As some of you may know, Bobbi and I presented to the University of Maryland senior dietetic class. We actually spoke on their last day of their class, Issues and Problems in Dietetics, which is the “capstone” course. Rebecca taught the class and had a TON of guest speakers ,who are “rockstar” dietitians.
Anyway, Bobbi and I presented on the Health at Every Size ® (HAES ®) approach and weight stigma. We chose this topic because its not commonly addressed. But its SO important.
We strongly believe the lack of discussion of this approach is one of the top 5 “issues and problems” in not only the nutrition community, but also the health community. At the beginning of the class, I asked the students if they ever learned about the HAES principles, and they all shook their heads no. I wasn’t surprised. I am a graduate of UMD and everything I learned about the HAES approach in school was through my own research, most of what I learned was really post-grad (again through my own research). To be clear, I received a wonderful education from Maryland, I’ m a nerd and absolutely loved all the science courses.
However, I’m not condoning the fact that it’s not uncommon for nutrition classes to have a very weight loss centric approach.
The vast majority of dietetic programs (and health field programs in general) are focused on weight as an indicator of health. They teach that weight loss automatically equates to improved health. And this is something that totally needs to change. Why? Well, 95-98% of diets fail. (Also, please note that I use the term “diet” very liberally. Any type of “lifestyle change” for the purpose of weight loss is a diet).
HAES advocates for health at every size, in every body
Please note. The tips outlined in this blog just brush the surface of the HAES approach. This blog was not intended to dive deep. I encourage you to read up some more. Linda Bacon’s website and ASDAH’s website are great places to start.
What is the HAES Approach?
Health at Every Size and HAES are actually trademarked terms from the Association of Size Diversity and Health. HAES is an evidenced based approach to supporting an individual along his/her health journey. This approach puts weight on the shelf and it does not use it as an indicator of health. Recommendations for change are based on behaviors as opposed to looking at the number on the scale (weight is not a behavior). Below are the principles of HAES:
1. Weight Inclusivity
Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement
Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care
Acknowledge our biases. Work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma. Support environments that address these inequities.
4. Eating for Well-Being
Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
5. Life-Enhancing Movement
Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.
How can you practice the HAES Principles? And what is the basic information you should know? Read more to find out. 1. Weight stigma prevents people from getting medical care.
a) What is weight stigma? It is the discrimination/stigmatization of individuals who live in larger bodies. You may be able to think of some examples if you picture the way larger people are portrayed in our society. (Lazy, unhealthy, people fearing weight gain…etc). Studies show that in the healthcare field, health care providers thought of clients with “obesity” as non-compliant, lazy, awkward, weak-willed, dishonest, lacking in self-control, sloppy, unsuccessful and unintelligent.
If that is the signal someone is getting from a health care provider, no wonder he/she is avoiding medical care.
In addition, there was actually a study done called “Obesity Stigma: Important Considerations for Public Health”. And in that study the finders said “Adults who face weight stigmatization and discrimination report consuming increased quantities of food, avoiding exercise and postponing or avoiding medical care (for fear of experiencing stigmatization.).” (ps I learned about this study on Haley Goodrich’s instagram account).But then, avoiding medical care may leaves certain illnesses to go untreated. And this can lead to health complications. Which is so awful! Everyone deserves unbiased care when going to see a provider.
2. Fat is not a bad word.
Most often, this term is used as an insult or criticism. Even the well-intended Jennifer Lawrence said, “It should be illegal to call someone fat”. Rather than seeing the word “fat” as bad, those of us in the fat positive movement work to reclaim this word as a description, just like “freckled nose” or “blue eyes.” We don’t need to get rid of the term “fat”. We need to change the connotation and stigma around it.
3. It is a MYTH that being “overweight” or “obese” puts individuals at significant health risk.
Yes, studies may find connections between weight and disease. BUT, many times these studies do not control for weight cycling, fitness/activity level, nutrient intake, or socioeconomic status when looking at this relationship. When studies control for these factors, the increase risk disappears! Or may even be slightly reduced. So, isn’t is possible that these other factors increase disease risk as well as weight gain risk? You cannot control your weight (only in extreme measures does weight change). It’s possible to follow a healthy lifestyle and make amazing changes to better your health and STILL not lose weight but that doesn’t mean you are doing something wrong.
4. Weight loss is not sustainable
Weight loss can be a very detrimental goal, when weight loss is pursued and emphasized in a society there is an increase in weight cycling, which increases morbidity and mortality. See below for a list of consequences from dieting:
b) Dieting reduces bone mass, which leads to osteoporosis.
c) Dieting increases cortisol and psychological stress→ increased disease risk.
d) Increased anxiety about weight → eating disorders/dieting.
e) Body dissatisfaction is linked to binge eating, lower levels of physical activity, and increased weight gain over time
5. Take a look at your own possible weight stigma/relationship with food
a) We can only take our clients as far as we have gotten. We need to be aware of our own biases and how they impact our language and practice.
