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Nutrition Month 2019 is all about unlocking the potential of food: to fuel, discover, prevent, heal, and bring us together. I was inspired by the sub-theme ‘heal’ to talk about Intuitive Eating as an intervention to heal your relationship with food.
In my work as a dietitian, I’ve come across countless people who carry a lot of shame and guilt when it comes to eating and have witnessed the fear of judgement experienced by many who are going to see ‘the dietitian’. I would hate for people to get the wrong idea about dietitians and think we are the ‘food police’ and are here to tell you what not to eat and judge you for choosing otherwise. This simply isn’t true. I hope to clear up this myth and share some information about a non-diet approach to health. As a bonus I highlight some great dietitians to follow if you want to learn more.
Dietitians Are Not the Food Police
Sometimes I very much dislike the word dietitian – specifically because it starts with the word ‘diet’. There is a common misconception that a dietitian’s job is to put people on diets. Yes, it’s true that some people have to follow a medically necessary diet to manage a health condition – for instance, a gluten-free diet to manage Celiac disease. We would refer to this as nutrition therapy. And yes, it’s also true that a lot of dietitians work in the area of weight loss and that’s the reason people go see them. Still, putting people on diets is not what dietitians do. Let me say that again.
Putting people on diets is not what dietitians do.
Our job is to use nutrition therapy to help individuals and populations treat, prevent, or manage health conditions across the lifespan. This means taking a more holistic view of health and considering a person’s food preferences, budget, culture, ability to cook, etc. as well as any other health conditions or personal goals when working alongside them. Think of a dietitian as a coach or facilitator to help you achieve your nutrition-related health goals, should you have the desire to make changes.
I understand why a lot of people think the only role of a dietitian is to help people manage their weight. We’ve all been conditioned to believe a person’s weight is central to their health and diet and exercise alone contribute to a person’s weight. We are inundated with this type of messaging day in, and day out, so it’s hard to take a moment and step back to think about what health really means and what the research really tells us about weight. There are many ways to measure health and a person’s body size is the result of a variety of factors, including diet and exercise, but also genetics, environment, the presence of medical conditions, and sometimes medications.
A Non-Diet Approach
As a society, our focus on manipulating body size in the name of health hasn’t really been effective. Most people who try to lose weight do achieve short term results, but in the long-term research shows that dieting results in overall weight gain, weight cycling (“yo-yo dieting”), and disordered eating patterns. And let’s not forget about the psychological harms and stress caused by dieting. Following a non-diet approach can provide health benefits without the negative side effects we see with constant dieting. Studies show that people who chose to focus on their health behaviours, rather than weight, enjoy improved body image and improved blood glucose and cholesterol. In addition, those with a positive body image are more likely to take better care of their health.
Health at Every Size® (HAES®) is a model of care using a non-diet approach that focuses on improving overall health by changing health behaviours that are within a person’s power to control to change. Working to improve sleep habits, adding more vegetables into satisfying meals, and incorporating enjoyable movement into the day, are all examples of health promoting behaviours that almost anyone can adopt, regardless of body size. Weight is not a modifiable behaviour – it is an outcome of many factors, and you certainly can’t determine a person’s health status simply by looking at them.
I know that for many people this is a big shift in thinking. I’m sure I’ve lost some readers already. It’s easy to confuse the concept and make incorrect assumptions. Admittedly, I’ve made them myself and am still trying to learn more weight-inclusiveness. I’ve recently read a couple posts that do a wonderful job of debunking the myths surrounding HAES®. You can find them here and here – I strongly suggest reading them.
Whether you’re open to this concept or not, I’m sure we can agree that everyone should have the opportunity to improve their health regardless of body size.
What Does Health Mean to You?
If you were to describe what health means to you, what would you include? Eating a certain diet and exercising regularly might be on your list. Perhaps you would include getting enough sleep, not being too stressed out or feeling energized. Maybe you would consider improved blood sugar control or cholesterol levels as good health. Maybe it means living until you are 100 years old. Health means different things to different people. Diet and exercise alone do not equate to good health, and neither does body size. Two people can eat the exact same diet, follow the same exercise regime and will be a different body size. It’s normal to see diversity in body size.
