As many of you are aware, Thanksgiving and Chanukah are happening at the same time this year! Since I am no expert on Jewish religion and culture, I invited fellow blogger Rachel to share with us her thoughts on this very special holiday season. Rachel maintains her own (and might I add excellent) blog which focuses on eating disorder recovery for the spiritually-minded Jewish community.
But if that doesn't sound like you, DON'T STOP READING! This is such a fabulous post about something every one of us can relate to- how to feel sane in a world that is diet obsessed and weight phobic. Thank you Rachel for sharing your unique and always thoughtful perspective on such a unique topic. Enjoy.
In case you haven't heard, two great holidays--Thanksgiving and Chanukah--are about to make an unlikely convergence. The resulting, "Thanksgivukkah," has become quite a craze, producing hybrid treats such as butternut squash sweet potato latkes, and even inspiring Conan O'Brien to get in on the action with the Turkey Dreidel. Personally, I feel like these two holidays are meant to be together--how else can you explain that the biblical Hebrew word for "give thanks," hodu (הודו), is ALSO the modern Hebrew word for, "turkey"? Coincidence? I think not.
The truth is that Thanksgiving and Chanukah also have some thematic similarities, chief among them being the shared emphasis on freedom, particularly cultural and religious freedom. Most of the original "Pilgrims" came to the New World because they were unhappy with the Church of England's inflexible, dictatorial style. In England, attendance at Anglican churches was mandatory and people didn't feel that it was safe to practice their religion openly in any other way. Similarly, the Maccabees of the Chanukah story rebelled against the Greeks' attempts to forcibly Hellenize the Jewish people in the Holy Land. Hellenic culture emphasized idol worship and focused on physical beauty--concepts that were deeply at odds with traditional Jewish values of monotheism and spiritual connection to Torah.
I find the common theme of freedom fascinating, particularly the Jewish resistance against a culture of materialism. Recently I have been feeling quite frustrated with the cultural world I inhabit--it seems that I can't go anywhere without seeing or hearing something related to dieting, weight loss, exercise, or physical appearance. Between television, radio, magazine covers, social media, and conversations overheard in just about any venue imaginable, there is no shortage of evidence that we live in a food-, body-, and weight-obsessed culture.
Recovering from an eating disorder while living in such an environment can be a maddeningly frustrating experience. A clinician I know explains it this way: "A person recovering from an eating disorder is recovering into a very disturbed world." To recover means to land above and beyond where the vast majority of people are in terms of food and body. Although it can be satisfying to have such an evolved perspective, it also can be challenging. It's hard to feel forced out of all the bonding that happens over discussions about exercise routines, and it can be daunting to try to practice "normal eating" when you are surrounded by people eating diet foods. Even though I know I should be proud of myself for doing what is healthy and supportive of a life in recovery, I sometimes experience shame around not complying with the prevailing cultural expectations. In those moments when I feel like I will scream if one more person comments on how she supposes she can afford to eat dessert because she worked out that morning, I have to dig deep and remind myself that I actually don't want to fit into that cultural norm--I've worked too hard to raise myself above it.
It is hard to swim alone against the tide. The Pilgrims and Maccabees knew this, which is why they each formed groups in order to defend and preserve their true values. Similarly, we need to surround ourselves with other people who can reinforce our commitment to a life free of the food-and-body obsession. This Thanksgivukkah season, I wish all of us the courage of our ancestors to keep our eyes and hearts trained on what is truly important and beautiful in this world.
A few weeks ago a wrote a post on food addiction and mentioned that I was working on a blog post for The Academy of Nutrition and Dietetics blog. It came out last week and I wanted to re-post it here but with a couple of other thoughts.
One of the things I love most about my job is that I get to blend the science of food and nutrition with the art of working with people in the real world. It's the careful balance of art and science that I found so gratifying. This relates to the topic of food addiction. In the real world, it can be a very heated and emotional discussion. I have seen ardent defenders and spirited critics of the concept as well as everything in between.
My purpose in writing this particular post was to review the actual research. I wanted to get clear and share what we know about food addiction via research, what we don't know, and what we need future research to take us. This is different than the clinical hat I normally where because I only minimally address application side of things. So please keep that in mind, along with the fact that I had an EXTREMELY limited word count! In any case, I hope that it's informative and I hope we can all keep an open mind to such a complex topic. The original version was posted here but I have pasted it below. I'd love to hear your thoughts and comments.
