Dana Jonson [00:00:09]:
Hello and welcome back to Special Ed. On Special Ed. Thank you so much for joining me today. I am thrilled today to have Ilona Phillips with us. Ilona has founded a psychotherapy group practice and specializes in treating eating disorders. She has over two decades of experience and she evolved from working solo to leading 30 clinicians showing deep knowledge in eating and anxiety disorders, among other areas. Ilona’s work and experience shows people how to navigate the way to recovery from eating disorders and anxiety disorders. Above all, she trains parents and guardians how to effectively support a loved one by giving necessary resources and encouragement needed.

Dana Jonson [00:00:48]:
Ilona is committed to aiding parents and caregivers in the healing journey of those battling eating disorders, providing valuable support to enhance treatment outcomes. Ilona passionately promotes mental health, well being and mindfulness. Hello Ilona, thank you so much for joining me.

Ilona Phillips [00:01:03]:
Thank you so much. I’m happy to be here. Really looking forward to chatting with you about this today.

Dana Jonson [00:01:09]:
Yes, it’s such an important issue. But before we get chatting as usual, I have to play my disclaimer, so let’s get that out of the way. The information in this podcast is provided for general informational and entertainment purposes only and may not reflect the current law in your jurisdiction at the time you’re listening. Nothing in this episode creates an attorney client relationship, nor is it legal advice. Do not act or refrain from acting on the basis of any information included in or accessible through this episode without seeking appropriate legal or other professional advice on particular facts and circumstances at issue from a lawyer or service provider licensed in your state, country or other appropriate licensing jurisdiction. So, Ilona, hello. Thank you so much for joining me. I have so many questions for you, but I wanted to start by saying I know that, you know, eating disorders are such a major issue for our children and particularly, and tell me if I’m wrong, but I think it’s at least what I see.

Dana Jonson [00:01:54]:
I should say what I see in my practice is usually around middle high school and then I know it occurs a lot in college as well, and that there are a lot of academic pressures that feed into the eating disorders and mental health issues. So I wanted to start, however, by asking you about your background and just how you got to be the person I’m asking about eating disorders. So if you wouldn’t mind just giving us, you know, your journey.

Ilona Phillips [00:02:21]:
Absolutely. So I actually come from Eastern Europe and my father was shot three times and almost died when I was 17 years old and shortly thereafter my sister developed an eating disorder. So coming from Eastern Europe, though, more than a quarter century ago, you can imagine that mental health care was not really a thing, nor was really Google and all the research that we have today. So I suspect that that’s really part of my journey. But I’ll, I’ll tell you a little bit more. I come again from Eastern Europe, growing up behind Iron Curtain, right? That carries all kinds of geopolitical stuff. And, and also my grandfather, who was a product of Second World War, was a very active alcoholic who actually died of alcoholism. So I have all kinds of history of mental health in my, in my family.

Ilona Phillips [00:03:10]:
But you know, I always thought I would be a lawyer. That has more to do probably with the geopolitical stuff and sort of fighting for truth, if we simplify it. Nonetheless, I actually didn’t get to law school after high school. And we have different educational system than US does, right. We go straight to law school, high school and also found myself unemployed. And so I figured languages are so important in Europe, right. I figured what better way to improve my English than to live immersed in a country that speaks it. So ultimately I ended up as an au pair in us again.

Ilona Phillips [00:03:48]:
1997 is when I came. Really wanted to stay just for a year, but found myself back to school. And this thing that everyone can go to school to college, yes, it may entail financial aid and loans and all of that was sort of mind boggling to me. And so listen, even here I still thought that I would pursue law, but then I had psychology professors who really rocked my world a bit. And so I really love psychopathology, organizational psych, you name it. And so ultimate, that’s how I found myself in this field. I started at the counseling center at Ohio State doing my internship and later fellowship. And my supervisor there was an eating disorder specialist.

Ilona Phillips [00:04:33]:
And so I had more interest actually in addictions. But there’s so much overlap between the two. Right. And having a supervisor is really ultimately what really led me to it. That’s a very long intro.

Dana Jonson [00:04:45]:
Yeah, no, it’s great. It’s interesting. You have a fascinating background. I like though that you also mentioned addiction as a mental health issue because sometimes we forget that. And I think that’s a totally different podcast. But I see a lot of addiction issues as well with children who are self medicating or families that are dealing with the stress of having a child with disabilities. And you know, and I think a lot of people look at that incorrectly and don’t realize that that is a component of mental health issues.

Ilona Phillips [00:05:16]:
We absolutely see that. I’m so glad you pointed that out because even with Eating disorders, they can get so, so severe that actually many parents suffer ptsd. So. Yeah. Yes.

Dana Jonson [00:05:27]:
And I can’t imagine. I mean, I’ve had clients whose children have eating disorders. And the level of stress that I see the parents going through is, you know, it’s really unbelievable. So I want to talk a little bit about how we get to those eating disorders, and I want to talk about the impact of academic pressures that contribute to those. I know from my perspective with my clients, a lot of what I see, and it’s usually girls, there are sometimes boys with. Boys do also have eating disorders. It’s not just a female thing. You know, we don’t own that.

Dana Jonson [00:06:01]:
But I do see it more so in girls than I do in boys. From my, from my, Where I sit, I find, or I’ve seen that a lot of times the girls who come through my office, they have undiagnosed learning disabilities, meaning that that’s adding an additional academic pressure to them. Right. So they are working harder and not seeing the results that they’re expecting out of them. Some children with learning disorders can mask it. They can, they can get through, but it’s so difficult for them. You know, like the kid who gets through school behaving all day, but comes home and falls apart because they were holding on so tight. And that’s sort of the way a lot of students are.

Dana Jonson [00:06:43]:
If they’re undiagnosed. Some kids are able to self accommodate and they are just white knuckling it through the day and they present as being okay students. But really there’s this level of pressure on them that’s sort of ridiculous. Well, I think a lot of the academic pressures in our society is ridiculous anyway for regular education students. But can you talk a little bit about how academic demands contribute to that stress and mental health component?

