Sober and Healthy – Interview with Nutritionist Lisa Licavoli

Recently, we sat down with Nutritionist Lisa Licavoli to ask her opinion on how nutrition, eating disorders, and addiction recovery go hand-in-hand. She has years of experience, a wealth of knowledge and expertise. Eating disorders are a real problem that persists today and no one in the nutrition space is more informed on treating and understanding the plights of these diseases than Lisa.

How did you begin getting involved in nutrition? What made you want to help people change the way they feel about their bodies?

Tami Brannon-Quan, Ph.D. and I were discussing what we thought were blocks to recovering from an eating disorder and we both agreed that a poor body image was a major impediment to recovery. When a person hates their body they suffer the consequence of low self-esteem, reduced confidence and even isolation, which keeps them trapped in their eating disorder and holding onto the false truth that “being thin enough is the only way to feel good about oneself”.

How would you describe your treatment style?

I treat each client as an individual. Some may need more nurturing and to be listened to, while others need facts and to be pushed. It may change over the course of treatment. Trying to help someone heal their relationship with food is a tough job so humor can help connect with clients and build the trust necessary to help them normalize their relationship with food & their body.

What is the correlation between substance abuse and eating disorders?

There is a big overlap between eating disorders and substance abuse, with some distinctions. Both misuse substances to the detriment of the person’s health and lifestyle. Food has been shown to affect neurotransmitters in the same way as drugs do. For example, sugar raises both dopamine and serotonin. For some people, this may be a pleasant experience but for others, it leaves them wanting more and more, as in the addiction to drugs & alcohol. There are some people who are considered “normies” who can eat part of a cookie or drink part of a glass of wine, feel satisfied, and leave the rest behind. When a person has an addictive brain they are wired to want more.

What causes an eating disorder?

It is complicated and differs for each individual. The research seems to point toward both nature (genetics) and nurture (the environment). Temperament is a big factor. Many of my clients feel like they were born with an eating disorder. They feel bad about their bodies from a very young age. For example, a parent can say something about their kids’ looks or what they are wearing (nothing mean or over-the-top) but only one will remember it and be affected by it. The critical self that is waiting for validation is already alive and well in the one person who goes on to have an eating disorder while the other siblings are unaffected. Media plays a part of course, but eating disorders have been documented pre-media. I also think our dysfunctional food system plays a part. Why is there 50 different types of potato chips available – to name just one item – and yet we are supposed to eat balanced meals in moderation? It seems like a trap. The amount of highly palatable foods available to humankind is dramatically different than it was even 25 years ago. Those foods are the ones usually eaten addictively. The pressure to be perfect has increased dramatically, including what we look like. As a society, we have set unattainable goals for appearance and weight for many people. Bone structure is a given and cannot be changed, muscle mass is somewhat predetermined as well. Many people resort to controlling their food or using food for comfort under negative circumstances.

How can I best help someone who has been diagnosed with an eating disorder, who is also going through substance abuse addiction?

Be supportive and nonjudgmental.  If a person is not ready to deal with their issues, whatever they may be, they may be angry that you said something to them. Don’t take it personally. You might suggest attending a free support group in the area, or online, or perhaps buying a workbook. There are several websites that are ED-focused with information, tips, and referrals. Individual work is a good fit for most people. They may reach out first to a therapist or nutritionist that specializes in eating disorders AND substance abuse treatment.  If it is determined they need more treatment they may benefit from an IOP, PHP or In-patient treatment.

Other than younger women, are there other groups of people that are more often affected by eating disorders?

Older women are a fast growing group with eating disorders. Going through menopause brings many body changes. Our society is reluctant to accept the aging body and when internalized, can lead to an eating disorder. Men are often overlooked. They, too, have eating disorders. Also, there is a higher than average incidence of eating disorders in the LBGTQ population. And don’t forget women in recovery. Many women in treatment for substance abuse have co-occurring eating disorders.

What is the difference between overeating on occasion, food addiction, and binge eating disorders?

Overeating on occasion is normal and even hard wired. If our early ancestors had access to the food they ate it. It’s when the amount and frequency get out of hand that a problem ensues.  Food addiction and binge eating disorder are often used interchangeably.  People with these issues have little control over food and overeat large amounts, followed by regret and shame.  Highly palatable foods are usually overeaten because they affect the neurotransmitters which cause a pleasurable reaction.

What are the biggest misconceptions about eating disorders?

They are not about vanity and superficial looks. These are deadly diseases that cause great suffering to those who have them. Anorexia nervosa has the number one fatality rate of any mental health disorder. The obesity epidemic in America, which is related to food addiction/binge eating disorder, is the cause of many major illnesses.

Lisa Licavoli, RD, CCN