then issues with emotional regulation, so feeling really big emotions, feeling emotionally out of control and people can present as more like the hyperactive, which I think we kind associate with little boys in first grade zooming all over the place. Or they can be more of the inattentive, which can present as more daydreamy and just sort of not paying attention and forgetful or people can be combined. So those are sort of the three success of ADHD.
Julie Church (07:24):
Great, thank you. And I guess beyond that, so that’s one potential diagnosis as part of your story and your journey. So we’re kind of starting there, but if you could expand for our listeners, what is even neurodivergence then? So if A DHD is one potential diagnosis or experience that people might have that then might have them in that being maybe labeled with that or having that terminology, who else, how else, what other symptoms or experiences fit into that?
Aleta Storch (07:55):
Yeah, so neurodivergence like you said, is a big kind of broad umbrella category. So that includes ADHD, but it also includes things like autism, obsessive compulsive disorder, and just other forms of what we would call mental health condition where the brain is functioning differently than, I’m going to put it in quotes, like normal brains. What we typically see among the broader population, and it’s not really a scientific definition, but it’s more of a terminology for individual folks who might have differences in the levels of neurotransmitters that are available or the number of receptors that are kind of functioning in the brain. So it’s a pretty big category, but it’s not necessarily a clinical term, if that makes sense.
Julie Church (08:44):
Great. That is helpful to say. It’s maybe not scientific in that way, but it kind of holds some of these mental health conditions or diagnoses that have emerged over the years. So is the current science saying in terms of cause or is this just genetic or what leads somebody to potentially be given some of those kinds of diagnoses? I know that probably could be a whole different podcast, but can you give us a little nugget?
Aleta Storch (09:09):
Yes. Yeah, and I don’t think it’s fully understood where that’s coming from, but we do know that it can be a mix of genetics and it can be environmental. So folks who experience trauma are more likely to have some of these diagnoses later in life. Something like the pandemic can cause some of these experiences. The thing we do know biologically is that there is some kind of difference in neurotransmitters, the way that those things are moving through the brain, the receptors that are associated with those neurotransmitters, and yeah, it’s very, very genetic. So if a parent has ADHD kid is very likely to have ADHD. So we kind of see that passed down through family.
Julie Church (09:54):
Okay, helpful. Thank you. Okay, so what else, I guess in some of this terminology, what other words or phrases would you want to clarify for our listeners before we get into the specificity around this and eating disorders?
Aleta Storch (10:08):
Great question. So a lot of people use neurodivergence and the terms neurodiverse and neurodiversity interchangeably, but they actually have very different meanings. So neurodivergence is really referring neurodivergence or divergent is referring to an individual. So someone whose brain actually functions differently. Neurodiverse is more within a group, so it’s designating differences among a group. So you could have a group of neurotypical folks and that group is not neurodiverse. And then neurodiversity is kind of in general among the population, we have differences in brains. So we just sort of live in a world with neurodiversity. Great. Hopefully that helps.
Julie Church (10:53):
Great. Okay. Well let me know if I misuse one of those three because it’s very similar, but I can hear easy to do. So I hear it, I hear the difference. So let’s see if I can learn from you even in the moment and see if I have that. Alright, so we’ve talked about these other mental health conditions that individuals might then have neurodiversity, autism, A-D-H-D-O-C-D, and other mental health concerns. What about eating disorders and what’s the intersection or crossover of eating disorders with this?
Aleta Storch (11:26):
So there is a major crossover. I actually pulled some actual STA for that. So the prevalence of eating disorders that we know of in the United States. So these are people who have been diagnosed that is about two to 3% and 30% of those people also have a DHD. So again, these are people who have been diagnosed with an eating disorder and properly diagnosed with A DHD and 30% is a pretty big number. And then in a 2011 Harvard study, females or female presenting folks with A DHD were four times as likely to have an eating disorder than those who did not have a DHD. Wow. So yeah,
Julie Church (12:08):
Those are big numbers. A lot higher
Aleta Storch (12:10):
For everyone.
