Webinar: An introduction to Eating Disorders

Summary

Highlights

• The session debunked the myth that eating disorders only affect young, thin, white women. People of any race, gender, or body size can be affected 🌈.
• Eating disorders often serve as coping mechanisms for dealing with difficult emotions and life situations, rather than just issues with food 🍲.
• Addressing eating disorders involves recognizing how societal pressures and identity factors, such as race and sexuality, contribute to their development 🚦.
• Practical strategies include using motivational interviewing techniques to manage resistance and foster openness in clients 🤝.
• Key resources and tools are available to aid social workers and healthcare professionals in identifying and supporting individuals with eating disorders 📚.

Key Takeaways

• Eating disorders are complex and affect a diverse range of individuals beyond common stereotypes 🎭.
• These disorders function as coping mechanisms for various psychological and societal issues 🛠️.
• Understanding the intricate relationship between identity factors and eating disorders is crucial for effective support 🌍.
• Assessment tools and strategies are essential for recognizing and providing support to those in need 🧰.
• It's important to ask the right questions and use appropriate language when discussing eating disorders with clients 🗣️.

Overview

Chapters

• 00:00 - 01:00: Introduction The chapter introduces the speaker, Alexander Zanis, who is the Social Policy and Communications Coordinator at CW. Zanis welcomes the audience to the webinar and expresses happiness at seeing familiar names in the virtual space. He encourages participants to engage using the chat and Q&A functions as they will be utilized throughout the presentation.
• 01:00 - 04:30: Poll and Presenters Introduction The chapter introduces the format for interacting during a presentation with separate options for general comments and dedicated questions. The audience is encouraged to use the chat for general observations and the Q&A tab for questions directed at the presenters. The chapter emphasizes the quality of the panel and encourages audience participation by posing questions toward the presenters. There is a demonstration of how to use the chat feature.
• 04:30 - 09:00: Land Acknowledgment and Objectives The chapter covers the introduction of a presentation, inviting participants to indicate their location through a poll, particularly focusing on regions in Canada. It also provides guidance on accessing presentation slides, explaining their availability throughout the session and in a handout widget, illustrated by blue and white icons at the bottom of the screen.
• 09:00 - 16:00: Organizations Overview The chapter 'Organizations Overview' provides insights into the valuable resources and support systems available to social workers. It introduces key tools such as the handout widget, slide presentation, and a video for later viewing. Additionally, it highlights the importance of a peer-to-peer support group available on Facebook, designed as a space for professional discussion and commentary. The presentation also encourages audience interaction by asking participants to share their locations. The CW offices are respectfully acknowledged to be on the unceded and unsurrendered traditional territory of the Anisha people.
• 16:00 - 21:00: Lived Experience Video The chapter titled 'Lived Experience Video' begins with a speaker expressing gratitude for the opportunity to host a webinar. The setting is underscored by its historical significance, having caretakers for time immemorial. The speaker also mentions a course completion tracker which attendees can use to access their certificate of attendance. It is emphasized that participants need to meet the required viewing time, but the certificate will only be available after the presentation concludes, regardless of whether the required time has been met.
• 21:00 - 31:00: Defining Eating Disorders The chapter titled 'Defining Eating Disorders' appears to be an introductory part of a webinar series. The transcript indicates logistical information concerning accessing a certificate of participation in the webinar. Viewers are advised to check their email or log into the platform to retrieve their certificate. This passage serves as a prelude to the main content, setting the scene for upcoming presentations.
• 31:00 - 36:00: Recognizing Disordered Eating Chapter Title: Recognizing Disordered Eating In this chapter, three organizations come together to discuss disordered eating. The representatives include Caitlyn Axar Rod from Sheena's Place, Aaron Houston from Body Brave, and Arie M Maharaj from the National Eating Disorder Information Center. Their speaker bios are accessible under the speaker bio widget. The chapter begins with the setup of a poll for audience engagement.
• 36:00 - 47:00: Prevalence and Myths about Eating Disorders The chapter titled 'Prevalence and Myths about Eating Disorders' begins with an introduction where the location of various attendees is noted, including the Prairies, Ontario, Atlantic Canada, the north-west coast, and others, setting the stage for a diverse audience. The speaker expresses excitement and gratitude for the opportunity to present, acknowledging Alexandra for her introduction. The atmosphere is warm and welcoming, encouraging interaction and ensuring attendees that assistance is available if needed. This section does not delve into the main topic yet but sets a positive and engaging tone for the upcoming discussion.
• 47:00 - 68:00: Intersectionality and Eating Disorders The chapter deals with the topic of intersectionality and eating disorders. It begins with the presenters introducing themselves and their roles. Caitlyn, a social worker and program and outreach coordinator at Sheena's Place, introduces herself and mentions her tenure of three years at Sheena's Place. Caitlyn also highlights her involvement in research and volunteering within the field of eating disorders. The chapter sets the stage to discuss the organizations Sheena's Place and Body Brave, hinting at their relevance in the discourse on eating disorders.
• 68:00 - 81:00: Best Practices and Responding to Eating Disorders In the chapter titled 'Best Practices and Responding to Eating Disorders', the speaker shares their personal journey of becoming involved in the field of eating disorders. They were driven by their connections with individuals who have lived experiences with these disorders and the pervasive influence of diet culture in society. The speaker is a strong advocate for accessible mental health support and emphasizes the importance of harm reduction and body inclusivity, both in their professional role at Sheena's Place and in their personal life. Towards the end of the excerpt, they transition the discussion to a person named Ari.
• 81:00 - 98:00: Assessment and Motivational Interviewing The chapter begins with an introduction by an individual named Ari Maharaj, who uses he/him pronouns and works as the Outreach and Education Coordinator at the National Eating Disorder Information Center (NEDIC) in Toronto, Ontario, serving across Canada. Ari identifies as a settler and expresses a strong passion for assisting underserved communities with accessing mental health support. The chapter briefly highlights his role at NEDIC where he is involved in outreach and education activities.
• 98:00 - 104:30: Resources and Q&A The chapter 'Resources and Q&A' focuses on the important role individuals can play in eating disorder prevention and intervention. It highlights the need to recognize and respond to diet culture influences and details how to engage in both short-term and long-term work with affected individuals. The speaker, a registered psychotherapist qualifying in Ontario, provides insight based on their eight years of experience in community and postsecondary mental health settings, now working in community practice.

Webinar: An introduction to Eating Disorders Transcription

• 00:00 - 00:30 hello CW members and anyone tuning in wherever you are wherever you're at welcome and thank you for joining us for another webinar today my name is Alexander zanis I am the social policy and Communications coordinator at the CW I know I say it every time but I am so happy to see your virtual names popping up on my screen if you haven't found that chat and Q&A function yet please feel free to pop it up um we're going to be using that throughout the present you
• 00:30 - 01:00 feel free to typee your comments or questions in either of those boxes what I will say though is if you want to have General comments about the presentation it's best to use the chat if you have dedicated questions for our presenters which we strongly encourage we have a wonderful set of presenters today incredible panel uh use that Q&A tab if you'd like any content specific questions you'd like for me to ask are uh presenters so feel free to pop those open at the bottom there I'm going to put a little message in there in the chat so that everyone can find it um and
• 01:00 - 01:30 say hi I also have a poll up asking where you're tuning in from if you want to give us a general overview of the kind of region in Canada that's also a great place to know if you have your slides open so if you have that poll function open great you have your slide open uh and you'll be able to access the slides throughout the presentation another place you can find the slides is in the handout widget um so all those blue and white icons at the bottom there will give you everything you need to access all the materials from this presentation
• 01:30 - 02:00 the handout widget is there uh with the slide presentation as well as a video that we will be watching later in the presentation uh and access to our peer-to-peer support group on Facebook which is your space to use and comment and discuss what's going on in the social work profession across the country uh amazing I see everyone tuning in please let us know where you're tuning in from Ottawa is located and the CW offices are located on the traditional unseated and unsurrendered traditional territory of the Anisha and
• 02:00 - 02:30 Al gonin peoples and I am so grateful to be able to work play live and Host this webinar onl that has had caretakers for time in Memorial I also want to flag for everyone that there is a course completion tracker that is where you will access your certificate of attendance you must hit those required viewing minutes before that'll be available however the certificate is not available until the presentation actually concludes even if you've hit those viewing minutes you still have to wait until the presentation ends for the
• 02:30 - 03:00 uh platform and the system to generate your certificate for you it'll be able to it'll be emailed to you as well as available on the platform itself so feel free to log on at any time if you didn't get that email or if you don't have the engage platform email address set up in your address book you may want to check junk or just log back in and you can download the certificate from the platform directly with all that being said I am so excited to pass it on to our webinar presenters this is part one of of a
• 03:00 - 03:30 three-part series we have three organizations joining us today that we are so grateful to have joining us Caitlyn axar Rod is from sheena's place we have Aaron Houston who is from body brave and Arie M Maharaj from the national eating disorder information center all of their speaker bios can be found at the bottom of the screen under that speaker bio widget and I do encourage you to pop those open so I believe we've had the poll open for long
• 03:30 - 04:00 enough let's see where everyone's tuning in from hello to everyone from the Prairies Ontario Atlantic Canada the north west coast we are so happy to have you joining us today with all that being said I am going to pass it over to our wonderful presenters please let me know if you need anything on the back end H and take it away thank you so much for being here thanks so much Alexandra hopefully everyone can hear me let me know if not um we are really thrilled to be here
• 04:00 - 04:30 with you today and the three of us will Begin by introducing ourselves and then we will move into the content so to start I'm Caitlyn I use she her pronouns and I'm a social worker and the program and Outreach coordinator at sheena's Place based in Toronto you'll learn a little bit more about sheena's play stic and body brave shortly but first we'll start by introducing ourselves as presenters so I've been in my role at sheena's place for three years now and I've been involved in research and volunteering Within the Eating Disorders
• 04:30 - 05:00 field for eight years I first became interested in eating disorders as a result of knowing many people with lived experience and as a result of being a member of a society that is strongly influenced by diet culture and many conflicting messages about food and bodies um I'm personally passionate about advocating for low barrier mental health support as well as harm reduction and body inclusivity both at sheena's place and in my work and life outside of sheena's place I'll pass it first to Ari
