Food Freedom Therapy™

Is Noom a Diet? An Inside Look into Noom

By now, you’ve probably seen an ad for Noom because they seem to be everywhere. They’re intriguing to many because they claim to be different than other weight-loss programs, largely in part due to having “psychology” element and also for not involving dieting. When I saw they were offering a free trial, I decided to sign up and check it out to see what it’s really all about. Now that I’ve had an inside look, I want pull back the curtain for you so you can see for yourself how accurate these claims are:

“Noom helps you build healthier habits to lose weight—no dieting needed!”
“Noom: Stop dieting. Get life-long results.”

Here we go 🙂

First, what IS a diet?

To be clear about what a diet actually is, here’s a definition from the Encyclopedia Britannica:

Dieting is regulating one’s food intake for the purpose of improving one’s physical condition, especially for the purpose of reducing obesity, or what is conceived to be excess body fat.

This “food regulation” can take on several forms, including reducing overall food consumed or cutting out specific foods.

So does Noom do those? Yes. And sorta yes.

Cutting Calories

The whole program is built on reducing calories. That’s really not so new, is it? That diet approach has been around for ages! How it works is you say what your goal weight is and if you want to go slow, medium or fast to get to that goal. Then they calculate how long it will take you to get there and give you a daily “calorie budget”. You don’t have to count the calories yourself, but you do have to log everything you eat and their program calculates it for you.

To be honest, my calorie budget was suitable for a toddler. Not a grown woman. Definitely not a woman who is nursing (which was never asked about in the assessment questions, by the way). I blew through my calorie budget by the afternoon. Of course, I wasn’t actually trying to stay within my allowance. To do so would mean eating less and/or choosing different foods (again, the very definition of a diet, amiright?)

Cutting Out Specific Foods

Now, they say that there are no “good” and “bad” foods and you can eat anything. Sounds great! Except that every food you log is coded in a color chart: green foods are thumbs up while yellow and red food should be “limited.” So, I guess technically there’s no cutting out certain foods. But color coding foods and saying some should be limited sure sounds like categorizing foods into good and bad categories. And it sure sounds like a way to make people feel bad about the foods in the red category.

“Get Life-long Results”

This is just a totally baseless claim to make. Their marketing claims that 77% of people lost weight and kept it off for nine months. First off, nine months is nothing in terms of a lifetime. Like every other diet, there is no evidence that it works long-term (meaning 5+ years). Weight loss research typically follows people one year or less, which isn’t a very long time considering most people aren’t interested in losing weight just to gain it back after 12-24 months. That kind of weight cycling is also incredibly bad for your health. (Check out this post to read about the negative health impact of yo-yo dieting.).

Additionally, that 77% success rate they tout is a bit misleading if you don’t know exactly what’s include… or in this case, left out. The study they used was by Chin et al (2016), which looked at data from about 36,000 people who used the app between October 2012 and April 2014. As clinical psychologist Alexis Conason Psy.D. explains:

At the time the study was written, the authors reported that over 10 million people had downloaded the app. However, the study only included people who used the app consistently for six months or more. In other words, the study only included the most successful users. Think about it: If you start a program, use it for a while, and it doesn’t work, what would you do? Would you continue paying each month for a service that isn’t delivering on its promises? No, if you are like most people, you would stop the program. And that is exactly what over 99% of Noom users did.

So, keeping in mind that this study is only looking at the 0.36% of Noom users (out of the 10 million people who downloaded the app) who stuck with the plan for six months of more, let’s see what they found. While actively using the app, over 30% of these users lost less than 5% of their weight. About 24% of users lost 10% of their weight and 22% lost more than 20%. That’s what happened in the short term, when participants were consistently engaging with the app.

At follow-up less than one year after starting the program, researchers had data on 15,376 of these participants (more than half of the sample was excluded due to missing data) and found that less than 10% of participants had lost and maintained 5-10% of their weight. Additionally 11% had already regained whatever weight they initially lost.

But because the millions of people who didn’t keep using the app weren’t even included in this particular study, the conclusion was that 77% lost weight while using the app—again, the stat Noom widely uses in their marketing. It’s actually pretty deceptive once you understand how that number was derived, isn’t it? As Conason puts it, “I guess it sounds better than 86% of users failed our program within a year. Or 99% of people couldn’t stick with our plan for six months.”

Other Concerns About Noom

Here are some other issues I have with Noom:

They don’t flag unhealthy goal weights. Of course, I think part of the problem with these programs and our weight-loss obsession in general is that a person’s healthy weight might be higher than what our culture considers a healthy weight. But that aside, I purposely set my goal weight to be low enough that it would be considered clinically underweight according to BMI. (Yes, I think BMI is horse manure but that’s a fun discussion for another time.) You should know that while the research on the dangers of being fat is questionable, the research about the dangers of being underweight is not. Being underweight is very dangerous medically. Setting an underweight goal should have been a big red flag for Noom. But the system didn’t flag anything and my “goal specialist” didn’t seem concerned. Yikes.
They expect daily weigh-ins. Now, I’m against weighing in general, but even if you do weigh, can we agree that doing so every day is excessive?
They encourage you to eat foods with more water in them so you get filled up on fewer calories. “Eat and drink more water” is a classic dieting and eating disorder tactic. Does it work in the short term? Sure, it can. Does it work in the long term? No, because no dieting hack does. I only did the app for one day, so there’s no telling what other dieting hacks they would have tried to push.
It doesn’t necessarily promote health like they claim. The kind of restriction they are promoting might be so extreme for some people, it would be incredibly not healthy physically, regardless of their current weight. Contrary to popular belief, people in larger bodies can be malnourished. And again, they didn’t care at all that my goal weight was clinically underweight.
They don’t screen for eating disorders. I have a huge problem with this, because they claim to be about health. Well, health includes mental health, people. Especially considering eating disorders have the highest mortality rate of all mental illnesses.

