The first part of this episode is available to all listeners. To hear the whole thing, become a paid subscriber here.
Nutritionist Abbie Attwood joins us to discuss how dealing with multiple autoimmune chronic illnesses led her down a path of dubious diagnoses and disordered eating, and how she ultimately found healing. In the free version, we get into how disordered eating can trigger and aggravate chronic conditions, why she believed she had “adrenal fatigue” and “leaky gut,” the role of obsession and OCD in orthorexia, and more. Behind the paywall, we talk about why it’s so easy to have your identity get wrapped up in disordered eating and chronic illness, how wellness culture preys on grief over physical limitations, the importance of self-compassion and how Abbie and Christy practice it, the prevalence of heightened sensitivity in IBS and other chronic conditions, how wellness-culture rabbit holes can lead to worsening symptoms, and the process of coming back to conventional medicine after a foray into the alt-med world.
Abbie Attwood (she/her) is an anti-diet, weight-inclusive provider with a masters in clinical nutrition. She is the owner of Abbie Attwood Wellness, providing both individual and group virtual nutrition therapy and body image coaching. She is also the host of the Full Plate Podcast and writes the accompanying newsletter.
Abbie has lived experience with an eating disorder, which happened at the intersection of competitive running, OCD, and several chronic illnesses—all of which have made her especially passionate about working with those who don’t always see themselves in the traditional picture of disordered eating.
She works with clients around the globe, supporting them in healing from disordered eating, chronic dieting, body shame, and compulsive exercising to move into a kind and respectful relationship with their body. Abbie’s approach centers on self-compassion, social justice, and body liberation.
She splits time between Maine and the Bay Area with her husband and their two quirky rescue pups. She’s a lover of breakfast, books, the ocean, and all the ice cream. Learn more about her work at abbieattwoodwellness.com.
Resources and References
Christy’s second book, The Wellness Trap: Break Free from Diet Culture, Disinformation, and Dubious Diagnoses and Find Your True Well-Being
Subscribe on Substack for extended interviews and more
Abbie’s Instagram
Abbie’s website
Christy’s online course, Intuitive Eating Fundamentals
Transcript
Disclaimer: The below transcription is primarily rendered by AI, so errors may have occurred. The original audio file is available above.
Christy Harrison: And now, here’s my conversation with Abbie Attwood. I'd love to start off by having you tell us a little bit about your history with wellness and diet culture, because I know there is a rich history there.
Abbie Attwood: Yeah, there is. It's always funny getting this question. I know you've gotten it a million times yourself, chatting with others, and I almost lose the timeline in my own brain. I'm like, oh, my God, it's such a messy web. But I think for me, what's important as I think back about what led me into diet culture and wellness culture is just my personality, but also my experiences as a kid. I've always struggled with my mental health. I've had pretty severe anxiety a lot of my life.
And then the other piece of that was that I grew up an athlete, and that has its own routes into diet culture and wellness culture. But I also struggled with a lot of health conditions most of my life. And so those three things I feel like were avenues for me into a disordered relationship with food, with my body, with exercise. When things kind of really came to head was probably when I was 18 or 19 when I really think, looking back, OCD, obsessive compulsive disorder, that onset happened for me. And as I've learned over the years, that's actually a really common age for it to happen, which is really interesting.
Christy Harrison: Why is that?
Abbie Attwood: You know, I don't know, and I don't know that anyone knows, but I think there's a lot of shifts that happen in the brain at that time. But also, tends to be a time when things are shifting for people in their life a lot. For me, I was probably a sophomore in college, and I think I was having this kind of crisis of identity. What always kept me feeling okay, even amidst feeling really anxious and looking back, having a lot of symptoms that would have suggested OCD as a kid. I had all these little habits and rigid things.
My mom was a cardiologist, and I remember going through this period of time when I was a little kid where I would make her check my heart every single night before I went to bed with a stethoscope because I was convinced that I was going to die overnight. Just things like that. I was always really worried about dying. And then in college, I think I just felt really untethered at a certain point. I felt like I had lost my identity as an athlete. I was just feeling a little bit uncertain about things. Also, I was in a weird place transitioning with friendships and relationships and started having horrible panic attacks. Like, really horrible panic attacks. And now I realize it was because of having a lot of intrusive thoughts from OCD about my health and about death and just being really scared.
