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If you live in a larger body, you know the daily assault of messages telling you that you're fundamentally flawed. Airplane seats become sources of shame, doctors dismiss your concerns with weight-loss lectures, and the constant judgment runs so deep that you start abandoning your own needs—convinced it's all your fault.

But what if the real problem isn't your body at all, but a system designed to profit from your self-hatred?

Recently, I sat down with psychotherapist Kacee Markarian to explore how we can care for our health without sacrificing our dignity or beliefs. Our conversation revealed powerful insights about ADHD-binge eating connections, the art of creating "thought boundaries," and what it truly means to reclaim your relationship with yourself—no shrinking required.

This work isn't about becoming a better version of yourself. It's about discovering that you were never broken to begin with.

The Real Problem Isn't Your Body

Let's start with something that I need you to hear: when you can't fit in an airplane seat, that's not a "you" problem. It's a design problem. Airlines chose to make seats smaller. They could have made them bigger, but they decided profits mattered more than human comfort.

The same goes for clothing that doesn't fit right, medical equipment that wasn't designed for larger bodies, or doctors who blame everything on your weight. These aren't personal failings—they're systemic failures. But it's easier to believe something is wrong with you than to accept that the people and systems around you simply weren't thinking about your body when they made their decisions.

This was a central theme in my conversation with Kacee—recognizing that we're living in a world that wasn't built with all bodies in mind. This is where internalized shame gets its grip. We start believing we're the problem instead of seeing these experiences through the lens of disability justice and accessibility.

Understanding the Real Drivers Behind Food Struggles

If you've ever found yourself in what feels like a "food trance"—eating without really choosing to, then drowning in shame afterward—you're not alone. And more importantly, you're not weak or lacking willpower.

What most people don't realize is that binge eating often has nothing to do with food at all. This is where Kacee's expertise really shines—she specializes in the connection between ADHD and binge eating disorder. It's frequently connected to dopamine dysfunction. When your nervous system is dysregulated, food becomes a way to self-soothe. It's actually an intelligent response your brain developed to cope with feelings you didn't have words for.

Think about it: before we had language, when babies cried, we fed them. Food has always been comfort, connection, and regulation. When you're "mining for dopamine" through food—a phrase Kacee uses on her website—you're trying to meet a legitimate need, just not necessarily hunger.

Kacee described this beautifully as "feeding a hungry ghost"—we're haunted by feelings we can't name, and food becomes the way we try to soothe a dysregulated nervous system. The problem comes when we layer shame on top of this completely understandable biological response. Instead of recognizing it as nervous system regulation, we make it mean something about our character or willpower.

The Power of Thought Boundaries

One of the most practical tools Kacee shared was the concept of "thought boundaries." Just like you might be picky about the clothes you wear, you can be selective about the thoughts you entertain.

Here's how to create a thought boundary:

• When a negative thought pops up, pause and ask: "Is this actually what I believe?"
• Follow up with: "Where did I get this information?"
• Ask yourself: "Is thinking this thought harmful to me or others?"
• Remember: "Because I do" is not a valid answer—dig deeper into the source

Simple phrases that work:

• "We don't do that anymore"
• "That's not helpful right now"
• "I'm not entertaining that thought"

What struck me about Kacee's approach is that the goal isn't to never have negative thoughts—it's to catch them quickly and choose not to engage. She emphasized that we can use "we" because it represents all the different parts of ourselves internally, making the boundary feel more collaborative than combative.

Adorning Your Vessel

Instead of trying to shrink your body, what if you focused on adorning it? This was one of Kacee's most powerful reframes during our conversation—shifting from hiding your body to celebrating it through how you dress and treat yourself.

This means getting rid of clothes that don't fit and don't make you feel good (yes, even if they're smaller sizes you're "hoping to fit into again"). Those clothes aren't motivation; they're daily reminders that you're supposedly not good enough as you are right now.

