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How can you improve your relationship with food?

As a primary care physician, I see many patients who struggle with their relationship with food. In the US, we live in a society where there are a lot of mixed messages about nutrition in the media that are heavily influenced by diet culture and the idealization of thinness. The patients that I see are often highly motivated to take good care of themselves to prevent or control a chronic disease. However, because of the misinformation about nutrition and weight loss that is shared throughout society, they can end up falling into unhealthy, disordered eating patterns or even develop an eating disorder. Disordered eating behaviors can include restricting calories or entire food groups when not medically necessary, creating rigid rules around food and exercise, binge eating (eating past the point of fullness and feeling out of control), feeling guilty after eating, "compensating" for eating with exercise or purging behaviors (vomiting, diuretics, laxatives, etc), eating in secret or avoiding eating in public, and more. These behaviors can be physically and psychologically harmful even if the person does not meet full criteria for being diagnosed with an eating disorder.

If you have struggled with your relationship with food- you are not alone! Eating disorders affect 9% of the population, but even those without clinically diagnosed eating disorders suffer from disordered eating behaviors- one study identified these behaviors in 75% of women ages 25-45. Eating disorders and disordered eating behaviors do not discriminate and are seen across people of all genders, races, ethnicities, and socioeconomic status.

Food is an important part of life- for our physical health, mental health, and our social well being and enjoyment of life. Trying to make changes when we notice problems with our eating patterns can sometimes send us further down the rabbit hole by creating more "rules" to follow. So what can we do to improve our relationship with food?

  1. Do not assign moral value to food: Food is morally neutral. There are no "good" or "bad" foods. Each food has its own nutritional makeup that supports our bodies' basic functions in different ways, and we need a combination of all types of foods to adequately fuel our bodies. Demonizing specific foods introduces guilt and shame to your relationship with food, and there is no benefit to this.

  2. Tune into and honor your hunger and fullness cues: This can be hard to do if you have spent a lot of time ignoring or suppressing these cues. Those who are suffering from eating disorders will need to work with their therapist, dietitian, and physician before they are ready to rely on hunger and fullness cues to tell them when and how much to eat. If you are struggling with disordered eating behaviors I strongly recommend discussing this with your own clinician rather than taking it on by yourself. Many people associate hunger cues with a "grumbling" sensation in their stomach, but there are many other cues that tell you it is time to eat. You may feel less focused, more irritable, tired, or "foggy." When you are ready to eat- choose foods you enjoy and that provide a balance of protein, fat, carbohydrates, and fiber. Ideally, you should sit down to eat, limit distractions such as doing work or watching TV, and give yourself at least 20-30 minutes to enjoy your meal. Eating with a friend or loved one can make the experience more enjoyable. Chew your food thoroughly and notice the taste, smells, and texture of the food. When you have an enjoyable eating experience that is not rushed, it is much easier to sense the feeling of fullness and to avoid eating to the point of feeling uncomfortably full. Keep in mind that certain medications and substances (such as caffeine and nicotine) can influence hunger cues as well- be sure to discuss the impact of any medications you are taking with your doctor so you can understand and mitigate these side effects.

  3. Don't let yesterday's behavior influence what you do today: Many people manipulate their intake out of guilt or shame over previous eating behaviors. For example- after an episode of binge eating, a person may significantly restrict their intake over the next day or days to compensate or "make up for" the food they ate during the binge. This behavior keeps the binge-restrict cycle going. No one does everything perfectly all the time- in fact it is not advisable to "perfectly" follow a certain eating pattern all the time because our bodies' needs are constantly changing. Your outcomes will be shaped by what you do most of the time, so if you have a day that doesn't go the way you planned it does not need to derail your progress. Give yourself grace to take each day as it comes and focus on nourishing and caring for your body, not following rules.

  4. Limit unhealthy influences: Now that almost everyone is carrying a smart phone in their pocket all day- we are constantly bombarded with various messages via social media. Social media is often at best a curated view of the best parts of someone's life, or at worst a sales pitch in disguise. When we scroll social media, we see images of people posed and dressed and made up to fit an "idealized" beauty standard, interspersed with ads from "health experts," supplement companies, telehealth providers, and weight loss programs. These companies prey on the fact that we are scrolling on social media and feeling inadequate, and they swoop in to provide a "solution." Limiting social media use and placing restrictions on the types of ads you see can help reduce this cycle of self-blame triggering disordered behaviors. Some unhealthy influences are not just on social media, however. Many people are exposed to unwelcome comments about their bodies from strangers and even loved ones, or enter environments that do not properly accommodate the range of body sizes and shapes. These influences can be harder to avoid, and the mental energy spent trying to avoid them is extremely taxing on mental health. We are starting to see slow societal change in embracing body diversity, but the onus is still on each of us to move the needle in the right direction. Practice avoiding making comments about others' bodies- even if you think it sounds like a compliment. If you have influence over a workplace, school, or business- make changes to accommodate individuals of different body sizes and abilities. As we practice these behaviors towards others, they will be reflected back to us and we will learn to be kinder to ourselves. We can reduce negative comments about our own bodies and choose clothing that feels good and allows us to move comfortably throughout our day rather than trying to fit into a specific size or style.

  5. Prevention is key: Many of our thoughts, feelings, and associations with food develop in childhood. If you have children, your comments about food and body image will influence the patterns that they develop. Avoid making negative comments about your body, about restricting calories or certain types of foods, or compensating for eating with exercise, especially in front of your children. We all want our children to grow up with adequate fuel for proper development, as well as healthy eating and lifestyle habits so they can continue to take good care of themselves into adulthood. Children, especially young children, take comments very literally. Labeling foods as "good" and "bad" will create associations that will remain deep seated and persist into adulthood. They will likely inherit your body size and shape as this is often genetically determined- so hearing you speak negatively about your body will echo in their brain as they grow and their body changes into its adult form. You can promote a healthy attitude towards food by talking about how the food is giving them energy to help them grow, eating regular meals together as a family, and introducing variety into their diet. You can encourage children to better understand their own hunger cues by not forcing them to finish meals or eat a certain amount of bites before getting a rewards or giving a punishment. You decide what, when, and where to serve food, they can decide whether and how much to eat. Avoid giving food as a reward or withholding food as a punishment- this further creates value-based associations with food.

If you want to improve your health and are struggling with your relationship with food- we can help! At Vida Family Medicine we take a holistic approach to your health and are mindful of addressing health problems with a combination of nutrition and lifestyle change as well as medication when necessary, without promoting strict rules or dieting. We recognize the impact that weight stigma has on health outcomes and follow a Health At Every Size® approach to care. We are currently accepting new patients, visit our website to learn more and become a patient.

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