Julie Church (12:11):
And I don’t know, I don’t have the stats on the crossover of individuals, the comorbidity of obsessive compulsive disorder and eating disorders, but I also know that that is quite high. So
Aleta Storch (12:23):
For sure, and it really makes sense, you kind of think about the pathway of getting there can fall into two different groups. So the eating disorder can actually function as a way of making up for important human needs that aren’t being met or maybe don’t feel like they’re being met for someone with A DHD. So some of those could be a sense of control or feelings of adequacy and competence and accomplishment. Those are all things that can be difficult to experience when someone has a DHD and is trying to exist in a world that is built for a neurotypical brain. So that’s sort of the first pathway.
Julie Church (13:02):
So then you, you’re saying, sorry, if that’s okay. So then you’re saying, yeah, somebody is not feeling like they have a sense of control or don’t feel a sense of accomplishment or some of those natural human needs aren’t being met, therefore an eating disorder develops for them to try to mask that or function in that way to have a sense of control by controlling food or having a sense of, I have accomplished this one thing and instead of other avenues of life, thank you. Yep,
Aleta Storch (13:32):
Exactly. Yeah. And that’s so normal to turn to food because it’s everywhere and it’s an easy thing to do, and we’re told we should be able to control that. And so I think it, it’s an easy place for folks with a DH, ADHD to end up. And the sort of second pathway in both of these can exist for someone is that the disordered patterns are more of a result of the symptoms of A DH adhd. So something like emotional dysregulation can lead to emotional soothing through food because that causes a dopamine release and folks with A DHD have low dopamine. It can also be all or nothing thinking or perfectionism, inattention and forgetting to eat sensory processing issues. There’s texture dislikes, flavor dislikes, that sort of thing. So those are the two ways that I’ve seen eating disorder show up for a DH adhd or
Julie Church (14:27):
To expand on that maybe, is there any other maybe a specific playing out or a scenario like let’s talk breakfast or let’s talk busy work schedule, and then what happens?
Aleta Storch (14:44):
Yeah, so if someone maybe doesn’t have a lot of structure routine, which happened in the pandemic, people were home, we didn’t know what to do with ourselves, and without those kind of built in or inherent reminders to eat or maybe being able to get food at work, it can become really easy to just forget, not tune into our bodies, so then we’re not eating all day and then all of a sudden at the end of the day, there’s this extreme hunger that can kind of turn into more of binge eating or more compensatory eating. Our bodies actually need that food. So that binge restricts cycle shows up a lot for a DH ADHDers. Another would be maybe someone who’s a really picky eater and there’s not a lot of foods available that they’re excited about or that they want to eat. And so again, there can be more of that restriction that then turns into binge eating with foods that they are willing to eat. And in the research, and I would say in dominant culture, when A DHD is talked about in terms of eating disorders, the focus is really on binge eating. And there’s sort of this belief that A DH ADHD is binge eat because we have no impulse control and we’re seeking dopamine. And that’s true that exists, but typically it’s because the restriction is there, the underlying restriction. And I think that gets ignored that it’s actually not a binging quote problem, it’s more of an unintentional restriction problem that is seen with a lot of the different symptoms.
Julie Church (16:22):
Okay. And would you say, what about the aspect of body image or appearance? Where does that play in more or less for this population that might end up finding themselves struggling with an eating disorder, but the root being some of these divergence? Yeah,
Aleta Storch (16:45):
Yeah. Yeah. I mean, I would say there are more cases of something like arfid where the body image piece isn’t as prevalent, and we’re all existing in diet culture, so a lot of a D fears have been exposed to that, and a lot of a DH fears are pursuing thinness because that’s what society tells us is important. So there is a lot of crossover with that. I think the difficulty for folks doing that healing work can come from some of that all or nothing thinking. So that mindset of I either look this way or it’s not good enough, or I need to feel good about my body in order to take care of it. And the emotional dysregulation when we’re feeling uncomfortable in our bodies, that can feel so overwhelming that then there’s just sort of this avoidance or the shutdown. So I do see a lot of avoidance of being in the body with a DH ADHDers because it is just like this visceral overwhelm.
