STOP! Before jumping into another weight loss program, you have to read this

Are you always on the hunt for a weight loss program that will help you control your eating once and for all?

Have you joined and quit many programs in the past because they just didn't help you? or because you felt ashamed for not losing the weight they promised?

Does it seem like no one can understand your struggle with food?

Before you start another diet program, hear me out. This advice could save you a lot of money and wasted energy thrown in the wrong direction and right into the deep pockets of the weight loss industry. 

The problem with weight loss programs and diets is that they do not ask the right questions to truly help people feel in charge of their eating. They only bark orders and spill so-called secrets that don't actually help you lose weight for good.
So, the question I have for you is- have you ever felt that your eating was out of control?

If you've answered yes, keep reading! There ARE ways to feel more in charge of your eating and stop feeling like food controlling your life. And no, it has nothing to do with locking the fridge, going for a walk or drinking lots of water before meals. 

Often diets fail because of unrealistic expectations of how little we can eat (or how easy it is to cut out certain foods). It is NEVER easy to avoid our favorite foods, it is never easy to bear with hunger and it is never easy to use thinness as a motivator to exercise or diet. This is because we are HUMAN and not robots. Anyone who tells you otherwise is either a) lying, b) has only been on the diet for a little while or c) is a robot. Over time any diet will become hard to follow and what's worse, is that you will start to think the problem is you, rather than the crazy diet.

Feeling like your eating is out of control is more common than you think. It can be due to following diets for what feels like a lifetime. It can also be due to eating too little early in the day which fuels over eating or feeling out of control with food later in the day.

Some of my client don't even realize they are eating so little and so restrictively.

Understanding what is a reasonable and normal meal can help you understand if under eating early in the day is leading to over eating or binging later on in the day.

A normal, healthy breakfast would be a combination of 3 or 4 of these 4 food groups: 

1 serving of milk or alternative

1 serving of fruit

2 servings of grain products

1 serving of meat and alternative. 

Here are some breakfast examples:

A balanced, healthy lunch or supper that is satisfying both physically and mentally is usually 2 grain products, 1 meat and alternative and 2 servings of vegetables along with a fruit or milk and alternative serving on the side. For example:

So, if you want to feel more in charge of your eating- aim to eat 3 balanced meals a day. Eating more often during the day and eating meals that are physically and mentally satisfying will help keep your energy levels high and hunger at bay. Use these example to help guide you towards normal eating.

If you think “well, I am certainly not restricting myself- look at how I stuff my face at night!” Consider this- believing that you are not allowed to eat your favorite foods or even normal foods like bread, can lead to feeling restricted. You don’t have to physically be deprived of foods to feel compelled to binge on them. This can stem from the “I want what I can’t have” phenomenon as well as feeling ashamed for eating foods labelled as bad or fattening.

So, truly avoiding certain foods as well as feeling like you cannot/should not eat certain foods can have the same effect = feeling out of control with food.

If you feel that your eating is out of control, don’t run into the arms of another diet, it will only make things worse. Instead, try eating 3 normal meals every day (maybe even a few snacks in between), consider how labeling foods as “bad” is affecting you and reach out to a local dietitian who practices mindful eating.

To read more about why the diet industry has lied to you about avoiding “bad” foods to help you lose weight, mindful eating and feeling more in charge of eating, check out these links:

Eat more frequently to help with energy levels and reduce binging

Eating in secret and other embarrassing side effects of dieting.

Think taking the addiction approach to food is best? Think again.

When "do no harm" can mean NOT talking about dieting

There has been much controversy in the nutrition and weight management world about the sometimes harmful role professionals can play when trying to help a client lose weight. Since doctors carry so much weight (so to speak) with their advice, it is extremely important that they give useful, easy to understand and sympathetic advice. By sympathetic I mean advice that takes into consideration their clients as people (not just bodies) who have limitations, feelings and are probably doing more for their health than they see. Obviously, it is also important to that doctors know their limitations in knowledge and make referrals. Knowing your limits can be harder than you think especially if you come from a background of an "all knowing" profession like medical doctors. This is where a lot of my frustration stems from- the "all important god" that is better known as your doctor who gives harmful and often wrong advice on weight loss. One big argument is the fact that the hippocratic oath may suggests that bad weight loss advice is unethical by actually doing harm to their clients.
Before I go further, I must state that not all doctors frustrate dietitians or give harmful advice to their clients. Unfortunately, I only hear the sad stories from my clients.

