Posts Tagged ‘behavior change’

“I love food too much!”

November 12, 2015

not sure about this snowman“I love food too much!”

I hear some version of this sentiment frequently from clients who struggle with their weight. Sometimes clients struggle with some form of eating disorder that involves binge or compulsive overeating but many times there is no diagnosis (at least not a formal one). They truly believe their excess weight is the result of some kind of character flaw, such as low willpower or an unusual fondness for food. Or perhaps they are addicted to food in general –or more commonly to carbs or sugar in particular.

The reality is that love often has little or nothing to do with our eating and weight problems, at least not in the ways we think it does. We can love food—arguably an important survival skill, but struggle with other aspects of our relationship with food. Food cravings or a feeling that we can’t stop once we begin eating certain foods may be confused with love. Unfortunately, like many of our primal relationships, we are not encouraged to delve too deeply into what is really happening because we should just automatically do the right thing. I mean we are all born knowing how to eat, right?!

With rare exceptions related to developmental problems, yes, we are all born knowing how to eat. We are even born generally knowing what to eat as well as when we are hungry and how much food we need. However, once we transition from breast milk or baby formula things can get complicated with food. We begin to rely on external cues to tell us all of these things related to eating. We eat when it is meal or snack time. Our parents or caregivers put food on our plates, largely choosing what we eat, and coax us to eat it all. I’m dating myself here but as kids many of us were expected to aspire to the “Clean Plate Club,” apparently in solidarity with starving children in Africa who weren’t as lucky as we were in the food department.

As young, inexperienced eaters it makes sense that our families and caregivers select which foods are available to us and schedule meals and snacks. The problems arise when kids are cajoled to eat beyond satiety or fullness. After many years of eating when, what, and how much we are “supposed to” eat according to external forces, we can lose touch with our ability to recognize early signs of hunger and fullness. When portion sizes are determined by others (moms, chefs, packages, diet rules, food pyramids, etc.) we don’t pay much attention to our fullness unless we still feel hungry or are overly full after eating. What we eat is based on all kinds of factors and there are many foods we are coached to eat sparingly or avoid altogether.

Foods that are considered “bad” become weapons with which we beat ourselves up when our eating doesn’t conform to what we’ve been told we “should” eat. When we eat “perfectly” (note the quotations because there is no such thing as a perfect diet) we are somehow elevated in status. When we eat well we are “good” and when we don’t we are “bad.” Adhering to some arbitrary set of dietary rules becomes a measure of us as people. Who we are is linked to what we eat –or don’t eat. Crazy isn’t it?!

Circling back to where I started, when we accept the idea that we should never eat certain foods, we set ourselves up to feel deprived. Sometimes we deprive ourselves of adequate calories or certain nutrients that we believe will make us fat (or not help us lose weight). The lack of enough food or a nutritional imbalance can lead to food cravings. This is particularly common with low carbohydrate diets, especially for people who have high levels of physical activity.

Other times we get enough calories but we don’t allow ourselves to eat foods we enjoy so we become fixated on these foods. When we finally have an opportunity to eat the forbidden foods we naturally want to eat a lot of them and may feel out-of-control around them. In these two scenarios we set ourselves up either biologically or psychologically to eat particular foods and/or amounts of food that feel (and may in fact be) excessive. This type of eating is then followed by guilt for not following our food rules, and shame for being flawed people who lack willpower or suffer from a food addiction.

Admittedly the topic of food addiction is complicated. I realize there is compelling research that shows sugar and highly addictive drugs like cocaine can light up the same areas of our brains—of course so do other rewarding behaviors like sex and exercise. Clearly, eating and abusing drugs are very different behaviors however. Labeling food problems as “addiction” creates the illusion that we know how to treat these problems: rigid abstinence.

After 15 years of clinical experience and extensive education and training related to dysfunctional eating and eating disorders, it is clear to me that we must treat eating problems individually. There is no single protocol that works for every person. Also, despite the progress we have made as a society in recognizing that addictions are not choices, there is still a considerable amount of stigma attached to any kind of mental illness, including addictions. So, even if labeling food and eating problems as “addictions” is accurate (which it may or may not be), it is not necessarily helpful.

What is helpful when we believe we “love food too much” or are in some way addicted to food?

