and why maybe it isn’t irresponsible
I recently had lunch with some fellow dietitians who all own their own nutrition counseling practices. All of us have been in practice for more than 15 years, but they went to nutrition school a good 10 or 15 years ahead of me.
The topic of a recent article in the Washington Post came up regarding, “obes*ity”, big food and the anti-diet push by Registered Dietitians. The article was upsetting and more or less scapegoating dietitians as promoting “o”, however what I found even more upsetting was a response letter from Mary Donkersloot RDN, more or less jumping on the Post’s bandwagon and throwing dietitians who promote intuitive eating and a weight neutral approach under the bus.
I found myself in the “hot seat” as the only dietitian at the table who practices, promotes and whole heartedly believes in IE. I left that lunch angry as a hornet but also incredibly sad and frustrated that the very people who hate on IE are the ones who seem to understand it the least.
I’d like to share with you why I believe in IE and why I have seen it be life changing for most of my hundreds of clients throughout the last 15 years.
1.) It is backed in science: To date there are over 125 studies showing the physical, mental and emotional health benefits of IE, including improved lab work, food peace, body image, and increased intake of “healthy foods” over the long term. Most studies show that weight fluctuations, ie yo-yo dieting, is much worse for our health than just being in a big body. Most studies show that weight fluctuations, ie yo-yo dieting, is much worse for our health than just being in a big body.
The only consistent result from dieting is weight gain beyond two years. Read that one again!
2.) It moves away from the assumption that weight is a health behavior and that what we weigh is 100% within our control: I think we can all agree that a “healthy lifestyle” of eating whole foods, getting some movement and using stress management techniques are good for us. Where dietitians disagree is when it comes to the how. What is the best way to motivate people? IE believes in autonomy (a very scary concept for diet culture gurus) and many “old school” food police dietitians believe they should just keep shouting at … I mean educating people to change their ways until it works. Hint: this can work in the short term, but it has not been proven to work long term!
3.) It puts clients in the driver’s seat and allows them a safe space where their lived experience is placed in highest regard. The amount of trauma I hear in my office is overwhelming. Most of my clients have been traumatized by physicians, dietitians, parents or partners for being in a larger body. It breaks my heart to hear how my clients have been denied care, yelled at or treated lesser than because of their weight and how this trauma has interfered with body trust. My goal is to support my clients wherever they are at. I won’t ever promise weight loss but that does not mean I will completely disregard health.
4.) It diminishes food noise because food noise is often a result of restriction. You don’t need an injection of a weight loss drug to diminish food noise. You need to legalize food so that it is all on a level playing field and you need to eat enough. Period. This is where many people get stuck when trying to do IE on their own. It’s common to still have one foot in restriction and that can interfere with success.
If you hold your breath, you’re going to have a lot of breathing noise, until you take a breath. Same with food.
5.) It encourages body respect/ body neutrality and self care regardless the size or shape of your body. Hating your body into submission is never going to work. Someone else hating your body into submission doesn’t work either.
6.) By acknowledging triggers, past traumas, and diminished body trust caused by chronic dieting, we can actually get to the why behind eating and then we can move forward towards wellbeing. The only way out is through. See number five.
7.) It acknowledges that dieting (restriction) is a major risk factor for developing an eating disorder and eating disorders are extremely bad for one’s health. It recognizes that we can not treat an eating disorder with the same method that landed us there. Just like we don’t treat frostbite with cold, we can’t treat an eating disorder by controlling food.
Think about your own life experience. Have you ever left a doctor’s appointment or a visit with a nutritionist or personal trainer where you felt ashamed? Did it lead you to beat yourself up further? If beating yourself up worked… wouldn’t you have the ideal body, shape, fitness, partner, job, financial health, etc, that you so desire by now?
It’s ok – it’s not you, we all have a pretty fierce inner critic and if they were effective at their job then there would be no need for dietitians, doctors or therapists. So, maybe, just maybe our health and body size are just a tad bit more beyond our control than we like to admit.
Just because someone in a small body tells you that you should do what they do so you look like them, doesn’t mean that person has the answers and you don’t. It assumes the person in the small body is the authority simply because of their body size and that is just silly.
I believe in IE because it works! Does it always lead to weight loss? No, but dieting has a 97% fail rate too. I believe in IE because the point is bigger than weight loss. The goal of IE is a peaceful relationship with food and your body and while I can’t change our culture, I can and do help my clients change their wellbeing every single day.
You can check out the IE studies here https://www.intuitiveeating.org/resources/studies/
