Posts Tagged ‘diet’

This blog has remained pretty inactive recently. Due mainly to my continuing struggles with my health, both physical and mental.

Short update on those: Some appointments in my health system finally opened up to see a PA for medication- they have no psychiatrist currently and therapists, nurses, and PAs have all been closed to seeing new patients. I sneaked by to see my therapist months back only because I had seen her years before and therefore was able to get categorized as a returning patient. But since I hadn’t seen someone about medications, I was still a new patient and therefore unable to see anyone who prescribed meds. They have started opening that up and now have some availability for current psychotherapy patients to be seen for medications.

Anyways, so depression has been bad and just finally getting to where I can try to see if it’s helped with medications.

Meanwhile my physical health has been total crap. I have been dealing with near constant nausea, that my anti-nausea meds aren’t helping with, fatigue, feeling weak, and sleep problems.

So I have spent my night sitting on my couch watching videos on youtube, mostly ted talks and tedx talks, because when I stand I start shaking and often end up throwing up.

So that is what I was doing when youtube recommended I watch this:

Obviously nutrition is an important aspect of health. Yet sitting here too sick to stand and dealing with debilitating depression watching this my question is- so how do we make good nutrition accessible to people dealing with serious illness?

I mean, I want that answer for myself!

Getting carry out food is sometimes the healthiest option I have but it’s expensive. I now am able to get groceries delivered so that is a huge improvement, as I at least can get the food without having to sacrifice all my spoons on the process. Of course actual food that is not ready to eat or microwavable meals still requires all the work of prepping it. I actually tried recently one of those food delivery services that delivers just the items needed fora few recipes. All you have to do is cook!

… yeah, turns out that “just the cooking” is the part that is hardest for me.

Hell, right now I have some melons I got delivered that I was going to cut up and eat… except even just standing and cutting is difficult for me right now.

Instead of telling people to think more about the choices of what goes into their mouths, I think we need to consider more what is restricting those choices? What makes us choose certain types of foods over others?

And when you start talking about food as medicine, then that means thinking about the specific restrictions that chronically ill people, who rely on medications, have.

Telling me right now that food can be a better treatment for my depression than medications isn’t super helpful. I would love to eat more healthy, fresh, home cooked meals! Almost always my reason for not is because of barriers to that, which are primarily related to being chronically ill.

I can renew my medications online, and my pharmacy actually has free delivery. I don’t even have to have the ability to get to the pharmacy. Then, for pills all I have to do is open a bottle and swallow a pill. No preparation, no cooking, no standing, required. My biggest illness barrier to taking it is not throwing it up. And pharmaceutical companies actually have planned ahead for that for some medications, with many being available in non-pill formats. Besides my inhaled meds for asthma, I personally also have dissolving tablets that can be taken sublingually, and suppositories (gross, but sometimes necessary). Other meds sometimes come in injection forms.

So if nutrition is potentially as effective, or more effective, in treating certain illnesses, how do we make it something that  is accessible for all people with those illnesses? So that the illness isn’t a barrier to accessing the treatment of that illness? Doctors get that my anti-nausea meds can’t be in pill form because you can’t make “not throwing up” the requirement for taking a medication meant to stop me from throwing up. Yet that is what we do when we treat food as medicine. Often the thing we say it can treat is the very thing that makes eating well difficult!

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I’d been meaning for a while to write about my experiences with motivational interviewing, and specifically the aspect of non-judgment in it, at my job but I guess I haven’t done that yet.

I was reminded of this recently though when I had some personal training sessions at my new gym. Which left me thinking that boy, personal training certifications should also come with motivational interviewing training!

Of course, I always think everyone in the world would benefit from a little social work training, so I’m a bit bias of course.

Let me back up first though and talk a bit about my experiences with this at work. Motivational interviewing is a method of brief intervention that is meant to help motivate people to change, but it does so in ways that are not pushy and never judgmental. Many of the underlying principles of motivational interviewing come out of person centered therapy as developed by Carl Rogers. I, myself, am a huge Rogers fan. His theory for psychotherapy is that change for people comes through unconditional acceptance and positive relationships, and so that is the primary purpose of a psychotherapist- to provide that unconditional positive regard and warm relationship.

