Be Nourished

The Size of Your Doctor?

By Hilary Kinavey, MS, LPC

Did you see this little article in the New York Times magazine on 3/18/12?

"How Fat Is Your Doctor" By Hope Reeves

"In addition to the hassles and indignities they face on a daily basis, it turns out that overweight people also may not make very good doctors — at least when it comes to treating overweight patients. Researchers at Johns Hopkins University surveyed 500 primary-care physicians and found that doctors who battled the bulge themselves (those with a body-mass index of 25 or above) were less likely to recognize fatness or offer their patients diet tips. Basically,says the researcher Sara Bleich, “your doctor is unlikely to diagnose obesity or have weight-loss discussions with you if they weigh more than you.” Thin doctors, typically, seem to be just freaking perfect."

This weight-biased data suggests that the discussions regarding weight in doctors offices across this country are actually helpful at producing change.  It also suggests that the discussions between doctors in larger bodies and their patients are not happening and those patients are somehow missing out on some important information.

Hmmmm? 

It has been my experience that many of my “overweight” clients are actually having second thoughts or actively avoiding medical care to steer clear of the recognition of fatness that is referred to in this article. Some work diligently to find medical practitioners who are willing to entertain discussions with patients of all sizes that involve sustainable and weight-neutral self-care.  Most don’t know where to turn, but certainly would like to avoid the sometimes shaming and often unproductive recommendations regarding weight loss. 

In fact, the research on weight bias through the Yale Rudd Center is showing that the most reported incidence of weight bias that people experience is coming from healthcare practitioners and family members.  Weight bias research shows the more bias someone experiences, the more times they will try to cope with that bias through overeating, dieting and other shame inducing methods that do not support sustainable health behaviors. (Puhl and Brownell, 2006/2007)

We also know, from research on Intuitive Eating, that women who can approach their bodies with some acceptance are more likely to eat healthy (Tylka, 2006).  Making assumptions about a person based on their weight, even in a clinical setting, has not necessarily encouraged sustainable health behavior change, and has often done the opposite, producing more shame and potential alienation. 

This article, in it’s own tongue in cheek way, suggests that finding a medical professional who mirrors your experience may be the way to go to avoid stigma. I also believe that sharing your needs and expectations with your medical professionals is one of the most important ways you can participate in your own care.

Linda Bacon, in Health at Every Size offers a letter that patients can offer to their health care providers that discusses a sensitive care approach for people of all sizes.

If you have or know of a provider that you have received compassionate or weight-neutral care from, we’d love to know. We are compiling a referral list! Email amaya@benourished.org with the name and contact information.

How light is too light?

A few weeks ago I went to heat up an Amy’s frozen meal for lunch – roasted polenta with swiss chard.  “Yum,” I thought.  Then I realized when I opened the box that this was an “Amy’s light & lean” frozen meal, which translated to 140 calories with 4 grams of fat.   “Yikes,” I thought, “I’m going to be hungry in an hour!”

I love Amy’s frozen meals for the occasional day when I don’t have anything else to take for lunch.  They taste good and when you look at the ingredient list, you don’t have to get out a chemical dictionary to understand what it is that you are eating. This one had sweet yellow cornmeal polenta topped with an organic summer stew of squash, sun-ripened tomatoes, mushrooms and a side of fragrant slow-cooked chard. (Take a look at the ingredient list of a Lean Cuisine or Weight Watchers frozen meal – you might be surprised.)  When you open the box and look at the food, it looks like something that I would have cooked and put in the freezer for a quick meal.

Now, I bought this meal because it sounded good, not because it was ‘light and lean.’  After discovering the nutrition facts, I wondered how many people would eat just this for lunch or dinner and think they are being ‘so good.’  Paired with a lean protein, this could be a very satisfying meal.  But on it’s own, it is not enough to eat.

When I got home, I looked at the “Southern Dinner” that I usually get – cornbread and beans with greens and sweet potatoes to see how this meal compared to the ‘light and lean’ one.  This meal has 310 calories and 7 grams of fat.  What’s wrong with this?  Why isn’t this one considered ‘light and lean?’

The mentality of many people in this culture is the lower or lighter the food is, the better.  My clients who severely restrict their eating because they are dieting or have an eating disorder eat ‘light’ like this all day long.  And they complain of being hungry all the time.  They also report craving carbohydrates like pretzels, bread or muffins.  And if they tend to ignore cues to eat and live with extreme hunger, they crave simpler carbohydrates like jellybeans and candy corn.  Sound familiar?

“Becoming familiar with your physiological hunger and working with vs. against it is helpful in avoiding overeating and/or feeling out of control” says Amy Tuttle of Nourishing Connections.   At Be Nourished, we work with clients to improving their meal mix by eating a combination of protein, fat and carbohydrate and they discover they are not hungry ALL the time.

