7 Must-Read Quotes from Potentia’s Featured Book of the Month: Secrets from the Eating Lab by Traci Mann, PhD

Eatinglabbest

 

Hello!

Congratulations on completing week one of the 52 weeks of 2016!

If you are like most people in our country, some of your goals/resolutions/intentions for the new year are around your health: how you feed, move and rest your body.

It is absolutely important to make health a priority (though not an obsession) in your life.

Yet, breaking through the noise about what it really means to be healthy is quite the challenge these days.

There are so many differing views on how to eat, how to move your body, what food is “good” and “bad” for you.

As a result, the meaning of health has become so skewed and good marketing that speaks well to your struggles and desired goals can also add to the confusion of what it means to be well.

Secrets from the Eating Lab: The Science of Weight Loss, the Myth of Willpower, and Why You Should Never Diet by Traci Mann, PhD is a gem of a book that reads with ease while digging into some involved research around the science behind a lot of the narratives around health, obesity, food choices and more.

I really appreciate how she guides the reader:

  • through the history and evolution of dieting
  • how to better discern the quality of the research so many health “facts” are based on
  • figure out what the key factors are which impact and define health

Below are some of my favorite quotes from the book along with my additional thoughts and reflections. It was really hard to decide which nuggets to quote from this book as Dr. Mann has packed in so much wisdom. It is a worthy investment, for sure!

1. The use of the BMI is controversial because the formula for calculating it is not based on any understanding of how height and weight relate to each other, and because people who have high muscle mass tend to get categorized as overweight, despite having very little fat. (p.4)

  • At Potentia, we have educated our clients and community for years on the flaws of the BMI as a measure of health. It is more of a marketing tool and not an evidenced based measure of true health. Be wary of how you use this information to define your definition of health. It also can be very shaming and trigger behaviors that are unsafe.

2. If their (the weight loss industry) products were effective in leading to long-term weight loss, they would soon put themselves out of business. These businesses count on repeat customers. Richard Samber, the longtime financial chairman of Weight Watchers, likened dieting to playing the lottery. “If you don’t win, you play it again. Maybe you’ll win the second time. When asked how the business could be successful when only 16 percent of customers maintained their weight loss, he said “It’s successful because the other 84 percent have to come back and do it again. That’s where your business comes from. (p.9)

  • Caution against investing in businesses which profit from your failure. This is particularly concerning as weight-cycling (repeated gaining and losing weight) is shown to be more dangerous than carrying extra weight. This fact is cited extensively in this book, too!

3. Researchers have known for a long time that diets don’t work. Now you know it, too. (p. 15)

  • In this chapter, Dr. Mann shares how she and her students dug into all the studies often used to validate why a particular weight loss programs/diet will work. She found three major flaws in various health and weight related studies on weight. It is also noted why it is important for you to understand the gold standard of research and how to be a better consumer and questioner of the data being quoted. “The research says…” need not shut down the conversation but instead be a conversation starter.

4. Think of willpower as brute strength. The amount of you need is larger than the amount of it you have, and the amount you have is nearly depleted by nearly everything you do. (p. 48)

  • Unpacking the science behind willpower, Dr. Mann points out that willpower – when used as a tool to maintain health –  is not the best approach to lifestyle changes. She eloquently helps you understand the science of willpower so you can make better choices and decrease the physical, emotional and spiritual struggles around food + your health.

5. Shame is more painful than guilt, and to add injury to insult, shame has been shown to lead to a release of the stress hormone cortisol, and another kind of cell in the immune system (called a proinflammatory cytokine), which, among other things can promote the growth of disease. (p.62)

  • When shame is running your life around how you care for your body, diets – or some kind of restrictive or rigid rules around feeding and moving your body – are often a go-to response. Diet related behavior is one of shame’s bff’s.