Motivational interviewing comes primarily from the substance abuse field. It is a method of working with someone who maybe is starting to see the problems with their substance use but often are not ready to make changes yet. We call this the contemplation stage. And the idea is first off, that you go with what they say and accept it without judgment. There is not judgment about their use, their reasons for use, or their reasons for not wanting to become sober. Of course the motivational interviewing part comes in with emphasizes the change statements they themselves make in order to help them move toward wanting to make changes. But it is NEVER directive. A therapist using motivational interviewing will never direct a client that they need to abstain from substances, or tell them that they are wrong for their reasons for using or the things they like about it or why they don’t see it as a problem. (ie “I don’t want to stop using because I will lose my friends”, “well those people aren’t really your friends then”- this is not motivational interviewing. Motivational interviewing would explore what this means for the client and accept without judgment that they fear losing meaningful relationships to them if they quit using).

Right now I am working in integrated healthcare. So I work with folks with physical health, mental health, and/or substance abuse disorders. A lot of what I do with this is actually applying the concepts of motivational interviewing to physical health disorders. A big one I work with is diabetes. And boy, have I noticed what a huge difference it makes in folks that they are not being judged! If I talk to someone with diabetes that is not well controlled about their diet, often they first thing they say is “I know, I know, I need to stop eating/drinking X” or something like that. They know. They have gotten the lecture many times from doctors and nurses. And those lectures don’t work. The tone completely changes though when I don’t respond by telling them what they have to do, or warning them of all the dangers of not doing what I tell them (the most common approach taken by doctors). From there, they often start talking about their own ideas for how they can make changes that make sense for them.

“I know, I shouldn’t put sugar in my coffee because of my blood sugar. I just can’t stand black coffee and I can’t get going in the morning without my coffee.”

“That makes sense, you need that boost of energy from coffee in the morning but you don’t like the taste of black coffee. And that would be a huge change to go from that much sugar to just black coffee.”

“Yeah, exactly. Though I think I could maybe cut down on the sugar a little bit”

“Yeah, cutting down a little bit would help and it would probably be less harsh of a difference than just trying to drink coffee black when you aren’t used to that.”

And then we explore more about how they feel about this and what their thoughts and plans are. They are used to being told though that they just shouldn’t put sugar in their coffee and that’s not a change that they are ready or willing to make. So they sit through the lectures and don’t do anything differently after.

 

I was reminded of this when I went through personal training at the gym because the trainer I worked with was very directive. And that did not work with me either. I like working out, but personal training made me feel like I was taking a class, with directions I had to follow whether they were what I wanted or not, and with homework and scolding if I didn’t follow directions or didn’t do the homework. (ok, so “scolding” might be a drastic way of phrasing it, but still, it was that feeling of having to do what you are told and if not you are “in trouble” in some sense.)

There were of course a few specific issues I had too. I told her early one what my goal in joining the gym was- about my current limitations, but how I want to regain the former activity and strength I had.

She accepted my comment that I was not trying to focus on weight loss, only to turn around and tell me how I needed to focus on fat loss. As though rephrasing it that way made it different.

Even though my focus was activity she also made nutrition the focus, telling me how I had to stop intermittent fasting. She also claimed this was both the reason I am fatigued all the time (not my illnesses!) and also why I’m fat. I do not react well to people who do not have the same health issues trying to explain to me the right way to deal with fatigue or the magic cure for it. Even someone who also struggles with chronic illness and fatigue, doesn’t mean their experiences are the same as mine.

The thing is, these topics probably could have been covered a lot better using a more motivational interviewing method. First off, motivational interviewing, if I say I am focused on activity more than nutrition we would focus there, not try to keep redirecting me back to nutrition. Advice would never be directive or one size fits all. She could have asked me how to I feel about intermittent fasting, how it works for me, if I want to change it (the answers would be that I feel better eating this way and no I do not want to change that). She could have asked if there were things I wanted to change, what they were, what my barriers to change are, how things might be different without those barriers, how to address those barriers, whatever. I’m not saying my diet is perfect all the time or that I couldn’t eat in a way that is healthier for me sometimes, including eating in ways that help me manage my illness better. I’ve written here before about the struggles of my illness making eating well more difficult, and yet when I don’t it can make my illness worse. It’s a bit of a catch 22 at times, because if I don’t have the spoons to cook, I don’t have the soons to cook. That’s how spoons work.

