Checking Out: Sometimes, you just gotta do it

IMG_9335I cannot believe so much time has passed. Here it is, St. Patty’s Day 2019 and I have not written anything since last Fall? I used to be so disciplined, waking up early every Saturday morning to write. There was always something that felt pressing to talk about, or some important message (in my mind) to share with whoever might be interested. Sometimes, I just needed to vent over some ridiculous diet thing I came across, to be sure to set it straight. Over the past several weeks (months), however, I feel like I have “checked out”. Trust me, there have been moments where I have said to myself “OMG, you need to write something about that, that is ridiculous!”. But then, the holidays came, I needed to visit my mom, the couch looked more inviting than the computer, “This Is Us” sucked me in. Football. Politics. You name it, I had an excuse.

What motivates me now to write again? It struck me that what I am going through is probably very common. The feelings that surface when you don’t do what you think you should be doing are different depending on who you are, but I am guessing there are lots of people like me who feel a bit guilty, inadequate, not living up to expectations. The funny thing is that at this point in my life I thought I had gotten over all that. “It’s good enough” has been my mantra for years now. And yet, I have been judgmental of myself, feeling “intellectually lazy”. By that I mean, I just don’t feel like thinking sometimes. This is different than just feeling “lazy” physically, which happens to all of us (listen to your body, I always say).

Anyway, with the New Year come and gone, I thought, “should I make a resolution to start writing again?” Nah. Anyone who knows me knows I don’t believe in setting unrealistic expectations for yourself (just another reason to feel inadequate!). Instead, I have kind of accepted that my life may be shifting as I get older, closer to retirement age (although as of now, I just can’t imagine not working at the jobs I love, with people I cherish). Maybe it is coming to the realization that as time goes by, career is so much less important to me than other things in life. I feel like things are changing fast. I see my mom getting older, slowing down. And although I haven’t lost energy physically (thank God) when mom and I go for long rides in the countryside, neither one of us can remember where we are going or how we got there….FYI if you have to get lost in Connecticut, Litchfield and Cornwall are beautiful, New Haven not so much.

Yes, I have to admit I enjoy getting lost in the countryside and listening to my mom’s stories much more than thinking about dietitian kind of things. There are times when I quite honestly am really tired of being a “nutritionist”. I get tired of the reality that so many people think about eating and food in ways that to me are just not fun. Sometimes it makes me sad that a person can’t just “dig in” and enjoy food because their thoughts are busy judging, fretting, worrying, feeling guilty, planning, ugh. Sometimes I wish I did not notice these things, but because of my career and because of the clients I worked with for so many years, I can’t help it. I have spent decades trying to undo whatever damage I can, every chance I can. Even though I don’t work specifically with eating disorders any longer, I still try to give anyone a reality check who asks me for one. “Is the keto diet good?” NO. “Aren’t carbs fattening? ” NO. “Should I count calories?” NO.  And on and on and on. I have been trying in my daily life to help anyone who asks me a nutrition question to avoid the lure of crazy diets that promise to make you into something that supposedly is better than who you are right now. I have spent lots of energy over the years trying to teach people, anyone who asks, about a more holistic approach to feeling happy and good in your body. This involves intuitive eating (which is much harder for some than others, much more difficult than it sounds for those who have dieted or who have body image issues or disordered eating). It also involves good sleep, joyful movement, good hydration, healthy relationships and mental health in general.

So I guess the reason I needed a “time out” or to “check out” for awhile is just because I got tired. And just because I am writing now does not change anything. I still am tired of thinking about nutrition, but I am not tired of trying to help others enjoy their lives. I may have just shifted, I have noticed, into enjoying the cooking and cuisine aspect of it all more than the nutrition aspect. It is just so awesome to watch as someone (tentatively) tries a spinach ball or mango salsa for the first time, and ends of loving it. It is even more rewarding to see an autistic kiddo who used to only eat candy now accept pears and strawberries and blueberries. It even makes me happy when my corn-dog lovin husband tells me my quinoa sliders are delicious : D

My priorities have definitely shifted, and I honestly don’t know when I may feel like writing again, and who knows what I may feel like writing about….but spring is around the corner, so I am guessing it may have to do with flowers…..

In the meantime, please check out this article about how people judge what we eat, it says it all     .Don’t Judge

Happy St. Patty’s Day!! Hope you eat or drink something green today, and I don’t mean kale!

 

Two Cookies and a Yogurt

Image may contain: foodThe other day I was casually chatting with a young man about healthy eating. When someone finds out you are a dietitian they often have lots of questions. Anyway, this young man said something that really stuck in my head: “I feel like a war is going on in my head” he said when talking about trying to eat healthier. Apparently, he had been trying to lose weight and thought he should totally avoid eating junk food, and, just like everyone else who tries to “not eat” something, it creates a struggle.  But the way he described it as a “war” made me think. I actually could relate to having “wars” in my head with lots of things. We all have ideas of what the “right’ thing to do is, and struggle with decisions on a daily basis. Whether it be about what we should be accomplishing, if we should spend money on something, if we should have another drink, or visit a loved one, or make an appointment for a colonoscopy.

But when it comes to food and eating, what does this “war” mean? What is going on here? Where does it all stem from?

