Categories
Nutritional counseling

The Milky Way: Why We Encourage Inclusion of Dairy in Eating Disorder Recovery

Dairy Eating Disorder Recoveryby Shelly Bar, MD, Katie Grubiak, RDN, and Lauren Muhlheim, Psy.D.

Dairy is tasty and good for you. Despite this, there are a lot of folks who are scared of it. You may have eliminated dairy from your diet in pursuit of better health or better digestion. You may have heard that the elimination of dairy would help with weight loss. You may have experienced gastrointestinal distress following the consumption of dairy products, concluded that you are lactose-intolerant, and decided you should therefore avoid dairy-rich foods like ice cream and pizza. However, did you know that—especially if you have an eating disorder or disordered eating —this might not be necessary and might actually make things worse?

In this article, we will discuss the many dietary benefits of dairy. We will also explain lactose intolerance and various interventions to address it so that dairy can remain a part of your diet.

Why Dairy is Important

Dairy, in both solid and liquid forms, is an excellent source of macro and micronutrients. Besides providing a balanced synergy of protein, carbohydrates, and—when it has not been removed from the product—fat, dairy provides a significant source of vitamins and minerals, including electrolytes. Milk is a significant source of calcium (300 mg per cup), potassium, magnesium, phosphorus, iodine, zinc, and B vitamins. Vitamin A and D are usually added to milk during processing, making it a good source of these nutrients as well.

Calcium is a crucial mineral for all teens and all people with eating disorders due to the risk of bone loss. Four glasses of milk a day provide approximately 1200 mg of calcium, meeting the daily needs of most teens and adults. Other dairy sources—such as cheese—can have the calcium equivalency of a glass of milk. Therefore, consuming four calcium-rich food or beverage sources daily can prevent the need for calcium supplementation.

The Advantage of Dairy Milks

The U. S. Food and Drug Administration (FDA) requires standardization of products labeled as cow’s milk. This means the macro and micronutrient composition in one cup of milk must remain the same across all manufacturers.  The only variation allowed is the percentage of fat—skim/non-fat, 1%, 2%, or whole—which can in turn alter the amount of fat-soluble Vitamins A and D that are added. Thus, you can be guaranteed to know exactly what specific amount of each nutrient you are getting consistently by drinking a glass of milk.

By contrast, standardization is not required for non-dairy milks, so their nutritional content can vary widely. Each manufacturer can determine the formulation of their beverage and the amount of macro and micro-nutrients it provides. On the whole, they provide fewer nutrients than cow’s milk. Some people might even make non-dairy milks at home. These would almost certainly be deficient in nutrients compared to cow’s milk.

Bioavailability—the body’s ability to utilize a nutrient—is another concern.  Bioavailability depends not only on the specific form a nutrient takes in a food, but on the other nutrients alongside which it is absorbed. In cow’s milk, calcium appears as calcium phosphate, which on its own is 30% bioavailable. Cow’s milk also contains optimal amounts of Vitamin D, phosphorus, magnesium, and zinc, synergistically enhancing this availability. Non-dairy milks may not contain adequate calcium in a form or nutrient combination for the body to easily access it. Some manufacturers are adding these nutrients in an attempt to market the beverage as promoting bone health. If the manufacturers of non-dairy milks are trying to model their products after cow’s milk, one must ask the question: why not drink the real thing?

Other factors that make cow’s milk superior to non-dairy milks:

  • Protein: Nutritional recommendations encourage adequate protein intake. Cow’s milk contains significantly more proten that most non-dairy milks, with the exception of soy milk. Some manufacturers of non-dairy milk are seeking ways to boost their protein content in response to consumer demand.
  • Carbohydrates: It is recommended that a majority of one’s total daily calories come from carbohydrates. Cow’s milk has carbohydrates sourced from naturally-occurring lactose. Non-dairy milks have varying amounts and sources of carbohydrates. Since manufacturers often market to “health-conscious” consumers—from our perspective, unnecessarily concerned about sugar—carbohydrate amounts in these products are often much lower. The naturally occurring carbohydrates in cow’s milk, in combination with protein and fat, assist in moderating blood sugar and replacing glycogen stores in muscle. Have you ever heard of refueling after a workout with chocolate cow’s milk? We cannot rely on non-dairy milks to offer the same synergy.
  • Fat: Fat is an essential part of one’s daily intake. Whole –or 2%–cow’s milk contains vital fat. This provides an optimal amount of essential fatty acids as well as satiety. The non-dairy milk manufacturers, marketing to the “health-conscious” consumer provide lower-fat products which are less optimal for health and satiety.

Why Are So Many People Scared of Milk?

Diet culture—as well as the clever branding of alternative milk products—appears to have increased fear of dairy products. Many people succumb to the belief that dairy is somehow harmful. They may be afraid of the fat in milk products. It may be that people who are looking for a reason to justify dairy avoidance will pin the blame on lactose intolerance. It has become trendy to seek out non-dairy milk alternatives and this is often veiled under the belief that lactose is bad for health.

In this context, it is important to understand that our human ancestors continued to consume milk and dairy products despite displaying symptoms of lactose intolerance for thousands of years, without any ill effects. 

What is Lactose Intolerance?

Lactose intolerance is an inability to digest lactose, the sugar that occurs naturally in milk. Lactase—spelled with an “a”is an enzyme produced in the small intestine which is responsible for breaking down lactose. When a person has insufficient lactase in their small intestine, the normal bacteria in our gastrointestinal tract take over and break down the lactose carbohydrate to create energy for themselves. When this happens, we get the production of gas and also increased motility of the gut. This is often what people refer to as symptoms of “toots and shoots.”

All female mammals produce milk to feed their young. The nursing babies digest the milk with the help of lactase. Usually, when the young mammals are weaned, they stop producing lactase, which makes sense practically. Why should our bodies waste energy making an enzyme that is no longer needed?

Humans, however, are unique among mammals in that we continue consuming milk and dairy products into adulthood. Approximately one-third of the population has a genetic mutation that allows us to produce lactase throughout our lives, making it easier to digest milk.

What are the Symptoms of Lactose Intolerance and How Common is It?

The other two-thirds of humans experience some degree of lactose intolerance. It is estimated that 36% of Americans and 68% of the world population have some degree of lactose intolerance. 

The symptoms of lactose intolerance include:

  • Diarrhea
  • Nausea, and sometimes vomiting
  • Stomach cramps
  • Stomach pain
  • Bloating
  • Gas

These symptoms usually occur within 30 minutes to 2 hours of consuming products with lactose. Lactose intolerance often runs in families and is most common in Asian Americans, African Americans, Mexican Americans, and Native Americans.

The other question that often arises is why some dairy foods cause gas and abdominal pain while other dairy foods do not. There is no clear answer to this question. Some people will say that their symptoms will start only after eating a great deal of dairy-based foods—such as pizza followed by ice cream.  Others will feel it immediately after only small amounts of dairy. It is thought that fermented dairy products like yogurt and hard cheeses are easier to digest.

What Are the Health Risks of Being Lactose-Intolerant?

Research shows that people who cannot make lactase do not suffer any significant health consequences. They do not die at a higher rate, do not have weaker bones, and have just as many children as people with the mutation do. In short, the risk is discomfort.

Most people have a partial deficiency rather than a complete deficiency of lactase enzyme, meaning they make some—if not a totally sufficient—amount of lactase. For people with eating disorders, it is important to understand that temporary partial deficiencies can occur when one decreases the amount of dairy they are eating, thus depressing the production of lactase enzyme. When a person is malnourished, it is likely they will produce less lactase. This may occur when someone has been restricting dairy foods, either because they fear that the foods are not “healthy” or because the dairy foods are causing physical distress.