Final Thoughts…

Anytime someone is claiming to not be a diet, but wants you reduce calories or eliminate foods, see it for what it is: nothing more than a re-packaged diet. Companies and influencers know that dieting isn’t really en vogue anymore like it was in the 90’s, so now they try to pass diets off as “wellness” and “lifestyle changes” instead. We think we’ve shifted away from weight loss to being healthy… but we haven’t really.

If you’re stuck in chronic dieting or an eating disorder, I’d love to help! Please contact me or schedule an appointment online.

Much love,

Sources
https://www.google.com/search?q=noom&oq=noom&aqs=chrome..69i57j69i60j69i61l3j69i60.2044j0j7&sourceid=chrome&ie=UTF-8

https://www.britannica.com/science/dieting

https://www.psychologytoday.com/us/blog/eating-mindfully/202005/is-noom-diet

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, OSFED, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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5 Myths about Intuitive Eating

If you’re not familiar with intuitive eating at all, you can read the basics about it here. In this post, I want to address some of the misconceptions I often hear about intuitive eating.

Myth #1: Intuitive Eating is a Diet

Intuitive eating is not a diet, although, unfortunately some people approach it that way. Intuitive eating is about having unconditional permission to eat all foods, which requires rejecting diet mentality and making peace with food. The goal of intuitive eating cannot be to lose weight because that will inevitably conflict with listening to and honoring your body.

Myth #2: Intuitive Eating Means Eating Whatever You Want, Whenever You Want

This is an oversimplification of intuitive eating, which does teach having unconditional permission to eat all foods and honoring your cravings, as we’ve already discussed. However, intuitive eating teaches ten principles that work together, so it doesn’t work well for a single principle to be applied without the others.

For example, principle #8 is “Respect your body.” To do that, you have to be attune to how your body feels and what it is communicating to you. If you eat nothing but ice cream, your body will not function optimally and will tell you so through stomach discomfort, blood sugar fluctuations, or a number of physical symptoms. (Interestingly, research shows the ability to perceive these sensations—called interoceptive awareness—is higher in intuitive eaters.) So the question when considering what and when to eat is not just what will taste good, but also, what will feel good to my body now as well as later?

Additionally, I’d like to point out that because intuitive eating rejects restriction and food policing, cravings for “junk” food typically decrease in frequency and intensity. Studies have shown that intuitive eating typically ends up with people eating a wider variety of foods. Yes, at first, you might find yourself eating a lot of the foods you previously restricted and that’s normal. As the Intuitive Eating book says,

“When you first begin the healing process, you may find that you’re eating more of the foods that you had previously restricted. This restriction has led to deprivation, and you may end up eating more of these foods for a while. Once the deprivation has healed, these foods will take a balanced place in your eating life.”

Myth #3: Intuitive Eating Just Means Eat When You’re Hungry and Stop When You’re Full

While two of the principles of intuitive eating are honoring hunger and fullness cues, that can be more challenging than it sounds. Which is why the other eight intuitive eating principles are just as important! Recognizing and responding to hunger and fullness is complicated if you’re still steeped in diet mentality, aren’t truly satisfied by your food choices, or are habitually using food to cope with feelings.

Myth #4: There’s No Care About Nutrition with Intuitive Eating

“Honor your health: is #10 of the principles, so definitely, nutrition is a factor in intuitive eating, and is often referred to as “gentle nutrition.” Being attuned to your body while making food choices will naturally lead to some care in nutrition, because while no foods are “bad,” some are obviously more nutrient-dense than others. Our bodies do not feel good eating less nutrient-rich foods all the time, so being attune to our bodies means we will notice that and want more nutritious foods as well. I’ve seen people swear they hated vegetables and they’d never want anything but cookies and cake if they let themselves eat intuitively who actually end up craving sugar less and wanting salads sometimes!

Myth #5: You Will Gain Weight with Intuitive Eating

I think this fear comes from the belief that letting go of food rules means eating high fat and/or high sugar foods all the time. We’ve already talked about how once feelings of deprivation are healed and principles of gentle nutrition are learned, intuitive eaters actually eat a variety of foods. Several studies have associated intuitive eating with having a lower BMI, though please, please don’t take that to mean you’ll lose weight eating intuitively. (Remember, this is NOT a diet and trying to lose weight will always undermine true intuitive eating!)

The truth is everyone will have a unique experience in regards to weight as they transition to intuitive eating. Some will gain weight while others will lose weight, and some will stay exactly the same. It depends on what weight your body wants to be at as well as how responsive you were to your body’s food and movement needs before versus how responsive to those needs you become as an intuitive eater.

Final Thoughts

Intuitive eating really is simple in theory, but it can be hard to put into practice. It’s a completely different relationship with food and your body than most of us have had since we were very young. While it does take time to unlearn diet culture and become an intuitive eater, it’s totally doable! If you’d like to talk with me about learning intuitive eating or have questions about it, please contact me or schedule an appointment.

Much love,

Sources

Tribole, E., & Resch, E. (2012). Intuitive eating: A revolutionary program that works (3rd ed.). New York: St. Martins Griffin.

