A Non-Diet, Weight-Neutral, Mindfulness-Based Approach to Optimal Well-Being

By Michelle May, M.D.

In this video, Am I Hungry? founder Michelle May, M.D. explains why many health professionals are shifting to a non-diet, weight-neutral, mindfulness-based approach to patient-care and optimal well-being.

Transcript:
A Non-Diet, Weight-Neutral, Mindfulness-Based Approach to Optimal Well-Being

I’m Dr. Michelle May, the author of the Eat What You Love, Love What You Eat book series and the founder of Am I Hungry? Mindful Eating Programs and Training.

Am I Hungry? offers non-diet, weight-neutral, mindfulness-based programs that empower individuals to take charge of their decisions about eating, physical activity, health, and self-care.

During this is a short video, I would like to explain what we mean by non-diet, weight-neutral, and mindfulness-based.

What is a Non-Diet Approach?

A non-diet approach doesn’t encourage restriction or deprivation. Instead, a non-diet approach encourages a more natural, instinctive way of eating founded on becoming attuned to internal cues. You may also be familiar with “Intuitive Eating,” a term originated by Evelyn Tribole and Elyse Resch in their ground-breaking book by the same name. A non-diet approach guides individuals toward a flexible, sustainable, and satisfying relationship with food by re-learning how to make decisions based on their own body wisdom in any situation.

This is important because there are many examples of professionals and programs that claim they are not a diet, yet ultimately promote restrictive eating. Whether they call themselves a “diet” or not, many programs that claim to focus on “healthy eating” or “lifestyle change” are in fact based on some form of restriction.

Examples of restrictive eating messages include:

  • Recommending that you consume a certain number of calories, grams, or points
  • Eliminating or restricting certain foods, ingredients, or macronutrients (most often carbs or fats)
  • Avoiding or limiting “tempting” foods
  • Eating on a schedule, not eating after a certain time of day, or fasting for a specified period of time
  • Earning food or the right to eat by exercising or using exercise to pay penance for eating

In short, a non-diet approach promotes awareness of internal cues and application of internalized decision-making. Therefore, arbitrary rules about food or eating are not compatible with a non-diet approach.

Instead, a true non-diet approach encourages a more natural, instinctive way of eating. That means re-learning how to manage food intake by becoming attuned to internal cues such as hunger and satiety, rather than external rules that may be confusing and difficult to follow indefinitely.

The non-diet approach shifts away from the concept of “good” and “bad” foods and supports the idea that, for most people, all foods can fit into a healthy lifestyle. Instead of a rigid eating plan, the non-diet approach encourages individuals to meet their nutritional and fuel needs with attention to balance, variety, and moderation while acknowledging the important role of pleasure in eating.

So what’s the problem with diets?

The short answer is they don’t work and they’re counterproductive.

The innate physiological and psychological responses to food restriction make it virtually impossible to adhere to a restrictive diet in the long run. Diets require an unsustainable amount of restraint, willpower, time, and energy. Caloric restriction results in physical hunger, increased preoccupation with food, and strong cravings to eat. Dieting also activates the portion of the brain responsible for attention to and reward properties of food, increasing the likelihood of food intake. The high resource requirements, combined with a strong drive to eat, ultimately results in the dieter “giving up.” Breaking the restraint is often followed by a strong urge to overeat and, in some cases, binge eating.

Further, many people have developed triggers to eat when they’re not hungry or overeat once they start. Instead of learning to recognize and address their triggers, dieters may overeat foods that are “allowed” on their plan. When they go off the diet, the triggers continue to drive overeating, compounded by the guilt of breaking their diet. This eat-repent-repeat cycle is damaging physiologically and emotionally. Among other things, it can result in weight cycling, disordered eating, low self-efficacy, depression, and lower self-esteem.

So what do you do instead?

Am I Hungry? Mindful Eating Programs and Training use a non-diet approach and mindfulness-based strategies to help participants free themselves from the eat-repent-repeat cycle and develop a healthier relationship with food and their body. I’ll talk more about that in a moment, but first let’s talk about another key tenet: Our weight-neutral approach.

What is a Weight-Neutral Approach?

A weight-neutral intervention is based on the fundamental idea that a person’s health status or risk level cannot be assumed based on a number on a scale. The weight-neutral approach acknowledges that body weight is determined by a complex set of genetic, metabolic, physiological, cultural, social, and behavioral determinants, many of which individuals cannot change. Instead of focusing on a weight-oriented outcome, participants in a weight-neutral program are taught to take charge of factors such as thoughts and behaviors, which ultimately lead to improved well-being, regardless of weight.

The fact that weight loss programs do not create lasting changes in weight or health has been proven time and time again. A comprehensive review published in the Journal of Obesity, “The Weight-Inclusive versus Weight-Normative Approach to Health,”1 concluded that:

No weight loss initiatives to date have generated long term results for the majority of participants. This review summarized numerous studies on the three most documented negative effects of a weight loss focus: weight cycling, disordered eating, and weight stigma, all of which are detrimental to one’s health.

