Diabetes and Intuitive Eating

As you know by now, I’m all about intuitive eating (IE) and the non-diet approach.  I read and hear a lot about people with diabetes fearing and believing that because of their medical condition, they can’t and will never have the opportunity to eat intuitively.  I completely disagree with this.  What is intuitive eating all about?  It’s about connecting your body with your mind.  It’s about learning to recognize and listen to your hunger and fullness (satiety) signals.  It’s about mindful eating and coping with your emotions without using food.  It’s about respecting your body and learning to exercise in ways that feel good, as well as respecting your body by honoring it with the nutrition that supports it and helps it to thrive.  Doesn’t all of this sound perfect for someone with diabetes?!  See, you CAN eat intuitively with diabetes.

I personally think that IE should be part of all diabetic education, especially those with type-1 diabetes.  Eating disorders are almost twice as likely to occur in diabetic patients, especially those with type-1 diabetes.  It’s been shown that 30-40% of teens/young adults with diabetes skip insulin after their meals as a means to lose weight.  This is not healthy or safe.  In fact, poor blood sugar control can lead to major, extremely dangerous complications.  When we teach diabetics to focus on numbers, counting, and portion control without factoring in their mental and emotional health, it puts them at a greater risk for developing obsessive behaviors around food, weight, and their bodies.  This is where IE can be extremely helpful.

Contrary to what some people may think, IE is not about eating cake for breakfast, lunch, and dinner.  It’s about learning to eat by simply tuning in to your own body and mind.  It’s about never following another diet in your life.  It’s about not needing to google if you should be eating carbohydrates or oils.  It’s about shutting out all the gibberish regarding any kind of diet or eating routine/regimen.  You’ll learn what foods feel best in your body.  You’ll learn how eating too much of any food (including sugar) will make you and your body feel.  You’ll learn that you don’t have to (and you probably won’t want to) clean your plate just because it’s in front of you.  You may even learn that the cupcakes you’ve secretly been bingeing on don’t even taste good and in fact, you dislike them all together.

Now, will all of that come to you overnight?  Absolutely not.  It’s a long process, as is anything.  But the longer you do it, the more experience and knowledge you’ll gain.  The bottom-line is that you want and deserve to feel good in your body.  Following a set diet and being hyperfocused on numbers is not likely to lead you down a path of peaceful eating.  And eating should be peaceful – not chaotic or tied up in morals.  If you eat a piece of cake and also happen to be a diabetic, you are not a bad person.  Nor does it mean that you have sabotaged your health.  We need to teach diabetics differently.  If you’re reading this and you are diabetic, don’t think you’re any different than anyone else, because you’re not.  And you deserve to live a happy, mindful, peaceful life 🙂

Happy Eating, Whole Living ❤ Kate

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A recent tofu sandwich with plum sauce made by a co-worker.  Such a nice treat for something different 🙂

Dieting Really DOESN’T Work

More people are starting to realize that dieting doesn’t work, thank goodness!  Because really, dieting doesn’t work.  But before we can say that we’re stepping away from the diet mentality, we need to define dieting.  What is a diet?  There are the typical diets, of course–Jenny Craig, South Beach, Atkins, The Grapefruit Diet, calorie and carb counting/ restricting.  Then, there are the modern diets, such as Paleo, raw food, clean eating, and gluten free.  And what about vegetarian and vegan diets?  Do those count, too?  One main factor that defines dieting is the purpose behind choosing what you eat.  Is it to lose weight?  To tone your body or burn more fat?  Is it simply because this is what you are used to doing and can’t even control your thoughts around food choices?  Also, I think it’s important to consider your relationship with food and your body.  Do you feel that they are connected in a positive or negative way?  Is your self-worth defined, even in part, by what you eat or how much you eat?  All of these factors can help in defining dieting.

There are many reasons you shouldn’t diet–there are books written about it!  But I’ll name some of the most important reasons here in this blog post.  Hopefully it will get you thinking about your relationship with food and how you can improve that relationship to become a healthier one.

