In theory, I agree with the 10 principles in Tribole and Resch's Intuitive Eating: A Revolutionary Program That Works. They're all about healing disordered eating -- which, let's face it, is rampant among Americans, be they fat, thin, formerly fat, or formerly thin:
Intuitive eating is an approach that teaches you how to create a healthy relationship with your food, mind, and body--where you ultimately become the expert of your own body. You learn how to
distinguish between physical and emotional feelings, and gain a sense
of body wisdom. It's also a process of making peace with food---so
that you no longer have constant "food worry" thoughts. It's knowing
that your health and your worth as a person does not change because you ate a so-called "bad" or "fattening" food.
As I say, in principle these concepts (generally and more specifically as they're articulated by Tribole and Resche) are absolutely spot-on, and I actually have very few quarrels with the specifics of the book. It's well-written, insightful, and also suggests a number of practical exercises to help develop a healthier approach to the complex relationship among food, feelings, and our bodies that exists for many of us.
But --
Ultimately the book is written by nutritionists, and that's the source of one of its inherent weaknesses, I think. Yes, Resch is a licensed "nutrition counselor" (in Beverly Hills)-- but what neither of the authors is, as far as I can tell, is a psychologist, degreed in psychology. That is, despite being all about developing a healthier relationship with oneself and food, I think the book as a whole unintentionally underestimates the really complicated, deep-rooted, and engrained nature of disordered eating among those who are, specifically, morbidly obese.
I think the book may be most effective among people (women specifically) who may carry a little extra weight or who are compulsive dieters (or both).
But I'm not sure how effective it will be -- at least, as the sole tool -- for those who have been morbidly obese most of their lives, and it has its real limitations for WLS patients, though, to be fair it's not intended for WLS patients; if one can internalize the principles in this book and live them, one will never have to opt for WLS in the first place.
But that's a pretty large if, statistically speaking. The cold, hard fact of the matter is, only 5% of those who are medically morbidly obese will achieve sustained weight loss through conventional means; the other 95% will gain that weight back or fail to lose enough weight to reach a healthy BMI. The book can be really helpful for folks with a lifelong history of morbid obesity -- but speaking as one who spent the vast majority of her life morbidly obese, I believe such folks are going to have to diet and follow an eating plan in order to lose the weight at all, in order to lose it in a timely fashion, and in order to maintain a goal weight -- in addition to developing a healthier relationship with themselves and food. Similarly, just following a diet will rarely do the trick. And even then, those actions may not be enough to get you to a healthy place. People can develop a more intuitive, mindful approach to food, eating, and nutrition over time, and they can follow diets and exercise plans -- but in isolation those elements may never be enough for folks with morbid obesity to stake their health on, get the weight off, and keep it off.
While I believe folks can heal from really damaged -- and damaging --thinking and behaviors (rather as one can mend a piece of broken china and make it whole again), there are generally areas of vulnerability and weakness that remain (like the visble cracks on that mended piece of china) -- and extra steps often have to be taken to shore up those areas. Emotionally, physically -- it's going to depend on the individual, but the battle against morbid obesity and in favor of greater emotional and physical health generally has to be fought on several fronts, in multiple phases.
In my case, I'm an emotional eater who can still convince herself that her emotional desire for food is actually her intuition speaking. What I want to eat and what I need to eat for maximum health and vitality do not always align. Since having my DS, they match more closely than they ever did before, but they're not in sync a lot of the time. When I can't sort out the feelings from the food, I absolutely must rely on other cues:
- A daily food journal (I've kept it religiously since my surgery in 2005):"Okay, I may think I'm hungry; I may even feel hungry -- but I can't actually be hungry because I just ate a balanced, sizable meal half an hour ago, This must be about something else."
- A food plan (there's no single food plan that's right for everyone -- but there is a plan out there for each person): Even if I'm not hungry, I may still want to eat -- even after I've felt my feelings, processed them, and taken care of myself in other, non-food-related ways. (I view myself as a food addict who will always be in recovery; my DS helps make me the equivalent of a dry drunk, but the addiction itself isn't gone.)
That's where a food plan is helpful, regardless of my feelings. As a DS patient, my plan has few hard and fast rules, but they include the following:
- A minimum of 80-120 grams of protein a day. That's the bottom line. It doesn't matter if I want to eat it or not -- I must or I risk serious deficiencies that can lead to death.
- Ditto for certain vitamins and other supplements. Without them I'm sure to run into nutritional trouble leading to serious illness or death; with them, I have a chance of minimizing those risks, but some deficiencies are usually inevitable with most forms of WLS -- people need to realize prior to surgery that they're exchanging one set of health issues for another).
- And, to maintain my weight loss (and guard the precious gift of remission of Type II diabetes), I must minimize simple carbs as much as possible (I was pretty compliant during my initial weight-loss window with that third requirement; I'm not so consistently successful with this right now, though I still eat far fewer carbs these days than I did prior to surgery).
For other WLS patients or for non-WLS people, other food plans will be appropriate. But the key word here for me is plan. I believe plans are necessary for effective, timely, sustainable weight loss -- with or without WLS. Okay, don't call it a diet -- but don't expect to be able to develop intuitive eating without one, either -- not if you're morbidly obese and have been that way for a lifetime.
And on that note, I think I'd better adhere to my own plan and start swallowing my daily dose of supplements.
Breakfast today was a bowl of strawberries and a bamana, which was a really dumb, unhealthy way to start the day for a DS patient --> fructos = Sugar Central. Lunch was half a high-protein bagel with cheese and meat (much better choice), and this afternoon will include a protein shake and then a latte (options I feel comfortable with and good about). Dinner? I don't know yet because I'm spending the night in San Francisco at an old friend's house (a girls' sleepover to catch up on our lives -- yay!). But it will include protein and lots of it, that much I know -- and I'm packing a ready-to-drink protein shake for the morning to get tomorrow started off on the right foot.
As I didn't do today!
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