Ilona Phillips [00:07:10]:
Yeah, you know, it’s, it’s. Gosh, we could sit here for hours to really tackle it from all angles. But, you know, eating disorders are sometimes labeled anxiety disorders. So there’s a, there’s a really high overlap with anxiety disorders, particularly OCD or, you know, OCD tendencies, but really all anxiety disorders and certainly plenty of perfectionism, sometimes mood disorders. Right. Depression and others. And we, even with anorexia, we see a lot more research now coming forward showing overlap with autism spectrum disorders. So, you know, it’s the whole gamut.

Ilona Phillips [00:07:45]:
Right. And sometimes even bipolar, yada yada. So you’re right. Right. There is a lot of academic pressure and a lot of my clients. And you’re right, this is across all genders we certainly see also trans folks, you know, having plenty of diagnoses of eating disorders and identity in general. There is a lot of pressure and I’m so glad that you’re bringing up that many of these students can hang on and actually mask it. Right.

Ilona Phillips [00:08:10]:
And being in college counseling center, I have seen plenty of students who even ADD was diagnosed much later in life. That’s because they could compensate for so darn long. Right. That it’s not even diagnosed till much later in life. So we have to pay attention to that. And the perfectionism is not helping. So you know, many of my eating disorder clients are some of the most brilliant clients I have.

Dana Jonson [00:08:33]:
Yes.

Ilona Phillips [00:08:34]:
And it’s, it’s right. That’s sort of the double sided.

Dana Jonson [00:08:37]:
That’s why they’re able to mask it. That’s why they’re able to cover it up. Right. Because they figured out how to, you know, and when we say. I don’t like to say smart because that’s not really what I mean. A lot of kids are smart but, but having that ability to figure out how to self accommodate to a degree, it doesn’t make it easier sometimes. I know. You know, some, some kids have these great self accommodations but they’re actually take longer to, to implement, you know, so it’s not necessarily the way we would teach them, but they’re able to get that done.

Dana Jonson [00:09:08]:
Or you know, for children who are of high intelligence, a lot of times school isn’t smarter than they are yet. Right. So they are able to get through with doing less. So it’s not until they get to a level where they’re truly challenged that they’re going to develop these concerns and they may have anxiety in different areas that is disproportionate, but it hasn’t really overwhelmed them yet. And they’ll get to that place eventually. Do you think it’s just us like the parents like. I know, I know as society in general, we put a lot of pressure on children. I have four children who are.

Dana Jonson [00:09:49]:
Well, I have five children, but two are in college and two are going next year. So I’ve been through the process of looking at schools and all of that and I was fascinated when. Because our philosophy was. And that’s probably because I didn’t like my college. You know, there’s a lot of pressure where I went to school and where you went to school next. It was very, you know, a lot of it and I didn’t like that and I didn’t like the school I went to. So I left after A year, you know, because I was going for all the wrong reasons. So with my children, I’ve had a completely different journey.

Dana Jonson [00:10:19]:
My oldest went to a transition program, so she kind of. That fed into the college she goes to, so she did that. And my other child saw one school and was like, this is where I’m going. Which just blew my mind. I was like, no, we need options. And she got into that school and she went. So that was a different experience. And then my other two, same kind of thing.

Dana Jonson [00:10:37]:
It hasn’t been too difficult, but for us, it wasn’t about what’s the best school you can get into. It was when somebody didn’t do well on the standardized test. It’s okay, well, do you want to apply to schools that are going to look at that, or do you just want to not apply to schools that are going to look at that? So those are the kind of conversations we have. What has the program. Look at your grades, look at your gpa. What are schools you. You think that, you know are competitive but that you’ll get into, blah, blah, blah. And one of my children came home and said, well, you know, my.

Dana Jonson [00:11:07]:
My advisor said, my list isn’t good. And I said, why? You’ve got, like, enough. She had like eight schools on her list, which I think is more than enough. And she’s like, well, because I don’t have any, like, real safeties or real reaches. And I’m like, what? She’s like, I have to have options that are. I said, well, let me ask you this. Do you want to struggle all the way through college, or do you want to go someplace that works for you, that teaches the way you learn, that you’re going to be comfortable in the environment and all this stuff? And she’s looking at me like, well, yeah, of course. I’m like, but if you go for a reach and it’s only reason you’re doing it is because, you know, that’s.

Dana Jonson [00:11:44]:
That’s the only reason, right, Is because it’s better. Or when I’m using air quotes for better that no one can see, but you know, better. And to me, that was a result of my journey and not enjoying my college, my initial college experience. But there is still this idea that you pick your school based on what’s quote unquote best. And sometimes that’s not the right school. It might be too hard, but it also might not be the right program for you. Different schools teach differently. So is it just us as parents in schools? Is there, you know, I know social Media also plays a huge piece into it because now you can see who everybody, where everybody got into, and suddenly that’s a competition.

Dana Jonson [00:12:28]:
Where’s the pressure primarily coming from, do you think?

Ilona Phillips [00:12:31]:
Yeah, that’s a very good question, and I think you’re right on. Right. It’s coming from all angles. I mean, there are also kids. I mean, one of my kids is a very committed student on the perfection side. She has no pressure from us, really. And this is redundant or reductive. Right.

Ilona Phillips [00:12:48]:
We really, truly just want her to be happy. We know she’s gonna succeed wherever she goes. Right. So I think that actively, I would say we do not pressure her. But, you know, there can be subtle ways that we as parents do that. Right. She also has two parents who are very successful, yada, yada. I mean, this could come from all kinds of angles.

Ilona Phillips [00:13:07]:
But I do agree with you. You know, our kids can really make. A lot of. Our kids can make the best of any school, to be honest. It’s funny, a couple of years ago, I did this sort of as a. Just a project with a friend of mine. This was not a sort of very serious endeavor, but we did this college podcast called Unloc in College Life. We just did sort of one season, right.

Ilona Phillips [00:13:31]:
And we interview a number of college students. A lot of them are student leaders. I think it’s very interesting to listen to that. Some of them are transfer students. Some of them have all kinds of other challenges that students face. But being on U of M campus. Right. University of Michigan is very, very rigorous, and we see students from around the world for some of the reasons that you mentioned as well.

Ilona Phillips [00:13:53]:
I mean, it’s an excellent school in many ways, but it doesn’t have the best programs for every kid and every field and every focus. So, yeah, there’s pressure everywhere, like you said. Right. It sounds like one of your kids was getting pressure. I don’t know where she was getting these ideas of reach school and, you know, so it’s everywhere.