What are the consequences of a weight-focused approach?

The conclusions of that review and other research are:

Weight Cycling

The most common outcome of weight-loss programs is not sustained weight loss, but weight cycling (the repeated gain and loss of weight, often referred to as yo-yo dieting). Weight cycling has been definitively linked with adverse physical health, including loss of muscle tissue, hypertension, chronic inflammation, more weight gain over time, less physically active lifestyles, some forms of cancer and, most notably, higher mortality. Weight cycling is also associated with diminished psychological well-being, such as greater emotional distress and lower self-esteem.

Disordered Eating

The pursuit of weight loss can lead to disordered eating behavior. The review finds “there is growing evidence that individuals who try to achieve and maintain a weight-suppressed state are at risk for binge eating disorder and bulimia nervosa.” Another recent study on a mindfulness based intuitive eating intervention extends this concern beyond diagnosed eating disorders to “problematic eating behavior” such as chronic overeating and loss of control over eating, which are surprisingly prevalent in American women.

Weight Stigma

The focus on weight and weight loss results in weight stigma. The prizing of the thin ideal, weight loss and “healthy” weight as determined by BMI sets people up for weight stigma: negative attitudes and beliefs about people who don’t fit the mold.

Weight stigma is associated with diminished health and well-being including:

  • increased caloric consumption
  • diminished exercise
  • binge eating behaviors
  • low self-esteem
  • depression
  • decrease in self-rated health

What is a Mindfulness-Based Approach?

One definition of mindfulness is purposely paying attention to the present moment; cultivating awareness of both internal and external experiences; observing and accepting these experiences as non-judgmentally as possible;  choosing how to respond; and making intentional decisions.

Eating is a natural, healthy, and pleasurable activity for satisfying hunger. However, in our food-abundant, diet-obsessed culture, eating is often mindless, consuming, and guilt-inducing instead. Mindful eating is an ancient mindfulness practice with profound modern implications and applications for resolving this troubled love-hate relationship with food.

We love the definition of mindful eating as eating with intention and attention:

  • Eating with the intention of caring for yourself
  • Eating with the attention necessary for noticing and enjoying your food and its effects on your body

Mindful eating is much more than “eating slowly, without distraction.” While that’s certainly an important part of it, at Am I Hungry? Mindful Eating Programs and Training, we believe that mindful eating encompasses the entire process of eating:

  • Awareness of your physical and emotional cues
  • Recognition of your non-hunger triggers for eating
  • Learning to meet your other needs in more effective ways than eating
  • Choosing food for both enjoyment and nourishment
  • Eating for optimal satisfaction and satiety
  • Using the fuel you’ve consumed to live the vibrant life you crave

This broad application makes mindful eating a powerful tool for developing a healthier, happier relationship with food.

How does mindful eating help resolve eating issues?

Many people who struggle with food react mindlessly to their unrecognized or unexamined triggers, thoughts, and feelings. In other words, they re-act, repeating past actions again and again-feeling powerless to change. Mindfulness increases your awareness of these patterns without judgment and creates space between your triggers and your actions.

For example, whenever you notice that you feel like eating and pause to ask the question, “Am I hungry?”, you’re able to observe your thoughts and choose how you will respond. Instead of reacting mindlessly, mindfulness gives you response-ability. That is how mindful eating empowers you to finally break old automatic or habitual chain reactions and discover options that work better for you.

The Mindful Eating Cycle

All the Am I Hungry? Mindful Eating Programs are based on the Mindful Eating Cycle, a simple model to help increase awareness of the hundreds of eating decisions you make every day.

These are the questions the Am I Hungry? Mindful Eating Cycle helps you answer.

Why? Why do I eat? Or in other words, what is driving my eating cycle at any given time?
When? When do I feel like eating? When do I think about eating? When do I decide to eat?
What? What do I eat? What do I choose from all the available options?
How? How do I eat? How, specifically, do I get the food I’ve chosen into my body?
How Much? How much do I eat? How much fuel do I consume?
Where? Where do I invest the energy I consume? Where does the fuel I’ve consumed go?

Am I Hungry? Mindful Eating Programs guide you to address these questions so you can live the big, vibrant life you crave!

One final note…

Some people assume that a non-diet, weight-neutral, mindfulness-based approach can only apply to otherwise healthy individuals. As a physician, I feel that those with chronic medical issues stand to benefit even more from a more sustainable way of managing their eating! When dietary changes or limitations (even necessary or practical ones) feel like a diet, patients are likely to struggle with the eat-repent-repeat cycle, making a condition like diabetes very difficult to stabilize.

More important, when we help patients shift their focus from weight to well-being, we create an opportunity for curiosity, learning, self-compassion, and self-determination!

 

1 Tylka, T., et al. (2014.) The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss. Journal of Obesity, 2014. doi:10.1155/2014/983495

 

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