And that is what kind of led me down this road of first, disordered exercising, because that was the only way I could manage a lot of that fear and anxiety and the panic attacks was to run. It was the only thing that kept me from feeling like I was just falling apart, because a lot of my OCD was somatic, which is that I was really obsessed with breathing, and I couldn't stop focusing on my breathing. And I thought that if I stopped actually thinking about breathing, that I was gonna stop breathing and I would have these panic attacks. And so if I ran, I suddenly just didn't have to worry about that. My body did it for me.
Anyway, so that was that rabbit hole. But at that same time, I started getting these slew of symptoms and was then diagnosed over the next several years with multiple different chronic illnesses. And that kind of just added fuel to the fire and led me down these different paths of disordered eating behaviors with all of these suggestions for how to "cure" each condition with certain foods. It just got really messy. I spent a lot of time in the hospital for a few years for both those conditions. But also what I think now was a lot of malnutrition coinciding with that. And I still look back and wonder whether a lot of those chronic illnesses and autoimmune diseases would have happened had I not been undereating at the same time and over exercising.
Christy Harrison: I think about that a lot. I think we might have talked about this in our episode of your podcast, actually. I have an autoimmune thyroid condition in my family, but I really wonder if I would have gotten it, because it didn't seem like I was going to. And then, as soon as the disordered eating and over exercise started, that happened. And a lot of other chronic health conditions cropped up then as well. Digestive stuff, other autoimmune stuff, skin issues, connective tissue issues, all of these things that were, I think, aggravated. And I don't have any real evidence to support this. I'd be curious, actually, to do a deep dive and see if there is any scientific research on this. I looked into it a few years ago and there wasn't really much.
But I think it's super interesting with the rise of autoimmune conditions and especially that they affect women so disproportionately and everybody's sort of rushing to blame something. And alternative medicine and wellness culture loves to blame food and blame particular dubious diagnoses like adrenal fatigue or chronic candida or leaky gut or whatever it might be. But I really wonder what role disordered eating plays in the onset of these things. Not to say that maybe we would never have developed an autoimmune condition, but did it take less time or did it become more severe? Would we never have even known we had it if it wasn't for this extra stress on the body? I'm just curious.
Abbie Attwood: I'm so curious about that. And I think the last thing you said is really my hypothesis, which is the stress. And I think we really overlook that culturally, I think in terms of just how obsessed both wellness and diet culture has become with these specific things, blaming specific foods. We overlook how massive stress is as a risk factor for all sorts of health conditions. Not just autoimmune or chronic illness. And then we also underestimate, in my opinion, how much stress the body is under when we're not eating enough. Which is silly when you really think about it. Because of course, I mean that is arguably the most important thing we can do to keep our body feeling safe is to eat enough. And so what greater stress is there than the fear of not getting enough? That's a survival instinct.
And I totally agree with you. I think there's a huge connection there. And I agree with what you said. There's definitely no self blame on my part. I don't think, like, "Oh my God, I should have done something differently in that way and I never would have gotten sick." But I do think it exacerbated, perhaps was a catalyst and perhaps worsened a lot of my experiences around those chronic illnesses because of the extra stress that I was putting on myself by getting so intense, hypervigilance.
And that's a critical and judgmental place to be with yourself. That's not a compassionate place to be. And it took me a long time to realize that. I thought I was taking care of myself, but now I look back and realize how much damage that did to my wellbeing by just feeling so afraid all the time. It was such a precarious place to be, to feel like every choice you made could make or break your health. That's an awful place to be.
Christy Harrison: Especially for someone who was already so worried about dying. I can imagine that just brought those fears up to 11. You actually had something going wrong in your body now.
Abbie Attwood: Yeah, a thousand percent. And it was interesting because I was diagnosed with different conditions. You have Hashimoto's. Is that right?
Christy Harrison: Mhm.