Julie Church (17:47):
Okay. Yeah, I would love to hear more about that because as you share, you’re using the language of the intuitive eating or listening to the body or connecting to the body. And I would love to know the unique considerations of where that plays in the struggle and then where it plays into the healing, right? Kind of where does interceptive awareness and intuitiveness intunement, where does it fit in
Aleta Storch (18:14):
With my clients and folks in my membership, we talk a lot about what you called interceptive awareness, so the understanding of kind what’s going on inside of our bodies. And a lot of folks with A DHD and just folks who are neurodivergent, that interceptive awareness isn’t really fine tuned, so it’s really easy to tune out or ignore body use. So that can be with eating, but it can also be needing to go pee and just putting it off and not noticing until it’s like, oh my gosh, it’s an emergency, I need to go deal with this. So the same sort of thing happens with food where there isn’t an awareness because we’re paying attention to so many other things and the stimulus in our environment is kind of taking over. So then we’re not tuned into our internal experience. And again, that creates that restrict binge cycle because if we’re not stopping and noticing, oh, I’m hungry, then we’re not going to eat. And similar with fullness, it’s easy to just eat and not pay attention, and then all of a sudden be like, whoa, I am really, really, really fallen uncomfortable. And so we do a lot of work around developing that skill of tuning into the body. And with something like intuitive eating, it’s really built for neurotypical folks because it’s like, well, just notice, just pay attention and the hunger will come.
(19:43):
A lot of folks with a DHD are on stimulant medication, so that adds another layer where you can listen all day long, but you’re not going to feel hunger in that maybe traditional body way. And so it can be really helpful for folks to learn what are some other, maybe not cues, but indications that you need food. And typically that’s a worsening of A DHD symptoms. So poor focus and concentration, just feeling really distracted, feeling really tired, that sort of stuff.
Julie Church (20:15):
Okay. So feeling tired, I guess it’d be a physical sensation, but what you just shared was a little bit more thoughts or experiences. Would you say though that there is an eventual ability to connect to the body and listen and notice those cues for these individuals? Or would you say that it’s more needing to find a long-term solution, not going to be connected to those physical cues?
Aleta Storch (20:40):
Yeah, I would say both. I think for some people it’s easier to maybe build that and probably easier for folks who are not taking a stimulant medication, they don’t have that additional barrier. I think for some people they will be able to notice those more physical sensations, but they might need an external cue as a reminder to check in. And I think that’s the piece where a long-term solution can be really helpful.
Julie Church (21:12):
I like that. Yeah, that’s a good clarification. Can you speak in terms of the stimulant medication? My understanding is some people might be on that all the daily and others might just use it PRN, okay, I need to study for this test, I’m going to need focus for this project at work. I’m going to take this. Can you speak a little bit to that in terms of the population and then how much of it is, how long, maybe, what’s the word? The not shelf life, but the
Aleta Storch (21:42):
Like half life?
Julie Church (21:42):
Yeah, yeah. So what is the halflife of these kinds of stimulant medications for somebody that might be on it all the time versus the person that’s just using it? PRN?
Aleta Storch (21:53):
Yeah. And obviously claimer, I’m, I’m not a prescriber, not a pharmacist, not medication expert. I’m not asking you to leave, what’s your disclaimer? But with the Adderall, extended release is an example. So with an extended release stimulant, that’s going to last more like eight to 10 hours depending on the individual body and metabolism, that sort of thing. So that’s where people have the not eat, not eat all day, and then six o’clock hits and then they’re starving because the medication has worn off. And so then they’re like, oh, there’s the hunger cues, and then there’s immediate release, which lasts about three to four hours. And oftentimes that’s prescribed more to kids. And I’m not entirely sure why, but being on an immediate relief can be really helpful in creating those natural waves of, okay, I’m not hungry because I ate. And then by the time it wears off, oh, okay, I’m hungry. And then you take another medication after you eat. So I’ve found for a lot of clients talking to their prescribers and actually switching to immediate relief can be really helpful at the beginning stages of healing with food and eating, just yeah, because it’s one less barrier to work with.
