Emotional Eating with Melainie Rogers: Rational Wellness Podcast 162
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Melainie Rogers speaks about Emotional Eating with Dr. Ben Weitz.
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Podcast Highlights
5:22 Losing weight is difficult, which is why 70% of the population is overweight. One of the problems is that many people overeat or binge eat for emotional reasons. When our clients are feeling anxiety, they tend to eat carbohydrate foods, which tend to increase the amount of serotonin in the brain. And while we are in this global COVID-19 pandemic, we are seeing a lot of anxiety and lot of this type of overeating.
7:34 When working with a weight loss client, we have to try to help our clients to understand their eating behavior and then work backwards to try to understand what feelings are triggering their behavior.
9:12 Not everybody who’s eating for emotional reasons have an eating disorder, but many do. A good acronym is HALT, which refers to eating for the following reasons: 1. feeling hungry, 2. feeling angry, 3. feeling lonely, or 4. feeling tired. If you do this occasionally, this could be normal, but if you’re doing this two or three times per week and feeling out of control, this is an eating disorder.
10:18 The difference between overeating and binge eating is that if you ate a whole pizza and then felt really full, that would be overeating. But if you did it and felt out of control and great distress by doing it, that would be binge eating.
11:00 One of the best strategies is to sort out what is biological or physiological from what is emotional. If someone skips breakfast and eats very little for lunch, then it is biological to be extremely hungry and to overeat because of that. If they binge at this time it would be considered a physiological binge. For patients with emotional eating problems it is important to eat consistently throughout the day.
12:20 Eating consistently is important for emotional eaters to break their cycle, but in the Functional Medicine world now the hottest trend is to skip either breakfast or dinner so that you 12-14 hours without eating, which is referred to as intermittent fasting, which is considered to have anti-aging properties. Melainie said that if intermittent fasting works for you and you don’t binge at the end of the day, then continue doing it. But if you find yourself overeating during that 8 hour window, then that may not be the right program for you. During Ramadan where you fast from sunrise to sunset, they often gain weight, since they tend to overeat or gorge at night.
15:22 The difference between physiological and emotional binging is that if the client is eating food consistently throughout the day and meeting their nutritional needs and they are still overeating or binging, this is emotional because they are hungry or angry or lonely or tired. It is important to make clients aware of this.
16:26 Mindfullness is being aware of what you are eating. Paying attention to whether or not you are really hungry. You should not eat when you are distracted, such as by watching t.v.. It can be helpful to jot down on a notepad how hungry you are on a 1 to 5 pt scale before the meal and how you feel after. It can also be helpful to write down what you are eating throughout the day, so you are aware of how much you ate.
20:15 The app Recovery Record can be helpful for clients with eating disorders.
20:50 Negative body image can be the motivation for eating disorders, so it is important to work towards having a positive body image or at least get to body neutrality, which means I just appreciate what my body can do for me. I may not love my body, but I’m not beating myself up all the time. It can be very difficult in our society where we are bombarded with imagery around the thin ideal.
23:25 If we eat unhealthy foods, we deplete our bodies of necessary vitamins, minerals, and other nutrients such as protein, which may make us crave more food. For example, craving sweets could be an indication that we are dehydrated or lacking vitamin C, while a craving for salty foods might mean that we’re deficient in sodium or calcium or magnesium or zinc. Eating a lot of low nutrition junk food can lead to someone being overfueled calorically, but underfueled nutritionally.
25:40 Eating foods like breakfast cereals that are fortified with vitamins and minerals is not as nutritious as eating real, natural foods like fruits and vegetables that are naturally high in vitamin and minerals and many other phytonutrients that are important and others that have yet to be discovered and appreciated. We are programmed to seek out variety in food so that we are more likely to eat all of these important nutrients and this can’t be replaced by a poor diet and a multivitamin. Supplements can be most beneficial when they top off a healthy diet.
27:21 A lot of people are feeling extra amounts of stress due to the current coronavirus pandemic and are more liable to eat unhealthy, processed foods that require minimal preparation. And such processed foods are actually less expensive per calorie than natural, healthy foods and many people are out of work or making less. And such processed foods tend to have a longer shelf life if you are stocking up to avoid frequent trips to the grocery store.
29:56 A lot of people are confused about what to eat, since the science seems to be changing and there is so much misinformation on social media around food and wellness. There are many wellness coaches and diet gurus with very minimal training in the science giving advise about the best way to eat. We have completely opposite diets–the meat only carnivore diet and the vegetable only vegan diet both being promoted and discussed as the best way to eat, so it is not surprising that so many people are confused about what the best way to eat is. The diet debate is as polarized as the political debate in the US right now.
32:52 We know that exercise has incredible benefits for mental health, physical health benefits, motility, flexibility, joint stability, bone density, etc. But high intensity exercise or overexercising can be another form of obsession like an eating disorder. This can be just as harmful as undereating. Overexercising can be very harmful and is done for an underlying body image issue, so we need to find out what is underlying the motivation for their behavior.
36:11 It is not unusual that clients who come to us for weight loss will tend to underreport what they are eating by about 50% because they feel shame and guilt that they have over not being able to do what we have asked them to do. Our job is not to shame them further, but to figure out how we can set them up to be more successful.
