Check, check, check, check, check. I stand far away now.
Check, check, check, check, check.
Hello!
How is it going?
I feel like I ask that every time.
How's it going?
My name is Kenna.
I'm Koelle.
That was a baby dip.
And welcome back to another episode of Diagnosing a Killer, the mental breakdown edition.
So content warning, just before we do start this episode, I wanted to make sure that everyone
was aware this episode includes a lot of talk about eating disorders and signs and symptoms,
as well as treatment options for that.
If that is something that is a sensitive topic for you or someone that you know,
we encourage you to listen to one of our other mental breakdowns.
And we have also included the number for a helpline you can call or text in the show notes
if you want to utilize that resource as well.
Thank you for joining us and we will see you in our next episode.
I have a one that I didn't even think was.
I feel like I can't hear myself at all.
Really?
Is this better?
I don't know.
I think this is better.
Does it?
I think it's better.
Do you think that maybe like because you're on one side of the microphone,
you're hearing like the left or the right?
I don't know.
And then you know, vice versa?
I don't know.
We still haven't figured this shit out.
It's like how many episodes?
One microphone.
How long?
We've been doing this for like a year and a half now.
We still can't figure out how the fuck to make our microphone not sound weird.
Well, it sounds fine every time we post it,
but when we're actually recording and listening to it, it sounds weird.
I feel like I was a little quiet on last time.
Yeah.
Was it the mental breakdown?
I think one of them I sounded a little quiet.
Oh, I never realized when it sounds differently.
When I've ever it's posted, but I'm pretty noticed when we're actually recording.
I'm pretty sure we recorded those episodes together though.
So it was like, did we?
Or were they different days?
No, that was the same day, the last two mental breakdowns we recorded on the same day.
Yeah, but the case, because it sounded different than the case,
because I listened to the case.
Oh, that was a different day.
Yeah, the Gary, I was going to say Gary Sinise.
No, not Gary Sinise.
Gary Ridgway.
Yeah, Gary Ridgway.
Yes.
Who is it?
It's your son.
I just wanted to tell you something.
What's up?
I need to change the calendar to February.
February.
Okay, go ahead and do that on your own.
Okay.
Love you.
See you in a little bit.
We'll go back down really quickly.
This is going to be a short one.
Yeah.
Okay.
Yeah.
I'll be right back.
Okay.
Okay, back to the episode.
We do this thing where we don't,
like if something happens outside of us recording,
we don't like stop the recording.
We just let it go and then I'll just edit it out later.
Yeah.
Yeah, that was a real raw footage that I just heard.
But yeah, I hope everyone liked the Gary Ridgway episode.
I was really excited about that one.
It was a lot, but I think that we got a lot of really good
positive feedback from it.
A lot of Instagram messages and stuff.
So that was really great.
We're getting up there.
We have like a little over 300 followers on Instagram.
Yay.
I was like, that's pretty cool.
And that's why it sounds so quiet.
Yeah.
The computer was turned on.
So yeah, that's pretty cool.
And I'm looking forward to continuing to put content out for you guys.
I have another Instagram post comment I'd like to read.
I'm reading off of the Instagram post comments
because no one's emailing us.
So email us.
Email.
Use the email.
So on the Gary Ridgway episode, we posted on Instagram,
someone commented, new fan of the podcast,
such an informative episode.
I actually got a chance to speak with the FBI
profiler, Mario Tool, that spoke to Ridgway herself
to try to get him to confess.
Amazing work.
Keep the cases coming.
So that's really, really interesting.
That's awesome.
Yeah, we're able to...
I was like, DMS, give us all that info.
Like we want to know.
So if you're listening, go ahead and DMS if you want.
I want to hear all about the conversation that you had with her.
If anybody else out there has an interesting
perspective from a case, or if you were closely related to a case,
or you know of a case, or you know somebody who knows a case,
email us.
Yeah, let us know.
Give us that information.
I'd like to maybe do an episode or two where we comment on people's emails
and stuff and we read them and we kind of just go through personal stories.