• 05:00 - 05:30 and then Aaron to introduce themselves hi everyone my name is Ari Maharaj I use Heim pronouns I'm the Outreach and education coordinator at the national eating disorder information center based out of Toronto Ontario but serving the entire country that we call Canada um I'm a settler on this land and I think I'm really passionate about um helping support underserved communities accessing mental health um challenges or issues uh and my role at neic we get to
• 05:30 - 06:00 do a lot of work on eating disorder prevention and so I'm really excited to get a chance to talk with all of you today on the crucial role that all of you can play as you learn to recognize um respond navigate diet culture with folks and potentially get to do some some short-term work or some long-term work with clients who are around you um I'm a registered psychotherapist qualifying in Ontario by trade and worked in community mental health for about eight years um in postsecondary mental health to start and then some Community Practice and then um now
• 06:00 - 06:30 getting to do um policy prevention research education work with neic so um thank you so much and I'm gonna pass it over to Ain awesome thanks Ari hi everyone my name is Aon Houston I you she her pronouns I am the training and education coordinator with body brave um that's located in Hamilton um but we have clients from all over Ontario and and all over Canada for some of our programs as well um I into this work um first of
• 06:30 - 07:00 all as someone with lived experience um having navigated quite a few different um kind of healthcare and support systems during um my time struggling with an Ian disorder and so um I'm really really passionate about um the part of my work in which I get to um educate professionals um whether it's Physicians or dietitians or social workers um from from a place of lived experience of knowing how much that education can really help um in providing really positive and Powerful
• 07:00 - 07:30 support for um your clients or your patients so really really excited to be joining everyone here today um and get some great learning done I'll hand it back over to Caitlyn thanks Ain um so before we dive into our eating disorder related content for today um we want to provide our own land acknowledgement as well so as we learn and reflect about eating disorders and people's relationships with food today it's important that we recognize
• 07:30 - 08:00 the systemic violence that some communities on the land we call Canada have faced and still face today First Nations innu and mainy peoples often had their traditional methods of procuring food and their relationship with the land forcefully altered through the processes of selller colonization the residential school system aimed to sever these connections among children with exploitative processes and treaties that weren't upheld creating the conditions for poverty that that many unfortunately still live in to this day as of
• 08:00 - 08:30 September 2021 44 boiling water advisories remain in 32 communities impacting these communities ability to prepare and engage with food as Charities providing treatment and support to those with body image issues and eating disorders Sheena play netic and body brave acknowledge that First Nations matey and inuent peoples are often left out of body image and eating disorder spaces including research treatment recovery spaces and conversations surrounding stigma and
• 08:30 - 09:00 support it's our responsibility to work towards decolonizing these spaces and to create supportive environments for all folks who desire support as non-indigenous settlers we we see acknowledging these truths and actively working towards reconciliation as critical especially in the context of learning about mental health food and the ways in which these things interact so we do have some resources on this slide if you download the slides all of the anything underlined is hyperlink so
• 09:00 - 09:30 you're able to access um some more information about um resources um for allies specifically all right so moving on to our objectives for today um these were shared with everyone in advance um when registering for the webinar so I won't go over them too specifically but today in general we will be talking about eating disorder Basics we will be busting some myths we'll be talking about aspects of identity and how um
• 09:30 - 10:00 those intersect with eating disorder experiences and we'll be sharing some strategies for providing support um now just to make sure everyone is in the right place um and to keep everyone updated there will be a part two and a part three of this webinar in November and December and so in these webinars we will be exploring diet culture and weight stigma as well as strategies for providing support more specifically and more in-depth we will be touching on these topics today but just um so that
• 10:00 - 10:30 you know where to find more information about these things please come back um for parts two and three so a couple of kind of housekeeping items on our end um before we get started um as Alexander mentioned please ask questions throughout um in the Q&A um we would love to hear from you throughout and at the end of our webinar um we also want to remind everyone to please take care of yourself you know we all have our own
• 10:30 - 11:00 relationships with food and with the body and sometimes the content that we go over in this webinar um can be difficult it can bring up challenging emotions for some folks so please take breaks if you need um this is being recorded as you know and it will be available um to folks afterwards so um if you need to take a break you know we're still living in a pandemic and many people have competing priorities so do what you need to do um today and know that you can come back to the information afterwards um as well please eat during this
• 11:00 - 11:30 webinar that's really important to us um to normalize that um nourishing your body when you need to um we know it might be lunchtime for some folks here today um or snack time for everyone uh and lastly we are presenting from our personal and professional contexts Aon Ari and myself um and so this will not represent every single perspective or approach so please take what feels relevant for you today and leave the rest um we would love to enourage critical thinking as um the more
• 11:30 - 12:00 critical thinking there is the better in our opinion all right so a little bit about our organizations um I'll start with sheena's place so we are as I said based in Toronto we are a community mental health charity that supports people affected by eating disorders and disordered eating so that includes people with lived experience as well as their loved ones we do so exclusively through the provision of group-based support so we do not do any individual counseling or therapy but we offer many
• 12:00 - 12:30 many different types of groups um currently we are offering about 30 weekly groups um that cover many different topics and and um types of support all of our programs are free of charge and they are open to anyone ages 17 and older in Ontario uh and no eating disorder diagnosis or referral is required so we will go over in our um part three in December more about how to um engage with our services as well as netics and body Braves um but just to
• 12:30 - 13:00 start that is um a little bit of information about us so maybe I'll pass it to Aaron to speak about body brave and then AR frenetic awesome thank you so much um yeah body brave is an Ean disorder treatment center we are a terrible organization um that offers virtual low barrier eating disorder treatment and support um across Canada or in Ontario depending on our program so we um offer
• 13:00 - 13:30 kind of a variety of different um options for for people to kind of best meet them where they're at so that goes from um guided self-help which someone can kind of do on their own we have um an app and a system that kind of helps guide um people through recovery um to therapeutic support groups um that are that are LED um and around a specific um idea or um content and and we also offer kind of medical examination individual Psychotherapy those kinds of things um
• 13:30 - 14:00 so trying to to meet people where they're at depending on on what they need in their recovery um yeah we're charitable organization um we are so honored to to work with organizations like nek and sheena's place that are all doing such incredible incredible work um we are fairly new um a little bit newer than sheena's place and and netic that have been doing this great work for so so long so we were founded just in 2016 and so um yeah are
• 14:00 - 14:30 still kind of finding our footing and finding out what works and and all of those things um and yeah that's body brave I'll pass it over to Ari neic the national eating disorder information center is based at the university health network in Toronto Ontario um but we operate Canada's national English-speaking toll-free telephone helpline and an online instant web chat service that is um a ious confidential um and self-referral and no
• 14:30 - 15:00 diagnosis necessary and so we have folks reaching out from the ages of 7 to 77 um people for themselves people for their siblings people for their family members um people for their clients um we have trained support workers who are there to take your calls or take your chats and we like to think of ourselves as a hub for eating disorders across the country that if you reach out to us and you're potentially relevant for services at sheena's place or body wave you bet that we're linking you to them or if you're
• 15:00 - 15:30 relevant for services in Alberta or BC or Manitoba um we have a Canada wide listing of 700 plus treatment and support providers across the country um that includes all of our provincially funded care providers but also um professionals operating in private practice from a a non-et of more weight inclusive and eaing disorder informed approach that will'll do a semi-structured interview with them just to see it's a free lisening of providers so no money is involved is we're also a charity just really here to make sure
• 15:30 - 16:00 that people are getting access to eating disorder informed information um as we go and let Caitlyn mentioned in part three we'll come back to our three organizations and assist you with system navigation because that's one of the hardest things about eating disorders and mental healthare in general is ensuring that our clients have access to the information and support that they need and I know that all of you were probably sometimes um maybe throwing your hands up wondering what's there and eing disorders and so I'd love for you to remember that medic exists as a support option um for all of you to
• 16:00 - 16:30 potentially access yourself and I'm going to throw it back to Caitlyn thanks Ari um so next we will move into sharing a video and hopefully I can get the tech right for this um but this is a video about one individual's lived experience and we'd love to start here as a way to Center um lived experience in our presentation today heaven forbid a man deals with something that a woman does you know this idea that like if it's a woman's disease
• 16:30 - 17:00 you're not as much of a man for having [Music] it there were many different steps that turned what were smaller unhealthier behaviors into something that was out of control I think this is common for people with eating disorders is one day they might have the realization that yeah this is an eaing disorder but but generally at that point they've probably
• 17:00 - 17:30 had it for quite a while my earliest memories of what I would consider to be disordered eating disordered body image started probably as early as Middle School looking back I would say what I was doing was a lot of chronic dieting it was in university that that sort of spiral into exercise compulsion and from there um some behaviors that I think people would associate with anorexia a lot of um periods of starvation and then um more behaviors that people would associate with bulimia
• 17:30 - 18:00 so a lot of binging and purging um calorie counting being obsessive of tracking my food all that sort of thing when I physically started to make myself Purge that was when I knew it had for sure crossed the line into something that was unhealthy before I think I could sort of kid myself that the excessive exercise was healthy even though I didn't enjoy it um when you're actually making yourself Purge I think it's sort of hard to kid yourself that
• 18:00 - 18:30 there's something health related about that for me I think it was a mental health issue it's not actually about the food it was an intense fear an intense anxiety where I felt like the only thing I could do to make that intense anxiety go away was to get rid of it people assume that um you know specifically that anorexia is a white teenage girls problem they don't realize that body image
