Weekend Wonderment 8.24.13

This was a week where the topic of loneliness went viral. Check out this incredible 3-D perspective on loneliness in our very “connected” world.

And here is a spot on article noting how loneliness is a bigger threat to our health than weight issues.  Truth.

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Raw, real and gloriously authentic, Dr. Brené Brown talks church.

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Interesting, informative insights on anxiety, eating disorders and schizophrenia.  Increased understanding about the spectrum of mental illness will ensure more people get the help they need.

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Swoon over this mash up of “Brave” by Sara Bareilles (a personal favorite) and Katy Perry’s new song, “Roar”.  Watch, be awed and left with a big smile on your face.

http://www.youtube.com/watch?v=c-wa1_y6uZQ

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An apology letter from a former weight loss consultant stirred up a lot of chatter on the interweb. Provocative, sincere, honest, this letter offers a unique perspective from the heart of the diet industry.

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Back to school must haves: These adorable “gentle reminders” pencils would be a wonderful gift to a student you know heading back to school or for anyone needing some fun encouragement.  And I am loving this sweater that screams fall in my favorite color.  How cool that you can have it custom made to fit you.  I am in line to order mine this week.

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Busy is the new “fine” but we are living at a pace that is unsustainable.  It is time to (re) define success and make wellness a priority as we follow our dreams and passions.

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My husband and I have been having so. much. fun with this cookbook.  I love Deb Perelmen’s blog, too.  Her latest post is full of peaches, glorious peaches which is appropriate for National Peace Month. She always uses real food that never sacrifices flavor with simple techniques = pure palette joy.

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Just because.  🙂

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In awe and wonder –

Rebecca

Discover the Power of Your Wanted and Unwanted Identities

1. I decided

I am ____________ (fill in the blank).

Many of you can finish the sentence above with a variety of descriptors and attributes. The core beliefs about your identity directly impact how you make decisions in your relationships, at school, work, and in life.

Culture, your family of origin, your faith community, schools, and places of work are constantly communicating messages about your worth and value.

Some of these messages are negative and challenge your ability to see your true worth and value.

And at some point, you start believing some of the negative messages shifting your lens on yourself and the world.

You are not alone. We all wrestle with negative core beliefs about our identity. Sometimes these negative beliefs are screaming at top volume between your ears while other negative beliefs are a quiet whisper that nag at you daily.

Regardless of the volume, inaccurate core identity beliefs can lead to unsafe and broken relationships, isolation, eating issues, addictions, chronic pain, depression, and anxiety.

Usually our negative beliefs come from experiences in our story and have taken root in our brains in an effort to keep us safe but end up working against us.  Most of these negative beliefs fall into one of the following categories:

  • I am not enough/I am not _____ enough
  • I am not not safe
  • I am not capable/in control

Our upcoming (re) define Identity workshop will help you:

  1. identify your ideal and unwanted identities
  2. build awareness on how you respond when you are seen in ways you desire and fear
  3. narrow down the core negative beliefs that are keeping you stuck in your relationship with yourself, God, and others, launching you into the process of reclaiming your true identity, worth, and value.

For those seeking to dig deeper and and get unstuck with struggles around your core identity, I recommend finding a practitioner certified (or in process of certification) in EMDR.  This is a powerful psyhchotherapeutic approach that has changed the way I conceptualize cases, approach trauma and all distressing life events.  You can find a local practitioner in your area here.

Space is limited at our upcoming (re) define Identity workshop on September, so register soon if you are interested.

ReDefineIdentity

We cover this material more extensively in our cornerstone Workshop: (re) define Courage: Dare to Show up+Be Seen (formerly Cultivating Courage).

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Our September Weekend Intensive has sold out but there are still spots available in the Nov 1-3 weekend intensive.  January dates for weekend intensives and weekly workshops will be going live soon.  Sign up here to be the first to know about these dates.

 

Enjoy the last days of summer and all the best to those transitioning back to school!

Rebecca

 

Weekend Wonderment: Inspiration from the Interweb

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Be the Gift.  Give yourself the gift of forgetting about yourself, the to-do lists, the plans, the appointments, the shoulds and have-tos. Thank you, Ann, for this heartfelt reminder. I needed it this weekend.

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Never, ever, ever forget: You are Loved. Thanks to Jeanne Oliver Designs for bringing this to my attention.  Blessed.

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Beautiful, grounding, convicting.  Read this and then take note where you feel your heart tugged to redirect how you spend your time today.

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Yes, let’s change the world for Greyson, my daughter, all kids.

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Darling is taking orders for their fall issue.  Order now and receive their latest print magazine full of beautiful photo shopped-free pictures, lovely words printed on gorgeous paper and receive the digital version as a free bonus.

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Here is more brilliance from Barn Owl Primitives (where I purchased the We Can Do Hard Things sign seen as you enter my therapy office). These are words that I want to flow out of my heart to my kids – especially during this season of preparation for and transition to school and the big, big world.  May we all live these words and not just say them. Actions indeed speak louder than words.

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No, juicing is not an eating disorder but for some it can be a disordered eating ritual masked in the spirit of healthful living. I appreciate this honest and humorous perspective of a world where the efforts to be healthy are sometimes a bridge to orthorexia (the obsession with eating healthy) and, well, deep hunger.  Now head over to Kayla’s Q&A with Megan on juice cleanses for some facts on this practice.

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A common area of struggle I see in my office is managing the in-betweens of life: relationships, jobs, school, physical health, and so on. Jeff Goins’ new book will encourage and challenge you to savor your in-betweens. The tension created in times of waiting can be the catalyst for our best art, so slow down and do not rush your in-betweens.

