The All In Podcast

Episode 40 - Stories of recovery: Krista

• Florence Gillet • Season 3 • Episode 40

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In this testimonial episode, Krista explains her extended journey into recovery.

Mentioned in the episode:
Emily Oster, Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong--and What You Really Need to Know (The ParentData Series)



To find support in your HA recovery:
Get the "No Period. Now What?" book at noperiod.info/book.
Get the French version "Je n'ai plus mes regles" book at noperiod.info/livre.
Get the German version "Keine periode - was jetzt?" at noperiod.info/buch.

To join our support groups, please visit noperiod.info/support
for English, noperiod.info/communaute for French, and noperiod.info/community for German.

To make an appointment with Dr Sykes and get individual support to get your period back or improve your fertility, please go to noperiod.info/appointments
To make an appointment with Florence Gillet and get help with the body and mind changes happening in recovery please visit www.beyondbodyimage.com

You can find us on social media:
Instagram:
@noperiodnowwhat in English
@jenaiplusmesregles_livre in French
@keineperiodewasjetzt in German

...

Welcome to All In, a straight shooting, science based podcast about periods, fertility, and nurturing health outside of unrealistic beauty expectations. We will mostly, but not exclusively, focus on hypothalamic amenorrhea, HA, a component of relative energy deficiency in sport, formerly known as the female athlete triad. I'm Dr. Nicola Sykes, scientist and author of the book No Period, Now What? I specialize in helping people understand how their eating, exercise, and lifestyle habits are keeping them from hormonal health and their best life. My work focuses on regaining periods, improving fertility, and breaking free of the rules underlying diet culture. My name is Florence Gillet. I'm a certified eating psychology coach, a former HA patient, and an advocate of health at every size and body neutrality. I help people let go of their obsession with size and appearance to regain self confidence, finally appreciate their bodies, and live an overall fuller, more joyful life. Every two weeks, the All In podcast brings you real recovery stories, expert insights, and new scientific research on HA, hormonal health and fertility, with an unmissable touch of body respect and women's empowerment. Just a reminder that this podcast represents the opinions of the hosts and their guests. This content should not be taken as medical advice, it's for informational purposes only. And because each person is unique, please consult your primary care practitioner for any medical questions. Music by the Andy Shulman Band, available on Spotify.

Nicola:

Hello, everybody. It's been my experience recently, both in discussions with clients as well as folks in my support group, that there's a group of people whose journey includes working on hypothalamic amenorrhea, HA, recovery, a few different times. In some cases, it's working on recovery in order to get pregnant, then falling back into the HA ways, particularly during the postpartum time. For others, life happens, maybe some stress, possibly addition of exercise and periods are lost again. There's often this idea that X worked for me last time. So it should again, but that's not always how things go. Today we're going to talk with a client of mine for whom this has been the case and discuss some aspects of her recovery journey that we think will be useful for many of our listeners. Krista, welcome and thank you so much for being here with us. Could you give us a brief introduction to who you are and where you're coming from?

Krista:

My name is Krista. I am 40 years old. I live in Northeastern Pennsylvania. I'm a professor at a university. I'm a mom of a soon to be three year old.

Nicola:

Hmm.

Krista:

I have a husband. Anything else? Hobbies, interests, those types of things. There's not a lot of time for hobbies and interests when you're a full time working mom in academia and have a toddler, and you have a full time, very busy spouse. But if I had them, it would be really love to run really love puzzles and ultimately I love learning more than anything else, so I'm in a well suited profession. Yeah.

Florence:

Definitely. Welcome Krista. We love learning too, Nicola and I, so welcome. So most of us who ended up having HA, got the condition from a combination of under fueling and overexercising in an attempt to control our physical appearance. So can you tell us a bit about your story and how you lost your period?

Krista:

well, so mine is interwoven with having an eating disorder my entire adult life, or teenage life, and I personally think that far more people With HA do and it's just not formally diagnosed due to weight stigma and not being definitively underweight. I don't know if either of you saw that Colorado just passed some new legislation saying that weight can no longer be used as a criteria for eating disorder treatment through insurance so I was very excited about that That was kind of why I think a lot of people aren't being properly treated for something underlying. So, I got my first period when I was 14 years old, on my 14th birthday, shopping. So that was fun. And at that time I wasn't engaging in any disordered eating or exercise. I was being a normal teenager with my friends living my life. And my periods were always very heavy and very frequent, but, you know, only recently did I learn how normal that is for the first few years. So of course, doctors want to put you on birth control immediately and all those types of things, but I never did that. Because within a year, I lost my period. Within a year, my eating disorder developed, and it lost it pretty quickly just due to pretty intense restriction. And with the knowledge I have now, I got bleeds irregularly infrequently over maybe a few times a year until I was in my early 20s and was put on birth control, but I don't know if they were ever ovulatory. And I know that now because no one ever talked about that. Right? So I can't ever say I recovered my period by any stretch of the imagination. I think when you're very young, your body can tolerate a lot more than when you're older or, you know, when you've not been going through this for many years, it'll come back more easily. So I would have bleeds from time to time, but it was always very sporadic. Then I was put on birth control and would for basically from age 21 to after I got married at 29 and I never bled. Even though I was supposed to have a withdrawal bleed and was told, Oh, that's normal. You're active, right? You're an active person. That's normal. Like, just over and over again. I was never in a underweight BMI category, so it was never flagged as that being a problem. And I heard that repeatedly. Oh, your weight is normal, even though. If they had known enough to do any due diligence, there would be many physiologic, let alone every psychological sign that I had a serious eating disorder. So, when I then got off the pill thinking we'll get pregnant, and there was nothing for years. Four years. So, but again, still not being treated for an eating disorder. I was with endocrinologists put on at various times between like 29 and 34, put on like estrogen patches, progesterone supplements. I was overdosed for thyroid medication because I also had a thyroid condition, which is very common with all of this, so it wasn't until I actually like formally got diagnosed and entered eating disorder recovery in late 2016 that I started getting some periods again, but it could be 22 days apart, 45 days apart. It was all irregular, but I told myself I got my period back, but it's just not normal, right? I'm different. My body's different, right? It's not regular. But it would come and go and that was basically 2017 till spring of 2020 was just this cycle of I'd get them every 25 to 45 days and then I'd lose it for six months because the smallest thing would happen stress wise, and it would go. So even if I didn't change my eating or exercise, like we went, I went through a very stressful period at work, my husband got cancer and I nearly lost him, and then COVID, you know, so there was always something.

Nicola:

Ooh.

Krista:

something. So in the spring of 2020, we decided, after he survived cancer, we were going to try to get pregnant. So I went to fertility. And again, they do all my blood work and they're like, well, we just can't predict your ovulation. So we're just going to put you on letrozole to stimulate ovulation. I didn't want to do IVF. Plus I couldn't afford it. And I said to her like, is it worthwhile to try to regulate, restore my period naturally and not go through all this. She's like, oh, that could take forever. I could get you pregnant next week. And at this time, you know, to put this all into perspective during this whole 20 year period. I won't say numbers, I mean, I was easily anywhere from, you know, To Pounds less than I am right now. And I'll speak to that later I'm sure but I got pregnant very quickly with letrozole, and I had a very healthy pregnancy. I only gained about pounds, however, the whole time due to food and exercise, and then lost a significant amount postpartum with breastfeeding and stress and things like that. And I kept being told by the doctors, Oh, you're breastfeeding, you're breastfeeding. It's 9, 12 months out, 14 months out, you're breastfeeding. And then when I wasn't breastfeeding anymore and nothing was happening, I found Nicola's book, met her, and then by the end of the year, I got my first period. And we'll talk more about what that took, but I am a week away, cause I can tell you, basically to the day, an hour, right now, when I will get my next period, and it will be next Thursday afternoon. And that is, will be my 17th one, in a row, on a 28 30 day cycle.

Nicola:

That's amazing.

Krista:

It's mind blowing I'm actually quite a clock when my body is happy. But easier said than done with the rest of it. So that's my been my journey. I basically went 25 years without a regular period, which is scary. And I'm not unscathed from that health wise. So

Nicola:

It sounds like you spoke with a lot of people along the way who could have given you some different guidance. Yeah.

Krista:

They don't know.

Nicola:

So, tell us a little bit about the symptoms that you noticed when you were sort of in the depths of your HA and what your big driver for recovery was?

Krista:

Well, at postpartum, my big driver for recovery, like what really got me to finally recover my period for good was twofold. One, I was terrified about my bone density. I had osteopenia many times through DEXA scans, and that is all that gets the attention. You know, I know that estrogen and progesterone play far more roles physiologically than that, but that's what gets the attention. So because pregnancy and breastfeeding take such a toll, that's what I was really, really scared about. And that really helped me hyper focus through the hard moments on that. But also, I don't want to pass disordered eating and a poor relationship with my body onto my child. So I was and continue to be committed to not doing that and healing myself to not be, well, that's fine for me, mom, but what about you, you know, like I was that teenager. So I will inevitably have one. But that was the real motivation of just is the rest of my life going to be this? This battle? I was so sick of it. And, you know, with how many years until menopause I have, you know, I wanted to be as healthy as I could. It's just the, the factor I think of age and experience. When I was 17, 18, and I would get my period, my head would say, you are quote, fat enough to get your period. And I would restrict more and exercise more. And that feels like a different person now, and I think some things you just need to live through

Florence:

Yeah. Yeah.