• 18:30 - 19:00 eating disorder issues that a there're there's all different kinds of them and that it doesn't matter your race nationality gender identification sexuality none of those things really matter the other men that I've met who were seeking out help I remember like repetitive themes themes of them feeling like when they talked about it to other people that it wasn't really recognized even in school for health and fitness they want one of the female athletes
• 19:00 - 19:30 that was in my program had dropped the amount of weight that I did I think it probably would have been addressed in that way a lot more and a lot quicker I think more than anything sheena's place normalized my experience it was like Hey man you're not the only person who deals with these issues you're not the only guy what I've said to people who I've worked with who struggle with eating disorder behaviors is try to imagine a
• 19:30 - 20:00 life where body image food exercises where those things aren't a problem for you where if these things weren't consuming what you were doing what you might do with that life that was my motivation for getting better but there were many days when I was actively pursuing recovery whatever you want to call it where um you know where I struggled it felt difficult and I felt
• 20:00 - 20:30 like okay I've made these strides I'm not doing these select behaviors anymore but I'm still dealing with things that this anxiety like am I ever going to be able to just exercise or just eat a meal without it being an issue and I would say that probably lasted for a good at least a year after I started getting help I would still have those periods of fear that it wouldn't um go away but um did I think it does I think
• 20:30 - 21:00 at some point you can make the choice to say I'm worth getting some help for like my life is worth pursuing help deciding to try to get better but it's not as easy as just saying screw it I'm going to eat dinner there was a lot of goal setting and there was a lot of failing at those goals but the biggest thing is not beating yourself up I think that just throws you back further
• 21:00 - 21:30 okay I know some folks had some trouble seeing the video um but hopefully you can access that after um it is linked on the previous slide um in the slide deck so um know that that's available for you on YouTube um so what is an eating disorder um we will be using the term eating disorder as has been made pretty clear
• 21:30 - 22:00 so far um and that is essentially for consistency so that we are using the same language but we acknowledge that this terminology does not resonate with everyone um like all mental health challenges Eating Disorders occur on a spectrum like you see here so we fall all fall somewhere on this spectrum um on the left hand side someone who has a more positive or neutral relationship with food or their body they may sit here so experience body acceptance engaging in flexible balanced and
• 22:00 - 22:30 intuitive eating and movement um and a person who's on towards the left side of the spectrum they might not have super positive body image or love their body every moment of every day um but they might experience what we would call more neutral body image so knowing that self-esteem and self-worth are not solely defined by the body as we move towards the right into the middle um we have what we are calling disordered eating symptoms and um this is a
• 22:30 - 23:00 collection of behaviors and thoughts that may interfere with a person's quality of life or functioning to different degrees um as we heard Jay speak um you know for for him at a certain point it started to really become a problem but it wasn't um like all of a sudden one day waking up everything changed it was gradual um and I think what's worth noting here is that the collection of of behavior you see although they are being given the label
• 23:00 - 23:30 disordered a lot of these things are very normal or um expected responses to what we might call abnormal or problematic situations or contexts and we'll speak more about some of these in particular um throughout our time today now as we move towards the right of the spectrum where it says eating disorder diagnosis here we have a list of diagnoses based on the DSM or the diagnostic and statistical manual now as social workers of course we are
• 23:30 - 24:00 not in a position to be diagnosing um so I won't go over the criteria in detail here but I'll briefly review um the terms here that are listed so that folks are on the same page when it comes to language so binge eating disorder essentially involves engaging in episodes of binge eating and so what this means is eating an objectively large amount of food in a discreet time period and feeling a loss of control control while doing so so binge eating
• 24:00 - 24:30 is not about you know eating past the point of fullness or eating seconds or thirds of a person's favorite meal it's really about this loss of control um binge eating disorder is the most common eating disorder however the diagnosis was only added to the DSM in 2013 in its last iteration and so for that reason it is very underrecognized in both research and practice bmia nervos is characterized by cycles of binging and purging so a
• 24:30 - 25:00 person essentially what purging means is a person will attempt to compensate for the binge through various means that could include self-induced vomiting laxative or diuretic misuse excessive exercise as well as fasting or medication misuse so an example of that would be for some folks with type 1 diabetes um they might misuse their insulin as a way to purge which can be quite dangerous now anorexia nervosa is
• 25:00 - 25:30 another term that you might be familiar with and this is characterized by cycle oh sorry reading from the wrong the wrong one um anorexia nervosa involves an obsession with uh restricting and controlling one's eating um it's also paired with an intense fear of gaining weight um and I'll skip down one so arid or avoidant restrictive food intake disorder this resembles anorexia in many ways and that the primary symptom is restriction um but the difference is
• 25:30 - 26:00 it's really not connected to body image or a fear of weight gain um arfid is more like extreme picky eating and so um an aversion to certain foods maybe based on their taste or their texture to the point where a person's nutritional needs are not being met um Pica is the persistent eating of non-nutritive substances so in plain language eating things that are not food or what we wouldn't consider food um rumination disorder is the repeated regurgitation of food that is not that like other than
• 26:00 - 26:30 self-induced vomiting so more having to do with the gag reflex um and then you'll see acronyms here osfed and Eed so otherwise specified feeding and eating disorder and unspecified feeding and eating disorder essentially these acronyms um represent a category of um symptoms where someone might not qualify for one of the diagnoses listed above but their um symptoms are still considered frequent or severe enough to be deserving of some kind of casual
• 26:30 - 27:00 diagnosis um now the last um the last label here orthorexia this is not an official diagnosis in the DSM um but it is something that um has been increasing in prevalence and it's something that um folks are seeing more and more of as the years go on and so essentially what this word is used to describe is an unhealthy obsession with eating healthy or clean I use quotation marks when I say that um
• 27:00 - 27:30 accompanied by compulsive often accompanied by compulsive exercise and so as you can imagine um you know this can be a lot more Insidious it can be a lot harder to spot in a culture that um is preoccupied with eating or exercising in a particular way um so speaking to what I mentioned earlier with the normalization of a lot of these symptoms um you know something that um makes disord is hard to identify as how normalized some of of the behaviors can
• 27:30 - 28:00 be and so before moving on I just want to speak briefly about um diagnosis so we know that diagnoses can be really helpful for some people they can be validating they can allow folks to gain access to treatment and support however they can also be quite problematic for a few different reasons um the DSM in general is scaled to fairly white norms and it can be less helpful when talking
• 28:00 - 28:30 to folks who are not white or folks whose first language is not English um there are also many barriers to acquiring a diagnosis and as always individuals experiences might not fit neatly into the categories that are outlined in something like the DSM we know as well that a person's you know diagnosis doesn't necessarily indicate severity and it certainly doesn't dictate a person 's worthiness or for treatment or their need for
• 28:30 - 29:00 support um many many people without a diagnosis both in the Eating Disorders world and outside of that are in need of treatment and support and this is really unfortunate because um a diagnosis often acts as a gatekeeper for treatment especially in Canada in the Eating Disorders world or field a person typically needs a diagnosis in order to access publicly funded treatment at least through hospitals we're seeing some organizations like body brave um
• 29:00 - 29:30 challenging that and trying to provide free treatment to um people Beyond some of this criteria but it's extremely hard to access um and it is understandable of course given the lack of resources um and so it makes sense that strict criteria must be put in place in order to triage people but ultimately this is problematic because many many people are not getting the life- saving support um and treatment that they need the last thing I'll mention about this is that um you know labels assigned to people can
• 29:30 - 30:00 have a very real impact on how they think about themselves and so something that we I guess our first um point that we will encourage you to do is to ask clients or patients how they feel about their diagnosis or their lack of diagnosis whether this is about an eating disorder or another physical or mental health uh challenge or condition okay um so I will move on to our next our next slide which is um a few more
• 30:00 - 30:30 points about recognizing disordered eating so here we have listed some behavior and physical changes um that you may or may not notice in someone who has an eating disorder or who experiences disordered eating so I'll give everyone a moment just to read through those on their own and I encourage you to take note of any that is surprising or anything that you have questions about and you are welcome to ask any questions in the
• 30:30 - 31:00 chat I will also acknowledge that the font is a little bit funky on our slides we apologize for that um something happened in the uploading process to the platform so um if you do download the pdf version of the slides the font should be a little bit easier to read so a couple things I'll point out um um our first that someone might
• 31:00 - 31:30 exhibit many of these signs or very few of them um as as is is fairly obvious someone can exhibit you know any one of these things and that can mean so many things other than an eating disorder right um so loss of interest in what used to bring joy um that could of course represent um a mood challenge like depression or something like that um something else that I want to point out is that weight gain or loss although that's mentioned as the first physical change here that may or may not occur
• 31:30 - 32:00 depending on the individual everyone's body is different everyone's metabolism is different and so although we often will r or a lot of people will rely on changes in weight um to you know identify if there is an eating disorder this is um not something that we should be relying on um folks will often also go to Great Lengths to hide certain signs or symptoms due to Stig or feelings of guilt and shame and so
• 32:00 - 32:30 it's possible that a lot of these things are happening including something like a weight change but it might not be readily observable and so this really speaks to the importance of asking people um about what's going on okay so I'm going to move on for now but if there are questions about um any of these um Behavior or physical changes um please just take note of that and you're welcome to ask later on when it comes to prevalence and severity um based on global prevalence data it's
• 32:30 - 33:00 estimated that 2.7 million people in Canada have an eating disorder this is a very high number of people but as mentioned it can be difficult um to recognize eating disorders and there are a lot of issues around diagnosis which um we've touched on and we might not fully get into today um but when it comes to severity Eating Disorders have the second highest mortality rate of all mental illnesses this is second to opioid addiction um and leading causes of death um from
