Weight Wars: What Really Happens When You “Try to Help” Your Partner Lose Weight

Every morning was the same. Margaret would sit at the table for breakfast with her husband before he left for work. She would have her measured cup of Special K with 8 ounces of skim milk and a cup of black coffee. Her husband, on the other hand, would have his usual 2 large pancakes dripping with butter and thick maple syrup and several links of his favorite breakfast sausage. His coffee was sweetened and lightened with cream. He would read his newspaper as usual, and then when they were done, she would clear the table. On his way out the door she would bid him to “have a good day” and out he went. After she closed the door behind him she would go to the window and peer through the blinds as he left the driveway, made his way around the corner, and then out of sight.

The next thing that happened was predictable because it had become somewhat of a habit, or maybe it was something different (an act of rebellion?) As soon as she felt safe, Margaret would head to the fridge. The leftover sausage was thankfully still warm. She would pop a few in her mouth and gobble them down fast while standing in front of the open fridge. What else could she have? Leftover meatloaf, some pie from a party, cold french fries from a restaurant (her husband’s leftovers, not hers, she never ordered fries). Then, one after the other she would eat these random foods in a manner that was not enjoyable. No, she was not savoring some good food because she was hungry. There was little enjoyment here, and she really didn’t know what was going on. But I had a feeling because I had seen it one too many times before.

You see, Margaret’s husband was trying to help her lose weight. Over the years her weight creeped up and she often complained about it. Whether he also had an issue with it, or was only trying to help her I don’t recall, but the affect was the same. He became the food police and she became the prisoner. But she got to break free when he wasn’t around. Deep down, she was also angry and resentful that he was trying to control her, yet she didn’t have the awareness or strength to speak up. I ended up referring her to a therapist to help her with these issues and we worked on ways to stop her binge eating. Margaret’s story is not unique, and trying to help a partner with weight concerns and dieting is not unusual. Being partners together working on healthy eating and exercise can be a great thing. Understanding when it spells trouble, however, is critical.

Whether you relate to either side of this scenario, I have some suggestions from having witnessed so many situations where good and loving intentions backfire. Are you the person who is adamant about eating healthy and feel your partner should too? Have you listened to your wife or husband complain about his or her weight for years and so you feel compelled to say something when you see them taking 2nds? Are you worried about your husband’s newly diagnosed hypertension and now your fear for his health causes you to point out the sodium content of everything he puts in his mouth?

Or, maybe you are the person under the microscope (at least that may be how you feel). Do you find yourself choosing what to eat in a restaurant because it won’t cause your partner’s eyes to roll? Do you quickly hide the snack in your hand when your husband or wife enters the kitchen (because you are sneaking something and don’t want to be found out?). Do you feel sad inside because the person who is supposed to love you seems to be focused on your body size and shape instead of the real you?

When we care about those we love rarely do we do or say things to hurt them on purpose, yet when it comes to weight, dieting and eating, it happens all the time. If you have someone you care about or who complains about weight and you want to help, or, if you feel like the victim in this dynamic, here are some suggestions I have learned are helpful to restore peace and hopefully, happiness.

  1. Have a conversation. Stop pretending. If you are feeling hurt by the fact that you feel like you are being watched when you are eating, say something. Wait until you are not feeling angry and think about what you really need for support. Since every situation and every relationship is different, you may or may not feel comfortable with this. If you don’t feel like you can have a peaceful and productive conversation, and you truly are finding yourself eating out of resentment or if you are binge eating in secret, consider getting some support from a professional therapist who specializes in eating issues. Life is too short and if you can’t have a conversation it is likely the situation will get worse.
  2. If you are the one who has taken on the “watch dog” or food police role, but sense that your partner does not appreciate, or even gets angry at your diligence, why not ask them? Even if your partner asked you for support initially, you need to find out what that means. It may not mean they need comments from you, or maybe they thought they did need that kind of policing, but now it is not helpful anymore. The best thing you can do when you want to help someone is to ask: what can I do to help?
  3. Take a chance. Eat it in public. Eat it in front of your partner. Don’t hide when you eat. When you go to grab that snack and find yourself gobbling it down while standing in front of the fridge before you get caught, stop and ask “is this really enjoyable?” Eating food you enjoy is one of the blessings of life. Instead, walk over to where you normally have a meal, get a plate or napkin, and sit down. Enjoy your snack. Being aware of what you are eating, how it tastes, how your tummy feels, how hungry you are (or aren’t) is the first step to getting more in tune with your body and intuitive eating.
  4. Do some self-reflection. Do you recognize a pattern in your life when it comes to dieting and weight? Does your weight fluctuate depending on if you are dieting or not? Sometimes, we get into patterns in our relationships involving dieting and this can affect our relationships. The non-dieting partner may not know how to help and just assume they are being supportive when they become the food police after the big dieting announcement. If you recognize a pattern, my suggestion (of course!) is to consider getting off of the dieting band wagon. There are lots of resources and support for ways of living that are focused on intuitive eating and health (instead of weight). Check out Health at Every Size as well as a great non-dieting blog Dare Not To Diet

In this world focused on dieting, eating fads, weight, fitness and all that, changing your ways in not easy. I always have believed that caring about your health is way different than obsessing about your weight (which is not exactly in your control). There IS a way for us to work together toward a sane goal, but it has nothing to do with the scale and no food police needed. Instead, it involves partnering with each other to agree to make time for meals together. To agree to take a walk together or do yoga together, or turn off the TV during dinner time. It may be to learn to cook together, to try new vegetable recipes, to learn about special diets together (if one spouse needs to follow a low sodium diet for hypertension, for example). In this case, working on keeping giant bags of chips out of the house for the person who does not have the issue (they can buy a bag for lunch at work, instead). Creating a healthier eating environment at home to be supportive of each other’s health goals is way different than watching and commenting on what we eat. At the same time, deciding to go out for pizza and enjoying every minute (no comments about “breaking the diet” please!) does not mean you gave up on health. No, it means you are learning to incorporate normal balance in your life, and enjoying pizza on occasion does not mean you don’t care about your health.

With spring around the corner, I can almost smell that feeling of hope in the air when I walk outside in my garden and see some new life emerging (among the finally diminishing layer of dirty snow). I hope you consider a new life with no food police, no guard dog, just complete freedom and peace. Wherever you live, with whomever, that is the way it should be.

The Crazy Confusing World of Food

 

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It dawned on me recently that the simple act of eating is anything but that. Something as basic as obtaining and preparing food shouldn’t be that complicated. But it is. It struck me when I witnessed my Italian mother frying burgers this weekend. I had just finished making a few pounds worth of turkey burgers for her which I freeze so she can have them for a few weeks. I add in diced peppers, onions, garlic, grated carrots, cheese and seasonings then fry them in a bit of oil in a non-stick pan. They are yummy and healthy. My mom, however, had a few burgers that she had bought and also needed to cook those. So she proceeds to pull out a heavy fry pan and pour in about an inch of olive oil. She is known for her yummy sauce and eggplant Parmesan, however she rarely cooks much for herself.  Except apparently burgers on occasion.Anyway, I was a bit surprised and asked her if she was aware that those beef burgers probably had enough fat and wouldn’t stick so she really didn’t need all that oil (I was thinking about the cost and waste as she would surely have to dump most of it when she was done). Well, she just rolled her eyes. You can check out her reaction for a good smile, Mom frying burgers  Needless to say, hot oil splatted everywhere, but she does what she does, cooks the way she likes to, and it’s all good.

