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Gloria Lucas offers a harm reduction approach to eating disorders

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KAYTE YOUNG:  From WFRU in Bloomington, Indiana, I'm Kayte Young and this is Earth Eats.

GLORIA LUCAS:  The same old narrative that we hear, that it only happens to white folks and white women. And I argue that eating disorders not only don't discriminate, but they target marginalized communities such as women of color.

KAYTE YOUNG:  This week on the show, a conversation with Gloria Lucas, the founder of Nalgona Positivity Pride. We'll be talking about her organization's social justice approach to eating disorders that centers the specific needs of black, indigenous and communities of color. And she shares details about her new eating disorder's harm reduction course. Our conversation is just ahead. Stay with us.

KAYTE YOUNG:  It's no secret that we live in a culture fixated on thin bodies as the ideal body type. Anti-fat bias is pervasive and often gets couched in health concerns while other more dangerous health risks are ignored. Almost anyone living in this culture can end up stressing about weight and taking actions to control it. For some, it goes further. Today on the show, we're talking about eating disorders. We won't be going into specific weight numbers or calorie counts, but just a heads up to take care of yourself in case this is a sensitive topic for you.

KAYTE YOUNG:  For anyone encountering eating disorders primarily through the media, the picture that often comes to mind is an ultra thin, affluent white woman, often a young woman, skipping meals or throwing up after binge eating. The reality is much more complicated. Eating disorders can affect people of any size, gender, sexual orientation, race, ethnicity, age or income. And not everyone with an eating disorder is underweight. Disordered eating can present in a number of different ways from restricting the diet to the point of anorexia, or compulsive binging, which may or may not be followed by purging behaviors, including over-exercising, a cycle also known as bulimia.

KAYTE YOUNG:  There's even an unofficial type of eating disorder known as orthorexia, that involves an obsession with clean eating or with finding and strictly following a "perfectly healthy diet". The stereotype of eating disorders as an issue that primarily affects white women has meant that they often go undiagnosed for women of color, for men and transgender folks. The Body Mass Index, or BMI is the system used by most medical providers to determine ideal weights. Because that system was developed with problematic methodologies that did not take into account the wide range of human body types: a black woman, for instance, in a more curvy body, could be suffering from anorexia but be told to lose weight by her medical provider who is only looking at her BMI scores.

KAYTE YOUNG:  And that's just one example. There is so much to explore on this topic. With us today, to help us unpack some of this complexity is Gloria Lucas. She's the founder of Nalgona Positivity Pride, based in Los Angeles and she's developed a harm reduction program for eating disorders.

GLORIA LUCAS:  My name is Gloria Lucas. My pronouns are she and her. And I am a eating disorders awareness educator.

KAYTE YOUNG:  You're the founder of Nalgona Positivity Pride. Could you tell me about the organization and what you do?

GLORIA LUCAS:  I like to describe Nalgona Positivity Pride as not your typical body positive or eating disorders awareness effort. We really focus on centering the specific needs of black, indigenous people of color, commonly referred to as BIPOC, and so we focus on harm reduction. We focus on social justice and how it connects to the development and intensity of eating disorders, and also indigenous and community thought and practices. And so, I mainly focus on the socio-political factors that, from the past and today's, and how they contribute to the eating disorders that happen inside our communities. And so, we have a monthly online peer support group for BIPOC that is completely free, run by BIPOC as well, and we're also very active on social media.

GLORIA LUCAS:  We create a lot of content, and we provide a lot of education to universities, organizations, community members and we also have an online store with merch that has all of our different messages and missions.

KAYTE YOUNG:  Can you share with us some of your story about how you got into doing eating disorder advocacy work and what inspired you to start the organization? And what need did you see that wasn't really being met?

GLORIA LUCAS:  Well, for the past 40 years it's no secret, eating disorders have been portrayed as only happening to white woman from middle or upper class. And it's usually restrictive eating disorders or bulimia, and none of those are part of my identity or my experience. And so, I find that eating disorders happen because there's a clashing of elements and it extends beyond biological, psychological and environmental factors. I saw that contemporary eating disorder education and treatment; it really falls short on understanding how historical trauma and current systems of oppression play a role in the development of eating disorders.

GLORIA LUCAS:  And I saw that biomedical approaches to eating disorder treatment is too narrow and it's not the only way. I also saw pro-recovery messaging that really did nothing to support people who are in it, and who don't have the resources to receive adequate care. And you know, not a lot of resources have been put into keeping people safe, even while engaging in risky behaviors such as eating disorders. The field is very elitist, inaccessible and predominately white, and BIPOC people have predominately been an afterthought. It's never been at the center of treatment because today's treatment models are, first of all, profit driven for the most part.