Herbert BM, Blechert J, Hautzinger M, Matthias E, Herbert C. Intuitive eating is associated with interoceptive sensitivity. Effects on body mass index. Appetite. 2013;70:22-30.

Gast, J., Madanat H., & Nielson A. (2012). Are Men More Intuitive When It Comes to Eating and Physical Activity? Am J Mens Health, vol. 6 no. 2 164-17.

Madden C.E., Leong, S.L., Gray A., and Horwath C.C. ( 2012). Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutrition. Mar 23:1-8. [Epub ahead of print].

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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When Recovery Doesn’t Feel Worth It

Recovery from an eating disorder is incredibly difficult. Not only is the process itself just really hard, but it usually takes a long time and that in and of itself can be challenging. Sometimes it might all feel not worth it.

I understand. I’ve been there and so have many of the clients I’ve worked with. Part of the reason it doesn’t feel worth it, though, is probably because you don’t know what full recovery is like. It’s hard to imagine having peace with food and your body if you’ve never experienced it.

In earlier difficult seasons of my life, I was tempted to relapse back into my eating disorder. If we’re honest, we can admit that our eating disorders serve us in many ways, and that’s another reason it’s hard to give them up. But I didn’t go back to it, because I knew what it’s like to live without an eating disorder and it’s SO MUCH BETTER. Whatever my eating disorder did give me didn’t compare to what it stole from me. Whatever needs it met, I can meet those in healthier, better ways that don’t come at such a high physical and emotional cost.

But if you haven’t been on the other side of full recovery like I have, you might have a hard time even imagining what it will be like. So even though you can’t really know until you get there, let yourself dream. Try to create in your mind a picture of what being recovered might look like for you. Here are some activities that I like to do with clients to help them envision recovery.

Create a vision board. Cut out pictures from magazines (that won’t be triggering) and glue them on a piece of paper or poster board. Include pictures of places you want to go, activities you want to do, foods you want to eat, words that will describe you and your life, etc. Hang it up where you can see it often to help you stay motivated.

Journal about being recovered. Take some time to imagine a day in your recovered life. Visualize in as much detail as possible what you are doing, what you are wearing, who you are with, how you feel about life, how you feel in your body, what hobbies/activities you enjoy, or whatever else you would like to be true for you.

These activities might bring up a lot of emotions. Maybe excitement thinking about the possibilities, or sadness about what you’re missing out right now. It might even bring up anxiety or fear. It’s okay to also feel afraid of the things we want. Even if recovered life seems scary, try these assignments anyway and share it with your therapist, if you have one (and if you don’t please get one!).

Final Thoughts…

Overwhelming emotions, fear of weight gain, loss of identity, and so many other recovery humps make it tempting to give up before you fully recover. Please don’t give up. Reach out for support, give yourself compassion for how hard it is, and remind yourself what you’re working towards.

If I can help, please contact me or schedule an appointment online.

Much love,

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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Can You Be Fat and Healthy?

We are told over and over that people in larger bodies are unhealthy. It’s the underlying assumption that drives the so-called “obesity epidemic” that everyone from doctors to Michelle Obama to Susan on Facebook are ranting about. This assumption about weight and health is so pervasive that most people don’t even stop to question it.

So is it true? Does being fat automatically mean that you’re unhealthy? Or put another way, is it possible to be fat and be healthy?

Believe it or not (and most don’t at first), there’s empirical support for the idea that you can be fat and healthy. Let’s take a look.

What the “Evidence” Leaves Out

First, we have to realize that all the evidence we hear on this topic is selected specifically to support the fat=unhealthy assumption that already exists. It’s human nature to ignore or reject information that doesn’t fit with our preconceived beliefs. So much of the evidence that supports the idea that people can be healthy at all sizes (e.g. Health At Every Size, or HAES®) is not even discussed.

Here is a summary of just some of the data supporting HAES®, as stated by Dr. Arya M. Sharma, MD, DSc (hon), FRCPC. Dr. Sharma is a Professor of Medicine & Past-Chair in Obesity Research and Management at the University of Alberta, Edmonton, Canada, and he writes:

“For one, as reviewed by the authors, a comprehensive search of the literature reveals at least six randomised controlled trials indicating that a HAES approach (focussing on promoting health behaviours and size acceptance rather than weight loss) is associated with statistically and clinically relevant improvements in physiological measures (e.g. blood pressure, blood lipids), health behaviors (e.g. physical activity, eating disorder pathology), and psychosocial outcomes (e.g, mood, self-esteem, body image). None of these studies found adverse changes in any variables.”

Additionally, a government survey indicated that over half the “overweight” adults (51.3%) being targeted were metabolically healthy. There are studies showing that weight and BMI are poor predictors of disease and longevity (see the sources listed at the bottom), and the bulk of epidemiological evidence suggests that five pounds “underweight” is more dangerous than 75 pounds “overweight.”

In another study comparing the HAES® model to a diet approach, though only dieters lost weight, both groups initially had similar improvements in metabolic fitness, activity levels, psychological measures, and eating behaviors. After two years, dieters had regained their weight and lost the health improvements, while the HAES® group sustained their health improvements.

This is just some of the research behind HAES®, but truthfully, there’s way too much for me to cover it fully here in just a blog post. Please consider additional reading on the topic, which can be found on my Resources page.

What the “Evidence” Gets Wrong

The fact that contradictory evidence gets left out or dismissed is not the only issue. The other problem is that the evidence to support the claim that being fat is unhealthy is just not as cut and dry as we’ve been told. There is literally NO study that has proven being fat causes illness or disease. Some studies show an association between being fat and having certain conditions, but as anyone who has ever studied research and statistics will tell you, correlation does not equal causation. (Say it again with me: correlation does not equal causation!)