This happened after a fun day out. I often take my mom on little adventures on Saturdays since my dad passed to get her out of the house. This burger frying day was one of those days…anyway, the day involved lots of choices about food, meal planning, grocery shopping, restaurants etc. and as much as I do enjoy it all, it hit me that making all these choices and decisions can’t be easy for everyone, especially dieters, people with health issues, or those with disordered eating and body image concerns.

For example, have you ever gone to a restaurant with a 99 page menu, or how about 3 different menus? Do you struggle, like me, to make a decision on what you want to eat? Or, think about planning dinner, or lunches for work, or even a meal for a dinner party with friends. A birthday celebration, holiday, or even a camping trip. Being someone who loves to cook, and on top of that a dietitian who understands food and nutrition a bit more than most people, you would think decisions like this must be easy. Yet, I often find myself struggling and confused. And then I feel like a bit of a hypocrite.

You see, one of the things I also talk about when trying to help people be healthier is the importance of creating a healthier environment. Part of this involves purchasing better foods when you grocery shop, planning meals, and packing healthier lunches so you aren’t forced to buy something from the vending machine or fast food joint just because you are not prepared. I have educated people about choosing the healthier options in restaurants and also how to prepare foods to modify them to be healthier. And yet, there I was, sitting yesterday at the Cheesecake Factory with my mom, staring at this gigantic menu filled with choices (actually, there were a few menus), and all I initially wanted was something hot and soupy and tomatoey. On top of that, the calorie content of most of the items was listed and I wondered how their sales were affected after they started sharing that info. My mom was pretty funny in the way she reacted to it. “That can’t be right!” and I assured her it probably wasn’t. She is not a big eater (unless it’s sweet) and we both settled on chicken chili which came with bread and a salad and was perfect. I was glad there was something hot and tomatoey on the menu, which made it easier since I already had it in mind, however I think we both felt overwhelmed with all the choices. What do other people do? How do they figure out what to order?

And then we went to the grocery store. I wanted to be sure to cook something for my mom to have for the week (we decided on the turkey burgers) but also needed to get something for my “Sunday Cookin'” which I do most Sunday’s. I turn this into a relaxing but productive event as it is a way to relax before work starts again Monday, but I also prepare enough food for lunches for a few days, or even dinners. The problem lies in making a decision on what to make. I usually do some research into different cultural meals (Italian of course, Mexican, Asian, finally tried Indian which was challenging). This time I had no idea and couldn’t decide what to make, so was somewhat dazed and confused in the grocery store. I remembered my mom had an eggplant to give me so impulsively decided to go Italian. I bought Italian turkey sausage, beef for meatballs, tomato paste, I had the rest I was sure. Oh, and I also needed to make something for my nutrition class for our “tasting”. Maybe homemade potato chips using the mandolin I just purchased on my outing with my mom. Potato is a vegetable, so that counts. Plus I was guessing they would love it over my usual green things I push on them.

So we finished our shopping, finished our cooking, cleaned up and it was time for me to head home. On the way home, I remembered I needed to remember to find some ripe avocados to make some guacamole for “green food” tasting as March is National Nutrition Month (FYI) and I was planning another tasting for our school. I would need to go to Costco’s to get what I figured would be enough, about 20 hopefully ripe avocados at a cheaper price. I was definitely not in the mood to go and decided to wait until the middle of the week (I still had time). I was tired of thinking about food and cooking. When I got home and walked into the kitchen, I could tell my husband had been cooking. He was so excited to inform me that he had made his famous “chicken a la king” from the leftover roasted chicken we had. He puts pimentos and mushrooms in it and serves it over rice which he loves and I don’t love. He showed me what looked like 3 quarts of the stuff with additional large tupperware containers full of cooked rice. He ALSO made taco filling, so much so that he already had frozen a container. Apparently, he DID go to Costco’s and bought a gigantic package of beef.  Talk about food for the week. I put away my groceries, and did not want to think about meal planning, grocery shopping or cooking anymore.

Even though cooking is one of my passions, the rest of it isn’t. But what if cooking isn’t a passion of yours, then I imagine the rest of it is even less fun. How much easier to spend your time doing all the things you do enjoy doing rather than thinking about food, shopping, cooking, planning. Add on top of this the need to know a bit about nutrition if you care about your health. How do you choose what to buy considering both nutrition and what you enjoy eating? Add onto this the challenge of our abundant food and restaurant environment and you have triggers galore that make most of us want to throw our budgets (and nutrition) to the wind just for some sanity. And relief from thinking about it all. Trying to eat healthier just feels like too much work sometimes. Even for a dietitian who loves cooking.

Do we give up? Or instead, do we pick our battles? Does it really have to be perfect? I think of my mom and her olive oil. At 85 years of age, she walks 4 miles a day, goes to church every day, has a great sense of humor and an active and social life despite all she has gone through. Clearly, frying burgers in an inch of olive oil, or living off of ice cream for a few days hasn’t hurt her. The bigger picture is more important. Nurturing herself in ways that don’t involve food or nutrition clearly helps. Laughing, being active, having faith, reading, crossword puzzles, enjoying  her simple life. But most people, especially those with health issues or eating or weight issues can’t ignore the need to deal with food, and it is not simple at all. I think we underestimate how hard it really is to deal with all these decisions and do all the work to create a healthier lifestyle. I see people go gung-ho and then I see them totally give up. I wish instead that everyone just is gentler with themselves, and knows that it is ok not to be perfect at this. It is ok to “just not feel like it” sometimes and to treat yourself because you deserve it (and sanity comes first). I believe in taking advantage of the times you DO feel like cooking or reading about healthy recipes. That is why on Sundays I do my cooking because I find that is the one day I actually do have time and nothing on the agenda and I can take my time and enjoy the process. And that is why I may make a few things, too much food for sure but that is what freezers are for and tupperware and freezer bags. So then, when Thursday rolls around and there is “nothing to cook” for dinner, lo and behold, it’s like a restaurant right in my own freezer! Chicken a La King anyone?

So, don’t give up. Meal planning, grocery shopping, cooking, freezing food, etc, is not the easy way. But you don’t have to be perfect. Just start somewhere. And, who knows, this Sunday I may try some deep fried burgers……

 

Trying to Lose Weight? 5 Reasons You Should Never Have a “Goal Weight”

Mannequins head“I want to look like a supermodel” she said. Her answer to my simple question of “how can I help you” threw me. “Have you ever seen a supermodel?” I asked. “No” she said. “Then how do you know you want to look like one?” was my response. She was a young woman who needed some nutrition guidance, referred to me by someone who was worried about her eating habits. Although I loved her brutal honesty, I had to regroup to figure out what direction to go with this. Before I did anything I needed to find out much more. Oh, and she had a very specific weight in mind that she felt would accomplish this goal.

