Lyndi: 0:39

Oh, hello, lovely people, and welcome to this week's episode of no Wellness Wankery. Today, I'm going to be joined by Sarah Liz King, and she's an accredited exercise physiologist who I'm excited for you to learn about, because what she does is she helps people have a healthy relationship with exercise. She helps them recover from eating disorders or exercise addiction, which a lot of people really struggle with and it's hard to know is this a healthy amount of exercise? Is this excessive exercise? And so that's what we're going to be talking about today.

Lyndi: 1:12

We're also going to be talking about hyperthalmic amenorrhea a bit of a mouthful, but it's a condition when your period stops and it can be due to stress or intense exercise, low body weight or restrictive eating habits. So we're going to dive deeper into that in today's episode. Sarah is someone who's person, after my own heart. She is also dedicated to helping people recover from disordered eating, eating disorders, and find freedom with that, with food, and also build that healthy relationship with your body, something we know is ultimately so important. She helps women unlearn toxic diet culture and she's all about the science. She's holistic and this is why we love her. Welcome to the show.

Sarah Liz King: 1:52

Sarah, thank you so much for having me. I'm super excited to be chatting with you today.

Lyndi: 1:57

I'm excited too. I was saying to you in the intro I feel like we're allies, I feel like we're working towards a very similar cause and that cause is helping to reduce, to prevent disordered eating and helping people feel more comfortable in their bodies. How did you get into this space? How did you come to be? Tell us.

Sarah Liz King: 2:17

So I have my own personal journey of both an eating disorder and also a very tumultuous relationship with exercise. So I would say that my relationship with exercise probably preceded any form of like disordered eating, but I definitely fell down the diet culture rabbit hole and it led me into struggling with an eating disorder for many, many, many years, and I always made this promise to myself that when I had fully recovered, that I would be an advocate to ensure that there was better education and better awareness and to help people who were in the thick of it to know that there is hope and that full recovery is completely possible. So it definitely took me a long time to reach full recovery.

Sarah Liz King: 3:14

I think for anyone that has struggled with disordered eating or an eating disorder, it often takes a really long time to, number one, figure out what kind of treatment is helpful for you or finding practitioners that you really relate to and resonate with. And secondly, it's a really long process of unlearning unhelpful habits and beliefs and learning what is actually more balanced and feels good for you and your body. But once I got there, I was like, cool, now I'm going to like here, enjoy this for a couple of years and then kind of move my practice towards helping individuals. So I have been in private practice for a very long time but have worked with clients in inpatient facilities and, yeah, now my virtual practice is all online. So I help people worldwide recover from eating disorders, disordered eating, hypothalamic aim and aria and compulsive exercise. So it's been a whirlwind, but happy to be here.

Lyndi: 4:23

And it's so nice to have practitioners who do see clients one on one. So what I'll do every on the synapse I'll leave a link to Sarah's website down below. So if you are someone who's going, okay, I feel like I'm ready to start my recovery process. I want a little bit more of a handheld experience, which I think is a very important thing when you're recovering from an eating disorder. You can click website down below and I'm so glad that you mentioned that you can get full recovery from an eating disorder. I just think you know the process to recovery is probably a lot less linear than we would all like it. Sometimes you take two steps forward, one step back, sometimes a few steps backwards, and so I think, having someone who can support you through it you know, I wish it's something that I had had Can you tell me, was there a moment where can you tell me a little bit more about your experience with your eating disorder and your relationship with exercise and how that now interplays into what you do?

Sarah Liz King: 5:18

Yeah. So first of all, growing up I had a very uncomplicated relationship with both food, exercise and my body, which I was incredibly grateful for, was really active. I didn't really think about what I would eat in a day or much about my body at all. And that kind of really changed when I was in the last few years of high school and you notice your friend group thinking more about what dress they're going to wear to the formal and the kinds of clothes they're going to buy and the conversations around dieting coming in, which I'd never really cared about before. But it made me acutely aware that maybe my body was something that I had to think about more and I had to manage more, and it kind of was a little bit of a perfect storm.