Dana Jonson [00:14:14]:
Well, and I had one child, too, who was from the very beginning, and she came home in, like, second grade and was like, I’m going to go to Yale. And I was like, how do you even know what that is? And my stepfather had gone. So that’s why I think she. That’s where I think she got it. And she put more pressure on herself. That’s not where she went, and that wasn’t where she wanted to go. But that in the end, I mean, she was in second grade. She didn’t know what was, you know anything.

Dana Jonson [00:14:36]:
She was just going to go where Poppy went. She did always put a significant amount of pressure on herself, you know, she was. And that she didn’t need. And she also, you know, being. She has anxiety. And so we could see. Because she has a picking issue where that’s how her anxiety shows. And so we could tell when she’s stressed because of their visible signs of it.

Dana Jonson [00:15:00]:
And not everybody has visible signs. Right. So sometimes, you know, but for us, it was okay. We appreciate that you’re pushing yourself here, but you need to dial it down. So I found myself constantly trying to get her to take less classes or, you know, not. Or whatever it was that she was doing to take the pressure off of her. And I was thrilled because she actually, she was someone who should have taken the SATs during COVID So she ended up not having to take them at all. And I was like, oh, thank God.

Dana Jonson [00:15:28]:
I can’t deal with her stress over the SATs, you know, so. But, you know, that anxiety, too, I think, for that child was a lot of, you know, where everyone else was getting in to and where everyone else was going. And for me, my biggest issue with the kids is, are you doing your best work? You know, I don’t check power school every day. I’m not. I don’t think I’ve ever seen any of the college kids grades. You know, as long as they’re still allowed to be there, I’m happy, you know, are you okay? Is everything going well? And I think that, you know, but even from a very young age, even though I don’t think I was, and I’m sure I do pressure subconsciously, I’m sure that there are, you know, some ways in which I do that. There’s no way I don’t pressure my child at all. Right.

Dana Jonson [00:16:18]:
But even from a young age, she had that I have to go to. I have to do my best to go to the best college. And I thought, gosh, you’re so young to even. You shouldn’t know what college is yet. And yet there it is. So how do I want to talk a little bit about social media more specifically? And what do you see in social media? What are the primary areas in social media that you see that provide pressures and anxiety for kids? And is it. Does it happen as young as we think or as young as I think? Because I think it does impact kids. I mean, they’re all on social media.

Ilona Phillips [00:16:53]:
Yeah, absolutely. So my kids are not, and my daughter is 14. And believe me, we hear about it. Right. And it’s that conundrum. They may feel socially isolated if they’re not connected. So we all have to evaluate this on an individual basis and what restrictions you put on that. But it’s everywhere.

Ilona Phillips [00:17:14]:
I mean, listen, so much has been written, you know, documentaries have been made on this, right. How social media can really target especially our children. So I won’t go into that even as adults. Right. Likes and comments, look at the brain centers lighting up. So it’s a tough era, really. I don’t really envy our youngsters and all the pressures that they have to deal with. You know, it’s ages, long pressures have been here, right.

Ilona Phillips [00:17:45]:
Body image and fitting in and all of that. Then you add social media and we have a whole new ballgame. There are parents all over the world trying to tackle tech in the most mindful, thoughtful ways. And kids are so brilliant, they’ll find ways even through their camera, right?

Dana Jonson [00:18:02]:
Yes. So, gosh, I’ve got a hacker in the making here too.

Ilona Phillips [00:18:06]:
So it’s tough. It’s tough. You know, it can certainly play positive role, right? Like if we can guide our kids to media literacy, you know, they could select completely different people and groups to follow and it would have a. Have the opposite impact. Right. But that’s not always cool.

Dana Jonson [00:18:26]:
But do you think that that’s something we can address in schools too? Because I think when you say media literacy, I really like that. And I think that’s a really important thing for parents to understand and it is a struggle. And I think I’m more. I’ve been more strict around social media and television and stuff like that than I think some parents are. And my kids hate me for it. They’re always mad at me for something. But I think I also was fortunate in that I didn’t really need it as a babysitter. I mean, my kids were always in before school programs, after school programs and daycare and all that.

Dana Jonson [00:19:03]:
And so I get that if I was with my kids all the every day that that’s a different story. And I understand that. I don’t see any education on this in schools. I really don’t. And I even had one child who had some dangerous behaviors online because she just didn’t get it. She didn’t understand. And the way they decided to address it through her IEP just wasn’t even helpful. But is that something that you think would make a difference? Like should we be starting media literacy? And I mean real media literacy, like at a young age? I know a lot of schools say that they do it, but you know, it has to be, I think, much more integrated into what they’re doing.

Ilona Phillips [00:19:42]:
I agree with you. And I think it’s twofold, right? Sort of. Even the most skilled education goes only so far. Right. But then we have to hold our end of the bargain as parents because ultimately, right. The kids are often doing it at home. I mean, look how easy it is to reach for our phone if you have your phone on you, right? Like we often compulsively reaching for it. So you have to put in behavioral barriers like no phone in your room or no computer in your room.

Ilona Phillips [00:20:14]:
It’s just too easy. And I think that we cannot set up our kids to sort of think that they will self regulate self control that way.

Dana Jonson [00:20:24]:
The brain is not there, zero self control.

Ilona Phillips [00:20:27]:
We have to help them, unfortunately enough. I mean, we’re in a district that has very good schools here in Ann Arbor, Michigan, obviously very educated town. Right? All of this, and yet it still will go only so far. My kids certainly have had media literacy education all throughout. But again, you know, if I leave their devices in their rooms, I mean, oftentimes they’re so darn busy with homework. Right? But still it is so easy to reach for it. And I tell even my adult clients, leave that phone at the door. Leave it on a ringer.

Ilona Phillips [00:20:57]:
If someone needs to reach you, they’ll call you. I have clients who text and get on the phone, even driving. That’s compulsion.

Dana Jonson [00:21:03]:
It would never dawn on my children to call somebody. They have 18,000 other ways to. Because when I. So we have apps on their phones that block it, you know, that block certain. So they can always have their phone with them, but they can’t access everything. And they can usually access messaging, like text messaging, not Snapchat, which is a huge problem for them because they’ll be like, but that’s the only way I talk to them. Like, everyone can get a text, dial it down, but they can always make a phone call. And they go ballistic that they can’t reach us.

