JCIP #346 - Sophie Temple

In episode 346 of The Just Checking In Podcast we checked in with academic Sophie Temple.

Sophie is currently Doctoral Researcher in the School of Sport, Exercise and Health Sciences at Loughborough University, specialising in eating disorders, disordered eating and body image pathology during the menopausal transition.

She is also part-time Research Fellow in the School of Education, Department of Disability, Inclusion and Special Needs, College of Life and Environmental Sciences at the University of Birmingham.

Sophie's academic expertise is in the subject of menopausal disordered eating, and how it affects women during all stages of the menopause. 

In this episode, we discuss Sophie’s academic journey, how and why she landed on this subject within EDs, the lack of research on these women and why, and the work she is doing to shine a light on it and give medical professionals better tools to treat these women too. 

We also talk about the comparison between how EDs manifest in teenagers and young women vs menopausal women and the different internal and external factors which may contribute to these women developing one. 

For Sophie’s mental health, we discuss her own experience of disordered eating traits during her undergraduate university degree when she was a sprinter at Loughborough University, the factors in her childhood and adolescence which contributed to those traits, and how her own perception of what someone with an ED looks like changed over time and education.

As always, #itsokaytovent

You can follow Sophie's work on social media here: https://www.linkedin.com/in/sophie-h-temple/.

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Transcript

SPEAKER_00 0:13

Hi guys, welcome back to another episode of the Just Checking In Podcast. I'm your host, Freddie Cocker, and this podcast is brought to you by Vent, a place where everyone, but especially men and boys, can open up about their mental health issues, break down stigmas, and start conversations. In each episode, I check in with a special guest. We have a natter and a chat about all things mental health, as well as anything and everything else they are passionate about. If it helps that person with their mental health, we discuss it. My special guest for this episode is Sophie Temple. Sophie is currently doctoral researcher in the School of Sport, Exercise and Health Sciences at Loughborough University, specialising in eating disorders, disordered eating, and body image pathology during the menopausal transition. She is also part-time research fellow in the School of Education, Department of Disability, Inclusion and Special Needs, College of Life and Environmental Sciences at the University of Birmingham. I came across Sophie because of great friend of the pod, George Mycock, and she covers an issue within EDs I hadn't heard of before, and so wanted to cover on the podcast, which is menopausal disordered eating, and how it affects women during all stages of the menopause. In this episode, we discuss Sophie's academic journey, how and why she landed on this niche subject within the wider subject of EDs, why it shouldn't be niche given the universal experience of the menopause for females, the lack of research on these women and why, and the work she's doing to shine a light on it and give medical professionals better tools to treat these women too. We also talk about the comparison between how EDs manifest in teenagers and young women versus menopausal women, and the different internal and external factors which may contribute to them developing one. For Sophie's mental health journey, we discuss her own experience of disordered eating traits during her undergraduate university degree when she was a sprinter at Loughborough University. We talk about the factors in her childhood and adolescence which contributed to those traits, and how her own perception of what someone with an ED looks like changed over time and education. So this is how my conversation with Sophie Temple went. Sophie, welcome to the Just Checking In Pod. Thank you so much for letting me check in with you. When I came across your very important work through Great Friend of the Pod and hat-trick appearances now, George Mycock, I was very keen to have you on. How are you on this Sunday morning, pal?

SPEAKER_01 2:59

Very good, thank you. Thank you so much for having me. And yeah, I feel like I'm in company of some very big names, which, yeah, pleasure.

SPEAKER_00 3:07

I'll send the£20 to George after this.

SPEAKER_01 3:09

Yeah, please do.

SPEAKER_00 3:11

The subject we'll be discussing across many things in your journey is one I've covered with several women on the pod from a lived experience point of view, but not through the lens of EDs. So without further ado, are you ready to start the show and talk all about your wonderful journey?

SPEAKER_02 3:25

I'm very ready. Yes, absolutely.

SPEAKER_00 3:32

Let's start your podcast by talking about your wider academic journey, Sophie. So take me back to the beginning and tell me why you decided to stay in academia after completing your BSc undergraduate degree in psychology at Loughborough University.

SPEAKER_01 3:47

So during my undergrad, my dissertation was looking at menopause and eating disorders. And that was actually sort of something that came about by chance. So my professor Yves Horgeforce, she's wonderful, specialises in menopause, dementia, a real wide range of things. And mine at the time was eating disorders. I was working with Beats as a recovery coach. And I at the time I wanted to be a clinical psychologist, so I knew that was my interest. I didn't really know it would be a research kind of interest. So for my undergrad dissertation, we sort of combined the two topics, realised there wasn't really an awful lot on the subject at all. And yeah, that was when the sort of the idea for the PhD came through, really. And then we sort of submitted our application, got approved, and yeah, sort of started from there. So I think I've always had an interest in research in academia, but I think initially it was from uh, you know, doing that alongside clinical practice, and then it turned into once I found that sort of passion for menopause, disordered eating, that's when the PhD route came along.

SPEAKER_00 4:50

Now, for the listeners, they might be wondering because you said there you went straight to your PhD and you basically skipped your master's. So was there a part of you that wanted to study somewhere else and get a different experience, or was it more a case of a PhD is bloody expensive? If I can get support for this here, I'm taking it.

SPEAKER_01 5:08

Yeah, well, originally I was applying for clinical psychology masters. So the plan wasn't to do a PhD at all, it was to do a master's, and then was in my undergraduate supervisor E sort of suggested because the undergraduate dissertation went so well, I think I'd had a lot of experience within work outside my undergrad as well. You know, I'd worked in psychology basically since my first year of uni, whether it's doing support work, care work. I worked as an honorary assistant psychologist. I was doing extra research help for her during my undergrad, you know, writing book chapters, things. So definitely not the same as a masters, but I think we felt that by the end and doing the undergrad, doing the PhD would be something that would be good to do. So yeah, I think I was lucky in that sense that I was trusted in my abilities to be able to do that. So again, it wasn't sort of the initial plan, but that's the way it happened, which I think was really nice and this worked out really well.