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In awe and wonder –

Rebecca

The Dark Side to Celebrating Eating Contests

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For the last several years, I have started writing posts about the mixed messages of celebrating eating contests and the dangerous impact reverberated by these mixed messages – but I have never finished them.  This year, I am pushing back on my unhealthy perfectionism and finishing a post I started earlier this month.  I hear the PR voice in my head saying it is too late and the peak for sharing this has passed. 
Well, so be it.

The fourth of July is one of my favorite holidays. I am a fireworks fanatic and this year we brought both of our kids to watch the glorious display of firework fun in the sky. This holiday is a lovely time to rest,  play, and celebrate.

But one tradition around this holiday frustrates and concerns me: Nathan’s Annual Hot Dog Eating Contest and the many iterations that have followed its popularity. Some of my friends and family think I am a bit of a buzzkill for not being a fan of this kind of eating. Such is my life as an eating disorder specialist – I cannot unlearn what I know about the physical and emotional dangers of binge eating and Binge Eating Disorder (BED).

What is Binge Eating Disorder?

I like this write up by the Mayo Clinic staff on BED:

You may have no obvious physical signs or symptoms when you have binge-eating disorder. You may be overweight or obese, or you may be at a normal weight. However, you likely have numerous behavioral and emotional signs and symptoms, such as:

  • Eating unusually large amounts of food
  • Eating even when you’re full or not hungry
  • Eating rapidly during binge episodes
  • Eating until you’re uncomfortably full
  • Frequently eating alone
  • Feeling that your eating behavior is out of control
  • Feeling depressed, disgusted, ashamed, guilty or upset about your eating
  • Experiencing depression and anxiety
  • Feeling isolated and having difficulty talking about your feelings
  • Frequently dieting, possibly without weight loss
  • Losing and gaining weight repeatedly, also called yo-yo dieting

After a binge, you may try to diet or eat normal meals. But restricting your eating may simply lead to more binge eating, creating a vicious cycle.

(Notation from Rebecca: Many fall somewhere along the spectrum of BED. You do not need to have all of these symptoms to struggle with the issue. Denial, minimizing, and rationalizing often keep people from getting the help they need because they do not feel like it is that serious.)

5 reasons eating contests hurt our collective psyche around food

1. Eating contests give the impression that binge eating is always a choice. As of May, Binge Eating Disorder is now a clinical diagnosis in the new DSM-V. This is a huge victory for those who struggle with these issues along with those who are passionate about treatment and advocacy. Prior to BED officially being placed in the DSM -V, there was a lot of controversy around whether this diagnosis should be included; many thought this diagnosis was making excuses for those making bad choices. If this struggle was simply fixed by a choice, there would not be millions of people struggling with this serious issue. Addressing core issues such as attachment wounds, anxiety, depression, distressing life events and traumas, perfectionism, shame, and identity issues are at the heart of this struggle, not a simple choice. The choice available to those with BED is reaching out and asking for helping instead of staying stuck in the cycle of shame, pain, isolation, and physical distress.

2. Eating contests make BED and related behaviors a joke and sport to many. We laugh. We cringe. We build up the hype. It is a business and we are buying into it. This recent Forbes post on whether eating contests should be considered a sport noted:

“While spectators question the validity of such a label, its organizers say there is no confusion – competitive eating is a serious business in the world of sport.”

Man Vs. Food with Adam Richman (I confess, I adore Adam — he is so endearing!) is a perfect example of eating as sport. Adam travels to a new town each episode to discover a city’s best sandwich or meal and then engages in a restaurant’s food challenge by eating an insane amount of food in a designated time period. People are around him cheering him on as he takes his body on a dangerous episode of binge eating — for all the world to watch.

But my work with people on the disordered eating spectrum has taught me food competitions do great harm to our collective understanding of eating disorders and related health issues. This double standard keeps people struggling with BED spectrum in silence, fear of reaching out for help and making binge eating behaviors a joke. A sport.
Binge Eating Disorder is not a sport. Though many who participate in these eating contests may not fit the clinical diagnosis of BED, many of the behaviors mirror this serious illness. When we make binge eating cool to watch, we decrease the seriousness of this issue. It is time to stop the jokes and change the dialogue around this issue.

As long as we are watching, cheering on, and participating, eating contests will be good for business. And bad for health – mind, body, and soul.

3. Binge eating is very hard on your body. If you have ever seen the line-up at Nathan’s Hot Dog Eating Contest, you can see a representation of different ages, genders, and sizes of those who down dozens of hot dogs in a matter of minutes. Physically, binge eaters are at risk for developing: type 2 diabetes, gallbladder disease, high cholesterol, high blood pressure, heart disease, certain types of cancer, osteoarthritis, joint and muscle pain, gastrointestinal problems, sleep apnea, and other related health concerns. Professional binge eaters have the same health risks as those who are clinically struggling with BED. This is not something to be celebrated or perpetuated.

4. We have become obsessed with talking about food and eating contests just add to this unhealthy obsession. Food is personal and how we choose to feed ourselves is a very vulnerable topic. How we eat, what we eat, when we eat, and where we eat are all hot topics that can breed food shame and discord instead the joy of breaking bread with family and friends. Eating contests (and most reality shows for that matter) encourage us to become professional judgers and blamers. We talk about “good food vs. bad food” as if we are talking about sinning or staying pure; we Instagram our meals with a sense of awe and worship; the latest trends in eating, dieting, health dominate the majority of our conversations. We are obsessed with food. This obsession masks core issues of identity, worth, shame while fueling anxiety and depression. And the resistance to looking deeper is intense – understandably as it is much easier to talk about food than the messy, vulnerable, deep soul stuff.

5. Eating contests are a waste of food when so many are food insecure in our country and our world. In our country alone, food insecurity impacts about 15% of households. I often wonder about the positive impact companies and businesses that promote eating contents could make if they took their resources of time and money and fought hunger instead. We can change this demand by choosing not to watch and not to participate – which will shift how companies spend their advertising dollars.
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Post your feedback below and let me know what you think about eating contests? Do you think binge eating is just a choice?  I look forward to your thoughts on this controversial subject.