How do I feel about my own body?
What do I feel about other people’s bodies?
How do I think and feel about people living in larger bodies?
How do I talk to others about weight, shape and food.
In summary, the HAES principles advocate for adopting and maintaining healthy habits at every and all sizes. Weight is not an indicator of health. Every person can learn about habits that improve health. And every person can implement habit changes to feel more energized and healthy. Let’s be aware of our biases that can affect how we practice. AND let’s work to change them. Let’s be more inclusive and health focused.
ASDAH’s Trademark Notice must be prominently displayed on all publications utilizing the trademarked term/service: “Health At Every Size and HAES are registered trademarks of Association for Size Diversity and Health and used with permission.
The HAES movement is doing wonderful things and is making amazing progress with how we view health. If you have any questions, reach out to us at (240) 670-4675 or email me at firstname.lastname@example.org
By Caroline Best, Student Intern, and Alex Raymond, RD, LD.
Mindful eating or Intuitive Eating have become such buzzwords this past year. On Instagram, health blogs, and many other forums it’s almost hard to not to see the terms.
And I’m all about it.
Mindful eating focuses on purposely paying attention to your eating–that includes hunger and fullness signals, what you’re truly in the mood to eat and what type of food makes sense to have in that moment. I absolutely love this movement because mindful eating focuses on respecting what your body needs. There is no stipulation of diet rules or categorizing foods as bad or good.
And to me, it signals hope for changing the way we address food and health.
Resources for Mindful Eating
There is so much evidence that traditional dieting not only doesn’t work, but how it can be emotionally draining and damaging. An article in Psychology Today titled “Why Diets Don’t Work…And What Does” by Meg Selig summarizes a lot of this evidence really well. The article describes how most diets “don’t work”, but also goes on to discuss the psychological impacts of dieting, such as an increased risk of disordered eating, mental stress, and taking the joy out of eating
For something like intuitive/mindful eating to have become so popular means there is starting to be some recognition that restrictive attitudes toward food aren’t helpful or healthy. I’ve seen this on many non-diet Instagram accounts and non-diet bloggers.
Mindful eating is so many wonderful things. It is centered around valuing your body and honoring your hunger and fullness and what you need to maintain your energy.
One of my favorite go to meals to maintain energy: Grain bowl with a fried egg
However, we need to talk about what mindful eating is not.
I think this is something that absolutely needs to be addressed, because the diet culture world we live in has latched onto mindful eating and twisted into something that it’s not… which is using mindful/intuitive eating as a tool to change or manipulate your body. Or using it as an “excuse” to skip nourishing yourself when you need to.
Yes, it is great to advocate for paying attention to hunger and fullness. But sometimes we need to nourish ourselves when we aren’t necessarily feeling hunger. For example, last semester I had class 11:30-3:30 on Tuesdays and Thursdays. I didn’t love eating lunch at 11 because I normally wasn’t super hungry for a second meal that time in the day.
However, I recognized the importance of giving myself energy for four straight hours of afternoon class.
I recently heard someone describe this as “Highway in Traffic Eating” and thought it was a perfect analogy. If you’re not super hungry it’s still better to eat something for energy before you do something like drive through bumper to bumper traffic for hours where its hard to get off for food.
A busy day of school
Additionally, mindful eating is not a tool to be used to manipulate or change your weight or shape. Being intuitive about your eating means you are learning to trust your body to do what it needs to. You are learning about respecting your body’s signals and honoring them. Whether your body is saying it needs sleep, food, movement, water…etc.
So my input is to be mindful about how you’re using mindful eating.
It’s wonderful and commendable to want to be in tune with what you need and how to best nourish yourself. Paying attention to both hunger and fullness is a part of this. However, not eating a meal at a time when it would be “appropriate”, such as when it’s been a while since you’ve eaten or you’re not going to be able to stop for a meal for a bit , because of “being mindful about not being hungry” is not beneficial to yourself. And changes the basic principles of the movement. Mindful eating is all about providing the body with enough food to maintain energy and keep you nourished. It is not a suggestion to always wait until you’re hungry to eat. Be mindful about your health and nourishment.
