Stop Dieting, Start Healing
From a purely biological level, we require food to obtain enough nutrients and energy for our bodies to sustain life. This connection between food and our survival is why our relationship with food can become very complex. In fact, food plays a multitude of roles in our daily lives. We use food to socialize, to show we care about someone, to celebrate, and even for religious observance. These moments often leave a lasting emotional impact, which extends to our feelings about food. For example, you may not remember how awful you felt every time you were sick as a child, but you probably remember how it felt when your mom made you her special 'sick day' meal. But what happens when our emotions around food and eating begin to affect how we feel about ourselves?
A good relationship with food is characterized by neutral-to-positive thoughts and feelings about food and eating. Food does not define your worth or happiness but is seen as a source of nourishment and enjoyment. A person with a good relationship with food trusts in their body's ability to determine when they are hungry and when they are full, without a need to restrict or binge eat. A bad relationship with food is characterized by negative thoughts, feelings, and behaviours surrounding food. These can manifest in a variety of ways, such as:
• Labelling foods as "good" or "bad" and feeling guilty or ashamed about eating "bad" foods.
• Using food to cope with emotions such as stress, sadness, or boredom.
• Feeling out of control around food and binge eating or restricting food intake.
• Having rigid rules about eating, such as only eating certain foods at certain times or never eating out.
• Being overly concerned with weight or appearance and believing that food is the key to achieving a desired weight or look.
A bad relationship with food can have a significant negative impact on a person's physical and mental health. It can lead to eating disorders, such as anorexia nervosa, bulimia nervosa, and binge-eating disorder. It can also contribute to other health problems, such as obesity, diabetes, and heart disease.
Getting an exact measure on the number of people that have a bad relationship with food is difficult because it is a multifactorial issue, that cannot be measured by one metric alone. But, the number of people engaged in disordered eating can be a good indicator, as a negative relationship with food often culminates in disordered eating. To this end, a study carried out on 10,000 people in the UK found that as much as 23.1% experienced disordered eating behaviour at some point in their life (1). The real number in the population might be much higher, as many people may not even be aware that they have disordered eating habits.
A bad relationship with food can be caused by many things, but broadly they can be categorized into two groups: emotional/psychological factors and biological factors.
Biological factors
Our body's hunger signals mainly come through two pathways. The first pathway involves the emptying of our stomach and the release of a hormone called ghrelin. Ghrelin's primary function is to signal to the brain that the body needs nourishment, prompting an increase in appetite and motivating us to seek food. The second pathway operates through glucose-insulin regulation. Low glucose levels in our body stimulate ghrelin, triggering hunger. In contrast, insulin helps suppress ghrelin, turning off the hunger cues.
Carbohydrates from our diet are broken down into sugar (glucose), which our bodies prefer to use for energy. Carbohydrates, especially simple carbohydrates, are digested very quickly compared to fiber (not digested), fat, or proteins (digested more slowly). This results in the rapid emptying of food from our stomach and the swift absorption of glucose into our bloodstream. The speed at which glucose levels rise and fall is crucial for our bodies because:
Prolonged high levels of glucose can lead to persistent insulin release, which over time can result in insulin desensitization, pre-diabetes, and eventually diabetes.
Low glucose levels stimulate the release of ghrelin. So, the faster insulin removes glucose from the blood into the cells, the sooner ghrelin is released, which stimulates hunger.
Eating an unhealthy diet, high in processed carbohydrates, low in fibre, healthy fats, and proteins will make anyone feel ravenous, and this unrelenting hunger can impact us emotionally, and trigger a bad relationship with food. If you are ravenous the entire day and never feel satiated with your food, if you cannot go 3-4 hours between meals, or you experience extreme hypoglycaemia when you're hungry, it is worth considering if your diet is adequate.
No amount of willpower, journaling, or mindful eating can fix a broken metabolic system. Healing our relationship with food starts by using it as intended—for nutrients and energy.
Lifestyle changes
Keto and/or intermittent fasting (IF) have been praised for helping reset our metabolic system. Both diets work by reducing our body's glucose, either by a dramatic reduction in carbohydrates (Keto) or eliminating all food for a period of time (IF). Remember, our bodies prefer to burn carbohydrates for fuel, in the short term, drops in glucose stimulate hunger, so we can top up on more glucose. Over longer periods, low glucose levels push the body to pursue alternative fuel source – specifically fat. This metabolic state is called ketosis and is the goal of the keto diet. The ability of our body to use both fat and glucose for fuel without much effort is called metabolic flexibility and it is a hallmark of a healthy body (2-4). Ketones also inhibit ghrelin, causing us to feel less hungry.