Like that would be cool.
That would be cool.
Just personal brushes with anybody that has come in contact with any of these cases.
So that being said, this is a mental breakdown episode,
so we're going to talk about a mental breakdown.
And I chose actually this week to do eating disorders as my mental breakdown.
So when I was thinking about it, I was like, you know, eating of course is in the name.
But actually eating disorders are in the DSM-5 and they are considered mental health conditions.
So in the United States alone, there's an estimated 28 million Americans that have reported to have
or have had an eating disorder at some point in their life.
There is treatment for things like this as well.
So this is have or have had people that have sought treatment and stuff like that.
And of course age range is a thing as well when it comes into this.
We are going to talk about the six most common eating disorders.
Okay.
Just as just straight out of the DSM.
Eating disorders are a range of psychological conditions that cause unhealthy eating habits to develop.
They might start with an obsession with food, body weight, or body shape.
In severe cases, eating disorders can cause serious health consequences
and even may result in death if left untreated.
I know.
That's scary.
I know.
That's scary.
In fact, eating disorders are among the deadliest mental illnesses second to opioid use.
I believe it.
Yeah.
I'm pretty good.
That was or opioid overdose.
Corrected.
Correction.
But yeah, I saw that and I was like, dang, that's really prevalent.
Like I didn't realize how much it affects, you know, a lot of people, especially women.
Then I'm sure in America, which I'm sure you're going to get to all those statistics as well.
Now, experts believe that a variety of factors may contribute to eating disorders,
one being genetics, actually.
So people who have like a sibling or a parent with an eating disorder actually seemed to be at increased risk to developing one themselves.
Interesting.
Because of course you relate closely with those people in your life.
Yeah.
Personality traits are another factor.
A couple of things that are often linked to a higher risk of developing an eating disorder are neuroticism, perfectionism, and impulsivity.
You know, I don't think it's Scott Peterson, but there's another, maybe it was Chris Watts that struggled with eating disorders.
Oh really?
Like a male who was narcissistic.
Yeah, I thought it was Raymond Fernandez.
I don't know if I knew anything about him being a...
Oh, I just know he's like all about image and stuff like he was, so maybe that's why I was...
Yeah, he did wear a toupee.
Well, I don't know.
It's not the same.
It's not the same thing. I'm not saying.
Your eye roll was really distinct.
Yeah, but I just, I know that he was very thin, but that probably doesn't have to do with an eating disorder.
It mostly had to do with like his hermitism.
Like he was like a hermit in the house and stuff.
Yeah, but I'm pretty sure it was either, like I said, Scott Peterson or Chris Watts or one of those guys who was like the ultimate narcissist.
Yeah.
And he struggled with an eating disorder.
Yeah, I believe it, honestly.
Now, other potential causes, I'm sure that this is kind of a given is exposure to like social media or promoting ideas that you have to look a certain way.
Even cultural ideas are also included in that, which is, I didn't, I was surprised to read that.
So preference for thinness or, you know, preferences for being, you know, heavier, because in some cultures,
if you are heavier, then that means that you're wealthy, because you can afford to.
Right, you're wealthier, you're healthier, you can provide.
Yeah, exactly.
Also, more recently, experts have proposed that differences in brain structure and biology may also play a role in the development of eating disorders,
which I thought that was interesting.
This being the case, levels of the brain messaging chemicals like serotonin and dopamine maybe factors as well.
This is just new studies that they're trying to like that you get like dopamine from overeating, like eating in abundance.
Like you get the, yeah, you get that reaction.
Interesting.
So the first type of eating disorder that I would like to speak on is anorexia nervosa.
This is likely the most well-known eating disorder.
It generally develops during adolescence or young adulthood, and it tends to affect more women than men.
People with anorexia generally view themselves as overweight, even though they are usually underweight.
They tend to constantly monitor their weight and avoid eating certain types of food, severely restricting calorie intake in some instances as well.