Dana Jonson [00:21:35]:
Because if I block the messaging, if I block the texting, like they can’t reach us. I’m like, what? You could call? Like, why would I do that? Because that’s a way to communicate with people. And they would never know how to answer the phone if they didn’t know who was on the other end, you know, because they, they see who it is, they just have no concept of answer. They don’t know the number, they don’t answer it. I mean, I’m guilty of that too. Caller ID was The best thing that happened in my life because I just, I don’t answer if I don’t know the person. But I think, you know, and, and to your point, our goal was for our children to be able, when they went to college, sleep with their phone in the room and not be on it all night. And I, I don’t know that we achieved that, but that was sort of our goal.

Dana Jonson [00:22:16]:
So at a certain point we take the phones at night. When they’re younger we would take them, like physically take them. And then at a certain point we let them have it in their room. But like I said, everything’s blocked. So at least they’re not developing the habit. The habit they have is to have their phone near them, but it’s not to communicate. Although I have one child who I’m sure gets past all of it. I mean, like I said, I have a hacker in the making.

Dana Jonson [00:22:42]:
I don’t know how she does it. Like, I really don’t know how she figures this out. But a lot of these kids are born with it, right. They’ve had it their whole life. We’re just learning about it.

Ilona Phillips [00:22:50]:
That’s right. Yeah. It’s hard for us to parents to keep up really with all the tech and all the detours and shortcuts.

Dana Jonson [00:22:58]:
I think that would be a great, that would be a moneymaker, I think is holding a class for parents, you know, like, would have to be run by like a 12 year old or something, but you know, a class for parents explaining to them what the platforms are and how.

Ilona Phillips [00:23:12]:
Yeah, I think that there’s a Facebook group and I’m sure there are other platforms as well. I think it’s called something like parenting and tech or something like that then. And the answers and questions there are just mind blowing.

Dana Jonson [00:23:24]:
I’m going to have to find that.

Ilona Phillips [00:23:26]:
Yeah.

Dana Jonson [00:23:27]:
Oh, that’s fascinating. Well, it’s also, you know, when I have children who have. I’ve had children who are not safe online for a variety of reasons. And then for some reason my youngest is almost exclusively safe. She just, she just safe. Like I never see. Because we do have the ability to see their stuff if we want to, which is hilarious because they always think that we’re following them and I’m like, I have zero interest in your drama. Like I just want to make sure everyone’s safe and we’re being.

Dana Jonson [00:23:56]:
Whatever. But you know, it just. How, how does one kid suddenly get completely drawn in to that and another child not like, what. What’s going on in their heads? Yeah.

Ilona Phillips [00:24:07]:
So that’s very interesting. Right. Because even with eating disorders you always look, those are biologically. Right. Predisposing disorders and you might have a child who develops it and a child that doesn’t. Right. So you always look at both nature and nurture. So genetics, biology, but also the environment.

Ilona Phillips [00:24:26]:
And it’s fascinating. You kind of gets in the same environment and.

Dana Jonson [00:24:30]:
Yeah, well, and I have three children who are adopted at an older age. So it is fascinating to me because I didn’t raise them. So I’m sort of, you know, when they first came to us, learning their, their triggers and their anxiety and background while raising them, it’s sort of an interesting thing. But yeah, it’s it the way you said that because, you know, one child who I would expect to have, and she does have a lot of anxiety, but it doesn’t present through unsafe online behavior and another one where it does. So I guess that would be sort of like some kids get eating disorders, some kids get addiction issues or picking disorders or whatever. I guess it’s just how it manifests. Right. There’s no, there’s no formula for how something like that’s going to manifest.

Dana Jonson [00:25:15]:
Right?

Ilona Phillips [00:25:16]:
Yeah. I mean, I think you always want to pay attention to genetics if you know them. Right. Like for me, right. Like I will be paying attention to my kids substance use because of genetics in the family, but also, you know, I can educate them, I can let them know what this can look like and at the end of the day they’ll still make their decisions. And that is, that is a hard one for parents. Right. Like where is the balance of stepping in, not stepping in, what can you control, what you cannot control? And sometimes you have to let them learn through their own right.

Ilona Phillips [00:25:50]:
Sort of mistakes and the price that they have to pay for that. And that’s nerve wracking for parents to watch, obviously.

Dana Jonson [00:25:56]:
Yeah, yeah, obviously. Because some of the outcomes can be ridiculously dangerous. Right. It’s one thing for them to make the mistake of chatting with somebody, but it’s making the mistake of meeting somebody is a completely different outcome, you know, so it is incredibly difficult. Let’s talk a little bit about eating disorders in, in the academic setting. So I know from my perspective, when a child is brought to my place, so a parent calls me and says that their child has an eating disorder and that they, you know, they’re not getting, whether it’s accommodations or whatever they need in the academic setting, be it high school, college. And my first thought is, have they been fully evaluated? You know, are there any Other, if they, if they’re developing an eating disorder, something else is going on in my perspective, or possibly going on. So I would ask for a full evaluation.

Dana Jonson [00:26:48]:
And a lot of times we uncover some form of learning disability or underlying anxiety or both. There’s always a lot going on. So is that, I mean, would you say, is that a good place to start? I mean, obviously they need to be seeing some kind of doctor because it’s a physical issue. When a child develops an eating disorder and there’s nothing else going on, do you agree that there’s usually something else going on? Is it rare that it’s just an eating disorder?

Ilona Phillips [00:27:15]:
Yeah, that’s pretty rare. And we know like especially with anorexia, the more you under. And also let me just say that you can have a malnourished child across the spectrum of eating disorders. So it’s not just anorexia that we anticipate a malnourished brain, but the more the brain is malnourished, the more amygdala goes into overdrive. So yes, you can actually anticipate. Right. Even more anxiety going up. And actually when we refuel the child, when we refuel the brain, oftentimes some of these things go away.