Sarah Liz King: 6:13

I was a type A perfectionist personality, a high achiever, and when I left high school and went into university I struggled incredibly with depression, which was something I never anticipated that I would, and that first year at university I found so incredibly hard and I turned to exercise. You know, I saw one of the university counselors and they're like exercise more, that's definitely good for your mood, and so I took her advice, but I took it too far and exercise then became my life and I was doing way too much and I obviously won't tell you the amounts because that's unhelpful, but it was taking over my social calendar. It was, you know, I would prioritize it over going to lectures or studying, and then, as a result of that, I became very hyper focused on what I was eating. And the really unhelpful thing was I was praised for it. I was, you know, congratulated for how disciplined quote air quotes disciplined I was, but nobody knew that it was actually causing me so much anxiety and so much distress that if I wavered away from doing those things, I would crumble, I would break down, I would cry, I would feel so incredibly upset and that's what made me realize, hey, this isn't healthy, this is actually potentially an eating disorder, and I wasn't formally diagnosed for probably another year or so. And then, once I actually got that diagnosis, it still was a little bit of time before I actually sought help to recover and I guess how it has led to what I do now is I was incredibly grateful that, you know, many years after my initial diagnosis, I found a treatment program that worked for me and a therapist that was really helpful.

Sarah Liz King: 8:21

But I think one of the biggest missing links for me was like there wasn't any information surrounding what was okay exercise wise. How do I improve my relationship with movement? What does that even mean? It was very much focused on your food and your weight and kind of unhelpful thoughts and managing and changing those, but it's very much left to my own devices as to how I rebuild a healthy relationship with exercise, which I think is a really big focus in what I do when I'm seeing clients and talking to them is actually going to rebuild healthy relationships with yourself.

Sarah Liz King: 9:03

It isn't just about one factor, it's not just the food side of things. You don't want to be afraid of movement. I think avoidance is just as harmful as being kind of compulsive around something. But you need to have a good sounding board and try things out to actually figure out what is healthy and balanced and joyful for you, because having movement in your life is a good thing for our well-being and we want it to feel good. We don't want it to always come from a place of being worried or concerned about oh, am I doing too much or not enough, or is this coming from the right place? So that's a lot of where I put, I guess my efforts in with the work that I'm doing, as well as the kind of intuitive eating side of things, to and I think it's tricky, as you said, to know well how much is a healthy amount of exercise can we talk about?

Lyndi: 9:58

what is the signs that you might be Over exercising and getting into that tricky relationship with exercise versus what is a healthy relationship with exercise look like and, likewise, what does? How do we know, when we stepped into this kind of under eating, obsessive relationship with food and, conversely, what is that healthy relationship with food look like?

Sarah Liz King: 10:17

Yeah, such a good point. So maybe we start with the exercise things first, and I think I like to put these as like little, little red flags that you can look out for and, you know, maybe some green flags on the flip side of things that kind of give you an indication that you're on a good path. So I think the red flags Sometimes they aren't as obvious as we would think they would be, because a lot of the time isn't necessarily what you see. So a person could be doing A gym session and you know, two people could be doing a gym session and one, you know, the same gym session. For one person it could be healthy and they could be in a good mindset. For the other person it could be very compulsive.

Sarah Liz King: 10:57

So I think the thing that we have to think about is what is your intention behind that workout? Are you doing it because you want to promote overall well being and it's not taking away from aspects of your health? So by aspects of your health, I don't just mean your physical health, but also your mental health, your emotional health, spiritual health. Is it taking away from time with friends and family, career, all of those kinds of things? So is it taking away from any areas of your life or, on the flip side, the green flag. Is it adding to your overall well being, right? Is it kind of the little kind of sprinkles that if you get it is the nice to have, but if you don't do it for that day, you know you'll be okay? So that's one of the things that I would consider first and foremost. I think. Secondly is kind of considering how does it fit into your life? Are you scheduling your entire life around it and prioritizing it, as this is the thing I must do or does it easily slot into your life and you feel quite comfortable being flexible with it? Again, that's the difference between kind of that disorder or unhelpful versus that healthy relationship with exercise.