By Caroline Best, Christin Hensley, and Ivy Devadas (Student Interns) and Alex Raymond, RD, LD
I don’t remember a ton from middle school aside from not liking math class and going to Starbucks after school on Fridays. But one of my clear memories from 13 is from the doctor’s office. The nurse weighing me made a comment about making sure to not gain to much weight during puberty. It was a little comment. But it felt so negative. And to this day I still remember how uncomfortable it made me.
I don’t know a single person who has felt 100% positive about their body image 100% of the time. Body image is a complicated, ongoing, personal experience. It is further complicated by the fact that we are constantly bombarded with messages of an unrealistic view of what “attractive” looks like.
This post focuses on messages that tend to focused on young women. However, we absolutely acknowledge that young men are exposed to plenty of harmful messages as well.
While body image is complicated for everyone, women in their pre-teens and teens are targeted especially heavily with SO many problematic, degrading, and unrealistic messages about body image.
The language you use when talking to young women at a time when they are forming their ideas about the world, about beauty, and about themselves resonates more than you think. What might seem like a little comment about how your “new diet” is making you feel great about your legs or an opinion on how good someone looks after they’ve lost/gained weight contributes to forming ideas that there is *a way* to look attractive, which there absolutely is not. It reinforces the idea that our bodies define our self worth. And that if you do not “look” a certain way or look “your best,” then you’re worth less. Women (and men) are constantly bombarded with messages like this, which makes it really difficult to accept the idea that your body does not define your worth. So, be responsible with your words. There was a Huffington Post Article on this topic written by Sarah KoppelKam that I’ve bookmarked on my computer because I love it so much.
Here’s my favorite section from the article that I think is beyond wonderful. This is so important for everyone to hear:
“Prove to your daughter that women don’t need men to move their furniture. Teach your daughter how to cook kale. Teach your daughter how to bake chocolate cake made with six sticks of butter. Pass on your own mom’s recipe for Christmas morning coffee cake. Pass on your love of being outside.
Maybe you and your daughter both have thick thighs or wide ribcages. It’s easy to hate these non-size zero body parts. Don’t. Tell your daughter that with her legs she can run a marathon if she wants to, and her ribcage is nothing but a carrying case for strong lungs. She can scream and she can sing and she can lift up the world, if she wants.
Remind your daughter that the best thing she can do with her body is to use it to mobilize her beautiful soul.”
There is no set-in-stone way to talk about nutrition. However it is important to choose your words and actions carefully. Negative attitudes about nutrition can easily carry on to your preteen or teen. And they will mostly likely carry that negative attitude into adulthood. While there is no set-way to talk about nutrition to your preteen or teen, there are strategies you can use for addressing body image and health in a positive light.
1. Avoid commenting on weight gain/loss
Commentary on our children’s bodies is unnecessary and can often be harmful. And again, if reinforces the idea that our worth is defined by what our bodies look like. I can’t say this enough, but that is absolutely false! Compliment your children on academic, athletic, or personal accomplishments. Tell your children how much you love them, just because. Tell your children they do not have to be perfect, because nobody is. Avoid commentary on their physical appearance. Encouraging weight gain/loss because you think it would help your child feel/look better can have seriously detrimental effects, like poor mental health and the potential to lead to disordered eating or eating disorders. If you have serious concerns about your child’s health, speak to a dietitian or their doctor.
2. Encourage snacking on/eating a wide variety of foods
Focus on eliminating certain foods and/or calorie restriction can affect your child’s mindset about nutrition. Rather than enforcing the idea that certain foods always equal healthy foods encourage your children to eat a variety of satisfying snacks and meals. It’s important to set that example yourself. Remember, there isn’t one food that is going to make or break your health. In fact, putting foods on the same playing field has much better health effects (both mental and physical) than cutting out foods.
3. “Are you sure you want more of that?”
Trust your pre-teen or teenager to know what their body needs! Asking if they’re “sure” they want more food can cause anxiety. This sort of language can be damaging, especially if they’re already experiencing stress about body image. These comments can actually bring them further away from eating intuitively and trusting their bodies. Remember, everyone’s hunger/fullness cues are different.
4. All food are equal!
No food is “bad” or “good!” Every food provides different amounts of energy and nutrients that your body can use! Promote practicing eating a wide variety of foods when speaking to your teens about food choices. Again, please try to model this behavior yourself! If you are worried about your own relationship with food and adding variety. It may be a good idea to set up an appointment with a dietitian who specializes in the non-diet approach.
5. Don’t encourage your child weighing themselves in the name of “health management”
While this is seemingly harmless, having a scale accessible in your house can place unnecessary pressure of your teen. Weight is not a reliable indicator of health and using it as such can put your teen at risk for developing disordered eating habits. In fact, why don’t you try just getting rid of the scale if you have one!