I have my opinion about that war, and where it originates when it comes to eating, and it is complicated. I don’t think we can ever totally come to a conclusion with this as everyone’s experience is different. I know people who grew up with health food nuts (sorry, don’t mean to offend anyone, but I am referring to those who are kind of obsessed with eating healthy foods only…..whatever you consider healthy food….you are talking to an Italian here, I have trouble thinking sausage is not ok). And then there are those who have a different food background with cultures dictating the foods they are exposed to. Or, think about someone who grew up with a weight watcher kind of mom who was always dieting and talking about her weight, jumping on a scale and degrading herself depending on the force of gravity that day. Another common scenario I have seen these days is the truly good and caring parents who have heard from the pediatrician about BMI concerns with their child. These parents unknowingly start thinking they need to restrict their children and scold them for wanting what everyone else is eating. Then of course there is the cultural influence, the final word of what we are supposed to look like. One year big breasts are the thing to have for women and the next year it is all about muscles. Abs always seem to be “in”. The bottom line is how we look at food can be complicated. God bless the untainted soul who somehow is resilient to all of it. Far and few between.

No matter what the contributing factors are as to why an individual may be so affected as to feel at war with themselves when it comes to food, it is helpful to know we are not alone. The experts have been looking into this for many years. There happens to be decades of research exploring this phenomenon of what is typically referred to as “restrained eating”. I have talked about this before as it is a theme that never seems to have disappeared. People don’t seem to stop and re-evaluate, even when they experience the same thing over and over (dieting, losing weight, gaining it back, dieting again). Not sure why, but guessing it has to do with the constant focus and pressure on being the right body size, something that women especially seem to distract themselves with. Although those suffering from eating disorders focus on eating, weight and food for other reasons, I am referring to the “typical” dieter, that person who just simply wants to lose weight. Even for these people, looking at food in a restrictive way eventually can become harmful. The person who starts out just wanting to lose a few pounds often starts to look at food in a different way (once they start dieting). For example, before the weight concerns and dieting/restrained eating started, maybe they were a bit picky about what kind of cookie they liked. They could easily refuse an oreo because they only liked their mom’s homemade oatmeal cookies. Nothing could hold a candle to those. But, suddenly, after 3 months of dieting and avoiding sweets altogether, even fake cookies look good. At a meeting at work, if cookies are on the table, they call out to dieters. The bigger the “war” in a person’s head, the louder that cookie’s voice. The non-dieter, on the other hand, may glance at those cookies and just not want one. Yes, any cookie takes on a different meaning depending on the war in someone’s head.

But is it not just about cookies. According to that young man I was talking to, any “bad” food was a food to be avoided. Once he realized he needed to lose weight he fell into the trap of thinking what everyone else in the world seems to think: certain foods make you fat and other (healthy) foods don’t. The good/bad  all-or-nothing thinking when it comes to food is the problem yet again. Giving any one food this particular power is a mistake. When it comes to health (or even weight for that matter) NO FOOD IN THE WORLD has the power to affect either (well, unless of course it is poisonous, but that is not what I am talking about and I think you know just what I mean).

What I told this young man is the same thing I will tell you. Yes, nutrition matters because eating a variety of healthy foods gives us everything we need to feel good, do what we want and prevent illness. But, it does not have to be that complicated. I believe in working on “mindful” and “intuitive” eating, and listening to one’s body, which is not easy for everyone (especially dieters or those with eating disorders). But, for the typical dieter who is at war with themselves, I have seen it work to free them. I have seen people actually learn to have just one slice of cake instead of half of the entire cake…..like they did when they told themselves they should not have any, ever. When people are able to tune out the “war” voice, and instead tune in to their true hunger and actually give themselves permission to have it, a funny thing happens. Your body really does not need or want more than a normal amount of anything. It is only when we deprive ourselves, when we restrict and unrealistically tell ourselves we can’t ever eat something that we break down and overeat it. And continue a war that we will never win.

Instead, I suggest you care about your health, make it a priority. Eat your vegetables (experiment with ways to prepare them to make them taste yummy such as roasting). Include protein sources with all your meals because it makes you feel better and last longer. Eat fruits you enjoy because they taste good and are healthy. Buy wheat bread instead of white. But, for heaven’s sake, don’t go to war over something as simple as a food choice. Your body knows what to do if you learn to listen to it. A normal serving of anything will never hurt you. But, if you deprive yourself, you definitely will be more obsessed with food and more likely to overeat and binge on it…..and not feel so good afterward.

Oh, you might be wondering what the heck “Two Cookies and a Yogurt” means. Well, I hate throwing away food, especially cookies. So on New Year’s Eve when my good friends Barbara and Fred had us over, there were gobs of Italian cookies leftover. She offered them to me, and well, you know, I couldn’t say no. They ended up in my freezer and I have been having them with my coffee for breakfast ever since (only 6 left I think!) No, cookies do not comprise a well balanced breakfast however, throw in a Greek yogurt and you are good to go. Well, I am. Everyone is different. Eat what is good for YOU for breakfast.

But don’t go to war over a cookie.

 

 

5 Tips to Deal With Food Anxiety: When You Can’t Make Up Your Mind About What to Eat

buffetI am not a fan of buffets. I remember the very first time I went on a cruise, and hearing about the buffets and how wonderful they were. Not to me. Don’t get me wrong, the food looked amazing, but there were way too many choices: Asian food, Mexican, Italian, Thai, sushi bar, ice cream bar, salad bar, dessert bar, fruit bar and good old American burgers and fries. I would see something I thought looked yummy, but then walk a few feet and change my mind. I know the limits of my tummy capacity and there was no way I could try something of everything. So instead, we decided on the sit down dinner option (the only negative being you had to look presentable). Anyway, this option ended up being perfect. Each night we were presented with a limited (gourmet) menu with only a few choices for appetizer, salad, main course and dessert. This I could do. Not to mention, we were treated like royalty, and the food was spectacular. I loved it.