Practical steps for adorning your vessel:

• Throw out clothes that don't fit your current body (don't donate them to torture yourself later)
• Invest in at least a few pieces that make you feel good right now
• Look for size-inclusive brands and smaller designers who create for your body
• Remember: styles change anyway—you won't want those old clothes back
• Apply the same pickiness to your thoughts as you do to your clothing

Kacee emphasized that this principle applies to your mind too. Just as you wouldn't wear clothes that constantly pinch and bind, you don't have to accept thoughts that constantly criticize and diminish you. The selectivity you use in choosing clothing that makes you feel good? That's the same energy you can bring to choosing which thoughts deserve your attention.

Navigating Health Without Shame

Here's where Kacee's perspective really challenged traditional thinking. You can absolutely care about your health while rejecting the idea that your body is wrong. The key is focusing on what's actually under your control and what serves your wellbeing, rather than pursuing thinness as a goal.

Questions to guide health decisions:

• Am I doing this to care for my body or to punish it?
• Is my intention about health or about achieving a certain size?
• Am I treating a specific condition or chasing an ideal?
• Would I make this same choice if weight loss wasn't a factor?

Kacee shared insights about people in the fat liberation community navigating medical treatment, particularly around medications like GLP-1s. The key distinction she made was understanding that these can be anti-inflammatory medications rather than simply "weight loss drugs"—and that caring for a specific health condition doesn't have to compromise your values around body acceptance.

If you have a health condition that requires attention, whether it's fatty liver disease, diabetes, or anything else, you can address it without making it about your worth as a person. You can take medication, make dietary changes, or work with healthcare providers while maintaining your dignity and refusing to accept shame-based treatment.

Protecting Your Mental Health in a Fatphobic World

Even when you do this work, you're still going to encounter fatphobia. People are still going to make comments, doctors might still be dismissive, and airplane seats still won't fit. The goal isn't to eliminate these experiences but to change your relationship with them.

One of Kacee's most profound insights was that "people can only meet you as deeply as they meet themselves." When someone gives you judgment about your body, it reflects their relationship with their own body, not your worth.

Strategies for daily protection:

• Remember: people can only meet you as deeply as they meet themselves
• Their judgment reflects their relationship with their own body, not your worth
• Think of fatphobia as a societal illness, not a personal failing
• Build a strong support network of people who see your full humanity
• Practice the "force field" mentality—deflect harmful comments before they stick

Kacee also emphasized the importance of not commenting on anyone's body—including compliments. There's no winning when it comes to body comments, and if someone lives for the high of positive comments, they'll suffer when they don't receive them.

Starting Where You Are

If this all feels overwhelming, start small. You don't have to revolutionize your entire relationship with your body overnight.

Pick one area to focus on:

• Clean out clothes that don't fit your current body
• Practice the "we don't do that anymore" boundary with negative self-talk
• Find one size-inclusive clothing brand to try
• Write down where your negative body beliefs actually came from
• Stop commenting on other people's bodies (including your own)

The most important thing to understand is that this work is ongoing. You're not trying to reach some finish line where you never have another negative thought about your body. You're building skills to navigate a world that constantly sends harmful messages, while staying connected to your own truth.

Your body isn't a project to be completed or a problem to be solved. It's the vessel that carries you through your life, and it deserves to be treated with respect—starting with how you treat it yourself.

The revolution starts with refusing to hate yourself in a world that profits from your self-doubt. And that's not selfish or indulgent—it's the most radical thing you can do.

Want to learn more about Kacee's work on ADHD, binge eating, and fat liberation? Visit her website here: https://www.dopaminingdemystified.com/ 

TRANSCRIPT:

Disclaimer: The transcript below is provided for your convenience and may contain typos, errors, or grammatical inconsistencies, as it has not been professionally edited or proofread. Please enjoy it as-is and read at your own discretion.

Please note: The content shared in this podcast and blog post is for informational and educational purposes only and is not intended as medical advice. Always consult your healthcare provider for personalized medical guidance. 

 Welcome back to another episode of the podcast. I'm so excited that we brought back today literally for the most amazing topic in the world. Casey Markarian, again, she was on the podcast a few weeks ago when you're listening right now. The reason I brought her back is because we couldn't talk about everything.