Krista:

to change.

Florence:

I think it's one of those things also, you know, our prefrontal cortex is not developed by 17, far from! Right? And so exactly. So you really feel that shift, right? I find it so interesting. I had a conversation with my 12 year old daughter in the car last weekend, and she wanted me to buy her tanning oil. Ooh. And we live in Dubai in the desert and tanning oil with an SPF, you know, SPF seven or 15. I was like, honey, you're not getting tanning oil. And she was like, but why? I don't care about whether later what happens. And I was like, I know you don't because actually, your body is not ready yet to care for what happens. Yeah. But until your prefrontal cortex develops, I'm the one that's going to have to make those decisions for you. Anyway, hilarious. And I'm just conscious you, you talked about your interactions with doctors. Were you ever told you may have HA?

Krista:

When I first lost my period, yes, because, so at the start of the eating disorder, I was diagnosed because I was very obviously just like not eating at the beginning, but the care 25 years ago in central PA was like, you stay above this weight, we leave you alone. You go below this weight, we admit you. That's it. So I was smart enough to ride the line and to make everybody leave me alone. Nobody cared. It was like, put you on birth control. And then it just wasn't mentioned very much at all. Because I was on birth control for so long, and then I knew I had it, just because, like, I have a PhD in physiology, I knew what I had. But the doctors refused to attribute it to my weight, or my exercise, or stress, or anything like that. I mean, I even at times got like a, Oh, I wish I was as dedicated as you. Comments that were so inappropriate. Or many friends would be like, Oh, I wish I didn't get my period. Like, they would say things like that. So, no medical provider, whether an endocrinologist, not until I saw my eating disorder nutritionist, and psychologist, no medical provider in this, ever gave me an answer or a suggestion. Even the fertility doctor, you know, that should know more than anybody. That's not what makes them money, so. Yeah. It's unfortunate. It's very unfortunate.

Nicola:

It is, it is Part of why we're doing this podcast is education for people, both the patients and hopefully the medical professionals. So you said that you finally found"No period, now what?" after postpartum, you weren't getting your period back. So tell us a little bit about reading that book and what happened in your process of sort of deciding that this was what you were going to do.

Krista:

Well, I found the book through Googling, and when I saw there was data and studies in the book, I was like, yes! Because I need evidence that I can relate to. And whether it was looking at the typical fertility BMI, you know, for as much as that matters, whether it was looking at reds in terms of it being more about fueling your lean mass, not your fat mass. This data on the timing of food intake was wild. The data on the history of how the 2000 calories a day, what women really need, you know, I was like no way, I was angry, and floored, and freed at all equal measure at many different times reading the book. It was like understanding my whole health history in terms of like, well, why would the period come in 21 days versus 45 days? Either long follicular or short luteal. Like, everything made sense finally that I had gone through. So I finally had a roadmap but of course, easier said than done with execution. Because if it was that simple, you wouldn't have an eating disorder, like that's kind of part of the problem. And we've talked about that many times. Like, it's one thing to know what to do. It's quite another to be able to do it. But it was very, very, very informative and, and very frustrating that doctors, anybody I'd ever seen knew none of it. And it's, like, patients shouldn't have to educate their doctors, but I've had to do it countless times. For myself, for my mom, for my husband, for my child. That makes you just sad for the people that don't have the knowledge. You know, like, I'm very privileged to have the knowledge that I do. So, yeah.

Nicola:

Yeah. Yeah. How did it go for you when you started trying to implement All In? What did that look like for you?

Krista:

Well, it was a mess. I'll be honest, I don't know who are the people that are like, all right, I'm parking my butt and I'm eating what I want. Unless you were just like, oops, my period went away. How did that happen? Like, I just don't, it can't be that simple. I applaud people that can just, do it and I think that from my experience of listening to so many people's different like binge eating recovery, disordered eating recovery this and that I feel like the more black and white you are of a thinker the more you can just dive. I will find the nuance in the darkest corner of everything and cling on to it as the exception. So I, I started by like nudging down my cardio a little or upping my food a little or resting a little bit more. I was ticking at the boulder with a little chisel, like I was sculpting a miniature. Because I kept being very, very hyper focused on, well, I got my period back at this weight before, right? Like I'm even mocking myself right now. Like, you know, cause what I thought was my period back was not ovulatory. So it took some realism until I started ovulating and I was like, Oh no, um, I have very painful ovulation. I've been on all fours some days in pain.

