Why I became an intuitive eating dietitian and HAES practitioner
Since late 2017, I have undergone a philosophical shift that has changed my approach to counseling and health. I have switched from prescribing weight loss to practicing a weight-inclusive, Health at Every Size (HAES) approach. Read on to understand why I became an intuitive eating dietitian and HAES practitioner.
I cracked. A full on break in my fault line. It’s been happening gradually, subtly since day one of my private practice, maybe even before. But the BIG quake happened several weeks ago and I’ve been in a funk since, the layers of my earth shifting and moving as they figure out where to settle. I’ve been avoiding networking, hesitating with taking on new clients and procrastinating with projects. Why? It’s become so very clear for me to admit the truth to myself and you, and move past the funk that’s been holding me back. I can no longer pretend to love my specialty: weight loss.
When I first set out to start my practice, I wanted to help people feel their best. It's an awesome feeling when someone walks into your office and says you have changed their life, both physically and emotionally. There is a bit of high that accompanies weight loss, even for the dietitian. You celebrate with your client, high five and everyone is all smiles. We leave the session feeling like all is right. But what happens when the scale stalls or someone gains weight? It is rough. The mood immediately shifts and the next hour is spent rationalizing, negotiating, and talking people off an emotional ledge that inevitably makes the client blame herself (yes, 99% of my clients are female) and hate her body. As much as I tried to shield myself from the lows, I would inevitably absorb and internalize the disappointment and frustration. And even though I tried my best to educate clients about set point and encourage them to embrace it, I could see that for most of them, this was not a reality they wanted to accept. The cycle of body-hating, calorie counting, and increased exercise continued, perpetuated by me.
Not your usual dietitian
I have always prided myself for being a different type of dietitian. I don't do “diets” like Paleo or keto. I don't give strict meal plans, more loose guidelines. I tell people to eat anything they want. I teach them to eat when they are hungry and stop when they are full. If they are eating when not hungry or overeating, I help them figure out why. I encourage them to eat foods that really hum to them and decline foods that appear out of nowhere and look blah. But there were contradictions in my teachings. Eat anything you want, but try to meet your fiber goals most days, eat protein with most meals, exercise 3-4 times per week with two of those days being strength training days. Try not to drink more than 5 glasses of wine per week. Try and get 5-7 servings of fruits and vegetables in.
This was well-intentioned advice, both evidence- and experience-based. IT WORKS. Until it doesn't. Inevitably, life gets in the way. You can't always eat 25 grams of fiber or protein with every meal, sometimes you don't even want protein with every meal. And what about that stressful job that brings you little joy and food is your only relief? Let's not forget about your metabolism. Yeah, sometimes that comes in and says, "No more weight loss!"
Slowly, the thrill of my clients' weight loss faded. It became more difficult to celebrate the losses because the gains or stalls were hard to process. I started to become emotionally weighed down and no longer excited about my work, and I felt a gnawing feeling that my approach was wrong. But what could I do if weight loss was no longer my selling point? Panic set in.
And then something magical happened at the end of last year. I literally stumbled on intuitive eating. I knew what it was, but hadn't employed it. A client came in with a history of an eating disorder. She wanted to improve her relationship with food, but had concerns about some weight gain. Could I talk weight loss? Nope, that was out the door. You can't have the focus be on weight loss in someone who is recovering from an eating disorder. The only option was intuitive eating, which encourages you to listen to your body's needs while respecting your hunger and fullness cues. I had tried to employ these concepts with past clients, albeit with the aim of losing weight. And thankfully, after years of therapy, I felt extremely comfortable talking about feelings and how they often affect your food choices. So both pieces of the intuitive eating pie were easy for me to handle. But there was still learning to be done.