Julie Church (23:10):
Great.
Aleta Storch (23:10):
Does that answer your question?
Julie Church (23:11):
No, yeah, that was great. Just a little bit more in that. I think it’s one of those things that many people that are prescribed medications for mental health conditions and for other things to go, it’s kind of a side effect. And I think yes, in the realm of concerns around eating disorder or recovery, I know it’s always this question of like, Ooh, should somebody be on a stimulant? And it kind of brings me back to this thing I think about with chicken and the egg conversation of going, well, what came first? In some ways, and maybe it’s neither here nor there, but I do think that often even with any other depression or anxiety in the comorbidity with eating disorders, it’s like some people will struggle with those first, and then the eating disorder develops and some people might develop an eating disorder, and then they then develop depression and anxiety.
(24:03):
And I hear this similarly in this way sometimes of this of going, oh, somebody could kind of the chicken and the egg of which one is that the eating disorder could have come out of having their own experience with A DHD or OCD or I wonder of the flip side, and I don’t know, maybe you could speak to that of somebody that might develop an eating disorder, but then maybe not. The diagnosis doesn’t come until after they’re diagnosed with eating disorder, then they get diagnosed with A DHD or OCD is kind of going, oh, maybe that was preexisting. So just that little chicken the egg conversation.
Aleta Storch (24:39):
Yeah. Such an important thing to talk about. And it is so crucial to differentiate those two because an eating disorder can often present as a DHD if we’re not feeding ourselves, if we’re not nourished our executive function, that’s going to be organization and planning and attention and emotional regulation, all of those are impacted pretty negatively. So if someone who is undernourished for long enough is actually going to present as if they have a DH, adhd, so I think it’s totally safe to diagnose that, but a full assessment of when did this actually start? Is this something that you’ve experienced your entire life and now that maybe you’re in treatment, you have access to that possibility of diagnosis. But if it’s maybe symptoms that haven’t been lifelong, that would point to, okay, maybe this is the eating disorder that then led to these symptoms. And yeah, I mean, that’s a big assessment and not everyone has access to that, but maybe even just thinking for themselves, has this always been something I’ve experienced?
Julie Church (25:47):
As you mentioned, the diagnosis process. I’m curious if you could speak to that. What does an assessment look like for A DHD, and where would somebody do that?
Aleta Storch (25:59):
Yeah, the assessment is a very thorough time consuming process. So not a lot of people have access to that or even have time to go through that process, but it’s essentially looking across your entire lifespan and across different areas of your life. So within your family, within school and work and relationships, are these different executive function issues showing up? And if they have been around since someone was a little kid, that is going to be a better indication of having a DHD again versus like, oh, this just started when I began working at Google, which is really overwhelming place to work. So yeah, it’s a bunch of different tests. They’re like computer tests that kind of, I guess a theft brain function, organization planning, that sort of stuff. I got mine I guess 12 years ago, and I don’t totally remember all the ins and outs, but I remember it being a big thing, being really happy when it was done
Julie Church (27:05):
Well, and I think what you’re saying, yeah, it’s an assessment. It’s maybe interactive or question answering. There’s no blood test. It’s not something that somebody can just take to see, oh, this shows up in your genes somehow. So I think it’s just good to say that if somebody doesn’t know that, and that would be done through a psychologist or,
Aleta Storch (27:29):
Right, yeah, yeah, psychiatrist, psychologist. There are some ARNPs who can do a full assessment. But I do think, again, if it’s accessible, I do think that’s really, really important because of the potential for misdiagnosis, because A DHD can look like so many other things. It can look like borderline personality, sorry, borderline personality can kind of look like a DHD. If someone has experienced a lot of trauma and has pt, SD, that can look like a DHD. And so being able to rule out or diagnose those things and also recognizing it could be a mix of those things so someone can get the proper treatment. And then the other thing that I’ve noticed a lot of recently is kind of this misdiagnosis when someone is just trying to exist in hustle culture. So trying to exist in a world where there’s really high expectations, there is a lot of perfectionism. We’re constantly experiencing a bombardment of notifications and technology and stimuli. And so I think it’s important to ask, is this a DHD or is it just what happens when we try and exist in this overwhelming environment? And so I think, yeah, that’s something in the next couple of years, I think there’ll be more information around that, just something to pay attention to.