For instance, what if I told you that the more ice cream is consumed, the more murders there are. Crazy, but yes, it’s an actual correlation. However, I doubt anyone would claim that eating ice cream causes people to commit murder. You would probably assume it’s either a coincidence or that there is another factor driving both increases. Maybe the heat? People are more likely to buy ice cream in summer months when it’s hot, and perhaps people are also more likely to murder someone because hot weather can make people irritable and temperamental. We don’t really know, but the point is, that in examples like this, we see pretty easily that it would be erroneous to assume correlation equals causation.

Yet that’s what we do all the time with “obesity” studies linking higher weights to certain conditions. We don’t really know that weight causes those conditions, only that they correlate to higher weights. Perhaps there are underlying factors driving both? A very real possibility for that is the emotional stress involved with being in a larger body, especially for those who suffer bullying, discrimination, or even abuse. (It’s well documented that discrimination is a chronic stressor and can increase people’s vulnerability to physical illness.) Another possibility is there’s an underlying physical condition that causes both. Still another possibility is that larger-bodied people are less likely to seek healthcare due to negative experiences with fatphobic medical professionals, and therefore, conditions aren’t caught and treated as early or effectively.

Do you see what I’m getting at? We JUST DON’T KNOW but we sure like to pretend that we do. The truth is that weight, genetics, nutrition, medicine, mental health… all work together somehow and we don’t have it figured out yet (if we ever really will). It’s incredibly complicated! I’m not saying we should stop trying to figure it out, but we definitely should stop blaming everything on weight. A mistaken belief that we’ve already discovered the truth prevents us from searching for the real truth. And our mistaken assumptions end up hurting people of all shapes and sizes in many, many ways, but mostly, of course, those in larger bodies.

Want to Know More?

Check out my Resources page for recommended reading and podcasts related to HAES® and anti-dieting (start with Christy Harrison’s Anti-Diet book or Food Psych podcast if you’re not sure where to start). Or if you’d like to talk with me, please contact me or schedule an appointment online.

Much love,

Sources

http://www.drsharma.ca/obesity-the-science-behind-health-at-every-size-haes

https://www.buzzfeednews.com/article/kjh2110/the-10-most-bizarre-correlations

https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-health/interventions-resources/discrimination

Gaesser, G. (2002) Big Fat Lies: The Truth About Your Weight & Your Health. Carlsbad, CA: Gurze.

Flegal, KM et al. (2005). Excess deaths associated with underweight, overweight, and obesity.JAMA, 293(15) 1861-1867.

Flegal, KM, Graubard, BI, Williamson, DF, Gail, MF (2007). Cause-specific excess deaths associated with underweight, overweight, and obesity. JAMA, 298(17), 2028-3037.

Orpan HM, et al.(2009). BMI and mortality: Results from a national longitudinal study of Canadian adults. Obesity, doi:10.1038/oby.2009.191

Tamakoshi1 A, et al. (2009). BMI and all-cause mortality among Japanese older adults: Findings from the Japan collaborative cohort study. Obesity, doi:10.1038/oby.2009.190

Campos P (2004).The Obesity Myth. New York: Gotham Books.

Bacon, L, VanLoan M , Stern JS, Keim N. Size acceptance and intuitive eating improve health for obese Female chronic dieters. J of Amer Dietetic Assoc 2005;105:929-936.

Wildman RP, et al. (2008). The obese without cardiometabolic risk factor clustering and normal weight with cardiometabolic risk factor clustering: Prevalence and correlates of 2 phenotypes among the US population (NHANES 1999-2004). Archives of Internal Medicine, Aug 11, 168(15):1617-24.

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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#ScrewYourBeautyStandards

We are not born disliking our bodies. We are innocent in our self-acceptance until we learn there is a “right” way to look. After that, we evaluate ourselves against whatever ideal we are taught because it is our nature to compare. If we are fortunate, we will grow up in a family that values inner qualities over appearance. Sometimes that can protect us from internalizing the broader culture’s narrow beauty ideal. But it’s difficult to stay immune to all the messages from everywhere else… the teasing from kids at school… the magazine covers with Photoshopped images… the TV commercials pushing their weight-loss products…

And some are not fortunate enough to grow up in families where beauty is recognized in a diversity of shapes, sizes and colors. For too many, the pain starts at home and family opens the first wounds, which are only deepened by peers and the media.

Seemingly from all corners, the message is clear: We aren’t good enough. Not T-H-I-N enough.

Because thin = good and we so reason, therefore, fat must = bad, right? Some will even directly say that it is.

I used to buy into all of it, like so many do. I hated my body long before I developed an eating disorder, and it laid the foundation for me to go down that path. I was so desperate to lose weight, to be accepted, to feel okay for once. I was so mad at myself for not being thin like my friends and the pretty girls I saw in the media.

Thankfully, now I’m recovered—from both my eating disorder and my body hatred. But I’m still angry. I’m angry that we live in a culture that works so dang hard to make us feel bad about ourselves. You can’t go a day without seeing advertisements for products related to weight loss, makeup, hair dye, eye creams, tummy-control pants, and on and on and on. If you don’t feel pretty, thin, or young enough, then they promise to change that if you’re willing to spend enough time and money.