Abbie Attwood: I have that too.
Christy Harrison: Oh, yeah.
Abbie Attwood: Oh, my gosh. And you mentioned leaky gut. You mentioned chronic Candida. What was the other one that you mentioned? Oh, adrenal fatigue. Oh, my God. I went down all of those rabbit holes. Check, check, check.
I had a stack of books, Christy, on my bedside table on all of these things. I would read these going to bed at night. I was going to bed with this fear in my brain. But it felt like hope at the time, which is strange that those are different sides of the same coin in a lot of ways. "If there's a reason that I developed this, then there must be a way out of this" was kind of the belief system that wellness culture pushes on us.
Christy Harrison: And when you were believing you had all those things, do you feel like you were being unserved by the conventional healthcare system and that's why you were driven to those ideas, or how did you get turned on to these diagnoses in the first place?
Abbie Attwood: Yeah, it's such a good question. I think a relatively common experience, at least from what I've seen for myself personally but clients that I've worked with and just obviously being in this space for a while, as you have probably seen, too, which is just feeling alone and broken, and no one really has anything solid to offer you, because chronic illnesses by nature are chronic. We don't have cures for them. Especially when you're young that's such a scary thing to think. I'm gonna live the rest of my life with this. I'm gonna be in this kind of pain. I'm gonna be in and out of the hospital. I'm going to experience these flares and not know when they're coming. I'm gonna be on all these medications.
The doctors that you're seeing, you just want more from them and it's not their fault. Cause I've talked to a lot of people who felt really dismissed and I felt dismissed in some ways, but I just wasn't satisfied with what they could offer. It felt like we should be able to do more. But I do feel like I didn't get a lot of time with them and that they weren't perhaps as interested in what was going on as these alternative medicine providers were right? These people who claim to have specialized in these specific conditions.
Or, even more seductive are the people that have written books about, whether it's something kind of like paleo or a keto kind of thing, just these really prescriptive dietary approaches written by these people. And I won't need to name names, but who purport to have cured themselves through these diets or these ways of eating, they don't usually call them diets.
Christy Harrison: Oh, it's so seductive when they're painting themselves as the success story for this and showing that it is possible to cure yourself and heal yourself and live in total remission. And who knows if that's even true, right? Who knows how much of these people's stories are true? Because it's not scientific, it's just an N of 1. It's just someone saying something that might just be good PR for their book or whatever. Maybe they are still having flares or maybe they're secretly on a biologic or something. You never know.
Abbie Attwood: You never know. And anecdotes are not evidence. And I think that's what's really hard when you're in the thick of it and you're suffering so much and you are just such an easy target for that kind of information because again, like I said, it's the hope in that. Whereas before you're living in this place of fear and if somebody offers you something, you're so susceptible to it. And I think that's what made me so interested in this kind of overlap and co-occurrence of neurodivergence and wellness and diet culture and eating disorders and also chronic illness and eating disorders and wellness culture driving you into that rabbit hole of obsession.
And I think as somebody with OCD, you can only imagine. It wasn't just a chronic illness. I got driven towards these kind of dietary protocols or alternative medicine providers. I think it becomes very, and I use the word obsessive in a clinical sense, as somebody with OCD, but it can become that way for a person without OCD. And if your brain really attaches to that stuff and you can't let go of it. You just can't let go of it. You get so sucked in and it's really dangerous. I really do believe it's dangerous. And that's kind of where I found myself. And one of the conditions I have is neurological, and that was a particular rabbit hole for me into some of these really rigid diets and lifestyles, so to speak.
Christy Harrison: Yeah. And so what happened when you went on those diets? Did you have a feeling that I think so many people experience. I know I experienced this of the honeymoon phase with the diet, where the placebo effect is really strong. Feeling like, "This works. I finally found it. This is the solution." And then like, "Oh, wait, maybe it's not. Maybe my symptoms are coming back or having flares again." Of course we know that flares can ebb and flow and an ebb can coincide with starting a new diet. And so it can seem like the diet's working, but it's actually just sort of a natural ebb of the condition and then it's going to come back and it's cyclical. So I'm curious what your experience was like with those things.
