5 Ways a Dietitian Can Help Reduce Binge Eating

Posted on February 13, 2018February 7, 2018 by Alison Pelz, LD, RD, CDE, LCSW

Whether you are struggling with binge eating disorder or bulimia nervosa, a dietitian who specializes in eating disorders on your treatment team is a must.

If you have an eating disorder, you probably already know a lot about food. You probably know how many calories, how much fat and how many sugar grams are in different foods. You probably are an expert on the latest diets. You may be asking yourself, “Why do I need to see a dietitian for my recovery if I already know so much about food?”.

Remember, eating disorders are not really about food. Food and eating disorder behaviors are used to cope with stress, relationship struggles, worry, and other uncomfortable feelings.

Therefore, knowledge about food is not the issue, but rather how you relate to food.

5 ways that a dietitian can help in binge eating disorder and bulimia nervosa recovery:

1. Reduce chaotic eating associated with binge eating.

Binge eating can cause chaotic eating patterns in several ways. After a binge, you may find yourself not wanting to eat for several hours or skip the next meal. This turns into a nasty cycle because skipping meals can then lead to more binge eating. If you tend to binge (or binge-purge) at a certain time of the day, let’s say in the evening, then you may tend to restrict food during the day in order to “make-up” for binge eating later on in the evening. Again, restricting calories can exacerbate the binge eating. A registered dietitian will help set-up a meal plan to reduce the food chaos.

2. Ensure that you are eating enough at meals and snacks.

Studies show that food restriction leads to binge eating. Our bodies want to ensure that we get enough food. If we chronically underfeed it at certain times of the day then when we have access to food, we will eat more than we made need at that moment. Along with helping manage your chaotic eating style, a dietitian can help ensure that you are eating enough throughout the day with enough variety to help reduce binge eating.

3. Challenge mistaken beliefs about food.

A dietitian can help you sort out science from fad when it comes to eating, food, weight, and shape. There are a million messages about food on TV and social media and from well-meaning friends, family members, and co-workers. On any given day, it seems like the messages about which foods are “good” and which foods are “bad” to eat are moving targets. During the 90s, fat was the culprit. Now gluten and carbohydrates have a bullet on their head. Not only do we get messages about which foods to eat, but also how to eat them—eat these foods; not these foods; eat 6 small meals a day; don’t eat in between meals. You get the point. There are so many messages out there, it’s no wonder America is plagued with eating problems.

Challenging mistaken beliefs about food can reduce feelings of guilt and increase your confidence about food choices, which ultimately help reduce binge eating and the binge-purge cycle.

4. Learn how to eat “binge foods” without fear.

A dietitian can help you feel more confident around foods that on which historically binged. Once your eating pattern has become less chaotic and you are feeding yourself more regularly throughout the day with foods you enjoy, you will work with your dietitian on “challenge foods.” Challenge foods are foods that you avoid (due to fear of binge or binge-purge), foods that you regularly binge on, and/or foods that cause a lot of anxiety before or after eating them.

A dietitian can work with you several ways to do this, such as doing an in-the-office food challenge (yep, eating your challenge food during the appointment) and practicing eating the foods with others.

5. Intuitive eating.

One of the last steps of nutritional therapy for binge eating and bulimia nervosa is learning how to listen and respond to the internal cues your body provides. In other words, you will learn how to trust your body, not some diet, when it comes to feeding yourself.

Note: Consulting with a registered dietitian who has experience treating eating disorders is a must. While a registered dietitian is one member of the treatment team, a medical doctor, counselor, and a psychiatrist are also needed.

Forget About Diets To Improve Your Health This Year

Posted on January 9, 2018December 21, 2017 by Alison Pelz, LD, RD, CDE, LCSW

It is that time of year: Everyone’s talking about their New Year’s Resolutions. Many headlines promote the “newest” diet trends to “jumpstart” weight loss in 2018. A 2014 study found that “stay fit and healthy” and “lose weight” were the top contenders as New Year’s Resolutions, at 32% and 37%, respectively.

In my blog post, 5 Reasons Not to Diet in 2017, I encourage readers to stop dieting in order to feel in more control of their eating and health.

So, maybe you are concerned about your health. Maybe you have diabetes or a family history of heart disease, or maybe you are noticing that it is harder to move in your body at its current fitness level.

Maybe you are so tired of dieting that you just can’t diet anymore (the diet is the problem, not you), or maybe you are recovered from an eating disorder and you know that dieting is a risk factor for relapsing.

Choosing not to diet for weight loss doesn’t mean ignoring your health.

Dieting sets-up this all or nothing thinking. You follow the diet, watching meticulously what you are eating to lose weight. Dieting usually is paired with an exercise routine. On the other hand, if you aren’t dieting, you may have developed a “screw it” attitude. You don’t pay attention to how you eat and you don’t exercise until you are on your next diet. (By the way, this is no personal failing of your own- studies show that dieting doesn’t work long-term).