• 33:00 - 33:30 an eating disorder include suicide as well as cardiovascular failure due to restriction use of diet pills and laxatives and self-induced voming so these symptoms in particular can be very dangerous to a person's health um importantly as well mortality and health consequences are not dependent on body weight so many folks U might believe that the lower a person's weight is the more dangerous they're eating disorder is or the more severe it is um but this isn't true people of all body shapes and
• 33:30 - 34:00 sizes can suffer um the horrific consequences of um of Eating Disorders um covid-19 as well as is probably not surprising has increased the prevalence and severity of Eating Disorders both locally and around the world um and we'll speak later on to some of the functions of eating disorder symptoms and that will um probably give you a better sense of why this time has been particular particularly challenging for so many people and lastly early intervention
• 34:00 - 34:30 leads to a greater chance of recovery so as we heard Jay speak to recovery is possible many many people do recover um from their eating disorder um and uh the earlier someone gets treatment and support the better the chances um of recovery are okay so next we're going to move into speaking about three different myths um that are commonly held when it comes to eating disorders so the first myth is that eating diss are a choice um
• 34:30 - 35:00 this is of course not true um like all mental health challenges the causes of Eating Disorders are biopsychosocial um so a person might have a genetic or biological predisposition to an eating disorder and then environmental factors can come in and Trigger or induce symptoms and the combination of these factors is going to be different for each individual person um there's a lot we still don't know about the causes of eating dis ERS and so what we're speaking to here is based on current research with the
• 35:00 - 35:30 understanding that there is um still a lot to learn so some biological factors can include genetics um research shows that between 28 and 74% of the risk for eating disorders is through genetic heritability so that can be quite high for some folks um things like medications as well that influence apetite and weight um May interact with um with a person's chance of developing an eating disorder environmental factors
• 35:30 - 36:00 can include things like family and peer influence um so the messages that a person is getting from their family friends um people around them about food and bodies and eating and self-worth um societal beauty standards more generally as well social media living in a culture of constant comparisons um as well experiences of discrimination and oppression um and major life transitions so examples include entering adulthood experiencing pregnancy or grief and loss these are
• 36:00 - 36:30 all um things that can increase a person's risk of developing an eating disorder um especially if the the biological predisposition is there when it comes to some individual or psychological factors there are some personality traits that have been linked to um a greater chance of developing an eating disorder including perfectionism and impulsivity um how a person regulates their emotions of course um plays a role so if someone is more likely to turn to
• 36:30 - 37:00 food or exercise as a way to help regulate their emotions as opposed to other behaviors um or activities um body image and self-esteem so how a person feels about themselves as well as dieting behaviors so these are all things that can contribute the last thing I'll mention here is that the vast majority of people with an eating disorder have an additional Mental Health Challenge so most commonly this is depress depression or anxiety followed by OCD obsessive
• 37:00 - 37:30 compulsive disorder um substance use or post-traumatic stress disorder or experiences of trauma uh quite commonly um cooccur alongside an eating disorder um so all of that to say an eating disorder almost never occurs in isolation there's almost always something else going on um for a person and with that I will pass it to Aaron to take us through myths number two and three awesome thanks Caitlyn so the second myth we're going
• 37:30 - 38:00 to talk a little bit about is the myth that eting disorders are exclusively about food and weight um and of course this is a myth um in reality disordered eating um behaviors any disorder symptoms serve a function for people um and that can that function can be a lot of different things and a few of them are are written on this slide um but they serve a p a purpose for the person that is experiencing them or exhibiting them um and so these are some of the common um
• 38:00 - 38:30 functions that we might see the purpose that they serve for um for the person this is not an exhaustive list by any means but just a list um that there has kind of been some research around um and that we have often seen kind of in our in our clinical um practices or or in the work that we do um and there are of course other factors that perpetuate symptoms um so stigma lack of access to to support living in a world that is dictated um by diet culture so I invite
• 38:30 - 39:00 you to read through these symptoms that we kind of have here um or the the functions and um are there any questions or surprises looking at this list I'll give everyone a second are there anything up there that maybe you wouldn't have considered before or are there things
• 39:00 - 39:30 that you think are missing that maybe you you have seen um or or thought about oh yeah punishment and self harm someone mentioned um so yeah not sure if that's one that um you're surprised by or or didn't think of or any of the things but yeah absolutely and that's
• 39:30 - 40:00 one um you know that I think there are specific ideas that we think about when we think about self harm um and what that can look like but um denying oneself food or denying oneself access to um the care that they need is definitely um is definitely a form of self harm right um and and you can kind of see that more when when you um when you think about a different ly as as a denying oneself of of something um yeah
• 40:00 - 40:30 avoidance of sexuality is one that you might not have considered for sure um and that can look kind of very different depending on the person it's it's a very general thing um so it can be a result um that that kayin kind of touched on of avoidance or a result of sexual trauma and so wanting to avoid um you know sexualization using the symptoms to kind of change your body to protect from future victimization um you can also see a lot of connections to gender identity
• 40:30 - 41:00 um this is something we'll kind of touch on um going forward but if someone's gender is unaligned with their sex assigned at Birth then changing their body in certain ways May um be an important um that may serve as a purpose to to help them better align with their with their body um preservation of relationship yeah that's um that's definitely an interesting one um so you know if the if the focus is on an eting disorder or an illness in general in some cases it's easy or to ignore other
• 41:00 - 41:30 problems or um you know wanting to look a certain way or behave a certain way um if if relationships are dependent on that um can you say more about self soothing absolutely um so that can can look different depending on the behavior so for some people um who experience maybe more binge um binge behaviors um the act of of eating itself um can be self- soothing and and
• 41:30 - 42:00 that's something we all experience right um food is and can be a comfort and that is a totally normal thing um food is not just fuel food is something that um helps us create connections with people um like think of all the beautiful times you had over a dinner with friends or family right food is a great and powerful connector it connects us to our traditions and our cultures and all of those things and so um sometimes food or the act of eating can serve a purpose it can be self soothing it can be a way
• 42:00 - 42:30 that we can um you know take care um take care of our mental health but then it can also be something that we can kind of abuse in that way um of of that can be kind of our one tool for so soothing our s which isn't necessarily what we want awesome okay Safeguard against failure for sure I won't be able to go into too much detail I do want to make sure that we move on but
• 42:30 - 43:00 um for for some people with an disorder experience um you know it kind of feels like your life is put on hold that eating disorder kind of creates a buffer or cushion a cushion between yourself and the realities of life um you know if you're focused on staying alive or meeting a certain weight um then you don't have to worry about um
• 43:00 - 43:30 getting into a certain University or that kind of stuff this is completely myself talking um right but it can kind of um Safeguard you from the realities of of life outside of that awesome okay yeah hopefully we got into some of those things um the resource on this page just at the bottom there um goes into detail about all of these and there are some some other great um great research out there that kind of explores these but so the the idea is that eating
• 43:30 - 44:00 disorders and the behaviors of Eating Disorders really do serve a function um that's really really important and and so a really common one is just coping with negative emotions or avoidance that's one that we see a lot that can look different to different people the behaviors are going to be different for different people but yeah definitely that kind of coping or avoidance of whatever that looks like um is is really um apparent and so a big part of this is
• 44:00 - 44:30 um this restrict Bridge cycle that's really really important for us to talk about um and it's one way that eting disorders can kind of be triggered so understanding this cycle can be a really important part of understanding how eating disorder behaviors of all types are serving that purpose um and how that can then perpetuate kind of more and more behaviors um so we do want to note um and and this is true in all of our conversations but the intention is not to shame anyone who is currently on a
• 44:30 - 45:00 diet or who has been on one in the past um these behaviors are common um and engaging in them is very understandable it's a very um unfortunately normal way to respond to messages that we receive about our bodies and weight and Food and Health um but we do want to take a critical look at dieting and what that looks like and what that means kind of in this context um so yeah especially for folks in larger bodies engaging in a diet can be seen as socially expected um
• 45:00 - 45:30 there's an expectation that someone in a larger body would want to lose weight um and and all of those things and so sometimes even those kind of disordered behaviors or dieting is encouraged by Healthcare professionals um and so engaging in these behaviors um is unfortunately fairly normalized for a lot of people but we do want to take a critical look at it so um you can kind of start anywhere in this cycle primarily um you kind of start at the top there of um I need to get control um
• 45:30 - 46:00 or there's a lack of access to food but for any reason um your food intake lowers you are not eating as much whether that's because you are choosing um to be on a diet to try to you know watch your figure or whatever that is um or you do not have access to food um and so our bodies our bodies don't know the difference between a diet and starvation um they they don't care they don't know um and so that leads to Cravings to
• 46:00 - 46:30 hunger um you know our bodies want to Keep Us Alive our bodies are really really fighting for us and vouching for us here and so they um we think about food more we want food we are thinking about um the things we want to eat and all those things and that's our body trying to take care of us that's our natural response to to those those restrictions and so we have all these Cravings we're getting really hungry um and that then leads to kind of binging and overeating so we have been um depriving oursel for a certain period of
• 46:30 - 47:00 time whatever that looks like however that's looked um our body responds and then um when we do allow ourselves food we are often um overeating or or binge eating not necessarily um you know binging can look different to to different people um but overeating and maybe that's past the point of fullness maybe that is um compulsively kind of feeling like you're on autopilot um any of the those things that then leads to a lot of guilt or shame um you know either