Nicola:

Wow.

Krista:

The only time I can ever remember that pain was when I ovulated before I, you know, got pregnant. It sucks, but I'm grateful for it because I know I don't need to track my temperature anymore. I know when it's happening, you know, and then I know exactly when I'm going to get it now. So I know I never experienced that. So then I had to let go of that weight. And that was a big grief because I think part of it is. I like this, the sunk cost fallacy, have I wasted all this time or letting grieving the body that you thought was yours, you know, even,

Florence:

Yeah.

Krista:

yeah that you thought that you were supposed to be at especially if it was never an underweight one in the first place, you know, at least by BMI standards. So there's a lot of grief that comes with that intentional body change. So I had to let go of that. And we had a lot of. conversations about that for sure, about tolerating the weight and gradually, I had to gain a significant amount more than I ever imagined to get it back, but it was very hard. So it took at finally after like six months of working with Nicola, I was like, all right, I have to stop exercising. Like I stopped doing everything other than maybe a very short light walk once a day, or very light yoga for about three months. And it still, still wasn't coming back. I was going through prolonged dramatic follicular waves, but no ovulation. And while I know this is very controversial, and it's talked about in the book, my OB did prescribe me one round of letrozole, and it worked. And Nicola and I talked a lot about it, because I'm a perfectionist I didn't want to cheat, right? The system or anything like that. But I was doing all the things and I had 25 years of my brain not trusting me, you know? So, my hypothalamus needed a little nudge, but we talked about it and she said, like, if your body's not ready, this isn't going to work. You're going to get it once and it's going to go away again. And like I said, I'm about to get my 17th period. So I needed the nudge and I'm grateful for it because I was getting to a place where I was getting so depressed about everything I was doing and it resulting in not working yet that I was starting to feel like I'm going to give up. So I needed the nudge. I'm transparent about that, but I've told other people don't just go to that because if your body's not in place, it may not work. Okay. Or you'll just lose it again, so you have to feel like you are doing all the things, that you can before you make that leap.

Florence:

Nicola, can you tell us a bit more about that kind of strategy in terms of really helping support that nudge? Because we've had another testimonial talking about this, but I think it was with Clomid.

Nicola:

Yeah. I think it's very much what Krista was saying. So, I think of the hypothalamus as following Newton's first law. So an object in motion stays in motion and object at rest stays at rest. So when you have HA, your hypothalamus is, is suppressed, it's at rest. And so you have to sort of baby it in as many ways as possible. So that's fueling yourself well, fueling yourself throughout the day, cutting down or cutting out your high intensity exercise, going all in. And sometimes people go all in and their hypothalamus de suppresses, but it just doesn't quite take that last final step of restarting and starting the follicular growth process. And I wish I knew what the trigger was when somebody is going through recovery and that just happens, but I don't, and nobody does. So we're very lucky to have the medications, Clomid, Letrozole, the supplement, soy isoflavones, that can basically make your brain sense the normal signals to start the follicular growth process which is a drop in estrogen.

Krista:

It's the negative feedback loops. Our brains respond by changes, not by steadiness. I always thought that was funny.

Nicola:

Yeah. And so once you have that initial signal, then each hormone in the cycle kind of follows on from there. And if you are truly nourishing well, and your body's in a good place, then your cycles will tend to continue from there as they did for Krista. I talk about it in the Still No Period chapter in the book. And it's certainly something that I've worked on with a number of people, so you know, if it's something you're interested in. I'm also happy to speak with medical professionals if they're unwilling to do this. Because a lot of them don't want to because they don't necessarily understand how it's working and why it's working. So I'm happy to talk with people and explain.

Krista:

I sent my OB your book. I have no shame. I'm not afraid anymore because it's just irresponsible to not know these things.

Florence:

Totally. And if they're good doctors, I think they're usually happy to receive that information. Some of the medical practitioners are happy that there is this resource that they weren't really trained about, you know what I mean? But yeah, it can be taken the wrong way as well. I'm just interested My side is more the mental side of recovery. So how has that been for you? Because 25 years, this is literally way over half of your lifetime. And I'm guessing, I think for a lot of us we inherited a bit of a dieting legacy or dieting mentality legacy. Maybe our parents weren't dieters, but they had this mentality of like, you have to be a certain size, be careful, do this, do that. So, I'm just interested mentally what you would share for other people maybe that have a similar journey than yours.