Recently I had a few clients who were (and I quote) "traumatized by what my doctor told me about the need to lose weight". I can only guess that the doc's goal was to motivate the client to lose weight (little did he know that she is already doing many things to try to lose weight...did he even ask her?). However, I wonder the usefulness of stating that "[she] would be better off as a drug addict than addicted to food". Yes- that is a direct quote from the client quoting her doc.

Firstly, being obese is vastly different than being addicted to food (which is not a well supported theory amongst eating disorder professionals) so he first assumed she was addicted to food (again, not a diagnosis as popular as say, binge eating) and secondly that being skinny while doing drugs is better. Is that really based on science? Will that advice really help her lose weight? All that encounter did was make that day the "worst day of [her] life" (another actual quote). Was that advice ethical considering she may turn to unhealthy ways to lose weight such as diet pills, fasting, or very low calorie diets? All of which may lead to binge eating, skewed relationship with food and body hate.

Not only do my clients already feel ashamed and hateful of their bodies, but they have to return to see their doctor for a follow up. It's no wonder that they are scared, anxious, preoccupied about the upcoming visit. I wonder if these feelings will help or get in the way of communication at their next appointment?? It was certainly something that got in the way in talking about nutrition at our session. I was more than happy to discuss the encounter since issues that influence eating is something we discuss (not just diet advice) at appointments. However, I can only imagine how frustrated my paying client felt after leaving our session with little spoken about the topics for which she sought advice.

Weight shaming and weight bias as well as misunderstanding the complexity of weight loss is something that is expected from the masses. NOT from educated health professionals.

My advice to my clients who bring these stories to our session is easier to give than to take- find another doctor. Not an easy task in this city or in Canada. If that's not possible, perhap a firm but polite acknowledgement that things are being taken care of in the weight loss area with the help of another professional, then asking the doctor to get back to what they specialize in practicing.

Think taking the addiction approach to food is best? Think again.

I am so sad to hear of yet another book toting overeating or binge eating as food addiction. In the brief adaptation I read recently in Macleans magazine, I find it interesting that everything the author is describing as addiction can also be considered binge eating. More specifically, the trap of the binge eating and restrictive eating cycle. I am flabbergasted that people continue to chose the "addiction" route versus the mindful eating approach to dealing with a skewed relationship with food. It astounds me because the way in which they are treated are quite different- one being very harsh and relying on "discipline" and the other a more flexible, kinder, realistic way to live. 

Many feelings and thoughts written in the adaptation sound familiar- many of my clients have told me the same things. However, not one of them was able to fully adapt the addiction method without cycling between food restriction and binging. Also, every one of them have found that although addiction is an easier way to think about food, understanding how their emotions and body shame lead them to overeat or binge has helped more in the reduction of binges and cravings for binges. Here is a short summary of the difference between both treatments:

Sure, there may be aspects of the addiction model for treatment that can work for people, but in my experience, clients need way more than this approach to heal relationships with food and their bodies. Cravings are a normal part of life, how we deal with them depends on how we see ourselves (i.e. our weight and shape) and our relationship with food. People who eat intuitively may eat the food they crave, listen to their hunger to determine how much of it that they want and continue to eat according to their hunger for the rest of the day. This may mean they will eat a lighter dinner because they are less hungry. In fact, people who are intuitive eaters get more pleasure and comfort from food than people who eat mindlessly. 
People who do not eat intuitively and eat due to emotions, tend to get less comfort from food and end up cycling between eating for comfort, not being comforted and then eating more because they are ashamed of caving into a craving (which is a negative emotions that can start the cycle all over again). 

If you are looking for more information on binge eating or how to decrease over eating, these books take a more gentle and effective approach :

Eat what you love, love what you eat for binge eating by Dr. Michelle May
Overcoming binge eating by Dr. Christopher Fairburn
Eating Mindfully by Dr. Susan Albers (there is also a companion workbook called Eat, drink and be mindful)

If you are a dietitian looking for more information on the CBT and mindful eating approach to treating binge eating disorder, try these books (of course those mentioned above are a good read too):
A clinician's guide to binge eating disorder by June Alexander, Andrea GOldschmidt and Daniel Le Grange
Nutrition Counseling in the treatment of eating disorders by Marcia Herrin and Maria Larkin
Cognitive behavioral therapy and eating disorders by Dr. CHristopher Fairburn

Judging those who already judge themselves

Some people believe that judging people who "should" lose weight will help them to make the changes necessary to lose weight. Of course, those people are dead wrong but that is not the point of this post. The point is that judging others is useless since they often judge themselves more than can be imagined. 