SPEAKER_00 6:01

Let's get into the reason why we are chatting today, which is your PhD on disordered eating in women during the menopausal period. Now, to start with, when we chatted off air, you were very keen to make a distinction in language between menopausal disordered eating versus menopause EDs. Why is that important for you and obviously for the listeners as well to know?

SPEAKER_01 6:22

Yeah, so when I say EDs, mostly referring to eating disorders. And when we talk about eating disorders, we're talking about clinical threshold diagnosis. And when we're talking about disordered eating, we're talking about a spectrum of eating attitudes and behaviour that falls below that diagnostic threshold. And I think when we look at the research, there's a large body on eating disorders, whether that's menopause, whether that's adolescent populations, but I think there's less of an awareness about the standalone effects that disordered eating can have, not just as a precursor to if it reaches a certain level, then you get an eating disorder. And I think for a lot of women that I've spoken to, both in a research context and without, they might not have an eating disorder, but they have struggled with disordered eating in some form for years and years and years, and it's had a really big impact on their lives. But because they don't have that diagnosis, or because they don't reach that threshold, it's incredibly difficult to get support. And I think sometimes we can sort of think if we don't have a label, we maybe don't have validation or justification for those things we're struggling with. So I think for me it was really important to provide support to that gap where it's people who are below that threshold, but still could really value from that support. So yeah, that was really important to me.

SPEAKER_00 7:47

Let's go a bit deeper and set the scene for the listeners if we can. So, how and why do disordered eating traits affect menopausal women specifically at all three stages of the menopause? So, whether that's peramenopause, menopause, and postmenopause too.

SPEAKER_01 8:02

Yeah, so during the menopausal transition, obviously we have changes in our sex hormones, estrogen, progesterone, testosterone, and that can link with our appetite hormones. So a couple of those leptin, ghrelin, insulin. So in a very condensed sense, these appetite hormones control when we feel hungry, when we're satisfied, they send signals to our brain when to stop eating. But when we experience those changes in our sex hormones, that can actually interfere with our sensitivity and responsiveness to those appetite hormones. So what a lot of women I've spoken to have found that when they get to menopause, suddenly they might experience these really intense cravings, these really intense urges, they might feel more hungry than they usually do. Some women might feel actually a lot less hungry. And I think it's not necessarily well broadcast that that isn't, I think for some women they've said, especially if they end up eating more or binging, they can put that on sort of personal responsibility and self-blame, and there can often be sort of guilt and shame around that, whereas actually it's not realised that this can be because of those biological processes and those hormones. So in terms of the binge eating and the craving sides, that's where that can come from. I think, in terms of the more sort of restrictive eating that some women experience, I think a lot of the research, it's well established so that can be linked to body dissatisfaction and body image. And again, a lot of women I've I've just had personal conversations with, I think really struggle with in our culture. Aging isn't valued in the way that it should be, and it is valued in other cultures. And I think we have these thin youth-prioritised beauty ideals. So I think when a lot of women age, it's navigating that change in their social positioning, the way they're perceived by society. Power. Yeah, exactly. All these things which subsequently can lead to those changes in eating. So it's very complex, there's not one sort of factor.

SPEAKER_00 10:06

We're going to get to all of that a little bit later in the pod, pal. But like George did, you made a discovery when you started your research on this in the sense that A, you discover that there's no real statistics or prevalent statistics on menopause or women who've experienced disordered eating. Like George did, he discovered that there's basically no research on men with EDs, very sadly, but he's doing a lot of work on that. And B, there's only been a handful of studies even done on this subject globally, let alone the UK population. So given all of the focus that's basically on females with EDs in the current conversation, obviously that's more skewed towards younger women, teenagers, adults in sort of between the ages of 18 to 35. Did that surprise you, given that almost all women, obviously biological circumstances excluding, will go through this very challenging but universal biological experience of the menopause?

SPEAKER_01 11:00

Oh, a hundred percent. And I mean, definitely since I've started my PhD, for example, we do have some more prevalence statistics now, which is great. I think in terms of clinical eating disorders, about 3.5% of women during menopause have an eating disorder. But again, for those disordered eating, those subthreshold incidences where it might be underreported, it's more normalized, it's then very, very difficult to get data on that. And yeah, it's completely surprising. But I think unfortunately it's a broader issue in women's health. I think whether it's menopause, whether it's menstruation, whether it's during pregnancy, I just think generally there is a gap in women's health support where, you know, either women aren't taken as seriously, or perhaps we're using outdated measures or methods of support for women, which I think don't take into account those sociocultural factors and all these other complex influences that are happening during menopause. You know, a lot of women I've spoken to, it might be they go to a GP to seek support and it's instantly prescribed antidepressants. Or, or for example, when they talk about body imaginating, the conversation goes to metabolism and diets, whereas actually what they wanted was a conversation about validating these changes in their psychological relationship with food. So very surprising, but I think this unfortunately has been happening for a long time in various other stages of life, but definitely something that, yeah, hopefully I think is getting better as research goes on and medical practice advances. But yeah, very interesting and complex topic that I probably can't do justice to in this conversation.

SPEAKER_00 12:41

The listeners can't see, but you're very young yourself, and like George with muscle dysmorphia, you've become a thought leader on this subject quite quickly, right? That must be a bit of a process to adjust to, particularly as you also haven't gone through the menopause yourself, so you haven't got that lived experience point of view, but obviously you're trusted by these women, and that's a great testament to you and credit to you. How has that been for you to navigate?

