Press Release: 01/13/2019

PRESS RELEASE: 1/13/2019

Resilience Center is pleased to announce the beginning of an innovative new program: Resilience RecoverED: Intensive Outpatient Program for Disordered Eating, opening on January 17, 2019.

Resilience RecoverED is a program for adults who are at least 18 years old and who have a problematic relationship with food behaviors, which may include undereating, binging, purging, overexercise, to the point of interference with mental, physical, social, and/or economic health.

This intensive program is designed to help clients diagnosed with an eating disorder to gain insight into the neurobiological, emotional, and physical aspects of disordered eating, to change problematic behaviors, to build and strengthen a support system, and to learn to care for themselves in new, more resilient, ways.

The 6-week program includes weekly individual therapy, nutrition counseling, and both skills-based and process groups.

The first of its kind in Oklahoma, the program alternates between being offered on site at the Tulsa office of Resilience Center and online, using HIPAA compliant software.

“If someone can stream Netflix; has a computer, laptop, or tablet with a webcam; and a pair of headphones, then they have the technological capability to participate in Resilience RecoverED,” says co-owner and eating disorder therapist, Ryanne Mitchell, LPC.

This is the first telehealth intensive outpatient program for eating disorders in Oklahoma, and it is the hope of Resilience Center to be able to provide higher level, intensive services for individuals in need, regardless of proximity to Oklahoma City or Tulsa (the only two cities that currently offer this service).

For more information, call 918-861-4973 or visit www.resiliencecentertulsa.com/iop.

MEDIA CONTACT:

Ryanne Mitchell, MA, LPC

Resilience Center

rmitchell@resiliencecentertulsa.com

918-861-4973

Tele-whaaaa?

I don’t flatter myself to think that there are readers who have noticed, “hey, Ryanne hasn’t blogged anything in a while,” but I’m giving you my explanation anyway!

There has been radio silence as I have furiously researched, written policies and procedures, scoured the best curriculum components, created forms and guides, marketed, and untold other tasks all in preparation for something super exciting…

(are you in suspense??)

Starting next month, Joleen and I are launching a telebehavioral health intensive outpatient program for eating disorders (THE FIRST OF IT’S KIND IN OKLAHOMA!). Using HIPAA-compliant telehealth software, participants will be able to access comprehensive, specialized eating disorder treatment from across the state.

To say I’m excited is an understatement. This has been a dream since I started working at the inpatient program at Brookhaven and realized there was a figurative treatment cliff I was pushing my patient’s off of upon discharge. There just are not many step-down treatment options (or step up if outpatient hasn’t been working for you) in Oklahoma for adults with eating disorders, and not many people can afford the high cost of private treatment programs out of state.

We are launching our first 6-week pilot program on November 6, although enrollment is rolling. The group will be limited to 2-6 participants, so if you, a loved one, or a client are in need of affordable, accessible specialized eating disorder treatment, please reach out! You can get more information about the program and admission criteria in the REGISTRATION GUIDE, emailing IOP@resiliencecentertulsa.com, or calling 918-861-4973.

Sick Enough: Guest Blog by Joleen Wilson, RD

Thin Bias in Eating Disorder Treament

by Joleen WIlson, RD

When you picture someone with anorexia nervosa, what comes to mind? For many people, it may be an emaciated white female whose in her early 20’s. She appears pale and disheveled, and may have a feeding tube in her nose.  Not a lot of lay persons will say otherwise. More times than I care to count, I’ve had eating disorder clients tell me that they are not sick enough. Where the majority of this disillusionment stems from is the typical body type thought to be associated with anorexia nervosa. The aforementioned example is the traditional anorexia that many of us are familiar with. However, I’m here to say that anorexia (or any eating disorder for that matter) does not have a look. You cannot look at a person and determine whether or not they have a restrictive eating disorder. It takes some hard digging into their daily patterns and thoughts around food and exercise to diagnose that stuff.