Julie Church (28:50):
And what I love about what you just said is that really every listener in those that maybe have this diagnosis or don’t, could be subject to some of the ways that their brain might be wired or their life might be kind of oriented to even be leading to some of these difficulties of emotion regulation or executive functioning. And so I love that because it does make even what I want us to move into a little bit next, which is some of these practical things may be helpful for who cares if somebody has been diagnosed or not, but maybe they are finding, wow, I’m forgetting to pack my lunch now. What? Wait, help me. So it sounds like getting into those specifics and giving people some tools really has been helpful for folks. And so I’m curious if you could share more around some of those stories of hope and healing and some examples that really helped people move through not feeling held back by some of the ways that their brain work, because I think we all would love to find ways to continue to live more freely.
Aleta Storch (30:06):
I’m so glad that you named that piece that just because someone doesn’t have a diagnosis doesn’t mean that they’re not experiencing maybe even symptoms or characteristics of neurodivergence. And so a lot of these things can be helpful for people across the board or in times of stress or overwhelm or when there’s a global trauma that these aren’t just for folks with a DHD or autism and a clinical diagnosis is acceptable to everyone.
(30:44):
So with clients, with group members, the big thing that we really focus on to start with is that kind of awareness piece. So really understanding our brains, why are our brains different? How is this impacting our life? How is it impacting our relationship with food, with eating with body, and creating a little bit of self-compassion around that self-compassion and acception because we can’t undo neurodivergence, and the goal is not to make someone neurotypical. So yeah, creating space to say, this sucks sometimes, make life really hard sometimes, and this is where I’m at, and it can be okay. Then really working on establishing, meeting basic food needs. So really focusing on how do we get enough, how do we eat regularly? How do we get variety? Then once that’s established, focusing more on pleasure and satisfaction and gentle nutrition, then just accessing proper care and support communities. I found that a lot of neurodivergent folks really thrive when they’re in community and when they’re around people who share similar experiences. So yeah, we do a lot of work trying to help find these communities and support networks for folks.
Julie Church (32:05):
Great. So those kind of three categories. I’m hearing awareness, increasing awareness and self-compassion. The second one being helping them meet their basic food needs, and the third being community and connection, not feeling alone or isolated in it. And I feel like we talked a little bit about the awareness piece earlier, but I am curious about the meeting basic food needs category. What are some of your favorite tools to help people in that? What gets you, I don’t know, most excited
Aleta Storch (32:37):
And yeah, you’re nailing it there. That’s the logistics category. That’s where we can create skills and tools and systems and where there’s a lot of fun for creativity as well. So I guess a really good example would be folks really struggling with planning for meals throughout the week. So oftentimes people say like, oh, I had this idea to make these free recipes this week, and then I bought all the ingredients and then it just all rotted in my fridge because I didn’t want to make any of them. So what we really talk about is are you planning for variation and differences in your energy and your capacity and your motivation throughout the week? Because we know that sometimes those are going to be major barriers, and if you’ve planned this extravagant meal that you’ve never made before, right, it’s not going to happen. You’re not going to make it.
(33:35):
So you’re kind of setting yourself up for what feels like failure. So I like to talk about something called level planning. So I basically just created this system where it’s level one through five, and you essentially think of what are meals that I can make or have when I have essentially no motivation, I’m exhausted, I don’t have any capacity, no spoons left at the end of the day, and identifying five or six meals that fall into that level, and then working up the scale to a level five and maybe that extravagant meal of level five, and then thinking about what does your week look like? If you’re working every day and you have a big project due and you have plans with friends on Wednesday night, planning for level five meals throughout the week is not going to be helpful. So we really identify when do you need a level one or a two? And I think that can take a lot of the pressure off of folks who feel like, well, if I’m not planning for these big complicated meals, then I’m not doing it right. So doing a lot of that, doing a lot of outsourcing. How do we make the level three, level two maybe buy pre-cut vegetables? And so there’s a lot of room for work within that, not probably one of my favorite tools.