1. Every body is unique.

Every body has a unique metabolism and body composition.  While one person may feel more energy by following a certain food plan, another person may feel drained and famished.  Even diets that are “personalized” are often based on faulty calculations and scientific estimates, at best.  They aren’t really accurate.  Trust me, as a dietitian, I’ve had to calculate many a diet for patients over the years (as part of my job working in certain settings), and those calculations are far from accurate.  Even if we do know “scientifically” how many calories you should eat in a day, whose to say the best form of those calories for your body?  Really, only your body can help you to figure that out.  And if you’ve spent years dieting, it’s going to take a lot of time to get back to the place where you can really hear and listen to your body’s needs.

2. Dieting causes more problems than good.

In the long run, diets cause far more harm than good.  For starters, they actually cause you to gain more weight.  Many studies have demonstrated that dieters eventually gain more weight than what they had initially lost.  Many diets cause you to create more stress hormones, which tell your body to store more fat.  Diets can harm metabolism, slowing it down more and more with each diet you try.  Diets can also cause you to change body shape, meaning that more fat may actually be stored around your abdomen, which can be dangerous and lead to a higher risk of heart disease.

3. Food restriction of any kind makes you binge more!

When you feel deprived or when your body is deprived of adequate fuel, it often leads to binges.  This isn’t a bad thing, really.  It’s your body’s way of telling you that you are not eating enough.  Biologically speaking, your body is doing just what it should–it’s communicating with you to help you understand its needs.  But ultimately, binges are not healthful physically, emotionally, or mentally.

4. Diets lead to emotional and psychological damage.

Maybe you feel an initial boost of confidence after losing a few quick pounds?  But eventually, dieting leads to loss of confidence and self-trust.  Your confidence becomes directly linked to your weight and food intake, which is not healthy at all.  Dieting is linked to skewed body image and is directly linked to eating disorders.

“I want to be healthy and feel better, though!”  I hear this so much.  Most people really believe that dieting is the only way to obtain health and energy, when in reality dieting will take you further away from these goals.  The best answer?  Learn to eat intuitively, which means learning to eat for YOUR BODY.  No restrictions, no good or bad foods,  no wrong or right choices, and no mistakes.  It’s not an easy process or a short one.  Learning to listen to your body’s needs take a lot of time, patience, and practice.

The best advice I can give you is to start by working with a dietitian who specializes in intuitive eating, such as myself.  You can find an IE (intuitive eating) dietitian in your area by searching on the intuitive eating website.  You can work with me.  I’ll be adding “services” to the blog soon.

The point is, nutrition and health is much like psychology-one way doesn’t work for everyone.  Nutrition is subjective.  Just like working with a therapist can help you understand your unique psyche, working with an IE dietitian can help you understand your unique metabolism and nutritional needs.  But at the end of the day, like a therapist, a dietitian is a coach while YOU are the pro.  We help you tune in and hear those signals that are waiting for you to listen.  We are there to guide, support, and be the voice of reason.

Eating is a joyful, meaningful experience and dieting takes us further from health, wellness, and the pleasure of enjoying life.  Happy eating, ❤ Kate

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Breakfast should really be every meal.  Oats, cinnamon, a banana, and Trader Joe’s raw almond butter.

Social Media Boundaries

Social media effects us all whether we recognize it or not.  It effects how we see the world, how we view others, and how we interact with others.  It also effects how we interact with ourselves- our self talk and body image.  How many girls out there reading this right now scroll through Instagram, see the latest transformation post, and ultimately feel bad about themselves or feel as though they need to change, too?  I understand that many of these posts are supposed to be “inspirational” and “motivating,” but do we really need motivation to be anything and anyone else than who we are right now in this very moment?  Nope.  If you change in some facet, making lifestyle/health choices, that’s your personal decision that really shouldn’t be inspired by some random stranger’s latest ab shot.  And deep down in your heart of hearts, you know that even if you did exactly what that person did, you’re unlikely to look like them.  Why?  Simply put, because you’re you.

