Managing Chronic Conditions
Are you interested in addressing your chronic condition without a focus on food restriction or weight loss? Want to focus on sustainable behavior changes that feel additive, joyful, and address your health concerns?
If so, I can help you with any of the following conditions:
- Polycystic Ovarian Syndrome (PCOS)
- High cholesterol
- High blood pressure
- Diabetes (not on mealtime insulin)
- Healthful eating without food restriction
How a Health at Every Size dietitian is different
Health can be improved without a focus on weight. As a registered dietitian nutritionist who practices through the weight-neutral lens of Health at Every Size, I can help you work toward your health goals in ways that are not restrictive.
This means I do not provide rigid meal plans, food rules, or guidance on weight loss.
Instead, I help guide you towards an eating pattern that is flexible and sustainable for you.
This also means I will never judge you for your current or past eating habits, nor do I judge you if you desire weight loss.
Instead, we talk about what has felt hard about eating and being in your body, and how you can feel better around food and your body in the long-term.
A whole-person, client-centered approach
Together we will explore what health and healthy mean to you, and how any dietary changes may impact your relationship to food and your body.
We will also discuss the following aspects of physical and mental health and better understand where you may want to make changes:
- Establishing regular eating patterns with all the food groups
- Eating foods that feel satisfying and nourishing
- Including your favorite fun foods, such as sweets or chips
- Challenging food rules to help reduce guilt or shame around eating
- Managing stress and sleep
- Coping with challenging body image days
- Engaging in joyful movement that connects you to your body
- Incorporating helpful supplements
By working together, you will become the expert in and authority of your own health and eating---you will become your own Eathority.
Depending on your goals, we will meet weekly or biweekly until you feel comfortable spacing out our sessions together.
I am in-network with Aetna, Cigna, Oscar, and Emblem in the tristate NY area.
If you have one of these insurances, please call your insurer before your first visit and ask the questions in this form.
*Aetna and Emblem limit first visits to only 60 minutes. A 75-session can be accommodated with an additional $55 fee.
If I do not accept your insurance or your insurance does not cover our sessions together, pricing is as follows:
- $290 for 75-min initial assessment
- $185 for 45-min follow-ups
A limited number of sliding scale rates are available for BIPOC folks who demonstrate financial need. To receive a sliding scale fee, please email me to request an application.
Meetings take place via secure video due to COVID-19 concerns --- no travel necessary.
- Tuesday-Thursday: 9am-6pm
- Friday: 9am-3pm
Health can be pursued at any size, and that certain health-promoting behaviors can improve physical health even in the absence of weight loss.
Research shows that a Health at Every Size (HAES) model can improve health outcomes in people of all sizes. The HAES (pronounced hayz) model accepts and respects the diversity of body shapes and sizes, supports life-enhancing movement and eating for well-being. Intuitive eating is the eating pattern that supports HAES.
Intuitive eating and HAES offer viable, evidence-based alternatives for pursuing health and experiencing less shame around food and your body.
Many studies support their use in clinical practice, with the following demonstrated outcomes:
- Improved cholesterol
- Decreased blood pressure
- Increased physical activity
- Improved blood sugars
- Greater food variety in the diet
- Reduced food and body preoccupation
- Increased body satisfaction
- Less disordered eating
- Higher self-esteem
- Better coping skills
If you have previously attempted weight loss in the past, I would invite you to consider the following question: where has a focus on weight and weight loss gotten you? Have you been able to keep the weight off, and if so, at what cost?
Most studies show that weight loss efforts do not result in long-term weight loss for the majority of people. My clinical experience also supports these findings, and perhaps your personal experience does, as well.
In the short-term, food and calorie restriction can cause individuals to lose weight quickly, usually peaking at 6 months after the start of the diet. Most diets result in a maximum weight loss of about 5-10%. These losses are modest, and for people in larger bodies, many remain larger bodied and at continued risk for weight stigma and discrimination.