As I began following more intuitive eating accounts and working with two intuitive eating clients, it occurred to me that I eat intuitively. When I am hungry, I ask myself what sounds good and what will help me feel good. I stop (most of the time) when I feel just full. Sometimes I fumble, but for the most part, this is how I operate. I had also stopped weighing myself because it never actually changed my behavior and served no purpose except to make me obsess about a no longer sustainable number (self: I will never be my college weight and that is okay). As I watched my intuitive eating clients make emotional progress, my other clients continued to count calories and focus on the number on the scale. It slowly dawned on me that it felt wrong to be selling the latter. It really didn't feel good anymore.
This realization was also bolstered by a political reawakening. The 2016 election really shook me. As the daughter of (former) illegal immigrants and as a woman, I am disgusted by the bullsh*t spewed by the current administration. Lie, after lie. Spin, after spin. It's also deeply disturbing to have someone in the highest seat in office revere some women, specifically sycophants and/or those who are attractive and slim, while denigrating those who challenge him and/or don't fit a physical ideal. The stream of women coming to me because they felt fat and ugly, amongst the backdrop of a toxic political environment, reactivated a long-dormant side of me that is activist and provocative in nature. While I am not the type of person to get involved in political organizations, there is something about intuitive eating that strikes a deep chord. It forces people to challenge, resist and flout society’s thin ideal and the expectation that women should look a certain way and take whatever steps are needed to achieve that. Intuitive eating feels radical, and on the surface seems to fly in the face of everything I've been taught as a dietitian, which is to be prescriptive and authoritative. I may be an authority on food (I am the Eathority, after all), but I am not an authority on people's bodies. Clients are. And the more I tell clients what to eat and do, the further they stray from their own body's wants and needs, and become disconnected from their hearts. Do no harm? In my opinion, this is the worst kind of harm.
The reality is bodies are all different shapes and sizes. Yes, some may be bigger because of overeating or lack of exercise, but body size is mostly determined by your genes. Forcing your body to be a certain shape through restriction of calories and/or food groups like grains, sugar, dairy or even alcohol, just makes your genes craftier by slowing down your metabolism. It also makes you unhappy every time you encounter your favorite food that is now off-limits because it has gluten and sugar.
Why does our society endorse weight loss in the first place? Simply put, we are fatphobic. Our society places a premium on thinner bodies and elevates them as ideal. Women who do not fit this ideal feel pressure to achieve a smaller body because we equate thinness with moral superiority and health. We think fat people are lazy and have no self-control. We think they are unhealthy. Worse, we think they are ugly.
Weight loss via diets is the prescription for a larger body because we automatically assume larger bodies are unhealthy. When you diet or resolve to “finally be healthy," you will likely not achieve the desired shape, or you'll achieve it, but find it difficult to maintain. Yes, you get a little high at the beginning as you see the results, but after a few months, that bubble bursts and you’re back on the cheese before you know it. AND you’re overeating it. The reality is most diets don't work, and the vast majority of dieters regain the weight they lose and more. Dieting behaviors, such as restriction of a food, increases cravings for the restricted item, and people will often overeat when they encounter it. We know these things, yet we continue to push things like "clean" eating and diets as a weight loss solution, which only perpetuates harm and puts people at risk for more weight gain and greater body dissatisfaction.
Women and men in larger bodies, or those in normal weight bodies that aren’t “fit”, internalize that there is something wrong with their shape, that they are inherently unhealthy because our culture deems them so. In turn, they feel unattractive and are filled with shame. But being fat doesn't mean you're unhealthy. I've seen plenty of people in larger bodies with great blood pressure, blood sugars, and cholesterol. And guess what? I know a lot of thin people who don't really exercise and have little control when eating and drinking. Their genes just happen to code for a smaller frame and less body fat, so no one considers them outwardly unhealthy because they are skinny. But a fat person ordering a burger and fries? Notice the judgment in yourself next time you see a larger-bodied individual chowing down on a cheeseburger.