 

And I don’t mean to sound that mean toward her or anything because I could go through a lot of things I think she also did well working with me! And the reason I didn’t continue with the personal training was mostly financial (and in a related sense spiritual). My point was more so that being on the receiving end of that really had me thinking how much better (in my opinion) things like personal training could be if they utilized more motivational interviewing skills.

Comic shows a man and woman getting married. In the first panel the priest asks “Do you promise to love him in sickness and in health?” The bride answers “Yes.” Second panel the priest asks “Do you promise to love him ’till death do you part?” The bride answers “Yes.” Third panel the priest asks “Do you promise to order your OWN fries if you want them, instead of saying you DON’T want fries, then requesting a ‘taste’ of his, and helping yourself to roughly half of them?” Fourth Panel the bride says, “Wha… who wrote these vows?!” The Groom says, “Just answer the question”.

I saw this the other day, shared on a website, and honestly didn’t think too much into it at the time. Yet it’s been stuck in my head a bit since then, bugging me a bit more over time.

The thing that bugs me about this comic strip is that it plays on a pretty common trope- women want something like fries but don’t order them instead eating a large portion of their (typically male) partner’s serving of that food.

If you want fries, just order your own fries, right?

Why is it apparently so common for women to not just order their own fries?

I feel pretty sure the issue is mostly related to pressure women feel to not be seen ordering too much food or the “wrong” kinds of food. That is the part that bugs me. Makes me mad actually. That we worry, that there is any cause to worry, about being judged if we did just order what we want.

Which to be clear- I order what I want when I eat out. Still, I can certainly relate to worrying about being judged for ordering what I want. Especially because of my size, but also certainly because I’m a woman. Because femininity is associated with daintiness and being small- and so we should be eating small, dainty portions right? Or better yet just not eating those foods at all because food is for some reason very gendered in our society! Burgers and fries? Those are guy foods. Women should order a salad. There is also this social image of women as dieters, where in it almost feels like an expectation that women be dieting, and trying to eat better (and less). Even if we don’t, how normal is it to preface such things with comments about how bad we are being for eating this or ordering that? It’s not the slightest big out of place to hear “I really should get the salad but that burger just looks so good!” To the point that it starts to feel like a social obligation to make it clear we know we aren’t supposed to be eating the burger and fries.

I certainly fall into this. Especially because I do tend to eat a lot in one sitting, particularly since I practice intermittent fasting. When I eat out at a restaurant, that’s often the only meal I eat that day, so yeah, it’s going to be big. It’s just common sense it will be bigger than someone for whom that is one of 3 (or more) meals they eat that day. Because of that I do find myself thinking “I really want to order this, but what are the people I’m with/the server going to think of me ordering that much?” I think more often than not these days I end up at “well fuck what they think, I’m ordering the food I want”, but it’s also pretty clear that this is something a lot of women, myself included, struggle with thinking. I also find myself making comments about it sometimes, like I need to acknowledge to someone that I know it’s a lot of food, or even apologize for that. I remember for instance going to a Coney Island restaurant with a friend who was visiting from out of state, who had never been to a Coney before. Looking at the menu, I really wanted a chili dog. I also really wanted a greek salad. And also chili cheese fries. So what did I order? All of the above. (Also ate all of the above plus half of a big dessert dish split with my friend after. And it was good.) I also remember making some comment to my friend essentially apologizing and saying that I was about to order a whole lot of food for myself.  Which is of course completely ridiculous. I don’t need to apologize to my friend because I’m eating a  lot of food. If I want to eat it, I don’t need to justify it, or apologize for it to someone else.

I suspect though that this is the underlying reason why it is, according to popular culture at least, so common for women to say they don’t want something like fries, and then eat part of their partners. This eliminates some judgement about what the woman orders for herself- not just from her partner, but the (often imagined) judgement from other random people, as well as from herself. “I’m bad for eating this” isn’t just something people say far too often, but also something far too common for women to feel. Yes, we want the fries, but we have years of programming telling us we are bad if we give in and order them or eat them. So you don’t order them, you just eat a few of your partner’s, which maybe ends up being more than a few because damn it you did actually really want the fries.

So, I absolutely agree that if you want fries, go ahead and order fries for yourself! But also, while we laugh about this phenomena of women who won’t order their own fries, why don’t we also consider what we are doing as a culture to make women feel bad for ordering fries?

(Also, I have some frozen fries in my freezer that I am definitely thinking of digging out and cooking later tonight thanks to this post! lol.)

