Self-Care in the Festive Season

The festive season can be a particularly challenging time for people with food and body image concerns. Factors like warmer weather, summer activities, social eating, weight loss marketing and diet talk can all mean that these anxieties are at the forefront of our minds. Here are some of our tips for supporting yourself during this time.

Be a critical consumer - You’ve probably noticed that diet ads are everywhere right now - even more than usual! Remember no matter how ‘new and improved’ these diets claim to be, diets don’t work, and in fact they can cause significant harm to our physical and mental health. Remember these weight loss diet companies are part of a multi-billion dollar industry which profits from making us feel dissatisfied with our bodies. It’s a powerfully radical act to say no to diets and yes to self-care.

Be mindful of diet talk - You might notice those around you talking about dieting and weight loss more at this time of year. There are many ways you could choose to approach this, depending on your relationship with the person and your energy at the time. You might let people know you’d prefer not to discuss food and body size, and share your knowledge about the harms of weight-loss dieting. Or you could decide to use the helpful strategy of distraction to divert the conversation to another topic. At other times you might subtly (or overtly) excuse yourself and take some time away from the conversation, it might be the perfect opportunity for a bathroom break.

Take care of yourself when social eating - Try to avoid the urge to restrict food in anticipation of, or after eating a meal which might be larger or more challenging than foods you usually eat. Maintaining regular eating can help to regulate appetite and not set yourself up with all or nothing thoughts and eating behaviours. During social meals try to focus on conversation and connection with others to distract you from distressing food thoughts. If there are particular foods you’re expecting to be challenged by, your therapy team can help you practice exposure to these foods ahead of time in a safe environment.

Engage your support system - Let your support people know this could be a more challenging time, and explore how they can help. This could be creating supportive meal environments, encouraging you to eat regularly, or being available to talk through your challenges. Making regular appointments with your therapy team can also help to hold you steady. You could also explore and engage with non-diet, recovery focused content, see the ideas on our Inspiring Links page

Be kind to yourself - It’s understandable that this can be a difficult time, with many potential challenges and triggers. Do your best to practice self-compassion, and remember that this period will pass. Also remember to look for and really pay attention to the joyful moments - even if they’re brief, don’t let them pass by without your full attention.

(Here’s our Director Janet’s dogs sharing a joyful moment last Christmas!).

Getting Away for the Holidays?

Many people have mixed feelings about the holiday season - while it can be a time of joy there can also be significant challenges for people with eating disorders or body image concerns.

These challenges can be even more intense when you’re planning to go away for holidays, or to visit family. Time away from home can bring changes to routine and daily activities; spending time with different or more people than usual; different food availability or access; increased social eating; and reduced access to usual coping strategies or activities. We’ve put together some suggestions to help prepare for the holiday season.

Food and eating suggestions

• Discuss your holiday with your treatment team, and problem solve to make a plan together

• Where possible, plan at least some of your meals, and think about when you might eat out or do your food shopping

• Have some easy options available while travelling, pack snacks or foods you’re more comfortable and familiar with and use these as a back-up when needed

• Work with your Dietitian to consider what a balance of safe and challenging foods might be like for you during the trip

• Pack clothing you feel most comfortable in

Support suggestions

• Have a trusted person you can debrief with - a friend or family member. It’s ok if the person isn’t with you on the trip, plan some phone check-ins with them if needed

• If you know you need plenty of alone or quiet time, let the people around you know and plan it in advance

• Think about different types of supports outside your immediate network, e.g. helpful social media accounts, helplines or online chats (see below)

• When you’re in social eating situations, trying to focus your attention on being present with the people around you and use this as a distraction to help you avoid over-thinking about food

Coping suggestions

• Think about distractions or activities you find helpful at home which you could take with you, e.g. journalling, knitting, reading, puzzles

• Write yourself a list of helpful coping strategies which you can use as a reminder when things get difficult, e.g. distraction, urge surfing, challenging thoughts, mindfulness or self-compassion practices

• Prepare some resources to keep you motivated while you’re away, e.g. podcasts, books, social media accounts. Check out our inspiring links

• Where possible, try to pay attention to things you enjoy or feel grateful for while you’re away, e.g. being able to travel, basking in the sunshine, spending time with people you care about

• Remember this is a temporary situation and you will soon be back in your familiar comfort zone

Useful Services

• Eating Disorders Victoria Hub

• Butterfly Foundation Helpline

'Wellness' Program or Diet in Disguise?