Eating disorders pop up across the board. I’ve seen men with eating disorders. I’ve seen black females with eating disorders. I’ve seen gay men with eating disorders. I’ve seen women in higher weight bodies with anorexia, which is the ED I’m discussing today. I’ve also seen (for another podcast) women and men in higher weight bodies who think they have binge eating disorder, when really they have a restrictive eating disorder that forces them to binge eat (as a response to restriction). More often than not, these are the patients that are falling through the cracks. These are the patients who aren’t getting diagnosed and aren’t getting sent to treatment until it’s too late. Even if they are sent to treatment, insurance companies will frequently cut their days short because they either weight restore or they were in a normative weight category to start with.

For those of you out there who are reading this and have an active eating disorder and can identify with one of these groups I’ve mentioned, you ARE “sick enough”. Oftentimes, you are more sick and treatment resistant than those with the stereotypical body shape that anorexia is known for because of the constant battle in your head and the resistance to seek help. Please do not let this be a barrier for you. Find a clinician that “gets it” and is willing to work with you and your struggles around weight and food. Everyone deserves eating disorder care, regardless of their body size, gender, sexual orientation, or race. Eating disorders show up in a variety of marginalized populations. The reason we do not “see” them is because we aren’t looking for it. Doctors aren’t always looking for it. Dietitians aren’t always looking for it. Therapists don’t always see it. If you need help, be sure to reach out.

Let’s get into eating disorder treatment as it exists today. Some of the above situations can be classified by the DSM-5 as “other specified feeding or eating disorder, OSFED”, previously known as atypical anorexia. Right now, there are few treatment programs and insurance agencies who sympathize with this diagnosis. In essence, they are colluding with the notion that you are, in fact, not sick enough. This is rubbish. BMI is rubbish. Anyone who is suppressing their natural body weight by restricting, overexercising, engaging in substance abuse or otherwise to suppress their appetite (regardless of BMI) is “sick enough”. This is what keeps many people from treatment that they need, or keeps them from going back to treatment. They are either told by their medical provider that they aren’t at a dangerously low weight, or they go to treatment and see others who are in fact at a dangerously low weight. And this further drives their “not sick enough” mentality! They believe that their weight holds value, and if it is higher, that they must diet harder. Wrong! They simply need a treatment paradigm that accounts for this. Unfortunately, many insurance reimbursements are driven by weight, NOT behaviors. If their weight is stable or restored, they’re typically discharged to a lower level of care despite their readiness to do so. This very fact is the reason why I see so many patients with anorexia on an outpatient basis who cannot completely buy into the fact that they have anorexia and that they are, IN FACT, very sick indeed. If you skip meals, feel dizzy, and/or have organ dysfunction that stem from an eating disorder (bradycardia/tachycardia, arrhythmia, low BP, slowed digestion, kidney failure, and others), then you ARE sick enough. F the labels. Get help today.

EDulting: Houston Special

This month Tara and I had the opportunity to chat with Kylie Mitchell of www.immaEATthat.com. As total fan girls of her blog, we were super excited. Kylie has been blogging her experience navigating postpartum body changes, which resonates quite a bit for me right now. You guys. My twins just turned one. ONE! Truly the longest/shortest time. I digress...

I happened to be in Houston to present a seminar on eating disorders and postpartum mood disorders at the Postpartum Support International Conference. It seemed a great chance to connect and to pull from both our collective current/previous experiences with walking out recovery in the postpartum period. We are so grateful that Kylie was available and willing to jump into this kind of conversation with us. 

Think this won't be relevant for you? There is something here for everyone! Our conversation also wanders to how to pick advocacy battles and ways to check yourself when using gentle nutrition in recovery, which are relevant for anyone in recovery.

We hope you enjoy. 

 

Prefer to watch? You can also catch it on YouTube.

EDulting: Beach Body Bullshit

It's that time of year. It seems you can't shake a sarong without hearing some diet culture BS around getting "bikini ready," and the fad diets are in full force. The unfortunately reality, is that often it's really "relapse season" for many who struggle with eating disorders/disordered eating.