So I just discovered reading another blog that June is apparently is Migraine and Headache Awareness Month, and June 29th is apparently specifically set aside for raising awareness of Chronic Migraines. I’m several hours late but still as a chronic migraine sufferer I felt like I should post something myself. Chronic Migraines are defined as having migraines 15 or more days per month. Without medications my migraines are well over 15 days per month, even on preventative I still typically am at about 12-15 days per month.

Headache is also only one of many symptoms of migraines. Others common symptoms include nausea/vomiting, dizziness/vertigo, and fatigue. These symptoms can also change over time as I’ve learned. I’ve had chronic migraines since I was 10, and it was only within the last several years though that I frequently experienced nausea and vomiting with my migraines.

The above infographic that I found points out that depression and anxiety are 2 conditions that people are at an increased risk for with Migraines. Meniere’s Disease is another, which I’ve been diagnosed with as well. As I’ve been told by doctors, they don’t know what the connection between the two is, but there appears to be one as the majority of meniere’s patients have migraines (the alternate is not true though, as most migraine sufferers do not have meniere’s).

As for triggers, besides weather and stress (as noted in the infographic) other common triggers include bright lights, diet (not limited to caffeine), not getting enough sleep, hormonal changes, and exercise. Some of these are fairly well known for being bad when one has a migraine, but many people don’t realize that not only do things like bright lights (florescents especially) and exercise often make migraines worse when you have them, but also can trigger migraines.

I’ve been working on this post for almost a week I think since commenting on another blog about this topic, but it’s been hard for me because I don’t really know what to say but I want to say something about this.

For those who don’t know I struggle with depression. For me, it’s primarily caused by my other health issues and with that it’s something that sort of comes and goes, and typically it’s bad when my other health issues are also bad.

When I get depressed though, it makes it really hard to stick with eating healthy or working out, or really anything else related to my health.

And probably one reason I wanted to write about this is because I see it minimized so often. People treat making poor food choices when depressed as an issue with emotional eating and discount the difficulty it poses with fitness because working out is supposed to help depression, and these comments don’t really represent my experiences with depression and healthy activities.

The biggest hindrance with depression for me is that when I feel very depressed, I just don’t care about myself, I don’t care about my health, I don’t feel like it’s worth it or it matters to put in effort to do something for myself, and I don’t feel like I’m worth that effort. This part never seems to get brought up. I approach fitness and other healthy behaviors from a place of self-love. I believe that working out should come from loving your body not hating it. Hating my body or hating myself has never been an effective motivation for me to work out or do anything else to take care of my body. And part of depression, at least for me, is feeling worthless. When I feel terrible about myself, it becomes really hard to put in effort to do thing that I’m doing for my benefit.

I don’t struggle with eating healthy when I’m depressed because I’m eating for comfort/emotional eating. I struggle with it because I just don’t care about anything and I don’t feel like I’m worth the effort and usually the less healthy food choices are the ones that take the least effort.

For awhile for me it seemed like the biggest impact for me was on my diet, but that I was still able to push myself through a workout despite it. But actually last night I did an OHP workout and was feeling really depressed and it did not go well at all. I mean, I made it through the main lifts and lifted the set weights for the workout, but didn’t really do any assistance work and just the whole time did not want to be doing it at all. For all the reasons I’ve already mentioned.

And I hear a lot that it’s stupid to not workout due to depression because working out helps with depression- and I’ve certainly experienced that a lot before. But it also doesn’t always. It certainly doesn’t always have any immediate noticeable effect. I did not feel any less depressed after my workout last night than before. And even if it helps, it’s typically not a cure. Maybe the depression isn’t as severe if you keep working out regularly, but for most people it will still be there, and if the depression makes you not want to workout, that is a hell of a thing to fight through all the fucking time.

And I wish I had some advice to finish this post off with, something I could tell other people struggling with this that helps, but I got nothing. I clearly have no simple solution to this because it’s something that I still struggle with.

So I’ve posted before here about the problems with judging poor people for eating “unhealthy” foods. I was thinking about one particular aspect of the ways that eating healthy foods can cost more, in this case not so much in terms of money but time.

I am getting sick of people who suggest that cooking at home totally doesn’t take any longer than fast food.

Bullshit.

Starting backwards in the process, one part I think no one ever seems to consider is clean up. When people talk about how quickly they can make a homemade meal, they pretty much never include the time to clean up. Which in my experience, takes a lot longer.