Krista:

So, you know, disclaimer. I'm in this journey. I'm not on the other side of it, by any means. But I'm not going backwards. I refuse to. The mental side has been exponentially harder than the physical side. I was in a support group last Tuesday and someone said it is far harder to be in a recovered body with an unrecovered mind. And when I say recovery, just to clarify terminology. I view recovery like eating disorder recovery. I know you use the word recovery for period recovery. So I have period recovered, but not that. Your body responds far faster than your brain can change. So, if I wish, I could fix the mental and then because the body would be like, fine, whatever, you know, but when you talk about dieting culture, yes, and first of all, just not that they'll ever listen or know what a podcast is, but I love my parents. They absolutely were and continue to be chronic dieters, even despite knowing everything that I've gone through. It was extraordinarily important in growing up. I was a child of the nineties, right? Like the way thin supermodels, like there were no women in the weight room. It was very thin waif like ideal body type. And I was never a thin kid, I was always higher on the growth charts. My mom is naturally quite thin, but my dad's side of the family is not, so it's very easy for me to carry muscle. I was never a, like, a skinny kid by any means, but nor was I overweight, whatever overweight means, what weight, but at any rate, I got messages a lot of the time that I think my mom was very afraid that I would continue to go on this upward trajectory and then I would experience bullying and at the time it was like, oh, childhood obesity is the future ruin of the world. Like, we have to prevent it. So I think a lot of parents thought that they were saving us from pain by encouraging dieting. So, I was on a diet in second grade, third grade, fourth grade. I didn't have an eating disorder, you know yet because like when I was with my friends It'd be like oh I can eat, so I was just kind of my food is being controlled at home. My mom would take me to exercise classes with her from fifth grade on. Even though she was then trying to control and suppress her weight, my dad was either eating a 500 calorie cabbage soup diet or binge eating. So there was never any normalcy around food. And there was always the message that you have to control your body. And no matter what grades I got, how funny I was, how creative I was, how kind I was, it's like, I didn't get attention for that. I got praise when I started thinning out as I approached puberty and got taller and that's when I finally got some positive attention from family or for the first time from men, or men, boys, let's be real, you know, so. And that's just the truth. And that is weight stigma, right? But whether that should have been the case or not, my brain was programmed on dieting being important, right? Weight being very, very important. How you look being important. And then it was reinforced by finally getting positive attention, male attention, because again, parents do the best and they do better than their own parents, but it wasn't good from a body image perspective or self confidence perspective. So that belief then that I was set up got reinforced by when I naturally without trying got a little thinner kind of entering high school. It was like then boys noticed me for the first time. It might have also been due to like me figuring out how to control my curls and getting my braces off. And not being in school with not like everybody you grew up with anymore, right? The pool is wider, but my head said, wait, it was my weight and my appearance. And at times throughout my adult life, like I said earlier, I have a PhD, I'm a textbook author. I have accomplished so much, but I could step on the scale and feel like I'm absolutely nothing. And it's like, how do you undo that early, early programming? Like if I could lobotomize it, I would, because I have friends at various ages that it's like, well, that's what it is today. And I'm like, how do you do that? Like, yeah, like, what? They could just be like, ugh, I don't like that, but I can't control it, you know, like, I can't control my body. I think what can be the hardest part of this mental process is not only do you suffer from the symptoms of like the eating disorder and the mental side of the body image battle, you then make yourself suffer for having those thoughts in the first place and not being able to overcome them. So it's like any way you can be unkind to yourself, you find a way. So right now I'm trying, I'm really working hard on kind of trying to rewrite that script. Something I've been doing is EMDR, which is a type of like trauma based therapy that sort of tries to rewrite those scripts in your head. I found that really helpful. While sometimes it feels like progress is extraordinarily slow, you look back and you're like, I haven't thought that in a while. When I got on the scale, I didn't freak out as much as I used to. I got to the good, the headspace faster than I used to. Or you just notice positive thoughts come in and you're like, where did that come from?

Nicola:

Ah, that's really nice, yeah.

Krista:

But it's extremely painful and it's extremely difficult. And the last thing I decided that I, earlier this week, I was done making myself feel bad for having this problem anymore, because I wasn't getting anywhere with that. But it is very hard, and it's not like getting your period back means you just accept your body, and I thought it would. I said to Nicola, if I could just get my period back and run, I don't care what my body looks like. I remember where I was when I said that. Nope!

Nicola:

Mm hmm.

Krista:

What I have noticed is that I spend infinitely more time on negative thoughts than positive. So something I learned in marriage and family therapy is, and this is from the Gottman's work, is that it takes five positive interactions to undo one negative. So I was like, how can I apply that to myself, like, if I can say five positive things about myself, will that start to, I'm like, I never say one, you know, so if you look at your relationship with your body and yourself as a marriage, as a romantic relationship, those same principles kind of apply, so I decided I'm gonna try to do that, and it's really hard and uncomfortable. That's the next step right now.