• 47:00 - 47:30 we kind of failed our diet or um you know we think we're going to then gain weight or any of those things um but then we feel really bad we feel like we have messed up in some way shape or form or something is happening um and that then leads back to I I need more control I need to do better um and I will do better next time and then you can see how that just leads back into the cycle um and so this is really really important to to know that um dieting or
• 47:30 - 48:00 restricting um you know begins as an attempt to gain control um and and this is especially true in the covid-19 um pandemic or situation and we've you know the three organizations represented here have seen a huge influx in people needing our support and resources because of this um and so really really important to to mention so um yeah binging is a biological normal response to that restriction but it does become a
• 48:00 - 48:30 cycle and it does become something that it's very very hard to um get out of or break free from um and so often kind of binging does not exist on its own it is normally in response to um an attempt at restriction or a restriction which is um really important to to recognize and understand how these kind of different behaviors all fit together and don't necessarily exist um in in a vacuum and so um you know diets have been around
• 48:30 - 49:00 for a very long time Unfortunately they used to be really weird they're still really weird um based on a growing body of research we we do know that dieting does not work longterm that weight does not indicate Health there are many other things that um that play a role but so is really really important to understand kind of the role that this cycle plays and how these behaviors lead into each other um Caitlyn or Ari anything to add here yes we'll unpack this more definitely okay fantastic thank
• 49:00 - 49:30 you the third myth um is is a really really important one um and one that we'll kind of dive into a little bit deeper but um there's always going to be more to unpack um thinking about these things but so the myth is that Eating Disorders only affect thin white wealthy teen girls um which I mean we um in our practices and I'm sure in some of your practices you have um a lot of anecdotal evidence that proves that this is just
• 49:30 - 50:00 fundamentally untrue um but for for a lot of reasons and um whether it's the media or just um stigmatization in general um this is the myth that exists um when we think about Ean disorders we kind of picture the thin white um teenage girl who struggles from anorexia and I say that as a thin white girl who struggled with anorexia in her teens um the reality is that e disorders can and do affect anyone and we see that in our work every single day um so this is
• 50:00 - 50:30 really really important to keep in mind assumptions and stereotypes can be incredibly harmful um and they prevent those who don't fit that stereotype from receiving support either because they don't self-identify as needing help um so they you know they think I don't an En disorder fits this person and that's not me so I don't need that help or they don't feel comfortable asking um or because health professionals are just less likely to pick up on the symptoms or on the dangers um so we're going to
• 50:30 - 51:00 go through a few aspects of identity and how these kind of intersect with the development of e disorders um I do want to recognize that um I and um my my co- facilitators none of us um you know fit into every single one of these different identities and so we um do not want to speak on behalf of people who identify with these experiences but we do want to speak to what we have read and what we know from the people that we serve um and so Ari and Caitlyn are free to jump
• 51:00 - 51:30 in with any of your experiences in NE or sheena's place um but we do want to make sure that we are um acknowledging these pieces even if we don't fit into um into these identities so it's important to explore these ideas P personally and professionally by acknowledging and addressing them um and making sure that we're acknowledging our personal bias recognizing our personal privilege and the privilege um that is required of whatever kind of professional setting you you find yourself in um and tackling the power IM balances that exist there
• 51:30 - 52:00 both personally and kind of systematically in um whatever kind of institution or Foundation or any of those things you find yourself in um a lot of the data that we will kind of be going to is um American unfortunately um Canada's data on eating disorders is severely lacking um for a number of reasons attention and funding that un disorders receive is quite low um but they do kind of give us an important insight into a lot of these different pieces and so we'll we'll jump into some
• 52:00 - 52:30 of those so the first um kind of identity intersection that we want to get into is race um and so want to note very off the bat that um the information that we have regarding the prevalence and severity of eating disorders and disorder eating amongst communities of color um is deeply flawed and most likely misleading um but the research that we do have shows us some really important Trends so people have CED are just as likely if not more likely to present with e disorder symptoms um
• 52:30 - 53:00 black teenagers are 50% more likely than white teenagers to binge and Purge um and Hispanic folk are more likely to develop bulimia than non-hispanic folk um while there are similar incident rates um black women are far less likely to seek treatment for binge e disorder than white women um and are more than twice as likely to drop out from treatment um and people of color with self- acknowledged eating and and weight concerns were less likely than white individuals to be asked about their symptoms by a clinician so we have a lot
• 53:00 - 53:30 of kind of stats and information um such as these that are the result of stigma and discrimination and medical racism um and factors such as racism sexism classism um and you know stress as a result of all of those experiences do and can contribute to the risk of people of color especially women of color I'm developing Eating Disorders um also want to note that um in research historically black women were sometimes assumed to
• 53:30 - 54:00 experience less body dissatisfaction based on um the idea that African-American culture um Embraces larger or curvier body types um and this rhetoric not only kind of ignores the very real experience of black women who struggle with restrictive Eating Disorders but also kind of perpetuates the narrative that puts um restrictive based Eating Disorders kind of at this top of this imagin imaginary eating disorder hierarchy um so really important that when we think about race we think about the cultural practices surrounding food eating practices
• 54:00 - 54:30 tradition and that we are thinking critically about the biases that we have what expectations of resilience we have for people and for our clients um and it's important that we understand the limitations of the Healthcare systems that we have um and all all of those pieces yeah stats are all available kind of at the end and you should you should be able to see them um also do just want to note here indigenous communities um their relationship with food and and how they show up in disorders in the Healthcare
• 54:30 - 55:00 System um we kind of touched on some of those like intergenerational historical issues in the land acknowledgement um but just that colonialism continues um to to very much affect indigenous people's relationship with food and their bodies whether that's experiencing food insecurity limited access to adequate conditions for eating including drinking water all of those pieces awesome next kind of intersection we want to get into is around body size um and I did
• 55:00 - 55:30 see a kind of question about this um in the Q&A of of if um an obese client is um restricting um their food to lower their weight is that still considered disordered eating um and the short answer is yes um regardless of your body size or your body weight um you know if you have an unhealthy relationship with food um that is probably disordered eating and you should probably take a look um a critical look at that and not just kind
• 55:30 - 56:00 of blindly support that someone in a larger body would want to lose weight that's not necessarily what health necessarily has to look like so there are pervasive stereotypes that affect those in larger bodies and access to healthare um so one common misconception is that people with um large bodies can only have binge disorder um and only those in small bodies can have anorexia we know that this is not true people of all sizes can have anorexia that's why it's important um to um really
• 56:00 - 56:30 intentionally care for clients in larger bodies and and not assume their kind of eating experiences um so less than 6% of people with eating disorders are medically diagnosed as underweight so weight is is not super indicative of um eating disorder behaviors or having eating disorder so really really important to not um yeah kind of brush off um people who are at normal weights or in larger bodies um atypical anorexia
• 56:30 - 57:00 which is kind of you know what we think of it as anorexia but without um a specific kind of BMI um category is more common than anorexia um restriction food intake and drastic weight loss is dangerous regardless of starting weight um really really important to know doctors often or may diagnose symptoms of Mal malnutrition um in patients that are classed as overweight and Healthcare professionals are are about half as likely to diagnose someone with an eing
• 57:00 - 57:30 disorder if they're in a larger body compared to those um in normal or underweight categor so really really important to to know that people in larger bodies can IND do struggle with eating disorders um as a healthc care professional or social worker or however you identify yourself really important um to to understand that you're not immune to leaving The Stereotype these kind of stereotypes um and allowing them to impact the the care
• 57:30 - 58:00 that you provide to patients um patients and larger bodies report that they sometimes feel disrespected by providers um they perceive that they will not be taken seriously because of their weight they report that their weight is blamed for all their medical problems um and and all those kinds of pieces so really really important um to to think critically about our understandings of eating disorders and body weight and all those different pieces um and yes I see lots of questions lots of stuff happening in the chat which is fantastic um and we will speak about a lot of
• 58:00 - 58:30 these things in section two we really just want to provide um kind of a general overview um as best we can gender and sexual orientation um so queer folk um experience many unique stressors that can affect their relationship with their body and food um the acronym that we use at body brave and that um I will be using kind of today is s lgbtq i a plus um so those populations um should be understood and
• 58:30 - 59:00 and their relationship to e disorder should be understood within the broader cultural context of Oppression um so internalized negative messages or beliefs about oneself due to sexual orientation non-normative gender expressions or transgender identity is a potential factor that may may play a role in um individual's disordered eating experiences so really really important to know that so um people who identify is to SL lgbtqia plus are significantly at higher risk of developing an e disorder or disordered
• 59:00 - 59:30 eating than um heterosexual cisgender individuals and this is especially true for transgender non-binary individuals um potential causes or reasons for this are body image dissatisfaction um which can largely kind of be a result from the inability to meet gendered body ideals um as well as coping with trauma from discrimination oppression bullying and harassment um there was a a um a great study from the Trevor Project
• 59:30 - 60:00 um which is an American organization um conducted in 2018 um about disordered eating and eating disorders in um lgbtq youth which was kind of the first of its kind um and they found that of the over a thousand youth um that were surveyed 54% 54% had been diagnosed with an e disorder and 75% had been diagnosed or suspected that they had an e disorder compared to 5% of their heterosexual cisgender peers so um a very very high
• 60:00 - 60:30 um percentage of those youth struggled with eating disorders or disordered eating um and there are lots of reasons for that um but just really really important to know that especially um for transgender populations body dysphoria um or gender dysphoria body dissatisfaction all of those things um really do play play a role so um trying to you know lose weight in certain areas or gain weight in certain areas or um subscribe to you know gendered ideas about what your body should look like um