Happy belated 4th of July (take that perfectionism!)  –

Rebecca

Five Year Celebration and a Giveaway

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Potentia Celebration and Summer Giveaway!

5 years ago today, Potentia Family Therapy, Inc. was officially incorporated in the state of California. After writing a (big) check to the state, I was given a fancy binder with some very official paperwork. I had a notebook full of ideas and dreams. My first child was a little over two months old, my husband was moving to a new school, and life as I knew it was very different.  Blessed, full, and amazingly different.

Five years later, my family has grown from one to two kids, my husband has expanded the AP History program at his school (and is moving to a new AP prep this fall) and Potentia is now in a gorgeous space –  home to a team of incredible professionals dedicated to helping people heal their relationships with food, their bodies, and their stories.

At Potentia, our team has high standards of care. We believe our clients deserve:

  • the best in clinical, legal, and ethical practice
  • respect
  • dignity
  • hope
  • healing (in their own time)
  • safe community
  • authentic connection

Words cannot do justice to the courage, the sacrifice, the character, the growth, and the miracles we get to witness at Potentia. Thank you to my friends, family, colleagues, mentors, contractors, and all those who have helped shaped Potentia from dream to thriving practice. You all simply amaze me. (You rock!) I am also grateful for this calling God has put on my heart which daily strengthens my faith.

As we launch several new groups and workshops for the fall, we are also continuing our behind-the-scenes plans to make Potentia’s approach to (re) defining health available to people outside the San Diego area. Stay tuned…

But for now, we want to celebrate Potentia’s birthday! And what is a birthday without gifts?

Head over to Potentia’s Facebook Page and leave your birthday wishes to Potentia under the birthday post to enter into our birthday giveaway. Three winners will be chosen at random to receive a special mid-summer gift bag including a copy of Darling Magazine’s summer issue (which contains an article I was honored to contribute), sunscreen, lip gloss, a towel, and some other cool Potentia schwag.

Comments received up until 11:59PM today  – July 16th, 2013  – will be eligible for an entry.  UPDATE: We are extending this one more day until 11:59PM July17th.  Yay!

On behalf of the Potentia team (me, Megan, Molly, Kayla, Nicole, Kelly, Alyson), thank you for being a part of the Potentia Community.

Cheers, confetti, and hugs galore!

Rebecca
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Q&A Series: Cleanses

Q&A Series: Cleanses

Kayla Waler, MFT Intern at Potentia: So, we’ve recently tackled pertinent topics such as Paleo and gluten-free diets. My friends have expressed interest in a Q&A about juice fasts and cleanses. I know juice fasts and cleanses are popular, especially around certain times of the year…what can you tell me about this practice?

Megan Holt, RD, MPH, Ph(c) and Coordnator of Nutrition and Wellness at Potentia: In my experience, people tend to be interested in cleansing for one of four reasons: 1) weight loss, 2) detoxification, or 3) as a means of hitting a ‘reset’ button when they’re feeling particularly bad about their current diet or 4) for an energy boost. Cleanses usually involve one or more of these components: 1) a fast 2) some sort of product or regimen purported to remove toxins from the body, or 3) a colon cleanse.

Kayla: Let’s start by talking about fasting…

Megan: I tend to discourage fasting because it can reactivate disordered eating behaviors–whether that’s restriction or feeling out of control with food or feeling disconnected from hunger and fullness cues when one does start to eat again. I generally recommend against it for anyone who has suffered from disordered eating in the past. But for someone without a history of disordered eating, there’s really no harm in doing a juice fast or any fast for one or two days, as long as the person is hydrating appropriately. Beyond a few days, there’s no way one can really meet his/her micro and macronutrient needs for vitamins, minerals, fat, fiber, and protein through a fast (including a juice fast). So, if the fast is prolonged, say for two weeks, he/she will start to break down muscle tissue, resulting in a weight loss (muscle tissue is heavy and dense, about 1.7 or 2 times the weight of fat mass). This can’t be sustained without becoming malnourished, nor is it ideal to waste muscle tissue and lose strength. In such a state a person can expect to be in ketosis, a state characterized by elevated levels of ketones in one’s urine or a fruity or acetone-like smell in one’s breath. Ketosis is one of the hallmarks of starvation/malnutrition.

Kayla: I know detoxification is a trendy concept. What are the toxins people are trying to rid from their bodies?

Megan: Usually the claims about detoxification on these products are overstated and generalized/non-specific. Most refer to PCBs, lead, heavy metals, or environmental toxins like food additives, food coloring, pesticide residue, etc.

Kayla: And would a cleanse rid the body of these toxins?

Megan: Actually, there’s no evidence that a cleanse or fast would (although, as long as one is fasting, one is likely taking in less of these compounds, though they’re reintroduced once the fast ends). There seems to be nothing about a cleanse that is as beneficial as adopting a good quality of diet consisting primarily of plants and whole foods. But there isn’t much research out there; there haven’t been many high quality studies on cleanses because higher preliminary studies show no benefit. Cleanses are typically promoted by testimonials given by celebrities or people who have no training/educational background (major red flag).

One problem with cleanses/detox diets is that if someone had a poor diet before doing on a cleanse, they usually revert back to that diet afterward, as they often don’t build skills to enable sustainable changes. So, unless he/she makes a concerted effort to change diet and lifestyle, he/she will return to feeling just as poorly as prior to the cleanse.

Kayla: …because he/she is just reintroducing all the old stuff…?

Megan: Right. The benefits are not sustained and not sustainable. So if you wish to feel better, or are seeking the reported benefits of something like a cleanse or detox diet, the best bet is really working on changing quality of diet and increasing activity, both of which sustainably promote feelings of well being (without undesirable side effects).

