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

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.”

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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

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

 

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

 

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

Slowing Down + Feeding Ourselves Well.

Source: potentiatherapy.com via Rebecca on Pinterest

Today is National Food Day.

The effort behind this movement is a “nationwide celebration and a movement for healthy, affordable, and sustainable food.”

We believe there is room for all foods in how we feed ourselves.  We also believe food is medicine.  When we nourish well, we feel well.

So many we work with have:

  • an obsessive;
  • a fearful;
  • a love/hate;
  • a distant
  • a frustrating

relationship with food.  Food does not have to take away your power.  Instead, it can empower you to live, be, and serve well.

When our clients begin to heal their relationship with food, they discover their food preferences, the joy of caring for their bodies and, yes, the joy of eating.

Eating well = fun + freeing.

Eating well = freedom from the loud voices in your head that shame you for eating a food deemed “bad”.

Eating well = energy, clarity, slowing down, enjoyment, community, connection.

The grassroots effort of the Slow Food Movement to maintain the diversity + quality in our food supply while supporting farmers through purchasing locally grown whole foods is exciting because it brings home the fact that how you feed yourself not only impacts you but those in your community.

Slowing down and feeding ourselves well: It’s good for our bodies, our community and our planet.  AND it’s totally affordable. (Seriously!)

Wow! A big part of healing your relationship with food, your body and your story involves being a part of something bigger in your life.  One simple way you can jump start that process is by checking out your local farmer’s market and connecting with those who grow/raise your food.

Several venues here in San Diego County will be hosting events in honor of National Food Day. Visit www.foodday.org to find an event near you.

Also, check out the San Diego Farm Bureau’s website to find your local farmer’s market. (or the FB in your local area.)

Go get some farm fresh tomatoes for your tomato sauce.  Or grab some fresh apples and free-range eggs for your apple spice cake.  Pick up some freshly harvested greens for your dinner salad tonight.

And if you see us at the market, please say hello!  We are honored to be a part of your community.

Slowing down and eating well –

Rebecca + Megan

Everybody Knows Somebody

2012 Theme: Everybody Knows Somebody

In a few days, National Eating Disorder Awareness Week will kick off.  I am always blown away by the power, the emotion, the dedication of so many who participate in this week through speaking, writing, creative events through multimedia and more.  So many have been touched by eating disorders and the disordered eating spectrum.  And that includes you.

Eating Disorders and the Disordered Eating Spectrum continue to be misunderstood, glamorized and minimized.  The truth of the matter is, you know someone struggling with their relationship with food and/or their body.

Everybody knows somebody.

You know somebody.

Food and body issues are tricky. They are sneaky and sly and operate under the guise of health and productivity or laziness and undiscipline.  Be very clear: eating disorders are killing and disabling at rates that are scary.  Eating disorders are the most deadly of all mental illnesses. Do not let someone you know be another statistic.

You know someone on the diet roller coaster or obsessed about eating healthy to such an extreme their lives have become a prison to irrational fear, rigidity and control.

You know somebody who repeatedly talks negatively about their body and believes their worth and value are directly correlated to the number on the scale.

You know somebody who is depressed, anxious, suicidal because they feel so out of control with their behaviors and thoughts about food and their body.

You know somebody who is slowly dying inside physically, emotionally and spiritually.

You know somebody who wants to be loved and seen beyond their looks, their grades, their performance, their weight, what they eat.  You know someone who wants to be seen.  Period.

You know somebody in this kind of pain.

And there is hope and healing available for those who want to live their lives in peace and joy.  I get to work with the most amazing professionals at Potentia and at treatments centers around the country who are passionate about helping people heal from their eating disorder.

Eating disorders are complex and their causes reflect this complexity: genetics, family of origin issues, culture, temperament, physiological issues, traumatic events and more.  There is not a quick fix and no one to blame but the sooner someone starts the process to change, the better for their long term prognosis.

You know someone who needs to begin this journey.  Now.

Resources like edreferral and Gurze are wonderful sites to find practitioners at all levels of care who specialize in treating the whole spectrum of food and body issues.  Gurze is also a publishing company dedicated to provided resources on these issues. I would also check out The National Eating Disorder Association.  I love the commitment of the NEDA team and value their role in starting and promoting National Eating Disorder Awareness Week.  Hang out at these websites. Learn something new.  And share it with someone you know.

