Fresh Focus Podcast: EP #91
Title: the pursuit of intuitive eating
Host name and Credentials: Erin Gobeille, MS, RDN
Facility: VA Portland Medical Center
Guests and Contributors:
Audrey Perkins, Registered Dietitian Nutritionist and Certified Intuitive Eating Counselor. Clinical Outpatient Nutrition at VA Puget Sound in Seattle, WA.
Christina Johnson, MS, RD, Outpatient Dietitian at the VA Portland Medical center in Oregon

Erin: Welcome to the Fresh Focus Podcast, I’m Erin your host along side Audrey and Christina. Thanks for tuning in today with us, we appreciate everyone listening. Let’s get right to it, why would someone out there listening want to pursue intuitive eating and how can we as dietitians help?

Audrey: Hi Erin thanks for having us on the podcast today, When I am first meeting with a veteran, I usually ask if they can see themselves in some scenarios such as do you only focus on what the scale says and feel like you cannot trust your body and hunger cues?

Erin: yeah that is a great start, what are some other scenarios you commonly see where learning about IE could be really helpful.

Christina: I have a great example that I frequently come across which is when veterans are trying to ignore their hunger or beause they are trying to restrict and reduce calories or have had a long history of dieting, when I am talking to them they are tired of the food restrictions and are tired of following that dieting cycle. One specific instance was a veteran who had been working with for a while and he was only eating 1 meal a day for several years because he was told he needed to lose weight and thought he that was the best way to do it and would report not feeling hungry and would generally 1 meal a day because he knew he needed to, over course of the time he was able to slowly include more meals and started to feel hunger again and one additional bonus was he noticed his weight didn’t change like he thought it would which made him more comfortable with him eating more consistently.

Audrey: another thing I like to ask is do you feel like you have an emotional attachment to food? Are you prone to reaching for foods for comfort, nostalgia, or joy versus actual hunger? While it is completely normal and human nature to eat for emotional comfort its more common than not to come across and talk with veterans who rely on this regularly to the point where they have no other methods to cope with strong feelings like boredom, anxiety, depression, and stress

Christina: yeah, Intuitive eating is a strategy for your relationship with food and not your movement the scale. You may experience weight loss or may you not. Like we have said before the goal and focus is not weight. One of the benefits of intuitive eating is to switch the focus and come back to ourselves, to step back into our bodies and relearn your own internal cues and signals to then develop more trust with being able to give us what we need nutritionally.

Erin: We know that there is a big difference between fad diets and science-based approaches for weight loss, disease management, etc., but for some, even attempting to follow science-based approaches can lead to an unhealthy obsession with food. We, as a culture, have overcomplicated the natural process of eating.

Audrey: absolutely. Our approach to eating is consistently influenced by diet culture, articles & opinion pieces, documentaries, books, etc. there is so much out there. A good overview of this is Fresh Focus episode #70. If you would like to hear more about that check that out, And as you mentioned, even a well-structured nutritional approach may be problematic for someone that has developed a poor relationship with their food.

Christina: The beauty of nutrition is that there are many ways to approach healthful eating that don’t require obsession over the little details. In fact, this is why we reiterate and love the concept of intuitive eating. Lets not forget the 10 principles of intuitive eating
Which include,
rejecting the diet mentality
honor your hunger
make peace with food
challenging the food police
discover the satisfaction factor
feeling your fullness
cope with emotions and kindness
respecting your body
movement- feel the difference
honor your health with gentle nutrition
something to remember is there are individual concepts to build on but they are not stand alone they all intersect with each other in our classes and individuals basis we often see people making breakthroughs with more than one principle at a time for example, challenging the food police while making peace with food choices may allow someone to enjoy some satisfaction that food brings which then leads to a better personal understanding of their hunger and fullness cues.

Erin: if you are listening and you felt a connection to any of those points and want to experience those principles or learn more about them and what they consiste of then intuitive eating may be a good approach for you.

Christina: in addition to those principles another thing intuitive eating includes body autonomy and the idea that you have a right to make choices over your own body, whatever that choice is. No one food or meal will make or break your health, we need to help folks discover the satisfaction you have the right to delicious satisfying food or meals free of guilt.