Weight loss eventually plateaus, and once dieting ceases, weight is slowly regained, often returning to original levels. Studies have shown that 90% to 95% of dieters regain all their lost weight within a few years. Within the first year of dieting cessation, less than 20% of people are able to maintain their weight loss, and many regain 30-35% of weight that is lost. After four to five years, one-third to two-thirds of dieters regain more weight than was lost, although researchers believe this latter statistic may actually be higher.
The cycle of losing and regaining usually leads to another diet, more weight loss and eventual regain. This puts people at risk for the following:
- Cardiovascular stress due to fluctuations and increases in cholesterol, blood sugars, insulin and blood pressure
- Increased cravings, eating past fullness or binge eating
- Future weight gain
- Slower metabolism
- Muscle loss
- Emotional and psychological distress, including lower self-esteem
- Premature death, especially from heart disease
For the small percentage of people who are able to maintain weight loss in the long-term, losses are usually modest. Any health benefits that are observed cannot be fully attributed to dieting because it is difficult to untangle the possible effects of other changes, such as exercise.
Based on this information and studies showing that health improvements can be attained in the absence of weight loss, there is a strong case against prescribing weight loss via food and calorie restriction.
The short answer is no - genetics, age, stable access to food and equitable health care, ability to engage in sustainable health-promoting behaviors --- all of these matter much more for health than weight alone. But health and weight have been conflated, and our world is very much attached to an oversimplified view on health that causes harm to those who do not fit our society’s definition of what health looks like.
The long answer is that health is a complex topic. We have been taught to think about health in very black and white terms. Bodies are considered “healthy” or “unhealthy”, “good” or “bad”, “successes” or “failures.” There isn’t much room for exploring the gray space where health inevitably exists.
Science may have established a correlation between body size and risks for certain chronic conditions, but many studies do not control for other factors ---weight stigma and yo-yo dieting, which we know to be independently correlated with poor health outcomes.
Again, most studies show a correlation, not causation, between size and disease risk. Just because you are a certain size does not automatically mean you will develop a chronic condition. Additionally, developing a chronic condition is not a moral failing. Chronic conditions occur in people of all sizes.
Together we can unpack what health and healthy look like to you, and I would be happy to help you explore and redefine these terms on your own terms.
Sessions will occur either weekly or biweekly depending on your needs and how much support you feel you need.
Due to COVID-19 restrictions, sessions take place by secure video.
During the first session, we will discuss your eating history, how you feel about food and your body and any other relevant information you feel comfortable discussing. Depending on what your concerns are in session, you decide what manageable goals you want to set for the following session.
In follow-up sessions, we will begin any nutrition education you are interested in learning and how you can incorporate small changes into your life. We will also discuss any successes or challenges since the previous meeting or any topic that feels pressing to you that day.
I am in-network with Aetna, Cigna, Emblem, and Oscar in the tristate New York area.
If you have one of these plans and I am a provider in your network, you may have coverage for nutrition services.
Contact your insurer and inquire about your plan’s details using the questions in this form for people with Aetna, Cigna, Oscar, and Emblem. Please note that I do not call to verify benefits.
If you have one of these insurance plans but I am not a participating provider, your sessions will be subject to out-of-pocket fees.
For Aetna, Cigna, Emblem, and Oscar clients in the greater New York area, your insurance plan determines how many sessions you are allotted.
If you need additional sessions that your insurance will not cover, you will be responsible for paying out-of-pocket for these sessions.
For out-of-pocket sessions, I offer various package and payment options that we can discuss.
Sliding scale rates are available for those who qualify.
For any out-of-network clients, you can pay after each of our sessions. I also provide 10% off if you buy a package of 6, 8, or 12 sessions if you pay upfront in full.
Please contact your insurer to inquire about out-of-network coverage using the questions in this out-of-network form. I will provide you with a superbill after each session to submit to your insurer for possible reimbursement.
Sliding scale rates are available for those who qualify.
If you want to get to know me and my style, single initial consultation sessions are available.