TRIGGER WARNING: This article describes personal experiences surrounding disordered eating and exercise.

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A guest piece by a good friend of mine. Thank you for sharing your story.

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It’s 2016. I head to the gym at 10pm after a 12 hour day at work because no matter how tired I am, I feel I can’t miss it; I had a seafood laksa which was heavy on cream so I had to go, otherwise, I’m afraid it’ll show in the mirror. I worked on abs and cardio to burn it off and I feel better about myself now.

I look in the fridge for dinner and disappointment washes over me. All I have is chicken and rice (again). Everyone says I should be having it to compliment my training, but I can’t think of anything less appetizing right now.

Fast forward

It’s 2019. We had training tonight and worked on weight distribution when we were boxing which was challenging and fun. I feel like my function and performance is improving.

Looking in the fridge there’s leftover pumpkin curry – yum! I make sure I put some yoghurt in there for some extra creaminess and to take off the heat. Some custard for dessert and I’m satisfied and ready to study.

Three years on and my mindset about food and exercise could not be further apart. When I was younger, I was influenced by diet culture and felt like my personal worth was measured by my fitness and if I had a 6 pack. I developed a horrible addiction to exercise, sometimes going to the gym at midnight on a weeknight so I could keep momentum in my training. I created so many negative connections with food and restricted my diet to what I thought would help my muscularity; this caused body dysmorphia and when I ‘broke’ my diet I would spiral mentally.

In mid 2018 I transitioned to intuitive eating to improve my relationship with food and exercise. I can now accept if I miss a training session (and have rediscovered enjoyment in performance rather than look). I can now also eat without fear or restriction.

Intuitive eating allows food to be enjoyable again and removes the morality from eating – not good food or bad food, not low carb, not macros and no labels.

I would like people to know that negative body image and disordered eating can affect anyone. If you or a friend is struggling with these thoughts I would encourage you to reach out, as a peaceful relationship with food and body is possible.

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If you or a loved one is struggling with disordered eating, disordered exercise or body image concerns please reach out.

If you want to talk to someone right now

Kids Helpline (1800 55 1800) and Lifeline (13 11 14) have trained counsellors available 24/7 if you want to contact someone immediately.

National Services

The Butterfly Foundation

Butterfly’s National Support Line, 1800 ED HOPE, provides confidential support for:

• people with eating disorders
• people with body image issues
• family members
• friends
• anyone with a question about eating disorders or negative body image.

The Butterfly Foundation’s counsellors are professionally trained, compassionate and experienced in discussing eating disorders. Butterfly provides personalised coping strategies and support, and information to help increase your understanding of your, or your loved one’s, illness. They also offer guidance on treatment options and connections with other services and specialists.

Website: thebutterflyfoundation.org.au
Support services (available Monday–Friday):
Telephone: 1800 33 4673 (8 am – 9 pm)
Text-based chat via the website (8 am – 9 pm) or
Email: support@thebutterflyfoundation.org.au at any time.

National Eating Disorder Collaboration

The National Eating Disorder Collaboration is a great resource for up-to-date information and research on eating disorders. It also provides a list of state-by-state treatment services for inpatient, outpatient and community support programs in their ‘Services and Support Organisations’ section.

Website: www.nedc.com.au

Individuals living with a disability in Australia endure health inequalities related to a range of factors, including ineffective healthcare. All individuals deserve access to respectful and inclusive care. Healthcare that considers the complex physical, emotional, social and environmental determinants of wellbeing. Healthcare that caters to the abilities of each individual and supports them to engage in health enhancing-behaviours. This, my friends, describes the Health at Every Size approach.

As Liza wrote about in a previous blog, Health at Every Size (HAES) is a registered trademark of the Association for Size Diversity and Health (ASDAH). ASDAH outlines that the HAES approach is composed of 5 core principles:

• Weight inclusivity
• Health Enhancement
• Respectful Care
• Eating for Well-being
• Life-Enhancing Movement

You can read more about these principles here.

In working with individuals experiencing physical or intellectual disability, I have come to appreciate how applying these principles can help enhance disability care. In my day-to-day work, some examples include:

• Learning about how different food groups/nutrients can affect how our body feels NOT looks.
• Working on self-compassion and body respect NOT body manipulation. 
• Cooking to build capacity and skills and try new foods NOT to cut out enjoyed foods. 
• Grocery shopping tours to explore food preferences and food literacy NOT to compare calories on packets. 
• Interactive nutrition games to promote behaviours such as hydrating when playing sports or eating a varied diet to help with concentration NOT to elevate weight loss as a goal. 
• Education on weight science and the multitude of factors with disability that can lead to weight changes, such as medications and hormonal adaptations NOT placing blame and responsibility on the individual. 
• Communication with staff, other health professionals and family to reduce weight bias in practice and language NOT to reinforce stigmatising language and harmful weight-based goals. 
• Flexible meal and snack guides NOT prescriptive meal plans. 
• Understanding of disability and related eating behaviours NOT assumptions based on weight and size. 
• Acknowledging the social, emotional and physical significance of food NOT removing ‘bad foods’ without regard for overall quality of life. 
• Brainstorming enjoyable movement and community participation NOT forced physical activity.

People living with a disability experience enough adversity in their life. That is why I think it is paramount that I help lift the heavy burden of restrictive diets off their shoulders. HAES helps make this possible by centering self-care, acceptance and empowerment, regardless of size or ability.