SPEAKER_01 13:02

Um, I mean, 100% there was a lot of impulse syndrome at first, and I think I'm very conscious of people looking at me and thinking, okay, well, you haven't been through menopause, how can you speak on this topic? And I completely understand that reservation, but for me, it's I think part of the problem we've experienced in menopause support, whether that's in disordered eating or otherwise, is that women only being able to talk about it when they get to menopause age, you know. I think we need boys and girls being taught about menopause and the whole spectrum of people's reproductive life phases at a young age, not just having that conversation between women at menopause age, because I think the more broadly we can educate the population and the bigger spectrum of ages, cultures, people from different backgrounds that are talking about menopause, the easier it is to feel supported. You know, everyone in their life will know someone who is going to go through menopause or has been or is going through it and experiencing it. So I think whether that's your mum, your sister, a friend, a colleague, whoever, I think it's so important to be having these conversations. And, you know, it's something that the women in my life I've seen be, you know, affected both positively and negatively. And I think it's important for people to have an awareness to both share in those positives because I think it can also be a period of great growth and experiencing new things and all these positive effects, as well as being able to share in their struggles and support. So for me, it's definitely been an adjustment, but I do feel very comfortable now. I think I'm able to sort of say, no, actually, I do know about some research perspective, and I think we should be having these conversations and people should be learning. So yeah.

SPEAKER_00 14:50

I'm very pleased about that, pal.

SPEAKER_01 14:51

Thank you.

SPEAKER_00 14:52

Off air, you were very keen to talk about the importance of these traits in relation to the quality of life for these women. So, i.e., whether a woman has a very severe menopausal trait or not is one thing, but it's how those traits affect their quality of life, which can lead to potentially disordered eating. Can you just unpack that for me?

SPEAKER_01 15:11

Yeah, of course. So I think when we started the research, we were keen to look beyond menopause, sort of stage classification, you know, pre-menopause, early, peri-late, peri-post, because I think one, a lot of women might not necessarily know what stage classification they're in. And two, there can be overlapping of symptoms in different stages. So we wanted to look at quality of life because I think just because an individual is in a certain menopausal stage, or even just because they have severe menopausal symptoms, that doesn't mean that they're negatively affected by that. For example, if someone has a really strong support system around them, if someone has great coping strategies, you know, I've spoken to women who in their profession they're counsellors, so actually they've got a great toolkit of things that they can use to support their mental health and their well-being and changes in their relationship with food and their body during menopause because they've spent their careers doing that. So all of these things can contribute to whether having severe menopausal symptoms does actually affect quality of life and then does affect that body image and disordered eating. So I think it's a much more complex issue that goes just beyond okay, what stage are you in of the menopause? Because it doesn't necessarily tell you everything about a person.

SPEAKER_00 16:33

We spoke earlier about cultural attitudes in relation to the menopause and female fertility and youth and beauty, right? And I want to talk about it a little bit more here because whether you agree with it or not, a lot of women's power and status is linked to their fertility, their youth, their beauty, especially in the West, shall we say. Yes. And as this naturally declines with age, which is the age bracket when the menopause usually hits, that can provoke, like you've said, issues of identity, resentment, distress. Many women get cosmetic work done to slow down the aging process or even try to halt it entirely. There's a lot of female celebrities that we can probably name, but I won't. That decline in visibility and influence can be really hard to adjust for them. And I've read someone like Victoria Smith's book, Hags, which talks about this quite a lot. How is this societal change in attitude towards them a possible factor in disordered eating traits?

SPEAKER_01 17:25

I think it's such a complex experience because I think it's not only to do with, as you say, being exposed maybe to these beauty ideals in the media of depicting young women and thinness, but it's also, as you say, your kind of social positioning. So, for example, women have spoken to me about noticing that younger colleagues might be given opportunities that they used to be given but no longer are. It might be other people speaking over you in meetings and feeling like your voice isn't being valued anymore. One woman I also spoke to, and she mentioned about caring for an elderly relative and actually realizing kind of vicariously how because of this person's age, they weren't respected. And actually, back when they were working, they were top of their field, they were a doctor, they were, you know, sort of a pioneer in their field. So I think it's a mixture of those, yeah, as you say, beauty ideals, but also your wider social positioning. And then when you think, you know, we're spending maybe our free times on social media where you might be being exposed to this diet culture, propagating these images, edited images of young thin women, and then you've got in your workplace where you might not be being valued and respected as you should simply because of your age. You think there are various aspects of your life where that's coming in, and then when you put that together, it's sort of no wonder that these body image concerns and these eating changes start to change. I must say it's definitely something that I think I've noticed more in social media it being challenged in terms of the way we see aging. And I think there is more of a call for, for example, in other cultures, the older you get, the more respected you are, you know, and women are valued in other cultures as they get older for their wisdom, and it's associated with increased power. And I think there's definitely a lot more awareness now, I'm mentioning on LinkedIn, on Instagram of people sort of calling out other cultures that maybe don't do that and kind of questioning that. Why are we suffering because of these sociocultural invented beauty ideals, you know? Again, it's a very complex topic that I can't do justice to, but it's an interesting conversation.

SPEAKER_00 19:48

The uncomfortable part of this conversation is around loss of sexual power, right? And I remember listening to a podcast episode of a podcast that's sad and no longer going, two great women, they're in their 40s, and they were sort of making a funny story about this subject in the sense that one of them told her a story about going for dinner with a friend, and the friend used to be, I'm saying used to be, I don't want to get in trouble, used to be incredibly attractive, right? And she asked the Maitre D if she could have a better table, and he said no. And the Fred said some of the other lines of are I used to be gorgeous, they used to say yes to me on requests like that, right? So, how have you seen that loss of sexual power play a role in disordered eating from the research you've done, women you've spoken to, whether that's in funny little anecdotes like that, or maybe the loss of the male gaze when they're going out in public, anything like that, really?

SPEAKER_01 20:35

I think from our interviews, a lot of women touched on maybe sexual power in terms of intimacy with partners, that maybe loss of sexuality and then potential reduction in intimacy can not only come with sexual changes with menopause like loss of libido, whatever, but them not feeling themselves and kind of feeling like their partner doesn't find them attractive, even if they do. And again, a lot of the women I've spoken to have even said, My partner has never said they don't find me attractive. My partner is incredibly loving and values me and is reassuring. But if you don't feel yourself or you don't feel your sexuality internally, you don't feel like you have that sense of attractiveness, then it's very, very difficult to be vulnerable and and intimate with someone.

SPEAKER_00 21:32

So it can cause divorce.