I’m a chocoholic. I’m addicted to sugar. Once I start eating chips and salsa, I can’t stop.
How many times have you heard these and similar sentiments? If you’re like me, then you’ve heard them a lot! But over the past several years these sayings haven’t only been used casually, but also seriously considered in scientific circles. With the rise of obesity and the DSM-V’s (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) recent inclusion of Binge Eating Disorder, RDNs face difficult questions about how to address the issue of food addiction.
Below I’ll review the most recent scientific literature, completed by H. Ziauddeen and PC Fletcher in an article entitled, “Is Food Addictive? Is food addiction a valid and useful concept?” It’s an excellent article if you’re interested in a more thorough examination from both a neuroscience and clinical perspective.
Food Addiction Theory
Proponents of the term food addiction often cite four similarities between food and other addictive substances.
1. Food shares common drug pathways in the brain.
2. Food can activate reward neurons.
3. When consumed, dopamine receptors are altered.
4. Anticipation of eating activates brain regions seen in drug abuse.
Limitations of the Food Addiction Theory
While the concept of food addiction is extremely compelling, there are a number of reasons to exercise caution in its application. First, there is no actual definition of an addictive food. Researchers have yet to categorize which elements are addictive, identify if the term refers to one or many addictive substances, or characterize which features interact with individual vulnerabilities. “Although arguments have been made that certain aspects of eating in obesity are ‘addictive,’ we would caution against less stringent applications of an addiction model as these risk losing the explanatory power and the neurobiological grounding of the model.”
Second, there is very little research that supports the food addiction model. Much of the research has been done on animals. The outcomes of these studies contain elements that seem promising, while the results of the limited human studies are largely conflicting. The authors state that “the potential role of FA in the obesity epidemic … has acquired much currency with relatively little supporting it.” They go on to say that “… food addiction is unlikely to be a causal pathway in the majority of people with obesity.”
Third, the food addiction theory fails to consider other viable explanations for neurobiological phenomena. At RDN Evelyn Tribole’s April 2013 “Intuitive Eating Training” event in Salt Lake City, she suggested four limitations to the food addiction model to consider:
- Pavlovian conditioning
- Food is meant to be rewarding
- Restrained eating increases the hedonic value of the food
- Hunger increases neural activation
Clinical Suggestions for the RDN
As nutrition experts, RDNs are perfectly positioned to stay current on the latest food addiction research and interpret those findings for their clients. Given the fact that the research on food addiction is in its infancy, RDNs should stay tuned for new information. And in the interim, consider alternative approaches to help clients reduce compulsive and binge eating. Intuitive Eating, a program developed by two RDNs, is one such method that has garnered significant research in the past few years. For a listing of all the research, click here.
I've said it before but I'll say it again. I like really yummy food, really fast. After a long day of work, I don't have the time or energy to cook anything elaborate. And after I made this recipe for a group of friends, I knew that I had to share it on my blog. It's quick, simple, and most importantly DELICIOUS. I found it via Pinterest, so here is a link to the original site. I can't vouch for anything else on there.
6 cups chicken broth
4 cups cooked shredded chicken
2 (15-oz) cans Great Northern beans, drained
2 cups salsa verde (storebought or homemade)
2 tsp. ground cumin optional toppings: diced avocado, chopped fresh cilantro, shredded cheese, chopped green onions, sour cream, crumbled tortilla chips
- I think it tastes better with less broth and more salsa verde so I only used 4 cups of broth
Add chicken broth, shredded chicken, beans, salsa and cumin to a medium saucepan, and stir to combine. Heat over medium-high heat until boiling, then cover and reduce heat to medium-low and simmer for at least 5 minutes. Serve warm with desired toppings.
Marci's tip: You can also add all of the ingredient to a slow cooker and simply heat!
Several months ago I wrote a blog post about why I am not a fan of the TV show The Biggest Loser (TBL). Last week I heard that first lady Michelle Obama might make an appearance on the show to promote her (in my opinion) misguided but well-intended Let's Move campaign. And when I heard this news, my heart broke.