We had so much to go over. I'm gonna have Casey introduce herself again, just in case you are new to the podcast and just catching us right now. But look in the show notes. Make sure that you catch up on those episodes as well, where she's been on before. But today we're gonna focus a little bit more on binge eating Disorder and attention deficit and some of the relationships and how it relates to dopamine, and it's just fascinating her work.

So Casey, can you start out with introducing yourself just so that people know a little bit more about you. Yeah. Thank you so much for having me. I'm Casey Markarian. I'm a marriage and family therapist in Oregon and California private practice for the last 15 years, and I am doing consultation worldwide for my favorite topic, which is the correlation between A DHD and binge eating disorder.

And it's been really interesting in my practice because I am lifelong fat liberationist. Yeah, and I was noticing how often it was coming in and I see people in my practice who are fat liberationists, who are like, okay I think I have a DH adhd. Oh, I am wondering if that has something to do with the binge eating.

Oh, I'm getting diagnosed at GLP one for some reason or another, or I'm talking about getting put on some kind of stimulant. It's been really amazing to see the evolution in my work. Yeah. Oh, that's incredible. Okay, so one place I wanna start with you is that everybody I feel defines a little bit differently binge eating disorder.

And so I'm wondering if you can, not only just the definition, but how do you actually hear people describe it? Because I think you had some really interesting ways of saying, Hey, this is likely when I know someone, they don't even realize it's there, but here's what I hear them saying. Can you give people a little bit of context?

Okay. So if you look at the DSM, which is how we diagnose any kind of disorder, it was written primarily for you to get back to work. So when you look at the definition of binge eating disorder, and I'm gonna, I'm gonna just hyperbolically tell you, it's like you eat a certain amount of food in a certain timeline that is more and quicker than your peer.

Okay. So if you read that kind of definition so often, and I have binge eating disorder, myself included. I was like, oh I don't have that. I know, same. You're like, that is someone else that's like scarfing down food in this period of time. Exactly, exactly. Or, or, or utilizing food in a way that seems to be like harming yourself in some way.

And I was like, wow, that doesn't, I don't really even hear people talk about that so often, you know? Okay. So that's that. Criteria for diagnosis, what binge eating disorder is vast. It's unbelievably large, and it sounds like. What am I going to eat? When am I going eat it? How much am I eating?

How much are you eating? If I eat this, it's not gonna make me full. So what I'm going to eat after that is this. And then after that I'm gonna eat this. It's getting fixated on specific foods and only wanting to eat those foods, but it really is, a haunting by a hungry ghost. It's like internally in your brain.

Food food. All the time. When am I gonna get it? Where am I gonna get it? Where am I gonna get it? How am I gonna feel when I'm eating it, how I'm gonna feel after I ate it? And it really does take up so much room in people's minds, in ways that I don't think. We really understand. I think we're scratching the surface of really how to talk about it, how to get into it.

It is what I notice in my practice. This is a haunting by a hungry ghost. Oh, it's a really good one. Yeah. And I know you've spoken about the lack of control aspect, how it could almost feel like a trance that people described to you. And literally someone just used these words with me in a visit that I feel like I'm in a trance.

Yes. And I was like, ding, ding, ding. So obviously the more we've talked about things, it helps me more in my clinical skills. But are there any, is there any language that people come and, and you're just like, okay, this is always what I hear them say to me? Any specific phrases?

I use food trance often because this is much different than, oh, I'm in the mood to have some delicious something and I, have thought about it for a couple of days. So I wanna, go and get it. It's very different. And all of it can fall under trance. This is like you wake up in the morning and I will hear, hear people say often I have to get X food and I am on a mission to acquire it.

And it doesn't matter if I have appointments, it doesn't matter if I have to go to work. It's like I can force myself to go to work, but I think about it all day long and the minute I'm done with work, I am. I'm driving fast. My heart's, my heart is racing. I'm feeling really almost like an out of control feeling, which is where the trance comes in because there is not a lot of consciousness in the before, the during, and then the after.