Potentia joins the many individuals, families, treatment centers and providers in promoting eating disorder awareness.  At Potentia, we will be doing a week long event asking people to write on a piece of paper (we have cool artsy paper, pens and more for those who want to get creative) an apology to their body or a thank you to their body.  We will hang these note cards around the space and make a slide show of them at the end of the week.

If you want to contribute to this event, feel free to stop by and add your contribution to our display.  And if you live far away, feel free to send me an email and I will make sure your words are added.

Sororities and other local groups are already contributing.  I would love to add your voice to this display.  And all contributions can be anonymous.

Our hope is this display gets everyone thinking a little more about the seriousness of disordered eating and helps those struggling know they are not alone.

And yes, to be clear, you know somebody.  Now it is time to talk about it.

How are you going to use your voice during eating disorder awareness week?

In the name of Health

In The Name of Health

In the last several weeks, I received news about amazing women I know fighting for health in their lives.  One family member is fighting for her baby’s health as he struggles to eat and maintain his weight, another friend is planning for a radical surgery as a preventative measure against cancer.  A newer friend of mine recently discovered a mass in her lungs and has begun chemo therapy to tackle the cancer in her body.  All three of these women greatly inspire me with their courage, passion and strength.  In their quest for health, they face challenges, uncertainty and a roller coaster of emotion.  Their stories have unwritten chapters ahead of them as they seek to do what is best for their health.  Yet, my work has taught me that our quest for health can look completely different from person to person.

Health (re)defined

Health.  We hear this word a lot: In the news; in commercials for products and diets; in research findings; in schools; on magazine covers with claims of the best in the name of what is healthy. When looking further into the meaning of what all of these voices are calling healthy, I find such a wide-range of definitions.  Marriam-Webster online defines health as the following:

1 a : the condition of being sound in body, mind, or spirit; especially : freedom from physical disease or pain b : the general condition of the body <in poor health> <enjoys good health>

2 a : flourishing condition : well-being b : general condition or state <poor economic health>

If I use this definition as a platform for discussing health, then that leaves many I know operating from a warped and inaccurate view of what is truly healthy.  Many of the men and women I work with are striving for health, but in a way that actually depletes their health body, mind and spirit.  50+ billion dollars annually are spent every year in our country on diet and “health” related products.  Many of these products make a lot of promises but rarely deliver.  Others leave people in bondage so that they are fearful of living life without sticking to a specific plan.

This is a big theme as I seek to propose ways we can (re) define health as we know it.   We crave, hunger, desire for so much more.  Diets, health food, fear of fat, control, deprivation, denying who we are called to be for fear of rejection, alienation are some of the many ways in which we try to manage our pain and our fear.  Yes, we have choices on how we feed, move and care for our bodies and souls.  No, there is not a quick fix to being able to sit with the tension of it all.  But if we are operating from our passions, are in touch with our true identity – not one sold to us – then maybe, just maybe, the diet industry may go out of business (OK, a girl can only hope…) and health, quality health, can be achieved.

(re)Defining Health with Respect

The news is not lacking with stories about the “obesity epidemic” and television shows focusing on radical weight loss in the name of health are very popular. I will add my voice to the discussion on:

  • the disordered eating spectrum,
  • Orthorexia and how the quest for health can turn into a debilitating and often deadly obsession,
  • EDNOS (Eating Disorder not otherwise specified)
  • the HAES (Healthy At Any Size) movement
  • Intuitive Eating and a non-diet philosophy

Challenging various definitions of what is “healthy” can be volatile and feel very personal.  My hope is to respectfully challenge some of the beliefs, philosophies and motivations behind the many definitions of health out there with the goal of moving the discussion away from fear, prejudice and misinformation towards true freedom and health with passion, love and respect. There will be other contributors to add additional perspective to the effort to (re) define health.  Stay tuned.  Some good stuff is coming! I also hope you will join in this important discussion.  Your voice matters.

  • How do you define health?
  • What do think about the struggles of obesity in our culture?
  • Do you think an over emphasis on weight will prevent obesity or create more food and body issues?