6. But variables such as exercise, weight cycling, socieoeconomic status, fat distribution, and discrimination all factor into a person’s overall health…I hope you’re not still under the impression that you have to diet or obesity will kill you. If you exercise, eat nutritiously, avoid weight cycling, and get good quality medical care, you do not need to worry about obesity shortening your life. Especially if you shield yourself from weight stigma and the stress it causes… (p. 82+84-85)

  • Chapter 5 is powerful and provocative. It digs deep into the topic of obesity and myth-busting many narratives around carrying extra weight. The above words outline the complex factors which are a part of an accurate definition of health.

7. The benefits of exercise simply cannot be denied. Regular exercise can increase your life span, prevent disease, improve your mood, aid creativity, help you sleep better, and allow you to age more gracefully. These benefits are more easily attained than dramatic weight loss, and can be yours even if you do not lose a pound. (p.185)

  • Activity is a powerful indicator of your health. Finding an activity you will be motivated to do regularly is key. Now over-exercise, over-use injuries and complications related to hydrating and nutrition are flags that your activity has crossed over from being a positive positive part of your health into a negative one. At Potentia, we help our clients (re) define activity when this happens so moving their body can return to being a part of wellness and not the sole manager emotional pain.

There is so much good information packed into this book. I hope you check it out.

If you read the book, I would love to know what impacted you the most on how you view health.

All the best as you continue to challenge yourself to (re) define health in your life.

With gratitude –

Rebecca Bass-Ching, LMFT, Founder + Director of Potentia Family Therapy, Inc.

 

 

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Q&A Series: Should We Care About BMI?

worthnotanumber

In our Q&A series we’ve unpacked the paleo diet, the gluten-free dietcleanses, and yoga therapy. This week, Kayla Walker, MFT Intern, spoke with Megan Holt, MPH, RD, Potentia’s Coordinator of Nutrition and Wellness to learn about using BMI as an indicator of health.

Note from Rebecca: The following post may be triggering for some who are early in their recovery or struggling with their recovery, so please pause here if this information will not be helpful for you right now. There is some frank talk about numbers in this post because we want to offer some accurate information about the BMI, what it is, why it is not an accurate or helpful indicator of health and how its use is fueling the disordered eating spectrum.

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Kayla: What is BMI?

Megan: BMI stands for body mass index. It’s an equation commonly used in healthcare venues to estimate risk of developing chronic diseases that often accompany increases in body fat, such as diabetes, heart disease, and many forms of cancer.

Kayla: How do you calculate BMI? How do you know whether your BMI is in a healthy range?

Megan: The formula for BMI is:

BMI = weight in pounds/(height in inches x height in inches) x 703
or
BMI = weight in kilograms/height in meters squared

CDC recommendations categorize BMI in ranges of underweight, ideal weight, overweight, and obese, as follows:

Below 18.5 = Underweight
18.5 to 24.9 = Ideal
25.0 to 29.9 = Overweight
30.0 and above = Obese

Note from Rebecca: In 1998, the FDA changed the ranges for the BMI and overnight millions of people became “overweight” and “obese.” In his movie America the Beautiful, Darryl Roberts noted this changed was approved by a board that was directly connected to the dieting industry. Given the annual 50+ billion dollars which are spent on diets and diet related products, the BMI is regularly used as a marketing tool to support the use of various products in this industry. And since diets do not work – and in fact set you up to regain the weight and often more within 1-2 years – it seems the BMI is more of a marketing tool than a predictor of true health.

Kayla: Where did the idea of using BMI as a marker of health originate?

Megan: A mathematician (not a clinician) from Belgium by the name of Lambert Adolphe Jacques Quetelet came up with the BMI in the early 1800’s. His aim was to come up with an inexpensive proxy for measuring degree of obesity. Named the Quetelet index (and later BMI), it was used as a means of assessing “appropriateness” of weight for height.

Kayla: Why is BMI used?

Megan: After WWII it was noted that obese and overweight life insurance policy holders were at higher risk for morbidity and mortality were getting increasingly fatter.

It’s easy to understand and compute, it’s inexpensive, and gives us some helpful feedback in terms of anthropometric assessment, though this holds true mainly in the extremes (very underweight and very overweight/obese).

Note from Rebecca: Recent studies are showing a lower death risk for those who are considered “overweight” according to the BMI  furthering doubt the BMI ranges are not helpful in indicating true health.