Cruises aside, I believe having anxiety about what to eat or even whether to eat is a common thing, especially among those who are trying to eat healthier, or trying to lose weight. Yesterday I did a workshop on a college campus (all women) and one of the questions was “How do we know what to eat? What do we go by? I have a friend who writes everything down, all this information about what she is eating (like grams of carbs, calories, fat), it seems so stressful, and I just don’t have time for that!”

Great question, I thought. But it is so hard to answer in this technological and perfect-body focused world we live in. Even websites and apps with good intentions, and that want to promote health (such as the Choose My Plate website) seem to be fat-phobic and hyper-focused on monitoring every morsel of food and calorie burned in exercise, all with the intent of assisting someone in attaining a lower weight. But with technology, and all of the new food products out there taking advantage of our phobias of sugar and carbs and fat, it really can get confusing. I hear people wondering out loud if their lunch is healthy, if they should eat this or that, complaining about eating something they consider “bad”, feelings of guilt about what they eat, or what they want to eat. When it comes to deciding what to eat for breakfast, or what to pack (or buy) for lunch, or what to cook for dinner, people struggle. And when a restaurant is involved, it can get very confusing.

Some people may not be able to relate to this stress at all. They eat whatever is there. They truly don’t care. God bless you! But please don’t get frustrated with your family members or friends who just can’t ignore the bombardment of nutrition information or body shaming that is out there. So, this post is for them. If you get really confused about what to eat, or if you feel bad about choices you sometimes make, here are some tips I hope make you feel better. After all, eating is only one small part of your very interesting life!

Tip #1: Food isn’t everything. Look at your “big picture”. When it comes to being healthy, things like stress at work, poor sleep, not exercising and not having good friends and/or family are truly more important. Food comes next. If you figure out how to make everything else good, usually eating healthy is much easier. So, answer these questions honestly: do you sleep well? are your relationships healthy and nurturing? do you love what you do? are you able to be active? If you don’t have these issues settled then it will be much harder to figure out how to manage to eat healthier too.

Tip#2: Do you eat your 3 meals a day? Breakfast, lunch and dinner are words that our modern lifestyle seems to forget. Back in the day, I remember looking forward to eating lunch. These days, lots of people feel guilty taking time out of their busy lives to enjoy a good lunch and instead get by with coffee, packages of crackers or fast snacks. They down giant coffees instead of breakfast and wonder whey they need to nibble all night. Making meal times a priority in your life is important. If you nurture your body by giving it enough energy in the form of a meal three times a day, you are more likely to feel good, have energy and make wiser choices when it comes to eating and your health.

Tip # 3: When it is time to decide what to eat, and you are confused, ask yourself: am I craving anything? If you are, well, there is your answer as far as what to eat. Remember, a craving is when you really want something that you did not see. It is different than a trigger food, which is a food you see and then think you want. You can get over a trigger food, because once you walk by it (or change the channel or walk away from the coffee break room where the donuts are) you will forget about that food. But, if you are truly craving a food, if it is on your mind all day (for example, I sometimes really really really want Buffalo Wild Wings boneless Thai wings and boneless Garlic Parmesan wings). I start thinking about them at work and have to order them so I can pick them up on the way home. This happens about 3 or 4 times a year. It doesn’t matter what I may have planned for dinner or what is simmering in the crock pot. I want wings. I believe in listening to that voice that tells you that you want something specific. You really can live without a salad every meal. If, on the other hand, you are not craving anything specific, then by all means, go home and have that yummy healthy whatever you are simmering in that crock pot. (Note: for those suffering from Binge Eating Disorder or other eating disorder, this advice may not apply and you should use the strategies that work for you).

Tip #4: If you are one of those people who are confused about your feelings of hunger (not really sure if you are hungry or not) then it can be difficult to know if you should eat or not. If you can relate to this, then you might want to do some reflecting at those moments when you are wanting to eat, or not sure if you should eat, or perplexed as to how much you should eat. First, ask yourself: when did I last eat? If it was an hour ago then you may not really be hungry. If it was over 4 hours ago then chances are, your are hungry and need to eat. But the other important question to ask is”what did I eat?” If you actually did eat only an hour ago but thought you could get by with just a yogurt for lunch, then you my friend are probably hungry. If, on the other hand, only an hour has gone by and you had a good meal with protein, fat, carbs and fiber (think nice sandwich with meat on a roll, lettuce and tomato, some pretzels and a yogurt) then you might not really be hungry and should try to figure out what you really DO need.

Tip#5: Nutrition Matters, but one meal does not make the man (or woman). In other words, yes, you need to learn about healthy eating, cooking, food preparation, and the basics about what someone your age needs to have energy and be healthy. You may not like milk so may need a calcium supplement. You may not eat meat so would need to find another source or protein and iron. Yes, there is a reason we nutritionists say you need to “eat a rainbow” every day (make half that plate colors!) But, your body does not really care that your day to day eating has to be perfect. All it cares about is that over time, you get what you need. Nothing bad will ever happen just because you did not drink milk or eat veggies and fruits for a day or 2. Trends over time are what matter.

So, if you don’t want to think too much about eating or nutrition, well, that might be a good thing. Instead, keep it easy. Just work on increasing the basics: more fruits and veggies, including protein foods with your meals so you don’t crash and drinking more water.