Sarah Liz King: 12:10

And then I think it gets really tricky with amounts and intensities, because you know there's nothing to say that an intense workout is inherently bad, that, like you know, slow, gentle workouts always lead to being inherently good.

Sarah Liz King: 12:24

In my experience I've seen people who do both compulsively and both very healthily.

Sarah Liz King: 12:32

So again, I think you have to consider, you know, is this something that I'm doing because this is my preference and this is what my body is capable of Given my current health circumstances, or am I pushing myself from a place of fear or anxiety or needing to kind of micromanage my appearance? So those are kinds of some of the things that I would look out for, even ask yourself if you're questioning your relationship with movement and know that I guess the process of getting to a healthier place with movement is similar to how we get to a healthier place with food. It's through experimentation and exposure and challenging Our belief systems, and you know myself and other people out there are doing this helpful work so that you can get to that really joyful, peaceful place where you know it takes up not just the relevant, relevant amount of time in your day, but like space in your brain as well, amen, that's such a big one, the headspace that it can occupy can really take over and limit your potential.

Lyndi: 13:38

You've also talked about this idea recently on instagram that I really loved you talking about the difference between how to know if it's a genuine food preference versus, guess that eating disorder voice, that disordered eating preference going. I should be doing this, so are there any tricks that you have for us to tell? Is it my eating disorder voice or is it actually true preference? Would you tell people?

Sarah Liz King: 13:59

Yeah, again, I think disordered eating can often be so sneaky that we have to get really curious about it. And I love that approach of like that non-judgmental curiosity, like let's just like tap into that for a second. So when you're thinking about, for example, maybe you're going out to eat to a new cafe and you're maybe a little bit apprehensive, but you're a little bit excited as well and you've gone to look up the menu and you're like, oh, that item looks really, really good, I'm excited to choose that. And you get to the restaurant on the day and maybe that food item isn't available. So if it is kind of a true food preference, you'd probably be like a little bit disappointed. You'd be like, oh, that's upsetting, it sounded really nice, but you'd be able to kind of shift and change to what you would, you know, order something different and move on and maybe exceeds your expectations compared to what you were originally going to order.

Sarah Liz King: 14:56

If it's more of a food fear or coming from a disordered place, you might feel the complete opposite.

Sarah Liz King: 15:03

You might feel a lot of anxiety, you might order something different and really question it, you might feel guilty for eating that different thing, and so that is kind of that indication what happens when your original preference isn't available. Do you kind of go, oh, that's a bit upsetting and move on, or does it cause a little bit of a spiral to happen? And it's kind of tuning into how do I feel emotionally when I eat quote unquote safe versus unsafe foods, how do I deal with change and flexibility and variety? And we can really just, if we're honest with ourselves for a little moment, often recognize that sometimes, even though we think it's a true food preference, you're like no, I definitely don't like cake. It could also be that kind of disordered eating preference and so exposure and challenging it is kind of where you're going to figure out where that comes from and also helps you tackle it and overcome those fears so you can actually figure out what you like to eat again.

Lyndi: 16:05

I mean, I think that is such a beautiful way to look at it just becoming that gently curious of what is happening and hearing those voices inside your head so you're actually aware of them and you can hear when they're talking. I want to shift gears for a moment, because I know one of the things you talk about a lot that I'm really keen to talk about with you is how hypothermic amenorrhea and I'd love you to explain to everyone what that is and why it's important to rectify.