Nicola:

Yeah, absolutely. I mean, you've said a bunch of positive things about yourself on this podcast and I think, you've got so much to be proud of in terms of the work that you've done in getting to where you are today and, you know, everything else you've accomplished in your life. So you said that you've had your period back for a while now. I know that there've been a lot of times that we've sort of talked through that through those last 17 months. So just curious if you could share with our listeners some of the concerns that you've had through that time and how you've come through those.

Krista:

Well at first I was, for the first couple of months, I was still very afraid I was gonna lose it again. Like, I was still so worried, like when am I ovulating, when am I ovulating, oh god, like waiting for the mucus, waiting for the this, waiting for the that. I don't think about it anymore, and I think that that's interesting, like how you know you're kind of on the other side. Because I'm not reducing my food intake, and my weight's been stable, so I know that, I don't have to worry about it anymore. But what was so hard, the times we've talked were, I think I thought I played the game of like, well, this was the weight I had to gain to get it back. But like, once I start exercising again, it'll come back down, you know? And maybe I told myself I gained more than I needed to. You know, like I overshot. That concept. I just wanted to be the overshooter.

Nicola:

I hate that concept.

Krista:

And then it would come back down and what has been the biggest surprise. And, of course, it's like, you're the exception, not the rule, right? Is how little it's come back down despite, and I hope this isn't like, triggering for anybody, like a high training volume. I'm a runner, and I have been shocked at how little it's come down from like, the highest it got during when I wasn't doing anything and was eating even a little more. Even a little bit more than I am right now. So, I've just been absolutely shocked, and maybe that's You know metabolism a little bit slow or and something we've talked about is I'm on thyroid replacement I have no thyroid gland left from an autoimmune disease. So other people's thyroid adjusts, right? Well mine can't. I take a pill once a day. So what's expected for my metabolism isn't what is for somebody with an active normal thyroid gland. So I had to grieve that, you know, and then I get mad that I had to grieve it because on one hand I say, well, I probably would have lost a little bit more had I had a normal thyroid. And then I'm mad that I had that thought because I don't want to be feeling that way about my weight. Because the more I weigh, the more protective it's going to be for my bone health. And that was my goal. So it's like, I have three voices in my head at any given time, but the difference now is in the past, that first voice was the only one, and there were no counter voices at all. So, I think the important thing moving forward is that those other voices get stronger, even if that first one never goes away. It's just told to sit down and shut up really quickly, and it's seen for what it is. Right now, I think it's at least important that I check and not act on it. So the weight changes were the biggest surprise. I was sort of trying to make sense of why is it where it is. Especially, and this was very interesting, when I'm only a size up than one before I got pregnant. Like, and I'm in some of the same pants, because jeans are always a good barometer. And I'm like, how can I be potentially almost Pounds more and be in the same size? It boggles my mind, and when you had said that sometimes it's like literally your organs replenish their weight, I was like, okay. So that should say, scale means nothing, right? It doesn't matter, you know, but it's easier said than done. Intellectually, as a physiologist, I understand, but that limbic little emotional brain does not, and doesn't like it, but I'm very much working towards, if I just keep eating at it, no pun intended, of that voice getting quieter, and embracing being at a higher body weight, and, what I would like to also add that I don't think was in your book, but I learned by going out to Dr. G's clinic in November. You've had her on the podcast. I didn't see her. I saw one of her associates, and she had asked me, what did you weigh when you got your first period? And I told her, and she's like, you're only a few pounds more than that right now. And she said no adult woman should ever weigh less than the weight you were when you got your first period. That is the minimum weight you should ever be. And I'm like, no one has ever said that. And that was so extraordinarily freeing. Because that was almost like, even though I shouldn't need it, it was almost like permission to be at this higher weight. I could let go of the why of the years I spent at a different one, just by that fundamental thing. That this is, whether I like it or not, this is at the bare minimum where my body wants to be, and that's, I wasn't even active then. So I have more muscle, I have significantly more muscle on me now, you know, I'm older, I've gone through all this metabolic damage over the years. That was very freeing and allowed me to let go of the idea that I would ever be under, like, the range I am now. But now it's acceptance, which is always a hard part too.

Florence:

I think you're on your path. You know, you're on your journey. It takes time. So many of us have gone through the physical side of recovery. The one sentence you mentioned from the support group, I've been there too. Totally physically recovered, absolutely unrecovered mentally. It took time to get to the point where I am today. And I think you're really taking so many steps. Sometimes give yourself a pat on the back because this is not easy. And, I don't know, Nicola, if you want to ask something else, but I have a question specifically about the journey of pregnancy and postpartum

Krista:

It's a whole other podcast, but go ahead.

