What comes to mind when you hear "health coach?" You probably expect to be told, among other things, what to eat and what not to eat. Many health coaches' websites feature thin, attractive women eating, drinking, or cooking something green. While I can get behind green food, whole food, clean food, I am beginning to radically re-think the prescriptive nature of most health and nutrition advice. Heresy for a health coach, right? It's scary ground for me to question the orthodoxies in integrative and functional nutrition that label some foods as good and others as bad. We don't use those words -- we say they contribute to disease or support health, that they are inflammatory or anti-inflammatory. But the bottom line is that we usually counsel people to eliminate or restrict something. We know from psychological research that restricting something makes people want it more. Most "diets" are not sustainable and do not achieve their goals long term.
I have always felt a little uncomfortable giving people nutrition advice, especially before I know them really really well. Food is complicated (!) and everyone has a different relationship with it. Without understanding a person's history with and stories about food, their current eating patterns, their fears, hopes and dreams for their body, it just seemed irresponsible to tell them what or how they should eat. The potential triggers are endless. How many of us can receive nutrition guidance without an emotional reaction? Fear? Shame? Anxiety? In other words, a stress response. While I have a lot of questions about what foods are best for anyone's health, I know beyond a shadow of a doubt that stress is harmful to everyone's health. So, in the spirit of "do no harm" I tread extremely carefully in the area of food.
I recently read a new book by Jenna Hollenstein called Eat to Love, which draws from intuitive eating, a concept introduced by Elyse Resch and Evelyn Tribole in their 1995 book by that title. I'm surprised that I hadn't run across their work before but the concept was not part of my functional medicine or health coach training. I devoured Eat to Love in a matter of days and have literally felt like nothing will ever be the same. You know those moments in life when there is a seismic shift in your thinking, an AHA moment that seems to change everything?
For me, the epiphany was as much personal as it was professional. I have always had issues with food and body image. There was a lot of focus on food and thinness in my home growing up, with a mom and two sisters. I went on my first diet in middle school (anyone remember the Scarsdale diet?) along with my mom and sisters. It wasn't that I had been told to lose weight -- I don't remember that ever happening. But I was scared that I would get fat. It seemed like the worst thing that could possibly happen to me at the time. I look back at those women and girls - my self, my sisters, my mom, and it pains me to see how deeply they had internalized fat-stigma. We read Seventeen magazine. We were steeped in the same diet and beauty culture as every other American girl. That culture is like water to a fish, as in this metaphor: two young fish swim by an older fish who greets them, "hello boys, how's the water today?" They pass him and then look at each other and say, "what's water?" If you have never known it's absence, you don't really know it is there at all. That is what our cultural norms and images of female beauty, body size and shape, and good/bad food are like for most of us.
My mom was an early adopter of the natural food movement in the 1970s. She subscribed to Prevention magazine and made everything from scratch. She didn't buy junk food, sugary cereal, or soda. She baked cookies and made homemade granola. She was being a good mom trying to raise healthy children. She could not have known that for me, the restrictions would provoke a backlash. I became obsessed with "junk food," as we called it (Oreos and Devil Dogs stand out in my memory) and would gorge on them at friends' houses or when I baby sat. I had mental maps of the kitchens in my friends' and babysitting clients' houses. I knew where the snack drawers were and what kind of ice cream they had in the freezer. Consuming those foods was shrouded in shame. I snuck them. I saved Halloween, Christmas, and Easter candy for weeks or months (one time a swarm of ants besieged my bedroom and gave me away! That was humiliating). One night in ninth grade a friend and I couldn't find any sweets in the house so we made ourselves sick eating dried Tang (orange drink mix) with spoons. I kid you not. That was gross. I also recall doing that with Jello powder and Nestle Quik.
I learned to always look at my body with a critical eye. My hair was (is) very curly - totally uncool in the 1980s when I was an adolescent. Think Charlie's Angels. I got up half an hour early each day to blow it dry and then prayed that it wouldn't rain. Summer humidity was torturous. My hair felt wild, out of control, ugly and weird. I weighed myself and watched what I ate. When forbidden foods were available, I overate to the point of discomfort. Inevitably I would wake the next morning full of regret and recommit to "being good." I never starved or purged and my weight remained "normal," so no one ever suggested an eating disorder, but my relationship with food was severely disordered. It was rarely pleasurable to eat. In fact, pleasurable eating felt synonymous with out-of-control eating.
This was my normal until my early 20s when I had a roommate with severe anorexia. I remember sitting across from her at dinner one night while she ate half a head of iceberg lettuce with salt and thinking, "I'm not that bad, but I could be." I saw that she was ill -- her bones jutted out from her frail frame and she exercised fanatically. But I felt fat in comparison with her all the same, and that scared me. I began to search for a more moderate way to relate to food - one that would allow me to eat what I wanted but would not provoke the cravings and excesses that had been my normal. There were no models, no guideposts for that search. I went round and round in circles in my mind. I couldn't shake the fear of "getting fat" and I couldn't relax the vigilance.
In my mid-20s I developed severe chronic back pain, and another chapter of my life began. My movement was restricted by pain. I had always run, taken aerobics classes, and worked out. I'd been "fit" and "toned," which was essential to my sense of self. Suddenly I couldn't do any of that. My body changed and my fear of food grew exponentially. Weight, pain, and illness become all tangled up together in a really nasty gordian knot that I couldn't undo. One minute I was telling myself to accept my body the way it was. The next I was vowing to eat differently so as to change it. It was crazy making. When I think about all the time, energy, and resources that went into managing food and my body -- and what other things I might have done with those resources -- it makes me really sad. Now, at 53 and a certified health coach, I feel like the clouds may finally be parting . . .
. . . to be continued.
BELOW: 1) Pure eating pleasure at age four; 2) brave, strong, and unselfconscious at age six; 3) Charlie's Angels: THE standard of beauty during my adolescence; and 4, 5, 6) three covers from Seventeen magazine in the 1980s