Intuitive eating and non-diet approaches to weight and nutrition have been gaining popularity as many people elect to step off the dieting treadmill and change their relationship with their body, and their eating attitudes and behaviours. As these approaches have gained momentum however, many diet programs, companies and influencers have begun to co-opt the language of ‘non-dieting’ to mislead people back into the diet cycle. A number of established weight loss companies have re-branded, and new ‘wellness’ programs have emerged, with strong marketing messages about supporting people to make ‘sustainable lifestyle changes’ rather than focusing on weight loss.

However, when you really look at many of these programs it’s clear that they have not really changed their focus, but have instead become traditional diets in disguise – the new breed of diet industry companies. These so called ‘wellness’ programs continue to promote restrictive eating behaviours, encourage people to monitor their weight, and hold at their core the false idea that thinness equates to health - only now with an added side-serve of ‘wellbeing’.

So how can you tell the difference between an actual non-diet approach and a wolf in sheep’s clothing? One of the main differences between dieting and intuitive eating is the focus on weight loss and changes to body shape which are integral to dieting programs. Intuitive eating however is weight neutral, and focused on healing your relationship with food and your body. Intuitive eating is not about weight loss, it won’t ask you to eliminate any foods from your diet, or to label foods as ‘good’ or ‘bad’. Intuitive eating is a not a hunger-and-fullness diet but rather is about unconditional permission to eat all foods, building body trust and eating foods which feel satisfying and enjoyable. Another main difference between intuitive eating and dieting is that intuitive eating has a strong evidence base supporting its effectiveness, compared to traditional diets which are shown to be ineffective for 95% of people (especially in the medium to long term).

This re-branding of weight loss dieting to ‘wellness’ is dangerous and confusing for so many people. This new generation of diets aims to differentiate themselves from traditional diets by claiming that they are not ‘fad diets,’ that they value ‘wellness over weight loss,’ and some even use the language of eating disorder recovery as part of their marketing campaigns. Yet most of these programs continue to focus on food restriction, monitoring or logging what you eat, and weight monitoring. These programs now commonly offer self-care activities ‘on the side’, and may market themselves with health buzzwords or topics such as gut heath or inflammation. They offer a simplistic view of health and wellness, and a narrow assumption that weight loss equals health.

Studies show that weight loss dieting is one of the biggest risk factors for the development of eating disorders and disordered eating. Yo-yo dieting which is characterised by the cyclic nature of losing and re-gaining weight has been shown to have negative effects on physical health and how you feel about your body. Dieting also promotes the development of maladaptive eating behaviours. When our food intake is restricted, food often becomes our focus, which can cause obsessive thinking about food, and can result in either further food restriction, or episodes of reactive binge eating – where the body tries to gain back some of the energy which has become depleted from restrictive eating.

So how can you tell the difference – how can you differentiate a diet in disguise from an approach which is truly focused on enhancing health and wellbeing?

An approach may be a ‘diet in disguise’ if it:

• Encourages you to disconnect from your body by ignoring body signals (including hunger and fullness)

• Is focused on changing your body - weight loss or body shape/size

• Asks you to count points, macros, or uses approaches like a traffic light system

• Uses negative language around ‘good’ and ‘bad’ foods, classifying certain foods as inflammatory, detoxifying, guilt-free, or clean

• Recommends that you restrict or eliminate certain foods or food groups

• Acknowledges that diets don’t work followed by a BUT… (insert dieting behaviour here)

• Causes you to feel preoccupied with food and weight loss

• Recommends you buy expensive supplements or unusual foods

As an alternative to diet industry programs we recommend an individualised and therapeutic approach to understanding your nutritional needs, and changing your relationship with your body. If you’re ready to make this change, the team of Psychologists and Dietitians at Mind Body Well can assist.