This is especially true of people who suffer from binge eating disorder. Having a greater than normal concern for ones weight and shape as well as an over-evaluation of their weight and shape (meaning they feel they have more control than they actually have over their weight and shape) leads to much pain. These negative views of ones body and weight can be quite destructive as well as self-perpetuating. Having what is called a disturbed body image maintains an eating disorder and can actually predict success with therapy in resolving an eating disorder. 

As a dietitian, I rarely work directly with clients to treat a body image disturbance but I do work closely with many amazing psychologist who do just that. However, body image often comes up in nutrition sessions when clients insist they "should" or "must" lose weight. Losing weight before resolving an eating disorder (for those people who have a high BMI) is never recommended but many clients are convinced that losing weight will help increase their self-esteem. The basis for many people with an eating disorder is low self esteem or basing ones self worth on their weight, so does losing weight actually increase self-esteem? No. Surprisingly, despite the many protests from clients, losing weight does not miraculously increase their mood or self-esteem. Instead, dealing with what perpetuates negative thoughts, how to come to terms with ones body and how to enhance positive body image is what helps people feel better. 

Guess what else it helps with? You got it- weight management. Weight shaming, guilt-tripping, judging and all those other negative abuses DO NOT HELP. Loving and accepting ones body and shape helps people eat healthier, move more and just live healthier lifestyles. It may be hard to accept or change the way you think at first, but change is possible! Professional help from a registered dietitian and psychologist speed up recovery from an eating disorder and help you feel happier.

Acceptance or: How I learned to stop worrying and embrace my shape

If you are unhappy with your weight, raise your hand. 

If you are planning on accomplishing that really cool/fun/amazing thing after you lose 5lbs, raise your hand. 

If you feel ashamed or disgusted by your body, raise your hand. 

Unfortunately, in my line of work, many of my clients would raise their hand if asked these questions. Perhaps it is because I am sensitive on the issue, but I feel that too many of my friends would also raise their hand.
So you can imagine how happy I was to see this article come to light:  Adults with Greater Weight Satisfaction Report More Positive Health Behaviors and Have Better Health Status Regardless of BMI.
This study helps to prove what I (and many other dietitians) have been trying to explain for years- hating your body does not help you to eat healthier or be more active AND loving your body does not perpetuate unhealthy habits. One way to look at it is that negative thoughts or emotions (example: I hate my body) lead to negative outcomes (example: I might as well not even try). Where as positive thoughts and emotions (example: I accept that my natural BMI is 27) lead to positive outcomes (example: I can allow myself to enjoy a few cookies every once in a while but try to enjoy fruit everyday).
Why is "weight dissatisfaction" a problem? It was reported in this study that people with greater weight dissatisfaction reported more dieting, yo-yo dieting, consuming fewer meals, and being less active. All of the these things get in the way of the very thing these people want to do: which is to manage their weight.
One thing that has to be kept in mind when trying to manage your weight is the fact that we have less control over our shape and weight then we think or are led to believe. This over-evaluation of our ability to eat less, exercise more and to control our weight often leads to strict diets or very restrictive eating. Both of which lead down the slippery slope of further disappointment, body shame and even disordered eating.
The Canadian Obesity Network has done a lot of work in the area of "weight bias" or judging someone based on their weight. Weight bias is certainly a contributor to body shame and hopefully with time is something that will decrease with more awareness.

Are my eating habits normal? Use this tool to know when to reach out for help

There are a few ways to screen for an eating disorder. One short and easy questionnaire is called the SCOFF. SCOFF is an acronym that is used to help people & professionals remember the specific questions. It is touted as being simple, memorable, easy to apply and score. It is designed to raise suspicion of the presence of disordered eating rather than to diagnose. It is mostly used by health professionals but since it is easy to understand, it can be used by anyone. 

The SCOFF questions

Do you make yourself Sick because you feel uncomfortably full?
Do you worry you have lost Control over how much you eat?
Have you recently lost more than One stone in a 3 month period? (or about 6kg or 15lbs)
Do you believe yourself to be Fat when others say you are too thin?
Would you say that Food dominates your life?

To score the questionnaire, give one point for every “yes”. A score of 2 or more indicates that there are symptoms present similar to those in anorexia nervosa or bulimia. In other words, if you (or who ever took the test) scored 2 or higher, you may need help in re-establishing a healthy relationship with food and your body. 

There are other more in-depth questionnaires for helping to determine whether you have symptoms commonly associated with an eating disorder. One very popular one is called the Eating Attitudes Test-26 (or the EAT-26). You can take the test anonymously here.