GLORIA LUCAS:  Person comes next and community never, usually. And ultimately, it was my personal experience with an eating disorder that led me and pushed me to start connecting the dots and sharing with others because I knew I wasn't the only one.

KAYTE YOUNG:  What are some of the misconceptions about eating disorders? Especially when it comes to BIPOC communities? But any misconceptions you wanna talk about?

GLORIA LUCAS:  Yeah, I think that the same old narrative that we hear, right, that it only happens to white folks and white women. And I argue that eating disorders not only don't discriminate but they target marginalized communities such as women of color. And we see that eating disorders extend beyond women, right, they're pretty high in the transgender population and I also think that there's this belief that treatment alone is the solution and I argue that it's not. Eating disorder prevention and care requires many creative approaches that shouldn't just fall within biomedical approaches.

KAYTE YOUNG:  The idea of prevention is something I hadn't quite thought about when I was thinking about talking to you and, of course, that should be part of the discussion and just I think that comes into it any time that you're trying to take a wider view of something and look at the systemic situation instead of just saying, "Oh, we've got this problem, let's treat it." You can be looking at what's happening in these communities that's leading to these problems and how can we think about those before the treatment's needed.

GLORIA LUCAS:  Right, right. I think we do tend to forget about prevention because it's as if we have just accepted today's conditions as the norm, when really they're counter intuitive in so many ways. I feel that if we want to prevent eating disorders, we gotta make sure that people have access to food on a regular basis, and not just any food, but cultural foods. I feel that we need to really disentangle and deconstruct anti-fatness, and not just inside our communities but in medicine. People with eating disorders have really high rates of complex trauma. And over and over we have to be reminded that eating disorders are not about the food.

GLORIA LUCAS:  It's a multi-faceted phenomenon, essentially, and it requires so many angles, right, and if we want to prevent eating disorders, we have to start with the little ones. We even have to start from when people are pregnant. We have to start by addressing the past, addressing the injustices, because we don't start with a clean slate. You know, historical trauma teaches us that we are a product of our past through our environments, through genetic make up, through our culture. And so, we really have to go beyond food and we really need to stop being apolitical when it comes to eating disorders. This is a political matter, and the idea to think that eating disorders are not comes from a place of a lot of privilege, and that is why we need more people like myself who are inside communities who are the people struggling with eating disorders, and start passing the mic to those people, to the ones that usually don't even have a seat in the table when it comes to the next new eating disorder treatment modality. And so, there's just so much work to be done.

KAYTE YOUNG:  Can you say more about how it is a political issue?

GLORIA LUCAS:  For instance, I argue that past experiences of some of our ancestors experiencing food insecurity, multiple generations of that maybe through colonialism, maybe through racism, maybe because of displacement, poverty. And so many generations of that, I argue, have lead to dysfunctional relationships with food and our way of knowing our hunger cues, our way of handling stress. Because, more recently, it was discovered that yes, food insecurity has led to the development of eating disorders, and I'm like, "We have been saying that."

KAYTE YOUNG:  Mm-mm.

GLORIA LUCAS:  We have been saying that since day one. Now we have the research behind it, which is great, but we have been saying that. And so food is political. When we look at ourselves in the mirror, that is political. It is collective. And so, that is why a lot of women have eating disorders because the way patriarchy, the way Christianity, the way media, all of these factors have shaped--

KAYTE YOUNG:  White supremacy.

GLORIA LUCAS:  White supremacy, right, have shaped the idea of womanhood, have shaped the idea of desirability, and have really broken down women of only being commodifying the male gaze, essentially. And so, again, food and body image are political matters. Like, they just don't happen. Babies aren't born hating their bodies...

KAYTE YOUNG:  Right.

GLORIA LUCAS:  ...we are conditioned to dislike and sometimes hate our bodies. And so, yes, eating disorders cannot be washed away from the reality.

KAYTE YOUNG:  If you're just joining us, my guest today is Gloria Lucas. She's an eating disorders educator. And she's the founder and CEO of Nalgona Positivity Pride in Los Angeles. We'll return to our conversation after a short break. Stay with us.

KAYTE YOUNG:  Kayte Young here, this is Earth Eats. My guest today is Gloria Lucas, an eating disorders educator and advocate based in Los Angeles. Let's return to our conversation. You are offering a course in eating disorder harm reduction for our listeners who may not have experience or awareness about this topic. Can you talk for a moment about what kinds of recovery programs are often presented as options for those with eating disorders? And I'm talking about to those who have access to treatment at all.