Talking to Young Women about Their Health: A Personal Story from Ivy, A Nutrition Intern
From 4-14 years old, I played competitive soccer. I spent almost everyday kicking a ball around my backyard. Training, practicing, and playing games was my favorite way to spend my time.
I don’t remember many specifics about my time playing soccer, but one statement has stuck with me forever: “You should workout more — you’re out of shape.”
I’m know that my father, who was also my coach, doesn’t remember saying this. And I’m not sure what he meant by it. But that statement ran through my head every time that I exercised to the point of fatigue. My dad never intended for a fleeting sentence to influence my body image. And I don’t blame him for it doing so. It’s actually taught me to be more aware of my own speech about body image and nutrition.
Something I’ve learned as I’ve grown up is the importance of complementing people on who they are.
Not how they’re looking that day.
Tell your friend how happy she looks. Let your your lab partner know you admire how driven she is. Tell a teammate that her passion is incredible.
We all make small comments that can impact others in such huge ways. Everyday can be a new opportunity to change our own attitudes about body image and nutrition, as well as influencing those around us.
I can’t emphasize this enough… It’s so important we teach young women they are MORE than their bodies. Women (and everyone, actually) deserve respect no matter how their bodies present in the world. I want the younger generation to know that someone’s body does not define his/her worth. I personally like the website Beauty Redefined. They talk about this idea of being “more than a body.” I’d encourage you to check it out! Whether you love your body, like your body or hate your body, you are worthy of love, respect, and compassion.
By Caroline Best, Dietetics Student Intern. Contributions by Alex Raymond, RD.
Last week, I took my spring finals.
I celebrated finishing my last exam with ice cream and a 2 hour nap and it was honestly a great afternoon. After finals, I was staying in town to watch my roommate graduate and I was excited about all of this new free time. However, a few days into my break I was really tired and confused about why. I was sleeping in. AND taking naps. My time was spent mostly with friends. Compared to my past weeks of intense school commitments, my first week of summer was a breeze. I felt like I should be bursting with energy.
However, once I considered my dramatic routine change my exhaustion made a lot of sense.
Throughout the course of the semester I woke up around the same time. I ate my meals around the same time. I had pretty set routine of when I exercised, relaxed, and studied. Then summer started and with that came the physical and mental effects of changing up a schedule. Your body will most likely “notice” when your routine shifts. I was doing pretty much everything on a different schedule than what I was used to and my energy ended up a little wacky. I listened to what my body was trying to tell me and practiced a little self-care to help reestablish my energy.
Scheduled study time in my favorite study spot
I specifically wanted to write about the fatigue that can accompany routine change because Summer tends to come with schedule shifts for many people.
School lets out. Kids may be home for the summer. Family comes into town. People may take off from work or go on vacations. While sometimes there’s not much you can do as it takes a little while to adjust to something new, I do have a few suggestions to make sure you’re maintaining self-care during times of routine change.
Summertime: Warmer weather, flowers, and schedule shifts.
1. Pay attention to keeping your body nourished for energy
Something that I love about graduation week is graduation cookouts. Most nights I went to something where a friend’s family provided lots of food and I loaded up on some of my favorites like grilled corn and potato salad. I woke up feeling pretty full most mornings. I would have a brunch meal later in the day instead of eating an early breakfast.
Listening to your body’s cues about fullness and hunger is great. It’s actually a form of self-care. But part of the relationship between self-care and nourishment is making sure you have the tools to listen to what your body is telling you. Acknowledge when you’re feeling sensations such a hunger or fullness. But an important point I want to add is that it is absolutely okay to eat past experiencing fullness- for example when it’s been a few hours since eating and you know you need a meal or snack or if you just want some extra servings of a meal or dessert.
My schedule change shifted the amount I was eating at meals and the number of meals I was eating throughout the day. I had much better energy on the days where I snacked between my meals as I started to get hungry. The days where I would just “wait for dinner because it was happening soon enough” I felt very low energy. I definitely wasn’t respecting what my body needed. My take away advice is that schedule changes might affect when or how you eat. Be prepared and carry snacks, so you can recognize your hunger and honor it (even if it’s not “ time” to eat). This is one of the most simple and most important ways to maintain energy as your routine changes.
Have a few snacks to grab when hunger strikes
2. Get some alone time – Rest and Recharge
I honestly can’t emphasize this part of self-care enough. Routine change can be a hectic time and it’s so important to be aware of that. Personally, summer comes with a bit more free time and the option of warm weather plans. I wanted to include this point because I’ve noticed the drive to go out and do as much as possible as the weather gets nicer and the days gets longer is a pretty common feeling. Halfway into my first week of summer I realized I hadn’t had any real alone time. I absolutely love spending time with people. But going several days without taking time for myself left me mentally frazzled. I spent the next afternoon watching a movie in my room and taking time to enjoy a little bit of solitude.