The transition from Spring to Summer brings expectations of more revealing clothing, outdoor activities, and changes from more structure (school, work, kids), to less structure. All of these, on top of the extra media focus on diets and bodies, can be extra stress and triggers for those working on recovery from an eating disorder (heck, for all of us).

This month we tackle these triggers, the frustration with how the fitness/wellness industry is often the diet industry in disguise, and what to say to the haters. 

EDulting is hard, but we can do hard things. 

If watching helps you listen, here is a link to the YouTube video: https://youtu.be/QG20tfRAMMY

EDulting: Embodied Recovery

Tara and I were so pumped to have Tracy Brown, RD as a guest this month on our podcast! Tracy is a somatic nutrition and body image coach and has a wealth of experience and knowledge in helping people come home to their bodies and heal their relationship with food and weight. In this episode we discuss the process of becoming connected with your body during recovery as both a source of important information, of joy, and as a way to live out body acceptance.

Like many practitioners who value embodiment, I believe the self is inseparable from the body, that the body isn't just "a vehicle for transporting the soul," so it's refreshing to connect with someone so like-minded.

(By the way, I hate that phrase. It's often invoked when trying to convey the importance of taking care of one's body, like you would a car. The problem I have with that is continuing to view my body as an object, something to be tinkered with, maintained, and repaired without regard to the essential interconnectedness and interdependency of mind, body, and spirit. Last I checked, your mind and spirit were not dependent on your car to stay alive and learn about the world and yourself.) 

 

Tracy also has some great resources and tools if you want to learn more: 

Body Bashing Decoder: https://tracybrownrd.lpages.co/opt-in/

TBRD.jpg

Walk + Talk Therapy

Many of us struggle to get any time outside of our homes, offices, or cars (I miss you, vitamin D!). We struggle to incorporate gentle movement into our day. Some people even struggle with the intensity of sitting across from someone in the office, or with the intensity of having to sit in general for an hour. Wouldn't it be great to have the option to be outside, enjoying nature and the physical and emotional benefits of movement?

In my practice I frequently treat eating disorders and disordered eating. Thus, many of my clients have a punitive relationship with movement. They use it to punish themselves, "earn" calories and food, or in attempts to control body shape. Walk + Talk sessions are a way to introduce gentle, mindful (dare I say, joyful?) movement with support. Research also shows that physical movement can increase blood flow and access to different parts of the brain, which may offer a new perspective on old thinking. It also offers an experiential environment to learn new grounding techniques for anxiety and PTSD while building the mind/body connection.

I also work with new moms, and walk + talk sessions are well suited for moms, as mom can bring baby in a stroller or carrier and have 2 for 1 self care: therapy and a walk outside!

Heads up! Walk + Talk sessions may not be suited for everyone. Interested clients will be assessed for safety, confidentiality concerns, and medical stability prior to participation. 

FAQ:

Q: Where do walk and talk therapy sessions happen?

A: My office is close to many local parks and trails. We would meet at the park of your choice, then head out for our walk. 

Q: What should I wear?

A: You should come dressed in comfortable clothing appropriate to the weather and shoes for walking. 

Q: What about bad weather?

A: We will discuss a back-up plan before scheduling our first walk & talk session. The back-up plan can include using my office or having an online session. If you prefer to walk outside, I am not bothered by light rain, but it will always be your choice!

Q: Is this a cardio workout?

A: No! This is a leisurely walk and you can set the walking pace that allows you to comfortably talk. I am NOT a physical trainer and this is NOT an exercise plan. While we walk we stay focused on talking, but also reap the benefits of leisurely physical movement and being outside!

Q: Anything else I should know?