Kayla: What are the limitations of using BMI as a marker of health?

Megan: BMI does not account for differences in bone mass/structure, fat mass and lean body (muscle) mass, nor where fat is stored (visceral vs. subcutaneous).

Visceral fat (fat around the abdomen/vital organs) is much more inflammatory and problematic in terms of health risks than subcutaneous fat (under the skin).

It implies that thin or normal weight individuals are healthy and have lower risk of developing preventable disease relative to their overweight (according to BMI) counterparts, and this just isn’t the case.

Athletes are an excellent example of persons who tend to have higher BMI’s but carry lower disease risk. Similarly, body fat is underestimated in the elderly, as they typically carry very little lean body (muscle) mass. Remember, one can be thin and simultaneously unfit and/or unhealthy.

Kayla: What should we be using instead, or at least in conjunction with BMI, to predict health risks? What are other markers of health?

Megan: Waist to hip ratio, for one, needs only a measuring tape, and has more predictive power than BMI. Women should have a waist-to-hip ratio of 0.8 or less, and men 0.95 or less. Women are advantageously pear shaped, and thus carry lower risk for preventable diseases. Think of this next time you’re cursing your curves, and please STOP hating on your body!

Other methods exist that are quite costly and/or intrusive, but may be more accurate, such as requesting a lipid panel (which requires blood work) from your physician, or assessing body fat through use of skin fold calipers, underwater weighing, or bioelectrical impedance. However, assessment of percent body fat alone still does not account for ‘location’ of fat-visceral versus subcutaneous.

Kayla: How do you assess your clients? Do you use BMI as a health indicator?

Megan: I rarely, if ever, calculate BMI when working with clients, whether they are athletes or people struggling with disordered eating.

Rather, I use an assessment of their current diet and lifestyle behaviors and blood work results from their physician to measure risk.

When working with individuals who do fall in the extremely obese category, I find that they are well aware of where they fall in terms of BMI categories, and that calling attention to this is not helpful.In fact, it often deters these individuals from wanting to make changes to lifestyle, as they likely will remain in the ‘obese’ category even with a fairly significant weight loss.

We know that even mild weight loss, 5-10%, for example, is enough to significantly decrease risk of “Western” diseases, such as diabetes, heart disease, and numerous cancers.

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Thanks for reading our Q&A on BMI!

What are your thoughts about using BMI as an indicator of health? Has it been helpful or harmful in your journey to health? What additional questions do you have about health, weight, or body image?

We would love to hear from you and address your questions on health and wellness in a future Q&A blog post.

In good health –

Kayla & Megan

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Obsessing about eating healthy is not healthy.

1. Beware of using...

This morning my beloved cousin and life-long friend, Lissa Rankin, sent me an email noting a post she wrote for Mind Body Green, titled 10 Signs a Juicing Habit is Hiding an Eating Disorder.  In it, she addressed an issue near and dear to all of us who work at Potentia: when eating healthy can mask the serious emotional and physical issues of an eating disorder.

I am so grateful for her post as it is important to continue the discussion around this often lightning-rod issue. A continued conversation helps push back on a common narrative in our culture that if you do not meet the criteria for an eating disorder and you are eating whole, fresh, organic food, you don’t have a problem. But when lifestyle change leads to obsession, it is this narrative that can keep people stuck in an emotionally paralyzing state.

Obsessions are connected to a multitude of factors: low sense of worth, traumas/distressing life events, family of origin, temperament, and even under-nourishment. And many people are genetically loaded to be more vulnerable to obsessive-compulsive traits, which are found on the anxiety spectrum.

The obsession with eating healthy is called orthorexia.  Orthorexia is a sub-clinical term coined by Steven Bratmen, MD who is also the author of Health Food Junkies: Orthorexia Nervosa – Overcoming the Obsession with Healthy Eating. I will explore orthorexia more deeply in an upcoming post, but for now,  it’s enough to know that the problem is not simply about the food (I say “simply,” since we need to eat to live), but mostly about the obsessions and related impact on your life based on how you respond to your food obsessions.

