Heather Bray, RD
*Disclaimer: the views and opinions of this article are based on my professional opinion as a Registered Dietitian. This article is not meant to act as a substitute for medical or medical nutrition advice. For medical or medical nutrition advice that is designed for your individual needs, please consult your doctor or Registered Dietitian.
My thoughts on the latest Washington Post article - as a Dietitian, Certified Intuitive Eating Counsellor, HAES aligned and anti-diet practitioner
I agree that the anti-diet movement can come across as very extreme and one sided and like I always say about nutrition - it’s not black or white.
I think this article is told in a one-sided opinion and lacks quite a bit of nuance. I also, however, agree that the anti-diet opinion and demonstrations by some RD’s with a large following on social media can come across as confusing at the least. The food industry's adoption of the anti-diet movement can skew people's opinion of both the movement itself and the practitioners who endorse it. This leaves consumers feeling confused and skeptical of both food industry and the dietetic profession.
As a practitioner in this area I understand that not everyone needs an Intuitive Eating, HAES aligned, Anti-diet approach, although there is a very large group of people who do.
For those who I work with in this way, I’ve seen first hand the transformational impact this can make in one’s life. I’ve heard from people who spent 30+ years of their life dieting or spend over 95% of their day thinking about food to finally feel “free” thanks to the anti-diet movement.
The Correlation Between Body Fat and Chronic Disease
The article quotes a researcher from Berkley who says that:
“anti-diet advocates who deny the connection between excess body fat and chronic disease have “made up stuff that is a fantasy and a total fairy tale.’”
Facts: not all people with excess body fat have chronic disease(s). There are also many people without excess body fat who have chronic disease(s). Yes, there have been correlations made between excess body fat and chronic disease.
Here’s my opinion on the above as a HAES aligned, intuitive eating practitioner:
The anti-diet movement and being HAES aligned means treating people equally regardless of the number on the scale or body fat percentage. This doesn’t mean ignoring it but it also doesn’t mean focussing on it as a single cause or factor in determining someone’s health.
In fact, when I work with clients I give them the option to discuss weight or their body with me.
Again, it’s not about ignoring the connection between excess body fat and disease or the ways in which excess body fat can make one’s life difficult… It's about focussing on ways to improve health with small actions in one’s day to day life without shame. For example, starting with one meal at a time or finding ways to increase movement.
It’s also about understanding that health is complex and multifaceted and not all based on one’s body size.
Being a HAES aligned practitioner means that I support someone’s pursuit of health and their journey At. Any. Size and I will not treat them differently, nor do I believe they should be treated differently based on their size.
I also reject the notion that health has a specific size and therefore respect the fact that body diversity exists (e.g. if we all ate the same thing and exercised the same, we’d all still look different).
As a practitioner who’s done a LOT of work with clients with chronic disease, my primary focus is to get clients to eat in a way that’s most aligned with evidence. Which, if you took the dislipidemia recommendations (by the Canadian Cardiovascular Society) for example, it’s always about a Mediterranean style diet which I’m a huge fan of because it’s not extreme or restrictive.
Instead of getting someone to just focus on the number on the scale or the amount of body fat they have or calories they consume [which for most can feel like a guilt or shame inducing process], what I get clients to focus on is understanding how certain foods can help them. I also help them understand what makes them feel good and I empower them with nutrition education to make informed decisions.
Instead of focussing on eating less and imposing restrictive food rules that leave clients dreading appointments with me. This approach builds an alliance of trust and fosters feelings of empowerment - rather than shame and guilt. The feedback I always get from this approach is that it’s exciting and feels good to talk about food in this way. Most often I find that people end up making changes that are sustainable because they actually want to stick with them.
The "Eat Whatever, Whenever" Fallacy
One big misunderstanding about intuitive eating and the anti-diet movement is that people think it's about “eating whatever, whenever”. A big part of Intuitive Eating is about allowing all foods to fit which is often where this misconception comes from. There is also an entire chapter called Gentle Nutrition in Intuitive Eating which helps to explain what a balanced meal is. Or how moving your body can be important in both your physical and mental health.
About Weight Gain in those Working with Anti-Diet Dietitians
Intuitive eating isn’t designed to be pro-weight loss or weight gain. There aren’t any guarantees either way.
The article ends by explaining a story about an individual who gained weight working with an anti-diet dietitian and highlighting that this story isn’t unique. And to this I agree and can see why this is concerning for individuals.
I’ve seen many people gain weight in the beginning of their intuitive eating journey. This often happens as a result of adopting the principles of “rejecting diet culture and giving one’s self unconditional permission to eat” and going through the process of habituating previously restricted foods. Since people are excited to eat the foods they’ve previously restricted, a common phenomenon is to overeat said foods.
Many people who come to the anti-diet and intuitive eating space come from a long history of dieting and have gotten used to their body looking one way because of the extreme measures they had to take to get there or those who's weight has fluctuated a lot based on being on or off the diet du jour.
The goal of the anti-diet movement is to remove the ridiculous expectations of diet culture, including the ever perpetuated unrealistic “thin ideal”. It does not mean ignoring good, evidence based nutrition which is why it’s so important to work with a dietitian who understands this.
In my experience, I’ve seen that when clients are able to habituate foods - the food noise quiets, their overall happiness improves and they are better able to meet their nutrition needs. I’ve seen it improve people’s relationships along with work and exercise performance.
What I end up seeing most often is that a person who has habituated previously restricted food actually doesn’t end up consuming that food excessively anymore - because they’ve normalized it. The previously forbidden food doesn’t live on this pedestal anymore and they’ve built trust with themselves and are better able to regulate what and how much they eat.
As a RD I always work with people to help them understand their biology and what their physical needs are.
Just because I don’t promote restrictive diets doesn’t mean that I just throw science out the window and say “forget it, just eat whatever, whenever”.
I help clients understand ways to eat that fuel their body’s biology (e.g. getting enough protein, fibre and healthy fats and how eating more fruits and vegetables can be imperative in cardiovascular health, anti-inflammation etc.). But what I won't do is be the food police or perpetuate unnecessarily restrictive diets in the name of “health”.
I’m glad that this article brought up these common criticisms of the anti-diet movement, dietitian’s roles, food industry and Intuitive Eating because I think it helps us all have better conversations. I do not think that this approach to nutrition is for everyone but I do think that everyone can learn something from this movement.
If you’d like to learn more about the Anti-Diet movement, Intuitive Eating or Health at Every Size, I’d recommend the following resources:
Intuitive Eating 4th, Ellse Resch and Evelyn Tribole
Health at Every Size by Lindo Bacon
If any of this resonated with you, I’d love to hear from you. Feel free to comment below or reach out here.