I'm going to get right to the point. TBL stigmatizes fat people. Stigmatization leads to discrimination. And when people feel stigmatized their physical, mental, and emotional health declines. Just to prevent any confusion, I want to clarify a couple of things:
- I support the pursuit of health
- I support making lifestyle modifications that lead to more nutritious eating and physical activity
- And most importantly- I support behavioral changes that are EFFECTIVE and not harmful.
And this is why I cannot support TBL. It is entertainment that is harmful because:
- Research is clear, TBL increases anti-fat attitudes and weight stigma
- All the research we have indicates that when viewers watch TBL it doesn’t actually lead to positive behavior change such as increased exercise
- Contestants on TBL actually experience a severe drop in metabolism, burning fewer than 504 calories on average.
- A recent study showed that as many as 90% of contestants on the show purportedly regain all their lost weight
- Contestants on the show are at risk of developing eating disorders since they are asked to engage in severe over-exercise while consuming a semi-starvation diet
- TBL advocates for such extreme behaviors that actually put people at risk for future weight gain
Please consider joining with me to oppose the first lady, Michelle Obama, from appearing on TBL. You can:
- Share this blog post or video
- Sign this petition
- Share these pins on Pinterest
- Commit to boycotting the show
Metabolic Slowing with Massive Weight Loss despite Preservation of Fat-Free Mass
When Science Met the Biggest Loser
Weighing in on NBC's The Biggest Loser: governmentality and self-concept on the scale.
No clear winner: effects of The Biggest Loser on the stigmatization of obese persons
The effects of reality television on weight bias: an examination of The Biggest Loser
Learn More About the Health Consequences and Research on Weight Stigma
I love food that's high in flavor but short on time. So my favorite go to recipe in the fall and winter months are one pot meals. This recipe is a 15 minute Bean and Chicken Sausage stew I found on Pinterest via Real Simple. It's right up my ally (with a few tweaks). Serve it up with some crusty bread and you have a nicely balanced meal, plus leftovers for lunch the next day. Interested in a couple of other tried and true soup recipes, check out this one for Portuguese Kale Soup (which is one of my all time favorite recipes) and this one for Lentil Soup (that tastes a heck of a lot better than it sounds). Happy cooking!
1 tablespoon olive oil
1 12-ounce package fully cooked chicken sausage links, sliced
2 cloves garlic, thinly sliced
**Marci's suggestion: I'd also throw in crushed red pepper and a dash of your favorite Italian seasoning blend. I love seasoning blends and blogged about them here. Penzey's Spices are my all-time favorite for blends.
1 19-ounce can cannellini beans, rinsed1 14.5-ounce can low-sodium chicken broth
1 loaf country bread (optional)
Heat the oil in a large saucepan or Dutch oven over medium heat. Add the sausage and cook, stirring once, until browned, 2 to 3 minutes. Stir in the garlic (and any additional spices you want to add) and cook for 2 minutes more.
Add the beans, broth, and tomatoes and their liquid and bring to a boil.
Add the kale and ¼ teaspoon each salt and pepper. Simmer, stirring occasionally, until wilted, 2 to 3 minutes. Serve with the bread, if using.
What's your favorite speedy Fall recipe? I'd love to hear it!
Food addiction is a hot topic right now. I’m currently working on a blog post on food addiction for The Academy of Nutrition and Dietetics and look forward to sharing it with you after its release. But in the interim I thought I’d give you a taste by sharing with you some intriguing research. The proponents of the food addiction theory like to compare the neurological responses to food with the neurological responses to other addictive substances. The only trouble is that there are a lot of holes in the research that need to get filled before we buy that theory outright. (More detail to come in my forthcoming post.)
So being the neuroscience geek that I am, I started digging into the literature and discovered something important. There is a MAJOR component missing in the food addiction research (including the Yale Food Addiction Scale, a tool used for research as well as in clinical settings). It doesn’t account for caloric restriction and restrained eating.
What does this mean you might ask?! It means that we see a hyper-response in the reward region of the brain when we haven’t been eating enough (i.e. dieting or starving ourselves). This happens in response to seeing pictures of food, thinking about eating, as well as actually consuming food. Turns out that most people who feel that they are food addicts have an incredibly complicated history of dieting and disordered eating. It only makes sense that their brain response is extra active when they “give in” and eat a forbidden food…and then feel out of control while eating.