The third option is not often presented by the medical community or diet programs. This option is to eat nutritious foods, move your body in a way that feels good to you, get enough sleep, get medical screenings or check-ups as recommended, and so on in the spirit of health, not weight loss.

You may be thinking, “But don’t I need to lose weight to be healthy?”

No!

This answer never wins me any popularity contests. There is not great scientific evidence to show that having a larger body causes medical problems. I would argue that the disconnection from our bodies that dieting causes is what leads to health problems. Additionally, modern medical science has NOT come up with a non-surgical intervention or treatment for weight loss that works long-term (meaning the ability to keep the lost weight off).

There is good evidence that dieting can be a predictor of weight gain and problematic eating behaviors such as purging, binge eating, or other types of eating disorders. Additionally, it is natural for folks to stop exercising if it isn’t producing weight loss, despite the cardiovascular, muscular and mental health benefits of exercise.

There is evidence that health-promoting behaviors (weight is not a behavior) do improve our health.

Health as a Value

If you are reading this, I am guessing that one of your values is health. What is a value? A value is what you judge to be important in life. Examples of values include family, being financially independent, or acting in an ethical manner. Values can help us guide our behaviors. Honesty is a value that most of us share, so we do our best to not lie, steal, or cheat.

Oftentimes goals are confused with values. A goal is something achievable such as running a marathon or having a fancy car. With values, there is no completion date, and they can’t be crossed off our to-do-list.

When you put on your seatbelt or wear sunscreen you are practicing a behavior that is guided by your value of health. Every time you put on your seatbelt you are reducing your risk of serious harm when you drive. Going to the doctor for physicals and screenings or going to the dentist is another behavior that supports the value of health.

You may be asking yourself, “Isn’t body weight a value?” Unlike wearing your seatbelt, weight is not a behavior or a value. It is a biomedical marker. Lowering your cholesterol is not a behavior. You do things like take medication, eat a heart-healthy food or exercise to try to reduce your cholesterol levels. Eating nutritious food and moving your body in a way that feels good to you are behaviors that support a value of health.

What to do:

Get clear on your values around health.

Why do you value health? Maybe you love to travel and having good health allows you to do this. Maybe you want to have a long-life in order to see your children or grandchildren grow-up. The media or diet programs encourage you to “take charge of your health”, but these are vague statements that are only helpful in the short-term, not the long-term.

Set realistic measurable goals that support your values.

Getting physical movement in for a certain amount of time each week is an example of a concrete and measurable goal. Other goals include getting a mammogram once a year or getting a certain amount of sleep every night.

Set meaningful goals that align with your values.

Imagine that one of your values is traveling and you have a vacation coming up that requires a lot of walking. If you achieve a certain level of physical fitness you will be able to enjoy your vacation more. Focusing on the reasoning behind your value of health will help make the exercise more meaningful even though it may be uncomfortable or inconvenient at the time. (Instead of, “I should go exercise because it is good for me.”)

If you notice that you aren’t achieving your goals, consider if the goals you are setting are really meaningful to you.

Do you actually want to do these things, or do you just think you should want to? Set goals that are achievable (sometimes we set goals that are too big and we get overwhelmed). Consider psychotherapy if you think you may have an eating disorder, depression, anxiety, or other mental illness.

Finally, check out these other resources to learn how to ditch dieting & make peace with food: Intuitive Eating and Health at Every Size.

Are You an Emotional Eater?

Posted on October 25, 2017December 29, 2017 by Alison Pelz, LD, RD, CDE, LCSW

We are emotional beings.

As we go through our day we experience a wide range of emotions. We feel sadness, excitement, fear, anger, happiness, and the list goes on. That’s normal. We experience emotion while we are going about our daily lives: at work, talking with friends, relaxing and of course while eating.

So, it is normal to experience some emotions while you eat. You may have an emotional response to the meal, to the food itself, or to something else that is going on in your day.

Does this make you an “emotional eater?”

No.

Simply put, emotional eating is habitually eating in response to emotions (all kinds whether they’re happy feelings or distressing feelings) when not physically hungry.

You may be familiar with other habits people use to cope with uncomfortable feelings. These may include excessive spending of money or playing excessive amounts of video games, for example.

Thinking about, buying & preparing food, and eating food to cope with usually uncomfortable feelings is really the hallmark of emotional eating.

Emotional eating can be hard to figure out because we need food to survive! Furthermore, some health conditions and medications can cause an increase in appetite. Increased or decreased appetite is a symptom of depression.

Anyone who lives in Western society, unfortunately, is very familiar with all the mixed food messages we get in the media (for example, foods that we should and shouldn’t eat), which complicates it even further.