Thinking that your disordered eating is not "bad enough" to seek help or the idea that you aren't sick enough to merit the help of a professional is one of the main reasons people suffer from eating disorders. Getting help sooner rather than later helps to speed recovery and lift the burden off your shoulders. 

Eating disorders: "simple" solution, complex issue

Eating disorders can be hard to understand. What seems like a straight forward “skewed vision of one's body” is rarely this simple.

Providing a fridge full of good food or begging people with an eating disorder to "just eat!" very rarely works. No matter how minor the problem seems to be (and it is common to scoff it off as not serious enough for therapy) professional help is needed to recover. One problem that tends to be underestimated is binge eating disorder. Unfortunately, many people who suffer from BED have the same body image problems as people with anorexia or bulimia.

Why professional help? Because they help the sufferer deal with all the major complexities of an eating disorder. Believing yourself to be “fat” when you are thin (or a normal weight) is only one of the symptoms of an eating disorder. A major component that goes one step deeper is the fact that self-worth is based on weight. The higher the weight, the lower the self-worth. Rather than looking at all aspects of life that make up an evaluation of one’s self, like being a nice person, a good student, a kind daughter/son, punctual, reliable, etc-  weight is the most important aspect.

This is why exploring more than just body weight is needed for recovery. Specialized psychologists and dietitians can help with all behaviors of an eating disorder to help increase other aspects of life that make up self-worth.

When weight loss is the goal, no amount of weight lost is enough. Food becomes feared since it brings the person farther away from their goal of weighing less. This fear can be compared to a fear of dogs. If someone has an intense fear of dogs, they will likely do anything they can to get away from one or avoid being close to one. This intense fear can lead them to do things that puts their life in danger. Imagine running into traffic after being scared by a dog on the street or being confining to the house since there may be a dog outside. Neither of these behaviors are healthy but they are done to avoid the dog. Similarly, if someone is scared of food, they may avoid social situations where food is the main event, live with a dangerously low body weight or even sacrifice their teeth to get rid of any food eaten.

So, would offering food to someone who is scared help to decrease this fear? Well, in the short run, no. It is a process that takes time. Small exposures to the thing that is feared (whether it be dogs or food) and working up to the equivalent to petting a dog works best. Although someone who is underweight would benefit from eating high calorie foods, it takes time to work up to being able to do it. This process is best done with the help of a professional to help guide and provide support. Usually it starts by adding “safe” foods to a routine and progress to more “scary” foods.

One thing that has been proven time and time again, is that returning to a healthy weight by eating the foods your body needs is the most effective treatment for an eating disorder. 

NEW Binge eating disorder group starting in MAY at the "Clinique de psychologie cognitive comportementale"

The Change Clinic therapists are THE EXPERTS in eating disorder recovery.
Check out their website or the picture below for contact info!

How can binge eating be related to dieting?!

As discussed in earlier posts, binge eating can be a difficult problem to identify, especially by people who are suffering from it.
After understanding that further dieting does not help reduce binging, the next challenge is to find ways to improve your relationship with food (among other things like self worth and self esteem).

One of the first steps to decrease binge eating is to start eating 3 meals per day along with a few snacks. By eating regularly, you will avoid feeling deprived and very hungry, which contribute to binges. Your body will start to expect nourishment on a regular basis (rather than sporadically) and will better digest and metabolize the energy. Your mood is also likely to improve since you won't be swinging between feeling very hungry and too full.

Sometimes when our relationship with food is skewed, so are our signals of hunger and satiety. So it is not always easy to listen to these signals and only "eat when you are hungry and stop when you are full". By having a routine with meals and snacks, you don't have to rely on those signals. The ultimate goal is to listen to your internal cues but that takes time and practice.
Ideally you want to eat every 3-4 hours. Planning out meals and snacks may seem time consuming at first, but once you get into the habit, it becomes easier. It can help to use a guide to determine what to eat over an entire day (like the food guide) or even an outline of a meal plan that suggests ways to include the food at meals and snacks. Over time, you will find that you can plan out your meals and snacks in you head rather than rely on a written plan.
For example, most adults require:

One example of how those requirements look in terms of food is:

Planning a routine visit to the grocery store is a good start to having healthy food on hand- so make sure you make time during the week for a shopping trip.
Focusing on balanced meals can also help to reduce binging. The combination of protein, carbohydrates and fibre (from the meat and alternatives, starchy foods/grain products and vegetables) will help to sustain you between meals. However, it is important to remember that eating perfectly is not necessary! It is ok and certainly normal to have a less balanced meal occasionally.