Ilona Phillips [00:27:45]:
Right. So they’re so interconnected. But when I hear like my child is not being accommodated, you know, diagnosis, let’s start there. For eating disorders, I am very adamant about seeing an eating disorder specialized physician, nutritionist and a therapist. We know by far from research that that is sort of the best way to go. It’s a little bit different with children because ultimately the parents, the caregivers, are responsible for refeeding the child. That’s obviously very different for someone who is in college. But so if we introduce a nutritionist in there, it needs to be an eating disorder, specialized nutritionist.

Ilona Phillips [00:28:21]:
And then the accommodations for kids in middle school, high school can be even things like my child has to eat lunch with me in my car or they go home for lunch. Right. Because I have to make sure they get the fuel in. Sometimes they eat lunch at the nurse’s office. Right. But the nurse also has to make sure that they actually ate in. So a lot of accommodations, we may pull them out of classes that are clearly triggering. I mean, talking about still having a journey where our education system is lagging.

Ilona Phillips [00:28:50]:
Right. We still have schools and classes that teach very body image and diet culture filled education. And actually some of my clients have developed eating disorders after being in so called wellness class where someone was talking about basically how to lose weight and so, you know, we have some ways to go. A lot has improved. I’m really thrilled about that progress and still. Right. So the school environment can feed this in all kinds of ways. And.

Ilona Phillips [00:29:18]:
Or, you know, we get kids who cannot stay in academics. I mean, the eating disorder recovery needs to take precedent. You have to go all in or it’s just going to drag out for a really long time.

Dana Jonson [00:29:31]:
Right. Yeah. I remember a girl in my high school, her mother came every day to eat lunch with her to make sure that she ate something. We had a very small school, so everyone knew each other and everyone knew what was going on, but that’s why she was there, to make sure that she got some kind of sustenance in her. I do understand that, you know, that some children do need to be hospitalized, and that’s just a reality. So, you know, but from my perspective, the first thing I do is. And a lot of times parents like, it’s just an eating disorder, and I say, no, it’s not. We’ve got to get a full evaluation.

Dana Jonson [00:30:01]:
And I would have the school do a full evaluation. More often than not, other things come up and then we have to determine is this something where the child just needs some accommodations, like being able to leave school at lunch to go eat with their parents or some kids can’t. They don’t have the energy to do certain things because of it. So skipping PE or whatever it is or being able to take a nap, like a lot of those things are the accommodations. But I also find if they have an underlying learning disability, then we need to address that specifically. Right. And that’s not just an accommodation. That might be specialized instruction, which is the special education component.

Ilona Phillips [00:30:38]:
I really, as you think about it, I really, you know, neuropsych testing is a big one. Right. Even in college, like we then folks for just suspected add and then it reveals all kinds of. Right. Learning needs, can target them effectively. It makes such a world of difference for the student.

Dana Jonson [00:30:57]:
I also see sometimes and tell me if this is accurate, that the eating component is something a child can control. And so when children feel like their whole world is out of control, sometimes that’s the only thing they can control. Is that accurate?

Ilona Phillips [00:31:12]:
Yeah, you know, that’s a, That’s a. That’s definitely an idea that is floating out there. And it’s a little bit more complicated than that. I’ve seen folks kind of. And not. Not saying you are, but.

Dana Jonson [00:31:23]:
But no, I don’t. I mean, it’s not like the field.

Ilona Phillips [00:31:25]:
Had sort of reduced it to that it’s. It’s just we have to keep in mind, right. That it’s, again, neurobiological. Right. It’s a metabolic disorder, all of these things. Because I think that if we just say it’s about control and then the child can control it. Right. Which naturally they can because it’s an aid.

Dana Jonson [00:31:44]:
I hear what you’re saying. Yes.

Ilona Phillips [00:31:45]:
And then it can turn really into.

Dana Jonson [00:31:47]:
Well, that’s a good point because I think it is along the lines of addiction in that it’s not actually really within their control. And so I guess I don’t mean consciously within their control like I’ve decided to do this, but that it. That’s sort of how it emerges if they’re feeling other pieces are out of control. So it’s not. I don’t want to give that wrong impression that it’s something that they could just stop doing. Yeah, yeah. And it’s not. It is not that simple.

Ilona Phillips [00:32:15]:
Yeah, I totally get it. And it can turn compulsive.

Dana Jonson [00:32:18]:
Right?

Ilona Phillips [00:32:18]:
Compulsive behaviors are here. Like you said, the picking, for example. Right. It is to manage distress. The problem with all of those coping mechanisms, even though they make sense and although they may be short term effective. Right. To relieve stress in a very moment, they obviously create more distress long term.

Dana Jonson [00:32:35]:
And so you said one thing about how anorexia isn’t the only component. And I think we do need to address that. What are eating disorders? You know, how. How do they present? Because I do know that they are not just about anorexia. So, you know, it’s not just about not eating. So can you speak a little bit to what is the range of eating disorders that exist?

Ilona Phillips [00:32:59]:
The two that are probably. Well, maybe three the most known, right. Are anorexia, bulimia, of course, binge purging, or restrictive and purging, and then binge eating disorder. I think the one that sort of flies under the radar still a little bit more is arfid, which is a restrictive disorder and oftentimes, you know, comes from sort of three basic main causes. Number one, if someone was sort of traumatized somewhere along the way, so maybe they vomited on food or they saw someone vomited on food or choking and stuff like that. Oftentimes it’s folks who have sensory issues and they spill into textures right, with food. And so ARFID is still a little bit more under diagnosed. It sort of can be labeled as picky eating, but it can quickly also turn into anorexia because, you know, we talked about negative energy balance and again, if you’re genetically predisposed.

Ilona Phillips [00:33:58]:
Right. So you may have two people restrict food, and you will have two different outcomes. Right. Someone who predisposed to the restrictive disorders and negative energy balance will go that route. Some folks will maybe lose weight, then gain weight. Right. Go totally different route. And so even with arfid, if there is sort of picky eating and it’s now restricting so much that they’re also.

Ilona Phillips [00:34:19]:
Right. Losing fuel and losing energy, it can swing to all the way to anorexia. So then you’re dealing with a double whammy.

Dana Jonson [00:34:29]:
Yeah. Then, yeah, jackpot. And that. Great. What are some signs and symptoms that parents can look for? Because I know almost always the parents didn’t know for a long period of time. They just didn’t recognize it. So what. What are some signs and symptoms that parents can look for? Because I think it’s even harder in high school.