Any obsession, whether it be with food or otherwise, can be mentally and emotionally crippling. When the desire to make lifestyle changes and improve how you feed yourself is taken to an extreme, it can lead to orthorexia and eventually develop into more debilitating disordered eating and eating disorders.

In her post, Lissa noted key signs you may be using juicing as a mask to your disordered eating.  Below, I add some additional thoughts to unpack the important message of Lissa’s post. And thank you again, Lissa, for keeping this discussion going. It is a hot topic for sure, but I am so grateful for the conversation!

Here are Lissa’s 10 signs that you (or someone you love) is masking an eating disorder with juicing or cleansing:

1. Your BMI, or body mass index, reveals that you are underweight or normal weight, yet you replace meals with juice regularly.

Additional Thoughts: Yes, many people who are experiencing discomfort from negative body image want to lose weight or change their body. Restricting helps decrease the anxiety of this distress by the endorphins that are produced when their body is not getting enough nourishment. At Potentia, we use the BMI lightly. For most people, it is not an accurate indicator of ideal weight range. Plus, your worth is more than a number. Connect with Megan Holt for a consult to learn more about determining your ideal weight range.

2. You’re terrified of gaining weight, even if your BMI is normal or underweight.

Additional Thoughts: Regardless of your BMI, the fear of gaining weight needs to be addressed. Even if losing weight would be helpful to your overall wellness, a number of markers will be taken into account – not just your BMI. Your labs, your activity, physical pain, how you feed yourself, illnesses, medications, stress, social and emotional support and current life situation are all taken into account.

3. Other people think you’re skinny, but what you see in the mirror is a big fat slob.

Additional thoughts: Regardless of what other people think, if the image in the mirror triggers obsessive thoughts and behaviors, it is time to get help. And to those who are friends with someone struggling, be careful about compliments and encouragements around looks. If your loved one is in deep with this struggle, she will have a hard time trusting your words.  Validating her struggle and encouraging her to get help is a very loving support without feeding the obsessions.

4. For women, skipping periods or not menstruating at all can be a sign that you’re not getting enough calories. The body is genius. If it thinks you’re not at a healthy enough weight to have a healthy pregnancy, your periods will disappear.

Additional Thoughts: Yes – your body is genius! Osteopenia can lead to re-occurring injuries and is a sign your body is struggling. Getting your period back does not mean the recovery work is done. Until you do the deep soul work to manage your anxiety, this cycle of obsessions is likely to continue.

5. You binge on unhealthy foods and then either induce vomiting, exercise excessively, misuse laxatives, or use juicing as a sort of penance to undo the damage.

Additional Thoughts: Binging does not just have to involve food deemed unhealthy. It can be any kind of food, even healthy food. Many people attempt to mask their shame of binging by eating food that is not shamed by our culture and “junk food”.  And on that note, there is room for all food, even something that is not organic, processed or corn-fed – if the majority of your body’s needs are met with whole, fresh and organic when available and affordable.

6. You embark upon juice fasts that last more than a week. For example, a month of nothing but juice just isn’t healthy.

Additional Thoughts:  Lissa referenced our popular Q&A post on juice fasts.  This is an important resource as you think about the meaning and the motivation of your cleanse or fast. Even if you do not have a clinical eating disorder but are struggling with body image issues or eating issues, we caution against trying a fast to help manage your emotional distress. This choice could send you to a dark place that could take years of recovery.

7. You find yourself avoiding meals out with friends and family “because I’m cleansing.”

Additional Thoughts: This is such  a common struggle for those with orthorexia.  When eating fuels isolation, this is a red-flag.

8. Other people worry about how often you skip meals or cleanse.

Additional Thoughts: When those who care about you are concerned, it is not because they are working against your goals for health and wellness. Your disordered eating thoughts want to isolate you and be your only friend. In truth, eating disorders are toxic BFF’s.

9. Being away from your juicer or a juice bar triggers anxiety or even panic.

Additional Thoughts: If you lose flexibility in your lifestyle, it is a warning you are becoming a slave to your eating patterns. This is not how we are called to live.