It's, and the way people describe it really is I had to do this and I didn't even really realize. Anything about my actions until way after it happened. Yeah. Yeah I think people are really distressed, frankly, when they come in with it and I know it, right? Yeah. And then they keep blaming themselves.

That's why it's such a laughing matter to me when people will be out there that are helping people in certain areas, and they're like, just get all that food out of the house. It's like, are you kidding me? Oh, come on. That is not a barrier. There's a gas station, there's a food store, there's, I mean, come on.

That's just like not the answer, and it's not actually addressing anything, so, okay. Where is the place that people typically need to get to, to even seek out help from you? At what point. Exactly. So I think first of all, we have to really battle and tackle feeling really embarrassed.

So years ago, I'd say the big biggest difference between now and years ago is I would feel pretty sheepish about the topic because I wouldn't want anybody to feel shame or judgment. And also, I really wanna decenter diet culture. Yeah. You and I have laughed about this before, right?

The whole fat bodies are not failed thin bodies. Like that's your statement. And everyone loved it. The internet was just like, who is it? Yeah. Please use it all the time. Yeah. Because none of this is about restriction and none of this is about shrink shrinking one's body, I feel like it's just ultimately if a person is ready and willing to really know that it's not a moral failing mm-hmm.

It's not something that is wrong with them. And this is something we have to keep coming back to over and over again, right? You could know it, 10 minutes ago, and then now it's like, oh, well look, you know, it's really important to know that it is a physiological, it is hormonal.

There's something called satiation hormone. I mean, you talk about this all the time, and I appreciate it so much. It's like people get to a place where they're willing to talk about it. I think once they're willing to acknowledge that they can't blame themselves. Yes. Which is so hard. Yes. Ugh. It's heartbreaking.

Gosh, that's really powerful. And it's so true. Yeah. Back to picking the work and continuing to pick it. You said that to me one time. You're like, 'cause I was like, well, I know it, but then I mean, gosh, why do I keep going back to the, let's just say that diet culture version, right?

Yeah. And you're like, well, you know it, but you have to keep picking the work daily. And I was like, right. Oh yeah. Yeah. In like every moment. I mean, I, I am, I figured this out for our meeting today, I am 982 days binge free today. Wow. That's incredible. Right? But I wanna say, it is not easy. That is something I choose almost in like every breath.

And I know that might sound intense, but if you understand this. It's going to really impact you because that is the truth. No, I literally say this, that, and again, it's really about health. It's like every day I get up and I'm like, I'm gonna pick health. I know it's hard. I'm gonna get the steps. If this is something that is not. Physiologically on your side, I don't know the right words to put to it, but the point is, yes, every day, uh, that's really great. Almost with every breath having to picket, I can really, relate to that, right? And, okay, so let's say that someone, they've gotten to a place where they realize, okay, this is not my shame to own.

This is not my fault. They come in, they get your help. What are things that they need to look out for in order to even be able to get to any kind of place of treatment or help on it? Okay, so I. First of all, I think, okay, and maybe this is a good segue to talk about the A DHD diagnosis.

So A DHD just quickly is basically persistent patterns of inattention, hyperactivity, and impulsivity. And there are so many different versions of this, too many to talk about today. Ultimately, I think the last time, one of my favorite psychiatrists was talking about it, there were seven different types.

So many, right? Everyone really thinks about the little boy running around about that. Yeah. Yeah it's amazing. So I think understanding your mental health picture could be really helpful because while not everyone with binge eating disorder, has a DHD. Often if you have a DHD, you could have binge eating disorder.

And also, dealing with the dopamine deficiency and dysfunction of A DHD can lead to binge eating disorder. I always say is it possible to talk about mental health picture? The other thing is to really try to understand environment, like what's going on. And then I think, number one, what is your relationship with food and this.