GLORIA LUCAS:  What I think is important to know that only one in ten individuals will seek professional treatment for their eating disorders, and those who seek treatment are most successful when they enter treatment early in their diagnosis, so they recommend within the first three years. And more than 50 years of literature on eating disorders suggest that half of sufferers achieve full remission; a third experience residual symptoms and a fifth become chronically ill. So, when we create recovery only treatment models, we create carceral-like institutions. If we know that there's currently a really low success rate of full remission and long-lasting remission, mind you, if we know there's high rates of recidivism and that the majority of people with eating disorders will never step foot on an eating disorder treatment facility, and then we know that it's unethical to not provide strategies for people who are in it.

GLORIA LUCAS:  If we know that there are safer ways people can engage in their self-harm, maybe drug use, maybe risky sex, maybe gambling, whatever the case might be, if we know there are safer ways, it is unethical to not provide that education and have that education be accessible. And you know, some people might say, "Well, we give up on people when we just give them harm reduction." But I say the system already let us down. This broken eating disorder system already let us down. And treatment centers let us down also when clients are being resistant to the treatment, or "non-compliant", and I'm putting quotation marks. So, when providers take the oath of "Do no harm," they are breaking that oath when they only care about abstinence.

GLORIA LUCAS:  And they break that oath because of their moral views and because of their saviourism, essentially, and we're doing a great disservice to the majority of people with eating disorders, and not to mention black indigenous people of color will not heal under predominantly white treatment models. We need more than western colonial psychology to save us. We need a whole paradigm shift and I argue that we need to start over. And we need to start over differently by giving folks who are most marginalized the platforms and the resources to do so.

KAYTE YOUNG:  When most people enter treatment for eating disorders, like, for instance if they go into a facility, it is the model, the current model is abstinence only. You cannot engage in any of the practices that go along with eating disorders. Is that the case? Because I think that a lot of people who haven't had this touch their life personally might not really even have pictured what it's even like to have treatment for a eating disorder. And I think it's so different than, like, when you were talking about alcohol, or drug addiction, or gambling, we have to eat food, so you can't just abstain. Like, you can't just avoid the triggers or stay out of the environment. It's like every environment is a food environment.

KAYTE YOUNG:  And so, I don't know, I just think that I'm not that familiar and I think some of our listeners might not be that familiar with what the traditional models are for treating eating disorders. And you're saying it's mostly like an abstinence, like it's an all or nothing kind of thing.

GLORIA LUCAS:  Predominantly. I don't know of any harm reduction centered organizations or treatment centers. I don't know of any. And for the most part, there's different levels of care to begin with, and it all depends how severe your eating disorder can be. A lot of folks are pushed into treatment because it's an ultimatum or it's a conservatorship, I believe that's the term. And a lot of these institutions have a dietitian, sometimes a psychiatrist, have a therapist. Each treatment model can be different, but that's usually the team, and usually they're on site. There's a few more coming up as virtual treatment models, but that's still something that is fairly new. And many times, especially for adolescent youth, they do family-based therapy or CBT, cognitive based therapy.

GLORIA LUCAS:  Those are usually, like, the main models they use. And many times, the way these institutions are carceral is that they're completely cut from the outside world. They have to leave their home. They are given rules. They literally have to be supervised, even when going to the rest room, meals. They could lose privileges if they break rules or don't adhere to their meal plan. They could get kicked out if they're not moving quick enough. And there's way more ways in which treatment can be carceral or how they work. And, ultimately, accessing these services and wanting abstinence and maintaining abstinence comes with privilege.

KAYTE YOUNG:  Mm-mm. So, can you describe more what is eating disorder harm reduction? Some listeners may have heard about harm reduction when it comes to substance use disorders. How is it similar and what are some of the similarities and differences between substance use disorders and eating disorders?

GLORIA LUCAS:  Harm reduction is a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use or alcohol use. And so, harm reduction is a social justice movement built on the belief that people who use drugs deserve respect and rights and so it is a pragmatic response that focuses on keeping people safe, minimizing death, disease and injury that is associated with the higher risk behavior, and while also recognizing at the same time that the behavior may continue, despite the risks. And so, at the conceptual level, harm reduction maintains a value neutral and humanistic view of drug use and the drug user, and it focuses on the harms from the drug use rather than the use itself.

GLORIA LUCAS:  And some examples have been community management of opioid overdose, needle and syringe distribution programs, and supervised consumption sites. And harm reduction is meant to challenge us, because I feel that harm reduction allows us to accept the complexities of human suffering and confronting these human issues that everybody's so quick to remove from site and to get them to be "normal", and that's our inability to accept the conditions that we currently live under that push people to self harm as a means to survive. And so, eating disorder harm reduction is a paradigm shifting, compassionate and pragmatic approach that aims to improve the quality of life of individuals living with eating disorders without requiring or focusing solely on abstinence.

