Our bodies tell so much of the story of ourselves. In an ideal world, we’d be good friends with our bodies, appreciate them for what they allow us to experience of the world, and be in tune with what they tell us about those experiences. But because we don’t live in a perfect world, we can lose touch with the wisdom of our bodies. Or, because of past trauma, our bodies have become a scary place for us to be.
Getting back into our bodies can be a challenge, so we asked Tracy Brown, RDN, LD/N, a somatic nutrition therapist, how she helps people do just that. She talked about the effects of trauma on the body, how “feeling fat” isn’t really about body size at all, how the fight/flight/freeze reflex can keep us trapped in the diet cycle and how reconnecting with the body can help end the cycle.
And if you want to see body disconnection in action, I provided a spectacular example during this episode (you’ll probably know it when you hear it!). Last year was great professionally, but tough and also way too busy. I spent too much time working and growing, and not enough relaxing and regenerating. And I am someone that needs a fair amount of relaxation in order to function optimally for the long run. When we recorded this episode, I was experiencing the late effects of total body breakdown: exhaustion, headaches, and a real difficulty with concentration. It’s been a hard lesson in knowing my limits and learning to respect my body, but life is always a work in progress!
I rarely bring up the concept of thin privilege with thin people unless the situation warrants it (like when they are tsk tsking about fat people). My goal is always to try to bring people into the HAES fold with kindness and compassion, and I find bringing up something like thin privilege gets them on the defensive fast and shuts everything down and my seed planting goes to waste. Some might disagree with this philosophy and that’s okay.
I do talk about this quite a bit, however, with my clients in larger bodies because it provides a framework and understanding for why they experience weight stigma, and for why they long to be in thinner bodies. Who doesn’t want privilege?? We all want that.
At the same time, I strongly feel that dietitians and dietitians-to-be — thin or not –absolutely must understand this concept if they want to practice compassionate care. At some point, dietitians will treat people in fat bodies, and it is imperative that they understand how people suffer so under such an unfair system of privilege. (It’s also important to understand that we need to change the unfair system and not the body size)
So when Aaron and I gave an introductory talk on Health at Every Size and Intuitive Eating to a large group of dietetic interns, we were a little surprised at the “feedback” (more like vitriolic criticism) we got from several attendees for mentioning thin privilege (an example of the aforementioned shutting down). They felt they had been attacked personally by even the mention of thin privilege, even though no person in the room had actually been identified by us as having it — we were simply bring it up as a concept to consider when treating people in larger bodies.
Since we consider all life experiences fodder for a podcast, this was our effort to process the whole experience and talk about why acknowledging thin privilege exists is so important (I had it once and can tell you it exists). If you are in a smaller body, I hope you’ll listen to this podcast with an open heart and mind, because no matter what, all bodies are good bodies, and we always appreciate our thin allies.
I work with many clients who have binge eating disorder or, if not an official diagnosis, definite binge eating behaviors. All are in different stages of recovery, and many make great progress with learning to eat in an unrestricted, nourishing way that they feel good about while also ceasing binge behaviors.
My clients also come in a range of body sizes, but most typically are in larger bodies. Given our culture’s view of fat bodies, it doesn’t surprise me at all when they eventually ask, “When can I start trying to lose weight again?”
The reality is, my clients are not strangers to dieting and weight loss. They have “succeeded” at weight loss many times, always with the inevitable weight regain that we know comes with weight loss attempts. They have developed extremely disordered eating, if not an eating disorder, and struggle to know the best way to feed themselves. So of course, I know that attempting to lose weight again is a disaster waiting to happen for their health, their eating, their mental health.
But sometimes we need to hear the stories of others to fully grasp the potential impact of certain behaviors (like dieting and restriction). That’s why I was thrilled to talk to Sunny Sea Gold, author of the book Food: The Good Girl’s Drug, about her recovery from and subsequent relapse back into binge eating disorder. We are all susceptible to diet culture, even in recovery, and we need to be reminded regularly that diets aren’t the answer and that they were often the likely cause of a lot of our problems with food and weight.
People often send us questions for our Dietitians Unplugged podcast. We love getting questions and once in a while we’ll pick one to answer in our show. This one in particular was one we felt was probably on the minds of many people for whom HAES was a completely new concept.