SPEAKER_01 21:34

Yeah, exactly. And it and it's also a very vulnerable conversation to have. And again, I think a lot of the research does show with partners, the more knowledge about menopause they can have, and the more those conversations are having, the more socially supported the individual feels. And and so it can actually reduce the reported severity of menopausal symptoms. So yeah, it's really interesting, but I think again, all I can say from what I've learned from the literature and from speaking to women is if you can have those conversations and you feel like you can be in a safe space with your partner to have those vulnerable conversations, it can be, I think, a real catalyst for providing a safe space for that intimacy to return, if, as and when you want it to.

SPEAKER_00 22:22

I want to talk now about the comparisons between how disordered eating traits occur in younger women versus older women, right? I want to stay on this topic of sexuality or sexual power because with younger women, that sense of sexuality being imposed on you very quickly, especially if you develop earlier, as my friend Georgie spoke about on her podcast, it's very hard to deal with, right? Changing relationships with boys, they're now attracted to you in a sexual way, and maybe you're just seeing them as friends. That can be really, really hard. Now, for menopausal women, as you know, spoke to me off air about, their sense of self is well established by this point, but the sexuality is almost being taken away from them without their consent. But this time over a longer period and more slowly. Now, I'm not female, I couldn't say which is more difficult. How do these experiences compare through the lens of EDs from your research and speaking to these women?

SPEAKER_01 23:12

I think, well, I mean, puberty is very well established in the research as a period for vulnerability for disordered eating and eating disorders. I think partly because it is more abrupt and it is potentially more of a sudden, particularly in adolescence. Whereas I think during the menopausal transition, again, because we're not only till only recently, and I think one of the big catalysts was the Davina McCall documentary where she started talking about medicals and HIT. I think that was a huge catalyst in modern media that caused this conversation. Yeah, if you don't necessarily realize those changes are slowly happening, you can look back over a period of five or ten years and kind of think, how did I get here? You know, I'm struggling with my relationship with my body, I don't feel like I have a sense of body appreciation. My relationship is struggling and I don't feel comfortably intimate with my partner. I think if you're not necessarily aware that you can link it to the menopause transition because it's occurred perhaps more incrementally, it's very then difficult to externalise and think, okay, I've heard about this being a part of the menopause. Is there XYZ support available? Can I talk to someone I trust about this? Yeah, I think you have to be more independent in your seeking for support. And I think you have to be very well tuned with your body. I think a lot of the women I've spoken to, they say I've had to become an expert on my own body because I'm not going to get the support unless I conduct my own literature review and figure it out myself. Whereas I think when we're, you know, younger and going through puberty at school, you're kind of expecting those physical changes to happen and there's a lot more awareness about during your menstrual cycles how your hormones might fluctuate and change. Again, I still think there needs to be more support in that area for women's menstrual health anyway. As you touched on with by menopause age, women will have a more established sense of self-identity anyway. So I think when then those changes happen, what they say is that, well, actually, I've been used to how I am for the majority of my life, and I've not struggled with this for, you know, the past 30 years odd, which then makes subsequent changes more difficult. But and again, a lot of the women I spoke to this and oh God, I thought I'd been through this when I went through puberty, now it's sort of happening again.

SPEAKER_00 25:33

There's a big generational divide right now between young people and older people, and that's probably the same case for young women and older women. There's many reasons. I can't obviously speak to a lot of them, but I presume there's a lot. When it comes to the factors that cause or provoke disordered eating traits in younger women and older women more widely, can you just give my listeners an insight about some of those differences, some of those similarities, and maybe also how do you think we bridge this intergenerational divide between younger women and older women too?

SPEAKER_02 26:06

That's a really great question.

SPEAKER_01 26:09

I think in terms of similarities, I think all women, including myself, will have been exposed to media propagating beauty ideals, whether that's you go on Instagram and and you're just bombarded with sort of fitness influences and diet culture and messages about makeup and fitness and hair and how you need to look for the male gays. I think everyone can relate to that as a woman throughout their entire life, whether that's social media for younger generations or whether that's before social media was big, whether that's on TV adverts, whether that's on magazines, whether that's on billboards, I think that's something we can all relate to and how that can affect your body image and your confidence and your self-esteem. I think during menopause, and again, women I spoke to in research are now a unique factor can be that aging anxiety, I think, can play a role because I think as we age as we get older, again, and myself included, as I've changed from, you know, being a teenager to in my in my twenties, being aware maybe of how you're deviating from those youthful ideals and suddenly being very conscious of how old you are and how old people think you look. And I think a lot of what happens with disorder eating as well, changes in our eating behaviours can be attempt to gain back that sense of control, and it can be a behaviour that feels or behaviours that feel familiar and safe and ritualistic and can then kind of reduce that anxiety around eating. So I definitely think there are similarities in those experiences of beauty ideals, but yeah, that aging anxiety I think is something that for women I've spoken to have definitely touched on a lot, and even for me, I've I've noticed you just become more conscious of because you're just being shown these ideals all the time. And yet, unfortunately, our society isn't one that values aging.

SPEAKER_00 28:08

I want to talk about treatment now because I've spoken with previous guests, Diane Porterfield. She's an HRT practitioner, and that's just for menopause and women specifically, right? It's not for menopause and women who also have disordered eating traits.

SPEAKER_03 28:21

Yeah.

SPEAKER_00 28:22

So from your research, what support is there for those women who have both these categories, basically? And how have you seen these medical interventions support them? Yeah. And which ones have also maybe not worked too that we need to change?

