Tag: weight loss

If Losing Weight is your New Year’s Resolution, Don’t Forget Your Secret Weapon: IA

On By jodietitianIn dieting, hunger, Uncategorized, weightLeave a comment

Everyone is born with it. Babies and children know exactly how to use it. But something changes over time, over months and years, as our vast and varied experiences with eating and food accumulate. It gets unknowingly numbed, sometimes obliterated, taken away inadvertently by others, then finally thrown away by our own means. Eventually, most of us forget it’s even there, let alone how to use it to our advantage.

I’m talking about IA. Interoceptive Awareness.

Think about almost any child you know. A 4 year old will get half way through a plate of spaghetti and suddenly stop. “I can’t eat anymore”, or “I’m full” the child will insist. The informed parent will be wise and listen. But the typical parent will often visually look at the amount of food the child ate and feels it is just too little, it can’t be enough. So instead of allowing the child to follow is natural body signals, they insist the plate be finished, or the child take “just one more bite”. And so it begins.

That 4 year old body knows just how much he needs to eat. But he will lose this natural ability if his parent keeps this up.

Well, it’s that time again….New Year’s resolution time. People pledging to lose weight is probably up there as one of the most common pledges. I am not here to promote losing weight as a good goal for everyone, but I do know that lots of people gain weight over the years because they have lost touch with their IA. That means the weight they gained is not normal for them, it was a gradual accident. So let’s talk about IA, what it is, how you lost it and how you can get it back.

Interoceptive Awareness in simple terms is the way your body communicates with your brain about what is going on which helps you understand and decide what your body needs. A simple example is being thirsty. We have all experienced that feeling. You are outside working in the heat, or walking on a hot day. Your mouth feels dry, you feel uncomfortable and somehow you know you need water. That is your body using IA to tell you to drink. It involves a complicated process with your mouth, brain, blood volume etc. integrating signals and monitoring your physiology to make sure you do the right thing to stay alive: drink more water.

The same type of process happens with food and eating. Back in the day when I first became a dietitian in the 70’s scientists really didn’t understand how we knew how much or what to eat. They knew it was complicated (certainly genetics were a factor, as well as culture and environment) but they were just scratching the surface of it all. Leptin was discovered which was a big breakthrough. This messenger was found to actually monitor our fat cells for changes then sending signals to the brain to eat more or less depending on how much fat was there. If you ate too much, leptin would send the signal to eat less. The discovery of leptin was just the start. For those of you who are interested in a more detailed explanation, check out this article:https://www.scientificamerican.com/article/decoding-your-hunger-during-the-holidays/

We now know there is a specific messenger for fat intake, and for carbohydrates (every wonder why you sometimes crave sweets? Chances are you didn’t have enough carbs at your last meal). Yes, your body wants (and needs) balance. Please note that some people have to be on special diets due to medical conditions. Ketogenic diets are sometimes used for patients with seizures. Paying attention to carbs is important for diabetics. There are definitely medical conditions and genetic abnormalities that contribute to an individual who is not able to follow natural body signals. Babies born with Prader Willi Syndrome fail to thrive at birth however then tend to overeat with no shut off later in life and may gain an unhealthy amount of weight if not monitored. These are the exceptions. For most of us, our body signals and IA work fine. We just don’t listen.

Besides having well-meaning parents interfere with our natural ability to listen to our hunger and fullness, when we consciously try to manipulate our eating, especially in extreme ways, over time we really can do damage. I have had many patients in the past say “I am always hungry” or “I am never hungry”. Often, they have slowed their digestive processes and their metabolisms down by skipping meals or restricting, and they lose that feeling of hunger. They have to follow meal plans to get their digestive system and metabolism working again. Even if you have not gone to this extreme, but instead have simply tried to diet by eating less, your mindset gets engrained in a way that gets stuck. Many people simply don’t trust their hunger because the diet mindset tends to be “all or nothing”. Either you are walking around hungry because you are dieting or you are overeating and feeling uncomfortable, throwing caution to the wind because you are off your diet. This on a diet/off a diet lifestyle certainly keeps you disconnected from your natural IA.

So is counting calories, measuring foods or cognitively restricting your food intake the answer? As I have said many times, people do have the goal of losing weight and often do lose weight dieting, however they usually gain it back because they have not even begun to try to work on getting in touch with what their body is telling them. How do you start? Where do you start? One meal at a time. One snack at a time. Here are some tips to get you started.

  1. Identify Habits: before you can get in tough with your body signals regarding hunger and fullness you have to work on eliminating the triggers that cause you to eat when you really are not hungry.
    • Do you eat while distracted, such as at the computer, in front of the TV or while talking on the phone?
    • Do you graze all day instead of actually sitting down to a meal?
    • Do you keep food in your car, at your desk, in your bedroom?
  2. Designate a place to eat without distraction both at home and at work.
    • To help tune in to your gut messages it is helpful to avoid distraction and pay attention to what you are eating
    • Sit in a chair at a table or counter. Do not stand and eat.
    • Turn off the TV, leave your phone somewhere else, don’t read. Just eat.
  3. Designate meal and snack times if possible.
    • Snacking all day instead of eating a real meal can confuse your body. If you are a snacker plan on a breakfast time, ONE morning snack, a lunch time, ONE afternoon snack, a dinner time and ONE night snack
    • If you are a meal skipper and tend to wait until dinner time and after to graze all night INSTEAD plan 3 meals a day and ONE pm snack. Plan a breakfast time, a lunch time and a dinner time. You may not feel hunger since you have been tuning out your signals for too long but they will come back over time. Start small.
    • Be flexible. Eating at the exact same time every day is not the goal. It is the pattern we want to change. Eating within an hour time frame (for example, breakfast between 7 and 8, or lunch between noon and 1 pm) is a good goal. If this is hard for you even within a 2 hour time frame is a start in the right direction.
  4. Take time to think about what you want to eat. Sometimes your IA will plant a specific food or foods in your brain and that often means your body needs something. If you have been dieting and have been feeling deprived this may be difficult, but don’t give up. Take the risk, even for one meal a day. Some people feel too guilty letting themselves eat something they consider unhealthy. The goal is not to turn you into a junk food eater. The reality is that once you are in tune with your body, you will realize that you actually rarely crave junk foods as often as you think you will. I recommend if nothing is calling to you strongly, if you really are not craving anything, then try to choose a healthy meal that you really enjoy. Please note that if you are suffering from disordered eating, or have been diagnosed with an eating disorder please consult with your therapist and dietitian before making any changes to your eating. If you feel overwhelmed just thinking about any of this, I suggest even one consultation/evaluation with and therapist who specializes in eating issues.
  5. Tune in to your hunger/fullness level. Consider keeping a diary with a record of hunger level before eating and fullness level after eating. A scale of 1-10 is often used with 1 being “starving” and 10 being “stuffed”. A “3” might indicate normal hunger whereas a 4 is just a little hungry and you could wait to eat. After eating, a “7” would be a comfortable normal fullness whereas an “8” would mean eating a bit too much, a 9 definitely getting to uncomfortable. Keeping this record often helps recognize patterns and makes it easier to not eat when not hungry, and to be sure to eat when you are. Remember, this is a very subjective tool and I have known many people who can’t relate to it at all so if this is you, no worries! Just take the time to think about it. Stop and think about how hungry you are before you start eating, and reflect on how full you are after you eat a meal. Eventually you will identify how disconnected, if at all you are to your IA, to your awareness of hunger and fullness. (Note: we are all different with respect to a messenger (PYY) that tells our brain we are full. For some people PYY works really quickly and after eating a certain amount the messenger tells their brain to stop eating. These are the people you may know who just naturally do not over eat. For most people it takes 20 minutes for this messenger to work. For others it is longer. These are the folks who can seem to eat a lot at times but then feel uncomfortable a half hour later, complaining that they ate too much. For this type of person it might be helpful to set a timer for 20 minutes and after a plate of food wait for the 20 minutes before taking seconds. Chances are the fullness will kick in by then and that feeling of being overstuffed can be avoided). Oh, we also know that regular physical activity may help you be more in tune with fullness AND hunger.
  6. Appreciate the complexity of appetite. It is not that simple. The complicated neurochemical picture is hard to comprehend. There is so much to know. Did you every hear about NPY, the messenger that tells you to eat and won’t go away unless you eat enough protein? That is why after what you think is a healthy lunch of salad and fruit leaves you wanting more. Have you heard of ghrelin? This messenger also stimulates appetite and is elevated if you don’t get enough sleep! That is why you can’t seem to satisfy your appetite on those days after a late night out. Can you imagine how hard it is for someone with undiagnosed sleep apnea to maintain their normal weight? If you don’t sleep well, talk to your doctor. Finally, our emotions and personal histories make things even more complicated. We now know that pathways overlap in our brain that regulate both food intake and emotions. So if you ever used food to soothe yourself expecting to be able to suddenly be able to “listen to your body” is not realistic. Again, if you believe you are an “emotional eater” it might be wise to seek help.
  7. Educate yourself. Intuitive Eating is no longer a new concept and Mindful Eating is something that many people are working on. It is a much better goal than “losing weight”. Moving toward feeling better, feeling and being healthier is a good thing. Check out the website for more info. https://www.intuitiveeating.org/

Happy New Year! Here’s to NOT trying to be perfect, but moving a little bit each day to a more aware, healthier and happier YOU!!!