Extra Tip: If you ever find you stress out too much about what to eat you may want to seek out some support from a therapist who specializes in eating issues. Life is too short, and eating should be a joy, not add stress to your life. In fact, too much anxiety around eating may be a risk factor for disordered eating (see link below for a summary article on the relationship between anxiety and eating disorders). In the mean time, enjoy those buffets in moderation. Me, I will be at Buffalo Wild Wings.

Anxiety and Disordered Eating

 

Nutrition 101: Eat Like a Kid

Dunkin Donuts 0006

When I was a kid, I loved Sundays. My family would all go to church and after the mass my older sister and I would walk over to the rectory (where the priests lived) and go down to the basement to open the  money envelopes. It was a job we got paid for in donuts. Yup, after all the envelopes were open and counted, Father Flower (his real name) would come in with a box of donuts for all of us (maybe a half dozen of us trustworthy young Catholics). I loved donuts back then because we rarely got them. They were a treat. But it didn’t end there.

My dad would pick us up and him and I would go together to Valley Acres. This was a small local store that had the best cold cuts in town. We would wait in line and get our ham and salami and provolone. Next stop, Lin Lou’s bakery for the poppy seed hard rolls and Italian bread, the best. Finally, home for lunch. Mom would have the peppers all fried up by now. We would make the most delicious sandwiches on those fresh rolls with provolone and ham and salami  and fried peppers (nobody thought about cholesterol back then). After that, I would help my mom make the meatballs (it was Sunday after all, which was always pasta day, sauce, meatballs, sausage, eggplant if mom was feeling like it). I loved grating the Italian cheese and mixing up the meatballs for my mom. She would do the cooking and then we would all go playing outside while the sauce simmered all day. No electronics back then, and only 3 channels on the TV so not worth it, unless of course it was football season. Then I would be on the couch with my dad, glued to the Green Bay Packers, his team. Anyway, dinner would be all together at the kitchen table, a big bowl of meatballs and Italian sausage, pasta with sauce and freshly grated cheese, great Italian bread from Lin Lou’s bakery, green salad with tomatoes and cucumbers and lots of oregano and olive oil. Maybe dad would have a glass of cheap Italian red wine, and we would eat and enjoy every bite. Then we did our jobs, clearing the table, doing the dishes, putting them away. And that was it.

Today, many years later, I think about how eating was back then. Nobody really thought about it much that I can remember. When it came to eating as a kid, all I remember was that I loved the food my mom cooked. I loved the Italian traditions. And I loved those donuts. I sometimes roll my eyes when I listen to adults talk about food and diets and nutrition, and I often think “TOO MUCH THINKING!!!” Somehow, we survived, even without knowing much about nutrition. We just ate. And, mostly, we ate what we liked. What happened? Why don’t people do that anymore? How did it get to where we need to analyze every morsel we put in our mouths?

Yes, since then, we have learned a lot about how to eat to be healthy. We have learned about antioxidants and phytochemicals and fiber. Funny thing, the old advice of “eat your vegetables” pretty much covers all that. Back then, fast food establishments were far and few between. We had one McDonald’s in the state of Connecticut when I was in grade school and when we went once or twice a year, it was a treat. Those discs of a burger were very different than my dad’s burgers on the grill, but french fries were something new. Yes, we enjoyed our McDonald’s and it did no damage. But then again, we went so infrequently, and there were only normal sized burgers and fries and one size of shake. These days our food environment is much different. I think it messes with our natural ability to eat the right amount. I have worked with lots of families who don’t have much money, so going to buffets is a big treat. Back when I was in high school we had to drive to a different state to get to a buffet. It was a once a year thing all teenagers did when they got their license…I think the place was called Custy’s and it was in Rhode Island and the big draw was the seafood…lobster, shrimp and all the kinds of things you really could not afford on a regular basis. I never went but I was fascinated by the stories of how much people ate…how many lobsters, pounds of shrimp, etc. I didn’t really get it because I did not eat fish back then.

Looking back at our attitudes and behavior around food as kids or even teenagers is interesting when you compare it to how we think about food as adults. Somehow, along the line we lose something. We seem to lose (from my experiences anyway) simple appreciation for yummy food without judgment. As adults, we just can’t seem to help adding our adjectives to food. “This is bad but I am not eating carbs tomorrow”. When we go to a party or out to dinner, instead of looking at the menu for your favorite food, or to see what sounds the most yummy (like you did when you were little), most people are weighing the calories or healthiness or carbs or trying to figure out the points.  All of these cognitive methods to figure out what to eat weigh in to help you make the “right” or “healthy”decision about what to get. But, what most people are unaware of is that all this thinking interferes with your natural ability to choose food you like and enjoy.

Sometimes, of course, people who are on a “diet” or restricting to lose weight tend to behave somewhat differently. If they are being “bad” they tune out their body altogether, order too much food, overeat and feel very uncomfortable after because tomorrow, they will be “good” again. This is not what I am referring to as far as natural eating and choosing what you like. This is almost the opposite extreme, a type of “force-feeding” borne out of food insecurity, or the feeling that you may never get it again. That is what tends to happen with people who diet.

It is not easy for most people to accept the idea that you “can eat whatever you want to” and still be ok. You might be thinking “if I did that, I would gain 20 pounds!” The key word is “whatever”. The biggest mistake I have seen people make is giving power to food. Not any food, only certain foods. Somehow, a 200 calorie candy bar has more power than a 200 calorie spinach salad. People mistakenly believe that lone candy bar will “make you fat” because it falls into that “bad” category. The spinach salad with the high protein boiled eggs however, despite providing the same amount of energy (calories) is never the bad guy. Nope, most people would agree, hard boiled eggs and spinach will never make you fat.