This can in fact become a self-maintaining cycle: where someone has started to restrict dairy, then starts producing less lactase, then experiences distress when eating dairy, concludes they are intolerant, and restricts further. At many eating disorder treatment centers, it is often presumed that patients who have been restricting their intake will experience at least temporary partial lactose intolerance and so they are treated with the presumption that they will need additional lactase.

How Can Lactose Intolerance be Managed?

Fortunately, the solution need not be to avoid dairy altogether. The pharmaceutical industry has introduced lactase pills that clients can ingest prior to eating dairy products. The pills work like lactase produced in the body to break down the lactose in milk. Lactase pills are often used in clients with some malnutrition from any cause, as the amount of lactase enzyme produced and/or available is insufficient in their gut due to malnourishment even though they are not technically lactose intolerant. This allows them to better digest the dairy products that often add higher fat content to foods. The milk industry has also introduced lactose-free milk with added lactase. This product has nearly the same taste, texture, and nutritional benefits as milk. It does tend to be a little sweeter.

The Importance of Dairy for Eating Disorder Recovery

For a person with an eating disorder, dairy can be a critical food source. Milk has more calories and total macro and micro-nutrients than alternatives and can facilitate the refeeding process for those needing to restore weight. By contrast, milk avoidance undermines recovery by perpetuating fear around commonly-encountered animal-based foods and beverages and creating situations in which one can’t get all of one’s nutritional needs met. Just think about how many situations in which you find yourself in which pizza is the primary nutritive substance. While ethics around consuming dairy are often stated as a reason to avoid it, our highest obligation is to the patient.  In the context of an active eating disorder, it is best to reincorporate all foods and beverages. Later in recovery when rationalization is less of a concern, ethical tradeoffs can be re-evaluated.

If dairy products cause physical distress, we encourage the use of lactose-free milk or lactase pills until dairy is better tolerated. Dairy can also be gradually added back in an exposure-based hierarchical way. This is essential in preventing any fear associated with dairy and allowing the normalization of dairy into everyday diets. This way, “temporary” lactose intolerance can also usually be worked through.

We do not encourage the elimination of dairy from the diet unless a medical doctor trained in eating disorders has deemed it medically necessary. A medical doctor is also the only one who should recommend the removal of dairy due to a milk protein allergy (specifically whey protein or casein protein). However, this type of allergy is considered rare, occurring in less than 2% of the population. Children are more susceptible to milk protein allergies, but most outgrow their allergy by 5 years of age.

In Conclusion

We know that more varied and higher fat diets lead to more lasting recovery.  It is in the best interest of every person with an eating disorder to include as many dairy foods as possible in their recovery meal plan. If you have eliminated dairy from your diet or are supporting someone who has, we strongly encourage working towards the inclusion of dairy products. We recommend adding dairy back gradually and to use lactase pills to manage any physical symptoms. Lactase pills can safely be used long-term.

Dairy-rich foods are a traditional part of many food cultures. We want you to be able to enjoy an ice cream outing with friends, shared late-night pizza ordered in, and social gatherings around a cheese board. Dairy foods are some of the tastiest and most joyful foods and we want you to be able to eat them while strengthening your eating disorder recovery.

Source

Evershed, R.P., Davey Smith, G., Roffet-Salque, M. et al. Dairying, diseases and the evolution of lactase persistence in Europe. Nature 608, 336–345 (2022). https://doi.org/10.1038/s41586-022-05010-7

Categories
ARFID

How Diet Culture Can Harm Your Recovery from ARFID

by Carolyn Comas, LCSW, CEDS-S

People diagnosed with Avoidant Restrictive Food Intake Disorder (ARFID) struggle with consuming adequate nutritional intake due to either 1) fear of aversive consequences (i.e choking), 2) low interest in food altogether, or 3) sensory sensitivity to food textures, smells, or appearance. Usually, people with ARFID do not report refraining from eating due to fears of weight gain or efforts to lose weight. In fact, many people with ARFID welcome weight gain and want to expand their food variety.   