Middle-Age Alert: The Time to Act is Now (5 Tips)

On By jodietitianIn UncategorizedLeave a comment

The other night a bunch of us retirees were joking about what exact “age” we now consider to be “old”. We all remember way back when we were approaching our 30th birthday and how we felt . Being 30 was “old” to someone in their 20’s. But then we turned 30 and realized nothing changed. Now, 40 is definitely young (we have kids in their 40’s for heaven’s sake), and 50 we can barely remember, so that is definitely not old either. Now, we look back and realize how fast time flies. We wish we only knew then what we know now. So that is why, after taking this break from writing, I felt motivated to write again. To share with you what you might want to know now rather than later when it could be too late.

Do you sometimes wish you could see into the future and know what you are going to be doing and how you are going to feel in 20 years? Will you be working in a job you love? Will you be energetic and healthy when you finally retire? Will you still have the friends you have now? Will you be happy in your relationships? Not everything is in your control. Unfortunately, tragic events change lives and disease is sometimes genetic and can’t be prevented. But as I progress in years (you know, get older) I can’t help but compare the quality of life in those that make certain choices verses those that make other choices. There are consequences to our behaviors. Over time, the detrimental (or beneficial) effects of our behaviors add up. In other words, what you are in the habit of doing TODAY has a HUGE impact on the life you will experience later. If you want to be sauntering up and down those cobblestone streets of Cinque Terre, doing that bike and barge river cruise in Amsterdam, or just enjoying a swim in the pool at a resort in Cancun, the time to start thinking about the future is now.

 Most of what I am going to mention is nothing new to you. What I am hoping is you might appreciate the experience and observations of someone who is living through it, witnessing the changes and experiences first hand through those around her and feeling it herself. If your partner or mom give their advice it sometimes makes us resentful. I hope this post makes you stop and think.

 Here is a list of what I have personally observed to have the greatest impact on your future enjoyment of life itself:

  1. Moving Too Little (or Too Much)

 One of the benefits of retiring to Florida is getting to know a bunch of snow-birders from around the country. I have been blown away by the very fit people over 70 down here. Every day I see both women and men, some over 80, riding their bikes to the pool for water aerobics at 9 am. I see them walking their little ankle biters (I mean poodles) around the almost 2 mile block early in the morning or after dinner every single day. The same group of elderly men and women are going at it with pickle ball 5 days a week. Pete, who is 80, arrives like clockwork at 4 pm at the pool to do his laps for almost and hour. These happy, healthy elderly people MOVE and as a result, their bodies keep working for them, enabling them to have fun.

 On the other hand, I have observed some other people who do not move so much. They struggle going up stairs, they can’t easily get into the car, their knees and hips and muscles hurt. Yes, it could be arthritis or osteoporosis or any other affliction that plagues us as we age. So that is why I also pay attention to younger folk, people my age or even younger, who don’t yet have those afflictions, yet suffer from the same poor quality of life. They get sore from simple repetitive activities. They lose their breath going from place to place. Their body hurts after a little exertion. They struggle getting up from the couch or a lower chair. They have to rest a lot because their muscles just are not used to moving. Their “habit” of avoiding movement at all costs regardless of reason(too much time on social media, watching TLC, working at home on the computer, etc) is starting to affect their quality of life. Even at the age of 40.

 And then, of course, there are those exercise addicts who pride themselves on going to the extremes their entire lives. I have known people who didn’t stop at a few rounds of golf and had to play all day, every day and now can’t play at all because of shoulder issues. There are those with tennis elbow because they overdid their sport. Stress fractures and hip issues seem to have afflicted some elderly runners I have known because they never took a day off. The list goes on and on. Too much of a good thing ends up being a bad thing sometimes when you get older.

 So which are you? Do you incorporate some kind of daily moving in your life? Unfortunately, lots of people only “exercise” when they are dieting because their end goal is losing weight. This is a HUGE mistake. Actually, if this is your goal, and you can project into the future, think about what kind of life you want to be able to enjoy when you are older. Walking for 30 minutes a day, even if you can’t do it all at once (such as 10 minutes, 3 times a day) could change your future life. Over time it adds up. The typical person I have seen over my many years in the field joins the gym and starts the diet on the same day. They are determined and diligent. But it turns out to be almost impossible to meet the (ridiculous) goal of going to the gym consistently at 5 am before work or 6 pm after work 5 days a week in addition to following that restrictive diet. It is pretty emotionally draining to think about eating all the time in addition to the grueling workout schedule. Most people give in. They break the diet because with all that physical activity your body requires (and will crave) more carbs….which of course are not on most diets. So once the need for carbs (ice cream, cookies, chips) is naturally satisfied the diet is broken and the gym days are over, for now. Until the cycle starts again.

Instead, just imagine that over the next 10 years your body managed to walk 3,000 miles! Do you think that body would be stronger, more fit and feel better, even without dieting? The reality is that body also would sleep better, be more in tune with how much it needed to eat, be less stressed and happier as well as be at a more natural weight. The point is, if we stop linking moving with losing weight and dieting and instead just focused on how to incorporate more movement, even just walking 2 hours a week our lives would be different when we are older. Much different.

Take my mom for example. She is 91 years old and is in constant motion, walking inside the house, counting her steps up to 100 if she can’t get outside. When other people her age nap on the couch all day, she is out having fun. Because she can. She is the best example of how moving every day, no matter what it is, will change your life. She also is pretty funny. She loves to say “that will be a dollar” every time she gives advice or says a prayer for you that gets answered. I should have added humor in my list of factors that make you healthy. Anyway, as far as physical activity, you don’t have to run a marathon. Just start moving.

2. Smoking Cigarettes

 Duh. Of course you know smoking is bad for your health (causing cancer, heart issues, etc). And yes, if I look around at people who are over 60 and smoke, it is true, they do appear older because of how smoking affects your skin and appearance over time, but the health repercussions are what is crippling, not wrinkles. With that said, I realize knowledge is NOT power when it comes to smoking. Smoking is an addiction to a substance as well as a deeply ingrained habit that is hard to change. I can speak to this issue because of personal experience, so I am going to share that in hopes it may shed some light. If even one person quits smoking from reading this, I will be thrilled.

 So when I smoked cigarettes it was in the 1970’s. I was a senior in high school. I vaguely remember that my Newports cost about 50 cents a pack. I went off to college and for some reason, I went from a half a pack a day to almost 2 packs! And then, I clearly remember the price jumping up to over 60 cents a pack. That was it. I couldn’t afford that! Also, I was moving in to an apartment with 3 women who did not smoke and I did not want to be the one stinking up the place.

 So here is the thing, the important take-home message: I MADE A DECISION. Yes, I had “tried” to quit smoking before, and if you have tried to quit, you may relate. Before, deep down I would be thinking, “how long will I last?” This was the first time my thinking was different. I DECIDED that I did not care what I had to go through, I was quitting. I also remember consciously adopting a brand new identity: Healthy Person. This was new (which is funny as I was a nutrition major at the time, but smoking was socially acceptable back then). I also (as a “healthy person”) started exercising for the first time in my life. I dragged myself to the pool in the field house at UConn several times a week at night to swim. I had ants in my pants and needed to do SOMETHING. I remember leaving the field house and walking to my car in the freezing cold and my hair would turn into icicles and clink. Then, in the spring I took up jogging. I was REAL SLOW, but I felt so empowered and very cool as a “healthy person” it didn’t matter that it took me 20 minutes to cover a mile. I loved it. I was hooked.

 That’s the good part. The bad part was the process. Several years after the fact I became a Registered Dietitian. I took a part time job at the local YMCA and was trained by the American Cancer Society to teach their “Fresh Start” classes on quitting smoking. I learned about the 3 parts of being addicted to nicotine and smoking. I reflected back on what I went through and it all made sense. The first part is the chemical addiction. Luckily, it only takes about 10 days to get the nicotine out of your system. The second part of the problem is the HABIT you have practiced over the years that has become deeply ingrained in your brain. This means that certain things become “triggers” to make you want to smoke. For me, I had a cigarette when I took a break from studying (and I studied a lot). I had one with my coffee in the morning and one with a beer on the weekends. I had one after eating and socially smoking was always involved. I smoked when I was stressed and I smoked while walking to class and after class. Like most smokers, having a cigarette was associated with all kinds of activities. That is why every time you do the activity (eat, drive, have a coffee or a drink, etc) you are going to want a cigarette UNTIL you KEEP PRACTICING a new behavior. For me, it was being very aware of simply sitting there…doing nothing. That was it. The hard new behavior was doing nothing. Funny thing is now I crave times like that, just sitting in quiet. The reality is for any bad habit the act of practicing doing something different over time actually changes the brain’s pathways so that eventually it becomes automatic. You don’t have to think about it or even try anymore. You just have to practice.

The third, and most difficult for me anyway, is the “emotional” aspect of the addiction. I did not understand what was going on at the time. I just found myself crying for no reason. I felt like someone died. After the fact I learned that I had made a friend of cigarettes. They were there for me every time I needed them. They connected the events of the day for me. They filled the space, a void. And when I DECIDED to let them go, well, the pain was real. It may sound weird to those of you who never smoked. But smokers will relate. It is painful to let it go, and that is because of the emotional addiction. It DID feel like someone died because something was gone. But just like with a bad break-up, you do get over it. And boy, life is SO much better, especially as you age. After I quit, when I walked to class, I could not believe how much energy I had! I could breathe! This is how I am supposed to feel, I remember thinking. Trust me, you don’t even realize how crappy you feel until you don’t feel crappy. It is life changing. I honestly, thank God, still feel that good. 45 years later (or more).