Perhaps what we are seeing in the neuroimaging is a HEALTHY response to food in a starved state and not an indicator of addiction at all. Needless to say, the food addiction research is in its infancy and there are a lot of unanswered questions. But the current research does seem to point to another solution that could prevent unnecessary weight gain, decrease food obsession and diminish compulsive overeating- END dieting.
Perhaps you’re a skeptic? Take some time to browse the research below; and this is only a sampling!
Research Studies to Consider
Ciampolini M et al. Sustained self-regulation of energy intake. Loss of weight in overweight subjects. Maintenance of weight in normal-weight subjects, Nutrition and Metabolism, vol. 7, article 4, 2010. [ Free full text.]
Heileson J.L., & R. Cole (2011). Assessing Motivation for Eating and Intuitive Eating in Military Service Members. Journal of the American Dietetic Association, 111 (9 Supplement), Page A26.
Intuitive Eating was associated with lower body mass index levels in 100 active military troops.
K H Pietiläinen, S E Saarni, J Kaprio and A Rissanen (2011). Does dieting make you fat? A twin study. International Journal of Obesity.
Madden C.E., Leong, S.L., Gray A., and Horwath C.C. ( 2012). Eating in response to hunger and satiety signals is related to BMI in a nationwide sample of 1601 mid-age New Zealand women. Public Health Nutrition. Mar 23:1-8. [Epub ahead of print].
Stice E, et al. Caloric deprivation increases responsivity of attention and reward brain regions to intake, anticipated intake, and images of palatable foods. NeuroImage 67 (2013): 322-330.
Women with high Intuitive Eating Scale (IES) scores had significantly lower body mass index, which suggests that people who eat in response to hunger and satiety cues, have unconditional permission to eat, and cope with feelings without food, are less likely to engage in eating behaviors that lead to weight gain.
Ziauddeen H and Fletcher PC. Pro v Con Reviews: Is Food Addictive? Is food addiction a valid and useful concept? Obesity Reviews (2013): 14 (19-28).
I first read Brene Brown's book "The Gifts of Imperfection" nearly two years ago after watching her landmark TED talk. Both the talk and the book affected me in ways that no other work had before. Her research and message has changed me as a person and as a clinician. I actually wrote a bit about this in another blog post over a year ago. In the past couple of years Brene Brown has become a pretty big deal- first with TED and now OPRAH. It just doesn't get much bigger than Oprah. (I have my own mixed feelings on Oprah but that is perhaps for another blog post at another time.) But I love love love this exchange between Oprah and Brene. It's only a few minutes long so check it out.
So I have two primary motivators for gushing about Brene Brown.
1. On October 20, Brene is starting this super cool 6 week ecourse. It looks like a blend of her book plus art therapy. It's only $70 plus the cost of materials. You can read more about it here.
"In this 6-week art journal eCourse students will roll up their sleeves for hands-on, interactive art explorations that will help you move from who you think you're supposed to be...and embrace who you ARE."
2. I wanted to introduce you guys to Brene's work if you weren't aware of it already. She's written a couple of books but her book "The Gifts of Imperfection" is a fantastic place to start. In it, she introduces 10 guideposts that emerged from her research on shame and vulnerability. Turns out that the people who live "wholeheartedly" cultivate these gifts.
#3 Resilient Spirit
#4 Gratitude and Joy
#5 Intuition and Trusting Faith
#7 Play and Rest
#8 Calm and Stillness
#9 Meaningful Work
#10 Laughter, Song, and Dance
Perhaps this book resonated for me so much because these are the essential ingredients I see in my work that help to facilitate health and healing. Over the past several years I have come to scorn the "self-improvement" and always striving for perfection type of messaging. I have come to embrace the Buddhist principles of self-acceptance and self-compassion. I have learned that all we need "to be" is right inside of us. And that what we need most is to connect to what is already there. And Brene's research and writing beautifully illustrates how it is possible.
To finish up this blog post, I'd like to share a quote from "The Gifts of Imperfection" from her chapter on authenticity.
"If you're like me, practicing authenticity can feel like a daunting choice- there's risk involved in putting your true self out in to the world...I think we should be born with a warning label similar to the ones that come on cigarette packages: Caution: If you trade your authenticity for safety, you may experience the following: anxiety, depression, eating disorders, addiction, rage, blame, resentment and inexplicable grief. Sacrificing who we are for the sake of what other people think just isn't worth it. Yes, there can be authenticity growing pains for the people around us, but in the end, being true to ourselves is the best gift we can give the people we love."