The dieting trap
So, why are weight loss efforts unsustainable? Part of it is biological—everyone has a natural set point that the body wants to maintain or achieve. Another part is because there is a gap between what the conscious brain and the subconscious brain (your intuition/heart) want and this gap creates warring sides. Guess who wins out every time? The subconscious, of course. If these two are not aligned, if your conscious goal of weight loss isn't actually aligned with what your subconscious wants, you will fail at diets. Every. Single. Time. The subconscious knows that calorie counting sucks, and burgers and fries are delicious and not inherently bad. And it is deeply unhappy when the conscious brain forces it to do something that is not actually aligned with your subconscious values.
So how do you get these two to align and get yourself on the path to long-lasting health? Intuitive eating bridges the conscious with the subconscious by bringing together your brain, heart, and body. I've seen it work beautifully in myself and in clients whom I have coached in this method. It is not a diet, but a lifelong approach to eating that encourages you to listen to your hunger, fullness, and satisfaction while rejecting the diet mentality and letting go of expectations of a specific weight. The focus is also on healthy behaviors for the sake of being healthy, not manipulating the shape of your body. You focus on behaviors that make you feel good, and not because you feel pressure to look a certain way. Exercise becomes fun and not a chore. You give yourself unconditional permission to eat any food without guilt or regrets. No food is restricted, which lessens the appeal for many previously restricted foods. Some meals will be yogurt with fruit, and other meals might be pizza. You become in tune with your body's needs and immediately notice how food makes you feel, so you learn to make decisions based off of a bank of eating experiences. But the most amazing part is the freedom people experience with intuitive eating. Less time is spent obsessing about food and whether it's good or bad. And worrying about your weight? That decreases over time because you know you are giving your body what it wants and needs. Some people lose weight, some people gain or maintain it, but you learn to make peace with your natural body size. You feel emotionally lighter in a way that is empowering and freeing because you're tuned into your body, and no longer punishing it with foods it doesn't want and self-criticism it doesn't need.
Not the easiest path
But in the beginning, intuitive eating can be scary and hard. Years of entrenched dieting rules and body dissatisfaction takes time to undo. Intuitive eating is a process, a journey, and it can take unexpected twists and turns. Unlike dieting, intuitive eating deviations do not set you back; instead, they propel you forward and provide you with opportunities to learn more about yourself and develop better coping mechanisms along the way.
I still have A LOT of learning to do. I've signed up for an intuitive eating certification program that begins in mid-May and continues for a few months. In the meantime, I will continue seeing clients, but am no longer leading with weight loss. There will no longer be a scale in office. Weight is not a good enough indicator of health, contrary to what you’ve been told.
It's extremely scary to undertake this journey from a business standpoint because, let’s be honest, weight loss is an easy sell. Just a few nights ago, I woke up at 3am in a panic thinking, “What am I doing? I’m never going to get any clients. I can’t do this.” I had to talk myself off the ledge, which was not easy to do (Why is everything so much scarier at 3am?). But, as a colleague recently said, “Once you’ve seen intuitive eating, you can’t unsee it.” There is no going back.
Since I’ve made the switch, I’ve lost potential clients because, while they hear me and like the message, intuitive eating without the guarantee of weight loss is not what they are looking for. But I’ve also gotten a few people who weren't seeking out intuitive eating, and are open to trying it. It feels like I'm on the right path despite being terrified, and having people sign up for it only validates my decision.
And there you have why I became an intuitive eating dietitian and HAES practitioner. Over the next few months, you'll start seeing a change in my messaging as I switch over to the jargon associated with intuitive eating. My website has and will be changing, as will the content I create. Hopefully, you will join me on this new journey and be open to what I have to say. I’m sure I’ll say some controversial sh*t and misspeak a ton, but I’m willing to do it in order to help people find their definition of real health free from food guilt. Intuitive eating is truly for all, but it’s not easy to go at it alone, and I’ll be here to help anyone along the way. Let me know your thoughts and feelings about the subject and if you have any questions. I'll try my best to answer them.