As is usually the case, when someone is bent on focusing on such a specific physical goal, there usually are other matters going on. I was relieved to hear that she had a therapist so I proceeded to find out more regarding her eating and exercise habits before I rushed into education and explaining why wanting to look like a supermodel was not a reasonable goal. To be clear, although this is a true story, it could be anyone I have seen over the past 30 years (and although I am changing a bit of the specifics as I usually do, her eating and lifestyle are not unusual and could be anyone’s). It was her statement about the supermodel that was a bit more direct than any I have heard, as usually people don’t come out and admit this. Somehow, deep down, I am guessing most of us understand this is not a smart goal and would never say it out loud.

The funny thing is when I asked her if she had ever actually seen a supermodel, she said “no” but then asked “have you?” I answered yes, because I had worked with a male model years ago who gave me lots of details about the unhealthy behaviors the models did before a shoot. Basically, they would starve and dehydrate themselves to look “cut” and then when the work was done, the binge eating began. Clearly, the image you saw in the finished photo was not the image of a body that was natural or that could be maintained more than a week or two (without serious consequences, such as hospitalization due to dehydration which happens often). Or worse. Yes, there are many people who are naturally super-tall and super-thin, and there may indeed be models who eat normally. In his situation however, this was not the case.

Anyway, it was her honest statement that motivated me to write about the insanity of having weight goals. I realized that so many people go blindly on their way getting themselves into ridiculous, stressful, self-esteem damaging lifestyles that sometimes go on for years, all because of a stupid “weight goal”. I hate numbers in general, and when it comes to a fluid, changing, living body, something that will never be static, never be the same day to day, I dislike the use of numbers even more. What baffles me sometimes is how a person decides on the magical number. In many cases, people pick a number from their past. “When I was in high school, I fit into size ‘x’ and I weighed 140 pounds, so that is what I should weigh”, or “I read that ‘famous model/actress so and so’ is my height and weighs ‘x’ so that is what I should weigh”. And on and on. For most of the people I have seen, there is no way to reach that magical weight and live a life in any healthy, sane or even safe way.

You might be wondering “what is the big deal? Why not have a definite goal in mind?”  Here are the 5 reasons to forget about weight goals:

  1. Your body has a “Set-point” weight range it will fight to keep. I think of my father who was living proof of the meaning of “set-point” weight range. He was someone who I believe truly listened to his hunger cues and ate what he wanted. Being a traditional Italian and growing up with salami, sausage, fried peppers, Parmesan and fresh Italian bread he knew nothing about calories or nutrition. This is not why he ate. He ate the foods he loved and the meals my mom cooked. Every Sunday was pasta, meatballs, sausage, bread and sauce. He would sit there for what seemed like an hour and devour and savor his meal. He wasn’t big on sweets most of his life unless he craved something, then would have a good serving. His weight never really changed. How could this be, when he never spent a minute trying to figure it out? Set-point.
  2. You can ruin your set-point if you diet. I will never forget a patient I had years ago who had an eating disorder and would restrict then binge eat. She was in the health field and she understood what was going on when she did this however she had it stuck in her mind that she should weigh 125 pounds. She weighed 135 pounds. She had reached her goal at times through extreme behaviors however these could not be maintained due to the triggers for binge eating that resulted from her restrictions. She dropped out of treatment and I had not seen her in years. About 5 years had passed and lo and behold, she returned. The reason she returned she said was “I don’t want my set-point to go any higher”. She weighed 145 pounds (still within a normal weight range for her, but 10 pounds above what had been her norm). She knew it was her disordered eating behaviors that affected her natural set-point weight. All because she would not accept her natural body weight. When you have to experience extreme hunger every day in order to stay at a certain weight, then this is not your set-point weight range. And if you are binge eating then alternating with strict dieting as a result of wanting to be a certain weight, then you are at risk for ruining your natural set-point.
  3.  When you focus on a number you get disconnected from your body’s natural signals. Most people who have a weight goal in mind weigh themselves on a regular basis. When they jump on that scale and it does not move, they tend to jump up the restriction (“I am going to be good today”). What happens is they become more “cognitive” and less “intuitive” with their eating. They “figure out” what they should have for lunch and eat only the amount they believe will result in weight loss. What happens instead is they most likely do not eat enough calories, fat or carbohydrates. This imbalance triggers the brain to step up the appetite, and especially cravings for those particular foods that are being restricted. The cravings kick up a notch. Finally, whatever the trigger the dieter breaks down and has “just one” but then, that “just one” leads to another and another…..and another. The body is smart and won’t shut up until it is in balance again. The problem is the mind takes over and leads us to binge because we “are going to start tomorrow”. And the cycle of disconnection begins. Does this lead us to our natural and healthiest body weight range? No.
  4. That magical number has nothing to do with health. The issues of health and “obesity” has been argued before, with those saying weight is related to health. The reality is that having a healthy body is much more complicated than a number on the scale and has much more to do with lifestyle (and genetics of course). If you have a goal weight in mind, as you can see, the behaviors people tend to engage in do nothing to enhance their health. In fact, the opposite is likely true. Dieting to lose weight rarely contributes to health. If being healthier is something you care about then if you focus on restricting and losing weight you are missing the boat.
  5. It is only when you let go of that magical goal weight number that you will be able to actually move in the sane direction of achieving a healthy (and happy) you. I don’t try to talk people out of wanting to feel good about the way they look.We all want that. But, from what I have seen, most people who diet to lose weight and are successful (for a while) do feel good about themselves at first. But if they don’t get off the yo-yo diet cycle and regain that weight, they do not tend to feel good about themselves at all. If, however, they stop focusing on that number and instead begin the road of truly reflecting on their health habits (which yes, do include healthier,not perfect, eating) then the journey can begin. This is a long journey and is not predictable like a diet. There are no promises. It is about exploring your lifestyle and identifying the things that are doing you in.  Do you notice yourself mindlessly eating in front of the TV at night? Do you hate to cook so Chinese and pizza are a daily thing? Do you work late and struggle to fit in any kind of physical activity? Are you up until 3 am playing video games? Do you eat out of stress because you hate your job? Or, are you in a dangerous spiral of self-abusive disordered eating habits that you are yet to get help for? These are the types of things that need to be addressed that NO one diet can fix.

 

If any of this rings a bell, I hope you think long and hard about picking some random magical goal weight. Instead of wasting the energy doing unhealthy and impermanent things to get there (a place that probably has nothing to do with the real you), consider going in a different direction for once. Learn what healthy eating and healthy cooking is. Take the time to reflect on your lifestyle, and start with even one thing you want to change. Educate yourself about what it means to have a healthy lifestyle. Talk to friends you know well and trust, who you think manage to live this way and you might find out some strategies that might work for you, too, in this busy world. Work on intuitive eating and pay attention to all of the messages your body gives you every single day. Make your mistakes, feel yucky, but then learn from them. Over the months and years, guess what I have seen happen when people do this? They often just naturally land within a weight range that is truly natural for them. They do this while enjoying eating and good food, and living life to the fullest.

For more information on the negative impact of dieting, check out: Has Dieting Ruined Your Metabolism?

 

 

 

“Clean” Eating:Finally, the Answer…or Just Another Craze?

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Mom’s homemade Minestrone Soup: Is it “Clean” I wondered…?