Common symptoms include a very restricted eating pattern, an intense fear of gaining weight or persistent behaviors to avoid gaining weight,
a relentless pursuit of fitness and unwillingness to maintain a healthy weight,
a distorted body image including denial of being seriously underweight, and a heavy influence of body weight or perceived body shape on self-esteem.
Again, this is all straight out of the DSM.
Assessive compulsive symptoms are also present in people that have anorexia nervosa. For instance, many people are preoccupied with constant thoughts about food,
and some may obsessively collect recipes or even hoard food.
Interesting.
I didn't know that. I thought that was interesting.
I find that, yeah, especially the hoarding food, I find that interesting.
Yeah.
But is it just like, I'm going to eat it later? More like, hanging on to leftovers too long?
Yeah, maybe. Or, I mean, I'll get into the different types actually.
So it's officially categorized into two subtypes, the restricting type and then the binge eating and purging type.
Okay.
Individuals with restricting type lose weight solely through dieting, fasting, or extensive exercise,
and individuals with the binge eating and purging type may binge on large amounts of food or eat very little.
So it's both, kind of.
So that would, may explain the hoarding because they're going to, in the privacy of wherever, you know, consume a large amount of food.
Yeah, OICIC, okay.
In both cases, after they eat, they purge using activities such as vomiting, taking laxatives, or diuretics, or excessively exercising.
It can be very damaging to the body, of course.
And over time, individuals living with anorexia nervosa may experience thinning of their bones,
infertility, and brittle hair and nails.
In severe cases, it can result in heart, brain, or multi-organ failure and death.
Oh my gosh.
I know, it's a lot. It's really hard to listen to and it's really serious, you know.
That was number one.
We're going to move on to number two.
So number two is bulimia nervosa.
I'm sure this is the most common heard one as well.
Like anorexia, bulimia tends to develop during adolescence and early adulthood and appears to be less common among men than women.
People with bulimia frequently eat unusually large amounts of food in a specific period of time.
Each binge eating episode usually continues until the person becomes painfully full.
Now this is not every case, of course, but...
on average.
During a binge, the person usually feels like they cannot stop eating or control how much they are eating.
Now, binges can happen with any type of food, but most commonly occur with foods that the individual would usually avoid.
So almost like sweets or guilt, maybe like a cheat day food or something like that.
Yeah, like fast food or...
Okay.
Now, individuals with bulimia then attempt to purge, to compensate for the calories consumed and to relieve the discomfort in their stomach.
Common purging behaviors include forced vomiting, fast acting laxatives, diuretics, enemas, and even excessive exercise, like I said earlier.
Symptoms may appear very similar to those of the binge eating or purging subtypes of anorexia nervosa.
However, individuals with bulimia usually maintain a relatively typical weight rather than losing a large amount of weight.
So, is it... do you think that it's more of the satisfaction of eating the foods that they prefer?
The satisfaction of eating the foods that they feel guilty about consuming?
Yeah, I think it's...
It's not necessarily like about like a body dysmorphic situation.
Yeah, I think it's... I think it almost comes with like the guilt of eating so much or eating the food that you would typically avoid, like it said.
So that's where the purging comes in.
It's because, oh crap, like what have I done kind of.
Now, common symptoms of bulimia nervosa include recurrent episodes of binge eating with a feeling of lack of control,
self-esteem overly influenced by body shape and weight, a fear of gaining weight despite having a typical weight,
and recurrent episodes of inappropriate purging behaviors to prevent weight gain.
Now, side effects of bulimia may include an inflamed and sore throat, swollen salivary glands,
severe dehydration, irritation of the gut, worn tooth enamel, tooth decay, acid reflux, and hormonal disturbances.
And it makes sense with the...
Yeah, right.
Yeah.
Well, that could eventually lead to like esophageal cancer.
It really can.
With all of that acid.
Yeah.
In severe cases, bulimia can also create an imbalance in levels of electrolytes such as sodium, potassium, and calcium,
which can actually cause a stroke or a heart attack.