SPEAKER_01 28:37

I think in terms of medical interventions, you know, I mean, again, I'm not a medical practitioner, so it's it's a little bit probably beyond what I can provide advice on. But I think the most important factor is just listening to what women are saying. I think obviously as medical practitioners, they have such an extensive amount of expertise in its job. But again, I think women, when they go for support, it's likely, especially during menopause support, that they will have spent a lot of time looking into different treatment options. And for a lot of women, they will have been passed from person to person, from GP to medical practitioner to whoever. So I think for me, the important change we need to make in terms of supporting women from both a disordered eating aspect and when that intertwines with things like HRT, menopause support generally, it's listening to what they're saying and not try to change the narrative either to something that becomes focused on diet and metabolism and calories. If someone is coming and seeking support for their relationship with food during menopause, is it that they need more psychological support for that relationship with food? And yeah, I think just validating that in terms of support that exists specifically for eating disorders and disordered eating. I know in Australia, I think University of Queensland, a researcher called Gemma Sharpcho, she specialises in eating disorders and menopause. And they have designed a whole cohort, I guess, of resources for eating disorders during menopause and support resources, which are fantastic. But in terms of disordered eating and menopause, I think, you know, part of my PhD has been trying to develop those support resources that kind of highlight those changes in appetite hormones and sort of emphasize trying to have those conversations with partners and people you trust to kind of explain what's going on and I think normalize some of those hormonal changes and how it can affect eating.

SPEAKER_00 30:39

Before we reflect, I talk a lot on this podcast about how the men's mental health conversation is massively skewed and in my opinion, wrongly skewed towards crisis, right? So all the mainstream stuff is if you're a man and you're struggling, reach out, reach out. No one ever says reach in on these resources, by the way. It's always if you're struggling, reach out. And that almost ignores the fact that most people who are in crisis aren't able to reach out because they're struggling. That's the definition of it. So for women who are struggling with both the menopause and disordered eating, what cultural changes to prevent disordered eating before it happens and help them if it does start at the early stages? Now you mentioned body appreciation off-air to me is one possible factor, but what else can we say? Because I'm very keen to move the conversation. Obviously, we need to still have crisis intervention, but we need to be doing more prevention as well.

SPEAKER_01 31:33

Yeah, definitely. And as you say, body appreciation, I think it's very hard when you're struggling with something during the menopause to try and develop a new sense of either body appreciation or a skill that maybe you haven't looked into before the menopause. So I think a big thing is prevention and before women are getting to the menopausal transition. And one participant in our interview study articulated this beautifully, and she was talking about how I would never have had the mental capacity during the menopausal transition when I was struggling with my body image and my eating to start thinking about favourable attitudes towards my body and what I appreciate in my body's functionality. I just wouldn't have had the headspace. So actually, part of her endeavour to make menopause easier was just checking in with herself, you know, do I feel like I have those coping mechanisms in place? Are there, you know, things in terms of trauma, in terms of past experiences that I've struggled with that I haven't dealt with before? Because, you know, she said that once you do get to the menopausal transition, if you are experiencing those symptoms and they are negatively impacting your quality of life, it's incredibly difficult to navigate that whilst also then trying to navigate other mental health difficulties or other traumas or other things from our past, either to do with food or body image or outside of that, whilst you're amidst it. I also think pierceable is a huge one. I know so many women who have said that when I have conversations with my friends because they just don't want to talk about menopause all the time, and because they don't want to feel like they're being a downer or having a really negative conversation with their friends, menopause just laughed off and kind of it's all jokes about hot flushes or whatever. Whereas I think there's a real need for genuine trusting peer-to-peer conversations and opening that space for people to be vulnerable and actually open up about their experiences with the menopause if they want. And the same with, you know, family members. It's something I've tried to have conversations with my mum more about since I've started my research and you know her experiences. So I think if we can all just be patient and provide a safe space where we can have this conversation, that's a big one. And yeah, prevention as well. Are there things you can do before you get to that stage if you know that you've struggled with your body image andor your relationship with food before? Is there psychological support you can seek now? Are there self-help resources, you know, on charities like Beat you can look at to start navigating that before the manifold?

SPEAKER_00 34:20

Let's reflect on your academic journey so far, Sophie. So, first of all, what's been your proudest achievement on it so far?

SPEAKER_02 34:26

Oh my gosh. Hmm. That's a good question. I I don't know if this is really rabbish answer.

SPEAKER_01 34:35

I'm most proud, I feel like, of the I think the sort of social media networks I've made because they have provided a platform for some really open and vulnerable and interesting conversations with women. I've had so many women message me on LinkedIn or speak to me at conferences because of, for example, my LinkedIn page where I'm posting academic updates, that I just feel so privileged that people trust me to have those conversations. And I absolutely love having these conversations with women, whether they're talking to me about the amazing experiences they've had during menopause and how they've started new hobbies and how they feel like they've been released from these societal pressures for the first time, or how they've struggled and actually seeing the research we're doing and just seeing social media posts mentioning menopause has been incredibly invalidating. I think I'm really proud that I've been able to disseminate my research in a way that I think has been accessible to even a small platform of women.

SPEAKER_00 35:44

And as a final question before we move on, what has this journey also taught you about yourself?

SPEAKER_02 35:51

That's a very good question.

SPEAKER_01 35:54

I think um I think it's taught me that I need to trust myself that I can provide a safe space for people to talk and learn even if I'm not within the exact same demographic. So for example, in this instance, age demographic, I've not yet been through the menopausal transition. And I think when I started my PhD and I started thinking about how can I get this research out there, how can I reach out to the people who need help the most, I wondered whether I could do that in a way that would seem credible and seem like I genuinely understood. And I feel like I've learned to trust myself that I can do that. And also people aren't looking to catch you out. I've learned to kind of also be more forgiving in terms of people aren't necessarily looking at me and my research and my post and thinking, oh, what does she know? You know. So I think uh giving myself a bit of grace that yes, I can communicate that effectively, but also don't worry because not everyone's out to get you in the research world.

SPEAKER_00 37:09

We've talked about your brilliant academic journey so far, Sophie. Let's go deeper and talk about your own mental health journey now. So I ask all my special guests on this topic this question first. Take me back to early life, teenagers, and looking back, were there any early mental health experiences? If any, who's the Sophie we meet here?