Dana Jonson [00:34:50]:
I know we try to. In my house, I try to make an effort to eat dinner together. But nine times out of 10, somebody’s at basketball, someone’s at theater, someone, you know, we’re all eating separately. I’m not always aware of who’s eating what when. So I think it’s. And I think in my generation, too, and I hate to say this, but we are predisposed to think thin is good. So you see your child lose a little weight and you’re like, oh, they look great. When.

Dana Jonson [00:35:16]:
That’s not really the right response.

Ilona Phillips [00:35:19]:
Right, right. Absolutely. So that’s a. That’s a big telltale sign. Right. Children are growing. They have to be gaining. They have to be gaining well into their 20s, because if they’re growing and they’re not gaining, they’re actually losing.

Ilona Phillips [00:35:31]:
Right. And unfortunately, diet culture is everywhere. You will at times still have even physicians who will endorse this and say, you look great and, you know, maybe you’re just getting more lean. Do not. Do not. Do not mess with that. You know, but there are some more subtle signs. Right.

Ilona Phillips [00:35:46]:
So if your child is eating just chicken nuggets and French fries. Right. And actually, in arfid, that tends to be some of the preferred foods because you can sort of predict the texture, you can predict the amount. You are not mixing things together. Right. So you want, obviously, diversity in your child’s menu. Yes. It’s hard to know what they ate if you don’t see them all day.

Ilona Phillips [00:36:10]:
Right. They have sports, they have all these extracurriculars. But looking at what are they eating, how are they behaving around food? If they’re moving food around the plate. Right. That can be a telltale sign, certainly if they start talking about it. Right. Oh, you know, I’m just trying to get in shape and suddenly you find them compulsively exercising. That would be another sign.

Ilona Phillips [00:36:30]:
Keep an app on medical. Right. So are they doing at least an annual, maybe six months checkup? What is their weight, what is their height? We often find that actual eating disorders started for a lot of folks way many years back. Right. That we are catching it in a fairly extreme when they’re really dropping weight. But when you look at their growth charts, you will see that they fell off their growth chart years back. So those medical records can be really helpful. Pay attention to what their height, weight is at the doctor’s office, what their chart looks like.

Ilona Phillips [00:37:02]:
Sometimes kids start with oh, I want to become a vegan. And if there’s no history sort of within the family of veganism or maybe religious beliefs, where is this coming from? So it’s more, gather more information. Find out if you, if your child suddenly says, I’m going to restrict this or that, find out more, know more about it. Like what is driving this? Obviously, I mean, we have plenty of folks with eating disorders who are vegans and maybe it truly started with a really good intent of protecting animals, this and that. But if it’s now compromising their health, then maybe we need to find a different way to contribute.

Dana Jonson [00:37:37]:
Yeah, right.

Ilona Phillips [00:37:38]:
So it’s, it can be tricky. It can be all over the place in terms of, you know, warning signs. I’ve recorded some time ago a video on YouTube about warning signs. So, you know, obviously if your child is going to the bathroom after every meal or to the shower after every meal, if they again, compulsively exercise. Right. If they are in their room too much. I think in general with any mental health, pay attention to behavioral changes. Right.

Ilona Phillips [00:38:05]:
Pay attention to their mood, pay attention to their sort of self care and the signs are there. We just, you know, so often so busy, it’s hard to sort of really good.

Dana Jonson [00:38:16]:
And you know, that goes back to the pressures that we’re putting on them. Right. So it’s all kind of feeds back into it. And so what is the role of parents and educators in these situations? What should they be doing to support the children who have these issues?

Ilona Phillips [00:38:35]:
Yeah. So this is going to depend very much on where the kid is. Right. Is, are we talking elementary, middle school, high school, are we talking college? Two very different things. Obviously in middle school, high school, parents still would actually refeed their Child, it is up to the parent to manage recovery. In college it’s going to be quite different. But even in college, I tell to families, no one can do it alone. They need a support system.

Ilona Phillips [00:39:01]:
With some college students, if there’s a really problematic relationship with family, we might find alternative support. Right. Sometimes it’s mentors, sometimes it’s friends. Although you certainly don’t want to put it on other college students that they’re not professionals, all of that. And maybe it is the dietician, the physician, the therapist. So those roles are very, very different, you know, for schools. Invite educators to your classes. Right.

Ilona Phillips [00:39:26]:
Don’t have, don’t fill spaces for wellness teachers with, with no background in intuitive mindful eating. Non diet dietitians would be the best sort of educators for that kind of subject. And you know, hopefully, right. When schools get recommendations from providers, hopefully they can follow that. They can allow it, not give the kid a hard time or. Yeah, I mean, if you have specific questions, let me know because again, this is such a big topic, we could talk about it.

Dana Jonson [00:39:57]:
Right? I know it’s hard to be very general. How should parents be initiating these conversations though? You know, I mean, to try and be very mindful of, you know, be mindful of these components that we’re not, as we said, subconsciously putting these pressures on our children. How can we contribute in that regard?

Ilona Phillips [00:40:18]:
Yeah, so, so I think that, you know, always. Right. With any concern as parents, let’s manage our own behaviors. Right. What is your relationship with food? How do you talk about food? There are really no good, bad foods. Are you someone who diets like you got to keep that in check. Our kids are learning, right? They’re learning. Even the anxiety, if I freak out every time my kid crosses the street, they’re going to pick up on this.

Ilona Phillips [00:40:40]:
Right? So, so, so we teach them the language of food, the language of money, the language of relationships. You name it. Right. So that’s where that starts. And then when you are concerned, speak to the behaviors. Right. No one can dispute if I say, you know, every time you eat, you go to the bathroom, it’s hard to dispute that. Right.

Ilona Phillips [00:41:00]:
You always want to do it. Obviously from a caring, caring standpoint, you want to do it when you have enough privacy and time so it’s not rushed, sort of out the door. Hey, by the way. Right. But I will also say that sometimes parents are afraid to. So in eating disorder for kids, you know, below, college will use a lot of leverage. Right. So what is important to your child, that’s how you Then motivate.

Ilona Phillips [00:41:25]:
You know, it’s really important in recovery. Right. With college kids, it’s going to be more natural. Right. So if the kid is not doing well, they shouldn’t not be in college. There’s often so much pressure. I have someone who is in a nursing school and she really, really would benefit and really needs to be in residential treatment. And taking a semester off sometimes can seem like a really insurmountable task and.