A co-worker approached me last week to share that she had lost 10 pounds recently after she started to “eat clean”. I smiled the way I usually do when I really want to be happy for someone because they are happy….. yet my insides start churning because I absolutely hate the diet industry. I have learned that it does not help to freak out on anybody who is on a diet. It does not help to tell them that over 50 decades of research prove that diets don’t work in the long term and they often lead to food obsession and binge eating. People don’t want to hear that. They tune me out. So I just smile, but then usually ask what it is they are doing (if it is something scary I WILL share my opinion). It struck me that I honestly was not sure exactly what “clean eating” was. When I hear the word “clean”, I don’t think of food. I think of Lestoil. Or Comet cleanser, Windex, Pledge. Maybe Mr. Clean. You know, soap kind of things.

 

Anyway, when I asked this sweet person what it was exactly, she said it was about eating more whole foods instead of processed foods. Now that sounded pretty harmless. Still, I thought I should check it out a bit.

As it turns out, “clean eating” can mean a lot of different things to different people. The diet industry and diet world is pretty confusing (I think because they must have to change it up a bit, to keep making money off of promising something our culture values more than anything else: weight loss). Anyway, some clean eaters might fast intermittently, while others might eliminate many foods, considering some foods to be “bad” while others are “good”. But the basic premise of “eating clean” is to focus on whole foods verses processed foods. Hmmmm. Sounds like eating healthy, which can’t be bad. Or can it?

If we have the means to buy fresh foods, such as good meats, fresh fruits and vegetables, real cheese verses processed, good yogurt and bread made from real ingredients, then of course we should do that as much as we can. The problem lies in the extremes people go to eliminate foods, the guilt they feel when they break down and eat something processed, and the ultimate goal of eating this way (to lose weight). The thinking is at risk of morphing into the typical “diet mentality” or black and white thinking when it comes to foods and eating that lead to trouble. When this happens, then it becomes just another “diet” that will likely end in just another failure. Not good for our bodies or our self esteem (in other words, our physical and mental health).

If you are curious about this fad you need to be smart about it (sorry, I have to call it a fad because of it’s focus on weight loss). There is also sometimes a focus on unscientific claims about promoting fat-burning, and a yucky feeling of superiority I have sensed (if I don’t want to eat clean, does that mean I am eating dirty? I don’t get it). If you start believing you are totally going to eliminate any food from your diet (such as your favorite cookie, or favorite fast food burger) then you are setting yourself up, just like any other dieter. If, on the other hand, you truly are working on eating healthier, then trying to do more cooking, buying more whole foods instead of processed foods and being more moderate in your intake of those “fun foods” that don’t contribute much to your nutrition might be ok. Denying yourself totally of foods you really enjoy will only make you obsess about them more, and could likely lead to binge eating the very foods you have decided you shouldn’t eat.

So, as usual, my advice is to continue to care about your health and work on learning how to cook healthy but yummy foods. Work on getting more in tune with your body, your hunger and fullness, and getting rid of impossible food restrictions that do nothing to promote your health while draining your spirit and enjoyment of life. Eating should not be a moral issue and we should not be judged by what we do or don’t eat. In reality, it is quite simple, just like it always has been. I just wish we could return to the good old-fashioned lingo of “healthy” verses “clean”. To me, clean will still always refer to Lestoil.

For a great article on the topic, by another dietitian, see Clean Eating from Good Housekeeping Magazine.

PS If you are not eating any healthy foods like fruits and vegetables, meats and grains, and you drink lots of soda instead of water, and then suddenly stop drinking that soda and start eating more healthy foods, you may indeed lose weight. It has nothing to do with eating “clean” and more to do with making some healthy choices.

When Your Thighs Change Size Overnight (or do they?)

Waves, Sand and FeetI have never heard a man complain about the size of his butt. Women, on the other hand, seem to scrutinize almost every inch of their bodies. Their hips are too big, their tummy too fat, their arms jiggle too much. Their neck is getting saggy and so are their breasts. We just can’t win in the body image world (or sometimes it seems). With eating disorders awareness week coming up, and without a week going by when I don’t hear at least one complaint from someone about their physical body, I thought it might be good to write about it. In particular, I was remembering a handout I used to use with my eating disordered patients  called “The Theory of Expando Thighs” by  Karin Kratina, PhD, RD. She is one of the most respected among the eating disorder and body image experts, so check out her website and the resources she provides (and she has a new book coming out soon).

I do want to be clear that although in my work and life I tend to hear more body image complaints from females, males are not immune. Body image concerns are not discriminatory. I bet we all know a man who complains about his abs. But for the purpose of this post, I am going to focus on women.

Anyway, I loved this handout because it was a great visual explanation of what is really going on when we look down at our thighs and it seems they have grown overnight. Sometimes our eyes don’t see the reality.  Can a body part truly change overnight? No. So why is it that sometimes we feel that way? We look in the mirror and feel good. Then, we go to get ready for work, take another look and see something totally different. How does this hijacking of our mind, this total takeover happen?

The reality for most of us is we have so much going on in our lives. Stress at work, children to deal with, families, careers, school, and so many other things to think about. Yet, somehow, the size of our thighs (butt, arms, tummy) take center stage. The need to diet, count calories, lose weight, get these thighs back to normal becomes a priority. You should be trying to figure out what to do when your senior year ends. You should be filling out applications for that new job. You should really call that marriage counselor because for once, you told yourself you were determined to make your marriage better….or to end it.

None of these challenges sound like fun. Who enjoys worrying about getting a job? Who wants to think about the future? And who in the world really wants to see a therapist and delve into something that has the potential to turn your world upside down?

That’s where those thighs come in. And the calorie counting. And the gradual obsession with numbers and food. When you see your thighs as a sudden problem, you get to stress about it. Suddenly, you conveniently have something else to worry about. This is awful, these suddenly huge thighs! Time to diet, count calories, plan menus, etc, etc, etc. Who has time to think about the “real” (difficult, painful) issue. It works. As torturous as it may sound to have your thighs grow overnight, it is much easier to deal with than the real issues.

So, instead of seeing what is actually there, our eyes just might be seeing what is going to enable us to avoid “something”.

I don’t consider myself a body image expert by any means, however I have had the privilege to be educated over the years by my former patients who often had extreme body image distortion. There was no way for me to ever understand how someone who appeared emaciated to me could look in a mirror and see themselves as someone who needed to lose weight. One day, over 20 years ago, one of my patients, a very intelligent professional woman who had suffered for several years with an eating disorder was in for a weekly visit. Her weight was dangerously low and she had been in and out of the hospital. She told me she had had an amazing thing happen. She was in the process of applying for a new job and had to go shopping for a business suit. She first went into a department store at the mall, and no matter how small of a size she tried on, the suits just were too big. She figured it was just the brand, so she went to a different store. The same thing happened. Still, she told herself, it was the store, their clothes just ran big. After several stores, she was finally in the last one, a very expensive store that she was confident would have accurate sizing. She put on a suit jacket and looked in the mirror, and for a second, she said, she saw this emaciated woman swimming in a giant coat…..which was a size double zero. She left the store. This was the first time, she said, that she had ever seen herself as others see her. She said to me, “but, the eating disorder will not allow me to see myself as I truly am because then I would have to eat”. I will never forget that woman and the story she told me. For once, it kind of made sense.