10. You obsessively weigh yourself, and change your cleansing behavior as a way to diet yourself back to your target weight.

Additional Thoughts: Your worth is more than a number and dieting does not work. No matter what you call it, trying to lose weight by restrictive eating will only set you up to regaining the weight, even more than you lost, sending you on the dangerous weight-cycling path of disordered eating.

What do you think about the obsession of eating healthy? Is it an important response to weight issues in our country? Have you or someone you cared about ever struggled with orthorexia?

Cheering you on as you (re) define your definition of health –

Rebecca

 

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Weekend Wonderment – Better Late Than Never!

1. Your Health -

No surprise those with weight issues are more vulnerable to developing eating disorders. As long as we make weight a primary factor in determining health – and rewarding weight loss over overall wellness – we are contributing to the serious food and body issues in our culture.

Spread the word: You cannot be replaced!

A refreshingly honest, hilarious, and a little bit frenetic look inside the tension of being seen, authentic and vulnerable.

Love this blog on everything rustic and vintage on a budget. I just scored some of their amazing mini bread boards. I plan on getting more for gifts. You can even have each board engraved with up to 10 letters.  Sweet!

This is inspiring me to get my creative via my i-Phone photos. Who knew creativity and tech could be so fun and easy?

I am SO grateful for this website as I now have both kids in school and my oldest is needing lunches everyday.  The lists of recommended lunch gear saved me hours of research and the meal ideas and pics help with quick and easy planning.  Exhale.

This is an important post on bright girls, bright boys, and (re) defining perfectionism and being good enough.

Props to Matt Knisley for the heads up this new platform for books.  While I will always be a fan of old school books-in-hand, I am embracing technology and books. Netflix for books: count me in!

Donald Miller never disappoints with his powerful and convicting words. Read and be challenged to be brave and love without conditions.

In Awe and Wonder –

Rebecca

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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

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The Dark Side to Celebrating Eating Contests

http://lazygastronome.files.wordpress.com/2012/01/adam-richman-diet.jpg
 
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

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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?

—-

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

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Seeking True Health in a Health Obsessed Culture

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True Health

Is your definition of health keeping you unhealthy?

Maybe. Maybe not. But I recommend taking a critical look at how you define health in your life and to reflect on how your definition of health is impacting your overall wellness.

When you say something or someone is healthy, what drives your sentiment?

I usually hear the following impacting this statement the most:

  • Looks
  • Weight
  • Fashion
  • Food choices
  • Fitness routines

And by the frenzy of advertisements everywhere about all of the above, the definition of health in our culture has been skewed to meet the needs of for-profit industries while also fueling disconnection and shame about the food we eat, our bodies, and our stories.

It is time to start thinking critically about the messages we are integrating into our definition of health.

Any person, book, or program that touts drastic weight loss, cutting out major food groups, or specific results is a wolf in sheep’s clothing. None of these diets or “lifestyle choices” are sustaining after 1-2 years. The facts show weight cycling from dieting, disordered eating, and serious eating disorders are continuing to wreak havoc on our health.

I respect and totally get the desire to look good and feel good. Yet, there is a dark side to these pursuits when the meaning and motivations are based on fear, obsession, and untruths.

I am troubled by the loud chorus of people in the medical and wellness fields that are getting on the bandwagon of fear of fat and an over-focus on the number on the scale as a measure of true health.

And I am even hearing health preached from the pulpit. Yet when people in faith communities are equating virtue with the number on the scale or whether you eat certain foods, it only results in more anxiety, confusion, and discontent. Shaming people to lose weight or eat well in the name of God hits below the belt and increases psychological and spiritual wounds.

I am surprised how many people are still using the archaic BMI (Body Mass Index) as an indicator of health. It is simplistic, formulaic, and reductive. The BMI does not take into account your genetics, unique physical makeup, and lifestyle. Yet it is still used as the gold standard for whether someone needs to lose or gain weight.

And I am still skeptical of the FDA standards of the BMI knowing that many of the people on the board have or have had connections to the diet industry. If the BMI is a part of your definition of health, I encourage you to take a step back and reconsider its role.