Melainie Rogers, RDN is a Certified Eating Disorder Registered Dietician and accredited supervisor in the treatment of eating disorders. She is the Founder and Executive Director of BALANCE eating disorder treatment center™ and Melainie Rogers Nutrition, LLC in New York City. Among her many affiliations Melainie is the founder and recent past president of the New York City Chapter of the International Association of Eating Disorder Professionals (IAEDP), an Advisory Board Member at the Center for the Study of Anorexia and Bulimia (CSAB) and a former Board Member of the Binge Eating Disorder Association (BEDA). She is also an adjunct professor in the Department of Nutrition and Food Studies at New York University. She recently published Redefining Wellness: The Ultimate Diet Free Guide, a free e-book that contains contributions from 150 experts, which can be found on her redefiningwellness.co website.
Dr. Ben Weitz is available for nutrition consultations, including remote consults via video or phone, specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111 or go to www.drweitz.com. Phone or video consulting with Dr. Weitz is available.
Podcast Transcript
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. To learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast. Hello Rational Wellness podcasters, Dr. Ben Weitz here. Thank you so much for joining me again today. For those of you who enjoy listening to this podcast, please give us ratings and review on Apple podcasts. If you’d like to see a video version, go to my YouTube page. And if you go to my website, drweitz.com, you can find detailed show notes and a complete transcript.
Today our topic is emotional leading with Melainie Rogers. I think I butchered your name, but there are many-
Melainie: Oh, that’s perfect.
Dr. Weitz: There are many reasons why approximately 70% of Americans are overweight or obese. There are genetic factors that make it difficult to get and keep your weight into a healthy range. We may be taking certain medications such as antidepressants that tend to make us overeat. There are various hormonal factors, many of which can be treated. Insulin is secreted when we consume foods with a lot of sugar, and a large insulin surge in response to eating a bowl of breakfast cereal or a doughnut will tend to drop your blood sugar making you crave more sugar. By the way, I saw an executive from one of the companies that make cereal on CNBC, and he was bragging about the fact that, “Isn’t it so great that Americans now are eating cereal for dinner as well as breakfast?”
Melainie: No. Wow.
Dr. Weitz: Anyway, back to sugar and insulin. Every time we develop insulin resistance, so our pancreas needs to pump out ever greater amounts of insulin, which makes us crave more and more sugar, and more carbohydrates, and we end up in this vicious cycle that is hormonally related. In our society, inexpensive, highly processed, and addictive junk food is readily available. Such unhealthy food products have been specifically designed to be hyper palatable and addictive. And there’s aggressive marketing to convince us that eating such foods are good for us. And if we eat such high sugar, high fat, high salt foods regularly, we end up being depleted of necessary vitamins, minerals, phytonutrients. And so this may encourage our bodies to eat more to get those nutrients we need. Of course, being cooped up inside due to the COVID-19 crisis, which we’re currently undergoing with the stress and worries about getting infected and dying, as well as our loss of income, provide additional reasons for unhealthy eating.
Melainie Rogers is here to join us today. And she’s a registered dietitian and a certified dietitian and a certified eating disorder registered dietitian. She’s the accredited supervisor in the treatment of eating disorders. She’s the founder and director of BALANCE Eating Disorder Treatment Center in New York City. She’s the founder and past president of the New York Chapter of the International Association of Eating Disorders Professionals. And she is definitely one of the top experts in binge eating and anorexia, et cetera. She recently published Redefining Wellness: The Ultimate Diet Free Guide, which is a free ebook that contains contributions from 150 experts, which can be found on her redefiningwellness.co website. Melainie, thank you for joining us today.
Melainie: It’s a pleasure, Ben. Thank you for having me.
Dr. Weitz: Before we start the conversation, I’d like to start with a request or a comment. I know that, looking at some of your work and your blog posts, that you’re used to often speaking to a lot of women who may be more right brain in their thinking about emotional eating. I assume that they are probably a big part of your target audience. But I think most of my audience and myself are very left brain analytical focused. We talk about health and functional medicine. I think it’s important to deal with the emotional stuff, but if there’s a way that we can do it so that limited left brain people like me can understand it, that would be helpful.
Melainie: Sure. As a left brain person myself, I’m trained in research. So we will definitely talk about the research, and then of course behaviors.
Dr. Weitz: Very good. Losing weight is very difficult for most people, which is one of the reasons so many people are overweight. I think the latest statistics show in the United States, something like 70% of the population is overweight. I work with a lot of clients who are trying to lose weight and many of them have emotional reasons for why they eat. Can you explain some of the emotional reasons people have for overeating or binge eating?