Yes, absolutely enjoy all of the added plans that tend to come with summer. But be aware of what you need and if you would benefit from a break.
Sometimes self-care is going out to dinner with friends and sometimes self-care is canceling those dinner plans to watch Netflix by yourself. When you start to feel overwhelmed or worn out, take a breath and think about what you truly need. Take a walk by yourself. Watch an episode of something on your own. Treat your moments alone as a little mental break.
3. Journal your Thoughts
This is pretty similar to my previous point of making sure you have a few moments of alone time. But, I’m such a strong supporter of journaling, so I wanted to have it as a separate point. Times of routine change can be mentally stressful. For one reason or another, you are changing up the way you do things and this can can be accompanied by expected or unexpected stress. Take a few minutes whenever works best for you to write your thoughts down. I personally prefer writing a little with my morning coffee. Or before I go to bed. Even a couple moments of reflection can be calming. Journaling can help you gather your thoughts and give you a better perspective on how to approach change.
4. Rest When You Need Rest
This may seem like one of my more obvious self-care tips, but changing up a sleep routine can be surprisingly draining, at least for me. I’ve definitely noticed how you can be getting similar amounts of sleep, but changing “sleep hours” can cause fatigue regardless. My personal example is once I finished school I started staying up a little later and sleeping in later and it definitely messed with my energy levels a bit. Yes, I know common advice is not to nap and “mess up your sleep schedule”. But, if you need sleep, absolutely give your body the rest that it needs. No plans are that fun when you’re that tired anyway. Your energy levels will eventually adjust to your new routine. But as your body gets used to new schedule be aware you might need more sleep than you think you need.
To wrap it all up, most people will experience schedule changes throughout their lives and throughout their year.
I wanted to share my thoughts as summer started because schedules often shift with season change and I recently had some personal experience with this one. My biggest take away is that change can be exhausting or overwhelming and listening to your body’s cues and honoring them is so, so important to helping you have the most energy possible for activities you love and enjoy.
Activity Alex loves: Kayaking
Activity Caroline loves: Frisbee!
If you want any input on maintaining self-care or learning new self-care habits please meet with one of our wonderful dietitians.Contact our office at 240- 670-4675 or email me at email@example.com
I’ve been all about “cleaning up your Instagram feed” recently.” Sure, social media can be a breeding ground for comparisons. But, I do think if you’re following positive, non diet accounts they can be a tremendous support in helping you heal.
Below is a list of some of my favorite Instagram posts recently!
I understand that different things work for different people. Here are the posts that I like. But you do not have to like them. Who you follow is up to you. I recommend following some of these people. Also, I recommend “diversifying” your feed. Follow a bunch of different people who offer unique perspectives to recovery, HAES and food.
Emily Fonnesbeck, RD. @emilyfonnesbeck_RD.
2. Ivy Felicia. @iamivyfelicia
3. Haley Goodrich, RD. @hgoodrichrd
4. Summer Innanen. @summerinnanen
5. Megan Jayne Crabbe. @bodyposipanda
6. Lauren Newman, DI Intern. @gofeedyourself_
7. Marci Evans, RD. @marcird
8. Anti Diet Riot Club. @antidietriotclub
9. Fiona Sutherland, RD. @themindfuldietitian
10. Vallery Kallen, RD.@nourishedmindbod
11. Cinta Tort Catro. @zinteta
These Instagrams and posts are so positive. Also, they are wonderful examples of encouragement you can add to your newsfeed. In addition, removing accounts that promote harmful messages is so beneficial. Unfollowing these negative accounts is a form of self-care.
Lastly, what you see on a daily basis, or however often you check your social media, effects you more than you think. Creating a newsfeed bursting with messages of support, optimism, and love can have such a positive mental impact.
Also, if you need any suggestions of accounts or any input on overall self-care, please contact me at firstname.lastname@example.org.
Strategies from Clients on Vacationing with an Eating Disorder
It’s almost summer! This means events such as vacations, camps and other outdoor activities going on during the warm months. For someone with an eating disorder, this can also be a time of stress and anxiety. Going on vacation with an eating disorder can present many challenges. These struggles may be unknown to someone not struggling. The truth-of-the-matter is being in a different environment is daunting to someone in recovery. You are surrounded by people with limited alone time. There are often body image triggers present. Beach-ware is an intimidating factor. In addition, those struggling are exposed to different foods that may not be currently in their daily routines. These are all real concerns for those who are working to gain peace with the mind and body from eating disorder thoughts.