A: These sessions are the same as typical office sessions as far as length, scheduling, and cost. The biggest difference is confidentiality. Since we are walking in public, I am unable to control what others can hear or who we see. Generally this is not a problem, as it is not obvious that I am your therapist. Prior to a walk & talk session, we will review an informed consent for walk & talk sessions and discuss how to handle possible scenarios. If you ever feel uncomfortable with walking for any reason, we will stop and resume in office or online sessions.

Ready to learn more? Call 918-861-4973.

EDulting: Never Diet Again

It's podcast time! This month Tara and I stepped out of our comfort zones to do a video option for your podcast consumption. We had planned to broadcast live, but as usual, I did not to a test run, and we ran into some snags. And then more snags. 

We were able to salvage the video, but the audio is a tad off for the first several minutes. I tell myself we are modeling comfort with imperfection, wabi sabi, and cross my fingers that our audience is as forgiving as I imagine you to be. 

Enjoy some serious smashing of diet culture and mythbusting!

(Links to references in the show are listed below.)

Ryanne and Tara have soaped up their boxes to tackle the pitfalls of cyclical dieting and (hopefully) convince you to never diet again. Links to references mentioned on the show, as well as the podcast download and past episodes are available at www.resiliencecentertulsa.com/blog. ***The audio will sync up after a few minutes!

The Function of Fitness

What is the function of fitness?

If you look at the cover of Shape Magazine or other so-called “fitness” publications, you would think the function of fitness is to burn fat, have a toned body, flat abs, lean legs, and a firm butt. Literally, one headline calls out “Look Hot!”

shape look hot.jpg

Women’s Health doesn’t fare much better. Headlines offer a ride on the “Hot Body Express,” promising you can slim down and firm up fast if you only follow this tear-out workout routine for 14 days.

Beyond the disturbing message in all of these headlines that our bodies are mere sex-objects rather than the vehicle for our lives (one soapbox at a time, amiright?), we are totally missing the point of exercise and the function of fitness.

Here are some actual functions of fitness:

  • Lower blood pressure and heart rate
  • Strengthen muscles to improve chronic pain conditions
  • Increase bone density
  • Decrease harmful effects of stress hormones
  • Improved lung capacity and function
  • Increased endurance to chase toddlers
  • Better coordination, flexibility, and agility
  • Improved balance and spatial awareness (proprioception)
  • Better sleep
  • Stress management and improved mental health
  • Improved immune system functioning

Here’s the thing, though. Those benefits start to disappear if you are underfed (eating less than required) or over-exercising.

So how do you know if you’re getting too much of a good thing?

Normal exercise involves two critical behaviors: 

  1. Adequate rest. Additional rest when injured to achieve full recovery.
  2. Taking in adequate energy in correctly timed intervals to stay strong and at peak performance at all times. Any accidental undernourishment is quickly rectified. “

Translation?

If you are exercising every day for hours and/or not eating enough to sustain your activity (meaning, eating more than the bare minimum required, since you need the extra energy), then it may help to take a look at your relationship to exericise.

Below is an excerpt from an ED Institute article: Exercise as a Way to Restrict

Here are the six facets that are used to determine whether anything has become an addiction (including exercise): 

  1. Salience: does the activity become the most important one in a person’s life? Do they think about it more than anything else? Do they crave it or feel they are suffering without it? As soon as they are not doing the activity are they planning when they can next do the activity? Do they forego other previously pleasant activities in their lives so they can do the activity in question?
     
  2. Mood modification: That’s the subjective feeling of the “high”. The feeling of “in the zone” or “meditative” or “calming”, “neutralizing other stresses”.
     
  3. Tolerance: Needing to increase the amount and time dedicated to the activity to get the same levels of mood modification.
     
  4. Withdrawal Symptoms: Irritability, short-tempered, jumpiness, anxiety when unable to do the activity in question.
     
  5. Conflict: Interpersonal issues arising with loved ones and friends as a result of the activity. Family and friends expressing their anxiety, concern or irritation with the person’s focus on the activity. Intrapersonal conflict where the person experiences guilt or anxiety that she is harming herself and others with her focus on the activity.
     