Melainie: Absolutely. Not most people, but many people, guys and gals, I know you mentioned women earlier, but for overeating and emotional eating, it’s about a 50/50 split between guys and gals. The reason for that is because we all, male and female, experience emotions, and a driving force behind the key emotion, which is anxiety, is actually our amygdala. Amygdala is a part of the brain that is responsible for that flight freeze response. And that’s the part of the brain that’s responsible for pumping out this feeling of uncertainty and anxiety, generalized anxiety. What we know from emotional eating, Ben, is that most of our clients or general population, when they’re feeling anxious, they seek out carbohydrates, usually. They don’t usually seek out a chicken breast, right? The reason to that, my clients say to me, “My God, I don’t know what it is. Why am I addicted to carbs or sugars?” It’s not that you’re addicted to carbs or sugars. It’s that carbohydrates, specifically, when you ingest them increase the amount of serotonin in the brain. Now, many of your viewers may know that serotonin is the chemical that reduces anxiety. So we’re talking about a neurobiological process here, that we call emotional eating, because we think it’s all about emotions, but it’s actually a whole chemical response and a domino effect that leads to overeating. And right now with COVID-19, we’re seeing so much more of this type of eating.
Dr. Weitz: When we come in contact with someone who’s trying to change their weight, how do you determine what the underlying reasons are? Not everybody is willing or able to actually articulate why they’re overeating.
Melainie: Absolutely. And a big part of that, too, is that, as a society, we’re not actually encouraged to check in with our emotions, and certainly there’s a gender bias there. Where guys are definitely not at all encouraged to connect with their emotions, they’re encouraged to be stoic and to pull yourself up by your bootstraps and just get on with it. Which that kind of a suppressed emotion just leads to a lot of things going sideways, hence we’ve got guys and gals, but more predominantly guys, who drink excessively, who have sex addictions, who gamble excessively. Those are behaviors that are working sideways; too many underlying emotions, which they really have lack of awareness around. For us, what we try to do is help our clients understand, or at least start with the behavior because that’s very concrete, and then work backwards to, what’s the trigger around why you would do that? Often, for many people, that’s pulling back the layers to figure out what are those underlying feelings, which make people really scared. People get really scared to think about feelings. It’s amazing, actually, but yes, that’s the process.
Dr. Weitz: So is everybody who’s eating for emotional reasons, do they all have an eating disorder?
Melainie: No, not at all. But they probably have disordered eating. So it’s on a spectrum. For many of us at some time, we’re all going to eat out of emotion. A really good acronym that’s often used in the substance abuse world that we’ve adopted in the eating disorder world is HALT, hungry, angry, lonely, tired. The whole quintessential, I roll into bed or I crawl into bed with my pint of ice cream and binge, watch TV, Netflix, or whatever. So that’s emotional eating for comfort. Maybe there’s been a break up, or your boss yelled at, you or COVID-19. So it’s on a spectrum. And doing that occasionally just means you’re normal. But if you’re doing that two or three times a week and feel very out of control and can’t stop it, then by default of the frequency and the severity of it, then it may fall into the criteria of what is an eating disorder.
Dr. Weitz: And then, what’s the distinction between emotional eating or overeating and binge eating?
Melainie: Binge eating is when you eat a larger amount of food than other people would normally have. Let’s say you have two entrees for dinner. You eat very quickly, and you feel great distress doing it. It’s one thing to sit down and eat a whole pie of pizza, pizza pie, and be like, “Oh gosh, I’m really overfull. Wow, I ate all that.” But there’s not a distress attached to it. That wouldn’t be considered a binge. A binge is when people feel out of control and feel great distress by what they’re doing.
Dr. Weitz: Okay. What are some of the best strategies and tips to help patients, clients avoid overeating or binge eating?
Melainie: Number one thing we find is biological. My job as a registered dietitian is to separate out biological or physiological binges from emotional binges. How I would differentiate the two then is that, a physiological binge is when our clients get up in the morning, maybe they’ve binged the night before and they decide, “Oh, I’m going to skip breakfast this morning.” Or, “I’m not hungry for breakfast.” They get to lunch, and they decide that they’re going to have a tomato and a piece of lettuce, because they’ve got to make up for calories that they consumed the night before. And you guess it, by the time they get to the end of the day for dinner, they’re absolutely ravenous. That’s a physiological hunger. Then when they sit down to dinner, they don’t just have their steamed chicken breast and a little portion of broccoli that they intended to have, they in fact, go on an outright binge and usually have fried this and fried that and fried this and feel out of control. So that’s a physiological binge. How we try to reduce that is by having people eat consistently throughout the day. That means you have to have a breakfast, you have to have a lunch, you have to have snack, you have to have dinner. Go ahead.
Dr. Weitz: Yeah, I have to jump in here because this is a constant discussion we have in the functional medicine world. I’ve been working with clients with nutrition for over 30 years now. The big thing we started with was, people skip breakfast, they’re rushing around, they have a snack for lunch and then they overeat for dinner, and that’s why they’re all overweight. And the mantra was, “You have to eat breakfast, you have to eat within so much a period of time of waking up. You have to have small meals throughout the day.” For years we were preaching, “That’s the way to be healthy. That’s the way to balance your blood sugar.” And now the big thing in Functional Medicine is, the way to be healthy is to do intermittent fasting by skipping breakfast.
Melainie: I know. I know, right. I know. Because it’s the goal of getting a 12-hour break on your body, right?