Of course, someone with a clinically diagnosed eating disorder may suffer from the extreme as far as body image. Anyone, however, can get sucked into focusing too much on their bodies and end up wasting a lot of precious time. Whether you are having body image concerns or not, if there is something in your life you are not happy with (job, relationship, etc.) I always recommend getting some help. Life is too short to not be happy. Some things we just can’t control, but if we can, why not try? Even if you are in the worst of positions, and feel stuck and immobile, making that phone call is a step. It counts. You did something. You are moving in a better direction.

So next time you glance in the mirror, and something appears vastly different than the day before, don’t beat yourself up. And please, don’t take any drastic action. Instead, ask if there might be something in your life you could be avoiding….make a vow to work on your health (a very positive and rewarding goal). If you happen to be going through a difficult time, ask yourself if you can do it alone. With Eating Disorder Awareness Week starting tomorrow, make a pledge to start with yourself by loving and appreciating the body you have.

For more resources on body image check out:

Books by Dr. Margo Maine

Pursuing Perfection: Eating Disorders. Body Myths, and Women at Midlife and Beyond (with Joe Kelly) (Routledge, 2016)

Body Wars: Making Peace with Women’s Bodies (Gurze, 2000)

The Body Myth: Adult Women and the Pressure to Be Perfect, with Joe Kelly (John Wiley, 2005)

 

 

 

 

 

 

The Gift of Passion

IMG_8442I woke up at 5:10 am today, a Saturday morning, because of it. Lying there in bed telling myself I should just try to sleep in did not work. I figured I might as well just get up and do what I wanted to do. The several random thoughts floating about in my head since about 3:30 am were kind of interesting (or so my sleepy mind thought) and I did not want to lose them. And then it struck me how joyful it felt to be compelled to get out of bed because you want to do something that you enjoy so much. And after THAT I realized, even though it is not specifically about eating, food, weight, health and all that, I wanted to write about it. Because, in a way, it’s all inter-tangled.

I am no expert on “passion”, but I do recognize it in others. And, although I often take it for granted, I know I am blessed with feeling passionate about many things in my life, my work being just one of them. Many of my closest friends know just what I mean (probably why I was drawn to them in the first place). They all work, or have worked in jobs that were much more than a paycheck. A few of them were special ed teachers, now retired. Now that I work in a school with over a hundred special needs kids, I totally get it. Your body can be filled with joy just walking down the hallway, watching the interactions of the dedicated staff and the children who love them. One of my friends who is a retired teacher (and who worked with behaviorally challenged inner city teens) now volunteers in a prison, helping to teach incarcerated men in hopes that they will have a chance at a new life.  After many years of working, you would think she might want to sit around and relax awhile, but no. I am sure the gift of joy she gets when she leaves that prison far outweighs anything else. For some of my friends, caring for elder parents as well as being there for older children fills that need. And almost all of my friends have a passion for connecting and entertaining, sharing the joy of their homes and lives with each other.

Passion for some has nothing to do with their work (let’s face it, most of us tend to take jobs we may like, but also need to make ends meet). But, they find their joy in other ways. It could be creating the most amazing desserts in the world and watching the smiles on everyone’s face when they sink their teeth in. Or maybe it is renovating things, making old things new again. Creating things such as jewelry, playing an instrument, taking up a new sport, all of these things add a dimension to life that has nothing to do with making money. Gardening is a passion for many of my friends, myself included. Even when it is covered in a foot of snow, I still get that feeling when I look out at my garden with it’s angel statues and bird baths, ice covered pond and mini windmill spinning in the cold breeze. I know what’s under there and what will be popping up in just 60 days (but who’s counting?).

What happens when people don’t have a passion? We all know someone who tends to complain about everything. Or, maybe they just never seem too happy. Their lives may appear to be OK by typical standards. They have a good job, good relationship, health, a nice place to live, yet, something is “missing”. There is no feeling of joy present. Their energy does not fill you up, but instead tends to drain you. Of course, some people have big problems in life, and it definitely affect their happiness. That is not what I am talking about. It’s when everything in life is going smoothly, yet joy is still absent. What’s going on?

Could it be the absence of passion? I don’t believe it. I think we all have something we absolutely feel passionate about, but we ignore it. We are kind of brain-washed in our culture to do what it takes to be successful, make money, support yourself (unless that is just my experience or feeling, yours may be different). So we stop giving ourselves permission to act on our passions because they no longer are the priority in life. There’s no time.

Or, maybe we lose our passion because we just can’t accomplish it. We may have something we feel strongly about and want to share it with the world in our writing, or art or music. The reality hits that getting the word out on whatever it is that is so important to you may not go far. It’s easy to give up.

Maybe there is a way to reconnect with passion and add joy to life again. Ask yourself this question: what do I love to do? what makes me happy? Then, be honest about the first thing that comes to mind (“hula-hooping” popped into my mind….may have to go to the garage and drag it out). Or, is there something you have been working on because of your convictions, passion, beliefs? Have you started a novel, a painting, a cookbook, a small company but stopped because things aren’t moving as fast as you thought? Consider the way you feel when you are creating……isn’t it in the process that you feel that passion? Doesn’t that bring joy to life?

Making time for our passion is another story. Life is busy, yes, but if you are recording even one television show, then you have time (Beachfront Bargain, This Is Us, Walking Dead, I get it). Escaping with television, Facebook and YouTube might be relaxing, but making time for your passion, and finding joy in life is worth it.

So back to this morning and my tossing and turning and deciding to just get up. I was mentally working on a presentation I am doing (on a topic I happen to feel passionate about, Motivational Interviewing for Dietitians) specifically, how to use an empathetic counseling approach when it comes to helping children with weight issues. I came up with a few ideas for slides I did not want to forget. The second thing that was mixed up right in there with the slides was how to make a vegetarian lasagna for a gathering at my mom’s today. I literally was going through all of the ingredients I knew I had (fresh mozzarella, tomatoes, cauliflower, fresh basil, garlic, black beans, fresh Parmesan) and trying to decide if I need to run out to the store. Yes, cooking is another passion of mine, especially if I can be creative. And, one more thing jumbled up in there was figuring out my tasting for my nutrition class on Monday. Since another storm is brewing for Sunday, do I need to get to the store today? Another passion, making those kids happy.

One article in Psychology Today describes passion as “the last thing you think of before going to bed”, and “the first thing you think of when you wake up”. For some people with eating and body image issues, the obsessive thoughts about restricting, exercising, dieting, etc. do not represent healthy passion, and are anything but joyful. Maybe, getting reconnected with a healthy passion can add something positive to think about. Adding even one small happy thing to life is a step in the right direction. Plant a seed. Paint a picture. Volunteer at a soup kitchen. Take your grandmother out for ice cream. Make a new recipe.Sing a song. Jump rope, dance, and yes, hula hoop.

Find your passion. It’s all good.

 

It’s Time To Talk About It

No automatic alt text available.Margaret is in her 20’s, almost done with law school, an A student with a promising career ahead of her. Debbie is 54 years old. If you saw her you might think she’s got it all together for a woman her age. She is a smart dresser, hair always perfectly in place and she has energy galore. Pedro, on the other hand, is only 17. Tall and handsome with a shy smile who is the star swimmer for his high school. One of the “cool” kids, you would think he must be enjoying every minute of his teenage years. Robert is a 62 year old man, recently retired with his wife and known for his super fit physique. He still works out at the gym several hours a day and everyone knows him there.

