Break Up With the Scale

As a dietitian that believes in the Health at Every Size principles, I choose to practice something I like to call weight inclusive wellness. I respect size diversity and believe that people of various weights can have healthy behaviors and habits, and also have a positive relationship with food.

I had a really great conversation with a client last week about why I hate the scale. I cannot take credit for the following analogy but I love it! Dieting for weight loss is like playing the slot machines at Atlantic City. You see everyone around you winning (ding ding ding!!) and go into gambling thinking that YOU will hit the jackpot. But remember, we all know casinos get your money and statistics show we will not win. This is why weighing yourself does more harm than good: We all think we’re going to see a number we like (aka hitting the jackpot) but statistics show we will not win. The scale will probably creep back up over time and lead to negative feelings about food and body image. The good news is that there is a solution in weight inclusive wellness. You can be happy and healthy without focusing on the scale.

why scales harm

5 Ways to Measure “Success” Without Using the Scale:

Instead of focusing on the scale to measure progress, try to ask yourself these insightful questions:

1. How are you feeling about overall body image?

2. Are you responding to different emotions in a way that works for you?

3. What can you do to increase your self-care?

4. Can you try to eat when you’re hungry and stop when you’re full and mentally satisfied?

5. Can you move your body in a respectful, joyful way?

These questions can help guide you to a plan of action to feel happy and healthy about food and body image.

Resources For Eating Disorders And Intuitive Eating

I find myself suggesting resources all the time to clients and healthcare professionals to help everyone learn more about eating disorders, intuitive eating, and health at every size. I figured it’s time to share these valuable books/podcasts/e-courses with all of you.  It doesn’t matter if you are a client, family member, or healthcare professional- we ALL have a lot to learn.

 

Top Resources for Eating Disorders

International Federation of Eating Disorder Dietitians www.eddietitians.com/

International Association of Eating Disorder Professionals www.iaedp.com/

National Eating Disorder Association www.nationaleatingdisorders.org/

BOOKS

Life Without Ed, by Jenni Schaefer

8 Keys to Recover from an Eating Disorder, by Carolyn Costin

Overcoming Binge Eating, by Christopher Fairburn

Almost Anorexic, by Jennifer Thomas

PODCASTS
(Find these in your podcast app or itunes!)

The Recovery Warrior Show

The Eating Disorder Recovery Podcast

Resources for Health at Every Size and Intuitive Eating

Registered Dietitians for Body Confidence www.rd4bc.com

The Health at Every Size Community www.haescommunity.org/

The Association for Size Diversity and Health www.sizediversityandhealth.org/

Intuitive Eating Community http://www.intuitiveeating.org/

BOOKS

Intuitive Eating by Evelyn Tribole and Elyse Resch

Intuitive Eating Workbook

Health at Every Size by Linda Bacon

Body Respect by Linda BaconBody Kindness by Rebecca Scritchfield

Savvy Girl, A Guide to Eating by Sumner Brooks and Brittany Deal

PODCASTS
(Find these in your podcasts app or itunes!)

Love, Food

Body Kindness

Food Psych

Dietitians Unplugged

Life, Unrestricted

The Body Love Project

E-COURSES

EDRDPro Symposium:15 experts (myself included!!) presenting on eating disorders, HAES, and intuitive eating! The symposium begins April 28th.

Kylie Mitchell’s IMMAEATTHAT “How to Eat” Course 

Christy Harrison’s Intuitive Eating Fundamentals Course

 

3 Things to Do in January Besides “Diet”

Ugg… January is here! It really is “national dieting month” and even though I’ve tried to avoid “diet talk” as much as possible, I still hear friends, family, and clients talking about how they are going to be “good”, “eat clean”, “lose weight”, and “finally take control back”.

So if you know me, you know I’m all about creating a happy and healthy lifestyle. No diets needed! Dieting can increase disordered eating behaviors and habits, and also send you down a destructive relationship with food. So rather than diet, what can you do? Here are some ideas so you don’t have to diet and feel deprived. Rather live your life and feel fabulous about food!

1. Practice Your Intuitive Eating Skills. One of the best things you can do for yourself when everyone around you is trying to detox or go on the latest “New Years Resolution Diet” is practice your intuitive eating skills. Intuitive Eating is comprised of 10 principles that help you reject the diet mentality, honor your hunger and fullness signals, and improve your relationship with food and body image. Instead of removing foods from your diet this month, try adding in more healthful options and remind yourself that there is space for both apples and ice cream. Practice eating mindfully instead of restrictively by truly tuning into your body’s hunger and fullness signals. Finally, one of my favorite principles is “Challenge The Food Police” – which means that you practice saying ‘No’ to that voice in your head that tells you that you’re bad for not doing the detox that everyone at your office is doing, or good for skipping dessert at that party. Food is neither good or bad; food is just food and all foods fit into a healthy lifestyle!