Sarah Liz King: 16:29

Yeah, so you're right, it is a huge mouthful. Hypothalamic amenorrhea, or you'll sometimes see it abbreviated as HA, is a condition where people with periods lose their menstrual cycle for three months or longer and it's due to a combination of things, but the three main things are over-exercising, under-fueling your body and or psychological stress. So our reproductive system isn't something that our body sees as quote unquote essential. So when it feels that it's in a stressed state and being under-fueled and kind of extending too far with your exercise does lead to your body feeling pretty stressed, it's going to shut down reproduction. It doesn't want to use extra energy for you to reproduce in a time where it perceives it to kind of be going through a little bit of a famine. So it shuts down. And when you don't have your menstrual cycle, you might be thinking to yourself oh, that's so convenient, I don't have to deal with this every single month. Like, what a pleasure.

Sarah Liz King: 17:39

But I think what we don't recognise is that menstrual cycles and periods exist for reasons extend far beyond fertility, and when we are not having a regular menstrual cycle and our hormone levels are low, it has huge impacts for our overall health. So things that can be impacted are our bone health, our cardiovascular health there are. There's correlation to kind of changes in mental health, so increased rates of depression and anxiety. When you're in a low energy state you can also feel really cold, really fatigued. Your libido can be quite low. Your hair, skin and nails might suffer. So there are all of these things to consider in the wider context that hormones really help us with in terms of our health. So regaining those cycles isn't just about great now I have my future fertility restored but also it's about all the things that we actually cannot see that get hugely impacted, like our bones, our cardiovascular system, even things like, you know, other hormones like our thyroid and stuff like that.

Lyndi: 19:28

Also important things. And what do you say to someone who's like, hey, I, I feel like I have missed my period. It's kind of gone missing. There's also a bit of fear of trying to make changes. Be one of the first things you'd be talking about with someone in this position to encourage them to make it something that we should work on, and what should they be doing.

Sarah Liz King: 19:48

Yeah, I think you have to kind of radically accept that it is really scary to make changes and that you don't have to make every single change all at once. I think when we think about committing to a process of change, we often have this very black and white thinking of either I do all of the things and I make all of the changes, or I stay completely where I am, which we know is very, very common when we think about like diet, culture and dieting and fitness and all of that kind of thing, and so always invite people to kind of go. It doesn't have to be like that. You're allowed to slowly move into some changes and know that those are still beneficial, because in order to change our behaviors, we also have to come up against challenging all thoughts and all beliefs, and that can be very mentally exhausting. So for anyone thinking about change in relation to regaining their period or tackling any form of disordered eating, you are completely allowed to make changes at the pace that you feel you can comfortably sustain. There's no point in throwing yourself in the deep end only to retreat a few weeks later because you feel so outside of your comfort zone with no skills to cope. That's not what anyone wants for you.

Sarah Liz King: 21:07

So if you are someone that's like, oh, my period's missing for a little while, I don't really know where to start. I think the first thing is looking at are you nourishing your body consistently? If there are long gaps during the day where you aren't not having any food, could you maybe think about adding a snack in and then work on that for a couple of weeks, just something simple, and then layer that. Okay, now that I've got that in, maybe I can look at the portion sizes of my meals and make sure that they are adequate for what my energy requirements are. And so having that layered approach often feels, I guess, less anxiety provoking than throwing yourself in the deep end.

Sarah Liz King: 21:52

And I think, secondly, if you're like thinking to yourself, oh yeah, but is my missing period due to hypothalamic amenorrhea, always go and seek advice from a health professional. It is a diagnosis of exclusion. So there are many reasons why a person's period may go missing. Hypothalamic amenorrhea is one, and I guess there's, like you know, on my page many more resources as to the difference between that and PCOS, which is another common condition that can cause missing or irregular cycles, and making sure that you have a really definitive answer as to what is impacting you is incredibly important because obviously treatment is different between the two?

Lyndi: 22:36

Can we talk about body image, body confidence, because I think this is such so closely interrelated with why we do these behaviors that make us feel safe, and so often it's driven by this. It can be driven by things like trauma or stress, but it can also be driven by a hate of how we look, body dysmorphia. What are some of the things that you would tell someone, or even just one thing, to help them work on body image, to help themselves feel like they're not in that stress state of I have to try and fix this?