Dana Jonson [00:41:50]:
Right.

Ilona Phillips [00:41:50]:
I get it. Right. Because if you’re in engineering and nursing school, sometimes you don’t get those classes again until a year later. So I get that it’s disruptive, often before even a semester, but it’s saving lives.

Dana Jonson [00:42:02]:
Right.

Ilona Phillips [00:42:03]:
This could go on for years and years could become fatal. I mean, let’s face it, disorders are highly, highly fatal. And so when you’re asking, you know, what role parents can play, I guess those are my main points. Right. Don’t be. Don’t be afraid. Certainly approach it from a place of kindness. Seek your own support so that you can approach it from a grounded place.

Ilona Phillips [00:42:23]:
Reflect on behavioral changes. I’m a big fan of doing contracts with children, especially with college kids. Right. Like these, like, outline it from a business perspective. Contracts protect both sides. Everyone knows what the rules of engagement are. Right. And if we are not, if it’s not happening, then how do we support you? Where do we go from there? So they’re not a dirty word.

Ilona Phillips [00:42:45]:
They’re not. I do often find, especially in the college population, that parents are sort of walking on eggshells a bit. Right. And I know it is a fine line and adults may refuse your involvement in their care.

Dana Jonson [00:42:59]:
Right.

Ilona Phillips [00:43:00]:
Find a way. And I will say, as providers, you know, if we do not have that release of information sign, that doesn’t mean that we cannot listen. And so if you have information. Right. Crucial to the treatment, we can always receive your message. So it’s again, right. Take where we go.

Dana Jonson [00:43:16]:
Right. And so many things depend on the student and whether they’re receptive or not. I do like what you said about taking time off if necessary. I know particularly high school students. I know college students as well. But particularly high school students flip out if they’re not going to graduate with their class and if they’re behind their class. And I really think we need to get rid of that stigma. Number one, because you’re not, not graduating with your class because something you know, because you weren’t capable of it is.

Dana Jonson [00:43:46]:
I get. This is what I hear a lot. They’re really smart when they’re here. They do well when they’re here. And I’m like, well, yeah, but if they can’t get to school, there’s. There’s an issue with that. So. But, you know, you don’t have to graduate on time.

Dana Jonson [00:43:58]:
And the other piece that I’ve learned is that there are a lot of ways to make credit recovery in high school. You know, if you’re in high school for kids who did have to take six months off or something like that. I’ve had children do online classes that their school will accept during the summers. And I mean, no kid wants to do school during the summer, but it’s, you know, they’re all doing something if they’re working or whatever. So there are a lot of ways to do that. Credit recovery, but not graduating at the exact same time is okay, you know, And I think parents need to think it’s okay.

Ilona Phillips [00:44:29]:
Well, let me ask you this. If your child had cancer, because both of them can be fatal, would we. Having that discussion.

Dana Jonson [00:44:36]:
That’s such a great point, because I think if some. If a child had cancer, you wouldn’t be thinking about school at all. Right. You would just be like, what do I do to get them better? And you really need to have that same concept when it comes to eating disorders, because as you said, they’re fatal. Or.

Ilona Phillips [00:44:53]:
Yeah. And we are not there. I know that we can be in denial and the child is not always emaciated, not at first, you know, so it’s. I wish it was as clear, but I do hope that we get there, that we understand. I mean, we do have children dying of eating disorders, you know, And I think that we can always say, well, that won’t happen to my kid, but it could. And the other thing is that, yeah, in a big schema of things, what is six months? In a scheme of life, what is six months? Let me tell you this, even from a student perspective. You know, I saw someone in undergrad, and then she wasn’t ready. She wasn’t ready to recover.

Ilona Phillips [00:45:25]:
And she said, I’m just not ready to do the work. She checked out of therapy, and she came back to me in grad school when she was working on her PhD, and you know what she said? Yes, I might knuckle through. Yes, I’m now doing a PhD. But what I really wish is that I had done this so long ago because my undergrad was not really a great college experience. I was too preoccupied with the eating disorder. Really takes over their thinking. Yes, they’re often brilliant. They can still do the academics, but it’s not quality of life, right? So her looking back now in a PhD program, she said, I just wish I didn’t waste all of these years struggling, right, and really dig into, dug into recovery a lot sooner.

Ilona Phillips [00:46:10]:
But eating disorders and especially anorexia, right, are notorious for not really knowing just how we, how sick we are. And so that’s where the people around us are really, really important to hold us accountable. Anosognosia is super, you know, is a very well known factor in anorexia. You really don’t know how ill you are. So even for the student it was sort of easier to say sort of looking back now, but when she was in it, she didn’t really fully understand just how sick she is. And this is why we sometimes use low dose antipsychotics when treating anorexia, right? Because you are seeing and thinking things that are not there. So that’s where we need the adults to really step in and not be afraid. Certainly educate yourself so you know what you’re doing.

Ilona Phillips [00:46:56]:
Use the providers that are available to you, but don’t listen again, right? As overwhelmed parents, it’s so much easier to not look at it, to hope, wish it away, be in denial, bury our head in the sand. But we could make a big difference. Sometimes I see folks who have had an eating disorder for decades and that’s incredibly sad. Some with profound health impact that will not be reversible, right? Osteoporosis, heart impact, you know, cardiac. I’m not here to sort of fear monger, but I do think that we still, and this is really why I’m doing this, right. Like I want people to understand. I still don’t think, despite Google and despite AI, I still don’t think that there is a really solid understanding across the board of what this really looks like and what it could be.

Dana Jonson [00:47:45]:
Yes, and I think you’re absolutely right and I think it is important to remember that it’s not just girls, it’s not just high school girls because I think that’s, that’s the number one, that’s where we go to when you’re, when you say eating disorder, that’s what we sort of assume and that it is. And it, and that it is fatal. You know, it’s not, it’s not something you can come back from and you can develop, as you just said, issues that you can’t reverse. I know for some children, if they, if they don’t gain weight or lose weight, they don’t grow and whatever they were supposed to grow that year, they’ve just lost it. Whether it was 1 inch or 3 inches, you don’t gain that back later. So, you know, and.