Dr. Weitz: Yeah, or 14 hours or 16 hours, and pressing your eating window into a narrow range It’s funny how it comes full circle, but anyway go ahead…
Melainie: It’s so funny because… No, you’re absolutely right, because it used to be low fat and then it was no carbs, and now it’s, sorry, intermittent fasting. I don’t really advocate any one diet. What I do for my clients is try and figure out what works for them. But we do know conclusively that if you skip breakfast… Or let’s say you don’t do breakfast, I’m cool with that too. I’ll work with whatever the client wants to do in the sense of guiding them. But if you’re just eating lunch and then you’re eating dinner and you’re binging, I would suggest that you’re just not taking in enough calories for the day, and that’s a physiological binge. Yeah, those intermittent fasters out there, whatever works for you. But if you are binging towards the end of the day, then you may want to have a look at that. What’s interesting about that, Ben, is that it used to be, “Don’t eat after 7:00 PM.” But I think that went out the window because with our current lifestyle, people don’t usually get to dinner until 8:00 or 9:00. So I think this is the new modification on that, which is just trying to create some kind of gap. But also it makes me wonder that, are people just there for binge eating or grazing through those eight hours that they can eat? During Ramadan, for example, when the Muslims fast for a month, people gain weight.
Dr. Weitz: Is that right?
Melainie: Because they starve and then they binge. I’m laughing. I’m sorry. It’s not a laughing matter. But we know that the-
Dr. Weitz: No, no. I know that you’re laughing out of irony. Yeah.
Melainie: Yes, out of irony. I mean, we know from the research that the number one way for people to gain weight is by restricting so excessively that they end up being out of control around food. That’s just a physiological fact.
Dr. Weitz: If that’s the physiological or part physiological-
Melainie: Yes, binge.
Dr. Weitz: Then what’s the difference between the physiological and the emotional?
Melainie: If a client is then eating consistent food intake throughout the day and meeting their nutritional needs, their fuel needs for the day, and they’re still finding that they’re getting out of control with eating and it’s not hunger-driven, we know it’s emotionally-driven. So then that becomes the big question of, what are those underlying emotions? So for people who are overeating it can be, the acronym I used earlier. Well, hungry, we just eliminate it, because we’re having consistent eating. But now we’ve got angry, now we’ve got lonely, now we’ve got tired. And so it’s important for clients to then have a look at, “Why am I eating right now? I know I’m not hungry.” That brings into play mindfulness, which is just observing your behaviors and not judging, Ben, but just being curious. Like, “Why am I doing this? I don’t want to eat this. I’m not even tasting it.” So helping clients increase that awareness around their behavior.
Dr. Weitz: What is mindfulness? Everybody throws it around. And when I talk to people, a lot of people are not really sure what it is.
Melainie: Sure. Mindfulness from the definition or how we operate with our clients is really awareness. Just being aware that, “Hey, I’m reaching for the third or fourth, or fifth slice of pizza, and I haven’t checked in if I’m even hungry because I’m usually disconnected.” If we think most of us are disconnected like this from what our body is needing from a hunger and fullness perspective, that’s our internal regulatory system. Leptin, ghrelin, PYY, all those great feedback hormones are dictating that. What we really want to practice or get back into doing is checking in with our body and saying, “Gosh, I think I’m full. I don’t actually need that extra slice.”
Dr. Weitz: What’s a practical tip for somebody who’s sitting down and they’re eating. Is there a little tool that they can use to be mindful while they eat?
Melainie: Absolutely. There’s a lot of different ones. Some of them come back to the oldies but the goodies which is, “Don’t eat when you’re distracted.” And for many of us it’s for dinner anyway, sitting down in front of the TV or the computer and eating, and we look at our plate, “My gosh, gee, did I eat all that? I didn’t even realize it. The plate’s empty, I must have eaten it.” That’s distracted eating. First and foremost, try to reduce the distracted eating. Which means, turn off the TV, shut down the computer, sit there and be thoughtful and notice yourself eating your meal and check in with your body. For some people, it can be helpful if they have a little notepad and just think, “Oh, how hungry am I?” And use a one to five point scale? “How hungry am I when I go in? How full am I at the end of the meal? So that they have a little bit more data collection that can feel more concrete for them around this process, so it doesn’t feel new and ethereal and not scientific. Those are just a couple of real simple things. The other thing is when you plate a meal, if you go back for more check in, ask yourself, “Am I still hungry?” “Yeah, I’m still hungry. Maybe I’ve got some mouthfeel going on, so maybe I want some dessert to wrap up,” or something like that. It’s really checking in with yourself.
Dr. Weitz: Okay. What are some of the other techniques we can use?
Melainie: Some other techniques to use would be having a look at… Checking in, “Did I eat throughout the day today?” For some people, writing it down can be really helpful as a scientific experiment on themselves. So that-
Dr. Weitz: You mean write down what they’re eating?
Melainie: Yeah. Or even if you don’t want to write down what you’re eating, just write down the time that you ate throughout the day. So for some of us, we’re so crazy busy, Ben, and honestly, you can forget to eat. Your introduction earlier was about people who are just on the go, and you can really get delayed in eating consistently throughout the day. So if you even just decide that you’re going to write down what time of the day you eat throughout the day. It doesn’t matter what the food is for now for this example. Then you can just check, “Did I eat lunch?” “Yes, I did.” “Did I have a snack?” “Yes, I did.” “Did I have dinner?” If on one particular day, you’re overeating at the end of the day and you go back to your notepad and say, “Why am I crazy hungry? Or why am I wanting to overeat right now? Did I eat today?” And you check back and go, “Oh, I forgot to have lunch.” It can happen. It could happen. Or, “I grabbed a snack for lunch instead of a real meal. And that’s why I’m starving right now.” That kind of data collection is important.