And I mean lots of money. Beauty is a $532 billion industry and is expected to just keep growing. The problem is that every commercial you see isn’t simply trying to sell you something; first, it tries to convince you that you need what they’re selling. It plays on, sometimes even creates, insecurities. The subtle goal is for you to feel bad about yourself so that you’ll then want to buy something that will (supposedly) make you feel more confident.

While common sense likely tells us that we’re influenced by the media, it never hurts to have some research to back that up—which of course, it does. Indeed, research shows that media influence can lead children and adolescents to internalize ideals imposed by society, which also increases the probability that they will suffer from issues like body dysmorphia and eating disorders. Studies suggest this can start as young as six years old, if not even earlier. We’re talking Kindergarteners, maybe younger!

That makes me angry for every little girl that is harmed by these messages poured into her about her value and what she is supposed to be. I hope that like I have, you’ll learn to turn that anger and disgust that you direct at yourself for not being what you “should” be, and you’ll start getting angry at the diet and beauty cultures instead. Not because makeup is evil or dyeing your hair is inherently bad, but because being sold the idea that you can’t feel good about yourself without those things is wrong. Being told we have to be a certain BMI to be attractive and worthwhile is beyond shallow—it’s destructive and sick, and I will never stop fighting for a better world for my son and daughter.

If you’d like to talk about how to get break free from these destructive cultural messages and finally accept yourself as you are, please contact me about a teletherapy appointment or follow me on Instagram or Facebook.

Much love,

Sources

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.572.7007&rep=rep1&type=pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6540021/

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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The Effects of Dieting on Your Body and Mind

In my last post, I talked about the diet-binge cycle that results from trying to restrict certain foods or overall calories. I didn’t go into detail about the physical and psychological effects of dieting, so that’s what we’ll discuss today. And there are a lot of negative effects of dieting, despite the widely-accepted belief that dieting is good for your health.

Brain and Hormone Changes

Many dieters restrict carbohydrates, which is a primary source for glucose, but our brains needs glucose to function properly. “If carbs are strictly reduced, the brain will be cut off from its main energy source, which can drastically alter brain functioning,” says Cheryl Mussatto, RD (registered dietitian). “One such change can occur with serotonin, a chemical produced by the brain. Serotonin regulates our sleep cycle, mood and appetite, all of which will be noticeably altered along with experiencing brain fog.”

Also, as Jillian Greaves, RD explains, “If you’re overly restricting carbohydrates, this is a form of stress on the body that can disrupt normal endocrine function.” The endocrine system, responsible for your hormones, is related to many other systems in the body. “This disruption may contribute to cravings, an irregular or stopped menstrual cycle, hypoglycemia, mood swings, anxiety, chronic fatigue, suppressed immune function and thyroid disturbances.” Some studies show that low-calorie diets raise the stress hormone, cortisol, which can have some serious negative health effects over time.

Additionally, our brain is made up of 80% fat and also needs dietary fats to function properly. If you don’t eat enough fat, you may miss out on some of the brain-boosting benefits of dietary fats including better memory, lower risk of dementia and Alzheimer’s, and better focus and concentration. Medical studies indicate that people on diets have slower reaction times and less ability to concentrate than people not on a diet.

Dieting causes your metabolism to slow down to conserve energy and send it right back into building up fat stores. Also, a 2011 study shows that changes to appetite mediators—so-called “hunger hormones”—promote weight regain after diet-induced weight loss. These compensatory mechanisms driving weight regain last for at least one year and could be long-term or even permanent.

Sleep Problems

Some research connects restrictive dieting with poor sleep quality. In one study, even a short period of dieting (just four weeks) resulted in a significant decrease in the amount of time women spent asleep and a greater difficulty falling asleep. Sleep is an important part of health and a lack of sleep can result in inflammation, an increased risk for diseases, and other concerning side effects.

Nutrient Deficiencies

Many important vitamins like vitamins A, D, E and K, are fat-soluble, and your body needs fat to properly absorb those vitamins. Without enough fats, the vitamins you eat can pass through your system unabsorbed and can result in nutrient deficiencies. Also, restricting entire food groups can cut out main sources of important nutrients.

Weight Cycling (aka Yo-Yo Dieting)

Weight cycling describes the pattern of repeatedly losing and regaining weight, often with increased overall weight in the long-term. “Long-term diet research (two years or longer) suggests that most people regain all the weight lost during a diet, whether they stick to the diet or not,” Julie Dillon, RD says. “In fact, many regain more weight than was lost in the first place.” One 2016 study found that repeatedly going through these starvation cycles prompts your body to store more fat, which is likely a survival response against starvation. Also, dieting slows down your metabolism, as previously discussed. “If you follow people over the long term, dieters are more likely than equivalent non-dieters to end up gaining weight over the next 2 to 15 years after the diet,” says Sandra Aamodt, PhD, author of Why Diets Make Us Fat.

Weight cycling is linked with increased insulin resistance, a condition which can develop into type 2 diabetes (T2D). In other words, maybe yo-yo dieting is a more likely cause of T2D than weight itself! Weight cycling also causes other health complications such as higher blood sugar, blood pressure, cholesterol, risk of heart disease, and inflammation. In many cases, acute inflammation is a necessary and helpful human function that can promote healing in response to infection or injury. However, sometimes inflammation is chronic, which can make you feel drained or foggy and harms health, Dillon explains. “Short-term research suggests many diets lower inflammation, but research looking six months out or more shows that inflammatory markers increase.”

