Dietitians and Intuitive Eating
April 4, 2024 6:31 AM Subscribe
CW: Diet and weight loss talk
I have been an off-and-on dieter for more than 20 years and wish I had a better relationship with food. But, I have some probably diet-related health concerns. I am considering talking to a dietitian who can help me with intuitive eating, but I have some questions about how I can square that with some health issues that I need to manage.
Details ahoy.
I have been dieting off and on for a log time. Last year, I achieved what I felt was a good weight for me. All of my health indicators were very good, I was moving a lot and enjoying it, and felt good. I lost most of that weight through some significant restriction, but had added a lot of things back and was doing okay.
Then in the winter I had a back-to-back-to-back fight with what felt like a series of bad colds, but may have been COVID (for at least one of them). It threw me off all of my routines and disrupted my ability to exercise; I went from being able to run 10k without much the day before Christmas to now building back up to try to manage 5k, slowly. I also put on about 20lbs over maybe 3 months, due to inactivity and not paying attention at all to what I ate.
In the wake of all this I had some routine blood work that revealed my cholesterol was way up. I talked to my doctor and she said that because of that recent history, she wants me to try to see if I can manage it with lifestyle changes before prescribing something.
I made an appointment with a dietitian, more to create some accountability for myself. But in the midst of all this, I've really been wrestling with my relationship with food and growing just tired of these cycles of restriction and over-eating. I read the Intuitive Eating book and it really resonated with me and I wonder if, after 20 years of dieting, I even know what I like or want to eat anymore.
I'm considering consulting a different dietitian who specializes in intuitive eating, but I am concerned that I do need to restrict myself to some degree in order to manage my health issues. (I have had high blood pressure in the past as well, also managed when my weight is lower; I also have diabetes in my family and I'd really like to avoid that). I also just feel like even before I started dieting or caring about nutrition, I tended to over-eat, so I'm not sure whether I actually can trust my intuition, especially against a world of food that's specifically designed to make us crave it.
I also read this article today about big food companies campaigning through anti-diet influencers, which really tripped me up. I just don't know what to believe at this point.
I'm a bit torn as to what is the best course of action for me. (FWIW, I do see a therapist, and we have been talking about my relationship with food.)
I admit that out of vanity I would like to be smaller. But, more important to me is just having a healthy body and being able to return to the level of physical activity I was able to do a few months ago, and finding a way of eating that helps me achieve that without leaving me feel bad about myself if I decide to have a meal out with my family.
I have been dieting off and on for a log time. Last year, I achieved what I felt was a good weight for me. All of my health indicators were very good, I was moving a lot and enjoying it, and felt good. I lost most of that weight through some significant restriction, but had added a lot of things back and was doing okay.
Then in the winter I had a back-to-back-to-back fight with what felt like a series of bad colds, but may have been COVID (for at least one of them). It threw me off all of my routines and disrupted my ability to exercise; I went from being able to run 10k without much the day before Christmas to now building back up to try to manage 5k, slowly. I also put on about 20lbs over maybe 3 months, due to inactivity and not paying attention at all to what I ate.
In the wake of all this I had some routine blood work that revealed my cholesterol was way up. I talked to my doctor and she said that because of that recent history, she wants me to try to see if I can manage it with lifestyle changes before prescribing something.
I made an appointment with a dietitian, more to create some accountability for myself. But in the midst of all this, I've really been wrestling with my relationship with food and growing just tired of these cycles of restriction and over-eating. I read the Intuitive Eating book and it really resonated with me and I wonder if, after 20 years of dieting, I even know what I like or want to eat anymore.
I'm considering consulting a different dietitian who specializes in intuitive eating, but I am concerned that I do need to restrict myself to some degree in order to manage my health issues. (I have had high blood pressure in the past as well, also managed when my weight is lower; I also have diabetes in my family and I'd really like to avoid that). I also just feel like even before I started dieting or caring about nutrition, I tended to over-eat, so I'm not sure whether I actually can trust my intuition, especially against a world of food that's specifically designed to make us crave it.
I also read this article today about big food companies campaigning through anti-diet influencers, which really tripped me up. I just don't know what to believe at this point.
I'm a bit torn as to what is the best course of action for me. (FWIW, I do see a therapist, and we have been talking about my relationship with food.)
I admit that out of vanity I would like to be smaller. But, more important to me is just having a healthy body and being able to return to the level of physical activity I was able to do a few months ago, and finding a way of eating that helps me achieve that without leaving me feel bad about myself if I decide to have a meal out with my family.