If I run out and buy fast food, I am using nothing that requires cleaning up. Now counter or stovetops that need to be wiped down after cooking. No cutting boards, knives, pots or pans. And no plates or silverware to eat with.

Part of what got me thinking of this is being able to cook at home and still keep up with all my dishes right now since school is over. Because when I get busy, I am more inclined to order or pick up food, or just eat frozen foods that I can heat up and eat in the container, and the issue for me is less often the time and effort to cook the food than the time and effort required for all the clean up after.

Even when food doesn’t require cooking if it requires any preparation that typically means something that needs to be cleaned, such as a cutting board and a knife.

I also feel like people tend to underestimate how long it takes to prepare meals from start to finish, at least the folks who claim “I can make a whole healthy meal in just 10 minutes”. Even recipes that estimate prep and cook time I feel like often underestimate the prep time…. or I just am really slow at cutting things up, though even if that’s the case it just goes to show that how long something takes you doesn’t mean that’s how long it would take anyone.

And I get underestimating how long it takes. I do that all the time. I never realize how long a lot of things I do take until I’m actually in a time crunch and suddenly like “how on earth does it take more than 2 minutes to run downstairs and get clothes from the laundry and put the clothes from the washer into the dryer?” It feels like it takes no time at all to me, but when I actually look at a clock, it’s a lot longer than I thought.

I imagine the same is often true for prep time in cooking for many people.

And there is definitely a degree of “you can’t assume how it works for you is the same for everyone”. When it comes to cooking time for foods, a lot of foods you can set and do something else for awhile. Of course I have no timer in my kitchen and am bad at setting one of my phone for food so I often leave food and forget about it until it’s burnt. Or I have something in the oven and I’m up every 5 minutes to check on it (in which case I’m not super productive in what I’m doing between checking on it) and often I check on it and it’s not quite done and then check again and it’s burnt, because apparently it was much closer to done than I thought. Even still, I’m not terrible at this and a lot of food I can leave to cook and do other things while it’s cooking. This is not the case for everyone. I’ve known people who said they had to be in the kitchen the whole time they were cooking something or they would always forget about it and burn it. That makes cooking more time and effort intensive if you can’t multitask at the same time.

And then even more time if you don’t already have the food at home to prepare and need to run to the store to get it.

This probably sounds like making a big deal out of a minor issue, until you are living in poverty and exhausted at the end of a long ass day, and you have the choice of picking up some cheap fast food at one of the many fast food places nearby or cooking at home.

*and I really mean many. ever been to Detroit? I’m still shocked a lot of the time at how many fast food places there are around all the time, and I’ve live in or very near Detroit most of my life (23 years by my count). And many of them are even 24 hour unlike the far fewer grocery stores. Access to fast food around here is much easier than access to groceries.

And the fact that fast food often makes more sense for poor folks because not just of the cost but the time and effort when you are already exhausted from the stresses of poverty is a serious public health issue. One that we should be putting in real effort toward fixing, primarily by working to end poverty. Pretending poor people are just too stupid to realize that cooking at home is just as cheap, fast, and easy is not only not true, it’s not helping anything.

I want to talk about something that has been bothering me and that is the moralizing of eating. Not food (that is a different issue), but eating itself. This comes up in terms of the “why are you eating?” pieces of advice around identifying if you are hungry or bored or stressed or sad or eating for any reason other than physical hunger. And let me be clear that I have no problem with this topic or advice on understanding why we eat or crave certain things in and of itself.  What bothers me is simply when this is treated as if we all have some moral imperative to only eat when physically hungry. That it is some sort of sin to eat for any other reason. And that, I do disagree with.

I am all about understanding our relationships with food, understanding why we eat, why we crave certain things, and just all around being better in touch with our bodies and minds. I talked before in my post on intuitive eating that I tend to crave sugary drinks if I get dehydrated and that is really just me being dehydrated and what I really need is water (though I could get this through either plain water or other drinks). Along a similar line I’m all about understanding why I am hungry or craving any particular thing at that time. I think the more in touch we are with our bodies and minds the messages they send us the better off we are.

I also believe very strongly in my life in prioritizing what my time, energy, and mental focus. And I’ve talked a lot here before about how fitness is not my top priority in life, and neither is eating or my body size or any of that.