GLORIA LUCAS:  And so, what I'm trying to build with eating disorder harm reduction is education, education that leads people with eating disorders to have self-awareness and do risk management, and so it is accessible strategies that increase safety, reduce negative health impact associated with eating disorders. And my whole goal is to help people with eating disorders create a life worth living. And I think that's where a lot of treatment models forget, because all the focus is placed on the meal plan, or the wight gain, or the abstinence, that they forget that we need to help people build a life worth living, so that they wanna push to take care of themselves and to let community take care of them.

GLORIA LUCAS:  And so, it is a philosophy that understands that as long as we have oppression, there are going to be eating disorders. And so, it is a reasonable, logical response to helping those that are in that, in that storm, you know, who might never make it out.

KAYTE YOUNG:  Yeah.

GLORIA LUCAS:  And I would say that harm reduction is not an opposition of abstinence. I believe that it could be used from beginning all throughout life. Harm reduction doesn't require abstinence, but abstinence should have harm reduction strategies involved.

KAYTE YOUNG:  Yeah. It sounds like one aspect of harm reduction is taking away the morality aspect and the judgment aspect from the treatment, and just focusing more on the care of the person instead of is this right or wrong? It sounds like it's more about what does this person need to live their life?

GLORIA LUCAS:  Right. And I don't think that harm reduction is a way to sneak people, trick people into wanting recovery or wanting abstinence. That's not the goal of harm reduction. What I do think is harm reduction allows to minimize some of the noise.

KAYTE YOUNG:  Right.

GLORIA LUCAS:  And might, might help people come to that goal, wanting that. However, it's not the requirement. And it should not be used as a way to, again, motivate people into abstinence. Because, if we look at harm reduction, the philosophy is that harmful behavior, it's a neutral matter.

KAYTE YOUNG:  Right. Do you think you could give any examples of what it might look like to shift from an abstinence model to a harm reduction model?

GLORIA LUCAS:  I think it's starting off with simple strategies such as not brushing your teeth after self-induced vomiting. That's a way to protect your enamel from the acidic content. Things such as keeping yourself hydrated, especially if you have bulimia and keeping up with your electrolytes, because that is what could lead to heart failure, essentially is really low electrolytes or potassium. It is also looking at pharmacotherapy, different types of medications that might help. However, if the individual's not interested in medications, then looking at natural medicine and alternatives. Another thing that I cover is, you know, how do you take care of yourself while engaging in those behaviors? For instance, if you are going to engage in behaviors in a public restroom, how are you going to be hygienic about it, considering the location, right? Maybe having disinfecting wipes and hand sanitizer. So, these are things that no-one talks about at all because it's like, "Oh, we need to get you to this place."

GLORIA LUCAS:  Because it makes people uncomfortable, but even if it's uncomfortable we have to talk about it. Because a lot of folks with eating disorders, what it really is is the divorce from their body. And so, harm reduction gives them that compassion and non-judgmental approach that, even while you're self harming, you're still worthy of care.

KAYTE YOUNG:  Mm, yeah.

GLORIA LUCAS:  You're still worthy of doing things that keep you safe, or safer. And for me, if it weren't for eating disorder harm reduction, I couldn't be here. Because harm reduction has been there for me at the worst moments and eating disorder treatment has not. And so, it is a very personal matter for me, and I see what it's done for me and has helped eliminate a lot of stigma, a lot of judgment, a lot of shame, a lot of isolation.

KAYTE YOUNG:  I think, also, it sounds like it's offering a space or a community that says, "You don't have to be doing this perfectly and absolutely to be a part of this support." You can be reaching out for that support. Even if you're not ready or able to do everything to take care of yourself, you can do some things.

GLORIA LUCAS:  Right, it meets people where they are at. And it's come when you want to, leave when you're ready. And so, it's a way to have more people be in the table. And it's truly about love, essentially, and how community takes care of one another. Because if we look at the roots of harm reduction before public health co-opted it, or adopted it, however you want to look at it, it was started by drug users themselves. It started by rebel providers. That's in the same spirit that eating disorder harm reduction is. It's a way to radically love others without a higher moral ground of what it is that they need to be doing or where they need to be going. You know, eating disorder harm reduction is important because, as we said, what we currently have is not enough. It's not working for a lot of people. Not everyone has access, not everyone wants abstinence, and a lot of people have trauma from eating disorder treatment.

KAYTE YOUNG:  Yeah.