SPEAKER_01 37:29

Really am picking it now, aren't we? I think I think I've always every age been able to manage my mental health, all those sort of experiences because of sport. I think that's been a really important factor in any time where there's been struggles, whether it's sort of more deeper struggles or just day-to-day stresses. I think sport and athletics has been a huge one in helping that. I think where it's probably at times the worst time for me was my final year of undergrad going into that first sort of PhD year. I think it was leading up to that period of undergraduate exams and kind of just wanting to do anything to get through that and just feeling like I just need to get this done. I think you don't actually realise how long of a period that is, and if you let your mental health slide in any way, it's then very hard to rectify that afterwards. It's not just I can neglect my mental health and my relationship with food for six months while I get through these exams. When your exams are done, that stuff doesn't necessarily go away, and you suddenly have got a lot of work to do with yourself to undo that. So I think for me, that was my hardest period. But I'm very lucky that that has exponentially improved as I've kind of worked on those things and addressed them.

SPEAKER_00 38:59

Now, for the listeners, you're not just into sport, but you were a really good sprinter. You sprinted at Loughborough, not for Loughborough, otherwise you would be literally England GB left.

SPEAKER_01 39:09

Well, it's Loughpress. You don't have much chance.

SPEAKER_00 39:11

I mean, yeah. That imposter syndrome must have been mad just walking in and just like all team G V just turn up. However, you also experienced some disordered eating yourself during your undergraduate period. Now, what factors caused that to develop, maybe including the stress of exams, maybe excluding it, and how did you manage it alongside your mental health?

SPEAKER_01 39:32

Um I think for me, athletics and especially there was a factor, I think, because you're almost in this, like I don't know how you say it. It's an elite bubble, innit? It's an elite bubble. Yeah, yeah. And you're exposed to people not really wearing a lot of clothes. Genuinely all the time. Winter people are in crop tops and little shorts, or like, yeah, guys who got their tops up. And I think then from someone who's really trying to make it in a sport, and then you're exposed to these elite athletes who look like that, in your head, you sort of think, okay, well, if I want to make it, that's how I need to look. And I need to have this percentage body fat, I need to have this percentage muscle. And I think it almost becomes a an intrinsically linked with performance. I think for me also when I was studying for my exams, I've always been a bit of an academic nerd. Like grades have been always really important to me, and they're less so now, which is funny because you know, because I've done it, mate. Um but they were just the be-all and end all for me. And I think during university I found it quite a lonely time, and I think that was a way of sort of controlling something, and I didn't know it at the time, but I think that's what it was. It was having a control and thinking the rest of life feels out of control, and I don't know what's going to happen with exams or after studies, but this is something that is familiar in whatever sense, and I feel like it's helping me towards those goals. And I think one of the hardest things that I didn't realise was how that can then be linked with sort of anxiety and depression. And for me, that was something that was the most difficult to fix after undergrad, and what started happening first year of PhD was looking at the we've got ourselves a bit of a pickle here. Yeah, prioritizing that mental health, I think, during that undergrad would have done me a lot of good, but I think it makes you face things and it makes you address them. I think sometimes you have to get to that real low point to to wake up and realize something needs to change.

SPEAKER_00 41:39

In your childhood, you grew up during the time of the thin ideal, and I'm using air quotes there, size zero culture, and then we've gone all the way the other way, the rise of skinny thick that was popularized by the Kardashian family. Now, that body type isn't just unrealistic for most women, but it's also unachievable unless you do surgery, and then we had the rise of BBLs, all that sort of stuff. And then you went all the way to the other pendulum where you started with this kind of fat acceptance or how the body positivity moved into fat acceptance, then you had really extreme media portrayals of that, which I don't think were helpful either. Now we're kind of going back to the size zero culture again, which is also problematic. How did you deal with all of this growing up? Maybe comments that you received in school, outside of school, and why can't we reach just a normal, healthy balance for fuck's sake? Oh, that is the question.

SPEAKER_01 42:30

Um I think growing up, like you know, and you're just not conscious that you're being exposed to all of those things, so you're just sort of consuming it all the time. So I definitely don't think I realised I was amongst it, and those were the factors being at play at the time. I think for me, a big one now, I don't have Instagram. I have an account, but I don't use it, I don't have it downloaded on my phone all of the time, and that's not because I feel like if I had it, then my mental health would be really bad and that relationship with food would go poorly again. Mine's just a Muppet's reels, mate. But that's the thing, it's so hard to curate, isn't it? For me, I was just like, oh, it's easier just to not because it would really piss me off than when I'd spend a tenth of a millisecond like glancing at something to do with fitness. So I think that's been a big one in terms of sort of gaining back that control. But I think in my younger years, I didn't know that was a thing. And then a lot of it is our economy benefits from propagating these ideals, isn't it? You know, we then spend more money in cosmetics or fitness products or XYZ food to try and attain these beauty ideals. I think sadly it's a very inherent and normal part of our society and an economy now that many big businesses profit off. But I do think that at least there is more awareness now. Like the fact that you're even asking that question, I feel like says a lot that we have and people have a level of awareness that they can question that and critique that now. So I think a lot of it is just giving back the consumer. The power, whether that's through the consumption of social media or consumerism of products to fit in with this ideal. Yeah, I think knowledge is very powerful in that respect.

SPEAKER_00 44:11

You specialized in 100 metres and 200 metres as an athlete, and you also ran for your home club of Cheltenham Athletics Club. Yes. Big up Cheltenham. You spoke about that competitive environment at Loughborough, maybe some of the challenges of that. But what were some of the benefits as well that you had during your athletics career that were a net positive for your mental health? Because I always like to have a healthy balance too with these conversations.

SPEAKER_01 44:33

I mean, I think it's had no end benefits. I mean, I started when I was 12, and I still don't now. Sprinting, so I've been doing it for such a long time. I think as a child it taught me discipline, I think it taught me to manage my time. I think it gave me something to believe in and taught me ambition from an early age. I think it's just always been a constant for me, no matter what changes in terms of school, life, education, PhD, work, you always feel like you're doing something for yourself. And for me, I don't think I was ever one of those people where, as maybe exams or studying or work got busier, athletics would never be my sacrifice. It would never be, oh, because work's busy, I've been off training. It's well, I need to train now more than ever because this is something that I feel like I'm doing for myself and I'm putting my effort and I'm putting my time into, and that makes me feel good and I love it. So it's taught me all those things. It's shaped me, I think, who I am as a person. I think as a child, I was a very, I was very energetic and, you know, happy, but I was also then very nervous, kind of unconscious of what people thought of me. And I guess people pleasing, right? I was very much like that. And I think it definitely built up a level of self-confidence, where as I then aged, that sort of people-pleasing where for some people that might develop into something which negatively impacts their life and can go a bit too far, helped, I think, bring that back by instilling that self-esteem and that self-confidence that I got from sport and I got from performing well.