First, we can start by pretending we don’t know what the heck is going on. Instead of assuming we understand our problems, we can be more curious about them. We approach our eating habits with the series of questions we would use to explore anything we didn’t know much about: what, when, where, why, how?

“Curiosity will conquer fear even more than bravery will.” –James Stephens

Instead of immediately berating ourselves for eating that cookie or choosing a burger and not a salad, we can ask some questions. When was my last meal? Was I overly hungry when I arrived at the table? Was I frustrated with a situation at work and looking for something comforting? Did I eat quickly which made it hard to know when I was full (it takes our brain about 20 minutes to get the signal we’ve had enough)? Was I in a place where the burgers are awesome and the salads not as good? Am I sick of so many food rules and ready for something tasty and easy at the end of a long day? Many of my clients find the acronym HALT helpful to identify why they feel uncomfortable– am I: Hungry, Angry, Lonely or Tired?

There is much more we can do to unravel problems related to food and weight, however replacing assumptions that we are somehow flawed or cursed, with curiosity about what else may be going on in our complex relationship with food (and ourselves) is a good place to start.

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Gratitude: Antidote to “Not Enough”

November 25, 2014

I didn’t get enough sleep

I don’t have enough money

I need to exercise more

There is never enough time to get everything done

I’m not ___________ (thin, fit, attractive, rich, strong, smart, etc.) enough

Does your day start or end with any of these thoughts? What about throughout your day? Is there enough? Do you do enough? Are you enough?

Regardless of the abundance that surrounds us we often perceive a “culture of scarcity” – a mindset that can lead us to focus on what we lack versus what we have. A couple of years ago I was introduced to the work of Brene Brown, a psychology researcher who studies shame and vulnerability. Through her work she observes ways this “culture of scarcity” plays out in our everyday lives. The observation that struck me most is that people who struggle with emotional eating or binge eating, sometimes use food in response to these feelings of “not enough.” Brene suggests one possible antidote to subconscious and conscious feelings of scarcity and inadequacy: a gratitude practice.

“Piglet noticed that even though he had a Very Small Heart, it could hold a rather large amount of Gratitude.” ― A.A. Milne, Winnie-the-Pooh

While it may be naïve to think a simple gratitude practice is the solution to behaviors as complex as binge eating, I am intrigued by the idea that focusing attention on what we have versus what we lack can help us feel more fulfilled in our everyday lives. Many clients struggling with emotional eating issues describe food as a way to “fill” some type of void that has nothing to do with biological hunger. Despite their “knowing” this is a reason they eat, they struggle to stop such behaviors. I often encourage clients to identify what is driving the eating because if it is not physical hunger then no amount of food will “fill” them. The idea behind this strategy is that whatever the real need is that drives this eating cannot be met if it goes unidentified. Unfortunately the process of unraveling underlying needs is not simple and takes time.

Is it possible that focusing more on what we are grateful for may help us feel more “full” in a positive way? Can we “fill up” on gratitude to replace mindless activities that don’t serve us well?

I decided to try a gratitude practice myself, just to see what would happen. Though I don’t currently struggle with eating issues, I definitely fall into that scarcity mindset with respect to time, money, and many other things I wish I had more of. When I learned about the scientific studiesGratitude jar related to gratitude I wondered if this practice could impact other behaviors that distract my daily life and keep me feeling “busy.”

Last fall shortly after my return to Jackson, I was sitting at my desk with Ginny curled up next to my chair. I glanced at my favorite wedding picture propped on my desk beyond my computer, and then out my front window toward Snow King Mountain bathed in afternoon sunlight. Overwhelmed with gratitude, I wanted to freeze that moment. I was home in Wyoming with Dave and Ginny, I re-launched my dream career at Beyond Broccoli, and I was surrounded by mountains, a community I care deeply about, and immediate access to so many of the things I love to do. I knew that at some point the proverbial “honeymoon phase” of this new chapter of my life would fade, so I decided to start a gratitude practice. My hope was that at some point when the mundane aspects of everyday life replaced my bursting enthusiasm for all-things-Jackson, I could retrieve a few of these strips of paper and remind myself of all the aspects of my daily life that provide richness beyond measure.