 Not to mention the money you save. Let’s just say if a pack of cigarettes is about 10 bucks, and you smoke a pack a day, that is over 3,000 dollars a year. If you quit now and retire in ten years, that’s 30,000 dollars for that new house down payment, or better yet, for that European River Cruise on your bucket list. Enough said about smoking. But please, think about it. I hope you make the decision, go through the pain and come out the other side. Check out The American Cancer Society website for help https://www.cancer.org/cancer/risk-prevention/tobacco/empowered-to-quit.html.

3. Ignoring Nutrition (or Obsessing about it)

 Unfortunately, most people I have known and met over the years think about eating and food with the very narrow view of how it affects their weight. They think “good” and “bad” when it comes to food. They often have dieted over the years, lost weight, gained it back and then stop paying attention at all. It is socially acceptable to diet and focus on eating only as it relates to helping you lose weight or not. That’s too bad because food and eating well can be such a wonderful and enjoyable part of life. It is sad that so many people are probably reading this and thinking “are you kidding me? I am tortured by thinking about food!” So, I am not going to pretend this is easy. It is not. What I am hoping to convince you to consider trying to change extremes of eating. The fact is that eating more fruits, vegetables and healthy fats as well as fiber have a huge influence on preventing disease in our future lives. Waiting until you have prediabetes or heart disease is not a great time to start thinking about what you are putting into your body.

 When it comes to healthy eating, there are a few different mindsets I have noticed. There are actually people who escaped the entire diet-obsessed weight-focused movement and do not have the diet mindset at all. They like to eat. They just honestly don’t think about it. Let’s say you fall into the “ignore nutrition” mindset. Maybe you don’t think about what you eat because you simply have no interest in food. You never enjoyed cooking, and having people over for a dinner party is more stressful than joyful. Planning meals for the week and packing a lunch to bring to work feels like so much work. So you tend to pick up a burger for lunch or just grab some chips, a soda and a candy bar to get through your day. Isn’t that why they invented Coca Cola? You feel ok, what is the big deal? It is also easy to buy some frozen meals or pizza or whatever. You grew up with canned green beans and corn. TV dinners were the norm as was hamburger helper. Twinkies and Bugles were a staple in your home (and they still are).We all did not grow up in families with adults who just loved to cook. Some of us just could not afford to eat differently anyway.

  OR maybe you DO have the diet mindset, and you don’t want to think about what you eat because you are not following a diet right now. You DID fall into the craze but right now, you are off the diet bandwagon. You know you will be going back on eventually, when you are motivated again to lose the weight. Maybe it’s Weight Watchers, or Noom, or counting carbs or calories or “clean eating” (hate that expression). It doesn’t matter, just that now you are ignoring it all. So why not just eat what is easy, convenient, tastes good, quick, and especially what you know you won’t be able to have when you start that diet?

On the other hand there are those of you who may be TOO focused on what you are eating (and it does not always necessarily mean you are concerned about your weight). You read every label looking for whatever it is you are afraid of (fat, carbs, additives, artificial ingredients, etc). You spend way too much time worrying about what you are eating. You used to enjoy food but now eating is work. You tend to eat the same thing everyday because over the years you have found the foods and meals that make you feel “safe”. From my experience these foods tend to be low fat and low sugar foods such as plain yogurt, vegetables, some fruits, lean chicken and cereals with absolutely no sugar (heaven forbid you buy the honey nut cheerios by mistake). Going out to eat or to a dinner party is never that fun because typically the foods offered are not on your safe list.

 The truth is there are many different types of “healthy” eaters too. If you buy and prepare healthy foods most of the time, but CAN enjoy, and actually look forward to going out to a favorite restaurant or to a friends for dinner, then no big deal. Maybe you even buy what I call “fun foods” like your favorite ice cream or chocolate to have in the house when you crave them. You never feel guilty after eating anything. You may read labels once in awhile to check for protein or sodium or a specific allergen you react to. Maybe heart disease runs in the family so you prefer to choose products with no trans fat and less saturated fat. Well, this type of eater is probably balanced, not stressed out over food, but simply trying to create a healthy food environment. This person actually truly enjoys their kale salads and Greek yogurt with chopped fruit. But they also like and enjoy a wide variety of foods. They have a healthy relationship with food and eating, and they likely never dieted.

Another type of “too healthy” eater typically feels guilty after eating. They may have a long history of dieting and weight fluctuations. They may be in and out of “diet jail”. They will not eat something if they don’t know what is in it. They count calories and will only eat small amounts, or they lose control and binge eat, alternating with dieting. If this sounds like you then getting an evaluation with an eating disorder specialist may the only way to know if you truly have a problem that needs to be addressed. You can ask your doctor for recommendations in your area and with your insurance. If you don’t get help now imagine still being trapped in this draining mindset 10 to 20 years from now. I know people who are. This is no way to live.

 So what is they best way to eat if you want to be enjoying life in your older years? I believe making the effort to eat healthier without excessive focus on being perfect sets the stage for both a healthier body in the future as well as lots of joy when it comes to food and eating . Learning about healthy cooking and eating actually DOES matter. I have seen people in their 50’s and 60’s experience all types of health issues simply because of poor eating habits. Type 2 diabetes, stroke, hypertension, heart disease, digestive issues, etc can often be prevented with just a little attention paid to healthier eating (without driving yourself crazy). Little changes add up if you start when you are younger. Simply focusing on adding in fruits and vegetables helps. Remember, all fruits and vegetables provide antioxidants. It is these wonderful substances that fight the bad things, that help prevent damage and disease. I know people in their 50’s who have had heart attacks and who have lived on “brown food” (burgers, fries and not much else) their entire lives. Could it have been prevented? It’s worth a try.

So where do you start? Maybe you could start buying apples and bring one to work. It is perfectly alright to make it easy. Add some frozen veggies to your freezer so you could just microwave a portion to have with your dinner, whatever that is (frozen broccoli has just as much vitamin A and fiber as fresh). Buy a bag of salad at the grocery store when they go on sale if making your own feels like way to much work. Maybe start experimenting with cooking on the weekends if you have more time then. The idea is to just start somewhere. Check out the website https://www.eatright.org/ and https://www.myplate.gov/ for more guidance on healthy eating and cooking.

 Remember, stressing about eating is not good either. The time to start working on your relationship with food and eating is now. Check out these websites https://thecenterformindfuleating.org/Principles-Mindful-Eating and https://www.intuitiveeating.org/10-principles-of-intuitive-eating/ for more guidance on mindful, non-diet eating.

4. Bad Sleeping Habits

  If you are going to bed with your phone or iPad or laptop, or binge watching your favorite TV show until the wee hours (after midnight) and you do this on a regular basis, it is going to be next to impossible to eat healthier or move more. We now know that lack of sleep actually has a profound affect on the foods we want to eat. Lack of sleep affects metabolic messengers that make us crave carbohydrates and fats so that our goals of choosing healthier foods are sabotaged. Have you ever noticed that you are craving junk foods or greasy fatty food after a horrible night sleep, or after late night partying? You just can’t ignore it. Your body won’t let you. The urge to eat junk food is as strong as the need to use the bathroom. It’s physiological. There’s no stopping it. So if you are motivated to eat healthier, please don’t blame yourself or feel bad if you struggle. If you aren’t sleeping well, that is most likely the culprit.

 The other huge factor in predicting a healthier life in the future, moving more, is also going to be next to impossible if you are tired. If you aren’t getting rested, if you wake up exhausted every day, even getting out of bed can be dreadfully difficult. Who could blame you if you don’t want to go for a walk and especially go to a gym? It’s even difficult to make the bed or do the dishes when you are consistently getting poor sleep, let alone go for a jog.

 I probably should have put sleep as number one, because without it nothing else healthy can happen. If this is you, I strongly recommend asking your doctor about a sleep study. Check out the website https://sleepeducation.org/sleep-disorders/. The sooner you find out what is going on and how to correct it the more active and enjoyable, healthy years you can add to your life! I know people personally who have said “I feel like a new person!” after getting their sleep issue corrected. Don’t wait! The time is now!

5. Avoiding the Doctor

 Prevention is so much easier than cure. If you knew you had a very tiny precancerous lesion on your body somewhere that, if removed, could save your life, what would you do? Remove it of course! But if you don’t know it is there, the outcome would be different. Yet, so many people just don’t take the time to do the important recommended “screenings” that could mean the difference between life or death. Everyone my age knows someone who passed away because they did not get diagnosed with a disease until it was too late. Don’t let that be you. Yes, it takes time and is not always fun but if you could see into the future, you would have wished you did it. I hope you get that mammogram you have been putting off, or that colonoscopy or skin check for that new mole you noticed. Do that stress test. Tell your doctor about that chest pain or shortness of breath or any other issue that is new and not going away. The earlier you address it the more likely you can prevent something horrible and the more likely you can look forward to enjoyable years ahead. 

There of course are more things that affect your future health. Hating your job, struggling with a relationship, going through stressful life events all affect health. It is well established that stress affects everything. If you wake up with dread everyday, don’t ignore it. Ask your doctor about affordable therapy. Taking that first step is sometimes all it takes to feel more positive about life. Making an appointment with a therapist is the first step towards your new, happier life.

 Don’t wait until you are 60. Don’t wait until you retire and you think you will have more time (you won’t). Do it now. Start today.

That will be a dollar.

 

New Year’s Resolutions and Weight: Tips for Success (if you really gotta do this)

On By jodietitianIn Uncategorized2 Comments

Image may contain: one or more people and closeup
It takes a lot of tries to finally grasp that rubber ducky!