The Impact of Diet Culture

The current Diagnostic and Statistical Manual (DSM-5) excludes those whose eating is restrictive due to shape and weight concerns from receiving a diagnosis of ARFID. However, this does not mean that people with ARFID are immune to the societal messages around food and bodies. Sadly, we all live in a world that is very much driven by diet culture. Most of us, with or without eating disorders, can be impacted by diet culture. We are constantly bombarded by many sources, ranging from the media to doctors’ messages about the danger of fatness and categorizing foods as healthy or unhealthy. 

Dieting is one of the leading causes of eating disorders. According to a study by the National Eating Disorder Association, 35 percent of people who diet progress into pathological dieters. Of this 35 percent, up to 25 percent will develop a full-blown eating disorder. People with ARFID could develop another eating disorder, such as bulimia nervosa or anorexia nervosa at some point in their life.

People with ARFID already face the challenge of limited food choices and heightened anxiety around eating. They can be very vulnerable to messages that their preferred foods  “aren’t healthy” or “junk food.”  This can lead to even more anxiety and shame around their food choices. People with ARFID thus have to battle their disorder as well as the concerns that diet culture imposes around food and body size.

Dieting encourages us to ignore our bodies’ needs. Diet culture emphasizes that our worth is based on the size of our bodies. In Christy Harrison’s book, Anti-Diet, she calls it “the life thief.” And that’s what it does- it steals the joy out of fun events or the everyday activity because it convinces us we need to carefully balance everything we put in our body. And if we go off the diet or “cheat” we are made to feel bad and unworthy causing a vicious cycle of yo-yo dieting. 

People with ARFID with whom we have worked report confusion around some of these messages, which clearly come from diet culture, and affected their ability to eat their preferred foods:

  • “Water is the only hydrating beverage and I should only be consuming water.”
  • “I was only offered wheat bread which I didn’t like so I didn’t eat bread.”
  • “I must eat vegetables in order to be healthy.”
  • “Fried foods are bad so I should limit my chicken nuggets and french fries.”

Standing up to Diet Culture

If you have a loved one struggling with ARFID it is recommended to check your own relationship with food and body image. Explore your own internalized fat phobia. Great books include The Body is Not an Apology by Sonja Renee Taylor and What We Don’t Talk About When We Talk About Fat by Aubrey Gordon. If you are worried about the types of food you or your child is eating because it is “unhealthy” check in on what you are really worried about. Is it truly about the nutritional value of the food or is there a belief that these particular foods can lead to being in a larger body? If the fear is being in a larger body then you have work to do. Learn about Health at Every Size® and recognize that the size of our bodies does not correlate to how healthy or unhealthy we are.

Remember, it is better to be fed than to be dead. If all you or your child can eat is chicken nuggets or french fries or potato chips or white bread (or all 4), then that’s what needs to show up at each meal and snack. You or they should have permission to eat preferred foods at every meal and snack without shame. With therapy, the goal is to incorporate more food groups and decrease fear and anxiety around novel foods. Realistically people who struggle with ARFID might never have the most expansive palette and that’s okay. If protein has to come from a package or be fried then that’s where the protein has to come from. Insisting that one food is better than another can make a person with ARFID feel ashamed, embarrassed, or more anxious about their food choices and further limit their eating. We never want to limit the food choices of people with ARFID beyond those limitations that the disorder causes. Choosing to feed yourself foods our culture considers “less healthy” rather than not eating is the best and dare I say–-healthiest choice there is.

When it comes to expanding variety and trying new foods we always have to start with what feels safe for the person with ARFID. While the goal might be to eat blueberries the first step might be eating blueberry muffins or chocolate-covered blueberries. The goals of treatment are to make meals less intimidating and have the patient feel like they can master trying new things. We don’t want to increase shame by disparaging their food choices.