Audrey: exactly that….. I think the intention and the motivation behind everything we choose matters. A veteran beginning her journey with IE in one of our groups at the seattle VA shared her story on how dieting to be thin began for her during her time in bootcamp actually and she reflected on her desire to be thin was being influenced more by what the military wanted from her and not from her own desire to control size and shape of her body. Unfortunately the impact of this experience imposed this standard of health in her mind that years later she hasn’t been able to obtain and that her feelings of failure have lead her to try IE as diets just haven’t been working. She isn’t alone, we can often self-conceptualize as not being good enough. Instead of supporting health for the sake of function, quality of life, and longevity, we manipulate health variables for the sake of thinness, societal expectations and norms. Our veterans and society at large would benefit if we can recognize that our metric of success may have been misguided, and might be leading us to do things that aren’t really in our best interest when it comes with food

Christina: exactly Audrey I have almost the same story of a veteran who I met with last week and something to think about is trying to utilize that whole health approach and shifting to asking the person their why… Being able to tie in your goals to the understanding value is super important and being able to periodically come back to that reason and your why can help motivate you to continue on this journey. Its also a good reminder to frequently check back in with yourself when those thoughts or those behaviors or patterns come up that are kind of interfering with the ability to really get into the intuitive eating aspects.

Erin: what do you start with when seeing a veteran for intuitive eating or what are the first few things taught in your classes?

Audrey: that is a great question, since everyone is coming from different place with different experiences we often start meeting people where they are at, and often that is why identifying what their current relationship with food and their body is and how its been influenced by their previous experiences and dieting history from there we are able to slowly begin to implement the 10 IE principles.

Christina: and on my end on creating their awareness of their relationship with food and their body may be a lot of my veterans have a fear that they are going to be judged or have that history of being judged around their food choices and how they eat. A strong example of this is fear coming through surrounding physical activity for many of the veterans I have worked with many voiced not having a place they feel they can safely go to exercise due to the perceived fear of others judging them because of their weight or the size of their bodies.

Erin: yeah definitely I see that frequently too and a large part of IE is helping veterans shift that thinking……Your body is not the same as the next persons, we're not all meant to fit in the same shape or size or you know check off that box. Our genetics play a role, as do our environment, our habits, etc. These all play a role in our body shape, and function, and too often that isn’t getting discussed in these conversations. Even something as simple as fluid intake. For many of our Vets that have a hard time drinking enough plain water, when asked if they drank water growing up, they often say no. our previous experiences and learned behaviors and habits can be part of this discussion and we can learn from them.

Christina: a great place to learn, also learning how to pay attention and identify food rules and/or restrictions that may be present even when we don’t think they are, we encourage veterans to focus on that shift in thinking and being a little kinder to ourselves and being a little bit more flexible.

Audrey: yeah Christina and I think its important to note that there can be a level of grief so to speak involved in this, change can be very hard and learning new dietary habits is definitely hard for most of us. That process of grief can happen when you see these pictures and marketing that say “if you do X,Y, Z you’ll have this type of body.” You cannot grow 6 inches in height to look like this person but we often feel these pressures- we need to have realistic goals for ourselves to know what we can and cannot control with our bodies. One of my veterans took this advice to heart and changed his mindset from a weight loss number goal to focusing more on improving his meal diversity eating more high fiber vegetables and beans inplace of low fiber chips and white rice and in his case he has gone on to lose weight with these changes that he’s made and that has just been a bonus for him because he continues to focus on his food choices and creating more variety in his diet versus worrying about the number that is on the scale.

Erin: And also I think that can be helpful is viewing the body from a functionality perspective as opposed to aesthetic. That has been helpful even for me personally to build more gratitude and respect for my body by focusing more on how it's helping me to just survive and function day-to-day.

Christina: also being able to change your mind space, even if it's just within the intuitive eating process for the moment, or if you're in one of our classes and take a pause to disconnect from the societal pressures and just start thinking of yourself and what you may need. Sometimes can sounds selfish, but its really just self-care which we often times miss we refer to self care in a variety of ways throughout our IE course because it’s a big part of respecting your body one question often ask veterans to consider is if you were talking to a friend or a loved one what advice would you give them? Is it different from how you would talk to yourself?

Audrey: that is a great question. You know giving yourself permission to have one meal or one snack that you're eating just out of pure preference, and enjoyment, because you like it and you wanna eat it. Not having it based on any diet rules or trying to manipulate your body weight or shape at some form can be so freeing to do that.

Erin: for veterans listening how would they start here at the VA or what should they do if they are interested in talking with a dietitian?

Audrey: currently there are over 100 VA’s now offering IE counseling either 1:1 session with a dietitan or through a group setting. At our Seattle VA I offer personalized IE counseling so 1 on 1 services and I collaborate with a professional in mental health where we offer a weekly IE group and we accept enrollees from individual sessions that have expressed interest or through referrals from our collegues if you are interested if your facility has IE services you can reach out to your local VA or primary care clinic and ask to see a dietitian.

Christina: talking with a VA dietitan although not everyone is trained in IE or teaching classes can help give you the guidance into what direction to go moving forward whether that’s learning more about intuitive eating and applying more of those concepts as they're helpful and as they're applicable to your life or working with a dietitian for weight management or general health based on your why and what matters the most to you.

Erin: that is great information, such great conversation today, Thank you both again for joining today.
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