I don’t do them. Making  New Year’s Resolutions that is. I don’t like setting myself up for failure. That doesn’t mean I don’t reflect on things at the end of the year….. it just may take me more than the month of January to figure things out. But, tonight is New Year’s Eve and having listened to the “new year’s resolution” chatter already, I am pretty confident there will be lots of people living it up like there’s no tomorrow (as my mom likes to say) until New Year’s Day is over and it’s time to face the music.

Yes, people make resolutions about all kinds of behaviors they don’t like about themselves, usually focused on some health behavior change. Things like quitting smoking (yay), exercising more, eating healthier, losing weight. Sometimes people vow to spend less, save more, get a new job, go back to school, get organized, experience new things, etc. Of course, most new year’s resolutions I tend to hear about are related to wanting to change one’s body. You know, lose weight. It’s not just me, if you google “New Year Resolutions” there are lots of top-10 lists, and right at the top of most of them is “lose weight”.

I am not a fan of dieting and here’s why: As my friends and family know, I have spent much of my career trying to help people focus on health instead of dieting and weight loss. They are surely tired of me saying “listen to your body”, and they joke about it (especially my husband who loves to tell me his body is telling him to eat another cookie). What most of them will never truly understand is the struggle, pain, loss and often tragedy of those struggling with disordered eating. I have been forever affected by the lives I was blessed to share with some true heroes. Young and old men and women, girls and boys, mothers and daughters, who have fought this terrible disease and manage to keep going, and even to thrive despite its grip on their lives. I can’t forget them. And so, that is why when people tell me they want to lose weight, I struggle. Also, I believe in the “Health at Every Size” philosophy, and that someone’s body size, BMI or weight is absolutely no indicator of health despite our obsession with BMI and numbers. However, there are individuals who have been in their natural weight ranges most of their lives but then, due to some gradual but detrimental changes in their lifestyles gain weight that is NOT normal for them….and may affect their health because of that reason, NOT because of the number on the scale. I totally understand why those people would want to lose weight, and although reverting back to their original lifestyles that promoted their normal weight sounds easy, it is not.

So, despite my passion to prevent eating issues, I realize I really should not discount the feelings of others. If there is something that is important to you and you are determined to do it, it is not fun to hear someone else tell you it is a dumb thing to do. Plus, it doesn’t change things. It really doesn’t help.  People are going to diet, period. I have learned to keep my mouth (kind of) shut and let others learn on their own what works for them. Inevitably, life goes on. People lose weight, they may regain it over time (we all know people who say “such and such diet works! I lost 30 pounds on it last year!”). So they do it again, it is comfortable for them. Maybe some people (the lucky ones who don’t fall into a disordered eating pattern) may learn something good (like how to make healthier meals, smarter ways to shop, meal prep ideas, etc).  Do I wish they would avoid giving the diet industry even one more penny…..yes. But that is because I believe the diet industry all too often seems to prey on the insecurity and desperation of people striving to lose weight, and that bothers me. They make money off of the reality that most people are repeat customers due to the simple fact that by design, you start and then end the diet. Unless someone really becomes self-aware and uses the lessons learned in the right way, letting go of the rest of the ridiculousness all too often results in weight regain. For example, counting points (or calories, or carbs) for life just is not normal eating and not possible. I have NEVER seen someone adopt that as a forever lifestyle. So, you pay again. And again. And again. But back to what I said initially, I am not going to try to talk anyone out of anything. Not any diet (unless I know for a fact it is dangerous to that person), not any lifestyle, not any food. I am not an expert on anyone’s life, they are, so they know what is best for them, and they need to travel and learn in their own way, even if it takes a few rounds of it. What I do want to do, however is share what I hope might prevent disordered eating and what might truly help someone adopt a healthier way of looking at dieting, food and weight.

So, if you are one of those people with “lose weight” at the top of your New Year’s Resolution list, here are my tips for you:

  1.  Reflect on your “weight and lifestyle” history. Was there a time in your adult life that your weight was settled in a 5-10 pound range for several years and you didn’t have to pay attention to it? What was your lifestyle like? Sometimes we have even minor changes in lifestyle that eventually affect our health (or weight) such as moving from the city and walking everywhere to moving to the country and driving everywhere. Over time, the decrease in physical activity has an affect on our body. With that said, excessive physical activity isn’t exactly a doable lifestyle either. I have heard people say “in college I only weighed such and such, I want to be that weight again”. Well, in college, if you were on the track team and ran 70 miles a week, or maybe walked across campus day and night, or danced your butt off every weekend, that is not typical! You were probably at an unnatural low weight for you as an adult, and your present weight is more normal and healthy. Instead of thinking you should go back in time and be a certain weight, consider reflecting on your current activity level. Do you get an hour of joyful movement daily? Maybe that should be a focus instead of that number on the scale. So turn up that dance music, join the Y, find a walking buddy, or whatever you need to do to incorporate healthy movement into your life. Or, did your weight always fluctuate? Were you always on a diet, always trying to lose weight? Have you suffered from disordered eating such as binge eating alternating with trying to starve yourself and skip meals? If you have had extreme fluctuations in eating over many years and never got help, I would suggest an evaluation by a therapist who specializes in eating issues (ask your doctor for a recommendation). If, however, you have slipped into some unhealthy lifestyle and/or eating patterns such as eating out every day, drinking lots of soda or alcohol, watching 8 hours of TV a day, staying up way too late then maybe your weight really has been affected by these unhealthy changes and they are worth working on. And yes, although I would be happy because changing these behaviors will make you healthier, they may also help you be at your healthier weight, too (your goal). Bottom line: your weight and dieting history affect everything. Don’t ignore it and don’t compare yourself to others.
  2.  Reconsider your goals. If your diet plan or program makes any suggestions regarding how much weight you should lose (per week or whatever), I would suggest ignoring that. If you think your unique, individual body and metabolism is going to cooperate with anything but its own reality, think again. You will be setting yourself up for disappointment. You will not feel successful if you set yourself up with expectations involving numbers. Our bodies just don’t work that way. Fluid shifts may result in changes in the number on the scale which have absolutely nothing to do with what is happening regarding body composition (muscle vs fat vs water), so why judge yourself on it? The funniest story I can think of is when one of my patients came in after having ice cream the night before, thinking her weight was going to be up. Instead, it was down. “Oh wow, I didn’t know ice cream makes you lose weight!” she said….I had to laugh. The lesson is that your weight is going to fluctuate no matter what. Instead of focusing too much on that, could you consider looking at all the good things you have been accomplishing to be healthier?  Have you been eating more fruits and vegetables? Drinking more water, less alcohol and sugary drinks? Walking more? Sleeping better? Maybe instead of feeling bad because you did not lose weight, stop and think about all the healthy changes you have made. Find something positive. Then move on.
  3.  When your body talks, LISTEN. I was going to word this one “Beware of all-or-nothing thinking”. All too often when people start weight loss regimens they are “on the diet”. This implies something really powerful which many do not understand when they undertake this endeavor. It can be a set-up if you are not careful. I have used the term “diet jail” before. This analogy is pretty easy to understand, and worth repeating. When you start a diet it psychologically places you in “jail” where all the acceptable foods exist. The lean meats, fruits, vegetables and healthy “good” meals that you are going to restrict yourself to are available, and you are expected to eat a certain way as long as you are in there and until you lose the desired amount of weight. Outside of this self-imposed jail is the “bad” food. This is where the chips, ice cream, cookies, chicken wings or whatever else you are trying to avoid are. Unfortunately (or fortunately) our bodies know better than we do regarding what we are missing (again, I’ve talked about this but worth repeating). Since most diets are deprived of adequate fats and carbohydrates, if too restrictive our regulatory systems may send signals to our brains to fix it. This means you just may crave a cookie. Or chocolate. Or chicken wings. Since these are not in the jail (on the diet) where you planned to live for awhile, what is a dieter supposed to do? Often, since it is almost impossible to ignore body signals (have you ever had to REALLY pee on a road trip??) you give in. You break out of jail (or pull over on the highway). That is ok. What is not good is the way you react to this experience. Here is where you can make a change. If like most people, when you do what your regulatory system demands (eat the cookie, satisfy your body’s need for carbohydrates to function properly) you may be inclined to binge or overeat. It is natural to want to hoard something when you are deprived of it. But you don’t live on a deserted island, you are not a contestant on survivor and you really can get a cookie tomorrow if you wanted. Do you feel guilty because you ate the cookie? Guessing the answer for most dieters is “yes”. Well, instead of just accepting your self-judgment, why not try to give yourself some credit for being so intuitive and listening to what your body is trying to tell you? Can you try to eat just the amount of whatever it is to make that nagging thought (need) go away? The reality is that a few cookies (5 chocolate kisses probably satisfies a true chocolate craving) is no big deal. Binge eating IS a big deal because of the way it tends to make people feel (both physically and emotionally). Even then, it truly is a learning experience (“wow, this is harder for me than I thought. Maybe I need to research strategies to prevent this next time). The bottom line, if you are a dieter, this is likely to happen depending on the diet. If you can learn to eat healthier yet still fit in the foods you crave this is a behavior you can take with you for life, long after the diet ends. (Note: this does not apply to those suffering from Binge Eating Disorder, where professional help is needed; this advice is meant for the typical dieter who may overeat just because they broke out of diet jail).
  4.  Don’t give specific foods magical powers. Here’s a news flash: all food are equal when it comes to weight gain. I am not talking “big picture” for surely, if you eat a lopsided diet your appetite may be affected (no protein or no fat or no carbohydrates may affect your appetite and what you crave over time). I am talking day to day, meal to meal, snack to snack differences in food choice. Think of the ice cream girl. The ice cream did not make her lose weight, and if she gained weight it would not have been because of the ice cream. If your diet calls for only fruit for snacks for example, and you have that day when you just can’t look at another apple, having that muffin truly won’t make a difference. Again, it’s that darn smart body wisdom again, telling you what you need. So don’t give food that power. It doesn’t have it. Eating kale everyday or drinking some magic juice also won’t do anything magical. It won’t negate poor sleep or stress or smoking or a sedentary lifestyle. But if you like kale, eat kale : D
  5.  If there is a magic bullet, it is this.  Sleep. If you are staying up past 11 pm or midnight chances are you are going to affect your appetite in ways that won’t make you happy if you are a dieter.  According to one study, ” physiologic evidence suggests short sleep may influence weight gain through effects on appetite, physical activity and/or thermoregulation”- see Sleep Study . In other words, getting less than 6 hours of sleep may put you at risk for feeling hungrier, being too tired to be active and/or affect your metabolism in ways that may promote weight gain that is not normal for you. Clues you may not be getting enough sleep: needing a long nap on a regular basis. Naps longer than 20 minutes or so tend to interfere with falling asleep at night, and so the cycle begins. Do me a favor, do an experiment for a week and don’t nap, don’t take electronics to bed, turn off the TV, avoid caffeinated drinks after noon, avoid alcohol and try to get to bed by 10 pm (if you can). See how you feel.
  6.  Learn Learn Learn. If you look at your “diet” solely as a means to lose weight and change the way you look you are bound to be back where you started eventually. Instead, this may be an opportunity to learn so much about yourself. You may be forced for the first time to go grocery shopping in different isles. You probably have to cook more, and this is a good thing. Most healthy minded people I know have learned to enjoy cooking because in order to eat something both tasty and healthy, you really do need some skills. It does not have to be difficult, the microwave is fine. I know people who may have gone on and off diets but always have a few recipes they kept because they were really good. I suggest keeping a collection of dishes you have tried, maybe fast lunches or crock pot meals. No need to ditch the yummy healthy recipes you will find on this journey you have chosen. I tend to jot things down when I find a recipe I end up loving. I use google a lot! For example “Healthy Breakfast Casserole” gave me my favorite fast make-ahead breakfast for when I have company. “Best Ever Quinoa Sliders” and “Best Ever Gumbo” gave me other favorites. It really can be fun! I jot them down and stuff them in my recipe box (hopefully, you are more organized than I am). But healthy cooking is one thing to learn and keep, learning about yourself is the other great thing. Some changes come easy (maybe you discover yoga and love it). Some changes seem impossible. You may learn you struggle with one thing or another. Maybe it is too hard to break a night eating habit. Maybe you discover you can’t stop eating certain foods in moderation. No matter what happens to your weight, you will learn about yourself. And if you can’t fix it,just learning that you may need some help/support is a life-changing accomplishment.
  7.  If your diet program only focuses on food, be careful. Our eating habits are no simple matter! It drives me crazy when programs or health professionals spit out obvious information we all know without considering the individual experiences of a person. “Don’t eat too much sugar”, “Exercise more”, “Take smaller portions”, “Drink more water”,  “Limit eating out”, etc. etc. etc. What about the person who has tried to be active but just can’t because they were made fun of their whole life in gym class, failing that stupid pull-up test and mile run? What about the person who has been using food for 30 years because for them, it really is the only way they feel better? Or the person who has dieted for years and just can’t get out of that “all-or-nothing” mentality? Or the super picky eating adult who still only eats 3 foods? What about emotional eating, binge drinking, workaholism, stress, hating your job, bad relationships, not to mention health issues such as hypothyroidism, chronic pain, depression, anxiety, fibromyalgia? It is way too easy to give advice, to think you are helping someone by spelling out eating and exercise instructions. But that is just one little piece of the puzzle. If you are determined to use a diet plan, please know that it is not the end-all and there is no shame in needing support for other things you struggle with in life. It is all inter-connected after all.