What do all these individuals with seemingly a lot going for them have in common? They all are suffering from a disease that often goes unnoticed……until their world collapses. These completely different people all revolve their lives around “ED”. Short for “eating disorder”. ED does not discriminate between sex, race, religion, social class or sexual orientation. But people suffering from an eating disorder often have similarities in the debilitating affect on their lives.They likely wake up every single day of their(sometimes what feels like a) facade of a life thinking about food. They may weigh themselves daily with goal weights they have been obsessing about for weeks in Pedro’s case, or years, in Robert and Debbie’s case. When the number on that scale goes up, they have a really bad day. They may record every morsel and calorie they consume in a food diary, on an app, or in their minds. They starve, they binge, they purge, they are exhausted and feel like crap. And yet, even when they reach that initial “goal weight”, they still are not happy. So they lower it. Nobody seems to notice at first because our culture just loves it when people lose weight. Comments like “you lost weight! You look so good!” just fuel the fire. Our cultural focus on bodies makes it really confusing and hard for someone to stop the often dangerous behaviors they have fallen into. Even if someone manages to avoid serious medical and physical consequences (for a while) the psychological and emotional drains on a life are not always apparent to the outsider. But the person with the eating disorder often becomes depressed as they lose previously treasured parts of their lives (socializing, family gatherings, jobs, relationships) all because ED demands it of them. It becomes really hard for the person with an eating disorder to face food at social gatherings, to listen to comments and questions from family members expressing concern over weight loss and often sickly appearance as the disease progresses. Opportunities are lost, sports scholarships are taken away, dropping out of college and leaving a job, even relationship fall-outs happen because of ED. Sometimes, binge eating leads to excessive weight gain. Unfortunately, with the focus on childhood obesity, even children aren’t immune as they get the message at a very young age that the number on that scale really matters, and it is up to them to do something about it. The bottom line is appearance and body size of a person with an eating disorder are never the same, yet assumptions are made because of this, and this is a big mistake.

Every year during the month of February, the eating disorder community of health care professionals, those who suffer(ed) with eating disorders and the people who have been affected by them make an effort to educate us all. This year, National Eating Disorders Awareness Week is February 26th through March 4th. The theme or message is “Let’s Talk About It”. This is such a great message because the fact is, the earlier an eating disorder is identified and treated, the more chance there is to prevent it from getting worse, or to beat it. We need to talk about the fact that it is a confusing world with our focus on, and fear of fat. We get confused about what is important. Is it more important to be thin or should we just focus on being healthy? How do we fight the cultural ideal and still feel good about our bodies? And most important, we need to talk about the fact that nobody is immune, and no, you can’t tell if someone is suffering just by looking at them. Eating disorders strike children, teenagers, college kids, middle-aged and older adults. Fat, thin or in-between, rich or poor, educated or not, no matter what nationality or culture, you can’t tell what someone’s life is like or how miserable they may be.

Or, you may wonder about yourself. Is your obsessive calorie counting really a problem? Do you say to yourself “well, I do need to lose weight” and think your diet is just “healthy?” but you do feel drained from thinking about it all the time? Is it a problem that you feel guilty for missing the gym? Do you constantly think about your bulging middle-aged tummy and have started cutting out foods to fix it? Do you have an eating problem you are starting to worry about? To help you answer these questions, or to at least lead you in the right direction, why not take the free screening offered by the NEDA website (National Eating Disorder Awareness). Go ahead and take the free screening Get Screened, or share with any friends and/or family members who may know loved ones they are worried about. Remember, the earlier this debilitating disease is identified and treated the better chance for recovery. Don’t wait. It’s time to talk about it.

Get Screened

Self-Sabotage or YOLO:Intrepreting That Voice in Your Head

Spending too No automatic alt text available.much time in Italy can really ruin you. After a wonderful 3 week trip over a year or so ago, to celebrate our friend’s 25th anniversary it was not easy to transition home to New England. There were no platters of beautiful homemade pastries and espresso to wake up to every morning. No liter jugs of amazing red wine sitting on the table at lunch time. No longer did we have 2 hours to linger over dinner. Back to rush rush rush. With the exception of one little habit I seemed to have fallen into. Wine.

As most people know we Italians love our wine, especially red wine. As a dietitian I have rationalized how good it is for me (and probably the reason my HDL level, the “good” cholesterol, is out of sight). The problem was, during that vacation we drank wine pretty much daily. We did not drink excessively, just often. When a liter pitcher of wine is 4 dollars, why not have it with your pizza while sitting outside under an umbrella in the sunshine on a cliffside in Cinque Terre, or while watching the children chase the pigeons at an outdoor cafe on the island of Murano? After all, You Only Live Once.

When I got home, a meal no longer felt complete without a glass of good wine. Oh, and of course I needed to find one of those glass pitchers that were all over Italy (and no where to be found in stores in CT). I finally found one on-line and was all set. Unfortunately, the reality that I was no longer in Italy and had to go to work took a while to sink in. I found myself sleeping poorly. People think alcohol makes you relaxed and sleep better, but it actually interferes with sleep. And for me, someone who needs to remember to drink water, I found myself getting somewhat dehydrated on a daily basis. Not good.

Since then, I have obviously had to readjust to real life. As I was working on easing back into a healthier lifestyle, I noticed some very interesting things going on in my head. You know, that voice we all have in our minds, often referred to as “self-talk”. I have written about self-talk before, and how important it is to be aware of what you are saying to yourself, as thoughts affect mood and moods then affect behavior. When there is a constant negative dialogue going on, eventually negative, or non-supportive, and often unhealthy behavior results. So, as I have been reflecting on this wine “habit” I have come to the conclusion that it is very difficult to distinguish between when this voice is giving appropriate advice, or when it is basically trying to undo all efforts and progress to a healthier lifestyle. I am passionate about savoring life and all it has to offer. I absolutely LOVE the expression You Only Live Once (YOLO). I don’t believe in rigid anything. Rigid diets, rigid exercise plans, rigid house cleaning, rigid schedules. When life gives you the opportunity to experience something awesome, I say go with it. For example, I was planning on getting some work done last Saturday, but then found out there was a Women’s March in my state that I had the opportunity to join. The work could wait. Sometimes, if I come home from work after a long day and tell myself I need to rest, and my husband had a hard day at work and wants to go our for dinner, I quickly change my mind about that rest. I love rolling with it all. You know, YOLO.

But sometimes, I may come home from an especially chaotic day at work, feel emotionally drained, and cracking open a bottle of wine makes lots of sense. The dialogue in my brain may go something like this: “You deserve it. You only live once!” When this same dialogue happens more than once in awhile, well, an unhealthy habit is formed. That YOLO language sounds more like sabotage.  One definition of sabotage: “any undermining of a cause”. I came to the conclusion it is not always obvious or easy to keep a healthy balance in life when it comes to living that happy-but-healthy-ish lifestyle we all want. How do we find that balance, and know for sure that we need to go for it (YOLO), or that we need to make a different choice because in reality we are sabotaging our efforts, or “undermining our cause”of wanting to be somewhat healthy?

After much reflection, here is my advice to those who can relate to this, and also struggle with the balance between enjoying all life has to offer, yet maintaining healthy balance in life. Remember, this is my experience only. Yours may be different.