Thanks Brene, I think so too.
You've certainly heard the term "clean eating." As you think about those words, what images, feelings, and connotations get conjured up? What does the term "clean eating" mean to you?
Toby Amidor, RD and media-savvy nutrition expert recently wrote about clean eating in an article in Today's Dietitian a few months ago. She explained that clean eating "encourages the consumption of more fruits, vegetables, whole grains, and lean meats with fewer sugary high-calorie beverages and saturated fatty food." That sounds reasonable, right? I'm a dietitian, of course I'm in support of eating foods that nourish the body and support health.
BUT...I'm also incredibly interested in the power of semantics and the power of the meaning that gets all wrapped up in our eating habits. Sometimes people ask me how I can stand talking about food all day long. Even some of my therapist buddies ask if I ever get bored. And the answer is no! And that's because food habits are layered with all sorts of meaning. And part of my job is to help my clients untangle the layers of meaning when need be. If the way we eat gets too wrapped up with our identity, our eating habits may lead to exaggerated feelings of guilt, shame, anxiety, depression, and even self-hatred. And these feeling further distance our connection to the physical experience of eating. It probably goes without saying, that feeling this way over the long-term isn't good for our health.
When it comes to eating, my job is to help neutralize the harmful feelings of judgment and shame while deepening physical connection and awareness.
You may be asking yourself, what does this have to do with the notion of "clean eating?" Perhaps nothing for some of you. But for others, it may be highly problematic. The word clean carries with it the idea of being good, worthy, and virtuous. And the antithesis of clean is dirty, bad, or naughty. If you find that you are constantly feeling guilty about your food habits, these terms might be more harmful than helpful. Creating some distance from the semantic notions of "clean" and "good" might be useful. Instead, you could focus on the physical experience of how certain foods feel in your body during and after a meal.
One way to do this is to try a one day journaling experiment. You'll be recording three pieces of information. First, you'll make a note of what and how much you ate. Second, write down any inner commentary on what you ate (ie "that was bad I should haven't had that"). And finally you'll indicate how that food tasted and the way it felt physically in your body after (ie tasted yummy but noticed feeling gassy and bloated after).
This simple practice is intended to help you separate your physical experience from the narrative in your mind. If this concept resonates for you, give it a try. See what it's like to create some space from the judgement and "shoulds" of eating while discovering what types of foods allow you to feel your best. Your body and your brain just might thank you for it!
The lovely Amber Barke and I are facilitating another Intuitive Eating, Intuitive Living workshop in my office in Harvard Square. We hope you'll join us! Here is a link to the registration page and below you'll find the workshop details.
Intuitive Eating, Intuitive Living
An insIght Workshop with Amber Barke LICSW, RYT and Marci Anderson MS, RD, cPT
A weekend intensive workshop to restore balance & provide skills to support lasting wellness.
We live in a culture that encourages over-working, over-committing, and over-thinking. This can take a toll on our bodies, our relationships, and even our self-esteem. For lasting wellness, prioritizing self-care and re-connecting with our intuitive healthy selves is a necessity, even though it sometimes seems like an indulgence. This workshop is designed for clinicians, instructors, students, or anyone who wants a time-out from the pressures of everyday living. Through yoga, mindfulness-based exercises, lecture, and conversation you will leave with a tool box of resources for your own lasting wellness or to share with others. We believe that you have the means and insight to be in charge of your health. We plan to give you the opportunity to access that power.
Concepts Covered: Intuitive Eating training, the seven hungers, physiology of the stress response, yoga and emotional anatomy, meditation techniques, progressive relaxation, guided visualization, skills for managing challenging emotions, research on happiness and positive psychology
Where: 22 Hilliard St. Cambridge, MA 02138
When: Ocotber 11th - 13th
Friday evening, 6:00pm-9:00pm
Sunday 9:30 am-5:30pm
Investment: $295 early-bird discount by October 1st, $350 full-price
Registration limited to 6 participants. Reserve your space now!
Payment plans are available. Please contact us at: marci@marciRD.com or email@example.com to learn more.
We are not able to provide refunds