What I have seen most people do who have moved away from eating foods they love is a tendency to walk around almost never being satisfied. As a result, they may tend to nibble and pick on more and more “good” or “healthy” food…..only to eventually consume more calories than they would had they satisfied their appetite (both physically and sensory satisfaction) by eating exactly what they really wanted. The key is they are less likely to overeat when they are satisfied. Remember, however, everyone is very different. I am referring to those who do not suffer from Binge Eating Disorder (BED) and those who have typical brains and appetites that may only be off a bit because of normal dieting. There are those whose brain chemistries will lead them to eat beyond a typical amount if they allow themselves certain kinds of foods (usually sugar and fat). Most people (I hope) who have such an eating issue usually work with specialists who help them cope with their issues. The typical dieter or even the typical “healthy” eater however, is who I am reaching out to.

The bottom line is that it is NOT the “whatever” that matters, but the “how much”. If you eat just one candy bar (or burger and fries, or whatever the case may be when it comes to “bad” food) it is no different to your body than eating an equivalent of “healthy” food that may not satisfy you. The secret is to listen to your fullness. For those of you who are disconnected from this feeling, it may take time, but don’t give up. Do some experimenting. I often use the example of a college girl I worked with years ago. She had been eating very little during the day, restricting herself to a plain salad for lunch, but then began nibbling on “healthy” snacks throughout the night. She would have several fat free granola bars, rice cakes, sugar free jello and apples and by the time she went to bed, she did not feel so great. She also was frustrated with having to be thinking about food and eating all night. When I asked her what she really wanted at lunch if she could eat whatever she wanted, she said “a cheeseburger”. So she took the risk and agreed that just once she would get a burger for lunch and see how she felt. I will never forget her expression (and happiness) she had at her next visit when she shared her experience with me. “I felt so satisfied! And the best part was that I was not thinking about food all day! I actually ended up having just one snack instead of a dozen and felt much better!” She had to take that risk and try it once. But it literally changed her life.

Does this mean you should throw nutrition caution to the wind? Not care about eating healthy ever again? Of course not! I believe in choosing healthy food, learning to cook healthy meals but educating yourself on how to make food yummy, too. However I also believe in living in reality. The fact is that you may really want the onion rings and not the side salad. And that’s ok. Plus, if you eat a few onion rings and feel satisfied I bet you are less likely to be seeking out food shortly after a restrictive meal.

So go ahead, take that step, even if it means just being honest with yourself (even if you can’t actually order that favorite food, at least you are considering it). Who knows, a fluffernutter may be in your near future yet.

PS A bit of advice: if you have been eating an extremely high fat diet such as visiting McDonald’s or other fast food joint on a daily basis, your body may actually be craving more fat than is typical. If you honestly don’t have a clue about nutrition, you may want to seek advice from a registered dietitian. Ask your doctor for a referral to a dietitian near you. Even one visit will give you direction.

 

 

 

 

With Age Comes Wisdom(But Not Always When it Comes to Eating)

Image may contain: 1 person, tree and outdoorI think of him as the “Bird Man”. I was only 18 years old and little did I know at the time it was probably because of him that I became a dietitian. I was a freshman at Clark University in Worcester, Massachusetts and he was the graduate student who taught my biology lab. I was a biology major because I just loved the subject and everything to do with how every living thing worked (except the paramecium or amoeba). I had no idea about what I “wanted to be” when I grew up. But I realized I never wanted to be the Bird Man. He studied birds and bird calls (apparently, his thesis was about this topic), and he had us listening to hours of bird tweets, marking down different marks according to how long or short the tweet was. This was not my idea of fun. Anyway, I had no idea at the time that I could have chosen any topic in the field to study, and maybe, it would have been more interesting. Instead, when I consulted with my adviser about changing majors, he asked what interested me. At the time, my best friend at school was a vegetarian, and the food she ate was very different from what I ate. I answered “vegetarianism”. “Well, you should be a dietitian” was his recommendations, and so I changed my focus and transferred to UConn where they had a nutrition program. If I mentioned this story before, I apologize. Age has taught me I am becoming my mother (pictured here, eating ice cream even though she is lactose intolerant).

Anyway, yogurt with sunflower seeds and honey no longer interests me, and if I am honest, I have no interest in vegetarianism either. That was short-lived, but I have no regrets because over the years, I have discovered what truly does fascinate me, and that is behavior. My passion is promoting health and happiness and peace, and being a dietitian , that means peace and happiness with food and eating. Food being such a basic part (and necessity) of life, you wouldn’t think it would be so hard, right? But for many, it is.

When I worked exclusively with patients with eating disorders, I grew to appreciate even more how hard it is for people to change. When I encountered older women or men (in their 40’s, 50’s and one woman I clearly remember in her 60’s), it struck me that age did not necessarily bring wisdom when it came to making healthier choices in life. It was way more complicated. Now, between working more with families who have children with eating issues and even with encounters with your average “dieter”, I am discovering there are many barriers to change and everyone is different.

These are some common scenarios I often see:

  • Your average middle aged person who has gained a few pounds and wants to lose it. They try a certain diet (be it paleo, juice cleanse, Weight Watchers, it really doesn’t matter), they lose weight, and as time passes they gain most of their weight back. But then, despite the fact that they regained the weight, they repeat the process.
  • The person with an eating disorder who is in denial, and despite family and friends expressing concern and worry, they refuse treatment.
  • The person with an eating disorder who does get treatment but still struggles (and often beats themselves up because they are still struggling).
  • The parent with a child who has health issues because of a poor diet yet can’t change their own eating habits.