  6. Relapse: Attempts to avoid or moderate the involvement in the activity are punctuated with repeated returns to the activity at a quickly restored or even heightened level than before.

To recap:

If you feel you can’t get through a day without exercise, you can’t manage your mood without it, you are exercising more and more, you get cranky when you can’t hit the gym, and you keep going even when you are tired or hurting, I have to question if what you’re doing is really about health. Because none of that sounds healthy.

Now, I’m not anti-exercise. I just believe in finding exercise or movement that energizes you and compliments your unique health goals – both physical and emotional. You do not have to “earn” your food in the gym or punish yourself with exercise for eating. The goal of exercise, of fitness, is not to burn fat or have toned arms or to be sexy for anyone else, but to celebrate what your body is capable of and to provide it another tool to stay healthy.

For further inspiration, check out this video smashing body size/fitness stereotypes by REI.

 

The End of Dieting

We all drank the koolaid. It wasn’t our fault, really. We have grown up on decades of ever-evolving, ever-contradictory nutritional advice, all of it seemingly focused on controlling weight, with a touch of health thrown in for good measure. Even worse, weight has been sold to us as a synonym for health, and we bought it, hook, line, and sinker. What a tragedy.

cookie monster gif.gif

Add up all the time, energy, and suffering you have given to this fallacy. The time spent planning exactly what you will eat and when, adding up calories you increasingly do not feel entitled to. The energy you've spent punishing your body. The suffering you have felt by measuring your worth by a number on the scale, feeling less-than, unworthy, or ashamed of your body for existing in its natural state. 

I’m sucker for a redemption story, though, so the tragedies can end there, if you believe these magic words:

Diets don’t work.

You know that old tongue-in-cheek saying about insanity? Doing the same thing over again and expecting different results? I’m pretty sure they invented it in response to dieting. Maybe you already know this, but you keep dieting anyway, imagining the science couldn't possibly apply to you. I’m a former smoker, so I get it. I can’t tell you how many times people would say to me (utterly unsolicited), “you know that smoking will kill you right?” I never did this, but in my fantasies I would drop the cigarette like a snake bit me, stamp it out, frantically shake the person’s hand, thank them gratuitously for this new information, for saving my life, just to see what would happen. My point is, I KNEW smoking was harmful, but I did it anyway. Some of you have heard that dieting and restricting is harmful, and you do it anyway. If that is the case, I hope you don't mind one more pitch for camp non-diet.

I’m going to give you the benefit of the doubt, though. I think that most of you don’t know that diets don’t work. You think you don't work, that your body doesn't work, and you are broken in some way. I’m hoping to free you from that and from every New Year’s resolution to “lose weight” from now on.

I’m going to tackle some of the common things I hear to justify dieting and break down why they don’t work. For the sake of mutual understanding, I’m defining dieting as taking in less energy than your body requires (roughly 2500 calories/day for women and 3000 calories/day for men) and/or restricting or eliminating entire food groups for no medical reason/for the primary purpose of weight loss or weight control. 

You might do this by skipping meals, cutting down calories or portion sizes, using gum or distractions to ignore your hunger, using low calorie replacements, omitting nutrients (like carbs or fats), always choosing the "healthy" option when dining out, not eating after certain times, filling up on water before meals, and so on.

“2500 calories?! My body doesn’t need that much food.”

Out of sheer curiosity, I looked up the recommended daily calories for my 4 year old. It was 1500-1700 calories. Why wouldn’t your body need more energy than a 4 year old’s??

Let’s break down those calories.

Your brain uses roughly 700 calories/day alone. Its primary fuel source is glucose, aka carbs.

Your basic body functions that support staying alive (heart, lungs, etc.) take another 700-1000 calories/day.

The rest of those calories go to giving you energy to think, move, and get shiz done during the day. And yes, even *your* body needs them.

"Weight loss is calories in vs. calories out, so if I cut some calories, I'll lose weight."