This is one of the things I notice people either wanna kind of push themselves to talk about, which I have so much respect for, or you start talking about it and they ghost, they don't wanna talk about it, which I also have so much respect for. It's such a difficult, multifaceted topic. So if you could think about it by way of your behaviors. And this is where not internalizing it comes in. Like not making it about that moral failing, like something is wrong with you because I guarantee you, there is nothing wrong with you. We do live in a culture that does want you to think that. Yeah. Oh my gosh. I know, I know. It's like when you say it, I'm like, I need you to say it like 10 times.

I know. Me too. I say it to myself. Yeah, exactly. It's like such a great reminder. It's almost like you can like settle your shoulders into it. It's like, well, what happens if this wasn't my fault? And a lot of times when people get on a GLP one medication and it works on the brain, you can have a moment where you're like, wait a minute, was this never my fault?

Was this? And again, I wanna be really clear, this is not about making your body smaller. It's about getting some control over your mind and your thoughts. Like when you have. Food noise that feels like it's controlling you. It is the most liberated feeling to get on a GLP one, maybe get on a stimulant medication and really be able to feel like, whoa, is my brain quiet?

Can I make choices that don't feel like the trance? Yeah. Yeah. Okay. So I'm hearing that people need to actually have a good evaluation because is there anything else going on? What's their environment looking like? Is there other treatment that's needed? Let's, let's assume, which we know is totally not the case, that they're actually gonna be getting all that help, because I find that's already impossible.

But, and then I know you are a complete unicorn because I have people all the time asking me, Hey. Do you know someone that can work on this more therapy side with me with food because I'm seeing someone and they don't know what to do here. Like they literally, they have someone that they're working with and this is just not something that they know how to navigate.

So is there a tool or two or a perspective that person can start to think about as they're seeking out someone like you to help them work through it? Yeah. Yeah. I will say, maybe we can all laugh at this. The tools are a little bit boring. I like that you say that 'cause people are like really expecting something new.

I know, I know. And I, and I just wanna be honest that like, you know, the tools are the know move your body. And I know, I know. But all of that, all of that energy somatically, like what leads us to, and I have this funny saying it's my website, right? We're mining for dopamine, so I call it dopa mining.

Okay. So the website is dopamine demystified, right? Because I wanna take the mystery out of mining for dopamine because how interesting that we mine for dopamine. And it's always I guess often things that are terrible for us. Yeah. So, so things that you can do to kind of lower your desire to mind for dopamine.

Okay. Move your body. Get enough sleep. I know, you know, I know I say it too, and it's one of the hardest things that, and stress management, but it's, look at this, you're listening at number two. Number three is so important. It's protein.

I don't know if this is universal knowledge, but protein makes dopamine okay. And ugh, it's really intense, right? Dopamine is a chemical messenger it's a neurotransmitter. It works with the brain. So when you have a high amount, and I'm not saying a high protein diet, because I've learned that, having higher protein is different than a very high protein diet.

Yeah, yeah. Yeah. Focusing on that protein, it's going to deal with blood sugar. It is gonna make you feel less. Oh, just out of control and for people that really feel like that's just breathing, this is so unbelievable for them. So if they focus on the moving of the body, which is just go for a walk, go outside, look at the sky. This is not about using exercise as a punishment because that is something that I think that we do certainly to fat bodies. Getting enough sleep, which I think is really challenging. And then the protein with knowing that you're creating more dopamine, I think would be totally a great way to start.

But again. They are kind of boring. Yeah they're not boring at all. What's interesting is. They're exquisitely hard to do if you haven't been doing them right. Like, that's the point, is that exercise. It's so funny, I I talk about this I can't remember how many years ago, but when I first started to say, Hey, I'm gonna get more active it was hard for me to, even with my flip flops on, or just get on the treadmill at all.

And nowadays I'm like, oh, I'm walking an hour in the morning. I'm like, I don't even wanna say it. 'cause I don't want someone to hear that and think, oh my gosh, I need to walk an hour. Just please start wherever you're gonna start and do anything. And yours might be so like, I love walking, but your version might be.

Dancing a few minutes with your toddler, it's gonna look so different. Yeah. Based on where you're at. Literally when I talk about like marching in place in the commercial break, if that's where you're at, that's where you're at and it's amazing. That is something, right? Oh my gosh.