We need to create peace, joy, and relaxation around meals. Labeling food “good” or “bad” or “healthy” or “unhealthy” can increase anxiety and discomfort.  Patients may second guess their food choices or end up becoming even more limited in what they eat. A fat-phobic mindset can be intimidating. Taking a Health at Every Size ® approach will be as important as it is in the treatment of anorexia and bulimia. It is the safest approach to navigating the world of diet culture. 

Let’s push back on diet culture and spread the message that all bodies are good bodies regardless of their size. We need to make the world safe for people in fat bodies and for those in thin bodies who are fearful of becoming fat. Ultimately, diet culture is not only harmful to people with other eating disorders but is also harmful to those with ARFID.

Groups at EDTLA

We have groups for adults with ARFID as well as parents of teens with ARFID. For more information, check our Groups page.

Categories
Eating Disorders Exercise

Cutting Down on Food and Fitness Tracking

Photo by Luke Chesser on Unsplash
Have you been tracking your food via a calorie-counting app?

Maybe you’ve been tracking your exercise through a wearable or other system. Did you know such tracking:

  • May encourage a disordered relationship with food and your body?
  • May actually be jeopardizing your health rather than helping you to monitor it?

If you’ve noticed that you’re becoming obsessive about what you eat or how you move your body, it might be a good idea to examine your relationship with any tracking devices you are using.

People may track their weights, food consumed, and workouts in the name of health. But for many people, tracking such data can actually be detrimental. Preliminary research shows that the use of MyFitnessPal can contribute to eating disorder symptoms in undergraduates (Simpson & Mazzeo, 2017), adults with eating disorders (Levinson et al., 2017) and men (Linardon and Messer, 2019).

The research is not clear about exactly why these devices can be so detrimental. In my experience working with patients with eating disorders who track, tracking cuts people off from their bodies and their own regulatory systems. People who track become reliant on objective measures and data for making decisions about how much to eat and how hard to exercise. They lose awareness of their own bodies’ signals. Perfectionistic traits may drive them to eat fewer calories, take more steps, and increase their distance or pace during a workout. Even those who don’t struggle with a diagnosable eating disorder can be negatively impacted by these tracking devices and apps, with individuals who previously had a perfectly normal relationship with food suddenly feeling completely consumed with thoughts about what they’re putting into their mouths.

This was brought home to me when working with a patient who was obsessively tracking his workout metrics. As we discussed doing a bike ride without his fitness monitor–just as an experiment to see how it felt—he argued passionately with me, with one telling objection being, “How will I know when to take a drink?” He had been timing his consumption of water according to time and distance.

I asked him the same question back:  “How will you know when to take a drink?” Hearing it from a third party, he realized how strange the question sounded and how disconnected he had become from his own body.

Similarly, patients who count calories and carefully dole out lunches of specific caloric allotments become frightened when faced with a lunch of unknown (and likely higher) caloric value. Knowing that restaurant portions are larger and more calorically dense then the meals they make at home, they ask me how they can possibly avoid overeating. And then they are amazed when they find that they are sometimes satisfied with less than the entire portion of the restaurant meal, precisely because it’s more calorically dense and satiating.

Once they are no longer eating according to self-imposed strictures, eating becomes a different experience. They gain the capacity to tune in to how they feel while eating the food, rather than just eating to completion of their allotment–and they find that their bodies tell them when to stop eating. Life without tracking can become a freeing and enjoyable experience in which you can be fully present during meals and exercise and engage with the people around you and your surroundings—having deep conversations without intrusive thoughts and becoming mesmerized by beautiful surroundings when you exercise outdoors, for example.

Our bodies are wonderful, self-regulating mechanisms. Our bodies tell us when we need to urinate or have a drink of water or when it’s time to eat and when it’s time to stop eating. When we succumb to diet or wellness culture and stop trusting our bodies and start relying on external systems to tell us when to drink or how much to eat, we become disconnected from our bodies and we lose the ability to recognize these signals.