Julie Church (34:53):
Cool.
(34:54):
Yeah, yeah, absolutely. That’s awesome. And I think they seeing somebody be able to still feed themselves, meet their basic needs in the midst of that. I also think that integration, knowing your philosophy around food and nutrition, being from that non diet, anti-D diet approach, you’re working with people that yes, if you’re using more convenience foods or already prepared foods, processed foods, it’s acceptable and you are good and you are loved, and that’s okay. And I think that too, just probably having to be a voice into lots of people’s experience that’s so influenced by diet culture about saying one thing or another in regards to food being good or bad. So
Aleta Storch (35:39):
Yeah, there is so much shame and stigma around that, right? Well, if I’m not cooking and I’m just heating up frozen meals, then I’m not healthy. And I like to talk to clients about this big picture of health, almost like a pie, physiological biological health is just one slice of that pie. But then what about emotional and relational and mental and financial and eating maybe more of these processed foods support those other areas of health, and is that maybe then supportive of the whole? And again, I think that can be relieving for people that there’s so much focus on this physical biological health and not tending to those other parts.
Julie Church (36:25):
It just identifies the diversity of different kinds of eaters. We all are too. And
(36:30):
You mentioned creativity about this kind of trying to meet basic needs. All of us, I think there’s an element of creativity that has to come into our meal planning and food and eating, and some people like more novelty and want there to be a bit more of a creative expression or artfulness that goes into that aspect of their life. And others, it’s just more function and it’s not a part of any other big hit of who they are or what they want in terms of joy in their day. It’s a lot more function. And so I think it’s really, I’m sure that helping everybody just kind of discover they eat or they are, and then living into that versus trying to live up to any type of standards.
Aleta Storch (37:12):
Yeah, exactly right. Everyone’s an individual and unique, and we all get to be whatever kind of eater we need to be.
Julie Church (37:19):
Yeah, cool. I would love maybe Evan, as we’re sort of wrapping up our conversation, the community aspect was that third part of what you said really is important. And I would love for, you’ve mentioned it a couple times, talking about membership or your members, and so I know that you’ve created community for your clients and members and would just love to hear what you have to offer there as well as other ideas and resources out there and things that a leader will share. We can have in our list there on the show description so that you can get quickly to those listeners and find out about these resources. But I’d love to hear what you’re offering and others that in the community.
Aleta Storch (38:00):
And it’s exciting to say that there are so many more resources that align with helping every size anti-D diet, intuitive eating for folks who are neurodivergent now compared to five years ago. So five years ago it was like, well, I don’t know, there’s literally nothing out there. So I developed essentially a model like an eating with a DHD model. And over the last several years that has grown into this group membership. So it’s a monthly membership, people pay a monthly fee. We try and keep it really, really affordable to increase access. So anywhere in the world, anyone the world can join. And it’s workshops and it’s a private community, and it’s coaching with myself and the other dietician who works for me, Sarah, and body doubling sessions so people can show up and do their dishes every other week. So it’s a bunch of resources, but it’s also community and connection.
(38:55):
And we have guest experts who focus on different A DHD skills, and then we do workshops on things that are related to intuitive eating, that sort of stuff. So that’s a paid community. But then we also have a Facebook group, intuitive Eating with A DHD that’s free. Anyone can join, and there are some incredible conversations going on. There’s also a lot of colleagues and providers who are part of the group who identify as having a DHD. So there’s just a lot of support, there’s a lot of wisdom, a lot of expertise. So that is a really great free resource. There are quite a few eating disorder support groups for folks with a DH adhd. And if you go to my website and look at the resources page, I have some of those listed, and they range from free to free to paid. Those are kind of the best places to start. And on the resource list, they have book recommendations, podcasts, that sort of stuff as well.
Julie Church (39:52):
Oh, good. Okay. I was going to say maybe there hasn’t been anything published yet, but there’s maybe a little bit. Okay.
Aleta Storch (39:58):
Yeah.