Abbie Attwood: My experience was that it did not help at all. Not at all. And I don't even think I was under the impression that it was helping me at the time because it just made me feel like I was failing at another thing because these are so restrictive and they're so time consuming. That's another thing I forget about is how time consuming it was to try to eat in these particular ways, how expensive it was. Also the just constant hunt for these providers that claim to be specializing in these and how expensive that is and everything. But my experience was that it just caused me more stress and that I couldn't really sustain it. It just wasn't realistic in terms of eating in particular ways.
And so at the time, I was kind of assuming that I just wasn't doing enough because I knew I wasn't 100% to the rules all the time of this particular way of eating or whatever it might have been. But honestly, it did not help. I went on all the things, like dragged into the gluten free thing, all these particular vegetables to eat these.
Christy Harrison: The naturopathic kind of eschewing particular vegetables.
Abbie Attwood: Like, vegetables are bad now in some cases, right?
Christy Harrison: And then what are you left with? What can you even eat?
Abbie Attwood: Well, that's the thing. I felt like I had nothing left. And what was interesting about it is I had already been suffering from disordered eating for a while, and yet I still got dragged back down this rabbit hole every time I was diagnosed with another condition. I still found myself kind of getting dragged back down thinking, like, well, if I'm not doing this, am I just not being responsible? I'm just not taking care of myself and surely I can do this without developing disorder eating again. Now I know more. Now I can just make sure I'm eating enough, even if I'm just eating these things. But I personally did not feel relief from that. I did not feel relief from anything until I made the decision to go on the medications that I needed and to take care of myself in that way and to really more deeply heal my relationship with food.
Christy Harrison: So were you being prescribed medications and just saying no and going another way?
Abbie Attwood: Early on, yeah. Which makes me so sad thinking back because I was struggling for so much longer than I needed to be. So much longer. And not just for the symptoms of the chronic illnesses, but also for anxiety and taking an antidepressant or a medication for anxiety. Things like that. I was just assuming that if I could just get all of this other stuff under control, then that would get better. And so I wasn't going down the medication path at first.
Christy Harrison: What do you think made you decide not to? Was there rhetoric that stood out to you that was anti-medication?
Abbie Attwood: Yeah, and I think again, it was fear. There was rhetoric around kind of medications within. Just so much fear mongering around side effects and symptoms and really side effects. I was so afraid of the side effects of medication. And I didn't like the idea of being on medication. Not from a moral standpoint, but there was just a lot of anxiety about putting something in my body like that. And now I'm like, whatever, I love my little medication container every morning. But I could work myself up about potential side effects and all of these wellness gurus. And it's much more attractive when your brain attaches to catastrophic outcomes to think that food is a better path towards healing.
Christy Harrison: Yeah. Because it seems gentler. It seems less potentially harmful. I think this is the thing that I try to emphasize all the time to people is diets are not free of side effects. Right. There's actually no intervention that's really free of side effects, including doing nothing. And when it comes to changing your diet and changing what you eat, especially in a restrictive and radical way, the way that some of these autoimmune protocols recommend or really chronic illness protocols or "wellness protocols" across the board, it actually has significant side effects, of increasing those feelings of obsession that you mentioned and putting people at risk of disordered eating and increasing restrictiveness and decreasing ability to eat what you want and a decreasing menu and malnutrition, as you mentioned before. That's a huge risk. And I think that wellness culture and diet culture just really minimize that and sweep it under the rug.
Abbie Attwood: A thousand percent. That pressure to heal naturally, this idea that we can cure ourselves through lifestyle changes, like you said, it feels gentle. And we just don't understand or I didn't, I'll speak for myself, like you said, how dangerous that was. It made me fixate on my health even more and become like really hypersensitive to anything that I felt going on in my body and just attaching to all the fear based messaging out there and just furthering myself into this stigma against medical treatment. Not to mention all of the toxic positivity that I think wellness culture pushes forth. It can kind of catch you up in that whole rabbit hole.