A primary focus during sessions with clients in the weeks leading up to summer are surrounded by conversation about vacation preparation.
Many times with clients, we discuss strategies on how to combat potential triggers. I would like to share some of these on the blog!
1. Plan ahead.
While this seems to be a common theme for many clients, I believe it is particularly important when going on vacation! Talk to your family and friends about what is on the agenda. Especially consider activities and meals.
Will you be renting a house? Will you be cooking some dinners at home or going out to eat for most/all meals?
What type of cuisine will be available? Will it be mostly “safe” foods or “challenge” foods?
How active will you be on this trip? Is it important to pack extra snacks?
Dinner for the whole family
2. Food Challenge.
Depending on where you are in recovery, this also may be a good opportunity to set a goal to complete a food challenge. Perhaps trying a food you have not tried in a while. Go to a restaurant. Even considering letting someone else prepare a meal for you could be a challenge to accept while on vacation. Talk to your dietitian to see what makes sense for you and your recovery. This change in routine may be a good time to try something new.
Complete a food challenge
3. Prepare Fun Activities.
Before going on the trip, talk to others involved about some things you want to do while there. Plan some activities that you would enjoy doing. Plan events that will allow you to have some fun outside of what may be stressful meals. For example, if it’s a beach vacation, you may not enjoy laying on the beach everyday. Research the area and see if there is a day where you can find an activity everyone may enjoy. There are always other ways to enjoy time with family. Play games! Go putt putt golfing. Drive go-karts. Shop. Go on a hot-air balloon ride. Go parasailing. These fun activities will help to reinforce the reason we are here- and that is to enjoy time away spent with the ones we love!
Fun activities for the family
4. Pack comfortable clothing.
Make sure to pack clothes and bathing suites that feel good, make you smile and fit comfortably. This is a time to relax! Use the time to focus on the ones we love who are around us.
Pack plenty of comfortable clothes
4. Bring projects to work on and books to read.
Make sure to block off some time to decompress by yourself, if this is something you enjoy. Time alone is always a good time to process. Take a little time to breathe and prepare for more time with the family. This is especially important if you are sharing a house or hotel with other people. If you thrive on having time alone and down-time have a few options you can do. Read a good book. Use a coloring book. Listen to some music. Work on any sort of project that makes you happy.
6. Set an intention for the trip.
Setting an intention for a trip provides purpose and focus to what there is to appreciate and receive from the time away. Perhaps an intention might be to spend time with a family member you are not able to see often. Practice meditation. Try something new. Create lasting memories. Focus on thankfulness during this time. Whatever the goal of the trip may be, discuss with your treatment team ahead of time and create a visual list that you can bring with you. Read it each morning to help set focus for the day. Journaling may also help to refocus and jot down thoughts about how each day has been during the trip.
Set an intention for the trip
7. Reach out for support.
Let your treatment team, friends and family know how they can help you while you take a vacation. Have a conversation with your spouse, mom or dad about how they can best help you if you run into any challenges during the time away. Having a strategy in place ahead of time can help tremendously if you struggle while you are there. By putting these practical tips into place, it makes for difficult situations to be so much more enjoyable while away!
If you desire any additional support and encouragement while preparing for vacation, please click here or call (240)-670-4675 to schedule an appointment today!
Blog originally written by Kait Fortunao Greenberg, CEDRD, RDN, LDN. Edits by Alex Raymond, RDN, LDN and Kara Meyer, Student intern
I recently read a few posts on a National Eating Disorders forum about Lagom.
Having never heard of Lagom, I quickly googled it, then found a few books at my local library and read up on it. This Swedish concept means “not too little, not too much, just right”. The comments on the forum were about the challenge of eating enough to avoid a binge but not too much which you might consider a binge. This is a tricky concept because “just right” does not mean perfect. Just right means learning to pay attention to what your individual body needs and sometimes actually eating a bit more than you need and sometimes a bit less. Ideally eating becomes “just right” as you learn to navigate what works best for your body and under which circumstances.
The tricky balance of honoring your body, your nutrition and your recovery is often a long and windy road.
What I liked about these books is the way that they looked at how to balance not only eating, but all of life in a way that best suits you.
How can Lagom help find the art of balanced living?
Not only balanced eating, but also balanced living. I found the books to be interesting (although possibly a bit triggering for some) so I thought it might be valuable to outline some of my favorite takeaways from the books on Lagom.
If you think having more will alway make you happier, you will probably never feel like you have “enough”. How can you re-examine your values and focus on being with people you love and doing things you love? This makes me think of quality instead of quantity which also focuses on intention and mindfulness with eating and life.