And it’s most important to note that not everyone reports feeling better during or after a cleanse. Most people report feeling disorientated or lethargic, dizzy, weak, a little confused or groggy because they’re malnourished and not getting enough glucose to the brain to fuel proper cognitive processes and physical functioning. Some people often report feeling lighter, and I can see that because one may lose weight in the form of fluid and stool bulk primarily (and perhaps a smaller proportion of fat mass and muscle mass depending on how the cleanse or fast lasts). But most often, participants complain of weakness, confusion, or just feeling “out of it.”

Kayla: Then why do people believe a cleanse is beneficial?

Megan: In part due to the power of testimonials—some people do report feeling better. Certainly people can report feeling better after adhering to a really nutrient-dense juice cleanse for several days in a row. But when someone is coming from a place where their diet is poor, of course they are going to feel better when diet improves. The problem is that it’s short term. We know that fad diets don’t work in terms of sustaining weight loss, and cleanses/detox diets are not exceptions.

Some people notice that a one or two-day cleanse or fast helps them to break habits of mindless eating and get back to a cleaner quality of diet. For example, someone who takes a one or two-day fast or cleanse after the holidays. Having said that, if you’re someone who is willing to stick to a juice fast or cleanse for just a few days as a means of hitting a ‘reset’ button, then you’re probably also apt to resume your pre-holiday eating style without doing the cleanse/fast.

Kayla: I know fasting can be dangerous because of the risk of malnourishment. Are there other risks? Can a cleanse regimen be dangerous?

Megan: Cleansing and fasting can be especially difficult and contraindicated for people with altered nutrient needs due to illness (diabetes, kidney disease, etc.). So, prior to participating in a cleanse or fast, I’d suggest consulting first with your physician.

Kayla: Earlier, you mentioned colon cleansing. Will you explain what a colon cleanse is? Why do people do it, and what are the pros and cons?

Megan: A colon cleanse is usually performed with an enema, commonly salt water or purified water injected into the colon. The idea is to remove any metabolic waste that the colon hasn’t removed on its own. Conventional physicians usually don’t support colon cleanses because there isn’t evidence to support the reported benefits. The colon is self-cleaning… it does a really good job of getting rid of metabolic waste on its own. So, we don’t need a procedure to cleanse the colon. In fact, introducing a foreign object into the colon can actually be pretty risky. Perforation of the bowel is another big risk with colon cleansing, as are infections and electrolyte disturbances.

Proponents of the colon cleanse will say they are introducing higher levels of good bacteria and getting rid of “bad” bacteria in the intestines, but there is really no evidence of that being the case, and the introduction of good bacteria is something you can get from eating probiotic-containing foods and a primarily whole-food plant based diet.

Also, we have a liver and other important organs that perform that function for us without prompting. Environmental toxins can not be metabolized or cleared by a cleanse or fast, unfortunately. If you are looking to make a change to feel better, my advice is to follow something that is sustainable for you, preferably a nutrient-dense, plant-based diet—though not necessarily vegetarian—with a high intake of whole foods: fruits, vegetables, whole grains, legumes and plant based fats.

What are your experiences with cleanses and fasts?  Have they been helpful or triggering of disordered eating thoughts and behaviors?

And thanks so much for your interest in this Q&A series.  Please keep us posted on future topics you would like us to cover in future Q&A posts.  Thanks for reading!

In good health – Megan and Kayla

Q&A Series: Gluten-Free Diet Unpacked

Unpacking Gluten-Free Diet
Unpacking Gluten-Free Diet

After getting the scoop on the Paleo Diet, I sat down with Megan Holt, DrPh(c), MPH and Registered Dietitian, to get more information about another popular diet craze–the gluten-free diet.  –Kayla

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Kayla: So, what exactly is gluten, and what is the gluten-free diet?

Megan: Gluten is a protein found in wheat and other grains, but it has been incorporated into a lot of different food products.  Rye, barley, bulgur, triticale, some oats (due to cross contamination), and wheat products, of course, contain gluten, as do many sauces and meat tenderizers or seasonings.  Gluten tends to slip its way into many products because of its elastic structure and ability to act as a thickener. A gluten-free diet is simply an exclusion of gluten, which means the diet rules out all of the pastas, breads, pastries, and cookies that are gluten-containing, but also many other sauces and seasonings.

Kayla: I know that I’ve heard a lot about gluten-free products and the gluten-free diet within the last year or two, but how long has this diet been around?

Megan: The idea of a gluten-free diet gained popularity about 5 years ago, but it really exploded about two years ago in conjunction with the Paleo diet.  A number of studies have supported benefits of a gluten-free diet for certain subsets of the population, and largely as a result of the popularity, we have an increased awareness (and an increase in the number of people being tested).  We are now more aware of the symptoms of gluten sensitivity, and, given the availability of gluten-free products on menus in stores, sticking to a gluten-free diet is far less stigmatizing and isolating than it was in the past.  These are real benefits for people who are genuinely gluten-sensitive.

Kayla: What are the benefits of gluten?

Megan: There are decades of research that supports the use of whole grains in our diet.  High intake of whole grains are protective in terms of lowering risk of major causes of death in the United States:  cardiovascular disease, type II diabetes, metabolic syndrome (in part due to the fact that low intake of whole grains is associated with higher abdominal fat and obesity).  Breads, grains, and pastas make up the bulk of the western diet (for better or worse), so one benefit of gluten intake in the US is that many of our grain products (which are gluten containing) are vitamin-fortified.  So, we tend to get a lot of vitamins and minerals, like folate, fiber, iron, and zinc, from gluten-containing products.  Of course, there are other, sometimes better sources for these vitamins, but gluten-containing products are a really common accessible source in the US.  Finally, whole grains themselves are very satiating, and they contribute to sustaining normal levels of blood sugar, even more so than a lot of the gluten-free counterparts.  One example would be whole wheat pasta versus (gluten-free) brown rice pasta.  Whole wheat pasta is a little more stabilizing and has more fiber and protein than brown rice pasta.  That’s just one example of a not-necessarily-healthier gluten alternative.