If you’d like to find out more about Intuitive Eating, check out our pre-recorded online program (click the image below).

Other relevant Blog posts:

• What is Intuitive Eating?

• Let’s set some perspective on ‘Food Addiction’

• What does it mean to be a Non-Diet Dietitian?

• Breaking up with weight loss

"Am I 'sick enough' for eating disorder therapy?"

It’s a common thought amongst people dealing with eating and body image concerns – that they’re just not ‘sick enough’ to need, or even to deserve therapy. Internally this might sound like all kinds of unhelpful self-talk including “I’m not sick enough to have an eating disorder”, “I’m not sick enough to need treatment”, or “My eating disorder isn’t as serious as others”.

There are many reasons why this minimising about eating disorders can be so common, the most significant being a lack of understanding about the nature and seriousness of many eating disorders. There are also so many cultural stereotypes which exist around eating disorders, including harmful beliefs that people with eating disorders look a certain way, and that eating disorders only happen to people in certain age groups or gender presentations. The truth however is that eating disorders can effect people of all body sizes, all cultural backgrounds, all genders, and all ages.

Another reason people can believe they’re not ‘sick enough’ to need treatment is the normalising of many disordered eating behaviours which occurs in everyday in diet culture. If it seems like ‘everyone’s doing it’ (ie. dieting), then it can be difficult to identify restrictive eating and obsessive weight concern as problematic - in fact these very thoughts and behaviours may be encouraged, especially for people who are in a larger body. The problem is that there’s a tipping point at which these thoughts and behaviours can become extremely harmful, and weight loss dieting can in fact be a significant risk factor for the development of an eating disorder.

For those who are already in treatment, the belief of not being ‘sick enough’ can be reinforced when certain medical tests or blood tests show results in the ‘normal’ range. It is important to note that medical indicators are just one sign of an eating disorder, and because every body responds differently, these indicators don’t show up in the same way for everyone. Rather than looking at medical results in isolation, it’s important to consider these results in combination with an analysis of eating disorder cognitions, emotions and behaviours, to understand the fuller picture of the impact of an eating disorder on a persons life.

Eating disorders are serious physical and mental illnesses, and every person who experiences an eating disorder is deserving of appropriate professional treatment - even if some days are better than others, even if there is no formal diagnosis of an eating disorder, and even if not everyone around the person recognises the eating disorder as cause for concern. Everyone deserves appropriate assistance to enhance their health and wellbeing, and improve their quality of life.

If you believe you might be experiencing the symptoms of an eating disorder, reach out to your GP and connect with a professional team who can assist your recovery. Read more about Establishing an Eating Disorder Treatment Team.

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At Mind Body Well, our team of psychologists and dietitians work together ro provide interdisciplinary care, in consultation with other members of the care team to deliver eating disorder therapy.

To learn more about our team of therapists you can CONTACT US, or complete the New Clients intake form below.

A Non-Diet Understanding of PCOS

September is Polycystic Ovary Syndrome (PCOS) awareness month. PCOS is a very common condition which affects between 12-21% of cisgender women and transgender/gender diverse people with ovaries during their reproductive years, with around 21% of First Nations people in this group being impacted. For many people diagnosed with PCOS the automatic recommendation from their medical team is to lose weight, or to prevent weight gain. This recommendation can however be highly problematic, so let’s explore the rationale behind weight loss advice for PCOS, and whether this is helpful management strategy (spoiler alert: it’s not!).