So that is my simple advice. I have so much more I would like to share but time is short today! We are getting ready for a month on the road, doing some exploring of the Southern USA in January. Being away will give me that time to reflect on the New Year and where I want to go. So far, I will share one thing I have figured out since my retirement in July. I still feel obligated to share my experiences somehow, to hopefully help others. Especially in the world of pediatrics and how weight issues are treated at times in children. I feel the need to get my 2 cents in, so finishing that book, even if it is just published on Amazon, is definitely a goal. Other than that, like most everyone else, I will continue to be grateful for all the love in my life, from family to friends to past co-workers and patients, students and families. ALL are what make me so thankful and feel so blessed.

Oh, that adorable little guy in the picture reaching for the rubber ducky? My new grandson! At not even 6 months old, he made me realize we must be born with determination. I watched him for hours mastering the skill of grasping for his toy (that is after he took a few months to get the fingers-in-the-mouth skill down pat). His face was contorted from concentrating so hard. His eyebrows furrowed, he looked so intense, he tried so hard. And when he finally got it and found out how to bring it to his mouth, the delight on his face was just awesome. We can do it, too. We can find our balance. It won’t come easy, nothing good or worthwhile ever does. If you are reading this, you surely were successful with lots of things in life (you got the ducky!). You got this, too. Happy New Year!!!!!

Ending the battle on obesity: can we talk about building health instead?

On By jodietitianIn UncategorizedLeave a comment

soupHave you ever gone to your doctor and had advice thrown at you without them even asking about the reality of your life? It is unfortunate that most jobs in the healthcare industry now revolve around “productivity”and making a profit. A friend of mine who consults in pediatrician’s offices around the state tells me the poor doctors scramble and stress about their time and seeing patients because their productivity is tracked by the companies that manage them. It is for this reason I believe some doctor visits seem rushed. It is probably why in some cases there is just not time for a doctor or nurse to get the information they need from you to counsel you appropriately. So many people I have worked with have told me they have felt insulted when told to “stop going to McDonald’s!” or “just exercise more” or “cut down on your portions” when the reality is they cooked only healthy foods, they ate tiny portions and they already were exercising. Or, even scarier, the eating disorder patient being told to “keep doing what your doing, your weight is good!” without even asking about the dangerous way the patient lost weight. So, it is not always lack of time, but, sadly, the tendency for people to make judgments about behaviors based on someone’s appearance or size.

A friend shared this great article with me recently that describes what is going on perfectly. In a nutshell, it tells personal stories of individuals and what they go through. It describes our “war” on obesity, and the repercussions of that war. Finally, it suggests changing our focus instead to one of promoting health.

Please take the time to read the entire article, it is worth it. huffington post article

The truth is, looking at our life as a whole instead of just the fat on our thighs (or butt or tummy) just may lead us in the right direction. Taking a look at sleep, stress, nutrition, physical activity, smoking habits, etc. and tackling a little bit at a time brings us closer to feeling good (and yes, probably looking our best, too). It is not glamorous or exciting or as dramatic as fast weight loss and the lure of dieting can be, but the difference is, it may be doable.

Two Cookies and a Yogurt

On By jodietitianIn UncategorizedLeave a comment

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.

 

 

If Diets Don’t Work, What Does?

On By jodietitianIn Uncategorized2 Comments

The Ultimate Diet PlanI made the HAES Pledge. That means I consider myself a “health at ever size” dietitian, someone who refuses to focus on weight and body size, honors diversity and promotes a healthy, sane lifestyle that includes fun movement and intuitive eating. I would love to pretend that everyone cares about their health and not just their weight, however I know this is not true. It does not mean I will ever promote weight loss for the sake of weight loss alone, but I often feel uncomfortable when those around me are doing everything they can to lose weight. Although I know through my experience with patients as well as reading the research on weight loss (there’s lots there) that strict dieting is not the way to go in the long run, I am not one who discounts another’s feelings and goals. That just means that if you tell me you want to lose weight and you are starting a diet, I am not going to lecture you, or tell you to stop wasting your time and to focus on your health instead (and that you are beautiful no matter what your weight or body size). If you are a loving, kind, good, nice person, of course I feel you are perfect the way you are. But you may not feel that way (just because you don’t like your body since you have gained that weight). And although I wish I could make you see the light (that focusing on being healthy is the way to go), I know I can’t.

So although you won’t find me trying to convince people they should not feel the way they do, you won’t catch me advising people on how to lose weight. It goes against my principles. You WILL find me trying to educate dieters though, because I have seen it all, I have been affected by what I have seen and I will do whatever it takes to prevent the bad things that can happen from dieting.  And that is what this post is about. If you insist on dieting to lose weight then I want you to be safe, stay healthy and aware of what you are doing. I want you to avoid the typical traps that dieting often sets. I want you to recognize dieting for what it is: a temporary answer. But mostly, I want you to never give up trying to learn what the permanent answer is to your weight and body concerns. And that is different for everyone.

The fact is that some people gain weight and although they may not like it, it is completely natural and does not affect their health. There are others, however, who do gain weight resulting from some unhealthy lifestyle changes or other issues and the weight gain is not normal for them.  Even for these individuals, focusing on dieting and losing weight typically is not the answer. Actually, lots of people gain weight just as a result of their dieting. Either way, I like to believe there is a “normal, healthy weight range” that a BMI or weight chart can’t predict. It is the weight your body is happiest at, the weight you tend to fall at when you are living a relatively healthy lifestyle, sleeping well, enjoying regular enjoyable physical activity, eating regular meals, eating healthy foods as well as other foods when you want them (not starving, not binge eating, not feeling excessively full all the time, or walking around hungry half the time). My goal for you, and the true answer as to how to be the weight you are supposed to be is to do some reflecting and learning.  Here is my advice to keep you healthy, safe and alive and hopefully, in touch with reality when it comes to your weight and health.