I already journal regularly so I chose to try a gratitude jar instead. I got a Mason jar from the kitchen and removed the steel lid. I cut a piece of paper into small strips and wrote a few of the things I was grateful for in that moment. I continued to do this daily for a while, savoring simple moments that made me feel joy and contentment. Dog walks and puppy kisses, random acts of kindness, playing in the snow, sunshine on cold winter days, feeling love and support. It didn’t take long to notice moments of gratitude everywhere I went. Now I don’t even have to read my little scraps of paper – I glance at the jar on my desk and am filled with gratitude.

I don’t know if this gratitude strategy can decrease general thoughts and feelings of scarcity for everyone. I do know this has been a powerful practice for me. I am more aware when I start down the scarcity mind set path and can stop myself or at least recognize what is happening. Though things are going pretty well right now, as with most years the past 12 months included moments of fear, pain, and discomfort, and there were losses. I can’t say I felt less of these uncomfortable emotions, but I do think I was a bit more resilient. The way I see it there is no downside to a gratitude practice and for me nurturing resilience following life’s inevitable hardships, is enough.

“To love someone fiercely, to believe in something with your whole heart, to celebrate a fleeting moment in time, to fully engage in a life that doesn’t come with guarantees – these are risks that involve vulnerability and often pain. But, I’m learning that recognizing and leaning into the discomfort of vulnerability teaches us how to live with joy, gratitude and grace.”
Brené Brown, The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are

“The Jungle Effect” as Antidote to Fad Diets

February 14, 2014

Many of you have heard me rant about various fad diets. I lament how easily these temporary promises of a better, thinner, healthier version of ourselves take hold in our often anxious and preoccupied minds. I know humans innately crave a mix of new experiences (and foods) as well as the comfort of familiar routines (and foods), so I get why at least some of these fads are appealing. We know at some level we will never look like the celebrity du jour touting this fad as the secret to her success. We understand that no matter how much we long for simple solutions to our problems, it is unlikely the complex layers of our issues will be unraveled simply and with minimal effort.

Yet we can’t help ourselves. The power of our imagination is so great that we enter each new fad wide-eyed with possibility. Maybe this time we will lose weight, gain health and self-confidence, and all of the problems we think are tied to our weight and appearance will magically melt away.

I am reminded of my favorite nickname of a hockey teammate in Seattle – “Dream Crusher.” Though I understand very well the myriad reasons all of us are attracted to different fads at some point or another (this extends beyond fad diets for those who think this post doesn’t apply to you), I am here to crush that dream. There are no quick fixes to solve complex problems related to weight and health.

Lucky for you I am not particularly comfortable with the moniker “Dream Crusher,” as appealing as it is for a defensive partner on the ice in the context of a hockey game. I prefer to inspire hope and to support the process of change that leads my clients toward their goals and whatever it takes for them to live in harmony with their values. So I have put together a class called “The Jungle Effect” to appeal to your sense of adventure while honoring your need for comfort and the familiar.

“The Jungle Effect” is a phrase coined by integrative physician Daphne Miller. Miller observed several patients who experienced health problems when they transitioned away from their traditional way of eating and adopted the ways of our modern, industrialized society. One client in particular spent time in a traditional community in the jungle as a child and when she returned to this place for an extended visit years later, many health issues she developed as an adult resolved.

Intrigued by this idea that returning to a simpler way of eating and living could reclaim health, Miller explores five areas in the world where populations still follow a mainly traditional way of life, including eating habits, and enjoy an unusually low incidence of various chronic diseases and conditions that plague much of the developed world.

There are many aspects of Miller’s approach that appeal to me. First, she uses stories of real people to introduce us to these exotic places and to give us ideas about how we can integrate traditional ways into our modern lives.

Next, there is a lot of nutrition myth-busting that occurs throughout the book, especially related to our annoying tendency to reduce nutrition to specific nutrients as a guide to a “healthy diet.” While she does introduce information about components in foods that have powerful health benefits like the omega-3 fats found in fish, she presents a broader picture of nutritional benefits. Popular ideas such as simply eating “too many carbs” is a general problem vanish as we learn that the people of Copper Canyon, Mexico eat a traditional diet that is composed of roughly 80% carbohydrates and enjoy one of the lowest rates of diabetes in the world.