Julie Church (39:58):
Okay, that’s great. I’ll make sure to have all of those linked for folks to access. And what else? I guess I am curious, listeners may be kind of sitting here going, gosh, I never thought that maybe this was me. And so any encouragement or next steps that you’d give to somebody that is feeling like maybe that’s what I need to target versus just sort of the same hamster wheel of addressing their eating disorder from the way they have. Maybe I do want to address it from this angle. What would you recommend for their next steps?
Aleta Storch (40:32):
Yeah, so again, if you have resources, if you have access to it, getting assessed and connecting with anti diet, and he providers, so therapist, dietician, you’re really struggling with an eating disorder, checking out opal, I think you all do a really good job of acknowledging neurodivergence and then just learning more about it in general. So like I said, there are books, there are podcasts, there are resources. A lot of them do have a lot of diet culture and fat phobic tones to them. So just being aware of that, being wary, taking what fits, letting go of what doesn’t, and then the community piece. Yeah, I think those are kind of the best places to start.
Julie Church (41:13):
Cool. Thanks. Thank you so much.
Aleta Storch (41:16):
Yeah.
Julie Church (41:16):
There’s one thing that’s sort of lingering for me and I wonder if we could have a quick little bit. I feel like our Fed was mentioned actually, you mentioned it sort of in the very beginning about your own story, and then maybe one other point, but I don’t feel like we, we’ve used the broader term of eating disorders, disordered eating. We haven’t necessarily said anything about arfid. And I would wonder if you could share where does that fit into this whole conversation and fill the listener in on that.
Aleta Storch (41:44):
So arfid, for folks who don’t know, it’s that avoidant restrictive food intake disorder. And so it is a restrictive eating disorder that’s typically not associated with body image concerns, that pursuit of the nisc. And it’s something that we feel a lot of among a DH ADHDers among folks with OCD folks who have autism. And a big part of that is that divergent folks can have this increased sensitivity to stimuli. So different textures, different tastes, different smells, even the way that things look can feel really overwhelming. And there can be this hard stop, nope, not going to eat that. And that can really lead to what would be called picky eating in that term. Again, there’s so much stigma around it. Limited food preferences would maybe be the better way of just driving it. Okay. Okay. So when you have limited food preferences, it’s a lot harder to meet your food needs, but trying to force yourself or force others to eat foods that are in terms of a sensory experience or really overwhelming, that can be traumatizing and can actually lead to more avoidance.
(42:59):
So I like to have clients fill out a food preferences survey where we look at what do you want to try, and then really talk about how do we meet your needs within these differences, and are there maybe foods that you’re avoiding because you imagine that it’s going to have that texture, and that’s where maybe some dental exposure work can come in. And I found that clients tend to be pretty open to that when it’s more experimentation and gathering information rather than you have to be able to eat these things in order to not have an eating disorder. So it’s definitely, it’s a gentle approach. And again, just working with those differences.
Julie Church (43:41):
Great. Thank you. And I know that we have seen more and more individuals coming to seek treatment at Opal with that diagnosis and are just continuing to pivot and change our treatment approach too. Since the needs are different and the structure that what we provide still can really help somebody work regularly on those exposures and trying new things, but also discovering just adequate eating again and bring all their other biological systems back online and allowing for them to really stay in their life, get back into their life. So thanks. Yeah, that is helpful for sure. And I see with so much of our conversation today will likely be a DHD or has been the conversation around A DHD, but I think the overlap with a I and autism or ARFID and OCD, obsessive Compulsive Disorder is also a whole nother conversation. So maybe that’s another podcast coming.
Aleta Storch (44:34):
Yeah, yeah. And like you said, there is so much overlap too. A lot of the things we talked about definitely apply to those other forms of neurodivergence, and there’s a lot of differences.
Julie Church (44:45):
Well, thank you so much for being here, and we’ll make sure to have all the ways that our listeners can get in touch with you too. And thank you listeners for being here. And thank you also to Jack Straw Cultural Center for our sound engineering. David Bazzi for our editing, and Aaron Davidson for original music. Until next time, have a good one. Have.
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