How to Stop Tracking

If you find that you are obsessively tracking your food or workouts, I invite you to try the following experiment:

  • Fitness tracking: do one workout without your monitor. During and after your workout, rather than looking at your metrics to evaluate the workout, ask yourself instead how your body feels/felt during the movement and afterward.
  • Food tracking: eat a meal where you do not know the caloric content. Tune in to how you feel while eating it. How does it taste?

Sources

Levinson, C. A., Fewell, L., & Brosof, L. C. (2017). My Fitness Pal calorie tracker usage in the eating disorders. Eating Behaviors, 27, 14-16.

Linardon, J., & Messer, M. (2019). My fitness pal usage in men: Associations with eating disorder symptoms and psychosocial impairment. Eating Behaviors33, 13–17.

Simpson, C. C., & Mazzeo, S. E. (2017). Calorie counting and fitness tracking technology: Associations with eating disorder symptomatology. Eating Behaviors, 26, 89-92.

 

Categories
Eating Disorders Family based treatment

Nana’s Poundcake, Food, and Cultural Connection

Food for us comes from our relatives, whether they have wings or fins or roots. That is how we consider food. Food has a culture. It has a history. It has a story. It has relationships. –– Winona Laduke

Food is about more than sustenance. It is about pleasure and joy and connection. Food is one of the ways we connect with our cultural traditions and our ancestors. This is one of the reasons I am so passionate about my work to help people with eating disorders. When someone has an eating disorder and they are fearful of eating or of eating certain foods, they miss out on the pleasures of food and they miss out on the opportunities to connect with others through food. They also miss out on their own connection with their relatives and their cultural heritage.

In my own family, my 103-year-old Nana has always been known for her piano playing and her delicious poundcake. While her prized Steinway piano now stands in my home, I did not inherit her piano-playing her abilities. I did, however, learn her poundcake recipe.

From the time I was a young girl, I have memories of “Nana’s poundcake.” Simple to make with only 5 ingredients, buttery and yummy. During visits to Kansas City, I looked forward to making it with her. And when she visited us in New York we would make it together. And, occasionally my mom and I would make it without Nana. My kids have had the experience of making poundcake with my Nana, their great grandmother. And they have made it with me. After she eventually passes, we will retain this connection to my Nana and my kids will hopefully continue to make and share her recipe with future generations.

 

 

 

 

 

Photos of my daughters making poundcake with Nana back in 2012 at her apartment (she was 96)

I am glad to have this connection to Nana and to be able to fully enjoy making and eating poundcake with all its rich butter and sugar. What joy and connection I would be missing out on if I were afraid of eating it. To be able to make it and eat it with enjoyment enriches my life and allows me to have a shared experience through four generations of my family. I will always have joyful memories of baking and eating poundcake with the different generations in my family.

Bonus Feature — Nana’s Poundcake Recipe

  • 1/2 pound salted butter (2 sticks) – softened
  • 1 3/4 cup sugar
  • 5 eggs
  • 2 cups sifted flour
  • 2 T vanilla

 

  • Cream butter and sugar
  • Add eggs one at a time while beating constantly
  • Add flour and flavoring
  • Pour into well-greased loaf pan (or bundt pan)
  • Bake at 350° for 90 minutes

Photos from a poundcake I made with my daughter in 2019.

Categories
body image Dieting

Sweatin’ for the Wedding: Say, “I don’t.”

Image by rawpixel on Pixabay

by Carolyn Hersh, LMFT

In November of 2018, my boyfriend proposed to me. It was one of the most exciting days of my life thus far. With a proposal comes the next exciting chapter: wedding planning. For many brides-to-be, this entails finding that perfect gown.

Sadly, although not surprising, once I got on bridal mailing lists, I learned I was also being targeted by gyms for “Bridal Boot Camps” and “Sweatin’ for the Wedding.” The weight loss industry found yet another way to weasel their way into a life event that should have nothing to do with changing one’s body.

Why is it that you could be with someone who you love for a certain amount of years, and suddenly the moment they place a ring on your finger you need to change your body? Why does looking beautiful equate to weighing less?