Dr. Weitz: Do you have any apps for doing that?
Melainie: Yeah, I do, actually. We don’t tend to use apps that have calories, because I find that that keeps everything external. I want clients to get back to their internal regulatory system with those hormones we talked about earlier. There’s a wonderful app we use called Recovery Record. And it’s really about logging what time, what you ate, but also hunger and fullness. Then of course, if we think about hungry, angry, lonely, tired, it can also tap into if there’s any kind of emotional eating going on as well.
Dr. Weitz: What role does negative body image or body dissatisfaction play in? How can this be overcome?
Melainie: It plays a huge role. Because usually what happens is that there is a dissatisfaction with your body and a desire to change it, which usually in our society now, which idolizes the thin ideal, that usually means weight loss, or for a lot of us it means beefing up. And so therefore there is usually an attempt to, in the weight loss case, there’s an attempt to lose weight and reduce calories. What we know is that when you reduce calories below a certain amount for an extended period of time, that physiological response we spoke about kicks in and then people end up overeating, they’re fallen off the wagon, they feel despair, they regain the weight plus some. So body image in our current society can be a huge trigger for dieting, weight loss, and weight regain.
Dr. Weitz: How does somebody get a positive body image?
Melainie: It doesn’t happen overnight. I would say it’s pretty tough to do in the current society where, Ben, we’re just bombarded with imagery around the thin ideal. What we work with with our clients on is, “Okay, let’s not go from negative body image and hating your body to, ‘I love my body overnight.'” I think that’s almost impossible. What if we just get to body neutrality, which means I just appreciate what my body can do for me? I may not love it. I may still think this about my stomach and my thighs, but I’m not beating myself up all the time. So we work on our clients trying to reduce behaviors that might add to the negative body image, which means unfollow on Instagram and social media accounts that have you comparing yourself to others. In some cases, we even have our clients take up their full length mirrors and just have the mirror above your head, for example. Because if you can’t view your body without picking it apart, then maybe it’s time to just take a short break from doing that. And then there’s a lot of cognitive challenging of a lot of the thoughts that we all have, some challenging on those thoughts and some reframing of those thoughts to get to at least an appreciation of what your body can do for you.
Dr. Weitz: Can you talk about how, if we eat unhealthy foods we tend to deplete our bodies of necessary vitamins, minerals, and other needed nutrients, such as, say, protein that may make us crave more food? In one of your blogs, you wrote that craving sweets could be an indication that we are dehydrated or lacking vitamin C, while a craving for salty foods might mean that we’re deficient in sodium or calcium or magnesium or zinc.
Melainie: Yeah, absolutely. Well, we know that, and you alluded to this earlier, that if you’re eating a lot of what we call low nutritious food, which still has a role in an overall eating plan, but not if it makes up all of the eating plan. So foods that don’t have a lot of vitamins and minerals in them can ultimately lead to someone being overfueled calorically, but underfueled nutritionally, which means they’re deplete in vitamins and minerals. Then I think that blog really just speaks to cravings and how cravings can direct us. If you listen to your cravings, they can direct you in a way of what you might need a little bit more of.
Dr. Weitz: But it says on that box of breakfast cereal that it’s fortified with vitamins and minerals.
Melainie: I know. I know. Which is why maybe it could be a good dinner choice. Yeah, I know. Isn’t that crazy? Absolutely. We’re finding that out that the portion of the population that might be nutritionally depleted, even though we do have a lot of fortification, vitamins don’t necessarily, because we’re still doing the research on this, right? They don’t necessarily check all the boxes just as a sole entity. It’s a lot more complicated when vitamin C is detracted from a food source because of all the other elements that play along with the vitamin C, versus a synthesized vitamin C supplement, as we well know. Yeah.
Dr. Weitz: When vitamin C is found in foods like oranges, there’s all sorts of bioflavonoids and other phytonutrients, many of which we’ve not even figured out what their role is. I’m a big believer in supplements, but supplements are topping off a natural diet. So you’re getting at least a good background of all those phytonutrients that are contained. Just recently, one of the studies on COVID-19, we’ve seen some positive data on vitamin C, but the bioflavonoids have been shown to be super helpful. I mean, some of the ones particularly that are found in foods that have vitamin C, like hesperidin and rutin. And so I think it’s important that you have a phytonutrient rich, healthy diet with lots of different colors of fruits and vegetables. And then take your vitamin C on top of that, you’re going to get a different response than eating Cheerios that are fortified with vitamins.
Melainie: Exactly. It’s amazing, Ben, because we’re actually designed to seek out variety in food. And this is the very reason for it. Because prior to us being able to actually identify that there are such things as vitamins and minerals, no one’s got a gauge built into their arm that says, “You’ve met your zinc intake and your magnesium intake for the day, et cetera.” Right? The way that our brains are structured is, we seek out variety of food to make sure that we’re actually getting in adequate vitamins and minerals throughout the day. Which is pretty genius when you think about it. And it can’t be replaced by just a simple supplement, as you rightly said.