Florence:

Because I think this is one of the things, again, I do not mean to blame doctors, but I wish they would talk about the risks to the mother, because there's a lot of doctors that go, and we talked about it before, Oh, the baby's fine. The baby's fine. If the mother is not capable, and is completely depleted in postpartum, baby is not going to be fine. They need their mothers to be present and enjoying and nourished and totally available. So I'm just curious if you're ready to share in a way to prevent other women maybe saying, I'll just have fertility treatments.

Krista:

Yes, so this is, well, I'm not against that because everybody has to choose. I don't know how long it would have taken. I probably would have never gotten pregnant because I was 37. So knowing now, like, I don't know how long it would have taken to go through all the steps to recover to that point, and it might have been too late. So I'm not against that, but I'm not afraid to talk about it at all, because I want to prepare people that if you are not HA recovered or in a strong place in recovery with your eating disorder, the baby will not magically fix your eating disorder because you will love it so much you won't care anymore.

Nicola:

Mm

Krista:

I wish that was true, but it's not. Nothing can make you love yourself but you. Whatever love yourself means. In fact, you'll feel doubly guilty and terrible for thinking about exercise and your body and food while your newborn is in your arms that you wanted for all of this time. And nobody needs to do that to themselves. At all of my appointments, I was always under the weight gain trajectory chart. Always under it. Like, I didn't even gain a pound until I was, like, 15 weeks. Like, nothing. And then it would shoot up, and then stay steady. But, I was always under. And every doctor was like, that's no big deal. I'm like, then why is there a bottom number? If you don't care, why is there a bottom number? And they're like, there's no data, there's no studies on it. And that is the definition of weight bias in medicine. I had a male OB until moving up to where I currently am. And I said, I promise you that if I was a pound over, you would be up my butt.

Florence:

Yes.

Krista:

But I'm five pounds under where I should be by your data and you don't care, you know, and what was even more frustrating was it is clear in my chart that I have a history of HA, that I had an eating disorder history, so if he even glanced at my chart, and when I was at my 10 week visit, said to me, be sure you eat a little more, but not too much, just like an extra candy bar a day. You're talking to somebody with an eating disorder history. I said do you think eating too much is the concern here?

Florence:

absolutely not.

Krista:

It's just they have no idea what to do. They have no idea because all of the data, everything they've been trained is preventing excessive maternal weight gain. So there's absolutely nothing. So two weeks after I gave birth, I was 10 pounds less than when I got pregnant. I lost all of the baby weight plus 10 more pounds within two weeks because of the metabolic cost of breastfeeding. And no one cared. And plus you're hyperthyroid for a little bit after as well. But it was like, no big deal. I had nothing left. Nothing left. And I don't know if having had more energy reserves might have made the terrible sleep deprivation easier, or the emotional side of things. I don't know, but I do know I spent so much of the first year until I started working with Nicola of my son's life, even though I was waking up multiple times a night, still getting up after maybe two, three hours of sleep and exercising at 5am, or throughout the day, counting every calorie, those type of things. I wasn't present. And I can't get that time back. I can't. But we live in such a culture, do you think every day I wasn't getting, Oh my God, like, look how you bounced back kind of messaging. Absolutely. It's just such a shame that it's like women are supposed to rip their bodies apart and then act like nothing happened three months later. Whether that's because that's when FMLA ends, if you're lucky enough to have it, or that's just the societal glorification of like getting your body back or whatever There's no such thing. It permanently changes after you have children. And, like, but we want to say that that's for the weak. The people that don't try hard enough. So, I wish I had rested more. I never slept when he slept. When he slept, I exercised. It really reactivated the eating disorder and I felt like I lost a lot of the progress that I had gained because of the overwhelm of, and, and truly just simply what I've come to learn is that the brain of someone with an eating disorder, weight loss, even when unintentional, triggers all the behaviors again. Ironically, right? It gets even worse, and funny enough, I feel in a more healthy place at a higher weight, and you would expect the opposite, you know, so. Well, your brain is fueled, like.

Nicola:

Absolutely. I think so many of us are healthier when we're at the weight that our body wants to be at, as opposed to a weight that we've been suppressing and under nourishing ourselves and having to manage by over exercising, not resting, all of that. I just wanted to say there's a book by Emily Oster called expecting better, and she actually looks at a number of the studies around weight gain and pregnancy and the conclusion that she comes to is that there's actually more negative impact from under gaining than there is from over gaining. So if people are interested, that's an interesting book to read.