Kayla: Can you explain gluten sensitivity? What is the difference between that and celiac disease?

Megan: So, with the explosion of the gluten-free fad, we’ve become better at recognizing the symptoms of gluten sensitivity, which is milder than celiac disease and usually characterized by physical symptoms, with no damage to the small intestine.  Symptoms can include: diarrhea, bloating, abdominal pain, rashes, joint pain, and other inflammatory symptoms.  Celiac disease is characterized by an immune response to gluten, which can lead to the destruction of the villi in the small intestine, which can be severe and debilitating.  Many of these folks suffer from serious nutrient deficiencies just because they can’t absorb what they’re eating, so the removal of gluten from their diets is imperative.  But true celiac disease affects less than 1% of the population.

Kayla: How does one confirm gluten sensitivity or celiac disease?

Megan: Well, the gold standard to check for celiac disease is a biopsy of the small intestine to look for flattening of the villi.  Some doctors will perform an endoscopy to actually look for damage to the small intestine, but some look to blood tests that reveal the level of antibodies that have developed.  If these antibodies are outside a normal range (high), it may indicate a gluten intolerance or celiac disease.  But usually people will just try an elimination diet–eliminating gluten and then reintroducing it and looking for symptoms.

Kayla: But that only works if you’re only eliminating gluten, not adding in other things, or completely changing your diet…

Megan: Exactly.  Most of the people I see are just starting to pay attention to quality of diet or trying to improve their quality of diet and may feel like one the markers of improving their diet would be excluding gluten.  When I see people who want to follow a gluten-free diet, what I typically ask them to do is see their physician to check if they can get a test to confirm non-celiac gluten sensitivity or celiac disease if that’s what they suspect.  If there’s no confirmation, we work for a few weeks to clean up the overall quality of diet and I ask them to pay attention to the appreciable benefits they experience from simply improving the quality of diet.  Then, we can exclude the gluten-containing foods, substituting them for something comparable for a month or so before reintroducing gluten and noting any symptoms.  Changing the overall diet while excluding gluten is not ideal.

Kayla: Are there any benefits of a gluten-free diet for people without gluten sensitivity?

Megan: None that are evidence-based.  If we’re just excluding gluten or substituting whole grains for gluten-free grains, then no, there’s no benefit.  Moving away from genetically-modified foods and toward organic foods is beneficial, and this is a shift that is often made at the same time as one decides to go gluten-free.  But generally, gluten-free products tend to be more highly processed and are not fortified, compared to many gluten-containing grains, so you actually get less fiber and have a higher intake of processed foods when you’re just swapping out whole grains for gluten-free grains–unless you have legitimate gluten sensitivity.  That’s always the exception to the rule.  For most of the clients I see, those who don’t have gluten sensitivity, reintroducing gluten after elimination brings on no symptoms, other than perhaps a bit of an adjustment to a higher intake of fiber.

Kayla: So how can someone going gluten-free for a legitimate reason do so in a healthy way?

Megan: There are ways to be gluten-free more healthfully, that are more than just swapping out the gluten-containing grains for gluten-free ones.  For example, someone can get a lot of nutrients from beans, lentils, and other whole grains that are gluten-free like brown rice, amaranth, quinoa, and gluten free oats, or from fruits and vegetables.  Using these foods as staples is very healthy.  I’m a firm believer that you can have a balanced diet that excludes things you don’t want to eat or things that don’t make you feel well, but you have to be intentional about adding other food sources to make up for what you’re losing.  You have to take a balanced approach.

Kayla: How can I tell if someone going gluten-free is really struggling with disordered eating?

Megan: Unfortunately, I often see people using the gluten-free diet in the service of disordered eating, that is, as a reason for restricting their eating.  Then, if weight loss happens, it’s because of the restriction, not because their diet is gluten-free.  If you’re concerned about someone going gluten-free, you can always suggest that they see their physician for confirmatory testing.  Other red flags:  Is he/she restricting food /calories outside of those that are gluten containing? Has there been an undue or unnecessary weight loss? Is he/she unable to enjoy food or participate in activities involving food?

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We would love your thoughts on our conversation about the gluten-free diet. Post your thoughts and any additional questions for us in the comments section below. Also, let us know if there are any other diet or wellness trends you would like unpacked in future Q&A blog posts.

In good health –Megan and Kayla

I have a confession to make to you…

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2013 has been full of some serious body image blues.

You know how it goes:

  • not feeling comfortable your skin
  • feeling like none of your clothes fit well
  • not wanting to see your image in a mirror or a picture
  • struggling not to be tempted by the false promises and quick fixes of the diet and so-called “wellness” industry
  • feeling less then, ummm, hubba hubba with your spouse
  • not wanting to be very social
  • playing the compare game

A couple things crept in that started to take away from my New Year’s calm and clarity (my word for 2013): lack of sleep because of all things toddler (winter colds, potty training..) and my newly diagnosed asthma.  I was missing my time with my boot camp buddies – my one-two punch for social and active time.

I hit a wall. Right about the time I was doubling the staff at Potentia.  We just completed two successful cohorts of our 8 week Cultivating Courage workshop and put dates on the calendar for three Cultivating Courage Weekend Intensives.

All good stuff.

I was super pumped about all these happenings but was getting really depleted and disconnected from my social support.  My health was starting to suffer, too.

And in walked my body image blues right through the front door.

Shame said, “You hypocrite.  You are leading these men and women to heal their relationship with their bodies and you do not even feel good about your own.  You are a fraud.”