Not necessarily, and definitely not long term. 

Our bodies are complex, dynamic creations, so why would something as important to sustaining life be a simple in/out equation of only one factor?  In truth, the equation looks more like this:

Source: www.precisionnutrition.com

Source: www.precisionnutrition.com

So what does all that mean? It means weight gained or lost is determined by these factors minimally (not to mention hormones and role of genetic expression):

Actual calories eaten: self explanatory

Calories not absorbed: Not everything we eat is absorbed. Additionally, some people engage in purging behaviors that decrease the number of calories absorbed. (Fun fact: Calorie absorption begins immediately in the digestive process. Even if you purge immediately after a meal, you still absorb about 50% of the calories. You absorb most calories eaten, if not all, even if you are misusing laxatives.)

Resting metabolic rate: This is the energy required for those "basic body functions that support staying alive."

 Thermic effect of eating: Ever hear of the meat sweats? Eating and digesting energy takes energy.

Physical activity: Exercise and what not.

Non-exercise thermogenic activity: The energy your body uses daily getting shiz done.

All of these are interconnected, and changes to any part will affect the whole, a whole metabolic system designed to keep you around a "set point" weight where it functions optimally. 

“I have a slow metabolism, so I need to eat less.”

Or

“I hit a plateau, so I need to cut more calories.”

In the words of Willie Wonka, strike that. Reverse it. You eat less, so you have a slow metabolism. You need to eat more calories.

Ever had that annoying experience of dieting super hard to only lose a few pounds, or, more infuriating, GAIN weight while dieting? Your body’s not flawed. It’s doing what it’s supposed to do.

Your body doesn’t know the difference between dieting and starving.

Remember that metabolic equation? Here's what happens if you restrict:

Source: www.precisionnutrition.com

Source: www.precisionnutrition.com

Restricting calories suppresses metabolism and thermogenesis ("burning" energy), so you don't necessarily lose weight (and may actually gain weight).

Even if you are "successful" at losing weight, your body will have suppressed your metabolism because it thinks you are in a famine, and it has utterly no awareness that you would like to fit into your skinny jeans. So, it does you this favor. Additionally, because your body loves you, it will stay suppressed for a bit causing you to put on weight once you stop dieting so that next time you’re faced with a famine, you can get through it. (Don't worry, your metabolism CAN recover after a period of eating sufficiently.) Bodies are pretty amazing. Why?

We have to eat to live.

This is a biological need. Wanting to eat more when dieting is not a lack of will power. It is not a failure. It is your brain and body doing what it is supposed to in response to the biological need to eat to live. It is not “bad” that you want to eat, that you need to eat. 

On top of this, when you are dieting/semi-starving, your body releases hormones designed to both drive you to eat AND make food taste better. Your body is all, “well, food’s not coming. Let’s make it taste even BETTER to eat, and maybe it will come.” This sets you up for overeating or binging while dieting. Your brain and body are pulling out all the stops, trying to get you to feed them.

Besides, dieting is stressful. So stressful that you will release cortisol in response to undereating, making you more irritable and (again) more likely overeat.

“What about ketogenic diets?”

There is no reason for you to be on a ketogenic diet unless prescribed by a physician, and usually then only to treat seizure disorders.

See above re: brain fuel. You see, when the brain gets no energy (aka carbs) from your meals, it will switch into a process called ketosis. Long story short, it will convert fat in your body into something sort of like glucose that your brain can sort of use. Only, ketosis can only meet about 75% of your brain’s daily needs. Additionally, prolonged ketosis will break down not only fat, but your muscles, leaving you more prone to injury and breaks.

This means your memory will suffer, your sleep will suffer, and your mood will suffer.

Sounds totally healthy, huh?

“Then why do I feel so energetic when I cut out carbs?”

I can’t say for sure. People with a genetic predisposition to eating disorders will often experience a calm or even ecstacy when restricting or eliminating food groups. If you experience this, you need to be extra vigilant in eating adequate amounts.