This means, that sometimes what I’m eating or why I’m eating is not my priority at that time. And I for one am done feeling ashamed of that. I stress eat sometimes. And I know that it’s because of stress, but it also takes energy and some mental focus to go through the “I just want cookies because I’m stressed, I’m not actually hungry” and resist eating the cookies. No, not a lot of energy or mental focus,  but when I’m rushing against a deadline to get a paper done, or proposal submitted on time, or anything else like that, my priority for all my energy and mental focus is on getting that done as well as possible on time. And that means, no, I’m not going to commit the mental resources to avoiding munching on some cookies while I do it. Because at the end of the day, not eating cookies is not that important to me. I don’t really give a damn if sometimes I eat cookies when I’m stressed. I do not think that is a moral failing, a character flaw, or some sort of sin.

And if eating some “junk food” when I’m stressed about getting something important done for a deadline is the reason I’m fat, I still don’t give a fuck. I’m still ok with the fact that I ate those cookies and I’m still ok with being fat.

Taxing Junk Food

Posted: March 12, 2015 in Uncategorized
Tags: ,

Today in my policy class we were talking about the way poverty is correlated with poor health for so many different reasons. I’ve written about this before on the topic of why judging poor people for buying unhealthy food is classist. In class today we were talking about this and moves toward making junk food more expensive, supposedly to get poor people to make healthier choices.

What frustrates me about this is the punitive nature of it. Which is what we are comfortable with, is punishing poor people instead of helping.  We don’t do anything to make healthy choices easier, cheaper, or possible- we just want to punish poor people for making the “wrong” choices.

Of course the idea of taxing them is nice, because we really, really like secretly regressive taxes. Sales taxes are regressive since poor people spend a higher portion of their incomes, compared to wealthier people who save and invest higher portions of their incomes. Lotteries are also regressive- they are used more by low income people and marketed to low income people. John Oliver talks about the way lotteries are marketed and mentions how one is marketed like a savings account for kids college funds, but is really just a gamble that probably provide nothing to his kids college. But the thing is, that works be cause they are marketing to people who can’t afford savings for college. He also notes that on average people pay only a bit over $100/year on lottery tickets- that’s not going to cover tuition for  one kid, let alone several kids and grandkids. Not to mention poor folks who don’t have much to save are less familiar with financial systems and savings/investment options (count me in that too), and many of these accounts can require a rather high minimum starting amount. Far more than the $1 lottery ticket.

So this idea of charging more or taxing “junk food” does nothing to address the systematic reasons eating healthy is not affordable to poor people. It does nothing to change a poor person’s access to kitchen appliances (fridge, stove, et cetera). It does nothing to address the issue of fresh food spoiling sooner, and the difficulty this provides with longer times to get to a store selling safe, fresh foods. It does nothing to address food deserts and the way in poor neighborhoods people may be forced into buying food at gas stations , party (liquor) stores,  and other places that don’t sell fresh healthy  foods, or they do but they are overpriced and often spoiled and unsafe to eat.

No, instead taxing unhealthy food does we like to do- punish poor people for being poor, without providing any real solutions.

Intuitive Eating

Posted: March 10, 2015 in Diet
Tags: ,

[Image says: One zen student said, “my teacher is the best. He can go days without eating.:” The second said, “My teacher has so much self-control, he can go days without sleep.” The third said, “My teacher is so wise that he eats when he’s hungry and sleeps when he’s tired.”

I was first introduced to intuitive eating by a therapist as something she recommended for treating (in conjunction with therapy and other skills) disordered eating behaviors. It’s also very common I’ve found among practitioners of HAES.

I would not say that I practice intuitive eating myself (kind of counter I think to tracking macros), but still I was thinking about the topic.

Intuitive eating, as I understand it (and I certainly am not claiming to be any kind of expert) is about being in touch with your body and it’s needs and acting on that. A lot of people talk about this in terms of trusting your body.

I hear a lot of criticisms of this, that basically amount to a belief that it’s ridiculous to think we can trust our bodies. That our bodies are terrible at saying what they need or don’t and thus we have to force out bodies to fit how we think they should work regardless of the messages your body is sending.

The thing that got my thinking about this is my experience with my health conditions and the way I act around it. I was thinking about my diet/what I eat. When I’m lifting I tend to track what I eat- I want to make sure I get enough to eat and that I am getting enough of the right things (mainly enough protein), because I want to build muscle. This is where I do not practice any form of intuitive eating and I would not trust my body to tell me how much protein it needs to build muscle.