Let me preface: I know that a Dietician is a special, and more certified, Nutritionist, but for me, just saying Nutritionist vs Dietician helped a lot. The word 'diet" is so loaded even though it shouldn't be. And I'm someone that is very very practical so usually that kind of word play in my head doesn't work, it did work this time.
I had a really really good experience with Culina Health (they are Registered Dietician Nutritionists), when I was in a similar situation of knowing the basics, not being terribly overweight or terribly ill, just needing to get on track and so tired of thinking so hard about literally every meal that I ended up hating eating.
posted by magnetsphere at 6:44 AM on April 4
I had a really really good experience with Culina Health (they are Registered Dietician Nutritionists), when I was in a similar situation of knowing the basics, not being terribly overweight or terribly ill, just needing to get on track and so tired of thinking so hard about literally every meal that I ended up hating eating.
posted by magnetsphere at 6:44 AM on April 4
Maybe I can help just by sharing my food life with you, I’m not healthy but I’ve battled weight in my life and a kind of eating disorder and have ptsd, probably complex if people really dug deep. I would consider myself a radical intuitive eater. I don’t make super healthy choices (like I eat too many Pringles) but my weight is SUPER steady. How it feels to me is really that I eat what I want when I want. Sometimes I stuff myself, but not often…. Because I’ll check in with myself and deep down it’s not what I want (the 3rd time) and that desire goes away. I’ll eat a fried egg on toast for breakfast and then a few snacks the rest of the day and a sandwich for dinner for a few weeks. I’ll eat a few apples. If I feel I really fancy it I’ll take myself out for a nice steak lunch, sometimes twice in a week. Maybe for 2 weeks in a row. It’s a little hard to describe but it does work for me.
posted by pairofshades at 6:52 AM on April 4 [1 favorite]
posted by pairofshades at 6:52 AM on April 4 [1 favorite]
But what I meant to say is that I have completely discarded the 3 meals a day thing. I have one or 2 meals a day, or maybe 6 meals a week in other periods- in which I eat a lot of tuna and chicken salad and apples… other times it’s lots of snacks, soups, a smoothie… interspersed with meals I LOVE… a steak and baked potatoes with veggies, all the sushi I can eat from my favorite place. But there’s no restrictions… just moderation… and I’m okay with being a little hungry and nibbling over the course of an evening. I don’t Love cooking, I don’t like the food I cook that much, and so this is just what works for me.
posted by pairofshades at 6:56 AM on April 4 [3 favorites]
posted by pairofshades at 6:56 AM on April 4 [3 favorites]
This is covered in the book. If you have to restrict because of health, you do it. You do not restrict for diet culture reasons. You make your eating choices based on what you know about YOUR body's response to the food you eat, and you can be influenced in your choices based on solid evidence-based information. If you know eggs make you dead, you don't eat them. If you know you should embrace more foods that are good for cholesterol and be mindful about high-cholesterol foods (and you have a real conversation with a real dietician about evidence-based ways to make that distinction and not rely on diet culture rumor mill), you can and should do that and make sure you're not overlaying diet-culture-punishment-culture narratives on it that are unnecessary.
IE is not "eat only what you crave", it is only "do not deny cravings for bullshit reasons". Eating more vegetables or ancient grains or whatever is not restriction. If you find some vegetables don't agree with you, like you can toot the national anthem afterwards, you are free to choose them less often or take a gas-x. You are not only concerned with hunger, you get to care about what the food does to you, whether that's mess up/improve your sleep or bathroom experiences or breaking out in a rash or your bloodwork numbers.
Give an IE dietician a try and see how it goes. I think it's going to be a much more positive experience than you're fearing.
posted by Lyn Never at 8:24 AM on April 4 [5 favorites]
IE is not "eat only what you crave", it is only "do not deny cravings for bullshit reasons". Eating more vegetables or ancient grains or whatever is not restriction. If you find some vegetables don't agree with you, like you can toot the national anthem afterwards, you are free to choose them less often or take a gas-x. You are not only concerned with hunger, you get to care about what the food does to you, whether that's mess up/improve your sleep or bathroom experiences or breaking out in a rash or your bloodwork numbers.