Ouch.

But here is where things took a different turn.  My discomfort in my skin did not necessarily dissipate but how I responded to these thoughts and feelings took a rather radical detour.

I practiced, practiced and continue to practice my shame resilience skills.  I dug in and wrote my daily gratitudes and read my daily devotions.

I got really clear on my needs and spoke them to my friends and family, not as demands but as requests.

I made my self-care – mind, body and soul – a priority and made sure my schedule reflected these values.

I practiced empathy with myself and others when judgements and crankiness reared their ugly heads.

I re-evaluated my boundaries and made sure I was not setting up walls which protect but also isolate.

I spoke my truth to my really, really safe people.

I now know I am enough even on days I do not feel enough.  I can hold that space while I feel yucky and not attack my core worth. Some days it is a bit of a knock down, drag out fight – but shame resilience has helped me run the marathon of living life reflective of my values and my true worth.

Wow.

Those who work in the eating disorder field are not immune to struggling with their own food and body issues.

And I am no exception.

It was pretty incredible to see how the ongoing practice of shame resilience kept me from dancing in the pit of self-loathing for very long.  It has helped me practice respecting my body even when I do not like it much.

Yeah, I am not immune to these thoughts or feelings.  But how I respond when they hit has truly been, well, awesome.

And as I say every day in my office, “Rarely are bad body image days about food, weight or the aesthetics of a certain body part.”

Negative body image is often the equivalent of that scratchy throat you get when feel you are starting to get sick. If you ignore the symptoms and do not take extra care to build up your immune system, you will get leveled and feel even worse, taking longer to recover.

And instead of going old-school and obsessing over weight, looks and what others think, my shame resilience skills are (almost) my default now and the obsessive tendencies to measure my worth by the number on the scale (if I had one) or how much I have worked out were not nearly as loud as they used to be.

This new response to shame has been so, so, so freeing and healing.  Instead of fearing vulnerability, I have grown to understand and respect its place in my life – though I do not like the feeling of it most of the time.

Reading Brené Brown’s books over the last few years have been so helpful in building my awareness about shame and normalizing the universal experience of shame.  I developed a whole new vocabulary.

But these last 9 months training with Brené, Robert Hilliker and the rest of the Connections team to complete my Certified Connections Facilitator Certification moved me from an intellectual insight of this work to a daily (well, mostly daily) practice.

I have seen the fruits of this practice in my marriage, my work as therapist and in my relationships with God, myself and others.

And this is why I can barely contain how excited I am to offer this work – Potentiafied for you in our Cultivating Courage Workshops and Weekend Intensives.

We have three Cultivating Courage Weekend Intensives scheduled for the remainder of this year: June 14-16, Aug 23-25 and Nov 1-3.  And my colleague, Molly LaCroix, and I will be launching our 8 week Weekly Cultivating Courage Workshop Series in January 2014.

For those who are local, we have some digging deeper workshops which will be launching this summer to give people a chance to freshen their Shame Resilience skills or have a toe-in-the water experience with this powerful work.

And plans are in the works to take this work online so our Potentia friends outside San Diego can have access to this material, too.  Make sure you are signed up to receive email updates so you can get the latest details on all of these happenings.

I would love to know what your questions are about shame and Brené Brown’s shame resilience theory.  Please email me directly at rbass@potentiatherapy.com or post your questions below.  If I feature your question in a future blog post, you will receive a copy of Brené’s most recent book, Daring Greatly.  So don’t hold back, I really want to hear from you.

Working on being my own cheerleader while cheering you on, too!

Rebecca

Q&A Series: Paleo Unpacked

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Lately, I’ve noticed a lot of chatter amongst my friends about the Paleo diet. Naturally, I’ve been a little curious about it, so I thought I’d talk with my fabulous colleague, Megan Holt, Ph(c), MPH and Registered Dietician, to get the scoop on the science behind the Paleo diet and her thoughts on how to eat right and stay safe in our diet-obsessed culture. – Kayla

Kayla: Thanks for taking time to talk with me today, Megan! I have some questions about the Paleo diet.  It seems like half the people I know are on it. Can you talk a little about what the Paleo diet is?

Megan:  So there have been versions of the Paleo diet around for 30-40 years–the idea of eating like our ancestors first surfaced in the 1970’s. Today’s Paleo Diet was coined and popularized by a professor, Dr. Loren Cordain. The idea behind it is that our bodies can’t process some of the foods–grains, for example–that have become staples in our diets since the industrial revolution. So, we are better off eating like our ancestors, the cavemen, with a diet that consists primarily of meat & vegetables with no dairy, grains, or processed foods.

Kayla: Well, that sounds pretty good, in theory.

Megan:  With this diet, as with any of the other fad-type diets, like Zone or South Beach or Atkins, there are always a few really positive and helpful features. A favorable aspect of the Paleo diet, for example, is the suggestion that you take an 85/15 approach to food…that is, you should follow Paleo principles 85% of time and the other 15% of the time non-Paleo foods are allowed. I like the idea of that sort of flexibility, rather than having certain foods be “off limits.”

Kayla:  So, what are the drawbacks?

Megan:  Many of the Paleo principles are far from evidence-based. The cavemen, for example, didn’t suffer from the diseases that we suffer from in the western society like stroke, heart disease, or cancers, but their lifespans were very short. They didn’t tend to live long enough to experience these chronic diseases…so we’re unable to draw strong conclusions or make a fair comparison. Also, the emphasis on animal products like meat, beef, is problematic.

There is the idea that saturated fats aren’t inflammatory or linked with preventable diseases as we once thought they were. The large majority of research suggests otherwise–that saturated fat still is a risk factor for several chronic diseases. There have been some studies that suggest a more mild relationship, but we still have lots of research to support keeping saturated fat to a minimum in our diet. Additionally, quality of animal products and production methods are drastically different in today’s society, and can’t be fairly compared with meat that was consumed by our ancestors.

