Health at Every Size

tuning out January diet culture messaging

tuning out January diet culture messaging

It’s mid-January and unfortunately, the new year diet culture messages haven’t dissipated.If this is your first year (or second or fourth) new year that you’re not signing up for a diet program or gym membership, it can be easy to feel like you’re doing something wrong. Especially with the barrage of advertisements for various diets this time of year, it can feel weird and maybe a little discouraging to be opting out. I wanted to give you a couple quick reminders if you’re feeling totally overwhelmed or defeated by all the diet-focused messaging this time of year.

can you be an intuitive eater on Thanksgiving?

can you be an intuitive eater on Thanksgiving?

Can you believe that it’s already more than halfway through November? It feels like this year is flying by and there hasn’t been much room to slow and down and breath. Thanksgiving is in less than a week (what?!) and while I am excited to go home and spend time with my family, I am also acutely aware that this can be a really challenging time if you’re struggling in your relationship with food. I’ve been talking with a lot of my clients recently about the upcoming holiday and wanted to share some of my thoughts about navigating food on the holidays.

Navigating Menu Calorie Counts in ED Recovery

A couple weeks ago, my partner was going through the mail and found my journal from the Academy of Nutrition & Dietetics (that usually goes straight into the recycle bin because hi, it's 2018 and if I want to find a research article, I'll just look online). He started flipping through and was reading bits and pieces and started reading one particular study about calorie counts being listed on menu items (spoiler alert: calorie labels didn't change health outcomes in any significant way).


With the new calorie labeling law going into effect earlier this month, I've had a lot conversations about this with my clients recently. If you're in the US, you've probably noticed that all restaurants (with 20+ locations) are now required to list calorie counts on their food items. As both a clinician and a consumer, I have a lot of issues with this. In fact, the original draft of this post was almost double the length because I wrote about these issues in great detail. But because I don't want to make you read a short novel, they've been scrapped (for now) and will re-emerge in a likely part two soon. What I want to address here is how challenging it can be to see calorie labels when you're recovery from an eating disorder. Because when your treatment team is emphasizing calories don't matter and then you walk into a restaurant where every item has a calorie count, it is confusing to say the least.

I totally understand how difficult it can be to be in recovery from an eating disorder and be faced with this information every time you go out for a meal. And the advice I would give to you in a perfect world would be "just order what sounds good!" But I also know that is a lot easier said than done. So here are some tips to remember when you're faced with calorie labels on menus:

1. Take a deep breath. Reminding yourself of some positive affirmations may be helpful  (I am worthy of recovery, I am allowed to listen to my body, I am safe no matter what I order, I am capable of managing this situation, etc). Try to create some space for yourself in that moment.

2. Recognize that these numbers do not have any bearing in your value as a person. They don't have the power to make you good or bad. They can't make you a failure. 

3. Think about what sounds appealing to you. Do you want something hot or cold? Crunchy or soft? Salty or sweet? Are you having any cravings? Use these answers to guide you towards the things that sound good to you in that moment. 

4. Give yourself a time limit. It can be easy to get sucked into a world of complex food math (maybe I should get that salad because it's X calories or I could get 1/2 of that sandwich and a small order of fries and that would be Y calories but if I do that, I can only have Z calories at dinner which throws off my whole day because I had ABC for breakfast and then what about my nighttime snack and on and on and on). To avoid- or at least shorten- that moment of uncertainty and panic, give yourself a time limit to decide what you're going to order. For example, if you're in line at a coffee shop, give yourself 30-60 seconds to decide on a drink and then stick with it when you go to order. If you're out to lunch with a friend, let yourself look at the menu for 3-5 minutes before making a decision and closing your menu. Set an actual timer on your phone if you think it will help. This isn't designed to be stressful, just a way for you to avoid getting sucked into that food math vortex. Give yourself enough time to look at your options and then make a decision without ruminating on it.

5. Order without overthinking. Think about what sounds good, look at the menu for a couple minutes, and then order what sounds appealing and manageable. Remember that not every meal needs to be *perfect*. Remember that you're allowed to eat all foods. And remember that every time you make choices that go against ED rules, you're taking one more step into recovery.

6. Try to stay grounded when your food comes. If you're with out with someone, try to focus on your conversation with them which is likely far more meaningful than nutrition labels. And if you're alone, consider bringing a journal and writing your way through the experience (or if that feels too intense, write about something different altogether). 

Seeing calorie counts can seem unmanageable but remember it is merely external information and that most of recovery is about re-connecting with your body's internal wisdom. In a perfect world, we would be able to clear our internal hard drives of all calorie counts, Weight Watchers point, macros, and all the other things we've memorized because there's no real need to know exactly how many calories are in 24 almonds or how many points are in a banana. This is all just  information that has no meaningful effect on your body; none of these numbers can determine what is most nourishing for you. Reconnecting with your body's needs and listening to your intuition is infinitely healthier than making frantic decisions based on what are essentially arbitrary numbers.