  1. Find the REAL answer. What is the actual story about your weight? I find people fall into 2 categories: those who gain weight because they are supposed to and it is normal, and those who gain weight in a sneaky way because they have fallen into a lifestyle that is not supportive of their health or feeling good. An example of the first group is the high school/college athlete who used to run 70 miles a week in order to compete at a high level on the cross country team. After college, they get their dream job and now barely have time to exercise (or maybe they now take a walk every day, you know, normal life exercise) and gain several pounds over time. Their new weight settles in a stable range, yet they can’t fit into their old clothes. Not wanting to buy new clothes in a larger size, they start to diet. This has all kinds of negative repercussions (such as making them preoccupied with food, binge eating, etc). In this case, the weight gain is completely normal with no affect on health, and actually trying to lose weight is the last thing they should be doing as far as health OR weight is concerned. Even though they gained weight, they needed to. After all, running 70 miles a week is not the norm. Who wants to do that forever? Unless you are someone who truly loves running, well, that is different. I believe we all need to do what we love and if competing in road races, running long distance, biking 100 miles is something that makes you happy, then go knock yourself out. But if you are doing it only to prevent weight gain, hating every minute, well, that is no way to live.                                                                                      Or maybe you can’t relate to this at all, and when you look back and truly reflect on your life, you realize some things have changed. This is the second type of person who has gained weight over time.  I can share some stories I have heard from others. Maybe they started a new job after college and now that they are making money they start going out to eat more often. Dinner used to be whatever mom made, but now it is the favorite pizza joint (and they throw in a free 2 liter bottle of Coke, can’t beat that). Or maybe they got married and their entire lifestyle changed. Lots of baking for the new husband who loves his cookies, watching movies together with drinks and popcorn. He is a couch potato kind of guy, so you join him (you miss the gym, but this is fun, too). Over time, you notice your clothes getting tighter, you don’t sleep as well, you get a bit more indigestion than you used to. In this case, the weight gain resulted from some changes in lifestyle that were not conducive to health, and actually contributed to feeling less than great. Figuring out why your weight changed and if it is normal for you, or not, is important. Because then, it gives you a focus. A diet is not the answer. Getting back into your healthier habits is. And it has nothing to do with the weight, but everything to do with how you are living (and feeling).
  2. If you insist on dieting, be aware of the “all-or-nothing” trap. Just because you “fall off” your diet by eating a cookie you then go on to finish the box. If you were needing a cookie, it just means your diet plan likely does not provide enough of what the cookie has. Is your diet low fat, low carb? Then guess what? THAT is what you will crave! a cookie. Or chips, pizza, ice cream….carbs and fat. Who craves grilled fish when they are dieting? Instead, try to take it as a lesson. Learn to listen to these cravings and enjoy what you want in moderation. Instead of binge eating or saying “what the heck” (actually referred to as the “what the hell” effect) and eating everything in sight because “tomorrow you will be back on track”-meaning back on “the diet”, eating some of what you want actually makes the craving go away. You feel better. In fact, when you hopefully go off the dumb diet (sorry, I mean the diet) this will have taught you that you can enjoy both those foods defined as healthy as well as those other foods, and nothing bad will happen. You won’t gain weight. You will just be a normal eater.
  3. Don’t skip meals. You have heard this before. Just today I had a patient come back for a follow up visit. I saw her a week ago because she could not stop herself from excessive snacking at night. Come to find out, she had been skipping lunch and breakfast. By evening, she was out of control. She simply started eating a typical breakfast and lunch (plate of meat, potato, veggie, water, cookie) and then dinner, and lo and behold….no more excessive snacking. Plus, she said, she felt “so much better”. Yes, getting some nutrition during the day does have an impact on your energy level. If you find yourself dragging and exhausted by early afternoon, maybe you aren’t eating enough. And, skipping meals lowers your metabolism and encourages weight gain (but you knew that). Finally, skipping meals really does affect your brain and your thinking. For some, skipping meals a can trigger even more disordered eating. There is no way to know who is at risk, but I don’t want it to be you.
  4. Get enough sleep. You have heard me say it before, I believe in listening to your body and food cravings, but when you don’t get to bed before midnight, and don’t get enough sleep (7-9 hours for adults, it varies) your levels of ghrelin will be elevated and this messenger makes you excessively hungry, and also causes you to crave fat and sugar. It is really hard to eat healthy when this is going on. Not to mention all of the other benefits of a good night’s sleep (feeling better, having energy, fighting illness). Napping doesn’t count, and actually can make sleeping at night even more difficult. Yeah, don’t nap if you can help it..
  5. Stay hydrated. I worry about people who diet because they are at more risk of dehydration as well as hurting their kidneys. When you diet too strictly, you actually break down muscle,which is protein which has nitrogen that needs to be excreted through your kidneys. So water is essential so as not to damage your kidneys. Your pee should be light yellow and you should need to use the bathroom every 3 hours or so. The minimum for most adults is 8 cups of water a day, usually 9 or 10. If you feel dizzy sometimes, this can be a sign of dehydration. The other (less scary) issue with dehydration is that your metabolism will not be working at its best if you are dehydrated. Hopefully, that motivates you to drink that water!
  6. PLEASE don’t connect dieting with exercise. We all need to move, be active because moving in ways we really enjoy is so important to our health. We can prevent heart disease, keep our bones strong, help us sleep, improve our mood, make our muscles strong, help prevent us from falling (especially as we age) and all kinds of other good things, both mentally and physically. Often, when the diet ends, so does the exercise. This does not make sense! Although, if you have the mindset that exercise is only to help you lose weight, then I guess it does make sense. But, in the long run, the real answer? Keeping fun and consistent movement in your life has nothing to do with dieting and everything to do with your mission to have the healthiest body you can have. So when this diet ends, keep on moving.

The reality is that any single diet that tricks you somehow into taking in a lot less calories than you were eating is going to result in weight loss. The problem is that nobody can sustain any particular diet because it is too hard, too boring and just simply not a normal way to live. Instead, the answer is to reflect on the reality of your weight. Have you been at a stable weight and have a healthy lifestyle, but just want to be thinner? Then, I am guessing your body will fight you every inch of the way, and focusing on being as healthy as you can is the sane way to go. If, on the other hand, you have fallen into some really unhealthy habits, have given up some of your past healthier habits (that also made you happy and feel good), then figuring out how to move back into a more balanced lifestyle would be more helpful than another diet (which basically just puts off the inevitable). It is never about some magical number on the scale. There will never be one diet that works better than they all work. But it is about feeling good. There is just something about sleeping well, having energy, feeling good that really helps you feel better about the body you were born with.

In the meantime, if you are on a diet to lose weight, I hope you stay safe, listen to your body signals (they are smarter than we are!), maybe learn to cook some healthy meals while you are doing this, discover some new vegetables or fruits you like. But mostly, I hope you take the time to learn about YOU. When the diet ends, that is when your story really begins.

The Sliver People

On By jodietitianIn dieting2 Comments

Image result for thin slice of cakeEating behavior has fascinated me for years. Maybe because of my Italian heritage and the tendency to “cook enough for the army, the navy and the marines” as my mom would say…..coupled with my discovery of the research on “restrained eating” and learning about the link between dieting and binge eating. Added to my years of working with people with eating disorders and weight concerns, I have a great appreciation for the complexity of eating, food, and why people do what they do. So I love when people tell me stories about food and eating. Last week at work one of my co-workers told me a story about a family dinner and how something a relative (great aunt) said that kind of bothered her.

It was a celebration and cake was being served. My friend, her son and her daughter were enjoying a piece of cake at the dining room table while this aunt sat on the couch watching. “Look at you all, stuffing your faces!”she said in a way that was kind of negative, as if she were witnessing bad behavior, or behavior to be ashamed of. My friend went on to tell me about this aunt who appeared to be criticizing them for eating cake. Apparently this person is someone who always resists the dessert…..she “does not eat sweets”. She has “willpower”. And she seems to look down on those who give in.

But then, here is the weird part, the question my friend had: she refuses to take dessert EVER…..but then eventually, every single time, after shaming everyone else, sneaks back for “just a sliver”.

OH! I knew exactly who my friend was talking about. She sounds like “The Sliver People”, I said. We both burst out laughing, describing what we see when people try not to eat something they really want but for some reason don’t allow themselves to have. After a good amount of giggling at the term we just coined, I went on to share my theories of The Sliver People. Now remember, these are just my theories (which are influenced by research on cognitive restraint and dieting behavior as well as what lots of my patients have described to me about the way they think and feel about food).

So what is it with the Sliver People? My theories:

  1. They have a “good food-bad food” mind set. Sweets are bad, dessert is bad, cake is bad, so nobody should be eating it. If you eat “bad” food, then you, by association are being “bad”. You have no “willpower”. You are weak.

My Response: if you like it, it is GOOD. If you have cake for breakfast, lunch and dinner, you won’t feel too good. It’s all about balance and “listening to your body”. If you want something sweet and don’t eat something sweet, you will likely be thinking about food all day. I would recommend eating that darn piece of cake and going about your day.

2. They think cake (substitute sweets, desserts, “bad” food) makes you fat. Magically, one piece of cake can add gobs of weight.