Yeah. I tell folks all the time walk around your house. Walk around the entire house, go upstairs, go downstairs if you don't have stairs to go up and down, just walk around the whole house. It's an interesting place to start, especially when you wanna decenter any kind of punishment when it comes to body movement.

Yeah. And then can I add a fourth one? Yeah. Okay. This one, this one is so funny. I mean, and I think it's pretty usual. Um, really watch out around social media because the issue we have here, okay. So ultimately it's not just social media, it's just being online. We have to be really careful, right?

Because when we go online, it raises serotonin and there are studies now that serotonin cancels out dopamine. So that fast acting neurotransmitter, which did, you know, serotonin and is, is also a hormone. Yeah. Did you know that? Yeah. Yeah. I don't know why I didn't know that. So when you're getting those fast hits, it really it's depleting the dopamine, so it's making it even harder.

Yeah, yeah, yeah. It's okay. So when you're working with people, 'cause there, these, there's a lot of different areas here, I find personally when I look through this list, sleep is the first thing I work on with people. I will not do more if you're not sleeping. Like we just can't, you can't reason.

You're overly emotional, we could get in all the physiology, but it's not gonna work out. Right. And then I actually do protein next. Okay. Because I find that, like you were talking about, people get so much benefit, forget cutting out ultra processed food, forget all of that. Mm-hmm. Like we could have another conversation.

How does added sugar interact? Da, da, da. Okay. But. Added protein. People will be like, I'm not as hungry. I don't feel like I need to go for X, Y, Z meals. And then I probably do exercise next, and then the social media and things like that. I think I'm weaving it in because people are constantly comparing to others or thinking that there's gonna be like another answer.

And I'm like, how about we just start to listen to your body and we start to do that instead of. What other people are eating or what they're doing. Right, right, right. Um, but do you have an, like an order where you see, this is just somehow how it always goes? Is it first that they have to stop the shame?

I'm just wondering if you see a pattern. Oh, totally. I love the way that you do it. I think that's really smart. Lately I've been really trying to focus on protein with folks because. Because I am so interested in addition and wanna get so far away from restriction that I'm like, just do whatever you usually do.

But if you add in protein, eat whatever it is your heart desires, but have that scoop of cottage cheese or have, and it's funny 'cause like even saying it out loud, like I don't want it to feel like any kind of thing you have to follow, because I think when you have to follow something, we tend to, no, I don't wanna go anywhere near that Right.

Rebellion. Right, right. Exactly. Exactly. Well, it feels too close to those places that we were all dragged when we were way too young because we have fat bodies. That's not fair. But this, this is just about, blood sugar regulation and then also creating, more dopamine. So with the protein.

I'm like, don't take anything out. Please. We're, this is not about restriction, but have you ever thought about it by way of addition? Yes. And that seems to be really helpful for folks. The other reality is it's going to help you feel more grounded, less in the trance. It's gonna make you feel more full just by way of what it is in your body.

Yeah. Yeah. So yeah, and it's been pretty successful. Focusing on that piece because, and, and like you say, 1% changes. So it's like, do it for one meal one time this week. Okay, let's come back. Let's talk about it. Let's see. And then let's add it to, yeah. It's how do we be consistent? I love that you bring that up, because people really think it's all three meals aren't perfect and they never have a bagel, that is not what we're talking about.

And it's the opposite. Yeah. So yes to just starting where you can and. And the other thing too, like I find there's not a magic number on protein. Yes, I have charts and I have rough thoughts and I follow things like in body to make sure that, muscle mass is staying great, but ultimately there's a really big range, how people are responding and how they feel with their hormones and.

Hunger levels it's almost like a self titration situation where like, we need to listen to you. Right? It's, I mean, isn't that just novel? Can we what, but this is where we've all been harmed. This is part of the disease. It's like you're not like a special one. You are just like supposed to blend into the collective, but , we shouldn't be doing the same thing for any of us.