We do have some serious issues to address regarding wellness in our country, but the myopic focus on weight + good food/bad food is missing so many other factors that contribute towards true health. And until we have a multidimensional view of health, we will keep spinning.

I talk a lot about what health is NOT.

I believe health is not:

  • determined only by the number on the scale;
  • achieving the “perfect” body or striving for unhealthy perfection;
  • eating food restrictively or based on a “good” food or “bad” food mentality;
  • unsafe relationships;
  • an obsession with eating healthy where there is no room for flexibility;
  • dieting and demonizing foods and food groups;
  • shaming, blaming, or judging self or others.

I also talk a lot about how I define health.

I believe true health is:

  • finding something you are passionate about and striving to spend most of your waking hours in this space. When people are bored or feel trapped in jobs or situations that drain them of their creativity, their motivation, and ability to sit in vulnerability, this has a negative impact on mental and spiritual health which in turn can develop into physical ailments.
  • having a relationship with money where you are living within in your means and have enough to give and save. Leaning too heavily on finances as a means of control or comfort gives money way too much power over your peace of mind. And using money as a means to medicate can create chaos and a cycle of stress that negatively impacts mental, physical, and spiritual health.
  • involvement in your local community. So many people are disconnected from the places they live, but emotional wellness comes when we feel safe, have purpose, and community.
  • having a faith + regular spiritual practice. Understanding we are loved beyond measure and there is a greater purpose for your life gives perspective and meaning in all circumstances.
  • having a deep soul connection with a special few individuals who you can be real with, share your fears, mistakes, dreams, and hopes. Feeling heard and understood creates connection. Connection breeds empathy and gratitude. Gratitude impacts how our brains fires and improves our well-being, body, and soul.
  • living in a body that has energy, its needs met, is rested, moves well, and is free from pain. And when many are living in chronic pain or have chronic illness, practicing the previous five points can actually help improve their physical health. The only numbers of real concern are on your labs checking your bloodwork and other internal functions.

In the days and weeks to come, I will dig even deeper into these components of true health.

I am curious: How do you define health in your life? What do you think of my definition of health?  I look forward to and value your thoughts and feedback on this important and controversial topic.

Rebecca

 

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Everybody Knows Somebody: NEDAW 2013

 

National Eating Disorder Awareness Week 2013 is wrapping up tomorrow.  This year’s theme is a repeat: “Everybody Knows Somebody.”

I have been thinking a lot lately about the people I have had the honor to meet and work with over the last (almost) 10 years. I wish I could share with you the intricate details of their stories of heartbreak, despair, pain, victory, and perseverance.  They have taught me so much about the disordered eating spectrum, grace, humility, and redemption.

What I can do is share with you how many of the people you interact with every single day are hurting inside and masking it so well that you have no idea what is really going on in their minds, hearts, and souls.

You are around people every day who are terrified of being found out, misunderstood, judged:

  • for eating a “bad” food;
  • for binging+purging;
  • for living on caffeine and crumbs;
  • for doing things with food and their body that would make your toes curl;
  • for being overweight and seen as lazy, stupid, a burden to society;
  • for not being able to manage life without their disordered eating thoughts and behaviors;
  • for their life being so chaotic, out of control, unsafe;
  • for hurting and hating their bodies, their lives, their existence.

You see their smile, their amazing work ethic, the kind disposition. You laugh at their jokes and praise them for their faithful service and always being available to help.

Or you may be distracted by their extra weight, their health struggles, their mood swings and think it is just about the food, just a phase, or simply manipulative attention-seeking.

Think again. It is probably so much more.

We live in a culture that is not showing any signs of letting up with the pressure to fit into a certain size, shape, look, way of being.  While there are more and more people desiring authenticity and courage — and stepping up and living it — there are still so many people you know who are terrified of being seen in their pain, their darkness, their cesspool of destructive choices.

I hear many cheer on stories and acts of vulnerability. I deeply admire those sharing their stories while living a life of courage. It is medicine for the collective soul.