Eating foods, meals, or snacks that provide us with a combination of carbohydrate, protein and fat helps keep our energy level up and our mood more manageable.  And it enables us think more clearly because our body and brain are receiving better fuel and we are not distracted by hunger. 

So the next time you are thinking about what to eat, consider composing your meals and snacks differently.  We’d love to hear what you discover along the way!

 

Navigating Holiday and Winter Stress with Acupuncture

By Susan Buhler, MSOM, LAc

According to the wisdom of Chinese medicine, the cold months of winter are an essential time to conserve as well as generate vital energy – so that you may live and feel your best in all seasons…

The ancient Chinese believed that human beings should live in harmony with the natural cycles of the universe and their environment. The cold, quiet, stillness and darkness of the winter season urges us to slow down. This is the time of year to self-reflect, replenish energy and conserve strength. It is the time to integrate the life-harvest of this particular year, in preparation for a new cycle of life that begins each spring. It is also a season to go to sleep early, rest well, stay warm, eat nourishing foods, and expend a minimum of energy.

In Chinese medicine it is said that winter is ruled by the Water element, and is associated with the Kidneys, Bladder and adrenal glands of the human body. The Kidneys are considered the foundational source of all energy or “Qi” within the body. Once the daily energetic demands of the body have been met, if there is any Qi that is in surplus, it is stored by the Kidneys so that it can be used in times of stress and change, to heal, to prevent illness, and to age healthfully and gracefully.

While optimal health and well-being in the winter season calls for rest, nourishment and energy conservation for revitalization of body and spirit, your holiday activities may have a different agenda.

We have all felt the realities of holiday stress. The holidays can be filled with a dizzying array of demands: visitors, travel, frantic shopping trips and financial concerns. For many people it is also a time filled with sadness, loneliness, anxiety or even anger. Even under the best of circumstances, with all of these stressors on top of the ordinary and extraordinary demands of daily life, and you may find this to be one of the most emotionally trying times of the year.

Stress, anxiety and depression are our subjective experience in our bodies that energy is not harmonious and balanced. Such mental/emotional states can lead to a disruption in the flow of vital energy throughout the body. These energetic imbalances in turn can weaken the immune system, and cause symptoms including physical pain, sleep disturbances, abnormal digestion, headaches, and even menstrual irregularities. Over time, more serious illnesses may develop.

Chinese medicine offers safe and effective treatment to help smooth and balance our responses to what can be a challenging time of year. It can help correct energetic imbalances and directly affect the way your body manages stress. Thus enhancing the body, mind and spirit, one may face the demands of life and the holidays, with grace and vitality.

When the body’s energy is harmonious, the mind and heart are peaceful, and life is health.

For more information or to schedule an acupuncture appointment at Be Nourished contact:
Susan Buhler, MSOM, LAc
971-216-9913

Also, check out Susan's December Stress Release Acupuncture Special! For more info, click here.

Nurturing Emotional Wellness with Acupuncture

By Susan Buhler, MOSM, LAc

 

At some point in life everyone deals with major upheavals or emotional distress. These events can trigger a host of unexpected feelings and behaviors - from depression and panic attacks, to major disruptions in sleeping and eating. The holidays in particular can be very challenging for many people who are striving to maintain emotional and physical balance.

 

From an Oriental medicine perspective, mental and emotional stress can cause a disruption in the flow of vital energy, or qi, through the body. This in turn may cause symptoms of depression, anxiety, pain, sleep disturbance, abnormal digestion, headaches, menstrual irregularities, and many more.  Additionally these energetic imbalances can weaken the immune system -- triggering frequent illnesses, or if under prolonged stress, more serious illnesses may develop. 

 

Chinese medicine is a powerful healthcare system that can alleviate and reverse symptoms associated with mental and emotional stress.  Acupuncture, of course, cannot remove the stressors that are inherent in our daily existence, but it can help moderate our response to various events and triggers by helping the body's energy be in greater balance. By doing so, the manifestations of stress and anxiety are lessened, and one feels calmer and has greater capacity for coping with the ordinary and extraordinary demands of daily life. When the body's energy is harmonious, the mind and heart are peaceful -- even during the holidays!

 

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As an expression of her continued commitment 

to sharing the benefits of Chinese medicine, 

Susan would like to extend a special offer to the Be Nourished community during the months of November and December in the hopes of bringing greater health and harmony to all of you.

For more information, click here. 

 

Susan Buhler, MSOM, LAc has been involved in holistic healthcare for over 18 years and is a practitioner of Chinese medicine at Be Nourished.  She incorporates acupuncture and herbal medicine, and has a specialized focus in women's health care.

The Real Problem with Body Acceptance

By Hilary Kinavey, MA, LPC

Last week Jess Weiner, a well-known speaker in the arena of body acceptance and self esteem wrote an article and had a Today show appearance to discuss how health and body acceptance collided in her life.  Her article has sparked debate in the Health at Every Size® community, and you can read some of the responses here, here, here and here.