I know, you know what's interesting? There's a channel that I follow and she was talking about how protein has become very vogue, right? It's like where, everyone, this is supposed to be the thing. I just think we're trying to get from zero to something. I don't know that we have to, again, like you were talking about, not like high protein.

Like most people I know are at zero risk of that same Well, and I think, you know what? I think it really is, trying to co-opt it into diet culture. And this is something I'm really passionate about. There were all these systems promising all these things, that we now know are not sustainable.

And when we couldn't sustain them, we felt internalized. Self-hatred. This is totally different. This is not a gimmick. Sure, you can go on meds. They work for you. They don't work for you. Sometimes the way you know they work for you as you see differences in your blood work.

It's not about making your body smaller, like how boring it's about can you feel relief? From what it is you struggle with. And I will argue forever that it is a disease, it's an illness to have the level of food noise people have. And insulin resistance. All of those things contribute to the way we feel about food and how we engage in it.

And. I will say one more thing. So often people with, fat bodies in a higher, scale number right, are actually undereating. Oh yeah, the malnourishment , you're not getting necessarily what you need. No, and, and also the eating disorders, there's, so often I talk to folks, right?

And they'll come in and they'll be like, I really wanted to see you, but I, I don't have bingeing eating disorder. And I'm like, oh, great. Let's talk. They are anorexic. They're anorexic, but no one will take them seriously because they have some BMI that we've, you know, attributed to some informa.

It's completely unfair and I see this very often. Yeah. So it's talking to folks about can you, can you nourish your body more? Can we talk about like, eating more? Yeah. And what that looks like. Yeah one of the things we're touching on here is that clinicians don't know how to diagnose any of this.

Mm-hmm. And it's really, even I would say until a few years ago when I did more training, I don't think that I was very skilled at pulling it out. I could tell like grossly abnormal things, but I'm convinced I probably missed in my primary cure days. Some of this, right? Mm-hmm. And also just the, when we're talking about disordered eating, I just heard it described as, it, it, it thrives in shame, right?

And so no one's talking about it. Unless you really know how to, what to ask. And if that person doesn't trust you, you're not going there. Like they're not gonna talk about it. No. No. And the shame. And the blame. I sometimes can't sleep at night.

'cause I think about all the times that like, wow, that was like binge eating disorder. And I didn't, I didn't catch it because it didn't feel like I could talk about it at whatever time that was. Yeah. Yeah. Yeah, it's interesting moments. I remember I never knew what night eating syndrome was.

And then later on I learned, and then I remember, oh my gosh, I remember this patient, the room, the story, what this person was saying to me. It was so classically describing like the whole pizza in the middle of the night. It was actually appropriate the treatment that I was doing with this person, but I was thinking about.

It's like I just didn't have a name for it, right? Mm-hmm. It was just very fascinating. Yeah. Oh yeah. Yeah. And we're all conditioned in anti-fat bias and the my least favorite, which I tell you, this is a hill I am willing to die on. This whole idea of calories and calories out. Completely get fucked with that because you know what?

It's like any other form of discrimination, just because it works for you. Do not put that on a collection of people. Yes. Yeah. Mm-hmm. No. Let's it on a shirt. Gosh, there was a study and, and the guy was like, you don't be mad that it's just that the calories are lower.

I'm like, but listen, dude, listen, people's hungers through the roof, before certain things, and I just, I just can't. So yeah, totally on that. No, no, it's awful. So, okay, so question people. They have awareness. They're starting to have awareness that this is a problem for me. They're seeking out some help.

They're hearing this. Where should they start if they're on their own? I think. Trying to do an assessment. So this is, gets a little bit complicated because of, again, I think the trauma that comes from having to quote unquote track food, track points, track calories terrible. That never should have happened.

But if you could do a mental assessment of just how do we feel around certain kinds of food and. Are there foods that I'm eating many times a week? And if I am, how do I feel about them? I think also, and this won't work for everyone, I wanna acknowledge that, right? But you could think about it by way of the dopamine dysfunction leading towards and, type of addictive.