The non-diet approach is a way of delivering medical nutrition therapy that focuses on optimising health behaviours. It rejects the notion that the pursuit of weight loss/body shape or size manipulation is the key to health. In fact, it acknowledges the damage that dieting for weight loss can do to our health and our relationship with food. Any of these side effects of dieting sound familiar to you?

• Weight cycling
• Food rules
• Inability to respond to hunger and fullness
• Restrict-over eat cycles
• Feeling guilty after eating certain foods/portions
• Lack of dietary variety
• Avoidance of carbohydrates/sugars/fat…
• Fear of weight change
• Stress when making food choices

On the surface, dieting with the intent of changing your body may seem like a harmless idea, maybe even health-promoting one. That is understandable considering we are swimming in a weight-centric wellness culture that elevates thinness. Often this occurs without deeper consideration for a) if weight loss is really necessary to improve the health and quality of life of the individual and b) what striving for thinness could really do to a person’s health.

Now, you may be thinking, how can a Dietitian help me without putting me on a diet?

Good question.

A non-diet Dietitian may help you work on:

• Connecting to and embracing your physiological hunger and fullness signals
• Body trust
• Achieving a diverse and flexible dietary pattern
• Breaking down black and white thinking about food
• Appreciating the natural variation in human body shapes and sizes
• Understanding weight science and the risks associated with diets
• Engagement in movement that feels enjoyable and sustainable
• Developing self-compassion to promote self-care
• Building food knowledge and a skillset around meal building

Importantly, this approach aims to help you get curious about your own body. When you think about it, diets, also known as restrictive meal plans/kilojoule counting/macro tracking/lifestyle (*cough, cough* weight loss) programs (I could go on!) assume that you do not have the ability to nourish yourself. They assume you need external rules and people telling you how to eat in order to find health. They tell you that there is no place for experimenting with food and no place for listening to your body.

This is simply not true. The non-diet approach helps you reclaim your body autonomy. It gives you the tools to navigate your own personal nutrition and wellbeing journey. You have the wisdom within you, the non-diet Dietitian is here to help you illuminate it.

So, what do you do?

I’m a Dietitian.

(Nervous laugh) Oh, I don’t usually eat chips/burgers/pizza/insert other stigmatised food. I’m usually a ‘healthy’ eater.

I have experienced many variations of this exchange recently when meeting new people and it has been playing on my mind. I can see why someone would have this response. It’s in the name after all – Dietitian. When the word ‘diet’ is on the table it’s not uncommon for people to think about food rules, guzzling fruit and vegetables and avoiding (perceived) ‘bad’ foods.

However, I must admit, this response makes me uncomfortable. I do not want you to feel compelled to have to justify your food choices around me. I certainly did not become a Dietitian so I could be the food police. I became a Dietitian to empower people to manoeuvre the world of food, nutrition and health in a way that enhanced their wellbeing. Essentially, I wanted to help people embrace food that made them feel good.

That is why in my work, I look at the bigger picture. Beyond food rules and diet plans. I appreciate that health and wellbeing are shaped by so much more than what we eat.

Of course, that is not to say that I can not see the value in nutrition. I just see greater value in viewing nutrition alongside other wellbeing-related factors, such as:

· Social connectedness and relationships

· Enjoyable movement

· Smoking

· Alcohol consumption

· Making time for sleep

· Body image & self-esteem

· Mental health

· Prioritising self care

These factors interplay with health, disease and eating behaviours – three areas that Dietitians help people navigate. Without consideration of these factors I would be unable to do my job effectively.

Instead, by viewing people within the larger context of their health, I am able to avoid making assumptions. I am able to see the harmful and misguided nature of making judgements based on food choices and behaviours.

Ultimately, I am able to see that whether or not you eat those chips says very little about your health.

You will not see before and after shots, weight loss “fitspo” or transformation pics on this website.

Why? For one, it is unethical for me to do so as a health practitioner (although that’s another story), BUT I also think there’s a lot in regards to health that can not be shown in one little photo.

When people choose to work on their health it’s important to accept that some people may need to gain weight, some may lose weight or some may stay right where they are.
This is not to say they have not improved their health – they could be eating more vegetables, moving in a way that makes them happy and their cholesterol may be down. All things we can’t see through a camera.

So if you are looking for transformation posts, I am sorry, I’m not your gal. But if you are looking for a compassionate space to chat about health, food and the occasional hilarious meme then jump on in.

Are you burnt out? Do you feel exhausted all the time? Does the thought of heading into the office make your stomach squirm? Or do you feel like you are getting nothing done? These could all be signs of professional burnout.

When we are highly stressed we can often become disengaged with food. This can happen in one of two ways.

We lose our appetite and forget to eat.
OR
We turn to food and engage in emotional eating.

When we have so much on our plate it can be hard to prioritise feeding ourselves in a sustainable way. So what can we do?

If our appetite is shot, it can be difficult to listen to our hunger and fullness cues. For some, it can be useful to set some rough times throughout the day to step away from the desk and eat. While mindful eating and listening to our bodies is important, at times of high stress these signals can be muffled. Using some relaxed structure in our day can act as a support in our journey back to eating regularly and adequately, in line with our body’s needs.

If you find your appetite does not return to your baseline, or these feelings are lasting longer than 1-2 weeks, reach out to your GP, Therapist or Dietitian for support.