Emotional eating has nothing to do with being weak, unmotivated, or not having willpower. Some of my clients are incredibly successful and determined folks. I know this may sound backward, but people who rely on food to get through stress are able to be successful because of their emotional eating.

How do I know if I am an emotional eater?

“Emotional eater” is not a diagnosis per se. But, it can be a part of an eating disorder. If you think that you have an eating disorder, please seek treatment immediately.

It is normal to eat when experiencing emotions because we are emotional beings.

Remember, emotional eating is eating in response to feelings that you think you can’t handle, so you turn to food to help you feel better.

Emotional eating usually makes you feel good in the short-term but worse in the long-term.

Emotional eating is problematic if it is one of the few (or only) coping skills that make you feel better.

Emotional eating becomes problematic if it is pervasive and negatively affects your life. This includes your physical health, social life & relationships, and/or career or academics.

Some tips to reduce eating in response to emotions:

Often people try to diet or follow some sort of a meal plan to make the emotional eating go away.

This almost always backfires.

Remember, the food is used to cope with feelings, so the feelings need to be addressed, not the food itself.

Notice your feelings. Right now, go ahead and try to identify a feeling that you may be having. Are you experiencing feelings of worry, hopefulness, anger, or contentment?

As you go through your day, notice the ebb and flow of feelings. Feelings come and go throughout out the day.

Oftentimes, there is a body sensation connected to a feeling. For example, when you feel worried, you may feel it in your stomach.

Try not to judge your feelings. Often we deem our feelings to be either “good” or “bad”. Happiness, contentment, joy, and hope are often labeled as “good” emotions. Fear, anger, and jealousy are often identified as “bad” emotions. When we judge our feelings, we tend to focus on eliminating the negative and pursuing the positive.

“Negative” feelings are a normal part of life. Once we learn to accept this and tolerate them we don’t have to use food to cope.

Now that you have named your feelings, you may be able to identify how it feels in your body. There are several ways to cope with intense feelings instead of using food.

Sit with your feelings. Try to accept that you are having an intense emotion and notice that it will pass.

If this feels too uncomfortable try these methods:

Distraction; which includes thinking or doing something else to not think about feelings. Distraction can include reading a book, listening to music or a podcast, watching TV, going out with or calling a friend or family member, or hobbies, to name a few. When choosing a method of distraction, consider using a method that is not harmful (such as excessive drinking, spending, etc.).

Work through your feelings by talking to a friend or family member, writing in a journal, or listening to music that may mirror the feelings you are feeling.

If you are reading this, then most likely you have been using food to cope with life for quite awhile. Often this habit is developed in childhood. So, be patient with yourself. It is going to take a lot of practice to cope with emotions without using food.

If you live in the Austin area, please call (512) 293-5770 for a free 15-minute phone call to see if my services are right for you.

This article is for informational purposes only. It does not replace mental health or medical treatment if needed.

Is the Good-Food-Bad-Food Trap Ruining your Relationship with Food?

Posted on July 26, 2017December 29, 2017 by Alison Pelz, LD, RD, CDE, LCSW

I can’t eat that because it is bad for me” or “That is a good food, so I can eat that anytime I want” are examples of the “good-food-bad-food trap.” They are common statements among the general public, and particularly dieters.

The good-food-bad-food trap is just as it sounds—dividing foods into different categories deemed either good to eat or bad to eat. Dieting and public health campaigns really reinforce this all-or-nothing thinking with a series of rules about what we should and should not be eating. While the intention behind this notion is good, it is actually quite problematic in practice.

Continue reading→

Breaking-up with Dieting (For good.)

Posted on July 12, 2017December 29, 2017 by Alison Pelz, LD, RD, CDE, LCSW

Starting a new diet can feel like starting a new romantic relationship—exciting, hopeful, and thrilling at first. Dieting promises that when the weight is lost, life will really begin.

The reality of dieting.

Just like a new relationship, starting a new diet usually feels really good. There is ease in following a new diet because you don’t have to feel preoccupied about what to eat. While there is effort in planning meals, there is this sense of relief that goes along with it. This dieting euphoria can last for a while. Just like a new relationship, starting a new diet usually feels really good.Continue reading→

6 Myths About Anorexia Nervosa That You Need to Know

Posted on June 27, 2017December 29, 2017 by Alison Pelz, LD, RD, CDE, LCSW

When you think of Anorexia Nervosa what often comes to mind is a young emaciated girl. These images are what we see in the popular media. Unfortunately, these images are misleading and confusing. Media images contribute to myths about anorexia nervosa and what it really is and “looks” like. Below there are several common myths debunked about the disorder

What is Anorexia Nervosa?

Anorexia Nervosa is characterized by an intense fear of being fat (or gaining weight) despite being at a low weight, having a low caloric intake which leads to weight loss or poor weight gain/growth in children and the inability to evaluate own body size and shape. Meaning the sufferer thinks their body is larger that it is.Continue reading→