  1. Ask yourself: do I have a “cause”? By this I mean a health goal. Is there something your doctor may have identified (high blood pressure, a need to decrease salt), or maybe a health goal you have for yourself (increase physical activity, decrease alcohol, etc). If something jumps to mind right away, then you know what it is. You must also ask yourself it this cause or goal is healthy and realistic. For example, if it is an extreme weight loss goal or anything to do with perfectionism, then it may not be a healthy cause. A true cause typically is more about clear-cut and damaging behaviors you may have fallen into and really do want to change (plopping on the couch, grabbing a drink, etc).
  2. If you have identified a specific behavior you want to change, and it is a realistic goal (litmus test: do most people agree this is a healthy goal?) take the time to identify your triggers. For example, for me, having an open bottle of my favorite wine in the fridge is not too wise, and may be referred to as a “sabotaging environment”. For the person who really needs to increase physical activity for health reasons, putting on your jammies the minute you walk in the door is also self-sabotage.
  3. Once you identify your triggers, modify your environment towards being more supportive. Make it doable. For the person who wants to increase activity, put on sneakers instead of slippers. Start small.
  4. Pay attention to your dialogue without judgement. Notice how hard it is to ignore. Even if you give in (I am putting on my PJs, I deserve it! YOLO!) don’t judge yourself. Instead, reflect on the reality (how many days are you actually putting on those PJ”s, and are you expecting too much to stop this behavior every single day? Can you modify your goal to make it doable?) If you change your dialogue to one of acceptance and learning (“wow, that was harder than I thought. Let me readjust this. On Tuesday and Thursdays I am putting on sneakers). In my world, Friday happy hour is totally good with me. And if a friend I have not seen in awhile invites me to happy hour during the week, I am going. This is not about being perfect. It is about gradually changing bad habits.
  5. Substitute a new behavior for the old one you want to change. Omitting something from your life leaves a huge void. You need to fill it up with something equally enjoyable but more supportive of your goals for health. For me, having a constant cup of hot herbal tea is symbolic of relaxation and serves a similar purpose as that wine. I feel like I deserve it and it represents nurturing.
  6. Instead of jumping right into your old behavior when it feels like a YOLO moment, take 20 minutes to stop and think. Postpone it, take a long hot shower and relax and think about your goals for yourself. Then make a decision without judgement. Is this just an automatic impulse, or is it truly an opportunity that arose, or a true need (you really may be exhausted and need to go straight to that couch). Some days are like that and it’s all good.
  7. Remember, it is repetition that creates habits, both good and bad. Once you get a few weeks under your belt of a new healthy behavior, you do feel better, both physically and emotionally. After a month or so, some new habits will take hold. After this, when you feel a YOLO moment coming on, go for it! Once it is a mindful choice and not just an automatic conditioned habitual response, then it truly is ok to totally enjoy every moment of every day. But, you want it to be your choice, not mindless.
  8.  Give yourself time. Don’t give up! Remember, it is all a learning experience.

I will always want to enjoy as much of every day as I can. I light candles for ambiance, even if nobody is home. I have “happy clothes” which I put on the moment I walk in the door. I may take hours to cook a single meal on Sunday because I enjoy every minute. But, these things don’t interfere with my health. Lack of sleep and dehydration definitely do. If you have something that makes you feel less than optimal, don’t beat yourself up or expect change tomorrow. But do start paying attention to that dialogue in your head. THAT is where to start, the rest will eventually fall in place. And if not, seek help. Life is too short and remember….YOLO!

 

GMO Foods Safe To Eat? New Report

IMG_7748I woke up yesterday morning, falling into my usual routine (heading straight to the coffee pot) and found an open magazine, folded over to a page entitled “The Verdict on GMO Foods: Safe to Eat””.Once in awhile my husband will come across an article on nutrition in one of his financial magazines he likes to read. He then will leave it out for me to read (in this case, it was Kiplinger’s Personal Finance Magazine). It was a short but informative article on a very recent and important report that was just released after a “2 year review of 900 research publications” by 20 scientists (according to the one page article). In addition to reviewing the research studies, the committee of scientists also looked at the incidence of certain conditions (cancer, obesity, autism,food allergy, diabetes, celiac disease, kidney disease) in Western Europe (where GMO’s are restricted) and North America (where they are not). They found no differences in the incidence of these diseases and conditions (suggesting that differences would be expected if GMO’s played a role). I don’t give much credit to “associations”……just because they didn’t find any is somewhat meaningless to me, but that is just my opinion.

The third point mentioned in this article was the fact that we really can’t distinguish differences between plants that are “conventionally bred” to be herbicide-resistant and plants that are genetically engineered to be. Apparently, it is difficult to tell the difference between the two, so it may be more important to look at the “product, not the process”. This appears to be the bottom line: experts call for an approach to regulation “that uses trait novelty, potential hazard and exposure as criteria” instead of making “sweeping, generalized statements about the benefits or adverse effects” of GMO foods. This makes sense to me. The process may be less important than the final product. The article even mentioned the fact that in the future, genetic engineering may enable us to make foods even healthier…hhhmmmm. My brain is having a hard time wrapping around that one.

When it comes to the push to label GMO foods, the controversy is that if they are considered safe, why do we need to label them? On the other hand, consumers have a right to know what they are eating. Just because this review states (for now) they appear to be safe, even the reports states “that doesn’t mean there will never be a risk”. I, for one, like knowing what I am buying. Also, as will saccharin and nicotine, it takes time to learn about these things. Hopefully, this report won’t hamper efforts towards labeling GMO ingredients.

For those of you interested in the details of the report (you can scroll around to the sections you are interested in), see the NAS website link at:

National Academy of Science Website

As with anything, and despite whatever scientific findings, we can make our own decisions regarding what we feel good about eating. I will continue to prefer cooking my own meals, with lots of colors and natural ingredients, herbs from my own garden, thrown together randomly as usual….I won’t freak if I find out something I ate was genetically modified, but to be honest, if it says “non-GMO” on the label, I am happy. Yes, although I prefer the flavor of home cooked foods, I will eat processed food if that’s what there is (nothing wrong with an occasional can of Progresso Minestrone Soup). Or a ritz cracker. The bottom line is healthy eating means being informed but then, making up your own mind. My cardinal apparently has made up his mind to eat non-GMO berries….and appears to be thriving.
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Restrained Eating Vs Intuitive Eating: Finding the Balance

donut vs apple and womanI was not surprised when my doctor told me I needed to take a calcium and vitamin D supplement after a recent bone density exam. Being at the age where bone density starts to diminish, and being a dietitian on top of it, I was fully aware that my intake of calcium was sub-optimal. But time flies by, doesn’t it? No matter how much I know about nutrition, somehow here I am. Although I do believe in good nutrition I have never been a fan of thinking about it too much (unusual maybe for someone in my field of work).

The reality is that dietitians and nutritionists are probably at a distinct disadvantage when it comes to “cognitive restraint”, or using your head to figure out what to eat instead of listening to your body. Our training can make it kind of difficult to “listen to your body” or “eat intuitively” which often translates into “eat whatever you want for heaven’s sake”. So, although I was well-aware of my dietary inadequacy, I admit to leaning more heavily into the “eat whatever you want for heaven’s sake” mentality…..which was not too good for my bones apparently.