But during times when I am not working out much due to being ill I don’t really make sure I’m tracking what I eat, but I’m also not eating much. Shockingly, I simply don’t feel hungry enough to eat a lot of food when I’m not as active. So naturally, the less active I am the less I tend to eat.

There are other limitations to “trusting one’s body” I think. For example, I know that if I let myself get dehydrated I will start craving pop or juice- any kind of sugary drink, when really water meets what I need just as well. On the other hand, this really does fit perfectly with intuitive eating, as it has been described to me, because it is about understanding your body and the messages it is sending. Learning that when I start craving sugary drinks it means I’m getting dehydrated. this applies to all messages about food and hunger our bodies send.

It also reminds me of another conversation I had recently about letting go of recommendations/rules about how we are “supposed” to eat. Intuitive eating and listening to your body’s signals isn’t just about listening to when your body sends signals of hunger, but also when it doesn’t.

I’ve mentioned before practicing intermittent fasting. A large part of this is because it fits well with my own natural inclinations. I spent a lot of time in my life forcing myself to eating breakfast even if I wasn’t hungry because of being told that you need to eat breakfast, and a big breakfast, even if you don’t feel hungry, because if you don’t then you will end up eating more total because later on you will be so hungry you will eat too much. Just like you are “supposed” to eat 6 or so small meals a day instead of big ones. Neither of these ever worked for me. I was no less hungry in the evening for eating big breakfasts, and eating small means 6 times a day just gave me 6 times a day I felt like I couldn’t eat until I was full.

Intermittent fasting works much better to me. It fits what works for my body. I’m not typically hungry first thing in the morning. And a lot of the time I get busy with whatever I have going on, it’s not till dinner time that I get around to eating. And I would much rather eat one large meal for dinner where I can eat until I am actually full, than eat a bunch of small meals.

I’m not saying this is the one right way to eat. Rather, I’m saying that I think we need to let go of the idea that there is one right way to eat. If eating small meals throughout the day works for you, go for it. I think most people do need to get better in touch with their bodies though. I know a lot of people who talk about how if they don’t eat for too long they don’t feel well, and so they do well eating small meals more frequently. That’s great! They are doing what works for their body and makes them feel good. I feel good listening to my body’s signals though where I wait until I’m hungry, even when that means going long periods between eating. Pay attention to what makes you feel healthiest, and go with that over any stupid “rules” about what is supposed to be best.

I read a comment online recently from someone saying they would not be as bothered by doctors “prescribing” lifestyle changes- diet or exercise changes, if they were actually done in a very specific way.

It got me thinking about some of the issues with these lifestyle prescriptions, and more specifically how we treat health.

Now, if you’ve read my blog before you know I’m not fan of measure the success of such lifestyle changes by weight loss, but I certainly think that diet and exercise have a tremendous impact on overall health.

The first problem I think this person did touch on- doctors are often vague about what it meas to eat better or exercise more, doctors don’t often get a lot of training on those topics, which also means that even if they are more specific they may not be basing those recommendations on any research demonstrating the effectiveness of that. If for example, there is research indicating exercise can help with condition X, we would need to know exactly what sort of exercise was shown to be effective- type, intensity, duration, and frequency. Otherwise what is implemented by the patient may not line up with what the research shows to be helpful at all.

An even bigger problem I think though, is the financial issue. A doctor can “prescribe” these changes, but for the most part insurance won’t pay for it. So if you have someone with condition X and research showing that 30 minutes of moderate intensity exercise a day is just as effective at reducing symptoms as the standard first line medication Y. But if the patient with condition X would be paying much more for a gym membership or exercise equipment than generic medication Y that insurance pays the majority of the cost of, that creates an incentive for the patient to just want to take medication Y.

I hear people complain that people are just lazy and want the easy solution- “just give me a pill”. But this completely ignores the structural influences. People don’t exist in vacuums. I think it is better to try lifestyle adjustments like diet or exercise changes that are shown to be effective before medications, cutting out a food allergen, or walking 30 minutes a day, typically has fewer side effects than pills. But for people to choose these over pills, we really need structural changes to how we approach healthcare. If our healthcare systems favor pills over lifestyle, then how can we expect that patients as a group will be different?