I love this quote about the importance of connecting with nature. It reminds me of the importance of slowing down and being present in the moment. My favorite way to stay connected to nature and live in the moment is to go hiking in the North Carolina mountains. Climbing the mountain on fairly rough terrain means that I have to pay attention to each step that I take.I have been climbing black mountain since I was a child and it always brings me a wonderful sense of peace and family. My family vacations there every year. My grandparents and great grandparents have been vacationing there for the past 100 years.
3. Early Bird:
A University of Toronto study showed early risers are happier than night owls. Getting up early has its benefits:
Time for exercise
Time for breakfast
4. How to Save Money like a Swede: The book includes a big list on ways to save money.
My favorite 3 are:
To get rid of unwanted clutter. Take all your unwanted clutter to a consignment shop or have a yard sale for a little extra cash. Also, if you are in the simplified mindset of avoiding too much stuff, you will save money by avoiding buying things you may only want for a minute and focusing on things you really want/need.
Use your local library instead of buying book.
Invite friends over instead of eating out
5. Fika: The next tip also relates to eating.
Take time to have coffee and a small sweet with a friend. This focuses on the importance of relaxing and connecting. Connecting is key with other people and also connecting with your body’s needs/wants when it comes to food and hunger/fullness levels.
I loved this section on four easy ways to spend time with friends:
Bonfire (my favorite is eating s’mores)
7. Children’s activities:
The book includes a list of impromptu children’s activities. I remember once hearing that people have the most vivid memories of family meals, family vacations and being outdoors. I definitely believe being outdoors is good for your heart and soul. The most clever activity I saw listed was to run through the alphabet and collect small pieces from the wild starting with different letters. This seems like fun for all ages!
I hope this give you some ideas of ways you might want to have more balance in your life. Balance does not only refer to eating, it encompasses all aspects of living.
What is one way you might want to explore a new way of balancing life or eating?
Fun fact about me. I love public speaking. But I used to be completely terrified of it! I don’t know what possessed me to do this… But, it was my freshman year of college and I decided to sign up for this program where you gave health/wellness presentations to UMD students. I don’t think I realized that I would have to give these said presentations in front of 100+ lecture halls! It totally pushed me out of my comfort zone. And now, I actually enjoy speaking in front of large groups.
Alex doing a cooking demo- which definitely takes public speaking skills
I recently gave a presentation to therapists titled “Practical Approaches to Treating Eating Disorders.”
As you may or may not know, eating disorder work is a very niche group. I love working with this population and couldn’t imagine doing anything else. But, it’s important to know that it’s not for everyone. For example, just as I love eating disorder work, working in the kidney disease population is not for me. I find it quite confusing and I have a ton of respect for dietitians who do that work! There are many therapists out there who do amazing work with their client and they don’t have adequate training in ED. Either they aren’t often exposed or they having gotten training. I was appreciative of the therapists who came out to my training. Many of them had seen an influx in clients with eating disorder symptoms and they wanted to know how to best support their clients. Even if best supporting them meant referring out.
1. Ask yourself, is eating disorder work right for me?
Like I said, it’s not for everyone! And that’s totally fine. It doesn’t have to be a good fit for you. Marci Evans, a dietitian in Massachusetts, created a quiz for health practitioners to take in order for them to see if ED work is a proper fit. You can find the link to the quiz here. If it’s something that interests with you, I encourage you to get additional training. Training is very necessary working with the eating disorder population. Many health practitioners in the ED field also get supervision from colleagues who may have more experience, so they are able to get support and feedback.
Dietitian Marci Evans has a great quiz on working w eating disorders
2. Get the family involved.
Many individuals who are struggling with eating disorders either do not want to get help or they are afraid to get help, just as this may be the case with other mental illnesses. I have had so many clients come into my office with food struggles who are fearful of admitting they are struggling because they don’t know what will happen next. Getting the family involved and helping them to understand the severity of eating disorders (both the emotional and the physical piece) is so important. Often times, it is the family members that encourage their loved ones to get the support they need to recover. I encourage you to have appointments with family members along with your client. I also strongly recommend that family members attend their own support groups. We have a loved one group that meets twice a month in our Columbia office.
3. Separate your client from his/her eating disorder.
Remember, your client is not his/her eating disorder. What does this mean? It’s the idea that the eating disorder (or ED) is a separate mindset/voice from the recovery mindset. The “ED” voice bullies the client into negative and hateful thoughts about him/herself. However, clients who are recovering do have some thoughts that are positive and focused on recovery. It’s helpful to bring out those thoughts and challenge the ED voice. I recommend reading the book Life Without ED by Jenni Schaefer to get a clearer picture of what this looks like.