GLORIA LUCAS:  And they don't feel safe in treatment. It reminds me a lot of what David Oscar Harvey shares, they said that insinuations hurt us far worse than any pain we could bring to ourselves, and that's true. People engage in eating disorders as a way to survive, as a way to maybe experience one less oppression by attempting to manage weight in some cases. Although I will say not everyone with eating disorders, their motivation is weight, not everybody. And so, it can serve a purpose for someone's life.

KAYTE YOUNG:  My guest today is Gloria Lucas of Nalgona Positivity Pride. She's an eating disorders educator and advocate. We'll be back after a short break, stay with us.

KAYTE YOUNG:  Thanks for listening to Earth Eats, I'm Kayte Young and Gloria Lucas is with us from Nalgona Positivity Pride. One thing I was going to say when you were talking about why an eating disorder might develop, the word "control" really comes to mind. Like, if everything in your life and your environment is out of control, having control of your body and what goes in it could really feel like this is one thing I can control.

GLORIA LUCAS:  Yeah, definitely. I think a lot of oppressed people, it does show up as a means of control and as a numbing factor, as a release factor, as a "I dislike myself" factor. I mean, it plays so many roles in a person's life.

KAYTE YOUNG:  Yeah. I was also thinking about something you said, just that I've been made more aware of, is that a lot of people really think, when they picture someone with an eating disorder, they think of a really thin person, and that's not the case. There's a lot of anti-fat bias that goes into the way people think about eating disorders, and that there are just really cruel and awful things that people think when they hear that someone who's not super skinny has an eating disorder.

GLORIA LUCAS:  Well, less than 10% of people with eating disorders are considered lower weight. The most common eating disorder in the US is binge eating. That being said, binge eating does not only affect fat people; people of all sizes can have binge eating. And people with bulimia tend to be what they consider average or higher weight as well. So, yeah, the majority of people will not have anorexia and will not be underweight, especially if you look at BIPOC communities. That's not to say that anorexia does not happen in black indigenous communities of color, but it's more likely that you will see binge eating disorder or bulimia. As a matter of fact, black girls and women, and Latina or brown girls and women have higher rates of bulimia than their white counterparts.

GLORIA LUCAS:  Native youth have also higher rates of weight loss attempts. And so, yeah, the majority of people are not thin and also fat people can have anorexia. Sometimes they refer to it as atypical anorexia, but that diagnosis itself, it's very problematic, because the onset of eating disorders tends to be 17, 18, I believe for bulimia, maybe anorexia, if I remember correctly. So, when you're 17, 18 like, that eating disorder can happen at any weight, any weight you are at 17 or 18. And so, anorexia can happen to anybody. And it's this anti-fatness belief that fat people deserve punishment, that they deserve to do whatever it takes to achieve a more desirable weight. I mean, that's a whole other conversation in itself.

KAYTE YOUNG:  Sure. Yeah. But also, what you were saying makes it clear how hidden eating disorders can remain if it's not something that's necessarily visible on a person, and so you can go through your life without anyone knowing about it.

GLORIA LUCAS:  Or you may, it may be visible but it's rewarded.

KAYTE YOUNG:  Right, exactly.

GLORIA LUCAS:  Over-exercising, dieting, restriction.

KAYTE YOUNG:  You're seen as discipled.

GLORIA LUCAS:  Correct, yeah.

KAYTE YOUNG:  Disciplined and in control. Yeah, that's the thing I think must be so difficult for someone who's...[SIGHS] Yeah. That you're rewarded when you're in the worst of it and then maybe when you're starting to recover you can get negative feedback from people around you. That just seems like the opposite of what someone needs and it just sort of shows how culturally connected eating disorders are.

GLORIA LUCAS:  They're culturally bound. They're culturally bound, because also one of the good signs of recovery from an eating disorder is weight gain. And what happens when you gain weight? Everybody has something to say about it, negatively.

KAYTE YOUNG:  Yep, and when someone's losing weight, it's automatically received as positive. No one's asking what's going on, you know, [LAUGHS] like, they're just, "Whatever you're doing, keep doing it." [LAUGHS]

GLORIA LUCAS:  Nobody says, "Hey, are you OK?"

KAYTE YOUNG:  Yeah, which was one of the questions that I had, was what needs to change in the ways that we talk about eating disorders and the language we use? And how can our language help or harm those who are dealing with eating disorders? But I also was thinking, just as you were saying that, that it's not just how you might talk to someone with an eating disorder, but if you're talking about prevention, then at a cultural level, we might need to be thinking about how we talk about bodies, how we talk about food, how we [LAUGHS] talk about how much people eat or don't eat. It's not just for those who are struggling with this.