Overeating & Bingeing

Weight is actually regulated by our bodies, and each of our bodies prefers to be within a certain weight range, called a set point. “Your brain will defend this amount just like it defends your body temperature,” explains says Stephan Guyenet, PhD, author of The Hungry Brain. As you lose weight, the amount of leptin in your bloodstream drops and sends a signal to your brain to help you fight to bring that fat back (remember those hunger hormones I mentioned earlier?). This is at the heart of why diets don’t work, says Aamodt (author of Why Diets Make Us Fat). “Whenever your weight changes too much, your brain will intervene to push it back to what it thinks is the correct weight for you.” This push-back from your brain is what Guyenet and others call a classic starvation response: your brain responds by upping hunger and cravings.

“In lab experiments, when scientists want to induce rodents to binge eat, the most reliable method for doing it is to reduce food intake until they’re at a lower weight and then expose them to super tasty food, like Cocoa Puffs or Oreos,” Aamodt explains. She adds that in human research, some studies that look at the brain show that this type of junk food activates reward centers even more fiercely in those who have lost weight. And, she says, animal research may suggest that repeated dieting makes the brain more vulnerable to binging behavior even after the diet is done.

Your body prefers to use carbs for a number of basic brain functions, so eating too few of them can cause your brain to fight back. “Cutting out carbs through any low-carb diet (including paleo and keto) can set a person up for binge eating in part because when we don’t eat enough carbohydrates, our body releases a brain chemical called neuropeptide Y,” says Julie Dillon, RD. “This chemical’s job is to tell our body to eat carbs — and eat them now.” When a person’s brain is flooded with this chemical, it can result in an animal-like instinct to go crazy on carbs — attack a plate of brownies or eat an entire pizza, for example. “It can feel like every cell in your body is demanding carbs, which can lead you to feel that you lack willpower,” Dillon explains. “But it has nothing to do with discipline. Rather, this neurochemical is trying to save your body from experiencing fainting, dizziness or worse!”

Body Image & Self-Esteem Issues

You might think that going on a diet would make you feel better about your body, but research shows quite the opposite. A study of college students showed that for men and women, dieting (even diets described as “normal” in severity) resulted in an increased concern with weight and a lower self-esteem. Another larger study showed that both men and women who reported dieting behaviors were less likely to have a positive body image. And of course, I think we are all familiar with the feelings of shame, failure, and poor self-image that happens whenever we “fail” at a diet.

Preoccupation with Food & Eating Disorders

The Minnesota Starvation Experiment, conducted in the 1940s, revealed groundbreaking information about how calorie deprivation affects the human brain. “It demonstrated that a lower calorie intake provokes the mind to overly think about food,” explains Dillon. Even years after the study had ended and participants again began eating a higher number of calories, participants who had been limited to diets of 1,500 calories per day found they felt fixated on food. Some participants even changed their careers, eventually becoming chefs. “Dieting provokes the brain to dream about food and consume thoughts. We believe this is a necessary evolutionary response to not eating enough,” Dillon says. And as we previously discussed, the response to deprivation is often bingeing, which can lead to eating disorders like binge eating disorder (BED) and bulimia nervosa.

But problems can arise even if the body is getting enough calories. Some dieters aren’t focused on consuming fewer calories as much as they are concerned about avoiding certain foods, sometimes entire food groups. Though these types of dieters might start out with good intentions of eating healthy, too often the diet rules progress into rigid thinking about food and disordered eating… sometimes even an eating disorder that has been termed “orthorexia” (orthorexia is characterized by an obsession with “healthy” eating).

Mood Changes

“Research suggests going on any restricted diet places a person at a higher risk for experiencing depression,” Dillon says. Numerous studies also link chronic dieting with increased stress and anxiety. Neither is surprising since, as we learned earlier, dieting affects serotonin functioning. Of the approximately 40 million brain cells we have, most are influenced either directly or indirectly by serotonin. This includes brain cells related to mood, sexual desire and function, appetite, sleep, memory and learning, temperature regulation, and even some social behavior.

Other Problems

Some people who diet, especially those on keto, might experience bad breath and even vaginal odor (a side effect referred to as “keto crotch”)
Dizziness, light-headedness, and lethargy/decreased energy
Decreased sex drive
Not eating enough carbs, a primary source of fiber, can lead to constipation, bloating and other digestive issues
Social isolation due to not being able to participate in social activities involving food
Decreased hunger and fullness cues

If Not Dieting, Then What?

Like me, Aamodt (author of Why Diets Make Us Fat) and other anti-diet professionals advocates for a style of eating called intuitive eating. It’s a non-dieting approach that allows you to listen to your body and nourish it with what it wants (sometimes kale, sometimes a brownie) in the amounts it wants (more or less depending on your hunger). It might sound too good to be true, and while it’s not, there is a catch. Intuitive eating is not just another diet disguised as “wellness”; the goal is not weight loss and that can be a barrier for some who are intent on losing weight.

As I said in my last post, I totally understand that giving up on intentional weight loss is difficult for so many reasons. It can be done though! If you’re interested in learning how to ditch dieting and making peace with your body and food, check out my resources page or please contact me.

Much love,

Sources:

https://www.nbcnews.com/better/health/what-happens-your-brain-when-you-go-diet-ncna802626

https://uhs.berkeley.edu/sites/default/files/bewell_nodieting.pdf

https://time.com/3092086/weight-loss-depression/

https://www.thedailymeal.com/healthy-eating/hidden-side-effects-popular-diets/slide-35

https://www.webmd.com/depression/features/serotonin#1

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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Why Can’t I Stop Bingeing?!

