How to Trust Your Body's Cues
This week is a special edition of this newsletter, where I’m answering one of your questions in a bonus Q&A.
It hit me a few months ago that I get way more questions for my “Ask Food Psych” podcast segment than I’ll ever be able to answer there, so I’ve started giving some occasional bonus answers here as a way to respond to more of you lovely folks (thanks to all who’ve submitted questions!).
This one is from a reader/listener named Celia, who writes:
Hi Christy, I want to start out by expressing my gratitude for you, the podcast, and the work that you are doing. I’ve struggled with disordered eating for a long time now and only realized it as such once I found your podcast and book. A couple years ago I worked a very fast-paced job in healthcare. The doctor I worked for only cared about how many patients we could see in a day, and for many months I worked [X]-hour shifts plus the drive to and from work without eating, drinking, or even getting so much as a bathroom break. Due to this unintentional physical restriction, I started to binge daily. I panicked. I thought I had a problem and that something was wrong with me. Then I turned to the internet for help (the worst thing I could have done!) and read a ton of blogs and pages claiming that eating so much causes weight gain which leads to chronic disease. “Eat this and not that only at these times of day to be healthy.” Of course this caused me to develop orthorexic, anorexic, and restrict-binge eating behaviors. I finally left that job back in August and I found you and the pod shortly after and I finally realized that I wasn’t the problem!! Diet culture and fatphobia are the problem and I was starving! I’ve been doing so much better since listening to the podcast, reading your book, and since I’ve started seeing a therapist but I am still having trouble trusting my body and my hunger and fullness cues. I am eating regular meals now and am eating more than I used to but I still have days, in fact many days, when I still feel hungry even after full meals. I am finding myself hesitant to eat more because I know I just did... I have thought about seeing a dietitian for a meal plan to get back on track but am hesitant since there are so few HAES-centric practices. Do you have any suggestions on steps I could take to feel more in tune with my body and trust what it’s telling me? And how to tackle this fear that diet culture has instilled in so many of our brains? I cannot thank you enough. -Celia
Thanks so much, Celia, for that great question and your kind feedback. Before I answer, I’ll just give my little disclaimer that these answers are for informational and educational purposes only, aren’t a substitute for individual medical or mental health advice, and don’t constitute a provider-patient relationship.
First I want to applaud you for recognizing that you’re not to blame for your bingeing, and that diet culture and starvation are the real culprits. Your experience is a powerful example of how even unintentional restriction often begets disordered eating. These are such important realizations, and it sounds like they’ve already led to a significant amount of healing.
I also want to reassure you that your body is incredibly smart, and it’s working hard to make up for the starvation that you went through. The fact that you often still feel hungry even after full meals shows that your hunger signals are doing their job, pushing you to get the energy you need to recover from deprivation.
That post-meal hunger is also a good indication that you need to eat more at those meals.
Often when we’ve been caught up in diet culture and disordered eating, we continue serving ourselves diet-y portions and preventing ourselves from going back for seconds—even when we’re consciously trying NOT to diet anymore. (I went through this myself many years ago, and I’ve seen it in countless clients, so you’re definitely not alone.)
The solution sounds so simple—serve yourself bigger portions, and go back for more if you’re still hungry—but it’s not always easy when you’re healing from disordered eating.
So if you try to eat more and find that diet-culture thoughts and beliefs are standing in the way, it’s important to get more support. An anti-diet, pro-Health At Every Size dietitian would be a great addition to your treatment team, and the dietitians on my list of recommended providers are well versed in these paradigms. Most are working remotely right now due to COVID, and many offer sliding scales for folks with economic hardships.
In addition to eating more at meals and perhaps working with a dietitian, I also want to put in a plug for snacks.
Not only are we “allowed” to eat snacks (because we’re “allowed” to eat whatever and whenever we want—we all have bodily autonomy), but in general snacks are actually necessary for meeting our physical needs as well as our mental and emotional ones.
Snacks often get a bad rap in diet culture, but the truth is that if we're only eating the usual three meals a day and not having snacks in between, we’re probably not getting enough food to meet our bodies’ needs. That’s because human blood sugar naturally ebbs and flows every few hours, even if we eat what feels like a lot at mealtimes.
Celia, you didn't mention if you’re eating snacks in addition to your regular meals, but from the way you worded your question it made me think that maybe you’re not, in which case I'd be curious whether incorporating regular snacks between meals and before bed might help you feel more satisfied and less hungry all the time.
It can definitely be challenging to talk back to any diet-culture thoughts that come up when you think about giving yourself unconditional permission to eat snacks in addition to meals, but I know that many people find adding several snacks throughout the day is a game changer for reducing hunger and bingeing.
Again, if you find it hard to allow yourself to add snacks (or to eat big enough snacks to satisfy hunger), working with an anti-diet dietitian can help give you the support you need.
The last thing that jumped out to me from your question is the role that working in a doctor’s office played in the development of your disordered eating.
That office sounds like a pretty toxic work environment, where the pace set by the leadership led to a lack of self-care for the team.
To me, that really highlights the fact that doctors are people too—not gods, as they’re often made out to be in diet culture. They don’t have everything all figured out, and the way they live their lives isn’t automatically “healthy” just because of their profession. In fact, it’s often anything but.
Some of that has to do with the Western healthcare system, where physicians are often completely overbooked and overworked due to the requirements of insurance and managed care (and these days, global pandemics.)
An untold number of doctors also struggle in their own relationships with food, exercise, and body size, whether because of the fatphobic curriculum that they learned in medical school, preexisting issues that attracted them to medicine in the first place, lack of time for self-care, or other factors.
I wonder if the doctor you worked for was struggling with their own disordered eating, since it sounds like they probably didn’t have much time to eat during the day themselves. And in my experience, people who have positive relationships with food tend not to engage in meal-skipping or encourage it in others.
Whatever the case may be, I think it’s important to acknowledge that the way you were eating when you worked at that office wasn’t health-promoting, even if it was tacitly encouraged by a doctor.
That may sound obvious, but I wanted to make it explicit because I’ve known many people who were unconsciously holding onto disordered beliefs instilled in them by doctors (especially higher-weight folks who experienced weight stigma from doctors), and challenging those beliefs was important for their healing. Maybe it will be helpful for yours, too.
Thanks again, Celia, for this great question, and I’m wishing you all the best in your recovery.
Submit your own question for an upcoming episode of the podcast or newsletter here.
This week on Food Psych, we’re reposting a fan-favorite episode that answers many frequently asked questions about intuitive eating and Health At Every Size.
Social worker and friend of the pod Ashley Seruya joins me for our second FAQ episode, where we discuss what to do if you feel uncomfortable in your body at a higher weight, how to handle chronic illness, and why food-intolerance diagnoses are often problematic.
We also talk about the effect of health behaviors versus the social determinants of health, what to make of weight-loss “success” stories, the importance of rest, and so much more.
Check it out right here, and be sure to subscribe to the pod so that you never miss an episode. We’ll be back next week with a brand new episode that dives even deeper into intuitive eating.
Here’s to all the ways our bodies help us heal from deprivation,
Christy