The opposite is more common, and there are TONS of articles out there on “how to overcome low energy when low carb.” Reframe this as “how to ignore the fact that your brain is starving when refusing to eat carbs because you want to lose weight,” and it starts to sound more and more questionable.

“I'm not on a diet, it’s a lifestyle change.”

Oh, ya’ll. This one really gets under my skin. In what life do you want to miss out on the glories of cheese, ice cream, melty pizza, or a perfect croissant?

Let me tell you about the lifestyle you have chosen.

You started X diet (excuse me, lifestyle) and you were committed. You counted calories or macros or exchanges. You took up spin classes. You lost weight, you met your goal, and you started to feel more comfortable with the occasional indulgence. You told yourself you “earned” it. Over time the constant need to meal prep and hit the gym every day became hard to sustain. The weight came back, and then some. You vowed to "get back on track" to lose the weight. You have repeated this cycle every few years (or months or less), each time blaming yourself for "falling off" the diet, when your body was never built to diet at all! 

“I don’t feel hungry, so why should I eat more?”

Dieting messes with your hunger and fullness hormones. For most people, dieting results in a drop in fullness hormones and a rise in hunger hormones (that whole your-body-doesn’t-want-you-to-undereat thing).

After long-term dieting and/or overeating (disordered eating), the signaling can be so damaged that you no longer feel hunger or fullness. The paradox here is that not having hunger is actually a sign that you need to eat more to repair those hormones.

(This may not hold true you eat often and don't allow yourself to feel hungry, in which case exploring any fears or feelings about hunger may be useful.)

“I’ll eat normally once I lose the weight.”

I’m going to pick on religion for a second here. Does anyone else remember True Love Waits? Is it still a thing? When I was in high school, participants signed a pledge to remain sexually abstinent until marriage. Participants were frequently told that sexual desires are sinful and in need of control. What do you think happened once participants married and have sexual relationships? There are often years of association between sexual desire and shame to undo. (More on this in this month's podcast.)

Now, if you lose weight, your brain will not stop wanting to fix the malnourishment, and you will also need to undo years of association between eating and shame.

“But what about all the negative health outcomes associated with obesity?”

Did you know that people in BMI category 25-30 tend to live longer that those in BMI range 20-25? Weight is associated with some health outcomes, but I think/hope we all learned at some point that correlation does not equal causation.

We need to ask why the link exists, what are the contributing factors – like job type, diet, physical activity, the stress of stigma, and disparities in medical care that may all play a role in negative health outcomes. Regardless, dieting is known to end up in greater weight gain. Why risk more weight gain by dieting if weight IS the issue?

“Okay, fine. What do I need to do?”

Stop dieting. Seriously. ASAP. Stop counting calories, creating a meal schedule, leaving out food groups, “earning” calories, and on and on. Eat enough, eat from a variety of food groups, pay attention to how different foods make your body feel, eat foods you like, and let your emotions play a role in what you eat (they do anyway).

Easier said than done, right?

Start focusing on healthy habits that are related health goals. Things like:

___ Cut the time it takes me to walk a mile (or be able to run a mile)
___ Be able to touch my toes
___ Be able to keep up with my kids/grandkids without getting
completely winded
___Think about food less often
___ Balance my breakfast
___ Become more self-confident
___ Minimize the negative self-talk
___ Sleep better
___ Feel more energetic
___ Progress to using a heavier free weight
___ Cook at home more often
___ Manage my blood pressure
___ Find safe places to express myself
___ _________________(Fill in the blank.)

If weight loss happens as a result of these behaviors, it happens. It may not. Your weight may not change at all. If you were under your body's optimal weight, you will likely gain weight. Your healthiest self may not look or weigh what you hoped, but health is far more than weight. 

Now, undoing years of nutritional misinformation and coming to terms with how you *feel* about allowing your body to do this is a longer post for another day soon!

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