Perhaps the best part of the book for me though, is that Miller provides a picture of each culture that extends beyond what they eat. There is no doubt the “what” is important, yet through Miller’s presentation of cultures as diverse as Crete and Iceland we are encouraged to look beyond what is eaten and contemplate how food is produced, prepared and shared, along with many other aspects of daily life in these communities that benefit their health.

“The Jungle Effect,” and more specifically the idea of pursuing more traditional ways of eating, is the closest thing I think we will find to a “simple solution.” By definition a culture that continues its way of life, including eating habits, over centuries is going to have a more simple approach than our post-industrial modern society.  The challenge then becomes reclaiming simplicity in a complex society, no small feat as many of you know.

Next week’s class through our local branch of Central Wyoming College is based on some of the important concepts from Miller’s book, complete with foods that represent these special places – Copper Canyon, Mexico, the islands of Crete and Okinawa, Cameroon, West Africa, and Iceland. We will explore some of the key concepts common to this diverse collection of cultures that contribute to good health and longevity.  Best of all, we will embrace the excitement that comes with trying something new while uncovering the comfortable, familiar aspects of this simple approach that require no special talents beyond our own inner wisdom.

What Do You Mean “It’s Not About the Food?”

January 29, 2014

Next week I begin a new series of Beyond Broccoli classes called Food & You: Exploring Beyond the “What.” I am excited about this unique option for nutrition education and support for the many people in our community who struggle with food, weight, and body image, using a behavioral nutrition approach that recognizes in many cases – “it’s not about the food.”

Not long after I started Beyond Broccoli back in 2001 I remember thinking that so much of my formal training and education in nutrition focused on what to eat (or not eat) for a variety of outcomes, and yet the most important work I did with individual clients came down to something we spent relatively little time studying: behavior change.

I remember learning about the “Stages of Change” model that describes the process most people go through to make changes. I was fascinated by this process, though I had no idea at the time this would be some of the most important information to my practice with individual clients. It didn’t take long for me to realize that struggles with food, weight and body image add layers of complexity to changing habits. If I want my clients to be successful in making sustainable changes, together we need to explore well beyond the “what” of their eating habits. So I have devoted much time and energy over the past dozen years to learning more about this whole process.

I suspect some find this idea of a nutritionist not focusing on the “what” confusing. Aren’t nutritionists supposed to be the experts on what to eat (or not eat)? Isn’t that why we consult with them?

As a Registered Dietitian it is important that I know about Medical Nutrition Therapy, or how nutrients can prevent or manage disease and illness. Here in Jackson it also helps me to know about sports nutrition to help my clients optimize food as fuel. Educating clients about the links between food and mood is important for both long-term health and how they feel on a daily basis, often a much more compelling reason to make changes. So yes, what we eat, and don’t eat, is definitely important and a major focus of my ongoing work (and continuing education requirements).

I am also passionate about the need for nutrition education to go beyond just spewing information. I enjoy helping clients acquire tools and build skills to actually apply this information in the context of their individual life situations – or more simply, the “how” related to eating habits.

However, I now know that actually making changes often goes way beyond needing to change, wanting to change, and knowing what to do. I can put together the best meal plan ever for someone, based on all the current research and my clinical experience, but if she isn’t engaged in the process of making the plan and it doesn’t fit into her lifestyle, isn’t compatible with her life goals and values, or doesn’t take into account where she is in the readiness for change process, this “ideal plan” is likely to fail. This leads me to the real crux of changing habits – the “why.”

As I see it, my area of expertise is food and nutrition while my clients and patients are the experts on themselves, even if they are not conscious of this fact. They know why they want to change, or think they want to change, and more importantly what they are willing to do. Sometimes it takes a bit of effort to uncover the layers of “why” and sometimes for clients who struggle with food, weight and body image (which is many of my clients) this process works better with the with additional guidance and support from a skilled therapist using a team approach.

This idea of enlisting additional support for the often challenging process of changing habits is why a group situation can be really helpful. The “Food & You” classes are a way to apply some of what I do with individual clients in a group setting. I offer nutrition education and support using this behavioral nutrition approach rather than dictating “eat this” or “don’t eat that.” Together we explore the myriad factors that influence what we eat, as well as how, when, where, and why. Each class includes a different relaxation or mindfulness technique to get things started, creative and interactive class activities to spur discussion, and a host of ideas, tools and a chance to practice building skills that can help participants move forward in their journey toward a better relationship with food.