With all of these situations (there are many more), one thing rings true among them all: despite a good reason to change and despite repeated experiences with failure, change does not happen. Why?

My thought (and experience) is that our expectations are not always realistic. No matter what the situation, we can’t change it overnight. Knowledge, and even age and experience does not translate into change. And guess what……that is ok. The problem is that most people trying to change have little tolerance for making mistakes or for failing. Instead of being accepting of themselves that it is perfectly normal to fail, the self-deprecating dialogue takes over. That leads to a very negative feeling that has the risk of overtaking everything. Feeling negative and berating oneself is not a good recipe for change.

Instead, can you entertain the thought of a different approach to eating? No matter where you are on the eating spectrum (it taken over your life because of an eating disorder, or are you just slightly concerned that what you eat may matter) YOU are the one in control of your thoughts. You may not feel in control of your eating, but there truly is hope.

My suggested steps to change? First, ask yourself these questions:

  1. Reflect. Take time to neutrally (non-judgmentally) think about where you have been when it comes to eating and dieting. Has your road been long, or are you just starting to think about what you are eating?
  2. What does your “self-talk” sound like? In other words, what are you saying to yourself that nobody else can hear? Are you being nice to yourself, treating yourself kindly as you would others, or are you being mean?
  3. How do you feel? Do you have energy galore, or is getting up and moving a battle? If you don’t have energy or you are dragging, do you know why? Have you addressed it with your doctor?
  4. Are there changes in the back of your mind that you really know you need to make for your health’s sake? More sleep, less wine, more exercise, quit smoking, more vegetables? Be honest and make a list. This does not have to do with weight. This has to do with health and feeling good and living longer (hopefully).

THEN, make an action plan:

  1. If your self-talk is negative, write down some “counter-statements”. These are positive things you could say to help put you in a better place. Instead of “I can’t believe I ate that (or did that, or whatever), try saying “nobody’s perfect! at least I am aware of what I am doing! I am working on it!”
  2. If you don’t feel good or have no energy CALL YOUR DOCTOR and get help figuring out why. I know many people who have thyroid conditions, especially later in life that after treatment changed their lives. Depression can also zap energy and will rarely get better without help.
  3. If you are trying to improve your lifestyle to be healthier, but struggling on your own, ask your doctor for a referral (you may need a therapist, physical therapist, sleep study or dietitian…check out Find An Expert to find a registered dietitian in your area.

Remember, any “mistake” you make is really a gift in disguise. It gives you insight into where your barriers and challenges are. You just need to take the time to reflect on what leads you down that path and be kind to yourself as you keep trying to find a better way. It may be that you need to seek help to get you to where you want to go, and remember, it will never be perfect. The path there is never smooth, but that’s ok. As long as you keep going. And learning. And accepting.

So what would I have been had it not been for the Bird Man? I have thought about this. I maybe would have been a Master Chef, or Master Gardener, or maybe a sommelier on a Caribbean Cruise Ship…..Maybe it’s not too late.

Summertime Smorgasbords: How Do YOU Deal With Too Much Food?

Image may contain: foodChili Dip with Nacho chips, chicken cream cheese roll ups, guacamole layered dip with olives, cheeseburgers, hot dogs, grilled chicken, pulled pork, bean salad, corn salad, pasta salad, fruit salad, tortellini salad, cannoli dip with cinnamon chips, homemade macaroons dipped in chocolate, brownies, sugar cookies, chocolate chip cookies, rice krispy treats, cheese cake, Death by chocolate, peanut butter bars, every kind of chip imaginable…..oh, and wine, beer, sangria and water. What do you put on YOUR plate????

That was only part of the food that arrived at our pot luck picnic this weekend to kick off the summer season. Needless to say, the chatter regarding food and eating was unavoidable.  My own daughter was comically stressing about what to choose when the desserts were out. “I’m so full!!! But that looks so good!!” Since she is not a baker and is also very frugal, yummy desserts like these don’t often come her way. I think she felt like she should take advantage of the situation and eat a bit of everything. Yet, she was already full. I simply suggested taking a plate of everything home…..that way, tomorrow, when she was hungry again and eventually in the mood for something sweet, she would be very happy. She thought I was brilliant : ) Such a simple suggestion, yet I am guessing a lot of people might not do this, thinking it was maybe rude to ask to take something home? Yet, I do it all the time for the simple reason being that I am not a fan of tummy aches. Sometimes, you just have to be assertive to take care of yourself….

My daughter’s reaction to my simple suggestion of taking some dessert home made me realize that these summer celebrations, while mostly fun and something we all look forward to, can be stressful to many. That day the dieting/food chatter was impossible to avoid. Some comments my daughter and I overheard:

  • “I didn’t eat today so I can have this”
  • “I am going to do an extra workout at the gym tomorrow morning to burn this up”
  • “I have been good all week”
  • “This week already has been bad, I might as well enjoy it today because after Memorial Day I am starting my diet….again”
  • “I can’t make up my mind what I want to eat, there is too much!”
  • “Get this dip away from me!”

And I am guessing that some people were having their own private thoughts about food and eating they may not have spoken out loud. When I worked exclusively counseling individuals with eating disorders it made me much more aware of how food-filled celebrations like these were absolutely scary. Typical thoughts from my patients were: Will someone be pushing food on me? Will anyone make a comment about what I am eating (or not eating)? Will I gain 5 pounds if I eat something fattening? Yes, everyone is different when it comes to how they handle exposure to such an overwhelming amount of food choices, and it can be emotionally (and physically) draining depending on your relationship with food.