How many times have you called yourself a failure after eating something you felt you shouldn’t have? After all, dieting is just a matter of willpower, right? So after every “failure” when we’ve eaten the wrong food or eaten too much food, we beat ourselves up for blowing it (again!) and are left feeling convinced we are weak… maybe even addicted to food. That would at least explain why we feel so powerless to stop the bingeing and overeating, even when we so desperately want to stop. “I am not going to do that again,” you probably promise yourself, and double-down on your commitment to follow the rules this time.

The truth is, your bingeing is not because you don’t have enough willpower. And it’s not because you’re addicted to food. It’s because dieting is a flawed methodology, with inherent side effects that cause its own failure. Notice I said that dieting is the failure—not you. Research shows that 80 to 95% of people who diet don’t lose weight long-term. That means it’s rare for people to sustain weight loss on diets, and those who do are statistical outliers. Still, dieting for intentional weight loss is prescribed all the time for all kinds of reasons! If dieting was a medication, it would never get FDA approval with such terrible success rates. Especially when you consider the mental and physical consequences of dieting, which I won’t go into detail today (check out this post for that). For now, I just want to look at the diet-binge cycle on a pretty basic level so you can see the domino effect that is set into motion the minute you start a diet.

Dieting: Restricting certain food or limiting amounts of food.
Dieting “High”: Initial feelings of control, accomplishment, and relief of anxiety related to weight and eating.
Deprivation/Obsession: Preoccupation with food, hunger, feelings of deprivation, and cravings.
Anxiety: Fear of losing control, anxiety around food.
Binge/Overeating: Bingeing on restricted or “bad” foods, “breaking the rules”.
Shame and Guilt: Feeling like a failure, beating yourself up.
Anxiety: Worry about gaining weight due to bingeing.
Dieting again to relieve anxiety… and starting the cycle all over again!

As you can see from this cycle, bingeing is an expected response to deprivation for most people (even some people with anorexia nervosa experience “binges”). There are biological reasons for this, in addition to the emotional ones, which we will discuss in the next post. So if you want to stop bingeing, you have to stop dieting and restricting. I know this isn’t the answer most people want, because it’s hard to accept that dieting doesn’t work. For one, we’ve been brainwashed to think it does and to blame ourselves for not being able to lose weight long-term. And also, because giving up dieting feels like giving up on the dream of losing weight and finally keeping it off.

Giving up on intentional weight loss is incredibly difficult given the weight stigma and biases that surround us, but it is possible. You can start rejecting diet culture by learning about Health At Every Size (HAES®), which provides a rarely-heard scientific perspective on issues related to weight. It would also be helpful to work with a good eating disorder therapist or dietitian who can guide you through the process of learning intuitive eating and healing your relationship with food and your body. If you’d like to talk with me about that, please contact me!

Check out the follow up post to this one, The Effects of Dieting on Your Body and Mind.

Much love,

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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No Pain, No Gain (Not)

How do I hate this tank top? Let me count the ways… Listen friends, if you puke or faint during exercise, your body is telling you to stop! Intuitive eating and intuitive moment go hand-in-hand and have the same underlying philosophy—Listen to your body! Our culture has done us a huge disservice to by making us believe exercise has to be painful or unpleasant to be beneficial. Even just the word “exercise” fills most people with a sense of guilt or dread (or both). How many times have we started exercising only to quit because we hated it?

Just like how intuitive eating requires dieting rules go out the window, joyful movement (as intuitive eating author Evelyn Tribole calls it), calls for tossing the exercise rulebook out the window too. You don’t have to burn X calories, exercise for X minutes, or do X workouts a week. You don’t have to throw up or be able to barely move the next day. Many people are turned off from moving their bodies because they think if they don’t do it hard or long enough, it doesn’t count. It does! Even light exercise can have a lot of physical and emotional benefits, so give yourself the freedom to explore what kind of movement feels good to you. Maybe it’s stretching or some simple yoga poses on your lunch break? Or maybe riding a bike with a friend? One of the ways I love to move my body is to push my daughter in the stroller outside while I listen to an audiobook.

Movement can be challenging physically but it should be something enjoyable! It shouldn’t injure you or make you miserable and it certainly should NOT be a punishment for something you ate. Let’s be kinder to ourselves when it comes to exercise and maybe we’ll discover it really can feel joyful!

Much love,

I’m Cherie Miller, MS, LPC, founder of Food Freedom Therapy™. I offer counseling for chronic dieting as well eating disorder therapy for Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other eating disorder issues. Contact me here or follow me on Instagram or Facebook.

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When Your Doctor Doesn’t Get It

I’m currently 5 months pregnant and have had some frustrating experiences with the midwives I see, even though I told them from the first appointment that I have a history of an eating disorder. But they are hyper-focused on food and have suggested fad diets. The last midwife I saw asked me to walk her through a typical day of my diet, starting with breakfast. I told her I was not comfortable with that (I’m very protective of the recovery I worked so hard to achieve!) and I don’t want to find myself triggered by focusing too much on diet. She said she wanted to be sensitive to that, but then proceeded to be anything but and asked me questions like, “Do you eat fast food?” with a judgmental tone.

Unfortunately, it’s common for people with eating disorders to have run-ins like this with the medical community. I’ve heard some doosey stories from clients, let me tell you, including the patronizing but typical, “Just eat,” or “Just stop it” responses when they finally have the courage to disclose their disorder.

So it’s completely understandable that for many people with an eating disorder, going to the doctor is a very anxiety-provoking experience. Sometimes, it can even be downright triggering. Here are some tips to help it be a more positive experience, as well as what to do when your doctor just doesn’t get it.