So it messes up your balance, like your chemical balance in your body.
Now, that is number two.
Number two.
Number three is binge eating disorder.
So kind of similar, but not the same thing as bulimia nervosa.
This is actually the most prevalent form of eating disorder and one of the most common chronic illnesses among adolescents.
Interesting.
It typically begins during adolescence and early adulthood, although it can develop later on.
Individuals at this disorder have symptoms similar to those of bulimia, again, or the binge eating type of anorexia.
So for instance, they typically eat unusually large amounts of food in relatively short periods of time and feel a lack of control, similarly to bulimia.
But people with binge eating disorder do not restrict calories or use purging behaviors such as vomiting or excessive exercise to compensate.
So common symptoms of this disorder include eating large amounts of food rapidly in secret and until uncomfortably full, despite not feeling hungry.
No use of purging behaviors such as calorie restriction.
Feeling a lack of control during episodes of binge eating and feelings of distress such as shame, disgust, or guilt when thinking about the behavior.
So again, similar to bulimia, but there's no purging at the end.
People with binge eating disorder often consume an excessive amount of food and may not make nutritious food choices.
This may increase their risk of medical complications such as heart disease, stroke, and type two diabetes.
Now, number four.
Number four is called pica.
Oh, pica.
You've heard of pica.
Interesting.
So pica is an eating disorder that involves eating things that are not considered food and do not provide nutritional value.
Like tum tum from Green Nenjas.
True.
Individuals with pica crave non-food substances such as ice, dirt.
Ice is food according to the FDA, by the way.
It's ice.
But I guess it's like all you consume.
That's true.
That's very unhealthy.
But literally, the FDA has the slogan like ice is food or whatever.
Ice is food.
Because it has to go through certain health requirements before it gets processed or whatever.
Oh, I see.
Sorry, did you just explain to me what the FDA was?
No, they're saying that there wasn't proper regulations going into the way ice is being transmitted.
Oh, I see.
So they started putting it on ice.
I see.
Rather than just food.
They were like, ice is food.
Ice is food.
They treated it the same.
Okay, fair.
Fair.
I was like, did you just woman-splain the FDA to me?
No, I didn't.
So individuals with pica crave non-food substances such as ice, dirt, soil, chalk, soap, paper,
hair, cloth, wool, pebbles, laundry detergent, or cornstarch.
Those are the most common.
I know.
That was a long list of things that were definitely not food.
Yeah.
Pica can occur in adults, children, and adolescents.
It's most frequently seen in individuals with conditions that affect daily functioning,
including intellectual disabilities, developmental conditions such as autism spectrum disorder,
and mental health conditions such as schizophrenia.
Interesting.
Yeah, I thought that was interesting as well when I read it.
Now, individuals with pica may be at increased risk of poisoning, infections, gut injuries,
and nutritional deficiencies.
Yeah, I bet you're going to the hospital regularly.
Yeah, absolutely.
That's got to be scary too if someone in your family is dealing with that.
Because how do you maintain, how do you constantly watch someone to make sure that they're not
eating 24-7 you'd have to?
They're close.
Yeah.
Depending on the substances ingested, pica may be fatal.
However, for the condition to be considered pica, the eating of non-food substances
must not be a typical part of someone's culture or religion.
In addition, it must not be considered a socially acceptable practice by a person's peers.
Like if it's a cool thing to do, then it's not pica.
It's just like the tide pods.
Oh my gosh.
Yeah.
Number five.
I like how the DSM-5 was like, but the tide pods are fine.
Yeah.
As long as there's a revolution happening.
As long as your friends think you're cool.
As long as it's for awareness.
As long as it's for the gram.
As long as it's for the gram, for the tiktok.
Now, number five is rumination disorder.
I've actually never heard of this before.
Rumination disorder.
That sounds very familiar.
I don't know why though.
Yeah.
Content warning.
This is a little hard to hear.