Summary of PCOS

• Symptoms of PCOS may include irregular or absent menstrual periods, fatigue, excess hair growth on the face and body, hair loss on the scalp and difficulties with fertility. Contrary to popular belief, you do not need to have cysts on your ovaries to have PCOS, however this is a common symptom

• Hormones play a big role when it comes to PCOS symptoms. People with PCOS often have higher levels of androgens including testosterone, as well as insulin resistance which means that our bodies are not able to use insulin to get glucose from our blood into our cells as effectively

• PCOS can cause chronic inflammation which can further disturb our hormones and increase risk of chronic health conditions including cardiovascular disease. Other factors that are common in PCOS and can increase inflammation include poor sleep and stress

• PCOS is also linked with a range of mental health conditions including depression, anxiety and eating disorders

• There is currently no cure for PCOS, however there are a range of options for managing PCOS symptoms and for enhancing quality of life

PCOS and weight

A significant proportion of people with PCOS live in larger bodies or report struggling to ‘manage’ their weight. Folks with PCOS often report that they find it hard to lose weight but very easy to gain it. One of the contributing factors to this is high levels of insulin and insulin resistance. Insulin is a growth hormone, so high levels tend to cause increases in weight.

One of the most common recommendations for PCOS management is to lose weight, often without taking peoples previous weight history into account. PCOS treatment guidelines often recommend reducing weight to improve PCOS symptoms and related biomarkers (i.e. blood test results such as testosterone or blood glucose), however sustained weight loss is very challenging and in many cases not possible, including for those with PCOS.

The good news? Other management strategies that don’t require weight change can be very effective in improving symptoms and biomarkers. And let’s not forget that people in bodies of all sizes can have PCOS, so it’s very important that weight loss not be focused on as a ‘one size fits all’ treatment.

Do weight loss diets work for PCOS?

Diets are unhelpful for the majority of people with PCOS for a number of reasons:

1. Diets don’t work for the absolute majority of people. 95-97% of people who engage in dieting to lose weight regain most or all of the weight within 2-5 years. 2/3 of those people gain more weight, and end up with a higher weight than where they started. For the majority of people of diet, this results in weight cycling with weight trending upwards over time. Weight cycling can increase the risk of chronic conditions such as cardiovascular disease.

2. Dieting increases the risk of developing an eating disorder. Eating disorders and disordered eating are common in PCOS, and dieting behaviour can add further fuel to the fire by creating an environment of restriction and preoccupation with food, weight and shape. Restrictive eating patterns or cutting out certain foods can actually increase the risk for binge eating – due to the all or nothing cycle which is stimulated by food restriction. This is often followed by an ongoing restrict-binge cycle, which creates an unhelpful eating pattern and relationship with food which can evolve into an eating disorder.

3. Some PCOS diet plans recommend cutting out entire food groups to manage PCOS. This can increase the risk of nutritional deficiencies, and as with any other restrictive diet can increase fixation on food and either further restrictive eating, or responsive binge eating episodes.

4. Insulin resistance is a common symptom of PCOS. With insulin resistance comes high insulin levels in the blood, which can impact our hunger and fullness signals because it stimulates our appetite. People with insulin resistance often report experiencing intense food cravings, particularly for foods rich in carbohydrates. This is because your body is not able to use the insulin in your body effectively to transport glucose from your blood into the cells, so it can literally feel like you are starving. The extreme hunger and food cravings often lead to binge eating episodes, which can then further increase insulin levels – and so the cycle continues.

5. What about carbs? You wouldn’t be alone in thinking that reducing your carbohydrate intake will prevent high insulin levels or insulin resistance. On the contrary - the stress experienced when following a restrictive diet can increase inflammation, which is actually linked with insulin resistance. Most people who have tried low carb diets find them to be too restrictive and ultimately unsustainable long term. Our bodies need carbohydrates from our food because carbs provide every cell and organ in our body with the energy they need to function. You know that pounding headache you get when you’ve eaten a low carb meal or haven’t eaten for a long time? That’s your brain screaming out for glucose. Low carb diets can lead to low energy, brain fog and mood changes, and also create a high risk of binge eating episodes.