Tell your doctor about your eating disorder or history of an eating disorder. I know, I know… I just talked about how awful doctors’ responses can be. And it is, admittedly, just a really uncomfortable conversation to have. But they don’t have an opportunity to respond well if they aren’t told, and they will hopefully show some sensitivity (there really are some who do!). Also, some meds are not recommended for people with certain eating disorders because of possible adverse reactions like seizures so your doctor needs to know your entire medical history when prescribing things for you.
Opt to do a blind weight or don’t be weighed at all. You can close your eyes or stand backwards on the scale while they weigh you so you don’t see your weight. Or you can just not be weighed at all. You might get some pushback, but it is your right to refuse.
Communicate with your doctor about what triggers you. Whether it’s avoiding being weighed or declining to talk about a fad diet that’s being suggested, you can draw boundaries by saying you don’t feel comfortable discussing those things. IMPORTANT: I’m not suggesting automatically shutting your doctor down about these topics, because ideally, they should be a part of the team helping you be healthy. And you need to be sure your motivation for avoiding these topics is pro-recovery and not to hide or maintain your eating behaviors. But some doctors just aren’t sensitive or informed enough about eating disorders to be helpful. So if you’re realizing your doctor falls into that category, be your own advocate and remember that you, not the doctor, are in charge of your care.
Find a new doctor if necessary. If advocating for yourself and offering your doctor some education about eating disorders isn’t working (or you don’t want to even put that effort in), don’t be afraid to part ways with your doctor. We as patients are consumers, which means if we’re not comfortable with the service and treatment we’re receiving, we have every right to take our business elsewhere and shouldn’t feel guilty about that at all.

A big part of eating disorder recovery is learning to find your voice, so these tips are not easy to do. But they are an opportunity to practice using your voice, taking charge of your life, and realizing you are capable. You can do it.

Much love,

Cherie Miller, MS, LPC opened Dare 2 Hope Counseling to help clients all over the country get free from their food, weight, and self-confidence struggles. Her specialty is eating disorders, including anorexia, bulimia, binge-eating, orthorexia and other unhealthy eating patterns. Contact her here.

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A Potential Flaw in Positive Thinking Psychology

Photo Credit: ileanaandrei.ro

There’s a lot of talk these days about positive thinking and how important it is to change your thinking to improve your health and happiness. And while I won’t argue that our mindset affects our feelings and behavior (because I believe it absolutely does), I am concerned that we can put too much emphasis on thinking. That’s a big statement for a Cognitive Behavioral Therapy (CBT) therapist to make! But here’s the balance that I would like to bring to the discussion: Though highly influential, thoughts are not an all-powerful force in our lives.

There are potential drawbacks to believing that everything we think affects our behavior. So even while we acknowledge the significance of our thoughts and strive to have healthier, more constructive thinking patterns, let’s also recognize some limitations of our thoughts. For example, thoughts…

do not always reflect what we really believe, feel or want.
do not always mean we will act on whatever that thought is.
do not always reflect reality.

Let’s take a closer look at why each of these points is relevant.

#1. Thoughts do not always reflect what we really believe, feel or want. We all have had bizarre, maybe even dark thoughts that pop into our heads at times—that is a normal part of being human. It does not mean you are “crazy” or a bad person. Some people struggle with these types of thoughts more than others, particularly people with issues like anxiety, obsessive-compulsive disorder, or postpartum depression. On the extreme end, I’ve had clients who had intrusive thoughts about things like stabbing their spouses or molesting their child (even though they had no reason or desire to do such things), and they worried it meant there was something evil inside of them. Being bothered by your thoughts is a sign that they don’t reflect your wants or values. In cases like these that go beyond the “normal” occasional bizarre thoughts we all have, there are often biological causes for these thoughts. There is sometimes trauma in that person’s past that can be influencing these thoughts.

#2. Thoughts do not always mean we will act on whatever that thought is. Thoughts do not automatically manifest into behavior. None of my clients who had bizarre, or even violent, intrusive thoughts ever acted on them because that is not who they were.

Now, sometimes our thoughts do line up with our feelings and that makes it more likely we will act on them, but it doesn’t mean we have to. This is key for my clients in eating disorder recovery, who might have obsessive thoughts about not eating or about thinking they are fat (and also feeling fat). Though it can be incredibly difficult, they can choose not to act on those thoughts. In her book, Life without Ed, Jenni Shaefer describes it as “disobeying” the eating disorder. We can have thoughts and feelings about harming ourselves and decide to call a friend instead. A tape can play in our head about how that big presentation at work will be a flop, but then it turns out we nail it.

#3. Thoughts do not always reflect reality. Thoughts, like feelings, are not facts. Research confirms that much of what we worry about doesn’t even happen.¹ And just because we think something doesn’t make it true. We can think we’re ugly and actually be attractive. We can think we’re an idiot and be very intelligent. We can think we are boring and socially awkward while in reality, people find us engaging and pleasant to be around. The stories we tell ourselves are just that: stories. And sometimes stories are only partially true or sometimes they are completely false.

It is really, really good news that while we work on changing detrimental thoughts, we are not completely at their mercy until they change or go away. We can still choose to ignore or to act opposite of our thoughts when they aren’t healthy. Remember friends, we are not just thoughts… we also have a will and a conscience and many other elements that make up who we are and drive what we do.

Much love,

¹References: “85 Percent of What We Worry About Never Happens” By Don Joseph Goewey (www.huffingtonpost.com/don-joseph-goewey-/85-of-what-we-worry-about_b_8028368.html)

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