GLORIA LUCAS:  I think it's what we place value on, where our attention goes, and I think to begin is to understand that eating disorders are not the person's fault and they're not easily fixed, and that's to begin with. And I feel that it's not just about, oh, take her to, or them to a treatment center and the problem will go away. No. We need to allow people to be in their bodies as they are right now. Some people say, "Oh, well, be careful how you speak about body image or about yourself in front of kids." But it's not just in front of kids, it's with everybody, and we need to leave fat people in peace. I mean, I think about all the attacks that [UNSURE OF NAME] deals with. Can we leave fat, black women alone? Can we celebrate fat joy, fat love? Why do we have to pathologize fatness? The pathology and the root of what a lot of these eating disorders and all these other health issues are coming is from the yo-yo dieting and weight loss attempts. Wouldn't it just be better to just let people be?

GLORIA LUCAS:  And this idea that we all have to eat healthy, we cannot eat healthy when our farm workers are being treated inhumanely. We cannot all eat healthy if health is a class matter. And so, I just think allowing people, giving room for people to eat whatever they want, essentially, because when we allow people to eat what they want to eat and be in their bodies, then what happens is we become more in tune with our bodies. Our bodies already have all the intelligence of eating, like when we're hungry, when we're full, but with dieting and these mixed messages about food, it just distorts our ability to be present with food. Again, food is a political matter. Yeah, that we have choices about food, no. Big agriculture already decided and the globalization of food production already decided what's gonna be in our plate, so this idea that there's free will, no.

GLORIA LUCAS:  So, yeah, I feel that next time you see a person that has gained weight, why do you have to comment about it? You don't think the person knows? You don't think the person has had to deal with the financial burdens of having to purchase new clothing and if they can? Maybe for them, gaining weight is the best thing that can happen to them right now, maybe they're taking medications, maybe they're highly stressed. Maybe they're having another chronic health issue. And maybe next time you see a person losing weight, you might just wanna check in on them, are they OK? Do they have food? Are they having a mental health crisis? So, yeah, this fixation on weight is just so disturbing.

KAYTE YOUNG:  People gain weight when they quit smoking. Just like you said, there's just so many reasons. And can we just let people be?

GLORIA LUCAS:  Weight management is a myth. 95% of diets fail. If you continue dieting, what ends up happening, you gain more weight than what you started with because the body is not made for dieting. Essentially, the body cannot differentiate if you're going through famine or your dieting. So, the way your body's going to respond to it, is let's do everything to keep this person alive and use every single calorie and affect hormones, and it affects everything. So, this idea of you just got to lose weight to be healthy, there's no such thing. You could lose weight momentarily, but check in five years, you're going to be back at where you were because the body has its own weight, and it's all determined by, for the most part, genetics.

KAYTE YOUNG:  If these ideas are new to you and you'd like to read more about why sustained weight loss is so difficult, or about the health problems associated with restrictive diets and yo-yo up and down weight losses and gains, we have links to some researched based articles posted on our website, EarthEats.Org. I asked Gloria Lucas to explain more about her new harm reduction program for eating disorders.

GLORIA LUCAS:  Right now, I'm working on a course that is going to be released in mid-January of 2023, and this course is for mental health providers and eating disorder professionals. The whole goal with harm reduction is how do you become a less harmful provider? You know, essentially. How do you become a provider with many more tools to help clients? And so, what I will be talking about is the health complications related to eating disorders, and the neuroscience of eating disorders. And there's a big push to educating individuals with eating disorders because all the times that we don't realize is that the way the brain is impacted through eating disorders makes us believe that there's something inherently wrong with us, but it is just the way our body is responding to that deprivation or that dysfunction.

GLORIA LUCAS:  And so, I will be providing the basics of how the brain is impacted when a person is struggling with an eating disorder, the reward system in the brain, the connectivity, the production of hormones, all of that. And I'm going to be talking about gastrointestinal care. So informing clients, like these are the complications that might happen because of an eating disorder, not to mention also the signals that a person might be struggling with an eating disorder, because the majority of people with eating disorders will more than likely to go see a healthcare provider for their GI symptoms and not their eating disorder.

GLORIA LUCAS:  So, gastrointestinal care and harm reduction, dental and oral care, pharmacotherapy and natural medicine alternatives, and how providers can work with clients with a harm reduction lens.

KAYTE YOUNG:  And so you said you're starting that in January?

GLORIA LUCAS:  Yes, it would be released in January and this will be a once a year offering.

KAYTE YOUNG:  And so, how do people end up participating in it?

GLORIA LUCAS:  Right now, it's going to be an online course. We not only provide this information for the professionals and clinicians but the community members. That's something in the works right now of potentially publishing handouts, making that information accessible on the internet, doing classes solely for community members, and for folks who are interested in the online course that I will be giving on eating disorder harm reduction. Folks can sign up to my email list to get the updates, or follow me on my social media.

