“But what if I have diabetes - it’s medically necessary for me to lose weight?” 

As a registered dietitian who specializes in Intuitive Eating, this is something I hear A LOT!   Back when I was a student, we learnt that if you lose even 10% of your body weight, this can help lower your HbA1c - the biomarker for diabetes.   

How do we reconcile this with Intuitive Eating.

  Disclaimer - I am not a diabetes specialist but as a registered dietitian, I am fit to treat diabetes.   

Let’s start off with the fact that, contrary to popular belief, Intuitive Eating does not believe in “just eat whatever you want.”

  The 10 principles are designed to help you reinstate your hunger /fullness and satisfaction cues.  

For many chronic dieters, they do not know when they are hungry or full because for so long the diet has told them when they SHOULD be hungry and when they SHOULD be full. 

  One way I help my clients understand if they are hungry or full, is to teach them about the hunger/fullness scale.   

This way, they can subjectively get in touch with the cues their bodies are giving them.

  In terms of satisfaction, this is similar. For so many people, the diet has told them if they “tried hard enough” or had “enough will power” they can make themselves like rice cakes, eggs, apple or cottage cheese (or some variation of diet foods).   Yes - it is true, our taste buds can adapt. However, whether for a child or an adult, force feeding is one sure fire way to make a person specifically NOT like the food they are forced to eat. Being force fed is a huge threat to a person's physical and emotional autonomy.   

As a parent of three, I completely 100 million percent understand the urge to force a child to eat. 

It can be completely overwhelming and frightening to watch your child not eat the amount you think they should be eating. Yes, sometimes, on a very rare occasion,  we must force a child to eat and sometimes there is an underlying health condition we must address when a child doesn't eat enough. However, most of the time, a child knows when he is hungry and when he is full. He knows what he likes and what he doesn't like. The best way to have a child try new foods, is to simply and calmly introduce those foods to the child.   Imagine it from your perspective - your parents come to visit you for the Holidays. They make you some pumpkin pie. They ask if you want a slice and you politely say no. All of a sudden, a spoon full of pumpkin pie is shoved in your mouth - do you think you will like this food or be happy to eat it again - my guess is - NOPE.   

So these cues need to be reinstated.

  On top of that, many emotions have been mixed with eating. There are many reasons for this and in many ways this is a positive thing. A child is born into the world and shortly afterwards, they go off to eat from their mother or from a bottle. That milk has a lot of sugar (lactose). It is sweet in taste and also comforting in so many ways.   

We do associate food with emotions and in many ways, that is how we celebrate. It really is beautiful. 

  But throwing dieting into the mix, and we now have a strong cocktail of guilt, self loathing and hopelessness associated with food. All negative and painful emotions to deal with.   If we can separate emotional hunger from physical hunger, we will not be using food as often to deal with emotional triggers. Many of my clients will begin to realize how important therapy will be for them to help learn coping skills to deal with strong emotions.  

Nutrition and exercise 100% play a role.

I will work with my clients on these topics. I will help create behavior modification. Adding fruits and vegetables. Switching some processed grains to whole grains. Combining protein with carbs to help delay gastric emptying.   

Finding exercises that the client likes and planning it into their schedule.

  I have seen clients implement these things and not lose a single pound, however, the next time they go to the doctor, their labs have improved.   

They sleep better and feel better. 

  Another important thing to remember about the topic of weight loss relating to health is that our research may be skewed more than we would like to believe. What we know about research is that correlation does not equal causation.  

We have all mostly concluded that being overweight LEADS to diabetes, heart disease and many types of cancer. They may be correlated but not causational. 

  For example, we know that African Americans are at a higher risk of developing high blood pressure. But now that we know that information are we telling African Americans to become Caucasian?   No, we absolutely are not doing that because that's impossible.  

I am not saying it is impossible to lose weight, but it kind of is in a lot of ways. 

  I think if you will access all the people you know who have lost weight on a diet, mostly every single person you know will have gained back that weight and more!  

Not to mention their now obsession with what they eat or don't eat, when and how much they exercise and it begins to take over their lives. 

  You may be diagnosed with a nutrition related disorder like diabetes, high blood pressure or renal disease. We can treat these diseases with medical nutrition therapy without being restrictive.   

We also have to interpret nutrition research with a grain of salt (pun intended).

  A person with high cholesterol is told not to eat too much cholesterol. However, the research now shows that most of our cholesterol is made by the liver unrelated to how much cholesterol we actually eat.    This is why I am not a fan of any form of restriction. I much prefer to get in touch with how your body feels as a result of certain foods. I believe that you can also make nutritional choices based on your medical history as a form of self care and not self punishment. Your intentions will make a big difference on the overall outcome.   

You can make healthy behavior changes and not change your weight at all. As a culture, we have a belief system that you CAN change your weight but you most likely CAN NOT.

  Whether that's because of genetics or environmental factors, who cares?   It doesn't really matter. We must shift our focus from weight to health. We must take away that black and white, all or nothing, “if I don't sweat it doesn't count,” thinking. If I don't lose weight, why eat healthy anyways.   

You can be healthy and be fat. You can have diabetes and still eat carbs. You can take care of your health without changing your weight. You can work on accepting that your body is exactly as it's meant to be. Don’t let diet culture tell you anything different. 

  [gravityform id="2" title="true" description="true"]   If you are ready to make peace with food and never say diet again, check out my website https://gilaglassberg.com and apply for a free 20 minute clarity call. I look forward to hearing from you!