4. Understand that eating disorders have serious medical complications.
It’s so important to make sure that an eating disorder client is medically stable and that you are checking in with behaviors that may cause medical complications (purging, restricting, over exercising… to name a few). I recommend to have a doctor with ED knowledge on board whom the client can see on a regular basis.
All of us want to be heard and understood. Sometimes, the most helpful thing you can do for someone who is struggling with an ED is to listen to their worries and concerns. Ask more questions and make them feel validated and understood. As with most (if not all) mental illness, it can feel like a lonely place. Someone with an ED wants to be heard. The more you listen, the more information you can gather to offer support/advice the client may need to move forward in recovery.
Want more information like this? Stay tuned. I am working on creating webinars for RDs, therapists, RD2Bs and other healthcare professionals to learn more about identifying and treating individuals with eating disorders. If you’d like to learn more, please contact me at email@example.com.
For more information or tips contact these Empowered Eating Dietitians
Family Based Treatment (FBT) for Eating Disorders with Support from a Registered Dietitian
Eating disorders are serious, life-threatening illnesses.
They affect both the person suffering as well as those closest to them. With treatment, true recovery is possible. This is especially true when intervention happens early. Intervention and therapy works best when consistent, and eating patterns are normalized. It is imperative to have a strong team in place. Teams often include a dietitian, therapist, and doctor. In many cases, loved ones are also a huge part of the support team. The treatment of an eating disorder can be lonely and stressful for the one who is effected and the family. Fortunately, we are here to give you support during this process. We will support you every step of the way. Our goal is to provide guidance and wisdom throughout every phase of recovery.
While there are various types of clinically proven treatment methods for eating disorders I wanted to share with you an intervention called Family Based Treatment (FBT).
FBT is also known as the Maudsley Approach. It is defined as “an intensive outpatient treatment where parents play an active and positive role in order to: help restore their child’s weight to normal levels expected given their adolescent’s age and height; hand the control over eating back to the adolescent, and encourage normal adolescent development through an in-depth discussion of these crucial developmental issues as they pertain to their child.”
This approach works well for younger children and adolescents who are living at home with their parents.
For sufferers, negative thoughts lead to extreme measures taken involving food the “Eating Disorder Brain”. This has the power to take over and negatively impact the decision- making process. This tends to be extremely stressful when an individual is solely responsible for their own recovery. While the ultimate goal is to have the young person take eventual ownership over the recovery, early intervention strategies with the help of a team of healthcare professionals and the families can make all the difference in long-term success.
Feelings and emotions associated with eating disorders
Phase I of FBT
Phase 1 is the weight restoration phase. Parents are responsible for making the food decisions. They help to get their child free of the dangers of malnutrition and low weight. As you can imagine, this is a lot of stress . It is hard work for the parents. Our team of dietitians are dedicated to making this recovery strategy as effective and easy for the parents as possible.
Phase II of FBT is returning “control” over to the adolescent. This means slowly allowing your child to make decisions when it comes to food. They may be able to start serving themselves or choosing what to have at lunch.
Phase III is centered around establishing a healthy adolescent identity.
You can find an in-depth description of this process from the Maudsley Parents site. This site is a wonderful resource for parents of eating disordered children. It explains this process and how to navigate the unknowns during the recovery process.
Here’s how we have helped families over the years with successful recovery using Family Based Treatment:
Providing families with easy-to-follow meal plans. We including portions, recipes, and timing of meals. This is everything you need in great detail to aid in proper caloric intake.
Grocery lists and meal prep strategies to help stay organized. Lists will help you have everything you need for your child’s recovery
Detailed list of snack ideas for both at home and non-perishable ideas for outside of the home.
Specific strategies to help make meal time less stressful. wWhat you can say to your child. How you can model recovery-style eating.
How to incorporate your loved one’s siblings or extended families during this journey to foster appropriate nutrition for all.
Options for take-out and restaurant eating.
Most importantly, 24/7 support for families to call or text their Certified Eating Disorder Registered Dietitian (CEDRD) with questions or concerns when loved one is struggling.
Let us know how we can help you with Family Based Treatment to help your loved one recover with an eating disorder. We offer both in person and virtual session for clients and families (together or separate) to help make this process as easy as possible. Please click here or call (240)-670-4675 to make an appointment. We have a loved one support group that meets in our Columbia office. If you would like to attend, please email Alex at firstname.lastname@example.org.
This blog was originally written by Kait Fortunato Greenberg, CEDRD, RD, LD. It was edited by Alex Raymond, RDN, LDN and Kara Meyer, Student Intern.