• 60:30 - 61:00 can be a really really big reason that um someone might struggle with an e disorder and that kind of goes back to those functions that we were talking about earlier I know I am zipping through these don't worry you could do so much on all of these we just want to make sure that we are kind of um sprinkling this important information kind of throughout um so that contextually we understand kind of where we're where we're coming from um another important aspect is gender I'm so historically
• 61:00 - 61:30 much fewer men were thought to struggle with Ean disorders than women um older statistics cite around 10% of the total number of people with Ean disorders were male U more recent estimates suggest between 20 to 25% of people with Ean disorders are male um and so there are a number of reasons why e disorders and men have received less attention historically um men are kind of generally admitted from the majority of e disorder research
• 61:30 - 62:00 there's a lack of recognition of e disorder symptoms by males themselves and by their friends and family right you're not necessarily looking um for the those same things um bias from professionals leading to less likelihood for an EOS or diagnosis um strong feminine branding or an exclusion of males in e disorder treatment centers or e disorder treatment support um e disorders present differently with different symptoms in um in males and females um and the
• 62:00 - 62:30 diagnostic criteria were very gender biased making it very hard for males to be um diagnosed so up until recently um a menorrhea or loss of a menstrual period was um part of the diagnostic criteria of anorexia and so if you did not have a menstral period you could not be diagnosed right and so that very drastically changes um the kind of prevalence and the severity of our understandings those e disorders based on that diagnostic criteria what we do know about men and E disorders is that
• 62:30 - 63:00 um between oneir and 1/4 of people that shrinks a lot with binge eating disorder um nearly half of those with binge e disorder are men um and subclinical e disorder behaviors um are nearly as common among males as they are as females so when you get into specific diagnosis and those kinds of things there is more of a gender disparia or um gender disparity when you get into kind of the behaviors itself um there's less
• 63:00 - 63:30 of that disparity so really really important disability nerd Divergence um important to note here that people will conceptualize disability differently uh it may not apply to everyone the point is to kind of discuss these intersections because they're prevalent but under research and under discuss so do just want to make that note that um the conceptualizations of disability are different for everyone and um and those pieces want to to make that kind of
• 63:30 - 64:00 disclaimer but um medical science and research is often done in a way that is not very representative of all people and so very little research has been done on the co-occurrence of disability and disordered eating but we do know that eating disorders affect those living with disabilities or those who identify as disabled um ableism and misconceptions about people with disabilities um May play a role in how we understand e disorders and how they manifest in people with disabilities so some things we do know um women with
• 64:00 - 64:30 physical disabilities are more likely to develop an e disorder than women without um 20 to 30% of adults with e disorders also have autism um ADHD is most commonly is the most commonly missed diagnosis in relationship to e disorders um on a personal note I think it's fascinating the relationship between ADHD and disordered eating um and there are a lot of great um people who are kind of starting those conversations which I think are really really interesting in how people relate to food
• 64:30 - 65:00 and those um those kinds of pieces people with intellectual disabilities are more likely to experience um feeding and eating challenges um so arid avoidant food um avoidant restrictive intake food um disorder um and rumin rumination disorder and Pika if you remember Caitlyn kind of talking about those um people with intellectual disabilities are more likely to experience those um as a result aism and diet culture um
• 65:00 - 65:30 people with disabilities are more likely to or maybe more likely to experience by dissatisfaction increasing their risk of developing order um and so reading the quote here it's really important reminder um in the context of Eating Disorders eating disorder strategies can be quite ableist um it's important to kind of look critically at those pieces okay obviously there are many many more intersections of identity this is the last one we're going to touch on today
• 65:30 - 66:00 um is socioeconomic status um yes I will share resources and literature to check out because I think they're so cool um sorry about ADHD that was in the chat um socioeconomic status so people in lower socioeconomic status brackets and those living in poverty are more likely to display e disorder symptoms um and obviously we kind of touched on this in the um restrict binge cycle um restriction does not have to be um something that is you know intentionally kind of chosen it can come
• 66:00 - 66:30 from lack of access to food um so you don't have access to food um or you don't have sustainable access to food and so then when you do have that access or you do get that food um you know your your body and your mind says I don't know when I'm going to have this again um I don't know if this is something that will happen you know tomorrow or next week and so binge binging can occur so um that restrict binge cycle really comes into play when we think about food insecurity um so possible causes of um
• 66:30 - 67:00 this kind of difference in lower socioeconomic status brackets um the stress of financial insecurity can exacerbate symptoms um so you know we talked about all the functions that e disorder serves um Financial insecurity um is very very stressful um and people you know want need to to cope with that stress in in certain ways um and then food insecurity is linked to to higher rates of restricting binging and purging as we saw in the restrict binge cycle um people living in poverty are also less
• 67:00 - 67:30 likely to access treatment um you know lowcost treatment options are extremely limited um you know organizations like body brave and Sheena place um try our best to to be super accessible but the reality is that there is not um enough Supply to kind of Meet the demand of people who need very low barrier um support um and not just treatment itself um but also diagnosis um Specialists Transportation all of those things um it's not easy to access those pieces so
• 67:30 - 68:00 especially um or engaging in disorder behaviors can be expensive um purchasing food to binge if if you are going out and kind of with the intention of purchasing binge food that is not necessarily accessible um to to all people and so also plays a role um and also an important component is the increase of food insecurity that we've seen as a result of covid-19 um whether that's people have um lost their jobs and so are not able
• 68:00 - 68:30 to access um sustainable food or food in the same way that they were before and all those kinds of pieces so um definitely also seeing in relation to the covid-19 pandemic um has very much impacted socioeconomic status of people and their relationship to to eating disorders um that was a lot as I said we could not get to every single um piece of someone's identity so just really important to to note that um you know try to think critically about the clients that you're working with the
• 68:30 - 69:00 people that you're working with and how Eating Disorders disordered eating um might serve a certain role in their in their lives um I'm going to pass it over to Ari who's going to kind of go into the next session um and we will kind of dive into more of these things in the next um session in November as well I take it away thanks Aaron and I'm going to take a giant breath with everyone because I think um that was a lot and I really want to normalize that it can be a lot
• 69:00 - 69:30 when we're living in a society and in a culture and in a training environment where many of us don't get a lot of formal training on eating disorders so fundamentally I want to thank all of you for being here today um and know that we're going to try our best in each of the three parts to be as practical as we can be as well and I have the pleasure of getting to do some of our practicalities in this wor part and today since we've been talking about recognizing disorder eaing and eating disorders our practicalities are going to be focused on assessment and so as a
• 69:30 - 70:00 clinician um I think this could involve simply asking questions about food and exercise behaviors um and this information might not actually be offered up willingly by the client because of the guilt and shame and some of the other stigma that Aaron and Caitlin have had a chance to to get and go um I'm going to ask Caitlyn to unmute if she can because I think she has a really wonderful story story about this that I think it's important for us to keep in mind yeah so thanks s just really
• 70:00 - 70:30 briefly um something that I always like to mention in these types of presentations is around the importance of asking the right questions so um I did my one of my social work um Master's placements um at an agency that provided individuals um counseling and I had a case load of about nine clients um and five of those cents had either an eating disorder or disordered eating um behaviors and I remember at the time my
• 70:30 - 71:00 supervisor um when we were debriefing one day said to me wow like it's what a coincidence that you like more than half of your clients um like exhibit you know disordered eating um symptoms like that's so interesting um given like your interest in experience kind of volunteering in that in that area and so I had to very politely um let her know that I didn't think it was a coincidence and that it was likely that I was just asking um my clients about their eating
• 71:00 - 71:30 and exercise um behaviors and I think that if more folks were asking these questions and and being more direct about that that they would find that more more of their clients also experience these challenges and so on this slide you can see some example informal questions um that we might used to ask around eating around exercise around past history eating disorders and normalizing that um I feel like when you ask your clients about eating an exercise it kind of
• 71:30 - 72:00 normalizes that that could actually even be an issue that many clients are just like all of us are navigating their own relationships with food and movement and might not even know that they have Liberty to discuss that with you in in a counseling or in a therapy environment um you can see some formal tools linked in the slide deck so scoff um the eating disorder screen for Primary Care the edq and the Ottawa disorder edting screen for youth for folks um under 18 they're all short or brief screens that all of
• 72:00 - 72:30 us as clinicians can access they're not ones that you have to be a psychologist or psychiatrist to use and so if you're really concerned and you're feeling like you prefer to use an a validated instrument you're free to use any of those linked tools um fundamentally I think our reminders are to make sure to ask permission um to ask our clients these questions to kind of prepare for that possible anger or denial given the kind of culture we have around food and shap to normalize that this can happen and to use their language so you've
• 72:30 - 73:00 heard the three of us use different language throughout our time today um if they use eating disorder language I'd use eating disorder language back if they use food stuff or they're struggling with movement then I'll use food stuff in movement um I think it's only on me to maybe bring up or um ask about language shifts in conjunction with my client and to do that transparently with them and ask them how or if or why they're using certain words to describe their experience because I
• 73:00 - 73:30 think that can say a lot about their experience too when it comes to talking about eating and exercise um here are some questions that I think you can potentially ask in a more casual format on the left around movement things like how did that movement make you feel are there certain types of movement that you prefer um letting them know that there's exercise doesn't just have to be um doing strength training or going on a
• 73:30 - 74:00 run or having to do yoga or things like that that there are many different kinds of movement that are around and the issue that when we often talk about exercise in this context is just trying to get people not sedentary and so I don't mind if they're skipping rope or if they're playing soccer or if they're doing Pilates if they're doing a martial art all of that can be valid PHS of movement too and I think think especially in our like North American culture here I think we're getting more and more rigid with our conversation around movement and um sometimes that