And the problem with eliminating grains is just that it’s not evidence-based.  There are loads of high quality studies that suggest that whole grains play a supportive role in our health. Paleo diet proponents have been able to cash in on other popular diet trends in our society, such low-carbohydrate diets, gluten-free diets and emphasis on foods with low glycemic index.

Kayla:  So, what’s the rationale for limiting carbohydrates and high-glycemic foods?

Megan:  Blood sugar control. The idea is that if we ingest foods on the lower end of the glycemic index, it helps us maintain energy levels and stabilize blood sugar. Some of that is evidence based–there’s some good in that. Limiting processed foods, added sugars, and high-fat dairy and encouraging vegetable intake is also helpful.

But a high intake of animal fats from meats, beef, sausage, bacon is absolutely not protective, nor is it environmentally responsible. Roughly 10-15 calories of grain is required to produce 1 calorie of meat, and ten times the amount of fossil fuel/energy is required to produce 1 calorie of meat versus 1 calorie of grains.

Kayla:  And what about limiting grains?

Megan:  We have decades of evidence in support of whole grains, unless someone has a legitimate gluten allergy or intolerance. Some really good things have come out from exploring the relationship between gluten intake and inflammation, but it is way overrepresented in our population. When we cut out a lot of processed foods and dairy and peanuts (not allowed on the Paleo diet), we have to remember that these are the most likely culprits of food allergies/intolerances.

So, it makes sense that when someone with an undiagnosed intolerance or allergy removes these foods from the diet, they will tend to feel remarkably better. And when someone without allergies cuts down intake of processed foods and added sugars, and increases intake of fruits and vegetables, they will naturally feel better.

This is nothing new, and it is not unique to the Palo diet. Anytime we improve quality of diet and move away from foods with poor nutrient density, particularly those which are easy to passively over-consume (think milkshakes, frappuccinos, pastries), we will experience improvements in terms of health.

But with nutrition research, it’s hard to tease out which aspects of a diet are resulting in the change…Are we benefiting from the foods we’ve removed or from the foods we’ve reintroduced in place of them? For example, when we cut out gluten, we cut out all the processed grains and many grain-based desserts/pastries.

When we cut out these foods, we’re going to notice some sort of benefit or resulting weight loss. We may substitute our Cocoa Puffs for something much more protective and energizing, such as a greens smoothie.  Of course we’d feel better, but this doesn’t warrant demonizing grains.

There are many factors to consider. If we feel better after cutting out a food, what are we replacing the food with? What other lifestyle factors have changed? Has there been a shift in our activity level? Are we sure we can attribute feeling better to the elimination of a food, like gluten? More often than not, it’s unclear. Roughly 20-30% of people who identify themselves as sensitive to gluten actually are.

Kayla:  Those are good points. So, what is your advice for someone who wants to be healthy, to eat cleanly, and/or to lose weight in a healthy way? How would you advise her to go about making food choices?

Megan:  I support eating styles that are evidence-based and sustainable in terms of how well they support health and lower risk of preventable diseases. What that tends to look like is roughly half, if not 60%, of food intake coming from carbohydrates, mainly whole grains, whole fruits and vegetables. About 15% should derive from lean protein and fatty fish.

We get a lot more protein from plant-based sources than we think (whole, minimally processed grains, legumes, nuts, seeds), so we don’t need to rely on meat. The rest–roughly 30-35% of our calories should come from plant-based fats like olive oil, canola oil, avocado, or grapeseed oil, versus saturated or trans fats like butter/dairy fat or lard. A small amount of saturated/trans fats are OK, but they shouldn’t represent the bulk of our intake.

Many of my clients have a long history of dieting and weight cycling, and benefit from a more flexible approach to eating and meal planning. In such cases, we try to identify foods that they enjoy and are drawn to that will also be energizing and health-promoting.

If your morning ritual includes coffee and a donut, then we talk about breakfast staples that appeal that offer more in terms of nutrient density. Surely we can find something that is more energizing, such as oatmeal with almonds and fresh berries. We’re not demonizing donuts here, but we have to acknowledge them as the less supportive choice.  Enjoy them as treats, but perhaps not as a breakfast staple.

Kayla: When I am with my friends who are talking about their Paleo diet, or going gluten-free, how can I tell if what they’re talking about is just normative, fad diet stuff, or if it has crossed the line toward disordered eating?

Megan:  I tend to look for improvements in quality of life when one is following a particular diet.  If they’re feeling better, maintaining weight that is right for their body and showing signs of improved energy levels, then great.  However, if they have to take unreasonable measures to comply with the diet, such as isolating themselves from social engagements that involve food, that might raise a bit of concern. Excess weight loss, even if the person does not appear “underweight” by current standards, is also a red flag.

Kayla:  And for someone in recovery from disordered eating, how can she keep herself safe in the midst of this cultural obsession with dieting?

Megan:  I’d suggest she just voice her concerns as they apply to her and her friends openly & non-judgmentally. If she’s meeting friends for some purpose that doesn’t relate to dieting or exercise, consider setting a limit around food- and weight-related talk (so ask friends to refrain from revolving conversation around dieting/weight loss). Supportive friends will understand and will be able to respect this.

Living in Southern California makes it nearly impossible to avoid diet talk altogether, as at least 2/3 of peer groups, especially female, are going to be dieting or interested in dieting or preoccupied with thoughts of wanting to lose weight. Surrounding oneself with a safe and supportive group of peers is crucial. There are women out there who have a healthy relationship with food and their bodies. 🙂

Avoid giving into the pressure of having to identify yourself by the dietary trend you follow (i.e. “vegan, paleo, etc”) as this often results in our feeling badly about our choices when we stray from the diet”s tenants.  Take a more flexible (and sustainable) approach and choose foods that you truly enjoy and make you feel well.