When you hear the term “intuitive eating” it typically is in reference to dieting behavior and offered as an alternative to stop the insanity of dieting. Yes, billions of people diet to lose weight, and many yo-yo, gaining and losing the same weight year after year (which we know is not good for our health, yet it is hard to give up that hope that this time it will stick). Despite the statistics on the failure of diets, I don’t tell people what to do and will support those who wish to follow some type of guideline because for some people, re-learning how to eat can be very helpful, and yes, it can stick. But this is probably rare, and from what I have seen at least in my patients is when it “sticks”too much it is really disordered eating. When it “sticks” in a non-harmful way is when individuals truly change detrimental habits even when they no longer are following a specific “diet plan”. So, how can you prevent the negative consequences of “cognitive” eating yet also avoid the repercussions of interpreting “intuitive eating” as meaning  “eat whatever you want”? The trick is learning how to do both: be “cognitive”, but also intuitive, gradually interweaving both into your eating style so that you can be both healthy and sane.

The first step is to try to determine if you are a “restrained eater”. Although “cognitive restraint” is often defined by the experts  as “the intent to limit food intake to prevent weight gain or to promote weight loss” to keep it simple, I like to think of cognitive restraint as “using your head to figure out what to eat” despite the signals coming from your body. Sometimes people think too much about food even if it is not because of weight related issues. For example, it is lunch time and you brought a salad. You are absolutely famished, craving a burger but will not allow yourself to go to the cafeteria to get one. You read somewhere that red meat is bad for you so you are not going to eat it. Or, it is 9 pm at night, you are counting your calories and according to your records, you still have 200 calories left that you can eat. You are not hungry at all…..yet you go ahead and pop some popcorn because you like popcorn and you “can have it” since it is just the correct amount of calories. You don’t pay any attention to the fact that you are not hungry. Both situations are examples of “cognitive” restraint, using your head and ignoring your body. Both examples are contrary to “intuitive” eating.

For research, investigators use very specific tools to evaluate if someone is a restrained eater or not. Some of the common characteristics of restrained eaters include, but are not limited to:

  • frequent dieting
  • counting calories
  • self-weighing
  • excessive fear of weight gain
  • guilt after eating
  • food avoidance
  • labeling foods as “good” or “bad”

For our purposes, if you can relate to any of these statements, you may have some characteristics of restrained eating. For those of us who are dietitians or nutritionists, or even those of you who educate yourself about foods and nutrition, you can also fall into the trap of too much thinking about what you eat. I have seen extremes in thinking when it comes to nutrition, with fads coming and going as well as information that is not evidence-based. Some examples include avoiding gluten at all costs, not eating carbs,avoiding foods with added sugar, avoiding processed foods, etc. Some people need to be on special diets due to medical conditions or allergies, or even having a digestive intolerance to a food. Avoiding GMO’s or choosing to eat organic or fresh food is not what I am talking about. It is having an unreasonable fear of foods that on occasion have no affect on health whatsoever. Missing out on eating your grandmother’s famous sticky buns on a holiday because you have chosen to avoid gluten (without evidence of an allergy or medical condition) is restrained eating. Feeling guilty because you “don’t eat processed foods” yet gave in and bought some Girl Scout Cookies to support your niece (plus you LOVE Thin Mints) is also unrealistic. Refusing to eat a meal in a restaurant because you don’t know what they put in it (even if you don’t have food allergies) might be an issue. If what you allow and don’t allow yourself to eat tends to interfere with your social life, well, that may suggest a problem.

What about “Intuitive Eating”? The basic principles of intuitive eating can be found on the website Intuitive Eating. Basically, learning to be more intuitive with eating means getting re-connected with your natural body signals, rejecting the “diet mentality” and relearning how to trust your body’s natural wisdom. This sounds simple, but it is downright scary for many. “If I let myself eat what I want, I will gain 50 pounds! I will live on cookies and ice cream!” or so the thinking goes. To be honest, from what I have seen in former patients, the process of moving into a more intuitive eating style is different for every single person and depends on their unique eating/dieting history. I have seen people do exactly that: live on ice cream for a week. If you have lived for several decades denying yourself certain foods and suddenly the bars come down, it is almost instinctual to dive in! But a funny thing tends to happen. You honestly and truly DO get sick of ice cream. Suddenly, grilled chicken looks very appealing. The wisdom of your body really does win out in the end. But the path is not always simple or easy (which is why I always recommend anyone who has a history of dieting and is tired of it seek the help of a therapist and a dietitian, preferably both who have experience working with individuals with eating issues). Some people do fine on their own, after reading the book Intuitive Eating by Evelyn Tribole (Author), Elyse Resch (Author) they can gradually make the changes they need to free themselves and move into a healthier relationship with eating and food.

The question is, how do we be both “intuitive” and eat what we want while listening to our natural body signals (and trusting them) yet also be “cognitive” in a way that helps us make smart and healthy decisions about eating? I feel ignoring nutrition is a mistake. I like the term suggested with intuitive eating called “gentle nutrition”. The reality is, if we eat a variety of all of the food groups (meats or protein foods, fruits and veggies, grains or starches or other carbs, dairy and fat) we tend to crave less. Imbalances trigger cravings. Remember the chemical messengers our bodies have to tell our brains what we are missing?  For example, serotonin levels drop in our brains when we don’t get enough carbs and trigger us to want sugar or sweets (survival!). Yes, our bodies are pretty darn smart that way. Eating well also makes us feel well. Learning what makes you feel your best (with foods that you actually really enjoy) is key. One example I often give is eating adequate protein to avoid that afternoon blood sugar crash. Without it, you will almost be guaranteed to run out of energy and be excessively hungry which is really irritating when you are at work and there is no fridge to run to. So planning to include your favorite yummy protein packed lunch is not what I call excessive “cognitive” restraint, but smart and enjoyable eating. Yes, you do have to think about it. But over time, you start to find your favorite, doable, somewhat healthy meals and snacks that taste good and make you feel good. You may make mistakes, you may change your mind (we all get burnt out on foods, even our favorites) and so you experiment with other meals and foods. The key is to keep learning through trial and error. You do have to educate yourself a bit about nutrition (the basics, not fads, even the My Plate government website is helpful for basic nutrition info if you can promise me you will ignore the weight loss focus of some of the links). Once you get a basic idea of how to balance meals to feel good and meet your basic needs, experimenting with cooking is also helpful. Last night I took my mom grocery shopping and made her favorite black bean and corn salad. She just loves it, and to watch her tasting it, you would have thought she was eating something amazing (to her it was, to me it is just bean salad, good, but not lobster salad which is much more amazing if you ask me). The point is, good food should be yummy, too.

For those of you interested in the reasons restrained eating often leads to increased hunger, you may enjoy the research article  Cognitive Restraint and Appetite Regulating Hormones which describes a connection between ghrelin, the “hungry” messenger and dietary restraint. Despite the leaps and bounds we have made in understanding how what we eat affects our brain chemistry and appetite, there’s lots we still don’t know. All the more reason to work on a better connection to the natural wisdom of your body.

One more thing. Clearly, knowledge about nutrition does not translate into action. I was well aware that I probably was not getting enough calcium in my diet (the ice cream in my morning coffee, yogurt and grated cheese on everything was not enough). Don’t be like me and wait for something to happen. I did purchase that supplement. Now I need to remember to take it : O

One step at a time.