Elimination Diet Red Flags: Stay out of the C-FAST

Elimination diets are a primary risk factor for getting stuck in the Conditioned Food Avoidance and Sensitivity Trap. Julia Cassidy joined me for an insightful discussion on this topic. She highlights the key warning signs that you may have developed a fearful relationship with food and what to do if you notice these red flags. Julia Cassidy is a highly experienced dietitian with 20 years of dedication to weight-inclusive and nutrition-sensitive care within the behavioral health field. Her leadership roles have included Vice President of Clinical Nutrition and Senior Director of Nutrition and Wellness. She is a Certified Eating Disorder Specialist Consultant, a Certified Intuitive Eating Counselor, certified in Nutrition Psychiatry, and a Licensed Body Positive Facilitator. Listeners can connect with Julia at [email protected] or www.thriving-nutrition.net

Watching other people eat foods you are restricting can be challenging. Janelle shares how she has come to a place of acceptance and compassion over the last 15 years of living with celiac disease. Janelle Smith, MS, RDN, CEDS (she/her) is a registered dietitian nutritionist and Certified Eating Disorders Specialist with lived and clinical expertise in supporting a peaceful relationship with food in the midst of gastrointestinal distress. She is passionate about educating other providers about disordered eating and GI diseases, so actively forms and leads initiatives with this mission, including the EDGI Training Project and the Dietitians in Gluten and Gastrointestinal Disorders subgroup with the Academy of Nutrition and Dietetics. She is advancing eating-disorder informed care at her position with UCLA Health Digestive Disease Nutrition Program, speaks on the topic at conferences, and has published multiple peer-reviewed research articles on the overlap. You can reach her at janellesmithnutrition.com and edgitraining.com

Visualization is a powerful tool to rewire our brain’s circuitry and create new pathways that lead to success. Visualization can change our relationship with food and help us move past conditioned food avoidance and sensitivity. Aaron Volpatti is a cognitive performance and injury coach, speaker, retired NHL player, burn survivor, and a graduate from Brown University- B.Sc Human Biology. He is also the author of Fighter – Defing the NHL Odds. A pioneer in Cinematic Visualization and athletic performance, Aaron’s unique practice has helped athletes all over the world. You can reach him at AaronVolpatti.com

Beth Rosen shares her story of accepting that her digestive discomfort was chronic but also realizing there were many treatments she could explore to get back to a great quality of life. She shares her top tips on travelling this road with persistence and patience. Beth Rosen, MS, RD, CDN, is a weight-inclusive Registered Dietitian specializing in GI nutrition and disordered eating. With 29 years of experience, she runs a virtual practice helping clients manage conditions like IBS, SIBO, and Celiac disease. Beth also educates health professionals through webinars and peer mentoring. Currently the chair of the Dietitians in Gluten and GI Diseases subgroup of the Academy of Nutrition and Dietetics, she’s a co-founder of the EDGI Training Project and author of the upcoming book Gut Goals. Learn more at www.BethRosenRD.com.

Food and symptom journalling can be effective when used properly. However, it can also pull you into symptom hypervigilance and the Conditioned Food Avoidance and Sensitivity Trap (C-FAST). Join Wendy and Dr. Melissa Hunt for tips on avoiding these pitfalls. We will also discuss how the brain amplifies sensations in the body and how you can turn the volume down on this communication. Melissa G. Hunt is a licensed clinical psychologist and serves as the Associate Director of Clinical Training in the Department of Psychology at the University of Pennsylvania.  She is a Fellow and Diplomate of the Academy of Cognitive Therapy and a member of the Rome Foundation Psychogastroenterology working group. Dr. Hunt conducts research on the best approaches for stress management, and into the causes and treatment of depression, anxiety disorders and chronic GI disorders. As a clinical scientist, her emphasis is on translating basic psychological science into treatments that are effective, acceptable, and accessible to patient populations. Her work focuses on identifying the underlying patient factors (e.g. unhelpful beliefs and maladaptive avoidance) that lead to reduced quality of life, impairment and distress, particularly factors that exacerbate chronic health problems and make them harder to cope with, and on developing and disseminating evidence based, empirically supported treatments for folks with GI disorders.  In addition to her research, she maintains an active private practice in clinical psychology in which she specializes in cognitive-behavioral treatment with patients with chronic GI disorders, as well as co-morbid mood, anxiety, obsessive-compulsive, and trauma disorders.  She is the author of two evidence-based, empirically supported self-help books that make CBT accessible to patients with IBS and IBDs, as well as an empirically supported treatment manual on CBT for IBD patients.  You can reach Dr. Hunt at [email protected].

