while my core nutrition philosophy is not something I’ve wavered on too much since becoming a dietitian, it is still evolving somewhat as I gain more experience and sift through fun new research, as it should. One big thing that has changed is that I rarely weigh patients or clients and I very rarely put them on diets (this of course excludes those with more severe medical issues, etc.). Ok technically that was two things, but work with me here as I have a story.
such a hearty and delicious breakfast – quinoa/oats with almond milk, cacao powder, sweet local berries, banana, chia/hemp seeds, coconut and lots of almond butter
when I was first starting out as a clinical dietitian, I did some extra work helping run a medically supervised weight loss program. I needed the money and wanted any and every experience possible, but thinking of this now I absolutely cringe. The program was extremely strict in that participating patients had to have a particularly high BMI, were put on a VERY low calorie diet and had to eat meals provided by the program that were packed with sodium and a laundry list of junky chemicals. I would have to hold sessions every week with a pre-planned lesson (courtesy of the program), mostly with tips on how to only eat these awful, prepackaged foods and manage crazy hunger levels. Every single patient who was on the program had tried dozens of diets already, lost and gained hundreds of pounds and were ready and motivated to give it another go. This would be THE diet that would help them lose weight and keep it off for good. Only, it didn’t. They all lost a lot of weight initially, which is common in super restrictive diets, but it was impossible to maintain over any longer than a few months. Bingeing or being “bad” was common, and much of the lessons were all about getting “back on track” or being “good.” I’ve never been a fan of those terms, but I really thought I could help these patients who so badly wanted to change. Each week I’d add more of my own ideas into the lessons and less of the programs, but at the end of the day realized it wasn’t something I could ethically do anymore. Patients would get so upset when their weight loss slowed or the numbers on the scale varied slightly, the episodes of bingeing would be followed by severe shame and depression, and they were almost always beating themselves up over something related to the “diet.” This was something I wasn’t very prepared for. Working with patients on their relationships with food wasn’t a topic I learned much, if anything, about during my dietetic internship but is so crucially important. Not to mention the fact that what crazy restrictive diets actually do is make weight loss harder by seriously messing with hormones and metabolism.
diets don’t work.
not only do diets fail to address the dieters relationship with food, which is very often THE most important issue, but they impart unsustainable restrictions on foods, food groups, calories and often put foods into “good” and “bad” categories. There may or may not be consistent “weigh ins” or assigned crazy amounts of exercise. Plans like this are almost always sustainable for a week or two, when motivation is high and the initial weight loss may occur. But after that, not so much. We as humans can only deprive and restrict ourselves so long until we physiologically and mentally reach a breaking point. This could be manifest in an hour-long binge on everything in the pantry followed by severe shame, quitting the “plan” entirely or on the other side of the spectrum, lead to an even more restrictive eating pattern and diagnosable eating disorder. Because diets also wreak havoc on our hormones, our bodies become more resistant to weight loss every time we enter into a new restrictive and stressful eating pattern.
lovely wild salmon with greens, roasted chickpeas, sauerkraut, avocado, side of sweet potato fries and peanut
There’s a statistic from a past research survey that estimates as many as 75% of women report having unhealthy thoughts, feelings or behaviors related to food and their bodies. This is the diet industry’s vulnerable and impressionable target audience. What diets essentially do is fuel these unhealthy thoughts further and fool us into thinking we need some gimmicky eating plan to make us “better.” They don’t help us work on our relationship with food or why these thoughts are occurring in the first place, making it nearly impossible to change.
This is why I’m such a fan of intuitive eating, because it’s not a diet, and it focuses on changing our thought process when it comes to eating and our relationship with food. It takes something that was once so easy for most of us, even if we have to go back to our toddler days, and that’s eating intuitively what we want when we’re hungry and stopping when we feel satisfied. There’s definitely more to it than that, and the book Intuitive Eating is an awesome resource.
being a “non-diet” dietitian and totally entrenched in this ideology, I often forget that having a non-diet mentality is still not very common. At least once every day I have a patient who comes in expecting to be put on a scary “diet” in some form and is shocked when I explain to them what we are actually going to do. I love seeing their reactions and I love even more how happy, fulfilled and hopeful they seem after our appointments. There is no fear of failing or vows to stick to something super strict or else. It’s awesome. And that’s the way it should be.