In general, in my career as well as in my daily life I have encountered a few different “types” of individuals when it comes to eating and health, and their reactions to something like my Memorial Day picnic would all be different. For example:

  1. The so-called “normal” eater: this person encompasses a wide variety of people. Picture the active young adult male (or female) who doesn’t know much about cooking, likes to eat and totally appreciates free food. This guy may not care much about how he looks as far as body size, but has the innate ability to listen to his body signals (or, really doesn’t think twice about overeating or feeling way too full). He tends to take exactly what he likes, enjoys his plate of food and may throw out what he can’t finish. He then runs off to play lawn games with friends. Or, picture the middle age or older person who no longer is as fit as they used to be, but never dieted and doesn’t know what a calorie is. They may talk more about their digestive habits than food and body size. They tend to grab food they enjoy but avoid the things they know give them digestive problems (as we age, for example, some of us can’t digest milk as well as we could before). Or maybe fried foods does not sit as well as before, so passing over the bacon chili dogs with cheese is not because of calories but because of the desire to avoid the uncomfortable repercussions.
  2. The “restrained eater”: this person does not have a clinical eating disorder (meaning they may not meet all of the criteria for a diagnosis) however they probably spend a lot of time thinking about food restriction, calories, etc. They are very weight-conscious and weigh themselves often to be sure they are not gaining weight, or because they are trying to lose weight. The way a restrained eater behaves at a picnic depends on which mind set they are in at the moment. If they are determined to be restrictive, they may choose only “safe” lower calorie foods (such as the grilled chicken and salad). They might be experiencing some inner turmoil because the food choices available are especially appealing to someone who tends to restrict them on a daily basis. They may actually break down and have something, but the guilt they feel after eating triggers a repetitive and negative, blaming message inside their heads. Or, they may overeat once they have “blown it”, knowing that days of restriction will follow. Yes, restricting intake and dieting is associated with binge eating. It may not make sense to a naturally intuitive eater why on earth someone would eat so much as to feel ill (sometimes referred to as a “food hangover”). The person who has never dieted won’t get it, but those who have put themselves in “diet jail” understand that you gotta eat while you can, because inevitably, the dieting days will start again. The bottom line for restrained eaters is picnics can be challenging.
  3. The eating disordered person: without going into detail, someone with an eating disorder (anorexia nervosa, bulimia or binge eating disorder) faces challenges beyond most people’s comprehension. They may have some great strategies to cope with these overwhelming situations if they have received treatment and this can help get them through it all. Sometimes, the hardest part for them is the scrutiny of others. That is why I make it a point to never comment on what someone else is eating (or not eating). It is none of my business. So please, do me a favor and keep your eyes on your own plate. Intentions may be good (they usually are from caring family and friends) but I promise you, unless your loved one personally asked you to be the food police, don’t do it.
  4. The “healthy eater”: this person may not be extremely restrained, but they prefer healthier types of foods. They may know little about calories and may not care about their weight at all. But they like good, wholesome and also delicious food. I know a lot of people like this (some may be referred to as “foodies”). They love to cook and discover interesting ways to make kale or beets. When you go to a party and there is that one unusual salad that you just can’t get enough of (and yet it’s main ingredient is vegetables), this is the person who likely brought it. Just this week I had a salad made of shredded broccoli, dried cranberries, walnuts (I think) and poppy seed dressing that was to die for. I also had a fresh corn salad with blueberries and cucumbers (go figure) that was also an unusually delicious combo. Besides enjoying cooking healthy type foods, these are the people who don’t eat much processed foods, not because they are worried about gaining weight but because they would rather make it themselves and know what is in it. I admit to being somewhat of a dessert snob in my old age (I can now taste the chemicals in a Twinkie). It needs to be homemade to taste good to me. Anyway, at a picnic these types of people may tend to be a bit selective but it is not the same as the “orthorexics” who will only eat super-healthy foods to the point of eliminating many fats, carbohydrate foods, etc. and who stress about eating perfectly. Normal, healthy eaters who prefer healthy food don’t waste a lot of time making their decisions about what they want to eat……they just may pick the more wholesome and homemade options (they really don’t miss the hot dog because they don’t enjoy them). But they won’t be passing up that homemade guacamole.
  5. The weight-conscious “healthy eaters”: these are people who have what is often referred to as “normative discontent”. They may be weight-conscious and try not to overeat, but they are going to enjoy themselves. As I may have written in another blog, in our culture it is difficult to not notice or care about body changes or weight gain as we age. Working on eating healthier and exercising but in a way that does not make you stressed out and does not affect your life in any big way is a different story than the restrained eater who feels guilt after eating. Still, focusing on weight in any extreme way (where it leads to meal skipping or restriction after a picnic or party day) may be a red flag. While it is reasonable to want to have a stable body weight as you get older, if too much energy has to be spent thinking about eating and food choices, or if guilt with eating enters the picture that is a different story.

The message I wanted to send today is that the summer fun has only begun, and my hope is that you will find a way to truly enjoy it at the same time as you honor your health, both physical and mental. That means accepting the person who YOU are and reflecting on your relationship with food. Do you find yourself feeling excessive guilt after eating at picnics? Do you starve or restrict before a party, then overeat and feel awful? Or, do you embrace and enjoy the great variety of foods you don’t ever get to have (because, honestly, who has the time to scrape corn off a cob for a blueberry corn cucumber salad?) If you find you really don’t enjoy these fun summertime food-centered events, try to figure out why….are you trying to be too healthy? are you afraid of gaining weight? Do a reality check. One meal or one day honestly has little affect on health or body weight. If you work on intuitive eating and listening to your fullness, you truly can eventually figure out a way to enjoy the entire event, food and all.