Describes a condition in which a person regurgitates food that they have previously chewed and
swallowed, then re-choose it and then either re-swallows it or spits it out.
Like a baby bird.
It's baby bird syndrome.
Baby bird syndrome.
Is it?
Is it the nickname?
No.
Probably.
Baby bird syndrome.
I mean, it could be probably nicknamed baby bird syndrome, obviously.
Yeah.
I wouldn't, I wouldn't.
Oh, that did things to my stomach.
I know.
Now, this rumination typically occurs within the first 30 minutes after a meal.
It's not that they're chewing it and then spitting it out and then chewing it again and then
swallowing it.
It's they're swallowing it and then regurgitating it.
Yeah.
And then eating it.
Yeah, that's such a sensitive stomach.
Sorry.
I'll have to repeat that to you.
I just wanted to make sure I got it.
Yeah.
Because like, that's intense.
Yeah, no, for sure.
This disorder can develop during infancy, childhood or adulthood.
In infants, it tends to develop between three to 12 months of age and often disappears on
its own.
They're just figuring out how to chew and swallow and then, you know, keep it down.
Asofa guys are just so tiny because like with my son, I remember he had this kind of terrible
cough and I had just got done feeding him.
I was either about to get in the shower or had just gotten out of the shower.
I couldn't remember, but I remember standing.
I was standing close to the bathroom and he coughed.
I mean, when he coughed, he just threw all of his milk like in my mouth, like all down
my shirt, like everything.
And I was like, oh my gosh, well, it happened like three times when he had this cough.
Me and Justin took him to the pediatrician and the doctor was like, no, it's very common
in babies that they spit up or they, because they're esophagus.
They're so, so small.
So it's male.
So I'm interested that I'm not interested, but that is interesting that it can occur
between six to 12 months, he said.
Three to 12 months.
Yeah.
So and then it usually disappears.
So what I was going to say next is that children and adults with the condition actually usually
require therapy to resolve it.
Interesting.
So it's not resolved in infants on its own.
Rumination disorder can result in weight loss and severe malnutrition that can be fatal.
I'm assuming because maybe when your food is chewed to a point of kind of mush, it kind
of gets rid of some of the nutrition or it gets chewed and then splow rather than ingested.
Rather than ingested completely.
Yeah.
Adults with this disorder may restrict the amount of food that they eat, especially in
public.
This may lead them to lose weight and become underweight.
When your body processes food that is like whole foods, you're actually burning more
calories than if you were to just juice all your vegetables and fruit and stuff.
So that kind of makes more sense.
Yeah.
That maybe like they're still losing a lot of weight because their body is not working
to breaking that food down.
It's already broken down.
Yeah, definitely.
Now, number six is avoidant slash restrictive food intake disorder or ARFID.
The term has replaced the term feeding disorder of infancy and early childhood.
So a little bit of a shorter name.
Yeah, feeding disorder is a little.
Yeah.
This was a diagnosis previously reserved for children under age seven.
It's no longer a correct diagnosis.
Individuals with this disorder experience disturbed eating due to either lack of interest in eating
or a distaste for certain smells, tastes, colors, textures or temperatures.
Common symptoms of ARFID include avoidance or restriction of food intake that prevents
the person from eating enough calories or nutrients, weight loss or poor development for heightened
age, eating habits that interfere with typical social functions such as eating with others,
and nutritional deficiencies or dependence on substances or supplements or tube feeding.
It's important to note that ARFID goes beyond common behaviors such as like being a picky
eater or toddlers and lower food intake, you know, because they don't eat as much.
Moreover, it does not include the avoidance or restriction of foods due to lack of availability
or religious or cultural practices.
So it's a really specific disorder.
So I just peppered two in here.
I don't have a lot of info on them, but.
I'm allergic to pepper.
Yeah.
So number seven is purging disorder.
Individuals with purging disorder often use purging behaviors like I said earlier.
However, they do not binge eat.
So it's a little opposite of binge eating disorder.
Oh, so it's without the binge.