My Response: the scientific fact is that one average piece of cake may have a few hundred calories (except my sister-in-law Michelle’s Mocha Marsh mellow 90 million layer cake she enters into baking contests which she manages to cram in a bit more melted butter and cream I am guessing that makes her a champion baker)….anyway, it takes much more than a piece of cake or one dessert to have any effect on weight, even Michelle’s. When you eat more calories than your body needs, it knows what to do. You don’t have to count. Think about it. When you eat a bigger meal than normal, something very strange happens: you no longer feel hungry, imagine that. You can go longer than an hour without thinking about food. So if you eat the cake and it is more than you normally eat, your appetite on its own will keep you in balance (if you learn to listen and trust it). Not easy for some people.

3. They have been dieting most of their lives. They are on a diet still. Cake is not on the diet.

My Response: when people “go on a diet” and eat only certain foods while eliminating others, we know they eventually have to “go off” the diet. Dieting and food restriction lead to food obsession and disordered eating, often binge eating. When dieters give in and have even “just a slice” feelings of guilt often follow. That is why restrained eating and dieting often lead to depression (in addition to the negative effect of starvation and inadequate energy intake on our brains and mood). I know I will never convince people to stop “dieting” or looking for that magical eating plan that will transform their bodies and their lives….but I won’t stop trying. Instead, if you focus on “healthy eating” and living, then having a piece of cake for dessert at a family celebration does not disrupt anything. It just adds to life’s enjoyment and moments we should be cherishing, creating memories together, savoring every single thing that is good…and I call that “healthy”.

4. They really aren’t hungry,but want to taste it. Their belly is full, but they know they won’t get this chance again (how often do you get a chance to try an award winning 9 million layer cake?).

My Response: I think it is “normal” eating to listen to your body, and if you know you can’t fit an entire piece of cake comfortably into your belly but want a “sliver”, it’s not a big deal. Chances are the person who takes just a bite because they want to taste it are probably not even noticing what everyone else is eating. They certainly are not being judgmental about anyone who decides to eat an entire piece. They are just eating what they want and not what they don’t want. Maybe they may take a piece “to go”. There is nothing wrong with that, honoring your body and staying in tune with it is something we all should be working on, that is if feeling good is your goal.

Are you one of the “Sliver People”? If so, do you recognize yourself in any of these descriptions? Remember, this is not meant to be a judgement of people who don’t take an entire piece of cake. It is meant to make us all aware of how we have been influenced by a culture that values thinness and weight loss and dieting at the expense of the true meaning of life. To cherish family, friends and celebrate all that we have, all of our blessings as much as we can while we can (if you ask me). To be thankful for all of it, every single day. To miss out because of fears of gaining weight, well, that is just sad.

Oh, and please don’t judge me because I only eat the frosting.

News Flash: You Have No Right To Comment On My Body

On By jodietitianIn UncategorizedLeave a comment

HidingIt happened again. Not once, not twice but at least three times this past week. I am so sick of it, it makes me so crazy and yet, sometimes I feel like I am the only one going nuts. How could it be that we seem to allow anyone at all to be as rude as they want to be, and yet it just goes under the radar? No, I am not talking about Donald Trump (although I very well could include him in this rant, since he is a perfect example of what I am talking about). Yes, somehow we have become immune (it seems to me) to knowing what is right and wrong when it comes to what we should or should not say…..about people’s bodies.

Yes, I heard a few stories this week, and have one of my own. And I know these are not unusual circumstances, I know the things I have heard are regular occurrences in many peoples lives. I also know that people don’t always think they are being hurtful when they make teasing or sarcastic comments about someone’s weight or body. Sometimes they think they are funny? Anyway, I have said a lot on the topic of commenting on weight loss, and the possible detrimental affects of giving praise to someone who has lost weight (especially a teenager) since sometimes the weight loss is the consequence of unhealthy starvation or eating disorders. When a teenager is complimented on weight loss it is hard for them to think they should stop. Praise feels good.

No, that is not what I want to talk about again. It is more about how people feel they have the right to say something about someone else’s body. Here are some examples of what I am talking about:

“Geeeez, Suzy, why don’t you just eat a cheeseburger or something?”

“Great to see ya! Put on a few pounds, huh?”

“You look so much better now that you put on a few pounds!”

“What’s that bump on your foot? Why does your toe point out?”

“Gettin’ up there in age, huh? Beer belly and everything!”

“Did you lose weight? Your face looks so sunken”

Get the picture? Does it all sound harmless to you? Most of us know what having “good manners” means. You would never think to go up to someone and say “You have bad breath” or “your face is ugly” or “what a big nose you have”. But yet, it is alright to make comments about how someone’s size ? Or body part? As if it means anything??? Are we all really that brain washed into thinking the size of anyone really matters? Do we all need to have perfect body parts? And why does it matter if someone changes their size? Why do you care if they gained or lost weight? Why the focus on that?

I think I know why. I feel like it is a “global brainwashing”. We are all supposed to think we would be happier if we were a certain size. Our bodies are supposed to look a certain way, and we all should be striving to be that (whatever it is, I think the focus most of the time is on stomachs if you ask me….that is what most of my disordered eating patients always thought about. And that is what most “normal” people I know seem to focus on). Yes, even if you don’t have any extreme eating issues of your own, or maybe you have body image issues that are considered “normative discontent”. Check out this blog on the topic Normative Discontent as well as this video Dove Video. Both are really insightful as to how and why we think the way we do about our bodies, the influences out there that we aren’t even aware of, and why, I am guessing, most of us kind of go along like robots working toward what we are brainwashed to think is important. And why some people think it is A-OK to address people’s bodies in a way that is not only rude, but also NONE of their business.

Granted, some people just don’t give a hoot. You can tell them they look like crap, they look better now that they gained weight (they may agree), or maybe they know they put on a few pounds since high school but they are ok with it, heck, we all gain some weight as we age, it is pretty normal, who cares. But, I am guessing there are some people who are very sensitive to comments about their bodies. I have known people in my life who are genetically very thin. They get made fun of all the time. The comment “why don’t you just eat a cheeseburger” is very hurtful to someone who can’t change their body. Or maybe they are going through something, and they may not turn to food to make them feel better like some people. Some people eat more and it helps them get through stressful times, but some people can’t eat. Telling them to eat a cheeseburger makes me want to smack someone.

So, what would I wish everyone would do instead? To me, everyone is a book. When I was working 40 hours a week as an outpatient dietitian, I did not care if someone was referred to me for “obesity” or an “eating disorder” or “pre-diabetes”. To me, every patient was like a book to be opened. Every person has their own story. And YOU don’t know it. You don’t know why they may have lost or gained weight since the last time you saw them. You don’t know how healthy they are or not by the way they look or their body size. They may have gained 30 pounds but now are doing triathlons (and can kick your butt). They may have lost a loved one and fallen into depression, and lost some weight…….and so do you really think you telling them to eat a cheeseburger is going to help? Stop being stupid.

Instead,if you notice something different that concerns you, why not look at the person inside instead? Re-connect. Find out how they REALLY are. Make time to get together. Then, be supportive. If it is a casual acquaintance that you may not see again for a long time, then why bother commenting on something as meaningless as how much weight they lost or gained? Take the precious few minutes to find out about their kids, their lives, what they are doing, and all of the stuff that matters.

I feel better, now that I have vented. I really wish people would catch themselves before they make a body comment. YOU may think it is meaningless, but you truly do NOT know what the other person is going through. Instead, focus on what really is important in life. And if you think it is your body size, I feel sad for you.

Oh, so my story this week?…a comment about my feet. What was going on with my toe? For some reason, it kind of sometimes turns in to my other toe, and I do sometimes worry that it is some weird neurological thing…but, Really? That is what some people notice I guess… I still wear my flip flops…it literally took me years to get over my not so gorgeous feet….but I really don’t appreciate anyone noticing them, let alone commenting on them. Ugh. So there you have it…some really nice people sometimes just need to say something I guess.

But I hope you don’t.

PS. In the school (for special needs kids) where I work, two of the classes cook on Fridays, then enjoy the lunch they prepare. I overheard a half of a conversation  of a few of the teenagers eating at a table I walked by. I am not sure what happened, but all I heard (out of the mouth of a very sweet guy who happens to have gained a bit of weight) was one comment. He said, very matter-of-fact….”people don’t like to be called fat”. Not sure if someone called him that, but I am going to try to find out.

 

Does Your Teenager Have an Eating Disorder? Signs and Symptoms You Should Not Ignore

On By jodietitianIn UncategorizedLeave a comment

scaleThey came to their visit together. Jessica (not her real name) did not want t be there. I let her stay in the waiting area fixated on her cell phone (she made up her mind she hated me, at least that is what her facial expression conveyed). Instead, I took her mother into my individual counseling room to get the story before I met with Jessica. It was one I have heard before. In fact, the entire scenario became predictable. Mom was all over the place, at first angry that her teenager was being so rebellious, she was driving them all crazy. She refused to go anywhere with the family, she hid out in her room, refusing to sit at the family dinner table. Vacations were a night mare. “She used to be such a sweet girl, so happy and care free, she LOVED helping me in the kitchen and really enjoyed going out for pizza with the family, but now she is like someone else. We don’t know what to do”. Next, after the anger, comes the crying. “She looks horrible. She passed out the other day and it was so scary. Yet, she won’t stop this. It does not make sense!”Jessica took to wearing very loose and baggy clothes, and it wasn’t until her mother walked in on her changing that she noticed her protruding ribs and the obvious weight loss. After lots of threatening, Jessica agreed to go to her pediatrician’s and was then referred to us. How did it get to this point, and how did this family miss it?