Given the buzz around Paleo, my clients in recovery are naturally curious about the diet:

  • What is with the Paleo diet?
  • Is it safe?
  • Why are so many people talking about it?
  • Would this be good for me?

I tell them, especially those who have been through proper treatment, that they know what foods are going to make them feel well and what their body needs in order to perform well in terms of sleep, hydration, nutrition–and they have to trust that.  I ask them to try to refrain from taking nutrient/diet advice from their peers, most of whom acquire knowledge from media sources without scientific merit.

I remind them, “Refer back to your own experience. You’ve been through numerous diets; you know where that’s taken you. Trust that you know how to meet your body’s needs.”

————
We would love your thoughts on our conversation about the Paleo diet.  Post your thoughts and any additional questions for us in the comments section below. Also, let us know if there are any other diet or wellness trends you would like unpacked in future Q&A blog posts.
In good health – Megan and Kayla

A Twist on Dealing with Negative Body Image

Negative Body Image.

In my tribe of Eating Disorder Treatment Specialists, we often say negative body image is the first to come and the last to leave in the treatment of food and body issues.

And that is a pretty constant truth from the many recovery journeys I have witnessed over the years.

My clients have taught me some more nuanced facts about body image, regardless of whether they have had a full blown eating disorder or not.

Everyone has (at least) a bad body image day.

Depending on where you fall, if at all, on the disordered eating spectrum, dealing with dark, obsessive, and/or negative thoughts and compulsions regarding your body is a part of the gig when dealing with disordered eating.

You may recognize all too well some of these reccurring negative thoughts used to bully and shame yourself – just fill in the blanks with your own words to customize these statements to your experience:

My ____ is so ____.
I feel so ______.
I am so ______.
My _____ looks so ____.
I just need to___.
When I _____ I will be _____.
I hate my_____.
My _____ will always/never be_____.

Ugh.

So many try to manage these thoughts and feelings by stuffing them and putting on their “I love my body” and “It’s all good” masks of virtue, hiding the truth that they are living at war with their body. Others externalize these thoughts and add to the cacophony of negative body talk and diet talk.

And this is where things often spiral.

Many try to manage the pain of being in their skin and their body shame by:

  • over exercising
  • restrictive eating
  • dieting
  • mindless, emotional eating
  • comparing
  • competing
  • shaming
  • all of the above

And this can lead to a dark journey into the world of eating disorders and disordered eating.  Yet, many hover in this place of emotional ickiness where they cannot shake the uneasiness of living in their skin and make genuine, though harmful, attempts to get relief.

For many of you, this battle really is not about your body.

If my client is stable emotionally and physically, and her needs are met nutritionally, then I often look at negative body image as a sign of something bigger.

Like when you get that scratchy throat feeling.  It is a sign you are on the verge of getting really sick; it is not just about the sore throat.  You know you need to rest, to take some extra Vitamin C, drink some tea, ask for help with projects, cut back on your social calendar.

When the yuck of a bad body image moment comes up, it is often a sign of something else going on in your life.  I move my clients away from the laser focus obsessions on what needs to change with their body and pull back the blinders to look at what else is going on in their life.

If you are feeling this way, it is important to asses:

  • if you are you getting enough rest,
  • how you are adjusting to weight restoration or weight loss (yes, weight loss can be very triggering)
  • stressors
  • social support — safe, sustainable, available social support
  • if you daily activities are life giving or draining
  • dieting behaviors
  • traumatic or distressing life events that have gone untreated
  • if your temperament is perfectionistic, obsessive-compulsive, cares big, and feels emotions intensely
  • labs taken within the last month and making sure all physical systems are operating well and your body’s needs are being met

I have learned that setting the expectation to always be comfortable in your skin is a set up for continual frustration and feelings of hopelessness.  (Not helpful…)

The key is not to focus on the goal of eradicating negative body image days (though the parallel process is to decrease the frequency and intensity of those days, for sure)  but instead to respond on those days, weeks, months when you are feeling crappy in your skin DIFFERENTLY.

Instead of defaulting to negative food and body obsessions and action, I work with my clients on how to acknowledge what they are really feeling and what they are really thinking in that moment. 

Then we focus on respecting those thoughts and feelings in the moment.  I also emphasize the truth in how my clients feel.  What they feel is always real but rarely is it ever fact.

Finally, we focus on how to respond differently when body hatred arises.  Instead of stuffing, minimizing or denying — which only fuel the negative thoughts and coping tools — I work with my clients on accessing new tools and strategies when the dreaded body yuck surfaces.

When there is too much focus on feeling better in your body and not looking at the correlation with bad body image to other factors — physical, emotional, social, and spiritual — then I think we are limiting the potential of experiencing true health and true healing.

And it is ok not to love your body all the time.

But I think it is imperative to focus on respecting your body and being grateful for your body — even when you do not like it.

You can actually dislike your body while also showing your body respect and gratitude.  Eventually, respect and gratitude will win if you hang in there.

For example, there are a good handful of people I know that I do not care for but I respect them, treat them with dignity and kindness, and find space for being genuinely grateful for the challenging relationship.

Consider this strategy in your relationship with your body.

With heavy doses of respect and gratitude in addition to responding differently to your bad body image days, the feeling of your body never being enough may dissipate, and an eventual truce with your body may be declared.

And if one of those days surfaces again, the hope is you do not shame yourself for backsliding in your recovery but see your body image woes as a clue, a hint to investigate what is out of sorts in your life.

All the while administering generous doses of respect and gratitude.

How do you deal with your bad body image days?
Do you agree that it is not realistic to achieve a space where you never have a bad body image day?

With respect and gratitude –

Rebecca