• 74:00 - 74:30 can make things I think pretty difficult when it comes to food questions like did it feel like that food gave you enough energy and especially for people that might have a little bit more awareness and like psychologically minded like how does nourishing yourself um align with your values those are really wonderful potential um questions to ask those questions around principles of healthy eating I really want to remind folks that while I think our food guide still
• 74:30 - 75:00 has a long way to go that our Canada food guide was updated recently in 2019 um to really move away from that rainbow model that many of us might have been educated on around that strict um n around portion sizes or food categories and instead more so thinking about a plate of first and foremost do you have an adequate amount of food on your plate because if you don't like Aaron talked about with the the B strict cycle um we might not ever have a chance to develop a positive relationship with food um when it comes to balance or flexibility
• 75:00 - 75:30 or pleasure making sure that those things are all relevant in our food conversations and pleasure being something that we have with food um those are all ways that I feel like you can use this information to talk to clients about eating and so I'm going to pause us here and I'm going to give you a minute just to um read this slide and absorb some of
• 75:30 - 76:00 these best practices um and feel free to ask any questions in the chat about them um I'm going to emphasize one or two of them but let's take a minute here just to review this
• 76:00 - 76:30 okay I'm looking through the chat to see if folks have questions about this specifically and know that we'll come back to some of the ones that aren't about this in a bit um one of the things
• 76:30 - 77:00 that I really love to do here um is to see if you can um focus on emotions where you can so sometimes I feel like we almost have a gut jump to make recommendations around food and exercise based on our own beliefs around food and exercise and what's healthy and I really ask you to use the information you have today to like hit pause on on that and really get to investigate at the end of this series whether you're best equipped to make those recommendations I feel
• 77:00 - 77:30 like we all receive information about food weight and shape from all across our lives from our family members to our friends to our doctors and now potentially to our from our social workers and I think if you're taking a chance to focus on their emotions um how they've been feeling lately and getting to unpack how um potentially their interaction with restricting or binging or over exercising started from an emotional place of a place of sadness or anxiety or worry or loneliness we might
• 77:30 - 78:00 have a great opportunity to potentially unpack an emotion in ways that I think all of you know how to do and to also potentially Bond and empathize and relate with our client because even though all of us might not have experienced just what deeding um I think we've all experienced different emotions that can be underlying it and that's an example of a of a best practice that um you can do if you're finding it really hard to give information or feeling like you're not maybe the best suited to make
• 78:00 - 78:30 recommendations about food and exercise specifically I'm going to also emphasize the one thing that Tanya is putting into the chat I I think also for what not to do is not to comment on someone's body so um often it's you look great have you lost weight that comes out of our our mouth so easily um instead like can we say it's so nice to see you if that's the feeling that we're feeling if that's that positive emotion that we're feeling or instead um really than someone for
• 78:30 - 79:00 coming and um get ready for therapy that day like do we have to make a comment on appearance or um comment on someone's like innate traits as opposed to their external characteristics um that's a really wonderful best practice so thanks for sharing that Tanya okay this slide I think is really important um and I really want to emphasize that the symptoms that appear here aren't necessarily in order of
• 79:00 - 79:30 increasing severity but more so an example of different factors that co-occur and can impact the severity of risk so for sure things like suicide risk or chest pain or heart issues require urgent attention and others like gastrointestinal problems or dizziness are less clearcut and while concerning and warranting medical attention they may not be things that one might necessarily would call for emergency care and so it's important that I think um we remember that there's a large proportion of people who have Eating Disorders or
• 79:30 - 80:00 who struggle with disordered eating who will not need this type of medical monitoring and who are safe to treat without medical emergencies being a major concern um of course from a place of safety and competence like ensuring the medical stability of clients are important um it's just important to know that these concerns might not be part of their experience and so doing an assessment to ask about these things having your flags come up if you hear chest pain or if you hear
• 80:00 - 80:30 dizziness or asking someone if they have been going through disorder deeding symptoms if they've noticed any any physical signs or any dizziness or chest pain um those are things to really flag for you what I don't want to have happen as I think sometimes from a well-meaning place we end up referring folks with eating disorders almost to too quickly to the place where like if they had come in with anxiety or they'd come in with substance use we'd feel like maybe we can have a single session with them or
• 80:30 - 81:00 we can really unpack where they're going from and sometimes we hear eating disorder we jump to medical and then we're like well I guess we can't see them and I think that also perpetuates this culture around like weight lists and referrals and folks being passed from person to person and so again I think that's valid if you're coming from a place of Competency where these things are coming up and someone does need medical monitoring but the slide's also here to let you know that um if this isn't true if this these things aren't coming up um it's really important for
• 81:00 - 81:30 us to keep in mind that maybe we can provide some immediate support to someone around them and ultimately um the stages of change something that you all might be familiar with through um work with substance use um or work with other conditions that motivational interviewing is a best practice for we often feel like is a really relevant um model to use here on medic toll free
• 81:30 - 82:00 heline in our chat service um we get a chance to assess stages of change all the time with people and really get a chance to normalize that it's okay if someone comes in in a stage of precontemplation where they might not see a problem with their current behavior or if they're contemplating that they're aware of their problem and they're thinking about recovery but they're understandably confused or unsure about next steps that's a really part normal part of someone's eaing disorder experience um and so we're going to go through a little
• 82:00 - 82:30 bit of motivational interviewing with you just to give you an opportunity to um unpack this yourself and provide some resources on it because it is like a really awesome short-term strategy um and we'll see how we do with time on it um before I do that I'm just seeing some questions in the chat that I think should respond to right away and so Peter's asking can you
• 82:30 - 83:00 clarify was that a Continuum of severity to incorporate into deciding when to refer for immediate medical attention more severe on the right yeah like I know that graphic can sometimes be a little bit tricky um it wasn't necessarily A Continuum specifically from left being worse and right being or left being less worse and right being worse um just more so a list of symptoms that you can potentially see um that might come up for eing disorders where immediate medical attention should definitely be sought when we're talking about some of the cardiovascular issues
• 83:00 - 83:30 like a regular heart beat or chest pain or the intent plan of suicide that's there but that all of those other bits in Orange um the gastro problems the dizziness the confusion those could also be places where medical attention is necessary and they could also be there for other reasons and so I more so wanted you all to have this as a sense of here some Flags ask around and to assess for and I think if you're noticing um the chest pain or the heartbeat or the suicide that you're going to have to risk assess for that
• 83:30 - 84:00 just like how you would for anything else um but also to know that sometimes these things can come up for other reasons and it might not mean that we have to call a doctor right away or send someone to emergency room that we might be able to do some harm reduction approaches with folks as we need to and we're going to get a chance to unpack a little bit of that in in part number three okay let's go through motivational intervie
• 84:00 - 84:30 now so for folks who aren't familiar with motivational interviewing and working with the stages of change um it's used as an effective means to building Alliance and really engaging clients who are ambivalent about change which many people with eating disorders can be um and often we're working to minimize power we're reflecting we're disarming we're not trying to argue or refute or contradict a client's point of view and so we really have to check ourselves in this process um often the
• 84:30 - 85:00 approach is to listen for underlying emotions to make tensi guesses at what a client means and validate the emotion so that the client knows that you get it or can correct you if you don't get it and so an example there is on the slide the client saying I'm not going to the hospital it was horrible last time you being able to say you're afraid it won't go well and it makes sense that you don't want to go again that was horrible for you and you need help so let's talk about that um you're guessing at that
• 85:00 - 85:30 emotion being fear you're normalizing and validating that they don't want to go again we're not really refuting that they need to go and we know that they need help so let's talk about what help could look like that link at the bottom there the Ed toolkit for pcps and BC was a 2018 toolkit that goes through more statements like this in case you want to read up on this afterwards here's some more examples so one where we can reflect back a
• 85:30 - 86:00 discrepancy um Often by verbalizing the discrepancy between the client's State and what they're actually hoping for so in this case it's really common for me to experience with a client that they are divided it's almost like parts of them are at war that one part really um is committed to the eating disorder and has the functionality set in place and really does doesn't want anything to change and other parts that are getting harmed as a result of it and so sometimes we can hear I'm not going to eat and you can't make me and one way to
• 86:00 - 86:30 respond is you're so scared to eat and you have no energy neither's what you really want it's hard to do this on your own and there is help so being that grounded Optimist for Change and getting to ask some of those change questions that are there how would you like things to change well standing in the way of you taking steps towards support and what have you done before that makes things better and so we won't have and I don't
• 86:30 - 87:00 think this is like the place or the platform for us to potentially get to go into to case study this but it's something that you all can potentially do with any kinds of peers consultation or supervision that you might have but I'm going to give you all a minute to review these examples and take a guess at maybe how you'd respond to Jesse Tanaya Isaac and mateline knowing that this is devoid of context and obviously this is a learning tool but take a
• 87:00 - 87:30 moment to think about that and I'm going to share a little bit on how I might um how I might respond just as one example and then we'll wrap up with some resources so I'll give you 60 Seconds
• 87:30 - 88:00 give you 30 more seconds and I'll go
• 88:00 - 88:30 into how I'd respond to these four one way to do so because it's not about being right or wrong we these are real humans and so we have to take into account all of that too
• 88:30 - 89:00 okay so Jesse is saying this is a waste of time I'm only here because my parents made me come one thing that I might try is you're frustrated at how it happened and you don't think this will be helpful and you're here now what hasn't worked in the past can we work together to talk about how we can make today a better experience for