Dr. Weitz: Unfortunately, a lot of people now are stressed, so they’re eating some of these unhealthy foods because they don’t require a lot of preparation. But the reality is, is we really have more time now because people are at home to fix yourself a really good healthy meal with lots of fruits and vegetables and actually being involved in preparing it, and prepping it, and cooking it. It’s actually an important part of getting the benefits and enjoyment out of a meal. I encourage everybody to do that. Now, on the other hand, I also understand that unfortunately, healthy foods are more expensive. You see at these food banks, you don’t see a lot of fresh produce being put into those boxes. You see boxes of cereal, and packaged foods and things like that. And because those are relatively inexpensive and ditto for junk foods, our fast food industry, which is probably still doing as much business as they were before because you can’t dine in but a lot of people do takeout anyway and it’s fast and inexpensive.
Melainie: Right. That’s so true. Also there’s a shelf life on those items that you mentioned at the food bank. Those things can be put on a shelf or put in a box, easily and stored, whereas fresh fruit and veggies don’t and they spoil. It’s just logistically a lot tougher. And also what we find with food scarcity is that some of the more socioeconomically challenged areas, particularly I can speak for New York City, anyway, there’s not a lot of grocery stores in certain areas, but there’s hell of a lot of fast food chains in those areas. It’s also access to food. So there’s a lot of factors that play into it. One other thing, Ben, is, yeah, some people are looking for what’s readily available. And this would be a good time to take the time to prepare some of these more nutritious meals and such. But I think honestly, it also comes down to motivation. I think so many people are feeling so flat right now with so much uncertainty that it’s just stressful. And when stress is high, your motivation tends to go low, which is counterintuitive to what would make you probably feel better. But we know about that, right? Motivation and behavior change is really tough as well.
Dr. Weitz: It’s interesting that there seems to be more information and ever on food, and healthy eating, and nutrition, and yet, a lot of people are still confused. Can you comment about that?
Melainie: Absolutely. I think it’s because there’s information overwhelm. They’re confused because, for example, we used to say that butter was bad, and then we went to margarine, and now maybe margarine is bad. So the science keeps changing and therefore consumers can’t keep up, is one thing. And now with social media, there’s such a plethora of information out there, it’s hard to even follow. And there’s so much contradiction out there as well. What my pet peeve is, is all the pseudoscience that is out there on social media. There was one stat I saw recently, which suggested that between eight to nine out of every 10 comments and information out there on social media around food and wellness is actually bad science or even no science. I mean, I’m a registered dietician. I was medically trained. And so everything that we do is based upon what is the research. So it’s frightening to see a lot of wellness coaches out there who have no training and no understanding of the research spreading incorrect and inaccurate information. I feel sorry for the consumer, because how can you possibly try to sort through what’s rubbish to fact? Then the facts actually do change as more and more research comes in as well. So it’s tough. I’m glad that I have the training that I have, but it’s still a lot of information to filter through.
Dr. Weitz: Yeah. If you’re on social media, it seems to me that the biggest trend right now is the carnivore diet, which is meat only. All you eat is meat.
Melainie: Right. Yeah. So a bit of caveman coming in there, but even caveman used to run around and get their root vegetables and fruits and berries from the trees and such like that. Yeah, it’s just another form of like the Atkins that was around a couple of decades ago, and it’s just the same thing-
Dr. Weitz: Even more extreme, you know?
Melainie: Yes, it is very extreme. It’s very extreme. The difficulty with that, and I know there are people who are pro; the difficulty with that, as we’ve seen with any of these eating plans, is that for a while it works for people until it doesn’t because taste fatigue, physiological needs are not met, et cetera. And then-
Dr. Weitz: Starving the microbiome…
Melainie: Exactly microbiome, and then people fall off the wagon. Then what’s so beautiful and brilliant about these diets is that when the consumer falls off the wagon, they blame themselves. They don’t look at the diet and say, “This diet was setting people up to fail.” Hence, it just perpetuates itself.
Dr. Weitz: What do you think about high intensity exercise for emotional leaders? You see people who are obsessed with exercise, especially the gyms are closed, but I’m a gym person and used to seeing certain people at the gym for hours at a time. And that’s another form of eating disorder is over exercising. So how should people who have a tendency towards emotional eating approach exercise?
Melainie: Exercise in moderation is really great for so many reasons. And you as a chiropractor and sports chiropractic person know this. I have a sports nutrition background as well, Ben. So you know that the mental health benefits, the physical health benefits, motility, flexibility, all of these things, we know exercise is really helpful up to a point. But what you’re speaking to is a behavior of obsessiveness and going above and beyond what actually technically is healthy. In fact, obsessive exercising is very unhealthy. What we look at with what we do is not just people’s obsession around food, whether it be undereating or overeating, but that obsessive tendency carries forth in other areas. And one of them, as you said, is over-exercising, which can be really harmful. But what’s really interesting about that is that some people overeat, or express their emotions through other ways; over-exercising is a way that people are trying to manage anxiety. It certainly has health benefits and therefore, unfortunately, it’s pretty normalized in our society because it’s like, “Oh, I envy that guy. Look, they’re three hours at the gym.” And it’s like, “Uh-uh (negative), that is so unhealthy.” I wonder about the work ethic, and also wonder about their relationships, because if you’re three hours in the gym, you’re not going to have some pretty happy people at home.