Annie shares her story of how the bulimia she developed as a teenager morphed into food sensitivity restrictions while she was enrolled in a “wellness” program. She developed chronic health problems and believed that food was the cause and that a restricted diet was the cure. Annie shares how these restrictions impacted her life and how she broke out of the trap and is now enjoying freedom from food. Annie is a recovered trauma-informed eating disorder mentor and intuitive eating facilitator with a dedicated focus on addressing misinformation in wellness spaces. She connects individuals with vital resources and offers specialized eating disorder recovery coaching, collaborating closely with other treatment providers. Her mission is to guide individuals towards a healthier relationship to food and self, while also equipping them with the skills to navigate and discern accurate information amidst the challenges of misinformation in wellness environments. You can read more about her story here.

Amy Slabaugh is a returning podcast guest. We released an episode in September 2023 talking about her journey with chronic, debilitating headaches and the importance of taking one road at a time (i.e. systematically trialling new treatments). Through this approach, she discovered brain training tools that dramatically improved her quality of life. Amy Slabaugh is a registered dietitian nutritionist specializing in intuitive eating and the dietary management of irritable bowel syndrome (IBS). In her practice, she loves working with people to foster a positive relationship with food and learn to nourish their bodies in a way that promotes health. For those who are experiencing adverse reactions in response to food, her goal is to help clients work toward minimizing their symptoms and improving their quality of life. Providing counseling for clients as they work through the C-FAST Treatment course is a great way to do this. You can reach Amy at AmySlabaugh.com.

Dr. Biesiekierski discusses her groundbreaking research, highlighting the interaction between mind and body in food sensitivity reactions in irritable bowel syndrome (IBS). Her research was a key finding to support IBS (and other conditions) being classified as Disorders of Gut-Brain Interaction (DGBI).   Dr. Biesiekierski's research focuses on improving diet management for gastrointestinal disorders (particularly irritable bowel syndrome and functional dyspepsia) through mechanistic insights along the gut-brain axis. She is a researcher and senior lecturer with the Department of Nutrition, Dietetics and Food at Monash University in Australia. You can reach Dr. Biesiekierski through the Monash University website here.

Dr. Laurie Keefer discusses how a flexible, curious and resilient mindset makes food reintroduction easier. She will also share her expertise and practical tips on how to make this change. Dr Laurie Keefer, PhD is a GI Health Psychologist and Professor of Medicine and Psychiatry at the Icahn School of Medicine at Mount Sinai in New York City. She has a more than 20 years of experience in the development and implementation of behavioral therapies for chronic digestive disorders, including Inflammatory Bowel Disease (IBD). She currently directs the GRITT Program, an integrated care model for Crohn's and ulcerative colitis patients within the IBD Center at Mount Sinai Hospital. She maintains a clinical practice focused on psychosocial concerns among medically complex IBD. If you would like help from a GI Psychologist, please visit the GastroPsych section on the Rome Foundation website (access here).

Health psychology focuses on how biological, social and psychological factors influence all aspects of health. However, many people are reluctant to see a health psychologist because the recommendation can sound like, “Your symptoms are in your head” or “Your symptoms are caused by stress; just relax, and you will feel better.” This is such a prevalent problem that I wanted to learn more about this field and explore the difference between health psychology and general mental health counselling. We are fortunate to have Dr. Megan Riehl on the podcast today to explain the difference. Dr. Megan Riehl is a GI psychologist who is a key opinion leader in the area of psychogastroenterology. She is an Associate Professor of Medicine and the Clinical Director of GI behavioral health at the University of Michigan. She is also the Director of Behavioral Health Services and Support for GI OnDemand. Dr. Riehl's clinical research focuses on the delivery of GI behavioral health treatment for patients with disorders of the gut-brain and IBD. Dr. Riehl participates on several national committees dedicated to research and education to enhance the psychosocial functioning of patients with gastrointestinal problems. Together with expert GI dietitian Kate Scarlata, she has co-authored a new book for those living with IBS – Mind Your Gut. Mind Your Gut is available in March 2024. Learn more here.