The goal I have for my clients (and anyone in ED recovery) is to be able to see calorie labels as neutral information.  The nutrition information that you once had memorized as well as the lyrics to your favorite song doesn't just fade away- although take comfort in the fact that as the distance between you and calorie counting grows, these numbers will start to blur and eventually pieces fade away altogether. What you are able to do is start working towards a place where this information doesn't have so much power over you. You're able to move to a place where knowing calorie information is like knowing exactly how many gigahertz the wifi is or the exact temperature of your refrigerator- both fine to know but probably not going to impact your life in any significant way. When we start placing less importance on external information and create more body trust, we're able to make decisions that nourish our minds and our bodies without guilt- and that is the ultimate goal in recovery.

Cover photo by Benjamin Zanatta 

The Case Against Fitness Trackers

Lately, I've been seeing an onslaught of Fitbits and Apple watches (and when I say lately, I mean the last 3 years). I've been discussing it more with clients and friends. It's actually become a part of my regular intake questions when I'm working with someone new - do you have a device that keeps track of calories/steps? Because if so, I want to talk about it. 

Before I go any further, I want to make one thing super clear: I am not trying to shame anyone for owning one of these devices. I don't want you to feel bad if you wear a fitness tracker every day. My point is to highlight the ways diet culture and the fitness industry have tricked us all into thinking these are all something we need to have to be healthy/fit and how that's kind of bullshit

My biggest issue with fitness trackers is the most obvious: the fact that they count every single step you take and compare it to some arbitrary standard and take away your ability to judge how much movement your body needs on its own. In an ideal world, the relationship we have with exercise, like food, should be intuitive. We are all born knowing when/how to move our bodies and when we're tired. But as we get older, diet culture stifles that intuition until we're trying to track every single calorie, minute, mile and bite. And I'm not on board with that; I want people to live their authentic lives and it's tough to do that when you're trying to quantify every moment of your day. When people go for walks I want it to be because it's nice out, because they want to appreciate their surroundings or connect with nature or to improve sleep or reduce stress- there's a plethora of valid reasons why taking a walk is beneficial (if you're medically cleared for exercise) but "because my wrist is beeping at me" isn't one of them. Competing with ourselves is a slippery slope - especially if a person has eating/weight concerns. This is especially relevant to people with a history of disordered eating or compulsive exercise, but I would argue that it has a certain degree of risk for the general population as well especially in a culture that loves to make everything a competition (seriously look at any reality TV show and tell me our culture doesn't love a good competition).

Secondly- these devices have a huge margin of error. This study showed that on average, fitness tracking devices were off on their measure of energy expenditure by 27% - with some devices being off by 93%. I'm no statistician but those are not great odds. I find it alarming that people are basing their health (or at least the way they feel about their health) on numbers that are essentially meaningless. Not to mention that weight is not as simple as calories in vs calories out (a post for another day). So even if these devices were accurate, they really don't tell us much. 

"But wait!", you may be thinking, "it's not just about calories!"

That's true. It's not. They also tell you how well you're sleeping. But I gotta tell ya- I have never owned a fitness tracker and I always have a relatively good idea of how I'm sleeping based on my energy levels. They also can track your periods (apparently)! But so can a hundred other apps (and regular old calendars). They can play music! They can connect to Bluetooth and GPS! They can tell you the time! Yes, yes, and yes. But there are plenty of other ways to do these things without potentially sending yourself into a spiral of obsession and shame. Also, I don't want a piece of plastic beeping on my wrist every hour telling me that I'm not good enough. Because even if you haven't taken a single step today, you are still enough and no device can ever take that away from you.

Look. I get that new devices and technology can be exciting. I also know that the capitalism game is sneaky. I do not believe for one single solitary second that the folks at Fitbit give a damn about your health. They just want you to fork over $200 so they can line their pockets. And the thing is- these companies are really skilled at marketing their products. And they really want you to believe it's about health. But it's worth remembering that at its peak, Fitbit was worth $11 billion (with a b). And it were up to me, every single one of those dollars would be included in the diet industry. Because more than anything, these watches take away your ability to sense your own body's needs. They trap you in rules and numbers...which sounds an awful lot like diet culture to me. 

I want my clients (and society at large) to know their bodies well enough to trust their own intuition about movement. I want people to take a rest day when their body is tired. I want people to be able to go out for a spontaneous dinner with friends even if they haven't "gotten their steps in" or be able to go for a walk on the beach without worrying about how many calories they're burning. I want people to allow for flexibility when it comes to movement, which can't happen when we're trying to live up to someone (or something) else's standard. I want people to rely on internal cues rather than external validation that what they're doing is "enough". Because you are always (alwaysalwaysalways) enough. And don't let any expensive piece of plastic tell you otherwise.

P.S. Don't get me started on introducing these devices to children. I was horrified when I went on their website to do a little research for this article and saw a device recommended for children 8+. Eight and up! When I was eight years old, I had very little concept of what walking a mile looked like and I wasn't engaging in "step challenges" with my friends and I sure as hell wasn't "tracking my progress". When I was eight years old, I was running around with my friends and riding bikes and building forts and smashing rocks (my favorite childhood past time). I didn't yet have a concept of exercise as a means to control my body and I hope I can say the same for my kids one day. I'm not going to pull out the research about what focusing on weight does in pediatric populations (right now) but....yikes Fitbit. Get it together.


Cover photo by Ben O'Sullivan