Florence:

Yeah, we'll put it in the show notes.

Krista:

I would love to.

Florence:

Wonderful. Cause also, I keep seeing those horrible messages about improve your fertility, cut out some foods and you're like, Why? Like, you know, of course, if you have, I'm saying anything,

Nicola:

Celiac. Yeah.

Florence:

you know, of course that's going to help, but it doesn't mean everybody has to cut off gluten. You know what I mean? It's one of those things. And I find that the narrative around fertility is really terrible.

Krista:

Well, and the narrative around like being BMI cutoffs for fertility treatment, because it's this built in assumption that someone with a certain BMI has so much circulating estrogen that it's suppressing their ovulation. And that assumption is made without doing any blood work or tests to confirm that. The assumptions made they have PCOS and somehow weight loss will fix that. Absolutely not. There's just so much built in assumptions when looking at a number. That is just absolutely tragic that people get denied that treatment because of weight. I, you know, get fired up about this. I do weight bias research.

Florence:

The whole word obesity we don't use on this podcast. Being in larger body is not a disease. There's no need to cure it with intentional weight loss. That actually doesn't work always backfire. It just doesn't make any sense anyway.

Nicola:

I think we've covered a lot of ground here, and most of the, most of the other questions that we've had, so Krista, why don't you just tell us how you're all in now,

Krista:

I am all in on breaking intergenerational trauma cycles of doing things differently with my child, because, again, like I said earlier, whether it's diet culture or other things, people just, you know, pass the pain like it's a hot potato and, we have the knowledge. There's no excuse now in this generation in this day and age. We have the knowledge to do better. I'm sure I'll screw him up in my own unique way, but it'll be brand new. So he can choose whether or not to pass that on. So definitely all in in trying to raise a human with the Optimal setup for psychological, emotional health and relationship with his self, especially his body. Always and always have been and will always be all in on being the best teacher I can. And I talk about my eating disorder history very openly with my students. I talk about the reality of hypothalamic amenorrhea and weight bias with my students. And I don't teach medical students. I teach a different health care profession, but all of them will deal with patients with these things that are experiencing weight bias that are getting undiagnosed, misdiagnosed because of assumptions based on weight. It is like my life's mission to train competent healthcare providers that have this knowledge that they're never going to get otherwise. And I'm very all in on reading World War II historical fiction right now. I keep finding book after book and can't get enough. I'm reading All the Light We Cannot See right now. And I finished The History of Love recently, which I probably read it three times back to back. So, I'm just finally doing something for me that is not productive, quote unquote, which I have never been good at. One of my therapy assignments once is you're going to go to a movie and you're going to sit there and enjoy yourself. And I was like, but I could be doing something else. And it was like, so, you know, kind of just finding a different definition of productivity. So, I think that's enough to be all in on besides my own journey.

Nicola:

That's fantastic. Yeah. I just finished Lessons in Chemistry, and really enjoyed that one as well,

Krista:

Oh, the show or the book?

Nicola:

The book. The book. Yeah.

Krista:

I watched the show. It was very good.

Florence:

That's awesome. We're so grateful for your time, for sharing with us, for sharing with all sorts of other people, you know, that will meet you and for trying to change not just your child's future, but also other people's paths. That's really fantastic. And we wish you all the best, Krista, you're definitely on the right path. So we'll be supporting you and cheering for you and you know where to find us if you need us. Thank you so, so much for your time. It was a great, great moment speaking with you.

Nicola:

Thank you. We'll talk to you soon.

Florence:

Bye.

Krista:

Yep. Bye.

One thing that always strikes me is how different each person's all in journey is. As I often say, there are many paths to HA and many paths out of it. Your journey is unique. That is so true. If you need more support on your journey, you should definitely start with NoPeriodNowWhat, which you can get at noperiod.info/book. And Florence and I both work with people on different aspects of period recovery and so much more. If you'd like more personalized advice and attention, you can go to noperiod.info/appointments to schedule a time to speak with me on fixing issues underlying missing periods, blood work, diagnosis, and lots more. or beyondbodyimage.com to work with me on the fear of weight gain and making peace with food exercise in your body. I also take care of the new French version of No Period Now What through the Instagram account@jenaiplusmesregles_livre. We also have joined clients and online support groups so you can access both our domains of expertise and get the physical and mental help you deserve to put an end to disordered eating once and for all. If you enjoyed this podcast and found it helpful, please subscribe and drop us a review to help more people find it. Also, join our online recovery community at noperiod.info/support in English and noperiod.info/communaute in French and let us know how All In is going for you. All In is not just about period recovery, it's about getting your life back. See you in two weeks!