Unfortunately, it has become the norm in our culture to experience pressure to lose weight for special events. A friend once shared that when she was dress shopping her consultant actually wrote down smaller measurements because “all brides lose weight.” When my dress consultant mentioned letting her know if I lose weight, my initial thoughts were, “Are you telling me I need to lose weight? Am I supposed to lose weight? What if I like my body where it is? What if I want to gain weight?”

Granted, our bodies can change. But, hearing about weight loss, exercise programs, and diets specific for the big day can be detrimental to our physical and mental health. The diet industry has found another market and doesn’t care how it impacts the people getting married.. Wedding planning can be stressful enough with trying to create a special day without the added pressure to create a “perfect” body.

But, here is the thing. Your fiance asked to marry you not because of what you’ll look like on that one specific day, but because they are in love with you and everything about you. Getting married is about making a commitment of love to one another. Your wedding day should be a celebration of that.

As brides or grooms, we should dress up and present ourselves the way we want to on this day but, it should not be at the expense of our health and well being. Remember what this day is about. Your wedding is not about the celebration of the size of your body but about the love between you and your significant other and making a commitment to one another.

What to do Instead of “Sweatin it”

Here are some tips I have developed to use myself and also with my clients who were wedding dress shopping:

  1. Buy a dress that fits you now. Don’t buy something a size smaller. Don’t use words like “my goal size” or “I’ll be pretty when I fit into this.” Fighting your body to go to a size it isn’t meant to be is only going to add more frustration, stress, and sadness. If the person selling you a dress keeps harping on “when you’ll lose weight” or “all brides lose weight” speak up and tell her that isn’t your plan. You do not have to be a victim of diet culture. Buy the dress that makes you feel pretty right now. Also, do not forget that many dresses you try on are just sample dresses. It’s okay if it doesn’t fit perfectly when you try the dress on. The one you get will be tailored to your already beautiful body,
  2. With that, remind yourself of the things that not only make you look beautiful but what makes you feel beautiful. One of my bridal consultants asked me when picking out a dress, “Do you want to feel whimsical? Do you want to feel like a princess? Do you want to be sexy vixen?” Wedding dress shopping became ten times more fun when I could close my eyes and imagine what style of dress would make me feel the most beautiful.
  3. Write down what you want to feel on your wedding day. Write down your hopes and excitements for this day. Think about what memories you want to hold onto.  While the idea of “looking perfect” in your wedding photos may be a strong drive to engage in diet culture, think about what those photos are truly capturing. Most likely, you’ll want to remember this as a day of celebrating love and new beginnings with your partner.
  4. It’s okay to exercise and it is okay to eat. It’s okay to follow your normal routine, As you plan for your wedding continue to follow your intuitive voice. For many people, weddings take months if not years to plan. Do not remove fun foods out of your diet for the sake of just one day. Listen to your body when it comes to exercise. Exercise because you want to give your body the gift of movement, but know it is okay to take days off too. Exercise should not be a punishment to your body.

In Conclusion

You do not need to lose weight for your wedding day. Ultimately, remember what this day means to you and your partner. Your wedding dress should be the accessory to the already amazing you. You know, the person that your partner wants to spend the rest of his or her life with. So, when it comes to “sweatin’ for the wedding,” say, “I don’t.”

Categories
Dieting

Don’t Diet! 10 Alternative New Year’s Resolutions

Photo by Moritz Knöringer on Unsplash
I am skeptical of New Years Resolutions in general because I think they promote all-or-nothing thinking (I also don’t like to categorize entire years as being bad or good for this reason). I don’t feel that one needs to wait for the year to reset to make changes in one’s life. I  am anti-diet and dread the increased obsession with dieting and weight loss that arrives with each January 1st.

So I thought that this year I would offer some alternatives to weight loss goals as potential resolutions for those who will be making some for 2021.

