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Talk Over RA: Breaking Free from Diet Culture

The #TalkOverRAcampaign encourages Canadians living with Rheumatoid Arthritis (RA) to find their own voice to set up a realistic plan with their health care providers to reach the specific goal treatments.

I am closing my participation in this year's #TalkOverRA awareness campaign with a blog around intuitive eating and breaking free from diet culture.

Diet culture is everywhere. It is constantly in our social media feeds, in our stores, on our TVs, and even at our dinner tables! It can be hard to ignore the constant, harmful narrative that we need to be a certain size to be healthy or the harm caused by labelling of our foods as “healthy and good” or “bad and junk”. It’s no wonder that everyone seems to be searching for the next best diet.

Last year, I introduced you to a number of diets through my On-Trend blog series, some of which were pretty restrictive. A few of those diets may be medically necessary, such as the Autoimmune Protocol Diet or the Low FODMAP Diet. When overseen by a Registered Dietitian or healthcare professional, they can be very helpful in understanding food triggers and managing symptoms. However, if you are considering a restrictive diet for weight loss, it is important to understand that these diets won’t lead to long-term weight loss (1).

In some cases, those highly restrictive diets can lead to weight gain after some initial loss. Our bodies react to restriction diets by slowing down the metabolism to adapt to this starvation mode as an act of survival (2). This can lead to a frustrating yo-yo dieting cycle of weight loss and gain. Yo-yo dieting is known as weight cycling and it can really impact your mental health. It can be very encouraging to lose some weight in the beginning, but restriction diets often lead to a feeling of being deprived. Deprivation can lead to binge eating and the guilt associated with it. All of which can have a negative impact on your emotional well-being.

Weight cycling has also been found to negatively affect physical health, potentially increasing risk factors for cardiovascular diseases and inflammation (3). This can be particularly concerning for those of us with autoimmune diseases. While m

ore research is needed, some studies are showing that weight cycling can lead to systemic inflammation due to the repeated increase and decrease of fat and its relationship with the body’s pro-inflammatory response (4,5). I often see this in my own practice as clients search for ways to help manage their symptoms with diet. I call this “Autoimmune Yo-yo dieting”. The cycling of weight can not only be frustrating, but it may also increase the incidence of flare-ups. All of this can really take a toll on the mind AND body!

An additional concern is that restrictive diets may also lead to disordered eating (1,3,6). Focusing on restricting calories, carbohydrates or certain food groups can cause a negative relationship with food or in severe cases: food phobias. Food phobias may be quite familiar for those of us experiencing autoimmune diseases because we may avoid certain foods that trigger our flare-ups.

On the opposite side of the dieting spectrum, you can find diets such as the Mediterranean Diet, Plant-based Diets and the Anti-inflammatory Diet. Despite their names, these aren’t really diets at all. They are more about making lifestyle changes based on personal food preferences, rather than restricting what we eat. An approach that has been gaining popularity over the last few decades is Intuitive Eating, which encourages a shift in lifestyle and mindset around food. The big idea behind the Intuitive Eating approach is for individuals to learn to trust their body’s hunger and satiety cues. This honouring of the body’s cues helps to foster a healthy relationship with food and a positive body image.

Intuitive Eating has been called the anti-diet. Rather than focusing on restricting what you eat to shrink your body, it encourages self-reflection and being mindful of WHAT you are eating, WHY you are eating it, and HOW it makes you feel.

Reflecting on these questions can help you to differentiate between eating for physical hunger versus emotional hunger. By bringing awareness to what and why you are eating, you can help to reduce mindless eating due to boredom, distraction or emotional reasons. Instead of restricting what, how much or when you eat, you learn to rely on your body’s cues. Intuitive Eating encourages you to slow down to enjoy the tastes and textures and to allow your body to signal when you are full. Studies have shown that by bringing awareness to the body’s hunger and satiety cues, respect and appreciation for the body also grows (1,6). Which makes sense right?! If you are focusing less on counting calories and feeling guilty about the food you eat, you have more time to enjoy your food and how it makes you feel!

Intuitive Eating is absolutely not a weight-loss diet and opposes traditional ideas about dieting, but it has been shown to have a relationship with lower BMI status and helping to maintain weight (1,7). Regular physical activity is encouraged by choosing activities that you find pleasurable. By choosing exercise and movement that you enjoy, it increases the likelihood that you will sustain the activity long-term. Regular movement helps to positively impact you physically and emotionally!

This is not to say that you can’t develop a positive relationship with food and your body if you need to follow a restrictive diet for medical, cultural or religious reasons. If you are considering any change to your diet, I recommend speaking with a Registered Dietitian or healthcare professional to help you find ways to listen to your body’s cues and meet your nutritional needs. Let’s get back to finding the joy in food!

If you would like to know more about Intuitive Eating and building a healthy relationship with food, check out this fantastic book "Intuitive Eating: A Revolutionary Anti-Diet Approach pioneered by Evelyn Tribole RDN and Elyse Resch RDN."

Special thanks to Cheryl Anderson, Nutrition Communication MHSc student at Ryerson University who assisted with the research and writing for this post.

To learn more about Talk Over RA and how to engage in meaningful conversations with your health care provider, download the Talk Over RA discussion guide and check out their website.


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