KAYTE YOUNG:  There was one thing I wanted to ask you about, one is the name of your organization, if you could tell us what the meaning is behind it? And also, I really love your logo and I would just love it if you could describe it and say what that means to you?

GLORIA LUCAS:  Yeah, so, how that term came to be is I worked with my dear friend, Darby. And they said one time in passing, "Oh, it's because we're Nalgona Positive." And I was, I started laughing because I thought it was so funny. And what that means in Spanish is equivalent to "bootylicious". So it means like, a woman with a fat butt, essentially. And obviously I never thought that Nalgona Positivity Pride would be this platform that it is now. But I just ran with it because it just made me laugh, it made me smile. And I feel that it served me in the long run because it's helped introduce conversations that might not otherwise happen. And so, it is a term that connects to my general audience, my target population and they know what it means right away. How the logo came to be is actually one of Darby's friends as well. Their friend, Lisa, they posted a baby picture and it was them eating a hamburger. And the way they were eating it was so unapologetic, I mean, they had food smeared all over their cheek and they were just stuffing that hamburger in their mouth.

GLORIA LUCAS:  It just make me think a lot of how, as children we have no shame when it comes to food. If we're hungry, we eat, that's it. And so, it just took me back to our original state. And right when I saw that image, I said, "That's going to be my logo." And so from that photograph, I had a friend design it and that's how my logo came to be.

KAYTE YOUNG:  It feels like a joyful and unapologetic image.

GLORIA LUCAS:  Right, and then people come to my page and then I depress them with all this information, so. [LAUGHS]

KAYTE YOUNG:  But it's in bright colors and...

GLORIA LUCAS:  [LAUGHS]

KAYTE YOUNG:  ...it's a lot of beauty and good design, so. [LAUGHS] Is there anything you would like to add that we didn't get to?

GLORIA LUCAS:  I think I would just want to let providers and mental health workers know that what BIPOC and other marginalized communities want in their support is they want more flexibility. They want providers that are open to exploring and experimenting with new strategies. They want non-invasive support. They don't wanna be removed from their communities. People want non-carceral approaches to care. They want community-based care. They want something that's actually truly accessible, something that's slower-paced, truly individualized care.

GLORIA LUCAS:  They want providers that are open to co-designing support. They want culturally centered and culturally affirming care. Because, since time immemorial, indigenous peoples world wide have been healing within culture, within community. A lot of communities of color, black and indigenous communities, heal alongside while they heal their culture as well. We can't be split up from that. They want land-based healing, and the understanding that there is no complete healing unless the land is, you know, given back, that it's not under colonialism. So we need to think more bigger picture to treatment, not just the more immediate, but the longer term. People want to connect to their ancestral roots. They want anti-colonial, anti-racist lens.

GLORIA LUCAS:  They want care that's actually invested in their community. A lot of treatment centers are monopolies. They're backed up by financial investors that don't care about the local impacts, what's happening on the local scale. So, a lot of these treatment centers need to evolve and actually work as community centers run by the community, that they are actually doing mutual aid. People want fat dignified care. Folks want either gender-affirming or genderless care, meaning that there's room for trans people, gender non-binary people, two spirit people. And, obviously, racial trauma and intergenerational trauma needs to be addressed. So these are just some of the things that folks wanted. Also, lastly, more neurodivergency in eating disorder treatment approaches. There's high rates of eating disorders amongst the neurodivergent community and so, how do we become not just neurodivergent friendly but neurodivergent led?

KAYTE YOUNG:  What you said got me thinking about how, you know, racist attitudes towards foods or just kind of a homogeneous approach, or white-centered eating plan, wouldn't be appropriate to a person of color.

GLORIA LUCAS:  Oh yes, definitely. There's, like, treatment centers that provide meals. A lot of times it's not food that they eat at home. A lot of dietitians have racist ideas about cultural foods. A lot of these treatment centers are very aggressive with their meal plans. And it's sometimes just like, "Here's your meal plan, like, go run with it." And it's like there's no grocery stores, emotional support, financial support. There's no information on food access. Many people don't experience that because all these treatment centers it goes over their head. Especially after COVID, there's so much food insecurity in this country. We have to decenter whiteness, we have to make room for other non-western world views.

KAYTE YOUNG:  In everything. But also in dealing with eating disorders.

GLORIA LUCAS:  I forgot to mention, the last thing I wanted to bring up is, you know, a message out there for all the folks who are struggling with eating disorders, is that you deserve to be met where you are at, that you deserve to not be judged if you don't want recovery, and that you are worthy of being taken care of and taking care of yourself, and that the community owes it to you to provide you with this education, very needed education. And I think that there's a lot of transformations that are going to take place in the way we view eating disorders. More importantly, they're not alone and to not be afraid to talk about their eating disorder.