 

Don’t Diet in 2021: Alternative New Year’s Resolutions

  1. Resolve to learn a new skill. Whether you’ve always wanted to learn to rock climb, play the piano, make dumplings, or cross-stitch, now is the time to do it.
  2. Commit to improving one relationship. Whether it’s getting to know that coworker, spending more time with your spouse, or getting back in touch with that childhood friend, do it in 2020.
  3. Pledge to reject self-denigrating body-shaming comments. Those negative body comments, often made between friends, make everyone feel worse. Try to avoid saying things like, “My thighs look too big,” “I hate my double chin,” “Does this make me look fat?” “I need to lose weight.”
  4. Commit to not dieting. Focus instead on eating intuitively according to your own taste and hunger and satiety cues. Your amazing body will regulate itself if you let it.
  5. Listen to one body-positive podcast. Improving your body image will make you feel better than dieting will. Here are a number of great suggestions.
  6. Spend more time in nature. Research shows that spending time in nature is associated with improved mental health. Go on a monthly hike, plan to visit a national park, or just spend some time outside appreciating your surroundings.
  7. Volunteer! So many organizations are in need of volunteers and there are so many important causes. You can devote your time to helping animals, saving the environment, or improving literacy. Volunteering provides health benefits and can boost self-esteem.
  8. Create something. Paint, draw, needlepoint, collage, write a story or a song. Art is a great way to express your feelings and the act of creating something can boost mood and self-esteem.
  9. Expand your cooking repertoire. Whatever your cooking ability, there is room to grow. Learn a new technique, master a new cuisine, and try some new recipes. Cooking is a great way to improve your appreciation for food and can help with mindful eating.
  10. Make no New Year’s resolution at all. After all, the passage from 2020 to 2021 is just a social construct — it affects neither your self-worth nor any progress in your life.
Categories
Eating Disorders

The gift of food by Dr. Elisha Carcieri

stock photo (not Elisha’s baby)

Two months ago, I experienced one of life’s greatest gifts when my first child was born. Throughout my pregnancy, I was mindful of what I was eating and drinking in a way I had never experienced before. Another person was reliant on what I chose to put in my body and I was acutely aware of the need to provide good nutrition to my little one. With this came an overwhelming sense of responsibility that I carried with me throughout.

Almost immediately after he was born, my son needed food. He was naturally driven to nourish himself and I felt so lucky to help him grow and experience this fundamental human need and pleasure…eating. Over the last few months, I have responded to him as he communicates his hunger with cries and other cues. I’ve thought more about how this innate drive becomes so complicated as we grow. What starts as a simple relationship becomes clouded with other factors outside of our bodies.

As life goes on, it is often not just hunger that drives us to eat. Social, emotional, and environmental factors work their way into our relationship with food. And unfortunately, so do guilt, judgment, and labels like “good” and “bad.” I think that maintaining an intuitive and forgiving relationship with food is a challenge for most, whether the relationship is officially “disordered” or not. Movements such as health at every size (HAES) and intuitive eating encourage people to begin to move closer to the simpler relationship with food that I’ve observed in my son.

In the case of eating disorders, the process of feeding one’s self moves beyond the complexity of what most of us experience in our daily relationship with food. With a myriad of potential causes and triggers, the eating disorder highjacks the brain and body in more ways than one. Thoughts and perceptions become distorted, hunger cues become erratic or in some cases nonexistent, and levels of key neurotransmitters and hormones are affected. Depression and anxiety commonly run alongside the eating disorder. The result is a serious, sometimes life-threatening illness that couldn’t be further removed from the pure relationship with food we are all born with.

Carrying and feeding my son, and watching him nourish himself so instinctually have been a reminder for me personally to continue to work toward eating intuitively. I am also reminded of how difficult this can be for those of us who are no longer newborns!

It is tragic the way eating disorders attack the fundamental act of nourishing oneself in a healthful, intuitive way, which is why it is so important to continue to fight eating disorders with early identification and treatment. It’s a fight I am privileged to be a part of.

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