It's not necessarily your having a behavior. As much as it's a response to what's going on in your brain. Mm-hmm. So it's complicated to talk about. Yeah. Yeah. Yeah, definitely. Definitely. Because I see people, um, sort of like pick a side with binge eating disorder, whether right, is it the environment that caused it or they're causing it.

I'm like, okay, how about if none of that mattered? And you just actually get some tools, right? Yeah. So I like, I like the way in which you're talking about this, so starting to think about your relationship with that. Maybe seeing if they can implement some of these strategies slowly building it out, just a little something that you work on daily for a month or two, and then maybe. Iterating on it and seeing if that, how that's helping. Yeah, I think the thought work is really important. Because I am a therapist, I also think often about are you a child of addiction?

Are you a grandchild of addiction? Because we know that certain types of A DHD. Are directly correlated with the environmental response of being a kiddo growing up in a household where a caregiver or someone close to you has an addiction, I think anything you can do to both take the assessment, do a little brain work, but also acknowledge that this is much bigger than just you.

This has to do with the way you were conditioned, the way you believe, and think about yourself. And then. Larger community judgment, shame, and blame. I know it's heartbreaking. It's like when you describe it, it almost feels insurmountable. Yeah. Because it's everything. Yeah. But I do have hope, having known you for a long time, that I feel like there is good help for people.

And I think that that's hopefully inspiring for people to hear today this is not like you live with this the rest of your life and stuff's always outta control. But that there, there are really intervention points that can really help ease the suffering that the person's going through.

Absolutely. And once you start thinking about it, I really do see it move pretty quickly. Yeah. Oh, wait a minute. I do remember having this experience when I was young with this particular type of food. I find people with binge eating disorder to be the smartest people because what they're doing is trying to regulate their nervous system by soothing, and they're soothing with what we were soothed with before.

Language food. I know, I know. It's beautiful nourishment. Yeah. Yeah. Oh. It may feel like a, a big mountain, but honestly it's small I think like peaks and valleys. It's a little bit, um, shorter the work. Once you start to acknowledge like, Hey, maybe this might be something I wanna start thinking about. I wanna put a pin in it there. 'cause I think this is really a there's a lot here that I think people can digest and I almost don't wanna overwhelm them with more. 'cause I know that me and you could keep talking for hours. You really could. So you gave some really good, you gave a definition today.

You really gave some good things, how it presents. Tangible things that people can do, how it's actually not as overwhelming, that things will a little bit more lock into place once you're actually looking at it in daylight. Do you think there's anything that we missed today with this specific topic of sort of the intersection of attention deficit and binge eating that you think still needs to be said?

I think maybe I just would leave it with Please do what any of us can do to decenter diet culture, please. I'm hearing a lot from folks like split camps, especially in fat liberation. You have folks that are really upset about what they feel like is predatory medications. I can absolutely understand where they're coming from. I just think all of us have the right to treat our diseases. Yeah. And if you have a disease that could be treated by a medication, I would really love that with no expectation that it will change the size of your body. Yeah. Yeah. And for a lot of people it doesn't, but it does give them a lot of freedom from.

Thoughts and the trance we had talked about before. Yeah. That's why I think it's so sad when insurance says, well, if you don't lose this 5% in the first three to four months, and I think a lot of not a lot like some of my patients, they really get relief and. That's treatment enough.

It doesn't need to be that the weight set point went down so significantly it's almost like the diet culture is, has infiltrated, right? What came first? I don't know. The insurance company, it's all the same we know that industry has influence on these things,

even like how we're categorizing things and stuff like that. But this, but just thank you for coming on today. And I always like that you do come from a non-diet culture lens because it's so much more healing the work that you're doing. This is not really about shape shifting. So thank you so much.

Can you tell everybody again where can they, where's the best place to find you to, if they wanna, reach out to get help with you, things like that. Yeah, sure. So Casey at, dopamine demystified.com is my email. I have a website, which is dopamine demystified. And yeah I would love to hear from anyone. I really enjoy this work so much and appreciate anyone willing to try to do it, oh, I love that. Thank you so much for coming on today again, just every time we meet, I learn so much. Thank you. Thank you for having me.