But when I step out of the safe zone of my home, my inner circle of support and Potentia, I am up to my eyeballs in snark, criticism, bitterness, cruelty, bullying, and fear. Yes, there is hope and light amidst the toxic culture we live in, but wow. It is intense out there and many are breaking under the pressure.

You may not notice these individuals screaming loudly from inside their minds, but look again.

You may be too busy, overwhelmed, or caught up in your our pain to see that others are struggling, too, right in front of you. Understandable. It is hard to be human.

Or you may think really seeing, sitting with, and empathizing with someone’s pain is too hard, unbearable. Indeed. That kind of connection is a full body commitment and investment. Healthy boundaries (not walls) are needed so you can discern what your limits are on any given day.

But I think we can no longer tolerate looking away from the pain of those around us. This is volatile ground to tread. But when you hear someone speaking poorly about their body, dieting (the gateway drug for eating disorders), negligent with how they nourish and care for themselves, please do not tell them how to change or look away.

Please do slow down and listen. Build a relationship with the person you are concerned about. Ask questions. Seek to understand. Listen some more. That in itself is so life-giving to someone living in emotional isolation.

I hear many people say, “I do not get eating disorders. That is not my struggle.” You may not struggle with food and body issues, but I suspect you know full well what it is like to feel alone, rejected, ashamed, overwhelmed, afraid, and helpless. So yes, you can connect with someone struggling with an eating disorder regardless of whether that is a part of your story.

Eating Disorders, Disordered Eating and all the related issues — obsessions with counting calories + dieting + eating “healthy,” good food/bad food, excessive working out, anxiety, compulsions, depression, suicidal thoughts, self harm behaviors, body shame, unhealthy perfectionism — are attempts for people to chase the ache of the core negative belief, “I am not worthy of love.”

At the heart of a lot of the wellness issues in our country is deep emotional pain. Genetics, family of origin, trauma, temperament, and distressing life events all play intricate roles in this complex and damaging illness, and the reductive solutions offered by many are fueling the pain, not relief.

As this year’s NEDAW wraps up, remember:

  • Everybody knows somebody in the process of recovering from somewhere on the disordered eating spectrum;
  • Everybody knows somebody who is painfully concerned with how she is perceived by others;
  • Everybody knows somebody giving up a food group or going on a diet with the hopes it will cure their emotional pain or physical ailments, only to be left unsatisfied and under-nourished;
  • Everyone knows someone who would rather hurt herself than somebody else;
  • Everybody knows somebody that is deceptively in deep emotional pain screaming out for help behind her smile and put-together demeanor;
  • Everybody knows someone who defines herself solely by the darkness of her story;
  • Everybody knows somebody who repeatedly talks negatively about her body, oozing with self-hatred and disgust when she looks in the mirror;
  • Everybody knows somebody who fears being fat, thinks she is fat, feels fat regardless of the facts;
  • Everyone knows someone who exercised for hours on end to the point of injury;

Everybody Knows Somebody.

You Know Somebody.

If you want to learn more about the disordered eating spectrum, check out the National Eating Disorder Association website. It is an incredible resource for those who are struggling with and those who are learning about eating disorders.

How have you reached out to someone struggling? What was difficult? What went well? Please do share!

Cheering you on –

Rebecca

 

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Holding the Numbers Lightly

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Numbers.

I have a lot of conversations about numbers in my line of work. And not the numbers that my accountant or financial planner talk with me about (ugh) but the numbers that are used to help us measure our physical health.

My clients over the last decade have taught me that these numbers can be destructive, shaming, and spike their inner drill sergeant to start screaming awful things about their worth + value.

Working with those who struggle with eating disorders, negative body image, and disordered eating has taught me a lot about some numbers and how they can be draining and all-consuming.

I am referring to the number:

on your scale
of the size of your pants
of calories or points of a food item
on your labs (I like these numbers but they can often be used incorrectly)
of calories burned

While I believe our emotional, relational, and spiritual health are deeply enmeshed with our physical health, I want to address these numbers — particularly the number on your scale — and how you use them as you seek to make changes in your physical well-being.