What we try to do there is we treat the whole person. So it’s not just about the food. It’s about what is your relationship with exercise? And also what’s driving that, and often it’s a body image underlying piece is driving that. For the guys it might be the bulking up, because there’s an underlying body image issue, which is an underlying anxiety issue. I mean, I’m simplifying these concepts, but for the point of the illustration. So we try to get at the underlying reason that one might be over-exercising and try to pull that back. Usually what happens is when you reduce, someone who’s an over-exerciser, when you reduce their activity, their anxiety goes right through the roof. Which is exactly what we want to see because then we’re like, “Okay, you’re self-medicating with exercise. So let’s get it, what’s the underlying anxiety about?” In the same way that someone might be drinking excessively, you take the alcohol out of the picture and you’ll see their anxiety going up. So we need to get at the underlying anxiety.
Dr. Weitz: How about a few tips for those of us who’re working with clients with weight problems? How about the client who’s not being honest with you? You make recommendations for changing their diet and exercise and they come back and four weeks later, no change, haven’t lost a pound, maybe gained a pound and they claim that they’ve eaten nothing all day except a salad and some tuna fish and an apple and they’re doing excessive amounts of exercising. You just know it’s not the case. How do you approach them?
Melainie: Well, there’s a couple of different things there. First and foremost, we know that for a lot of our clients, because of shame, and they want to be seen as doing the right thing, and they want to not do the right thing. They want to follow your recommendations. They want to please you, Ben, they want to please me. They’re coming in, they’re paying us money. And then they find they can’t. Then they feel great shame about their behaviors. And they also feel shame about the fact that they can’t do what you asked them to do. So they’re not always forthcoming with the reality. We know with our clients that 50% of what they tell us is either true or not true in the sense of, for our under-eaters, they’ll report that they’re eating a lot more than they are by about 50%. And for our over-eaters, they’ll under-report how much they’re eating by about 50%. So we know that from the get go, that that is part of the shame. Our job is not to shame them further, but to figure out how we can set them up to be more successful. So maybe those goals were too ambitious. Or maybe, actually, this is not just occasional over-eating, but there’s a serious problem going on here that they’re not able to rein in on their own, and they actually need more help and more support around that. And maybe they need more therapeutic support to handle the emotional stuff that’s causing them to overeat and then lie about it. Then of course, there’s the other piece… Sorry, Ben. The other comment there is, the lessons learned from the greatest loser is that people massively restrict and they’ve lost a lot of weight, even though they still may be in a higher body weight, their metabolic rate shuts down and all sorts of biochemical processes change. And that endures for up to six or seven years; we’ve seen from the research thus far. So-
Dr. Weitz: What have we seen from the biggest loser? Can you go over there?
Melainie: Yeah. From the biggest loser where they’re able to do research on people who’ve lost a hundred plus pounds and are able to follow up with them six and seven years later, all of them regain plus some. And what they actually found is that the weights they return to, their metabolic rates never recovered fully to what we would expect a person of their body weight to be. If you-
Dr. Weitz: Wow. This is almost all of them, you’re saying?
Melainie: Yes. If you look at the Biggest Loser, which I hate that show but for research I have to watch it. And I was horrified by the shaming and it’s just disgraceful. But if you remember, those contestants were exercising six and seven hours a day plus. So it wasn’t that a lack of exercise was affecting their metabolic rate, which is a common thought in the sports nutrition world, that’s for sure, that exercise will protect your metabolic rate. It’s not true. Again, I guess what I want to say for our higher weight clients, it’s complicated. There’s so much that we still don’t know because of weight bias actually, Ben. There hasn’t been good research done because assumptions were calories in calories out. We now know that that’s not the case. That it’s much more complicated and nuanced and sophisticated than that. And so our higher weight individual, our clients, we don’t have good research to be able to advise them accordingly. So compassion is really important. And then making those recommendations more baby steps so that they can feel good, and they can feel that they’re succeeding.
Dr. Weitz: What could you do? Let’s say you’re in with a client and this is somebody who’s trying to lose weight, and you know they’re not being honest about the food they’re eating, how do you coax it out of them? What kind of a conversation or what can you do? So, for example, you’re recommending that they need psychological counseling besides the nutrition coaching that somebody like myself can provide. But how do you even bring that up if they’re not even admitting?
Melainie: Well, if they’re not admitting that means their shame is too great. Even if you were able to… So here’s the thing, previously, what I guess might’ve been encouraged is to just say to them blatantly, “I don’t believe a thing you’re telling me and you’re lying because the scale tells me the truth.” So my question to anyone who would approach them in that manner is, A, “Will the client come back?” B, “Did you help that client in the future to seek out help?” What we find is that when clients drop out of treatment, it may take them two years to come back, if at all. And we know that higher weight clients disproportionately don’t seek out help because they’re ashamed about their body and their weights. So shaming is not a way to go.