2. Go for a daily walk. Gyms are notorious for their New Years Resolution marketing campaigns. If a gym is not for you, try the cheapest exercise on earth: WALKING. Taking a daily stroll for even just a few minutes/day can do wonders for your health. Start with 5 minutes and slowly work your way up! This is also a great way to manage stress levels. You can find a walking buddy in your neighborhood or at your office, walk your dog, or listen to your favorite podcast or music, all while improving your health and well-being.

3. Start a gratitude practice instead of “trying to change”. Unfortunately we connect “losing weight” to “being happier” when this simply isn’t true. Try to focus on what you have, right now! Actively thinking about what you are grateful for has been shown to reduce stress levels and increase happiness. Practice saying out loud one thing you are grateful for each day. Bonus if you can write it down or post on social media! Spread the word 🙂

Non-Diet Ideas for Health

I love these ideas to focus on health and well-being for the new year. All of these sound so much healthier than a diet!

  1. Go to a yoga class. Even better if you sign up for a class package!
  2. Try a new recipe and cook with your family
  3. Go grocery shopping and pick some new food items
  4. Eat out at a new restaurant
  5. Go on a hike
  6. Plan and BOOK a vacation!
  7. Go to bed 1 hour earlier tonight and get more rest
  8. Diffuse essential oils throughout your house or office
  9. Pick up a new book and read for 20 minutes each day
  10. Volunteer and give back to your community

My response to the CDR about the new “Weight Management” certification

I still remember getting the email from the Commission on Dietetic Registration (CDR) that said “Be one of the first dietitians credentialed to fight obesity in America”. I opened up the email and BOOM! In huge letters the email started off with “The wait is over.”  Obviously CDR is really excited about the new credential for Obesity and Weight Management.  See all the details on the certification here: https://www.cdrnet.org/interdisciplinary. However I am NOT excited about it, and in fact I am worried. I am so passionate about intuitive eating, body positivity, and forming a healthy relationship with food.  You can do that at any weight, and in fact some people even GAIN weight when this happens.  I decided to write my thoughts about this in a letter and posted it to one of my favorite Health at Every Size groups on facebook.  So many other practitioners signed this letter as well!

I hope with our response, CDR will notice our effort to include the Health at Every Size® (HAES®) principles in the certification material. But even if nothing happens to the certification, I hope this letter reaches dietitians, therapists, doctors, healthcare professionals, and clients. Know that you are not alone if you are trying to practice the HAES® mentality.  It’s hard in today’s world and we need all the support we can get.

Here is my letter.  Feel free to copy and paste (maybe change the part about your personal/professional journey because we are all different).  Send your own letter to interdisciplinary@eatright.org

**Edited to add: I created a change.org petition for this issue! Please read and sign for your support. THANK YOU!

haes-picture

The Commission on Dietetic Registration

120 South Riverside Plaza, Suite 2000

Chicago, IL 60606


Re: In response to the new Obesity and Weight Management certification program

To the Commission on Dietetic Registration:

I would like to express my concern, and offer some alternative education, for the new certification for Obesity and Weight Management.  I am compelled to write about these concerns after reading through the definition of a Certified Specialist in Obesity and Weight Management (CSOWN) practitioner, the content outline for the course, and the reference list to study for the exam.  I am hopeful that these remarks will make it to the Task Force and have some impact on coursework selected for this certification, and therefore an impact on those practitioners choosing to apply to take the examination.  Hopefully, you will hear from a lot of professionals, like myself, who practice dietetics with a Health at Every Size® (HAES®) mentality.  Like-minded dietitians like myself, who believe in the HAES® movement, passionately want our voices to be heard in the Academy of Nutrition and Dietetics and would support more education on the HAES® principles for dietitians, nutrition students, and healthcare professionals.

Ironically, as a Registered Dietitian, I always said I hated the word “diet” and preferred to talk to clients about a healthy lifestyle.  In the beginning of my career 10 years ago, I was a Certified Diabetes Educator and advocated for weight-loss plans through “dieting” even though I didn’t think I was educating clients about the diet mentality at the time.  Through clinical practice and experience, I learned that I was wrong to put clients on diets and focus on weight loss.  A weight-loss diet has a 99% chance of weight regain and an increased likelihood of disordered eating behaviors.  I started to find my way as a non-diet dietitian when I started to see eating disorder clients and became an eating disorders expert, especially in the area of Binge Eating Disorder.  This is when I discovered the Health at Every Size® movement, and the Association for Size Diversity and Health (ASDAH).