When it becomes clear to me that these numbers are toxic to my clients and are preventing any real change from happening, I often ask them to take a big risk and leap of faith.

I ask them to get rid of their scale.

Sometimes they are not ready to get rid of it, so I hold it at my office (you should see the space under my couch) or they put it in the trunk of their car or have a trusted friend hold it or hide it.

Afraid of losing control without their scale, my clients ask:

What if I gain a ton of weight?
How will I know if I am making progress?
What will motivate me for change without the scale?

I always respect this resistance. I get it.

It’s a frightening idea to let go of this measure that helps them manage their anxiety + fear and has been serving as an emotional container for some time. But if they are in my office, I suspect this means of containing has reached capacity.

The scale simply does not serve as an effective means of control and in fact spikes obsessive thoughts about weight, food, numbers, and what other people think.

Stepping on the scale fuels the “never enough” crazy-making because:

  • If it is higher than you would like, you feel anxious, depressed, ashamed.
  • If it is right where you want it to be, you are excited but also paralyzed by fear of doing anything that will change that number in the wrong direction.
  • Even If you have achieved a weight in the range that is best for your body, sometimes the desire to go even lower gives a rush that is hard to resist.

Contrary to the many messages we are inundated with in our culture, weight is not a direct correlation to our health.  Last week, the results of a meta-analysis study of weight and mortality revealed those deemed overweight were associated with significantly lower all-cause mortality.

This study is more indication of the need to rethink how we define overweight and obese. I want to be clear, the results of this study are not a pass for those who need to make changes in how they care for their body. But shaming people to make changes to better their well-being is not effective and is destructive.

Determining our well-being is way more complex than a number on a scale or an antiquated formula or chart. These faulty formulas are pervasive in our culture and prey on those who are feeling pretty crappy about themselves, who are desperate for change and relief.

When the number on the scale is the primary measure of your success in achieving your goals, you are vulnerable to a shame spiral.

When this number has power over your worth and value, it is time to get off the scale until you can recalibrate that way of thinking and learn how to bench negative emotion so you respond to your pain in ways that are not harmful to yourself and others.

Many clients report a positive emotional benefit after taking a break from the scale. They report less anxiety and that their inner drill sergeant has dialed back the volume.

Let me be clear: I think it is important to own all of these numbers…

…at the right time in your healing journey.

At the wrong time, shame, perfectionism, impatience, and fear can take these numbers and wreak havoc on your sense of worth, your mood, your focus.

Megan Holt, Potentia’s Coordinator of Nutrition + Wellness, often monitors the numbers on the scale for our clients while working with them on strategies towards true health that are customized for each individual. (Note: We all need a Megan in this culture!)

When our worth gets tied up in numbers, we make changes — often needed changes — for reasons that do not support sustaining change.

Our goal is to help people really discover where their bodies have the most energy and function the best. We support people discovering their food preferences and moving away from calling food good or bad. It is so amazing to see people find a way to enjoy food while still nourishing well.

When we use eating, restricting, or eliminating food in unsafe ways to take away the pain or to numb, dull, and repel, we do not allow ourselves to develop the emotional muscle to bench the hard stuff in life.

Food — eating it or restricting it — is powerful. It can be fun + enjoyable, too.

But for many, tolerating joy is very triggering and even less tolerable than shame and fear. Going back to the dark space, albeit uncomfortable, is known. And our brains like known.

So, if you are starting off this new year and food + body issues are one of your primary goals to tackle this year, awesome.

But please hold the numbers lightly.

And if you notice the numbers on your scale or on food items you are eating or the size of clothes giving fuel to your inner drill sergeant, then take a pause.

Ask your dietician, your nurse, or doctor to do blind weigh-ins for a while and not to talk about numbers for a bit as you seek to recalibrate your thinking.

These numbers are one of many factors that measure your progress on the journey towards true health, but they are not the sole indicator of progress as they may fluctuate for a variety of reasons.

Hold the numbers lightly as you seek true health in your life, and fiercely guard your heart from believing your worth is tied into a number.

Cheering you on —

Rebecca

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