Our listener wrote:
I just listened to Dietitians Unplugged episode about Tess Holiday. Can you explain to me your feelings around obesity in a little more context. I am confused with what you actually promote around being very overweight. I do understand intuitive eating. And let me note, I’m not commenting on Tess Holiday specifically or her being on a cover of a magazine. I’m talking about obesity in general. In your opinion obesity is not bad? How can you support that opinion if obesity is linked to an endless number of medical conditions? I see how one can be overweight but still healthy. Just as someone can be skinny and unhealthy. But at a certain point in time, if you are so over weight that you are declared obese then you have fat crushing your major organisms, you are shortening your life, and setting yourself up for a difficult aging processes. How can someone with that amount of excess weight still “healthy.” Thank you for reading, your inquisitive listener.
To be very honest, I wasn’t sure if at first we were being trolled. But I sometimes forget what a wonderful little HAES bubble I live in much of the time, both in my mind, and online (and even IRL with most of my local friends and acquaintances), and I realize that in fact, most people haven’t even heard of HAES and might have questions (and I’m pretty sure that early on, this was one of the skeptical questions I had very early on when being introduced to HAES).
For those of you who aren’t podcast listeners, I’ll give you the very quick and short answer to the question of, “Is there a size limit to HAES?”: No. Slightly longer answer: I feel that anyone of any size can benefit from Health at Every Size principles, and furthermore, dieting to lose weight is probably doing actual harm. My clients in large bodies have tried dieting more times than you can count, and aside from usually gaining even more weight than they lost in the first place, they come to be with extremely disordered eating and total confusion and frustration around the best way to take care of themselves with food and movement. And finally: I never promote a particular body size. To me, all bodies are good bodies. I am more interested in promoting the best, most sustainable and life-affirming ways to take care of the body a person has right now.
If you want the longer, much more nuanced answer to our listener’s question, give this episode a listen!
Many of you have heard this word before: orthorexia. But what is it?
While not an official eating disorder listed in the DSM V, orthorexia is a growing concern in the ED world. The NEDA website tells us,
The term ‘orthorexia’ was coined in 1998 and means an obsession with proper or ‘healthful’ eating. Although being aware of and concerned with the nutritional quality of the food you eat isn’t a problem in and of itself, people with orthorexia become so fixated on so-called ‘healthy eating’ that they actually damage their own well-being.” However, since there is no official diagnostic criteria, it can be very hard to recognize. It’s kind of a “I know it when I see it” situation, which isn’t great for those who suffer from it, because it means many people are probably getting overlooked.
I have orthorexic clients, and they’ve sought help because their “healthy” food choices are starting to ruin their lives. They have anxiety at the thought of eating anything outside their rigid “clean eating” food rules. It’s beyond “healthy eating” and making choices that meet both satisfaction and nutrition needs. It’s an obsession, and sometimes becomes a full-time job.
Aaron and I decided to tackle the topic on our Dietitians Unplugged podcast when he found a blog post that felt dismissive of the issue. If you are wondering if your eating might qualify as orthorexia, give this podcast a listen, and if you think you need it because your life is not your own anymore, reach out to a professional for help.
Feedback from participants has been great and we are helping people to get past the feelings of shame that sometimes come with a diabetes diagnosis, especially for those who are in larger bodies, and moving towards positive self-care. Learn more: HAES Care for Diabetes Concerns
I am often painfully reminded of the fat phobia perpetuated by the medical community on a regular basis. Not just from my clients and others who have countless stories of being denied adequate health care because of their weight, but also from my own personal experience.
I was 15 years old when I went to the doctor for my annual check-up, stepped on the scale, and was told that I was getting “too heavy” and would have to eat differently. Since at age 15 I was still largely reliant on my mother for meals and my school cafeteria for lunch, I could not imagine what “eat differently” looked like, especially as it pertained to my weight. Luckily, my Mom must have delivered a private screed to this doctor (the one that later dismissed her expanding belly as “weight gain” instead of the ovarian cancer it actually was) because he never mentioned it after that and my strategy to never get on the scale again worked until my early 20s, when I turned to dieting to manage a major life crisis. Notably, after that comment from my doctor, my eating became increasingly disordered as I internalized the shame of that visit.
I was reminded of all this the other day when I went to a “sleep class” to diagnose possible sleep apnea (a long shot, but my doctor thought it was worth a try for some recent stuff going on). The person leading the class explained how to use the equipment we would take home to monitor our sleep that night. She also said, “If you are diagnosed with sleep apnea and you weigh too much, you will have to lose weight, because that is probably why you have it.” She went on to say that thin people had it for other reasons, and that once we lost weight, they could look to see if we also had it for those other reasons. As though our weight was an impermeable barrier that would obscure any other problems we could potentially have.