According to the description of this new certification, “Over half of American adults are overweight or obese. In order to better assist individuals in their weight loss endeavors, the Commission on Dietetic Registration (CDR), the credentialing agency for the Academy of Nutrition and Dietetics, is unveiling a new specialist certification in Obesity and Weight Management.”  The main issue I have with this description is the reference to “weight loss endeavors”.  A diet for weight loss does not work long-term and the focus on weight can steer a client in the wrong direction.  It can have a negative impact by leading to weight cycling, weight stigma, in addition to the risk of disordered eating and developing an eating disorder.  Rather, health should be looked at as a puzzle and each piece is important.  It’s not WEIGHT that needs to be addressed, but rather a person’s relationship with food and exercise, positive behaviors around food, eating for well-being, exercise that feels good, and emotional, spiritual, environmental, social, and intellectual well-being.  There’s no question that nutrition and exercise are important pieces of the puzzle.  However, positive behaviors in these areas do not necessarily result in weight loss.  In fact, some positive behaviors are associated with weight gain.  The HAES® approach is weight-inclusive, meaning that clients with diverse body weights and sizes should be respected equally.

When I read through the content outline and recommended research for this certification, so much of the content is focused on weight-specific recommendations.  Many dietitians pride themselves in being evidence-based practitioners.  The evidence shows that weight is regained after a weight loss program, no matter the approach (see this study from Mann, T. 2007 https://www.ncbi.nlm.nih.gov/pubmed/17469900).  Why should the CDR train dietitians to promote weight loss if there is no evidence to support that weight loss efforts actually result in long-term weight loss?  Rather, it is known that positive behaviors around food and a healthy relationship with food will make a huge impact on a person’s health, regardless of weight.  A Registered Dietitian Nutritionist is the perfect professional to help clients on the journey to a healthy lifestyle, regardless of weight or the number on the scale.  RDN’s have the unique ability to use science, psychology, and physiological knowledge of the human body in order to help clients with weight concerns.  I would love to see HAES® concepts included in the content for the certification, or better yet, an entire section dedicated to the HAES® curriculum.  This would be helpful, not only to increase awareness among professionals, but to help clients who have weight concerns be taught the HAES® principles by those who receive this credentialing.

The HAES® movement may have a reputation to some people as being “healthy no matter what”.  This is simply not true.  Taken directly from the Health at Every Size® curriculum website (https://haescurriculum.com), Health at Every Size® principles help us advance social justice, create an inclusive and respectful community, and support people of all sizes in finding compassionate ways to take care of themselves. HAES® is about respect for body diversity, including those bodies classified as “obese” according to the BMI chart.  Respect is so important because these bodies should be celebrated no matter what size they are.  These people have been “shamed” so many times and we all know that shame never helps behavior change toward health.  The HAES® movement is all about health, not weight, because people at any size can be healthy.

With that being said, I encourage the task force to read Linda Bacon’s book Health at Every Size: The Surprising Truth About Your Weight, as well as Body Respect.  I also encourage the task force to read the HAES Manifesto (http://lindabacon.org/HAESbook/pdf_files/HAES_Manifesto.pdf), which includes many links to research articles and more explanation of their position.  This article, “Weight Science: Evaluating the Evidence for a Paradigm Shift” (http://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-10-9) evaluates the evidence and rationale that justifies shifting the health care paradigm from a conventional weight focus to HAES.  https://haescurriculum.com/ and https://haescurriculum.files.wordpress.com/2013/07/haes-curriculum-resource-list.pdf also have many resources for professionals to learn more about the HAES® principles.

Thank you so much for your consideration of this information.  I appreciate your time to read my letter and hope you will consider including information about the HAES® principles in the new certification program.

Sincerely,

Jennifer McGurk, RDN, CDN, CDE, CEDRD

Health At Every Size® and HAES® are registered trademarks of the Association for Size Diversity and Health and used with permission

Registered Dietitian Nutritionist Day- Why I LOVE what I do

Happy Registered Dietitian Nutritionist Day!  I am so grateful that I choose this career path all the way back when I was 18 years old enrolled in Nutritional Sciences at Penn State University.  I really had no idea what a career in dietetics “meant”, but I loved food and nutrition and especially the mental/behavior change part of the puzzle in overall health.  Fast forward 12 years, after 4 years in school, 1 year at Johns Hopkins Bayview Medical Center for my dietetic internship, and many jobs later, I now own my own business and keep evolving as a dietitian.  My interests have changed over the course of 7 (!!) years working in the field, but I am still so passionate about the role of a dietitian in health, especially eating disorders.  Happy Registered Dietitian Day to all my colleagues and clients.  Thank you for allowing me to be a part of your life and help guide you to health and happiness with food 🙂  Here are my top 10 reasons why I love being a Registered Dietitian Nutritionist:

1.  I get to help people change their relationship with food into a positive relationship rather than a negative relationship

2.  I get to see people get excited about food, rather than fearful and scared

3.  I help people overcome eating disorders and change the way they feel about eating

4.  I see the difference that nutrition makes in your mood and attitude about yourself

5.  I see hunger and satiety signals come back in people that lost them for years

6.  I work with people to get to the root of the problem of emotional eating, rather than “covering it up”

7.  I help clients fuel their bodies the right way for physical activity

8.  If you have any other medical conditions like diabetes, heart disease, high blood pressure we work on that too!!

9.  Nutrition science is always changing and I love how there are no “right” answers some of the time.  What we’re discovering now about nutrition is cutting edge information and that’s exciting!

10. I love having an amazing network of dietitians to work with.  If I’m not the best fit you, I can almost guarantee that I know someone who is!!  My network of dietitians expands across the county!!  :)

One Size Does Not Fit All

Last week I attended an iaedp event on “One Size Does Not Fit All: Understanding the Complex Interplay of Body and Mind when working with Overweight (or Fat) Patients”.   I went into the meeting thinking I had a good understanding and insight into what it feels like to be overweight (I used to be heavier than what I am today not counting pregnancy).  However, I left the meeting with even better insight and lessons learned. How we word feelings is very important.  Not only with the way that we talk to ourselves, but the way that we talk to patients/clients and other providers.

 

The main part of the meeting was three professionals presenting cases and case studies to our group.  All three talked about feelings associated with treating overweight clients and reactions in themselves as well as what they learned treating the clients.  We discussed wording used when talking about overweight (using the word “fat” vs. not using it), as well as what came up for providers.  We also talked about how genetics and biology play a huge role in determining someone’s weight and size and that we also shouldn’t always assume clients want to lose weight.  We always want to ask the client how they feel and what they want to get out of sessions when talking about weight.

 

The meeting ended with a great discussion on words we use in everyday life.  What do these words really mean?

Obesity: what does it really mean to be obese?  Now that the USDA has declared obesity a disease, how does it feel to be diseased?

Overweight: over “what weight” does overweight really mean?

Plus Size:  Are you calling yourself a clothing size?

Fat:  What does it mean when you call yourself fat? Are you describing a feeling or describing your weight?

 

I came away from the meeting realizing I need to use these sensitive words in a sensitive way, as well as how I choose to use the words “fat”, “overweight”, “obesity” in my everyday life.  I really do believe in a “health at every size approach” for so many reasons.  So why would I use the word “overweight” when working with someone- what does that word really mean?  On the flip side, some people commented that we should all use the word “fat” in everyday life- as it really doesn’t mean anything other than an adjective to describe someone that is bigger.  It’s just like when we use that word more often, the less “shameful” it becomes.  The beautiful thing was that so many health professionals had a great discussion about these issues and respected all opinions.

Welcome to Eat With Knowledge!

We live in a world where nutrition information is everywhere, especially around “dieting”. It seems like there are “diet” messages everywhere we turn, potentially hidden in disguise! “Diets” can be addressed as such, like “Whole 30”, “Paleo”, “Weight Watchers”, or can be “clean eating” or “healthy eating”.  The problem is that diets can lead people into a cycle of restrictive eating and overeating, leading to a lot of guilt and shame.

diet

Diets emphasize too much thinking with our “head” rather than trusting our bodies when it comes to food.  95% of diets fail but leave people thinking that it’s their fault. It’s not you, it’s the diet!

This blog will allow you to come to a reliable resource for nutrition information when you might not be sure where else to go.  As a Registered Dietitian Nutritionist specializing in eating disorders, I will not put you on a diet!!! I have exceptional training and education in food and nutrition and know what works for eating disorder treatment, as well as chronic dieting.  The answer is intuitive eating but what that means is different for every client.  I want to pass along my passion for nutrition and share nutrition knowledge with you!  I will provide my readers with:

  • Tips on disordered eating, eating disorders, chronic dieting, and intuitive eating
  • Topic posts about weight concerns, emotional eating, women’s health, and having a healthy relationship with food.
  • Nutritious recipes that are fast, easy, and flavorful
  • The latest research on nutrition topics

At Eat With Knowledge, my vision is simple: “Feel Fabulous About Food!”  At Eat With Knowledge, my mission is to:

-To respect all bodies and be weight-inclusive

-Enhance your physical and mental health

-Be your guide when it comes to meal planning and behavior modification

-Show you how flexibility works with food and activity

-Support you with your goals to help you feel fabulous about food