We know that our clients are going to under-report how much they’re eating because they’re ashamed of it. I’m just going to keep that in my mind, but I’m going to work with what they’re willing to talk about. That might be, I’m not going to comment on how much they had for dinner or not. I’m going to say, “Okay, well, did we have that breakfast?” How did you go with trying to get that breakfast in?” Or, “How did you go trying to get that lunch in?” “You know how we talked about having to make sure we get some protein in there? How did you go with that?” We talk about those one or two, or even three simpler ideas. Because the idea is if we can get food in and by food, I mean, you make sure you get your protein there, make sure you get your fat for satiety, make sure you get the carbs in there. I don’t want low carbs because you’re going to binge on those later. It’s a physiological response. If we can work on what we can add in at the times where there are gaps, then that can also help with overeating later on, even if they’re not reporting that.
I had one client that I worked with, Ben, for two years before she admitted that she was binging. I knew she was, but that’s part of her process. It’s like if someone’s drinking alcohol, and you know they’re drinking, but they won’t admit to it because that’s their process; denial. If you think of stages of change; denial, and then there’s pre-contemplation and contemplation. Motivational interviewing and thinking of stages of change with behavior can be really helpful as well. Also managing our expectations as the clinicians, because we know that if you just follow what I tell you, you’re going to really just see some great results and you’re going to be healthy and you’re going to recover. Then when they don’t do it, it’s really takes away from our sense of accomplishment. And so we have to check our egos as well and pull back and meet the client where they’re at with their process.
Dr. Weitz: How about when they come in for their first consultation and you’re somebody like me who just is super disciplined, and it’s like, “If this is healthy, then I’m going to do it. I can’t imagine why anybody wouldn’t do that.” You’re meeting a client and you know that they’ve had problems with weight for a long time. They may be told you that. How do you set them up for success? Because I know I’ve had the occasion more than once, unfortunately, of setting them up on a program and asking them to write everything down, and this is going to be so great. We’re all excited, and that’s it. Never saw them again.
Melainie: That’s right. That’s absolutely right. Because you set them up, you’re like, “We’re going to do this.” Yeah, because it’s overwhelming. It’s overwhelming for them. I think what’s really, really hard is, and I encounter this too, because I’m a registered dietician, so therefore, I know what to eat and what not to eat and all that stuff. I studied it for seven years, and other things. We have to be a little bit careful, Ben, because we bring our enthusiasm for what we do but if our clients were wired in the same way that we’re wired with our interests and our level of passion for this, they wouldn’t need our help. We have to bring it down a notch or two or three.
I like to share with my clients occasionally whatever, that I love my Doritos and my glass of wine. And I have to make sure I have my Kit-Kat or my chocolate every day; to normalize it and come down to their level, and to be able to say, “Gosh, I know this is really hard.” And maybe even reflect what other clients struggled with and how they were able to overcome it. Because I think using us as a benchmark… We’re the supposedly expert and we’ve done, hopefully, all this study and clinical practice to get where we are, but we still have to moderate that to help the clients. And maybe their baseline is this. Maybe that’s as good as it’s going to be for them, and they’re thrilled with that because it was better than where they were. But I hear you and I’ve been in the situation too. Beautiful plan and the client doesn’t come back, or they come in and they’ve done none of it. And that’s when you’re like, “Okay, those goals were way too big and overwhelming. Let’s just start with the basics.”
Dr. Weitz: Good. Okay. That was great. Any final thoughts you have for our viewers or listeners?
Melainie: I hope people have gotten out of this today just that, most people are doing the best that they can, and we can definitely help them to take that next step and take it in baby steps. Those extreme diets are usually not exactly what they’re cut out to be.
Dr. Weitz: How can people find out about your programs and getting in touch with you and your clinic and-
Melainie: Absolutely. Check us out on our website, which is balancedtx.com. And also we have a free 20-minute complimentary discovery call, Ben, for any callers who want to call in or sign in via our website. If you feel as though maybe you’re struggling or someone you love is struggling and you want to just get a better sense, “Is this disordered eating? Is this emotional eating? Is this an eating disorder?” We can help you sort through that.
Dr. Weitz: How about practitioners? Let’s say somebody like myself who’s not typically focused on the emotional stuff, is there a way, if I’m working with a client and I’m working with the dietary stuff, can we interface with you and your office on emotional part?
Melainie: Absolutely. I have a team of therapists and I have a team of nutritionists, so we have the medical piece and we have the psychological piece. Our whole philosophy is, gold standard of practices working collaboratively. So we would love to do that, Ben.
Dr. Weitz: So as a practitioner, how would I approach that with sending one of my clients too, but making sure that I can continue to work with them on the nutrition part?
Melainie: Oh, absolutely, that’s essential. Is if our clients come in with any kind of team member that they’ve been working with, our goal is to absolutely insist that they continue to see you because you know them the best. We want to hear from you what you’ve seen and observed so we can then set up the best care package for them with your collaboration and theirs. And then-
Dr. Weitz: So as a practitioner, would I call or-
Melainie: Absolutely. Just give us a call.
Dr. Weitz: Okay. Awesome. Thank you, Melanie.
Melainie: Thank you so much, Ben.
Dr. Weitz: Melianie
Melainie: That’s okay. It’s all good. Thanks, Ben. What a pleasure.
Dr. Weitz: It was a pleasure for me as well. Thank you.