So, if not dieting for PCOS what can I do instead?

• Discuss treatment options with your GP. There are a range of different medications, supplements and treatments that may help with managing your PCOS symptoms. It could also be helpful to see a reproductive specialist as part of your PCOS treatment team for more specialised advice and treatment options.

• Eating regular meals and snacks can assist to improve insulin sensitivity, regulate blood glucose levels and help to support energy levels. Giving your body adequate and consistent fuel can also help to regulate appetite and reduce binge eating.

• See a Dietitian who specialises in PCOS nutrition using a non-diet and weight inclusive approach. The Dietitian will be able to tailor recommendations to manage your PCOS symptoms and to support you to improve your relationship with food.

• Find a way to move your body that’s comfrotable, accessible and enjoyable for you. Movement is linked with improve insulin sensitivity, mood and sleep quality, as well as reducing long term risk related to chronic health conditions.

• Managing your stress levels can assist with reducing inflammation and improving overall mental health and wellbeing. You could also consider seeing a Psychologist to assit with developing healthy emotional coping and stress management strategies.

• Get enough sleep! Inadequate or poor quality sleep can increase inflammation, and feeling tired can contrinute to binge eating, so don’t underestimate the power of getting a good night’s sleep.

See also:

• Let’s get some perspective on food addiction

• What does it mean to be a ‘Non-Diet Dietitian’?

The Role of a Dietitian in Eating Disorder Therapy

Accredited Practising Dietitians are health professionals who provide nutritional counselling to encourage eating for physical, emotional and social wellbeing. A Dietitian who is trained and experienced in Eating Disorder therapy can assist people to understand their eating behaviours and relationship with food and exercise, and to develop patterns of eating which assist recovery.

Some of the areas an Eating Disorder Dietitian might focus on are: 

1.     Personalised nutritional assessment and recommendations – Dietitians undertake a thorough nutritional assessment, which enables them to provide education about adequate and regular nutritional intake which is personalised to the individual. This assists people to prioritise the foods they need to nourish their bodies and minds and is based on nutritional and behavioural science, rather than pop-culture trends and misinformation.

2.     Eating for wellbeing – Dietitians can help to dispel some of the myths of diet culture and move the focus away from eating behaviours which are labelled as ‘healthy’, but may actually be harmful. A Dietitian can assist people to understand the benefits of regular and adequate nutrition such as increased metabolic efficiency, improved digestive functioning, and reduced fluctuations in mood and energy. 

3.     Supporting flexible and social eating – Dietitians can assist people to develop the confidence and skills needed to eat comfortably in social settings by moving away from food rules to focus on other aspects of eating such as nourishment, taste and pleasure. A Dietitian can collaboratively develop strategies to assist people to improve confidence in choosing satisfying and nourishing foods across different settings and circumstances.

4.     Understanding weight – Dietitians can draw upon their scientific understanding of the body to assist people to focus on wellbeing rather than body weight, and dispel many of the common myths and assumptions about body size.

5.     Helping people learn about their bodies needs – Dietitians can assist people to learn to tune into their physiological cues of hunger and fullness, to trust their body’s inner wisdom, and to eat intuitively. Not only can Dietitians help people liberate from diet culture, they can guide an understanding of health, independent of body weight, shape or size.

6.     Being an important part of an interdisciplinary team – Dietitians work collaboratively with other health professionals including Doctors, Psychologists and Psychiatrists, to assist people with Eating Disorders toward improved wellbeing, and recovery. 

An Accredited Practising Dietitian can be an integral part of an interdisciplinary treatment team supporting people diagnosed with an Eating Disorder or challenges with food and eating. If you would like help with any of the above, please complete our New Client Request form at the link below and we will be in touch to get you started with one of our team.