Give an IE dietician a try and see how it goes. I think it's going to be a much more positive experience than you're fearing.
posted by Lyn Never at 8:24 AM on April 4 [5 favorites]
I also just feel like even before I started dieting or caring about nutrition, I tended to over-eat, so I'm not sure whether I actually can trust my intuition
Part of intuitive eating is REALLY learning to listen to your body and what you want. Sometimes our bodies might really want a lot of food. However, a lot of time we are overeating because we are not listening to our fullness OR conversely not listening to our hunger and letting ourselves get too hungry before eating.
Also, you can totally learn to shift your diet for medical reasons while still intuitive eating. You can, for example, have the goal to add more vegetables to your diet and be deliberate about what meals you prepare - you could work within parameters while still listening to your body. Like you might experiment to find what your "comfort foods" are within a vegetable-heavy, non-red meat diet.
You might as well give it a try - ask yourself, what's the worst that can happen?
posted by beyond_pink at 9:01 AM on April 4
Part of intuitive eating is REALLY learning to listen to your body and what you want. Sometimes our bodies might really want a lot of food. However, a lot of time we are overeating because we are not listening to our fullness OR conversely not listening to our hunger and letting ourselves get too hungry before eating.
Also, you can totally learn to shift your diet for medical reasons while still intuitive eating. You can, for example, have the goal to add more vegetables to your diet and be deliberate about what meals you prepare - you could work within parameters while still listening to your body. Like you might experiment to find what your "comfort foods" are within a vegetable-heavy, non-red meat diet.
You might as well give it a try - ask yourself, what's the worst that can happen?
posted by beyond_pink at 9:01 AM on April 4
I found the book Ultra Processed People to be enlightening, even life-changing, on my understanding of the research on the effects of Ultra-Processed Foods (UPF) (1) on humans. I hesitate to try to summarize the book successfully. This is not a Diet book. The tone is so low-key compared to American books and the content is so full of research and footnotes.
My take-aways were:
a. Ultra-Processed Foods are not compatible with intuitive eating because they trick our bodies that cannot recognize Ultra-Processed Foods as food and nutrition in the same way as unprocessed or medium-processed foods. The UPFs literally turn off our ability to know if we are full. This means the playing field is uneven and requires mindful selections of foods.
b. Everyone who eats is on a diet, either a chosen or unchosen one. It is better to make a choice instead of having it be made for you by the (high-profit margin) "foods" being sold to us every day. I'm not even going into the details of how the food companies manipulate all of this for profit which is outlined in the book.
c. There is a genetic component to all of these tendencies so comparing my experience to yours to someone else's is just not going to always work.
(1) I capitalize Ultra-Processed Foods because UPFs are defined in a particular way in the book differently than our non-defined general discussions of processed vs whole etc. and I don't want to derail into this different conversation.
posted by RoadScholar at 9:40 AM on April 4 [3 favorites]
My take-aways were:
a. Ultra-Processed Foods are not compatible with intuitive eating because they trick our bodies that cannot recognize Ultra-Processed Foods as food and nutrition in the same way as unprocessed or medium-processed foods. The UPFs literally turn off our ability to know if we are full. This means the playing field is uneven and requires mindful selections of foods.
b. Everyone who eats is on a diet, either a chosen or unchosen one. It is better to make a choice instead of having it be made for you by the (high-profit margin) "foods" being sold to us every day. I'm not even going into the details of how the food companies manipulate all of this for profit which is outlined in the book.
c. There is a genetic component to all of these tendencies so comparing my experience to yours to someone else's is just not going to always work.
(1) I capitalize Ultra-Processed Foods because UPFs are defined in a particular way in the book differently than our non-defined general discussions of processed vs whole etc. and I don't want to derail into this different conversation.
posted by RoadScholar at 9:40 AM on April 4 [3 favorites]
Certain intuitive eating counselors (for example, Christy Harrison) do not provide weight loss counseling. I’m not sure how well you can combine “intuitive eating” and “being smaller”. I would encourage you to separate health from size.
posted by shock muppet at 10:45 AM on April 4 [2 favorites]
posted by shock muppet at 10:45 AM on April 4 [2 favorites]
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I also just feel like even before I started dieting or caring about nutrition, I tended to over-eat, so I'm not sure whether I actually can trust my intuition
this is super me, and she has been able to give me some "hacks" (I guess, I hate that word) to help me figure out hunger/fullness cues even though my body is basically always like "yum, more" -- I think this is a common issue.
posted by goodbyewaffles at 6:43 AM on April 4