Author: Dana Notte, MS, RD, CD
Even if we, as practitioners, have embraced a weight-inclusive approach to care, inevitably, many of our clients will still have a desire for weight loss. Working with these clients isn’t necessarily incompatible with weight-inclusive care, so long as the practitioner isn’t reinforcing weight loss as a desired outcome. We’ll explore this topic, and how practitioners can work from a mindful eating perspective, through the following vignette:
Wendy is a 50-year-old woman who lives in a larger body. She reports she’s been struggling with her weight her entire life. She went on her first diet at the age of 14 and has been dieting ever since. She’s lost and regained hundreds of pounds over the last several decades and feels totally exhausted and defeated. She’s recently learned about mindful eating and is interested in learning more, so she schedules a session with you. Wendy is intrigued by the gentleness and flexibility of a mindful eating practice but remains desperate to lose weight. These days, though, she says it’s less about looks and more about concern for her health.
From this summary, it appears Wendy has realized that dieting for weight loss is ineffective, but still desires to live in a smaller body. It’s important for the practitioner to validate this desire so that Wendy feels heard and supported. But rather than aligning with this goal, the weight-inclusive provider should seek to understand more about Wendy’s experience.
Dr. Kari Anderson, LPC, CEDS-S, and owner and therapist at myEatingDoctor in Phoenix, Arizona says, “I would listen to the fourteen-year-old who first started dieting and learn as much as I could about her relationship with food and her body over the last 35 years. I would ask her what her experience has been living in a larger body, what her current health status is, and what her fears are related to her inability to sustain weight loss.”
Kori Kostka, a Toronto-based registered dietitian and owner of Nourished Body, emphasizes the importance of “approaching [the desire for weight loss] with empathy and curiosity” and taking the time to understand Wendy’s story and perspective.
Both Anderson and Kostka agree that pushing back on Wendy’s desire to lose weight or suggesting that her weight is not important, especially at the beginning of the relationship, is not useful or supportive. Rather, “I would be more interested in trying to shift her focus toward beginning to ‘feel’ better,” says Anderson.
Mindful eating can help do this. Anderson says she would educate Wendy on how mindful eating, “involves a greater [awareness] of body, mind, and heart…It involves unraveling the old rules and healing the relationship with food and your body beginning with neutrality (neither good nor bad) and cultivating a curiosity for how the body responds to certain patterns of behaviors and choices around food.”
Curiosity, experimentation, and reflection are themes that emerge from both Kostka and Anderson, reminding us that mindfulness is about openness and non-judgment. This approach can lead to exploring new ways of eating or attempting new behaviors that can ultimately support health and wellbeing without focusing on weight. For example, when working with clients on exploring new ways of eating, Anderson says, “I encourage them to get curious about it and [to] begin exploring the farmers market, preparing, and cooking in new ways. Slowly, the goal is for my clients to move toward food with wonder and not fear.”
She goes on to say, “It is also important to allow ourselves the pleasure of mindfully eating foods that connect us to others, to our rich histories, and the simple joy of eating. The key is to savor and embrace; not hide, sneak, or feel bad about ourselves.” In other words, helping clients see that food is more than the sum of its nutrients and that the role it plays in our wellbeing extends far beyond supporting solely our physical health.
If Wendy continues to express concern regarding her weight as it relates to her health, having a broader conversation about health might be useful. Kostka states that “health is individually defined” and working with Wendy to understand what “health” looks like for her might help shift her perspective and adopt behaviors that support that broader vision.
Anderson goes on to say that she’d explain, “Weight is not something that one has direct control over, that focusing on it can distract us from truly caring for one’s body…In the end, changing health behaviors and attitudes are the most important. Some people’s bodies lose weight as a result of them and others do not. I certainly try to help them keep taking care of themselves and live full lives, regardless.”
While it’s inconsistent with the spirit of mindful eating to position it as a weight loss intervention, we don’t need to position mindful eating as anti-weight loss, either. Mindful eating supports the body in settling where it wants to settle naturally. It’s simply a way to end the weight loss wars so many of our clients have been waging on their bodies for so long. And mindful eating can support health and wellbeing – that is our physical, mental, emotional, social, and spiritual health and wellbeing – whatever their weight.
For further information on the topic, join our Weight Inclusive Panel Discussion next Wednesday, June 5, 2024:
Navigating the complexities of supporting individuals within the weight-inclusive, non-diet paradigm poses a significant challenge for many practitioners. How do we effectively assist those who desire weight loss when it contradicts our core philosophy? Trained within a weight-centric framework, we may find ourselves unsure of how to provide meaningful support to clients seeking weight loss when we do not offer these services.
A psychologist, Alexis Conason Psy.D, CEDS-S, a registered dietitian, Brianna Theus, RDN, CDN, and a physician and coach, Michelle Tubman Ph.D. will gather together to talk about how to support clients/patients in their journey to LIBERATION. This panel will be hosted by Linn Thorstensson, DipNT, mNTOI, TCME Chair Elected.
Join us for a panel discussion featuring three experts representing diverse disciplines. They will share their personal journeys transitioning from weight-centric approaches to embracing weight-inclusive care. Additionally, they will offer practical strategies for navigating these delicate situations.
When? Wednesday, June 5, 2024 Time?: 12:00 pm - 1:15 pm Eastern Time Where?: Online. Register here
Course Fees
- TCME Community Members: Free
- Assisted: $15. Partially covers the cost while being supported by others.
- Baseline: $30. Fully covers the cost of the program.
- Supporting: $45. Fully covers the cost of the program while helping to support others.
Continuing Education Credits are available through APA, CDR, and NBHWC
Dana Notte, MS, RD, former TCME board member, dietitian in private practice at ThrivInspired Nutrition in Burlington, VT, and part-time faculty at the University of Vermont. She is an experienced non-diet dietitian, Certified Eating Disorder Specialist, and Certified Intuitive Eating Counselor who is passionate about helping people cultivate a balanced, peaceful, and healthful relationship with food and body. She specializes in working with young adults and adults seeking support to heal from chronic dieting, disordered eating, and eating disorders.
Contributions
Thank you to our contributors:
Dr. Kari Anderson, LPC, CEDS-S www.myEatingDoctor.com
Kori Kostka, BSc, MHSc (c.), Registered Dietitian www.mindfuleatingwithkori.com