• 89:00 - 89:30 you so again we're listening to an underlying emotion Jesse could be frustrated potentially a tentative guess at the emotion and being a grounded Optimist how do we make the most of today even because you're here Tanaya is saying no I hav't told my doctor about purging and I don't plan to I might respond to that with I he that tell me more are you worried it won't go well and so here we're not refuting or we're not disagreeing with the client
• 89:30 - 90:00 we're curiously asking for more and we're tentatively guessing at that emotion of worry because Tanaya might have real good reason for not wanting to talk to their doctor about this and they might need help for it anyways and so let's learn more about the situation Isaac I'm not interested in eating disorder treatment if it means gaining weight I might respond to that you're scared to gain weight and it can be really hard for you to get support for an eing disorder on your own let's talk about what you might be open to and
• 90:00 - 90:30 so the grounded Optimist the and being really key there and really like validating that it's okay that Isaac's scared about not getting weight maybe there's something there we want to unpack to and for meline while I feel healthy so why should I eat more than a th calories I might respond to that with I'm glad you feel healthy what does that mean to you how do you define healthy and so I'm not inserting my opinion on calories or numbers um I'm checking that
• 90:30 - 91:00 for myself and I'm more so getting a sense of what health means to them and are we diversifying their experience of health and we'll get to talk a lot about that in part two of the webinar um I know that we're at time and so what I really want to do is just wrap up by saying two things um one that sometimes with clients you can almost feel like you're going in circles like that top image on the slide and one thing that I think we can really provide for clients is providing that side angle and that
• 91:00 - 91:30 change of perspective to let them know that sometimes there can be an upward circle of progress even though you're still going in circles um I think we can be ones to help them see that and two that there are resources to be able to help you and so again I really want to mention we'll talk more about ntic at the end that we have information and refer s and can provide in the moment support to anyone Canada wide um that that toll free number listed at the top of that slide or on the online web chat
• 91:30 - 92:00 um we're here to support you and we're here to support your clients um some examples of services that we might be able to help you link to in terms of support agencies and this is an example for the GTA some of the hospital based programs that are in the region um we might help you find virtual treatment options like body Braves Community Based and OIP coverage virtual treatment for folks 17 plus um we might help you find private therapists or clinics we might also help you find virtual support
• 92:00 - 92:30 that's open for people in different parts of the country so sheena's Place being here for free group support for 17 plus in Ontario or some of the great work from meeting disorders Nova Scotia are looking glass BC in Nova Scotia and Vancouver that can provide support for people across the country um these are here as examples support resources for you to potentially um look into a bit more and it's something we're happy to link you to in addition to support for carers themselves you'll really get to learn more about some resources on this slide
• 92:30 - 93:00 deck too including some general information and potentially some more training for healthcare providers including some bits from body brave um for any dietitian friends that you have that eating disorder sensitive for dietitian or for sheena's places webinars um and finally some more readings around Health every size and weight stigma that might become more relevant after part two and some podcasts for you to listen to um fundamentally we really appreciate your time today and the slide deck will have
• 93:00 - 93:30 a bunch of um references for you as well um so please feel free to dig into these as you want to um but ultimately I'm going to pass it back to Alexandra to get a sense on how we're at with time and what we what might be the best way for us to handle um any other questions that we can get to answer yes excellent well we were so fortunate to have our webinar presenters answer questions throughout the presentation so I do know that a lot of these questions were answered during uh if you do have the time to stay on for
• 93:30 - 94:00 another 10 minutes we will do another about 10-minute Q&A section if you do have to hop off this is going to be recorded um so you're welcome to join back on anytime and just fast forward yourself to this part uh if you have if you do have to hop off so a huge thank you to our webinar presenters that was phenomenal and we are so great grateful for having you come and discuss this more with us uh just an FYI to those who are putting in the chat and Q&A the handout widget is the two pages you can
• 94:00 - 94:30 download additional documents there the bottom is the slide presentation you may need to rearrange where it is on your screen to access that the certificate of attendance is also available and will be emailed to you perfect yeah I think somebody just shook the hand out widget which is great um that the course completion tracker will be able to uh send you the certificate get once you're done this presentation once we all log off here um so yeah without further Ado let's hop into it I do want to say that
• 94:30 - 95:00 this is a presentation very near and dear to my heart so thank you to our webinar presenters for taking so much care and time uh with this and I know a lot of social workers out there are trying to address many needs during the pandemic and this is definitely one of them so I'm not sure if we answered this already but I will just ask um and and we can you know you can let me know if we want to move on to the next question but one of them is can you expand on safeguarding against
• 95:00 - 95:30 failure yeah absolutely I think oh Erin go for it sorry there's a lag on my end sorry Arin no problem um yeah so that was in the kind of like functions of an Ean disorder and so safeguarding against failure um was that kind of um the order being kind of the cushion or the buffer between um aspects of reality of life that someone might um be hesitant to um to go into and so the
• 95:30 - 96:00 e disorder kind of acting as um as that buffer um for people to kind of safegard them against some of the realities of of things that they might be scared to do or or hesitant to um to work towards and that's kind of the function that that the eating disorder serves Kaitlyn did you want to add anything in oh no sorry Aaron covered it
• 96:00 - 96:30 perfect um okay first of all thank you so much for this information I am curious if you have any recommendations for formal eating disorder training I know you had mentioned it briefly but if you want to just go over it one more time that would be great yeah um body brave has a um virtual online training um it's as synchronous so you can do it on your own time um for social
• 96:30 - 97:00 workers and psychotherapists um that's accredited with um the Canadian kind of psychotherapy um accreditation but for social workers I know it's a little bit different um and so it's about a three to four hour um training that kind of goes through a lot of the things that we have talked about and a few other things kind of a bit more in depth I can put that in um in the chat ch um if anyone is interested in kind of um that that course and learning a little bit more about um kind of those those eating
• 97:00 - 97:30 disorder pieces um and there are um lots of others as well um uh more specifically not necessarily kind of um um all involved all in one place but um different webinars like this that are available um for kind of healthcare Professionals in general and those kinds of things as well and on this slide here um that's probably 35 in the deck that you all will have there's a list of some resources um the academy for eating disorders as a guide for medical care um
• 97:30 - 98:00 cbte one of the modalities we'll talk a bit more in part three as a CBT enhanced for eating disorders there's a free online training right now that you can click and go through um webinars yeah sheena's Place netic um and body brave recently just come up with a course for for social workers and so social servic workers that um might be there for you to access on that body P site so there's some options that are being developed and we really appreciate you taking a chance to learn more about
• 98:00 - 98:30 this I did want to highlight that body brave has come out with a training design specifically for social workers and Social Service workers so please do take a moment and look into that if you are looking for uh increased trainings uh as many social workers know and what I believe we covered um having an increased tool belt that can address Eating Disorders when our clients come to us uh is just a great opportunity uh for us to expand our practice so thank
• 98:30 - 99:00 you for that um there's one more question I think before we wrap up and it kind of ties into what I see as a response for part three um and that is is there a preassessment tool that we can use to help yeah I can take chance answering that um earlier on in the slide deck I'm going to save everyone the opportunity of me clicking through all the slides to go back but we had a slide um earlier on
• 99:00 - 99:30 that said assessment at the top of it there were a couple of like validated tools um that have gone through peer-reviewed research methodologies there such as the scoff questionnaire or the edq um or the Ed screen for Primary Care um they have various items some three items some five items some 25 item and so depending on your needs um you can learn more on that slide deck by clicking those H hyperlinks and it'll tell you about the best way to use those validated tools um those could be means
• 99:30 - 100:00 of assessment if you'd like to do it that way um we often find that sometimes those validated assessment tools might not capture the diversity of experiences of eating disorders that your clients might have in front of you and so if you feel like you as you gain more knowledge in this can ask some of those casual questions that we posed throughout the presentation but especially in that assessment section when I started speaking um there are some examples there that that folks could listen to and potentially try useing as they want
• 100:00 - 100:30 to and many of these trainings that we just talked about in the answer to the last question we'll get to talk to you more about ways and which you can ask that sensitively and in part two you'll get to learn about sensitive ways to ask questions about things like weight and bodies and Food and Health as part of our um our what's the word like practical toolkit piece of presentation wonderful wonderful so you can register for part two and part three on the
• 100:30 - 101:00 registration page of this webcast you can also register for it on the CW webinar portal uh we do recommend you know watching this one first and then attending part two and part three but feel free to share it with your colleagues and your peers uh what a wonderful overview uh and an amazing starting point um for the next two offerings that we will be hosting uh we are at time now so I am going to wrap it up thank you to everyone who attended there were a lot of you and you were so
• 101:00 - 101:30 engaged and so insightful and so we always love to see that and really appreciate you coming and spending that time with us today um if you do have any other questions you can let us know um we are always looking to hear from you uh and I'll just give the final words to our presenters if they have any final thoughts before we wrap up thanks so much for having us and we look forward to hopefully seeing all of you and more uh folks back at part two and part three um we're also I'm happy to
• 101:30 - 102:00 share my contact information I'll speak for myself not my co-presenters but I'll put that in the chat as well so if anyone has follow-up questions feel free to reach out by email wonderful lucky lucky attendees we have such an incredible group here today and again we're just so thankful so with all that I am going to wrap this up we will place this on demand if you want to come back log back on rewatch it send it to your colleagues
• 102:00 - 102:30 to your peers uh and feel free to let us know in the chat uh how you enjoyed the presentation there is a survey that's going to pop up at the end so please feel free to leave your comments there we so appreciate to hear what you think and so that we can do better for next time H with all that being said thank you everyone and we will see you next time bye