It took all the willpower in the world for me not to stand up on a table and have my Norma Rae fat-solidarity moment, and luckily we found that no matter what we weighed, if we had sleep apnea, we would get the APAP machine anyway. Because, you know, “you need to be able to sleep so you can lose weight.” Whereas I thought we needed good sleep for health and to feel well, silly me!!
Anyway, all this to say that we need medical care and medical providers that aren’t fat phobic, that don’t prescribe interventions that are temporary at best, and who provide us with the medical care that people in smaller, more conforming bodies get. But where can we find these providers?
That’s where Ample comes in. Aaron and I recently did a podcast with Alissa Sobo, one of the founders of Ample, a rating site for people in marginalized bodies (think fat, trans, people of color, disabled people). The creators of Ample know that when someone fears stigmatization from the doctor, they don’t go, and that can lead to worse health in the long run. But we need to know who can provide stigma-free health care – and that’s where Ample comes in.
I hope you’ll give this great Dietitians Unplugged episode a listen to find out more about Ample and how you can help build this amazing resource. THIS is how we exercise the power of voice that we do have — and we CAN create a better future.
Is it Ample? Aaron and Glenys talk to Alissa Sobo, the creator of Ample, the first app that rates businesses specifically on their accessibility and inclusiveness towards marginalized bodies (fat, trans, people of color and more). In this episode, Alissa talks about her origin story of being fat-shamed at the doctor when she was pregnant and why she decided she needed to create a review site for people in marginalized bodies whose needs are just not being met. She also explains how this amazing resources works and how we can all help build on it. This is something all our listeners can help contribute to and we can’t wait to introduce you to Ample! BONUS CONTENT: stay tuned to the very end to listen to our first fun bonus content!
I wish I didn’t still have to say it, but the reality is that the diet industry still exists, people still feel bad about their bodies, weight loss is still the go-to medical intervention for people in fat bodies, and harm is still being done.
So I will say it loud and clear again for the new year: WEIGHT LOSS DIETS DON’T WORK.
Or to be perfectly accurate, they may work for a while, but all the available evidence points to the fact that over the long run, they DON’T work — the weight people lose is regained within three to five years. The science could not be clearer on this.
Looking at it another way — the Center for Disease Control and Prevention’s National Center for Health Statistics reports that nearly half of American adults are trying to lose weight at any given time, yet the statistics for “overweight” and “obesity” remain static at about 1 in 3 adults for each category. I’ve been hearing these numbers for years…so if our massive dieting efforts aren’t changing them, then that tells us something.
It tells us that trying to permanently lose weight is about as futile as trying to permanently change your height. But the weight loss industry continues to take people’s money and then blame them when their product doesn’t work.
So for the new year, my friend and Dietitians Unplugged podcast co-host, Aaron, and I decided to talk about why dieting doesn’t work. This is a great place to start for anyone new to our podcast, and hopefully our long-time die-hard listeners will appreciate the reminder of why they, too, are trying a different path to health.
As many of you know, this past year I delved into the realm of Health at Every Size care for diabetes.
Many people contact me looking for help with normalizing their eating, and I’ve noticed that folks struggling with blood sugar abnormalities often feel that a non-diet way of eating does not include them. They’ve been told by doctors or other health care professionals that they must focus on restriction and weight loss to improve their labs and health.
This could not be further from the truth. I have seen it with my clients who struggle from both disordered eating and diabetes or pre-diabetes. I have seen that helping them normalize eating patterns without a focus on restriction (in fact I emphasize including all the foods a person loves including sweets) or weight has improved their blood sugars, not to mention their quality of life.
That’s why I I was so excited to so a podcast earlier this year with Megrette Fletcher, MEd, RD, CDE. Megrette is a certified diabetes educator who provides non-weight-focused education for people with diabetes and pre-diabetes, and teaches other professionals how to provide this care as well. Founder of the Center for Mindful Eating, Megrette advocates for pleasurable, mindful eating and shame reduction to help manage blood sugars instead of restriction and weight loss. She is so generous with her knowledge, and truly someone I consider a mentor.
In this episode, she gives us a handy metaphor for understanding how our insulin works (the Insulin Knife!) and how we can best help our own bodies utilize its insulin. For those who have been scared by or felt shame for a diagnosis or family history of diabetes, we think you’ll find this episode extremely helpful in helping you get your self-compassionate self-care on.