SPEAKER_00 46:09

I want to talk about your recovery from those disordered eating traits now. Because when was the time where you felt you had overcome them? Did it just coincide with the end of exams? Did you have to put other tools in place to help you? What can you tell me here?

SPEAKER_01 46:23

Yeah, so it it definitely wasn't just the end of exams. I think that was the hard thing. I thought it would be. I spent, I think, the year leading up to my exams sort of getting worse and worse and worse. You know, depression started to creep in, anxiety. And then once I got to the end of exams, sort it would go away. And then I was just left with, I now don't have an activity to focus all my attention from, and I'm struggling with my food, my anxiety, depression, whatever. I think when I went to the GP to look at support, and it still makes me laugh today that there's a male doctor, and he sort of said, Yeah, so you're not underweight enough to warrant a referral, but we wouldn't want you getting any smaller. Oh no. And you know, and you're sort of sitting there as a I don't think they realise how much it takes for someone to come and when they're at the point of seeking kind of medical support, you know. So I had a yeah, a lot of psychotherapy for that and antidepressants, but again, I don't think that's what I needed because very much uh I trusted that that was what I needed because the doctor has said that's what I needed, whereas actually it was coming from broader life things that actually once I started talking about, it then took a further sort of one and a half years, two years to unpick that for that to improve. But once it did, it was incredible, and then I was the best I'd ever been in my life, you know, recently the past two, three years. So again, I think it's been that combination of just being confident in myself that I think I know what I needed, and actually that medication wasn't helping me and it wasn't what I need, and eventually came off that and was so much better. But um, I think yeah, you often put a lot of faith in medical professionals or or GPs or whoever to support you, but you also need to have an understanding, I think, of what works for you and what you need. And yeah, it's a combination of things.

SPEAKER_00 48:18

I'm hoping that there will be a few of your female peers from the athletics world who listen to this podcast, mate. So, what advice would you give to any female sprinters of any level or athletes from your experience that would help them avoid some of the traits that you unfortunately fell into?

SPEAKER_01 48:36

I think being aware that your appearance isn't indicative of your performance and that there isn't a one-size-fits-all body type for being successful in support, whatever that is. There are so many things that affect your performance, and again, appearance and weight, especially if you feel like you have a vulnerability with food or a vulnerability with your body image, isn't the one to focus on. I think there are so many things you can do around your sport, drills, gym programs, looking more into your sessions, prioritizing your recovery. That I think if you have any form of vulnerability in terms of relationship with food, just be careful, I think is what I would say. Food almost seems an easy one to fix because you just think, okay, well, I determine what I buy, but when it starts to become linked with appearance, it's very easy for it to go downhill quickly. So I think just knowing yourself in terms of is this something that could be a difficult point for me. I think I'm at the fortunate period now where I'm that would be fine for me to do now if I did want to adjust my nutrition for recovery. That's something I could completely safely do and have done and doesn't trigger anything. There's no relapses, there's no whatever. But I think just being honest with yourself, if you're at a point where you couldn't do that safely without maybe those disordered behaviors being triggered.

SPEAKER_00 50:11

Let's reflect on your mental health journey now, Soph. So, first of all, similar question as before. What has this mental health journey taught you about yourself?

SPEAKER_01 50:19

I think I'm just so resilient. I'm not gonna lie. I feel like I've overcome so much in what was a relatively condensed period of two and a half years where everything came at once and everything sort of hit, and it was a very, very difficult sort of dark time. But I think I've now come out of it and thought, well if you can do that, you can do anything. And the fact that I think I did that relatively on my own. I tried to get support and it wasn't a particularly positive experience until I went outside of the sort of GP system and looked for it myself in terms of talking to someone. I think, yeah, it's something I'm proud of. And I think it just made me realise, yeah, how resilient I am. And I think it puts other struggles in life into perspective now. You know, if academia's getting on my nerves or being difficult or PhD or and then I'm sprinting or whatever, you just kind of think, well, I've been through this and I've got through it, and I'm happy now. So at the end of the day, that stuff kind of doesn't matter. Sounds a bit cliche, but yeah.

SPEAKER_00 51:24

And as a final question, if you could go back and talk to that teenage Sophie who was being bombarded or consuming those unhelpful body ideals in popular culture, the Sophie experiencing those disordered eating traits at Loughborough University, or the Sophie who was about to start her mammoth PhD, what would you say to her, knowing what you do now, if anything at all?

SPEAKER_01 51:46

I would say trust yourself, whether that's going into exams and trusting that you will do your best and you don't need to rely on this food stuff and you don't need to overly control things, you know, get rid of all that. Just trust that you can do it and prioritize your well-being whilst doing it, you know. Trust yourself during the PhD that you are an empathetic person and you would, I don't think, ever convey or something in an unempathetic way that pretending you know everything when you don't, you know, trust yourself that you can disseminate things respectfully about experiences you haven't had, you know. Just trust yourself under difficult life conditions and circumstances that you can manage it without having to turn to those other things to get that sense of control because I think, yeah, you can do it, and those negative coping things can take a lot longer to undo than you think that they will in the moment when they're serving a short-term purpose and sort of false sense of control.

SPEAKER_00 52:59

Our final topic of conversation, Sophie, and it's one I try and have with all of my special guests if we have time. It is a general Natter and quickfire chat about our mental health. So, firstly, how is your mental health?

SPEAKER_01 53:10

I'm great. I'm wonderful. It's great at the moment.

SPEAKER_00 53:14

Scale out of 10?