Okay.
Without the binge, just purge.
Yes.
And then number eight is night eating syndrome.
Of course, it is what it sounds like.
Individuals with this syndrome frequently eat excessively at night, often after waking from
sleep.
Like you just get up and you go down.
It's like a midnight snack to the extreme.
She eat a lot.
I actually heard some interviews of people that had night eating syndrome and they, the
person in the specific interview that I listened to was like so upset because she was gaining
all this weight and she wasn't even realized that she was doing it because she was like
sleep eating.
Sleep eating.
Yeah.
Like she wasn't even aware of how much she was eating like at night and she's like, I
don't even remember doing this and now I'm like gaining all this weight because I'm eating
so much at night.
That's so interesting.
Yeah.
Cause you usually think that it's going to be like sleepwalking, like talking and maybe
like sleep, sleep eating might be in there with sleepwalking somewhere.
Yeah.
But that's interesting that it's like a separate diagnosis.
Eating disorder treatment plans are specifically tailored to each person and may include a combination
of multiple therapies.
Treatment will usually involve talk therapy as well as regular health checks with a physician.
Now it's important to seek treatment early for eating disorders as the risk of medical
complications and actually suicide are very high in comorbidity.
Yeah.
The comorbidity drug abuse, right?
Yeah.
I'm sure it's on there or drug usage rather.
Yeah.
So I have a list of comorbidities, but I guarantee that's on there.
Now treatment options include individual group or family psychotherapy.
This is also cognitive behavioral therapy.
This may be recommended to help reduce or eliminate disordered behaviors such as binge eating,
purging and restricting.
CBT involves learning on how to recognize and change distorted or unhelpful thought patterns.
Now medications can also be treatment.
A doctor may recommend treatment with medications such as antidepressants, antipsychotics or
mood stabilizers to help treat an eating disorder or other conditions that may occur at the
same time such as depression or anxiety.
Again, comorbidity.
And lastly, nutritional counseling is actually common treatment.
This involves working with a dietician to learn proper nutrition and eating habits.
It may also involve restoring or managing a person's weight if they have experienced
significant weight changes.
Studies suggest that combining nutritional therapy with cognitive therapy may significantly
improve treatment outcomes.
Now that's all I have.
I wanted to include as well.
If you or someone that you know is struggling or potentially struggling with an eating disorder,
you can contact the National Eating Disorder Association Helpline for support, resources,
and treatment options for yourself or someone that you know.
To contact, you call 1-800-931-2237 and you can actually text that number as well.
Yeah, that was my mental breakdown.
Thank you for bringing that.
That does take a lot of courage to bring a topic like this just because it is a sensitive
topic for a lot of people.
And again, with the comorbidity, like you said, it can also be accompanied with drug usage
and stuff like that.
So sometimes when you see someone that might be struggling with drug abuse or drug addiction,
drug usage, there might be something underlying there as well that they're also trying to
treat through that usage.
And so of course, we would rather you reach out to the hotline, the helpline, or seek
treatment for that versus potentially damaging your body further, especially if you're not
getting the nutrients that you require or if you have things like from overeating, like
having high blood pressure and things like that as well, that can also just compound.
So yeah, first you'll reach out to that helpline.
But thank you for bringing the topic because I feel like it's really tough to talk about.
I feel like it's an interesting thing to talk about.
And I feel like there's not a whole lot of awareness around it either.
I feel like people are more willing to judge based off of someone's look than actually
question whether or not they have a disorder.
Of course.
And like, yeah, you're right.
Like it's definitely a different topic than we've brought in the past.
And it was something that I was a little, you know, nervous to bring, but I'm nervous in
the best way because I want to raise awareness, you know, as well.
But I definitely don't want to upset or offend anybody.
But yeah, that was what I brought for today.
We will be back with another case pretty soon and then another mental breakdown as well.
Hope you guys enjoyed this episode and we will talk to you later.
Yeah.
Okay.
Love you.
Bye.