KAYTE YOUNG:  Thank you, I appreciate that message. It's great to talk to you.

GLORIA LUCAS:  Thank you for having me.

KAYTE YOUNG:  I've been speaking with Gloria Lucas of Nalgona Positivity Pride, based in Los Angeles. Gloria Lucas is an eating disorders awareness educator and advocate. She's launching an eating disorders harm reduction course in January. You can find links to her work and further resources on our website, EarthEats.org.

DANIELLA RICHARDSON:  Earth Eats is produced and edited by Kayte Young with help from Eoban Binder, Alex Chambers, Mark Chilla, Toby Foster, Abraham Hill, Payton Whaley, reporters at Harvest Public Media and me, Daniella Richardson.

KAYTE YOUNG:  Special thanks this week to Gloria Lucas and Nalgona Positivity Pride.

DANIELLA RICHARDSON:  Our theme theme music is composed by Erin Tobey and performed by Erin and Matt Tobey. Additional music on the show comes to us from artists at Universal Production Music. Our executive producer is John Bailey.

Head shot of Gloria Lucas with long brown hair, large glasses and pink shirt that reads: Eating Disorders are a social justice issue. White background, outdoors, some flowers visible in a shrub

Gloria Lucas founded Nalgona Positivity Pride after finding that the needs of her community were not being met by the current treatment models for eating disorders. (courtesy of Gloria Lucas)

“[It’s] the same old narrative that we hear, that it only happens to white folks and white women. And I argue that eating disorders not only don’t discriminate, but they target marginalized communities such as women of color.” 

This week on the show, a conversation with Gloria Lucas, the founder of Nalgona Positivity Pride We’ll be talking about her organization’s social justice approach to eating disorders that centers the specific needs of Black Indigenous and Communities of Color and she’ll share details about her new eating disorders harm reduction program.

graphic with a pink circle, black line scallop around the edge and a drawing of a girl with brown curly hair and rosey cheeks eating a hamburger
Gloria Lucas talks about the inspiration for her logo in our interview.(courtesy of Gloria Lucas) 

It’s no secret that we live in a culture fixated on thin bodies as the ideal body type. Anti-fat bias is pervasive and often gets couched in health concerns, while other, more dangerous health risks are ignored. Almost anyone living in this culture can end up stressing about weight and taking actions to control it. For some it goes further. 

For anyone encountering eating disorders primarily through the media, the picture that often comes to mind is an ultra-thin affluent white woman, skipping meals or throwing up after binge eating. 

The reality is much more complicated. Eating disorders can affect people of any gender, sexual orientation, race, ethnicity, age or income--and not everyone with an eating disorder is underweight.  

Disordered eating can show up in a number of different ways--from restricting the diet to the point of anorexia, or compulsive binging–-which may or may not be followed by purging behaviors (including overexercising) a cycle also known as bulimia. There is even an unofficial type of eating disorder known as orthorexia that involves an obsession with clean eating or with finding and strictly following a perfectly healthy diet.

The stereotype of eating disorders as an issue that primarily effects white women has meant they often go undiagnosed for women of color, men and transgender folks. 

The Body Mass Index, or BMI, is the system used by most medical providers to determineideal weights. because that system was developed with problematic methodologies that did not take into account the wide range of human body types, a black woman, for instance, in a more curvy body, could be suffering from anorexia but be told to lose weight by her medical provider who is only looking at her BMI score.

There is much to explore on this complex topic. With us today, to help us unpack SOME of this complexity, is Gloria Lucas, She is the founder of Nalgona Positivity Pride, based in Los Angeles. And she has developed a Harm Reduction Program for Eating disorders.

Resources:

Coalition for Overcoming Problem Eating/Exercise (COPE)  Indiana University-Bloomington

On why sustained weight loss is so difficult:

Maintenance of lost weight and long-term management of obesity-Medical Clinics of North America

Dieting Does Not Work, UCLA Researchers Report-UCLA Newsroom

 Why People Diet, Lose Weight and Gain It All Back- Cleveland Clinic

An interesting discusssion of this topic can be found here.

On The Accuracy of the BMI

Why BMI is a Flawed Health Standard, Especially for People of Color-Washington Post

How Often Is the BMI Misleading?-New York Times

Top Ten Reasons Why The BMI is Bogus-NPR (opinion)

An interesting discussion of The BMI on the Maintenance Phase Podcast

Music on this Episode:

The Earth Eats theme music is composed by Erin Tobey and performed by Erin and Matt Tobey.

Additional music on this episode from Universal Production Music.

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