SPEAKER_01 53:15

Oh tier 9. Yeah, a little bit of PhD stress, but nothing we can't manage.

SPEAKER_00 53:20

What age were you when you became self-aware of your mental health and you realized that the feelings you were having weren't physical and they were actually in your mind?

SPEAKER_01 53:27

Uh 18. Oh no, actually, no, that would have been the start of my undergrad, probably final year of my undergrad. So when I was 22, 21.

SPEAKER_00 53:40

And was it a eureka moment or a gradual process?

SPEAKER_01 53:44

Gradual process in terms of realising something emotional was going on. Eureka moment in terms of deciding that I needed to seek support.

SPEAKER_00 53:54

Can you tell me about the first conversation you ever had with someone about your mental health? So if you can remember, who was it with? What did you say, and how do you look back on it? Did it feel like the stereotypical big moment and weight had been lifted? Or on the other hand, something quite easy, natural, and normal to do?

SPEAKER_02 54:10

Ooh, that's a really good question.

SPEAKER_01 54:12

I don't know if this was the first one, but one of the things that comes to mind is one of my very close friends during undergraduate, I think making an offhand comment maybe one time after training about sort of struggling with food, and then that leading to a really lovely deep conversation about her struggles as well, because she was also an athlete and how that linked with athletics. And I think it was quite uh an influential moment in realizing other people were struggling too, but it wasn't too deep of a conversation where you felt sort of heavy afterwards. It felt nice and light and balanced, yeah.

SPEAKER_00 54:50

What things in life do you find that trigger your mental health? So it could be things people say to you a sound, a smell, a taste, a particular social environment, or have you not figured all of them out yet? Or have any at all?

SPEAKER_01 55:01

Hmm. Thinking people are annoyed at me for whatever reason. Whether that's like work, whether that's socially not mental health on a deeper clinical level, but just in terms of I notice that piques the stress and I need to talk to them and make sure that they're okay and make sure, mate.

SPEAKER_00 55:25

I'm a people pleaser recovery too. Resist.

SPEAKER_02 55:29

Yeah, we'll have to work on that.

SPEAKER_00 55:31

You'll get there. You'll get there. Conversely, what positive tools and methods do you use to improve your mental health or help you feel better? Which ones have worked and maybe which ones that you've tried but haven't?

SPEAKER_01 55:41

Oh, go to a track. Love that. Always got to go to a track to help your mental health. That's what I do. And sounds cliche, but just having a bit of a frank talk with yourself and almost making light of the situation in terms of just come on, crack on, it's not that deep. Someone's annoyed at you if you've done this wrong, doesn't matter, it's fine. I think that really helps put it into perspective sometimes.

SPEAKER_00 56:05

What is the best book, or as I call it, mental health Bible you've read for your mental health? Now it can be mental health or self-help related, doesn't have to be, can be fiction. And if you can't think of a book, album, TV show, any piece of popular culture.

SPEAKER_01 56:19

A bit broader than mental health, but The Power of Now by Eckhart Toll.

SPEAKER_00 56:24

Yeah, it's come up a few times.

SPEAKER_01 56:25

Yeah. Not in terms of specific mental health stuff, but I think in terms of stopping the noise in your head and being able to centre yourself. And again, that really helped me do that sort of trivialising your struggles and kind of putting them into perspective by just being like, My mind's annoying me today. Just shut up. And then it kind of quiets down.

SPEAKER_00 56:48

If there was a mantra in life that summed up your mental health, what would it be and why?

SPEAKER_02 56:53

Oh my gosh, a mantra.

SPEAKER_01 56:56

Um you win some, you lose some, probably.

SPEAKER_00 57:04

Hey, keep it simple. Like it.

SPEAKER_01 57:06

There's a period of time where we lost some and it wasn't great, but there's now a period of time where it's brilliant and you're seeing the benefits of working on it in the past. Yeah.

SPEAKER_00 57:16

What do you love about yourself?

SPEAKER_01 57:20

Um I like to see the fun in situations. I feel like I can be quite playful and childlike in terms of having that childlike sense of playfulness and curiosity, which I think has really done me well in terms of times of of stress and navigating difficult situations. That's sort of making lightheartedness, I think, of a situation. I appreciate.

SPEAKER_00 57:43

And as a final question, you can answer it any way you want. What more do you think we have to do to ensure people from all backgrounds, all walks of life feel comfortable and safe in opening up about their mental health issues or just their general mental health, if most importantly, they want to do it?

SPEAKER_02 57:59

Very good question.

SPEAKER_01 58:01

I think for me, again, very simple. I've learned if I consent someone is off in any way, whether I feel like their mood, they seem upset, concerned, even if I feel like they seem really happy, just asking them why, asking them how they are, asking if things are okay. And I think that has been a really simple catalyst of not being afraid to ask people questions has led to the most interesting and unexpected conversations with them. Because I think once you're brave enough to ask, people feel open to being vulnerable.

SPEAKER_00 58:37

Sophia has been an absolutely lovely chat. Thank you so much for coming on the Just Checking In podcast and talking to me, pal.

SPEAKER_01 58:43

Thank you for checking in. It's been wonderful. Yeah, I really enjoyed the conversation and some, I feel like very thought-provoking questions. So thank you.

SPEAKER_00 58:55

Well, that's all we've got time for in this episode of the Just Checking In pod. A big thank you to Sophie for being my special guest and for letting me check in with her. I'll put some links to where you can find out more about the brilliant work Sophie is doing for menopausal women and follow her on social media in the show notes. As always, thank you to all the vendors who've tuned into this episode. Remember, if you've liked what you've heard, please give it a share on social media. Tell your friends, family or work colleagues about us. If you're feeling generous, write us a review and give us a five-star rating on Apple Podcasts or Spotify or wherever you get your podcasts. If you like what we're doing or want to support us further, go to patreon.com slash eventhelpuk or make a one-off donation to our PayPal. All of those links are on our link tree. That's linktr.ee slash event helpuk. We hope to check in with you again very soon. And remember guys, it is always okay to venture.