Did you miss getting non-diet help with diabetes this year?
So many people reached out to us late this year to tell us they were sad to have missed enrolling in the group I run with Rebecca Scritchfield,RDN, HAES Care for Diabetes, and wanted to know when we were running our next cohorts. Good news! We are taking names for our waiting list on our HAES Care for Diabetes page, so just click the link or the image below and make sure to sign up so you’ll be the first to get notified when our next groups are available (likely early 2019). We help people concerned with blood sugars to stop focusing on restriction and weight, and to start making positive changes that feel good and are sustainable. We have had great feedback and will keep making this group better for you in future iterations.
When we are in school getting our nutrition degrees, we learn all about food safety, how to counsel a nutritious diet, a metric ton of chemistry, and medical nutrition therapy to treat various conditions and diseases. We spent some time learning nutrition counseling techniques too.
But rarely are we prepared for what is often at the root of so many eating problems: a fractured relationship with our body image.
In school, they never gave us the language to understand this, for ourselves or other people, and they certainly never gave us the idea that we might also help the healing.
But in fact, we need to be able to help our clients heal not just their relationship to food and eating, but also their bodies.
I’m not talking about doing the work of a therapist. I’m talking about being able to listen and validate and understand WHY someone could hate their bodies so much that they lose their ability to eat in any peaceful, nourishing way. And helping them to find ways to reconnect with their bodies with self-compassion.
We CAN and SHOULD talk about this with our clients, and in the below episode of Dietitians Unplugged, Aaron and I talk more about how we as dietitians can start doing this work.
“I used to love my thinner body, even though I hated dieting. Will I ever love my body again?”
This is an occasionally-heard refrain heard from some of the brave souls who have chosen to give up the pursuit of weight control through dieting and have instead opted for the unknown of what their bodies will do in response to a more peaceful relationship with food.
To review, there are three possible outcomes of giving up dieting:
You may lose weight.
You may gain weight.
Your weight may stay the same.
For anyone experiencing any of these outcomes (even weight loss), the work of body acceptance is necessary to help clear the path to a more peaceful relationship with eating. This is the work of body image healing.
I love the goal of body neutrality as a result of the body image healing work that we do. Body neutrality, to me, means you don’t have to feel in love with your body or how it looks, but you don’t loathe it either. You’re able to see your body as an instrument, not an ornament, and get on with your life and all the things you want to experience in it.
But sometimes we wonder if we will ever get to a place of loving how our bodies look. For some, body neutrality doesn’t feel like enough, and they remember a time when they were maintaining a lower body weight, getting societal accolades, and enjoying the way their bodies looked to the world.
Rarely do we seem to question why we need to love how our bodies look. Would we have this same desire to love our appearance if there weren’t such strong cultural messages about beauty standards? Would this need exist if we were stranded alone on a deserted island like Tom Hanks in the movie Castaway? I strongly believe the answer is no.
That’s why we need to talk about self-objectification, which is experiencing one’s body not from the inside, but from the outside, looking in. It arises from an unfair system in which women are judged more for how they look and not for what they do (one of the many unpleasant side effects of patriarchy).
We are presented with a relentless barrage of media images of women and messages around what constitutes the “right” look (and from the mere absence of other types of images, we can easily infer what constitutes the “wrong” look). It’s so easy to constantly compare ourselves to these images and develop that outside-in-gaze that becomes more dominant than the experience of being in our bodies.
I think it’s lovely to be able to look in the mirror and say, “Yep, good outfit” or “Awesome style I’ve got going today.” That’s a world away from, “I love how my body is mirroring unrealistic cultural beauty standards by being as small as it can today!” The first two statements are about objects on your body; the latter statement is about your body as an object.
For me, opting for body neutrality and appreciation of its usefulness was a far saner goal than needing to love how I looked on a physical level, because I no longer wanted to be a mere object to be admired.
I don’t actually think we need to love how our bodies look to live a richer life. We do need to understand why that desire exists, though.
I hope you go straight down the rabbit hole of this site because they have so many wise things to say on the subject of self-objectification!
Need help managing your diabetes, pre-diabetes, or insulin resistance?
HAES Care for Diabetes is back! Two tracks are available, starting on September 11 and September 13. Rebecca Scritchfield, HAES dietitian and author of the book Body Kindness, and I will be providing sound and compassionate non-diet, non-restrictive, non-weight-focused advice and support for managing your blood sugars. Click on the image below for all the details about this 4 week virtual counseling group and how to register!