So you’re trying to improve your body image but you also don’t want to be completely disconnected from social media, either.  I get that, and that’s okay.  Here are some things you can change to better support where you are right now in your journey.

1 – Clean out your accounts!  I’ve said this before and I’ll say it again.  Un-follow accounts that aren’t healthy for you and un-friend people who bring only negativity into your life.  It’s not that you’re being mean or harsh, it’s about creating boundaries.  We are taught (to some degree) about boundaries in life.  We know that it’s okay to speak up if someone is making us uncomfortable or saying something inappropriate in our work environment.  Social media isn’t much different.  We still have the right to create healthy boundaries, and that includes un-following, un-friending, and deleting accounts that don’t support you and your goals.  Who we surround ourselves with matters (didn’t our parents always say that?), and in this day and age, who we follow on social media matters, too.

2 – Be real.  I know that filters are fun sometimes, but do your best to refrain from using them when you are in the picture.  If you want to make your food shots a little brighter, I get that, and that’s okay.  If you’re trying to get a good picture of a flower and toning down the sun glare helps, that’s okay.  But don’t use filters to make your skin look a little tanner or your hips a little smaller or your thighs a bit more toned.  Get rid of those apps that are made for editing, improving, and altering our bodies.

3 – Follow body positive accounts!  There are so many great ones our there, just start hunting and you’ll find a million.  This doesn’t mean you can’t follow fit people; it just means that you follow people who aren’t just about fitness and food but also spread messages of love, light, hope, and positivity.  Follow people who bring smiles to your face and warmth to your heart.

4 – Read awesome blogs and listen to some awesome podcasts that support these messages and help you to continue working on these aspects of yourself.  A few blogs that I personally love are: RealLife-RD, Immaeatthat, and The Militant Baker, to name just a few.  A few podcasts I couldn’t live without are: Food PsychLove, Food – and Life, Unrestricted.

5- Don’t try to be anyone but you, and remind yourself of this on a regular basis.  The truth is, I think we all still struggle, even those who have great body-image.  We all have things to continue working on and we all have insecurities to some degree.  When someone else reminds of you of how you wish you could be, remember, you are exactly who you need to be right now.  And you are on your own path.

Life is glorious but we often get sucked into all the negativity that can surround us on a regular basis.  Remember to be the light in your own life.  Disconnect from the messages that bring you no joy in this life.  Life is just too short for all that negative nonsense!

Until the next post, happy eating!

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If Florida, it’s always time for a Froyo snack!

Say What You Mean

“I want to lose weight.”  Or “I need to lose weight.”

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What do you mean when you say this?  I hear it all the time and perhaps you even say it all the time.  But let me ask you a few questions…

1.)  Why do you want/need to lose weight?  

Oftentimes, people tell me it’s because they need to be “healthier.”  The reality is, you can be quite healthy regardless of your weight.  In fact, there are many people living extremely healthy, happy lives while still being considered overweight, obese, or even “morbidly” obese.  (I hate that phrase, by the way.)  Your weight doesn’t actually have anything to do with your health status.  I know this is incredibly difficult to believe, as it’s been pounded into our heads by society, doctors, and every other person within the healthcare system.  The truth is, habits and behaviors create healthy lives and healthy people.  There are SO many factors that make your weight what it is today – it’s truly not as simple as energy in-energy out.  Genetics, age, gender, stress, stage of life, sleep, hormones, medical conditions, and other factors come into play when it comes to your weight.  Losing or gaining weight isn’t the answer to attaining health.  (And I know it’s going to take a lot more time for you to believe that.  It’s taken a long time for people to make you feel the way your feel about your weight.  It’s a long process to learn another way of thinking.)

2.)  What do you really need?