In my experience, it drove me into orthorexia. I'm not unique in that. And I think orthorexia just created a lot of isolation for me. It damaged a lot of my relationships. It stressed me out. It made me, honestly, blame myself even more because every time that I would have a flare, I would just assume I wasn't doing enough.
Christy Harrison: That blaming rhetoric is so common, I think in diet and wellness culture that it's always the fault of the person and it's never the fault of the diet. It's never that this diet or "lifestyle plan" or protocol or whatever it is is not sustainable. It's that the person didn't do it right or didn't do it hard enough. And these plans and protocols and programs will all conflict with each other. So you couldn't possibly be doing them all at the same and doing them all correctly. And yet many of us try. I know I did. Let me layer on low carb and gluten free and all these things that don't really go together. Yeah, there's just so much blame on the individual, which I think is no coincidence, really, because it allows the sort of capitalistic machinery to keep going, keep turning.
Abbie Attwood: And I think at the core of the experience of chronic illness is feeling like your body is your enemy, that you are losing control over your body. And diet culture pushes forth this idea of kind of controlling the size of your body, right? The appearance of your body. Wellness culture kind of seizes on that. And it's also about the functionality and the experience and the symptoms. And so then I was just met with, "I feel like I have absolutely no control." Not only do I not have control over what it looks like, especially chronic illness can really impact that. I've gone through a lot of shifts with my body over the years because of that, which is natural. All bodies change, but especially with certain conditions, things can shift a lot. A lot of the rhetoric around medications also was very fat phobic.
Christy Harrison: It was about weight gain being a side effect.
Abbie Attwood: Of course, there's always that fear in our society, makes that such a real thing. It makes me really angry now to think of how many people avoid medication for that reason just because of that messaging. And the point is, I already felt like I was at odds with my own body. And I feel like wellness culture for me, deepened that gap between me and my body. It really felt like we were not one and the same. I was over here trying to manipulate my body, control my body, make it behave.
And the truth is that the only peace and healing I've found is to get closer to my body, to get closer to myself, to integrate into a whole person and realize me and my body are one and the same. And everything it's ever done was to try to protect me and to try to get me through things. But I don't know how to say this in an eloquent way. I feel like that was one of the things that destroyed my health the most, was just the burnout and the exhaustion of this constant attempt to control my body. It consumed me.
Christy Harrison: Wellness culture really preys on that, preys on that sort of adversarial nature of the relationship with our bodies, whether because of chronic illness, because of weight stigma, because of failing to live up to some ideal. It's right there to say, "Yeah, you're right. Your body isn't doing it right, and here's the path and here's the way to do it." And this idea that you are to blame for not doing it right or hard enough just obfuscates any responsibility for the failure of the diet or the protocol or whatever it is. There's just no accountability in wellness and diet culture for the failures. It's all put on the individual.
Abbie Attwood: Yeah. It's that bootstrapping narrative that just gets carried through. It's your responsibility as an individual to improve your health. It's your responsibility as an individual to control your health and your health outcomes. And I'm glad you mentioned that, because I think that at the core of OCD is really this deep, deep inability to sit with uncertainty. As humans, we all struggle with that, but with OCD, it disrupts your daily life to the point where it's hard to function. And so to have that met with this narrative around, you should be able to control this if you do these things.
Then I became obsessed with trying to find certainty and something that was never going to offer me certainty, because there is no certainty in having a human body. There just isn't. And I think that's the message that gets sent to us that's so damaging, is that this is something you can control. Look, I did it too. Look, here's my protocol. And the truth is none of us have full control over our health. And that is hard to sit with. And that's where I think we can really start healing. And that's the path through all of this, is to know that you're not doing something wrong just because of the uncertainty, just because of the lack of control you feel over your health. But that is actually just what having a human body is about. And it makes you feel less alone to just sit with that a little bit and know that no one can do that.
Christy Harrison: Right, right, right. Well, what did that path look like for you to starting to heal and let go and not be so consumed by these thoughts and not be so taken in by wellness culture's false promises?
Abbie Attwood: It's an interesting spiral that you go down. In my eating disorder, it felt like the more you became obsessed with what you ate and how your body looked, the more it fueled that.