Weiner, in her TODAY show interview, said she has identified a struggle in the body acceptance movement.  She and many of the women she talks to could embrace body acceptance but are not doing anything for their health.  This comment is so connected to the very life force and essence of my work in the Health at Every Size movement that I feel compelled to respond.

It is easy to assert that body acceptance is essentially health promoting.  This wonderful, logical idea is what captivated me 15 years ago and called me to this field.  It is known that when we experience love and self-acceptance, we are more equipped to act in our own best interest.  This truth is so far-reaching in its effect on our lives that we can find places of calm and peace that transcend the old disordered and deprived thoughts about ourselves; the one’s formerly rooted in worthlessness and isolation.

When I hear a woman say words similar to Weiner’s, I am most ignited and passionate about this body acceptance and Health at Every Size® movement.  I want to stand on my chair and yell (a kind and warm yell, if that is possible) “No, no, don’t abandon ship here.  Keep going!  There is more!  Don’t run from yourself now!  This is where the body-acceptance stuff gets really good!”

Loving our bodies does not mean living in opposition to our health.  Accepting and loving yourself into better health (or perhaps despite your health) is a simple and beautiful option that has spawned the “new peace movement” and has become a foundational tenet of Health at Every Size®.    Every body is a good body.

Embracing this tenet is much more challenging for those who've had an eating disorder, suffered from body hatred or live in a larger body.  Our bodies, especially after years of trying to change them, can become difficult to learn to love, trust, and care for because they are often identified as the source of all pain.  We question whether our bodies are betraying us.  Standing with our bodies and claiming them as a part of ourselves is difficult.  This is especially true when we are used to abandoning them when facing the challenges that come with inhabiting a body, such as health concerns.

So, it seems that there is an elephant in the room here.  At this time, in this culture, there is a space that exists between loving our body and acting on behalf of our health.   For many of my clients, myself, and I guess much of our culture, it can be hard to find the self-love and acceptance we need in that gray space.  The space is cob-webby, full of the old rhetoric and words, the language of fear.  The space is one where we hand over the expertise of our bodies to others, and we hope that we find a better, more improved version of ourselves on the other side (remember, this has never really worked before). 

Healing from this body-directed hatred and moving towards health is quite a process, certainly far more layered and involved than making a simple decision to join a movement.  So, when a person that represents medical authority gives you medical news that concerns you, it can feel like the best thing to do is abandon the “self-love” ship and go back to relying on the dieting mind to tell you what to do again.  There aren’t any new answers in returning to the old diet-y path, but it sure can be clearer than a non-diet,  approach Health at Every Size® approach to food, weight and health.  They definitely do not garner the “atta-girl” kudos that can make us feel better under these circumstances.

Feeling ambivalent about Health at Every Size® is part of the process.   This ambivalence helps us learn our own truths about our bodies, our minds and our hearts.  HAES™ and body acceptance are truly helpful and life changing and can be ripe with complexities.  There are no easy answers here, ask anyone that is putting this to work in their lives. The path to self-acceptance and self-love is a long and winding road, one so worth trekking.   One of the biggest challenges is the courage it takes to keep going.

 

 

Cooking as a Spectator Sport

By Dana Sturtevant, MA, RD

I was cooking some risotto last night, really enjoying my time, and thought, “Why don’t I do this more often?”  While I love to cook, I hate going to the grocery store.  I realized that going to the store is my biggest barrier to cooking.  When I get off work, the last thing I want to do is go to the store AND cook dinner.  But, if I take time over the weekend to pick out a few recipes and buy the ingredients, then I am more than happy to come home from work and cook for my family.

Many Americans rarely take time to cook a meal for themselves.  They’d rather spend time watching a show on the Food Network, which draws more viewers than any other cable news channel!  Last year, Michael Pollan wrote an article in the New York Times about America’s obsession with cooking as a spectator sport, and why the rise in cooking shows coincides with the rise of fast food and prepackaged meals.  He points out that the time it takes to the average American to cook dinner is less than half the time it takes to watch a cooking show.  And the popularity of shows on the Food Network doesn’t seem to be making people spend more time in the kitchen.

There are three components to managing meals: planning, shopping and preparing.  Some people plan their meals a week at a time, but I tend to approach food more like Europeans.  I take it a few days at a time and go to the store at least two times a week.  This works for me because a grocery store is just two blocks from my house.  But, the greatest predictor for me cooking during my work week is spending some time on Saturday mornings looking at recipes while I drink coffee.  One of my favorite sources for recipes is Sunset magazine.  I pick two or three to make the next week and go to the store to buy the ingredients.  When I’m driving home, I think about which one sounds best to me.  Then I put some music on the stereo, pour a glass of wine, and let the fun begin.

Bon appetit!