Eating disorders can happen at anytime, but transitions are especially tough. Back to school, back to college, back to normal life. Simple, predictable, or is it? Not for everyone. Times of transition and change, such as starting a new school, going away to college, new teachers, different friends, all of it can be a challenge for some kids. Times like these can be risky when it comes to falling into the grip of an eating disorder. Couple that with society’s obsession with losing weight and it is pretty easy to understand why lots of eating disorders often go unnoticed until it is almost too late. As a parent, what signs or symptoms should you look for? Some things that you should not ignore:

  • Weight loss. Sounds obvious, but actually, especially in teenagers who are larger or fatter, parents mistakenly tend too think the weight loss is a “good” thing. Even doctors make the mistake of automatically praising weight loss, especially if it brings a child closer to a “healthy” BMI (gag).  That meaningless number does it again…….clouds the judgement of otherwise smart and well-meaning people (parents and professionals alike). The great news is the American Academy of Pediatrics came out with a new report in August highlighting the risk of treating obesity in adolescents with disordered eating as well as the importance of focusing on health verses weight. See this article in American Academy of Pediatrics for the specifics. The bottom line is that we need to get off the losing weight bandwagon, fight the cultural message that everyone needs to be thin, or a certain BMI, and NEVER EVER praise weight loss in a teenager. Yes, there are times when a kid may lose weight. A teenager who is very sedentary who goes away to college and finds themselves having to walk 9 miles a day just to get to all their classes may indeed lose some weight. This is not what I am talking about. But even then, making a big deal about weight loss is never good. Even this kid, if they get lots of attention for losing weight may decide they like the attention, and start doing things to purposefully lose weight (I have seen this happen many times). Don’t do it. Don’t compliment weight loss in a kid. Instead, compliment growing up and being successful.
  • Food refusal. When your teenager has always loved your home-made macaroni and cheese, and even begged you to make it, but now refuses to eat it, NOT GOOD. Unless there is a really good reason for refusing a favorite (recent stomach bug, stomach ache, cramps, etc) don’t ignore this red flag. Should you try to force your kid to eat it, or pressure them to answer you as to why they don’t want it? Like I said, one refusal because they don’t feel good is normal, but a few times in a row is just not normal, however responding with anger is not helpful. Instead, I have found those parents who are able to open up a caring dialogue with their teen have a better chance at getting to the bottom of it. It is important to pay attention to all signs and symptoms so you can then make a plan to address it. Forcing food or anger does not help.
  • Decreased socialization. For a teenager with an eating disorder, any situation that involves food and eating is threatening. You will start to notice they don’t want to go to their friends houses, or to birthday parties, and they especially will try to get out of family functions (those typically aren’t a teen favorite anyway, but they are doubly horrifying because of the food involved). They may lose interest in going to what once was a favorite restaurant and a big treat. They will refuse to eat the family’s favorite pizza on “pizza night”. Red Flag.
  • Loss of menstrual period. Not that you need to keep track of your teenage daughter’s cycle, but if you notice she does not ask you to buy feminine hygiene products the way she usually does, ask. Don’t ignore it as this can be a sign of weight loss and inadequate calorie intake.
  • Obsession with exercise. If you notice your teen going out for long runs, or running both morning and night, or if you notice the bedroom door is always closed and when you walk in she just so happens to be exercising, this could be a sign that something is not right. Yes, being active is good for all of us, but if doing calisthenics is something new and different, and especially if your teenager seems to be hiding it, then this is also a red flag.
  • Going to use the bathroom after every meal. If this has always been normal for your child that is one thing, but if it is a new behavior, it could mean they are purging or throwing up their food. You can check the bathroom for evidenced or you may hear it, but don’t ignore this. Vomiting on a regular basis is an eating disorder behavior and could leads to electrolyte imbalances that can be deadly.
  • Body checking. Do you notice your teenager looking at her body, especially her stomach obsessively? Does she tend to squeeze her arms as if to check for fat? This is a common behavior for people with body image issues and should not be ignored, especially if other signs are present.
  • Obsession with food labels, writing food in a journal, or counting calories. I can’t tell you how many food journals complete with calorie counts I have seen in my life. It is NOT normal. It is NOT a good thing. Yes, there are apps and websites and even the My Plate site has trackers for this. I hate them.This is as far away as normal, intuitive eating as you can get.

So what should you do if you notice any of these symptoms? Remember, your teenager is not doing this on purpose. They can’t stop. It is a very complicated disease and the triggers and causes are different for each person. It is important to be empathetic, kind and loving and to avoid blaming as this will not help. The first step might be to call your pediatrician and share your concerns. They will probably want to see and evaluate your child and may recommend therapy and a visit to a dietitian. Be sure that both specialize in treating eating disorders. Your teenager probably won’t be happy, but you can also get support from the therapist as far as how to handle resistance. The sooner you address the issue, the better chances for recovery. Remember, it does not matter what size your kid is, if they are fat or thin. It is very easy to ignore some of these red flags, like I said, some are so socially acceptable and desirable that it is sometimes hard to see what is going on. Don’t ignore these signs. They won’t go away on their own, and the longer you put off getting help the harder it will be.

There is hope. You can get your old teenager back.But you gotta move fast.

For more information and for great resources, check out the website: Eating Disorders Awareness and Prevention.

New Study Links Positive Effects From Calorie Restriction: Why I Hate News Blurbs

On By jodietitianIn Uncategorized1 Comment

 

Green BeanI literally stopped in my tracks the other morning as I was walking out of the kitchen to go get dressed for work. The first thing I do when I get up in the morning (after pouring that critical first cup of coffee) is turn on the small television that is in our kitchen so that I can listen for the weather and traffic. Like most people, I have my routine that gets me out of the door on time. But that morning, the words I heard caught my ear and I had to listen. “New AMA Study shows calorie restriction has positive benefits!” Oh brother, here we go, giving people another reason to diet. I listened to the brief details (how much can you pack into a 2 minute blurb?) and learned that apparently decreasing your calorie intake by 25 percent can improve your mood, quality of life, sleep and sexual function. Really? I didn’t have time to check into it but knew I had to as I like to be prepared when someone asks me a question about things like this. Most people just automatically believe what they hear and that is what troubles me.

So I searched and found a summary of the study, see AMA Study To read the entire study you have to pay for the article unless you are a member of the American Medical Association (which I am not) so instead I just read the abstract. What I learned from working with many researchers in graduate school is that we need to consider many factors when it comes to study conclusions. We need to be critical. This is not easy, especially if the research is in an area where we are not experts. The field of nutrition and health is a complicated one because so many factors influence our health (and our weight). So I always look at a study and try to decide how much it means, if anything in the real world. I like to look at some of the obvious things, such as the number of subjects and the kind of people who were involved in the study as well as the length of the study. In this study, the 220 subjects were “nonobese” and “healthy”.  The subjects were divided into 2 groups: “calorie restriction” (CR) or “ad libitum” (AL). The measures were taken over 2 years (initial, one year and 2 year) and the results are based on “self-report”, in other words, people answered questionnaires. We know there is always a degree of error in self-report measures as people often answer the way they think they are supposed to. We also can’t know all of the confounding factors, such as the other influences in peoples lives that might have had an effect (a new job, a new baby, getting married, etc.). There are so many factors that affect mood and energy level. To believe that simply decreasing calorie intake can have all these benefits is wishful thinking. Even if after many replicated studies (which is always needed to really show cause and effect) do you really think it would be easy to figure out how to decrease calories by 25 percent? That is a lot! How is nutritional status affected? What if someone decides to cut out milk to achieve this goal? What happens to their bone health over 10 years? Do you think you will be in a better mood if you have osteoporosis? When you can’t get up and walk without pain? Maybe I am being a bit sarcastic and extreme, but the point is, it is never ever that simple.

Unfortunately, the people who heard this news blurb and may react to it are probably the ones who are already dieting and restricting to lose weight. In particular, I worry about those with eating disorders who are looking for an excuse to restrict. Remember, there is always opposing research that shows the exact opposite. In this case, you probably don’t have to do a literature search to know (but there is plenty of evidence there) that starving yourself or excessive dieting is more likely to lead to depression, not being happy. It is more likely to decrease your quality of life, especially if dieting and weight obsession become your focus. People I have worked with who have struggled with eating disorders have often lost so much. Having to take time away from college, or your family to be admitted to the hospital due to dehydration or starving, not being able to participate in activities you always enjoyed just because you don’t eat enough, even not being able to drive (I have seen it). Losing friends because they just can’t be around you any longer and watch you do this to yourself. ….this is the reality of calorie restriction.

Instead,  when you hear a news blurb that briefly shares a dramatic result such as this one, stop and think about how different we all are. Our lifestyles are unique, our dieting history and relationship to food is unique, and most importantly, our genetics are ours alone. Reign yourself in and refocus. What were your goals again? To feel good and be healthy and enjoy life to the fullest (I hope).  What are YOUR obstacles and barriers? Are their habits you have that you know might be affecting your health? Stress from work (need a new job?) Stress in your relationship (need some couples therapy?) Smoke too much (need some help here?) Drink too much (do you need to get help, or work on your habits?) Too tired to be active (time to see the doctor for that physical you keep putting off?) Live on fast food (time to start learning how to cook?)

Achieving health and happiness is not always simple. And even when you do achieve it, trust me, a wrench will be thrown in from time to time, such is life (as my mom always would say).

Decreasing your calories by 25 percent?…..not this girl.