Sarah Liz King: 23:08

Yeah, and I think it kind of goes perfectly off the back of what you said is your body was never really the problem. Something made you believe along the way that it was the problem and the solution was to change it. And I think one of the things that we get sold within the society that we live in is that happiness exists when we meet the cultural body beauty ideals, that all of our problems will be resolved, that we won't have any issues, that will experience the most joyful life if we simply fit into this mold. And I think anyone that has been through a process of trying to achieve that ideal has often recognized and realized that there are so many drawbacks that happen to their own life as a result of striving towards this unrealistic standard. So I think we have to say to ourselves am I taking personal responsibility for this huge societal cultural norm and is that my responsibility to carry on my own two shoulders? And the answer is no, it's not.

Sarah Liz King: 24:19

But unlearning your self-worth as it's tied to your physical appearance is a really slow process.

Sarah Liz King: 24:26

So I think the starting point is often widening your lens If I've put so much time and energy and effort into my physical appearance being really, really important and it's where I derive a lot of my value and my worth. Then, when that bucket gets tipped over, it's really hard to feel fulfilled, confident and good enough. So we have to think about what are all of the parts of my life and the parts that I value, about me as a person that I stopped caring about or reaffirming to myself when I put so much energy into my body. And then we can go okay. Well, how do we reconnect with those parts of ourselves and parts of our lives and reaffirm them as just as important, so that we can rebuild our worth as separate from our appearance? But that is a slow process and because I think we are constantly reminded of cultural ideals, about body size and beauty standards, it can feel like that one step forward, two steps back scenario. But I promise, if you keep being consistent and persistent and patient, that it will pay off.

Lyndi: 25:32

It will pay off. It will pay off and I sometimes feel like dieting, obsessing about how we look, trying to look a certain way, becomes a hobby for many people and we ask people what are your hobbies, what are you interested in doing, what are you doing in your spare time? And sometimes the response is I like watching TV. Because we can't give the actual response, which is I obsess over what I eat. I spend a huge amount of my free time thinking about how much I weigh, what I'm allowed to eat, how much I'm exercising, and so we give something that's offhand, like TV watching or whatever it is. But I think this sounds like a bit of a flighty kind of thing. But I think going and getting a new hobby it does in some way help to redistribute some of that headspace away from this obsession over how you look. You find that you can be interested in something outside of how you look. You start to get a little bit more value from maybe developing a new skill, whether it's sewing or beach volleyball or painting. You start to go oh, I'm good at other things and actually I can. Spending my energy on these things can give me a huge amount of fulfillment and it doesn't just have to be about this monkey mind of going around how I look. So I'm very pro women having hobbies, because sometimes I think we don't have enough hobbies beyond self-appearance and how you look is not a hobby. That's why that's what I want everyone to know.

Lyndi: 26:56

Sarah, I've loved talking to you. If you have one tip you wanted everyone listening to know. You want them to walk away going. This is something that they need to remember from this chat. What would it be?

Sarah Liz King: 27:08

This question always gets me every single time. I think the biggest one would be that if you're in the thick of it and you're struggling and you're feeling like you're never going to get out of where you are, I don't want you to lose hope, because sometimes things can change so much faster than you'd ever imagine and one day you will get there, even if it feels like it's going very, very slow. So my one piece of advice would be it doesn't matter where you are in your journey. What matters is that you're working towards a goal of freedom and I wish someone had told me that freedom is so much sweeter than I ever could have imagined and my life would be so much richer, even if, in the short term, it felt incredibly challenging to go through that process of recovery. So don't lose hope. There is hope.

Lyndi: 28:09

Oh, I love that. Imagine if women were sold freedom, if we were sold headspace, if we were sold the possibilities of all the things we could be, instead of being sold a thin ideal, and this idea that we just need to exercise more and eat less in order to be happy. I think the world would be a much better place. Sarah Liz King, thank you so much for coming on the no Wellness Wankery podcast Everyone. I'll leave show notes down below. You can find the link to Sarah's website if you would like to work with her. I think she's a fantastic expert in this space and I've loved having you on. Thank you, thanks for having me.