Ilona Phillips [00:48:25]:
And it’s so even. And you’re absolutely right. Right. If recovery doesn’t happen within a certain window, it won’t recover. And yet some will if they catch it and. Right. Sort of catch up. But you’re absolutely right.

Ilona Phillips [00:48:38]:
For some it will. It will not happen. Hormonal. Right. I mean, it’s infertility. It’s a lot of different things. Yeah.

Dana Jonson [00:48:45]:
And I think for parents, too, understanding this from day one, instead of waiting until there’s. Instead of being reactionary, being proactive, you know, from a young age, kids are on social media from the beginning, whether we like it or not. And, and talking to them about healthier body images and. And healthy body, you know, I know that’s what we try to promote is, you know, this is healthy. It’s not about being thin or fat. It’s about are you healthy?

Ilona Phillips [00:49:12]:
You know, are what and what is healthy for you? Right, right.

Dana Jonson [00:49:16]:
Because everybody’s different. And like I said, I have three children who are adopted, so I’ve got. My kids are all vastly different, you know, so no two people. Does it mean the same thing for in my house. But it is very important to. To recognize that it’s about what’s healthy for that person. It needs to be individualized. Right.

Dana Jonson [00:49:36]:
And so. Yeah. And from. You know, what I also want people to take away from this is, you know, from a special education component that there is there. There may very well be some underlying educational issues that have just simply not been addressed. And even if it is or. Or looks like it’s just anxiety and an eating disorder that can still be addressed and that there are still accommodations or sometimes even specialized instruction, special ed that your student could be entitled to.

Ilona Phillips [00:50:07]:
Absolutely. Absolutely Right. And the way they process information, I see this with college students when they really figure out what their learning disability is. Life changing, right? Yes, life changing. And neuropsych testing oftentimes can reveal that. I mean, one particular athlete comes to my mind. I mean, it was when she received really thorough and solid evaluation, it just opened so many doors. I mean, you know, most of her life she was educated in the wrong way that just did not work, was how she processes information.

Ilona Phillips [00:50:40]:
And it was a struggle, you know?

Dana Jonson [00:50:43]:
Yeah, no, that’s really awful. But I think it is difficult for, as we said, children who can get through, children who are white knuckling it. Right. Because it can be to some degree an Invisible disability. And we’re not really seeing what the. What the root cause is, you know, and so not addressing that. Yeah.

Ilona Phillips [00:51:01]:
And I think especially with girls and women. Right. They can often really compensate for a long time. It just looks different.

Dana Jonson [00:51:09]:
Yeah. But don’t forget, the boys can get it too, so.

Ilona Phillips [00:51:12]:
Well, absolutely. Absolutely. Right. I think that we, like, if I think of autism spectrum disorders or even add, Right. The girls can often socially compensate enough that it missed. But you’re absolutely right. It can be missed in anybody. And I just think, you know, years back, right.

Ilona Phillips [00:51:28]:
We thought of ADD just as sort of the distracted boy looking outside the window and not sitting still in a class. And we know they’re, you know, broader ranch than that, so. Yeah, I agree.

Dana Jonson [00:51:40]:
And I’m glad you brought up the autism or adhd, because I do think that a lot of times those students are trying so desperately to fit in socially that this can be the way to fit in socially. Right. If they, you know, they don’t want to be overweight. They don’t. That’s maybe just the one thing they can do, and they’re not doing it consciously. But that. That can be something that helps them. Absolutely.

Ilona Phillips [00:52:01]:
And the society will validate it. Right. So it’s very, of course, lovely. Very reinforcing environment, for sure. Yeah. And so I think, you know, surrounding our students and kids with diversity of all kinds, including bodies, shapes and sizes. Right. And that includes social media.

Ilona Phillips [00:52:18]:
You know, we. If you can look at their social media, what are they looking at? Is their diversity even in that way?

Dana Jonson [00:52:24]:
Right, right. And I know schools have certain flags that, you know, if a child looks up how to kill yourself, then it goes to the principal’s office or somebody’s office that they follow up on. They should also a really good recommendation would to make sure they have things about nutrition and eating. And, you know, if someone’s looking up how to lose weight fast, maybe that child needs to be looked at, you know, or something along those lines. So as a preventative measure, because as you said, it’s just. Just as damaging as anything else and fatal it can be. Is there anything we’ve missed? I feel like we’ve really covered.

Ilona Phillips [00:52:58]:
Oh, we can go. We could go on and on and on. I know, keep unpacking. But, you know, I think we covered some of the basics. And listen, I’m always available for questions, truly. So if someone listens to this and they’re confused or have more questions, I’m always happy to answer that. As for treatment, like really treatment, psychotherapy, I can only do that in the state of Michigan. But I’m always happy to answer questions, point folks to providers.

Ilona Phillips [00:53:26]:
So yeah, I’m here and you can find me both at Lotus Consulting in Ann Arbor and specifically for eating disorders and caregivers. It’s just under ilonafillips.com okay, great.

Dana Jonson [00:53:38]:
I’m going to have that information in the show notes. So anybody who’s on the go right now who can’t write this down, I will have your information in there so they can reach out if they have questions or don’t know what to do next. And thank you so much for being here because I really think this is such a critical area and we can all do something to contribute societally even towards that idea of body image and anxiety and mental health, that we all need to be aware of these issues and how other children might be. Yeah.

Ilona Phillips [00:54:10]:
And I think that the more we destigmatize this right, the better we equip folks to seek help to know what to do. No one needs to really suffer alone.

Dana Jonson [00:54:19]:
Yes. And I’m hopeful that this episode will help some people with that. So thank you so much for being here, Ilona.

Ilona Phillips [00:54:26]:
You’re very welcome. It’s my pleasure. Happy to connect anytime.

Dana Jonson [00:54:30]:
Thank you so much for joining me today. Please don’t forget to follow this podcast so you don’t miss any new episodes and leave a review when you have a chance. If there’s anything you want to hear about or comment on, please go to my Facebook page, Special Ed on Special Ed, and find me there. I’ll see you next time here on Special Ed on Special Ed. Have a fabulous day. The views expressed in this episode are those of the speakers at the time of the recording and do not necessarily reflect the official policy or position of any other agency, organization, employer or company or even that individual today.