A non-diet approach, such as HAES® celebrates this and values every person, of every size. It also celebrates the small but significant self-care acts you can take part in every day that don’t focus on weight. Something that almost anyone can do, regardless of body size is learn to eat (or rather re-learn as we are all born with this ability) in a way that nourishes our bodies, satisfies our hunger and helps us feel energized all while taking pleasure in the joy of eating.
Heal Your Relationship with Food Through Intuitive Eating
Intuitive Eating is a framework for eating that incorporates mind-body connection and awareness to guide food choices. It was created in 1995 by two registered dietitians, Evelyn Tribole and Elyse Resch. Intuitive Eating is an evidenced-based practice with a validated assessment tool and over 100 studies demonstrating its effectiveness. With Intuitive Eating, the success of your dietary changes are not measured in terms of weight, but rather in terms of behaviours. An improvement in your ability to eat when you feel hungry or stop eating when you feel full are two examples. Weight change is a side effect for some, and not for others.
There are ten principles to Intuitive Eating:
- Non-diet mentality
- Honour hunger
- Make peace with food
- Challenge the food police
- Feel fullness
- Discover the satisfaction factor
- Cope with feelings without food
- Respect your body
- Exercise to feel energized
- Honour your health – gentle nutrition
All foods fit in this way of eating (except for allergies and medical conditions requiring medically necessary diets). When you begin to practice intuitive eating, you are encouraged to be curious about the reasons that have led you to eating without feeling hungry or beyond feeling full. This is done without judgement. There are no “good” foods or “bad” foods, and the goal is to lose the guilt associated with eating so you can give up the battle with food. Over time, you learn to nourish your body, exercise for fun, and improve your health in a way that’s meaningful to you. And no, this doesn’t mean that you get to eat cookies and ice cream all day – although some people do at first, and that’s okay.
Dietitians Who Practice Body Positivity and Weight Inclusiveness
There are many dietitians that work within the HAES® and Intuitive Eating frameworks, and many more that view health in a weight-inclusive way. Some might use Intuitive Eating tools in their practice to help people understand hunger and fullness, and hopefully all dietitians provide a judgement free space to allow the people they work with feel safe and validated when sharing their eating habits, health concerns, and desire for change.
If you are interested in learning more or working with a dietitian who practices within the HAES® and/or Intuitive eating framework, below is a list of a few dietitians I encourage you to check out for the work they do and their great messaging.
- Cristel Moubarak, RD – Founder of Nutrifoodie here in Vancouver, Cristel offers cooking classes, food camps for kids, corporate wellness packages, and individual counselling. She practices a non-diet approach and has an infectious passion for food and nutrition. Be sure to read her blog too!
- Vincci Tsui, RD – Based in Calgary, Alberta, Vincci is a Certified Intuitive Eating Counselor and author. I’ve enjoyed reading her blog to learn more about HAES and Intuitive Eating.
- Marianne Bluodoff, RD – Marianne works with communities rather than individuals, but she still uses a non-diet approach and has great recipes that celebrate the joy of eating – you have to try the beet hummus.
- The Real Life Dietitian – Based in Boston, Massachusetts, Robyn is also a Nurse Practitioner who focuses on disordered eating and women’s health issues. I really liked her post on practicing Intuitive Eating during pregnancy.
You could also start by reading the book Intuitive Eating: A Revolutionary Program that Works by Evelyn Triole, RD and Elyse Resch, RD. It’s on my nightstand as we speak.
I have both a personal and professional interest in learning more about a non-diet approach to health , intuitive eating and the research behind them – I might do a few more posts related to this in the future. I’d love to know your thoughts on this topic or any questions you might have, so please let me know in the comments section below.
This post was inspired by the ‘heal’ sub-theme as part of Dietitians of Canada’s Nutrition Month. Find more information about Nutrition Month at www.NutritionMonth2019.ca.