And, remember, you can always take home a doggie bag : )

 

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)

 

 

 

 

 

 

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

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.

Feeling Stuck and Corn Stalks: Visualizing Change

Clouds and corn“I chopped down a corn stalk yesterday!” my patient (I will call Susie) said as she sat down for our session. She had binge eating disorder, and was in the habit of restricting her intake severely during the day, then after work she would pull into the drive-through of several different fast food establishments on her way home. First for several double burgers, fries and giant milkshake. Then, Dunkin Donuts for a bagful of donuts and large coffee drink. She would gobble this down with predictable feelings of guilt and remorse afterwards. No matter how much resolve she had the next morning (“that’s it! I am starving myself today, I don’t deserve to eat. I will make up for it. And today, I won’t do it” ) by the time 5 pm rolled around, her starving body screamed at her and her conditioned brain went into automatic pilot. Her car just seemed to turn automatically into that darn entrance with the sign that said “Drive-Thru Entrance Here”along with the giant yellow arrow to be sure you do not miss it.

Maybe you can’t relate to this behavior, maybe there is some other behavior that you do that you wish you could stop. Bad habits are complicated and more difficult to change than one would imagine. Sometimes, we look at others and think “how could they do that? why don’t they stop ______” Fill in the blank. Smoking, drinking too much, watching too much TV, not sleeping, starving themselves, binge eating, purging……all detrimental to our health. Why can’t we have more willpower? When my patients start bashing themselves (don’t we all feel kind of bad when we just can’t do what we thought we could do?), it typically is a pattern. We get into what you might consider “automatic pilot” mode, both with our thinking and with our behavior. You may have heard of “behavior chains” . Susie’s might look something like this:

Skip Breakfast and Lunch->Leave Work->Drive by McDonald’s->Turn in Drive Thru->Order Food->Eat in Car->Feel Guilty->Drive by Dunkin Donuts->Turn in Drive Thru-> Order Donuts->Eat in Car->Feel Guilty->Go Home->Eat More, go to bed->Wake up, Skip Breakfast, Skip Lunch, Leave Work and REPEAT CYCLE

My patient Susie wanted desperately to change this behavior, but her expectations of stopping totally and miraculously going home to eat a healthier dinner was not reasonable. Part of the reason is NOT lack of will power, but the reality that our brains are not always under our control when it comes to bad habits. To help patients understand this, and also because I am a visual learner, meaning, I need pictures to learn things, I use a “corn stalk” analogy to explain this phenomenon. First, identify a behavior you want to stop (for Susie, she wanted to stop binge eating fast food after work). Next, imagine what healthy behavior you wish you could do instead (Susie really wanted to be able to drive straight home and prepare a healthier and normal sized meal and not feel guilty).  Now imagine your brain as a very thick field of corn stalks. You have to get to the other side to your “behavior” or outcome. You see a beautifully paved path leading somewhere. It is shiny, made out of beautiful marble, glistening in the sun. So of course, you head down this path because it is so easy, and it is actually somewhat enjoyable.

Unfortunately, at the end of the path lies the exact behavior you have been trying to stop. For Susie, at the end of her nice shiny easy path is McDonald’s. And Dunkin Donuts. And binge eating, followed by guilt. What Susie really wants at the end of her path is a nice healthy meal, and feeling good. But there is no path to that scenario. She needs to make one.

Do you think it is easy to make a paved path through a giant field of corn stalks? No, it is not. Neither is changing behavior. Neither can be done overnight. For Susie to forge a different path, she needs to get herself a hatchet and knock down one cornstalk at a time. After lots of hard work, sweat and tears, eventually a path, albeit bumpy and conducive to tripping…well a path will slowly appear. Susie will actually be able to get down that path to the place she wants to be. Her old smooth beautiful path will still be there. But eventually, that old smooth path will start to be less smooth and easy as new baby corn stalks begin to grow. She will still be able to get by, but it won’t feel as easy or right. Eventually, over time, that old pathway will be covered and pretty much gone. The new path will start to be nice and smooth and very easy to walk down. Maybe not made of marble, maybe some smooth sand, but walking down it will feel pleasant and good, not like in the beginning.

How does this look in Susie’s “real” world? Take a look at her “behavior chain”. What Susie did was pick a place in the chain where she felt she could do something different. She told me “I don’t need to go by Dunkin Donuts. That is actually the long way home”. So the first hard work she did, that first corn stalk chopped down was taking a different road home and skipping Dunkin Donuts. She still went to McDonald’s, still ate too much, still was starving during the day, but she was able to make this change. She felt pretty proud of herself and had some hope. The next step was at the beginning of the chain, the skipping of breakfast and lunch. She did not want to eat breakfast, but agreed to starting to eat something at lunch. This helped her be less starving on the way home and eventually she was ordering a smaller amount of food at McDonalds. Another corn stalk down.

I have had many patients like Susie, all with different issues and behaviors they wanted to change. Those who accepted that change did not happen overnight often went on to change their brains by changing one little thing at a time. Most of us are not that patient, it seems, and so we try to change all at once. When we fail, we blame ourselves. Instead, if we stop and think about the corn stalk field in our brains, maybe we can accept that chopping down one corn stalk, changing even one little thing at a time will eventually get us where we want to go.

So can you think of any unhealthy behaviors you want to change? Then pick up that hatchet, it’s time to chop.