When we hyper-focus on our weight, it often means we’re feeling somewhat stressed or overwhelmed in other areas of our life, and we’re looking for a way to focus our thoughts, which actually does help to soften our anxiety.  Our brains are funny that way-when we feel anxiety, our brains try to focus on something else that we can control…and we often think that our weight is one of those things.  It’s not, though.  So what have you been ignoring lately?  What is making you uncomfortable?  What is causing you to feel some sort of emotion that you’d rather not be feeling right now?  Just coming to terms with the fact that you are overwhelmed by an emotion or situation can help you realize that your weight isn’t actually the problem.  And losing weight isn’t going to solve anything.

3.)  What would make you feel better in the moment and in the long run?

I know what you’re thinking: “losing weight.”  But think about how you feel on the inside, your energy, your stress levels, your thinking patterns.  What would ultimately make you feel better?  Maybe there are some behaviors that you need to work on.  Perhaps you haven’t had time lately to make meals that you enjoy or to even have regular meals/snacks.  Perhaps you haven’t been hydrating adequately.  Perhaps your muscles have been sore and some light, gentle movement would aid in releasing tension.  Perhaps you haven’t had any time for friends or family.  Perhaps you’ve been intentionally isolating and you know some socialization would actually help your brain chemicals function properly.  Perhaps you haven’t been in nature in a long time.  Perhaps you don’t have anyone to talk to about your deepest feelings.  Perhaps your missing some spirituality in your life.  There are SO MANY ways to answer this question and I guarantee that “weight loss” isn’t one of them!

4.)  What have you been eating lately and how often are you eating?

Our body has biological needs that must be met.  If we’re too busy to listen to these needs, we’ll often feel listless, tired, and in a bit of a funk.  And those feelings can make us think that some weight loss ought to do the trick.  After all, everyone says that losing weight gives them such great energy!  The reality is that specific behaviors aid in creating higher energy.  Also, weight loss can cause a certain high that makes us feel energized for a short period of time, but it wears off pretty quickly and most people are then generally left feeling even more tired and…often depressed.  Also, when we’re busy and stressed out, we are sometimes apt to not eat regularly, and when we do eat, we’re not tuned in with our body to listen to what it really wants and needs.  So think about what you really want to eat and plan to have regular meals.  Your body needs fuel to function!

5.)  Finally, do you feel in control of your eating…and your emotions?

When we feel out of control in some capacity, we often seek to control something, and that something is often food and/or our weight.  Some people will even tell me that they “binge” in the evenings on “bad” foods.  But when we talk further, they realize that what they’re experiencing is a lack of control over what and how much they’re eating.  They aren’t connected with the food or their emotions, and they’re seeking to escape their emotions through food.  OR sometimes they realize they’re eating is a bit out of control in the evenings because they haven’t nourished their bodies properly throughout the day.  Feeling like you’ve lost control over your eating and/or emotions will lead many people to want to diet.  But controlling your weight isn’t going to help you gain control over food or your emotions.  It’s an easy way to avoid the real problem for a period of time, but eventually you’ll have to face the real issue.

These are just a few things to think about when it comes to the aged old statement of “I need to lose weight.”  Oh, and lastly, I really want you think about something…What if you stopped worrying about your weight and/or body size/shape?  What if it just never crossed your mind again?  Answer that question in your mind or write it down in a journal.

WHAT IF YOU NEVER THOUGHT ABOUT YOUR WEIGHT OR SIZE/SHAPE AGAIN??

Weight Stigma is Real and Harmful

Weight stigma… it’s real and it exists not only within our society but also within our healthcare system.  We must acknowledge it and work towards eradicating it.  Unfortunately, the truth is, there’s many people within the healthcare system that don’t want to eradicate it.  They believe, within their heart of hearts, that obesity is going to kill people.  They believe that just a simple number can truly tell them more about their patient than any conversation can tell them.  It’s what they’ve been taught.  And really, it’s what all of us in healthcare have been taught from the time we began our schooling.  We’re taught to have a weight bias, to judge our patients based on their weight and BMI.  We’re told that it can predict their health status years down the line – a higher BMI means higher risk of heart-attack, stroke, diabetes, and many other diseases, right?  Actually, not really.  The biggest predictor of these conditions is behavior.  How do you treat your body?  How do you handle stress?  How much sleep do you get on a regular basis?  Do you smoke, use drugs, or drink excessive amounts of alcohol?  These things aid in predicting disease, along with genetics.

When a doctor sees a high BMI, generally one of the first things they do is recommend weight loss (dieting and exercise).  However, dieting is one of the biggest predictors of a weight problem-not vise-versa.  We in the healthcare community suggest a modest weight loss of 10% to aid in reducing the complications of some disease states.  “…As a result of these and other consistent findings demonstrating modest results of most weight loss interventions, there is recognition in the scientific community that existing dietary programs and medications can produce no more than an average of 10% weight loss.  This evidence has prompted agreement among a number of expert panels and scientific groups that health care providers should counsel patients to set a goal of 10% reduction in total body weight rather than struggle to attain ideal body weight.”*  But dieting (or even “lifestyle changes”) actually predicts weight gain!  “Patients who have lost weight through lifestyle modification typically regain 30% to 35% of their lost weight during the year following treatment, and regain most (if not all) of their lost weight within 5 years.”*

The point is… dieting and lifestyle modifications just don’t work.  Behavioral changes to better serve your life and well-being can and do work, but the person must be willing to make changes – not for weight loss but for body kindness and mental, spiritual peace.  In the process of becoming a “healthier” person, weight loss in and of itself really can’t be a primary goal.  One, because it’s not something we can actually control.  And two, because seeking weight loss generally takes us further away from our own intuition when it comes to eating and exercise.  We can’t listen to our body’s needs when we’re focused on an outside number.  And reaching a goal weight of some sort isn’t guaranteed to make anyone any better off.  “It is also important to note increasing research documenting a considerable percentage of overweight and obese persons who are metabolically healthy and non-overweight individuals who exhibit metabolic and cardiovascular risk factors.”*

Furthermore, weight stigma in and of itself wrecks havoc our health.  It often exacerbates eating disorders and disordered eating.  It belittles a person and pigeonholes them based solely on their weight and/or BMI.  Binge eating disorder is one of the most common eating disorders, and simply suggesting weight loss to someone who is struggling with this problem will only cause them further pain and suffering.

I speak of this matter not only in regards to physicians, but to all of us within the healthcare system-nurses, nurse practitioners, dietitians, therapists, and others.  It is so important to begin to assess individuals based on their behaviors and taking into account all of their history, including diet history and their relationship with food.  Dieting predicts weight gain, including weight gain greater than a person’s original weight.  Hence, when we ask someone to go on a diet, we’re basically telling them that their set point weight will eventually be even higher than it is today.  We are worsening a patient’s health by suggesting a diet of any kind.

This post is just a droplet in the sea of weight stigma problems.  (I’ll likely post plenty more on this topic.)  I urge you to take some time to listen to some Health At Every Size/ Weight Positive podcasts, read some blogs/ articles in this area, and really begin to educate yourself and understand this issue.

Here’s just a FEW places for you to begin reading further into weight stigma, the non-diet approach, Health At Every Size, and intuitive eating…

Podcast: Food Psych with Christy Harrison

Podcast: Love, Food Podcast with Julie Dillion

Podcast: Nutrition Matters with Paige Smathers

Blog: Immaeatthat.com with Kylie, RD

Blog: The Real Life RD with Robyn Coale (dietitian, nurse, and nurse practitioner)

Blog: Dances With Fat

 

*Obesity Stigma: Important Considerations for Public Health.  Am J Public Health. 2010 June; 100(6): 1019-1028. doi: 10.2105/AJPH.2009.159491 PMCID: PMC2866597.  Rebecca M Puhl, PhD and Chelsea A. Heuer, MPH.