Intermittent fasting (IF) is another popular way of regulating our glucose spikes. IF is an eating pattern that cycles between periods of fasting and eating. It does not specify which foods you should eat but rather when you should eat them. In this respect, it's not a diet in the conventional sense but more accurately described as an eating pattern. IF works in a fashion similar to the keto diet. The long fasting period causes a sustained drop in glucose and insulin, which in turn causes the body to dip into a ketogenic state, pushing the body to burn its fat storage for fuel.
There are many different ways to do intermittent fasting, but all of them involve splitting the day or week into eating periods and fasting periods. During the fasting periods, you eat very little or nothing at all. During the eating periods, you eat normally. Some of the most popular intermittent fasting methods include:
• 16/8 fasting: This involves fasting for 16 hours each day and eating within an 8-hour window. For example, you might eat from 12 pm to 8 pm and fast from 8 pm to 12 pm the next day.
• 5:2 fasting: This involves eating normally for 5 days of the week and restricting your calories to 500-600 calories on the other 2 days.
• Eat-Stop-Eat: This involves fasting for 24 hours once or twice per week.
Both keto and IF offer various health benefits that help the body fight inflammation. Both keto and IF also upregulate autophagy, a cellular process that involves the body's ability to "clean up" damaged cells. This process may help protect against various diseases and promote overall cellular health.
If you find these diets to be impractical or restrictive, I recommend reading the book, 'The Glucose Revolution' by Jessie Inchauspé. Drawing on the latest research, she presents various strategies to reduce glucose spikes and establish a healthier pattern of slow glucose release. Simple tactics, such as drinking water with ACV, can lower a glucose spike by up to 30%, or having carbs last in your meal can reduce a glucose spike by as much as 50%.
Image adapted from the glucose goddess instagram.
Emotional factors
Food serves not only as a source of nutrition but as the foundation on which most of our social interactions happen. As such, we all have emotional reactions to food. A certain meal can bring up nostalgia, happiness, positive memories, or anxiety and sad memories. Both positive and negative emotions around food can impact our relationship with it.
Many of the emotional aspects of our relationship with food stem from childhood. For example, research shows people with a bad relationship with food are more likely to have experienced some form of childhood trauma(5). For this reason, the best step you can take to help improve your relationship with food would be to find a qualified therapist who can help guide you through this – based on your particular experiences and triggers.
More generally, it can be helpful to journal your feelings around food and check in with yourself each day. Lack of sleep, stress, anxiety, and our menstrual cycle can all impact our desire to eat and what sorts of food we crave. Being mindful of these bodily cues allows us to gain deeper self-awareness and helps us avoid unnecessary feelings of guilt.
Another tip is to eat mindfully. Some of us are fast eaters and often distracted while we are eating. This means we finish our food before our bodies have even registered what is going on. Eating mindfully means being present while we eat and not being distracted, for example by technology or being in a rush. Eating mindfully can include putting down our phones, setting adequate time aside to eat, and chewing more slowly. These changes can help our body register how much we are eating and better respond to satiety cues.
De-center weight loss and diets
I have been on many restrictive diets in my life with the aim of losing weight. And when the desired weight loss didn't arrive quickly, I was all too ready to give up because it wasn't working. But, in fact, it was so much worse than giving up, because I didn't just give up and return to a healthy diet; I would often rebound because the diet was so restrictive. Our commitment to healthy eating is not about superficial appearance – at least it ought not to be – and this shift in mindset can help us reclaim control over our eating habits and relationship with food. So don't diet to lose X pounds in Y time. Make the focus eating healthy to nurture and take care of your body, one meal at a time.
Ditch the all-or-nothing mentality. How many times have you felt – oh well, I've broken my diet now; I might as well go wild today, and I'll get back to it tomorrow, but tomorrow never comes. This thinking is related to diet culture because we follow diets as foreign extraneous things, rather than something essential and part of our lives. Don't think of healthy eating as a diet; it's your life. This is how you eat. You might have indulged a little at your friend's birthday – but that's okay. Don't convert that one indulgence into 364 extra days of indulgences.
Organize your food. We often pile food onto our dishes, which can hide what we are actually eating and how much of it. It might be helpful to sort your meal into the different food groups. This will encourage you to think about what you are eating from a nutrition point of view – do you have protein on the dish? Fibre?
Lastly, but most importantly, being kind to yourself plays a pivotal role in healing your relationship with food. Understand that it's entirely normal to have ups and downs in your journey. There will be days when you make choices that align with your goal of a healthier relationship with food, and there will be days when you may stumble and make less ideal choices. It's essential to remember that one moment of indulgence or deviation from your plan doesn't define your overall progress.
Laying out your food on the plate can be useful way to see what you are eating, and ensure you are eating all the food groups for optimal health.
Instead of berating yourself for these moments, treat them as opportunities for growth. By showing kindness to yourself, you create an environment of understanding and forgiveness. This approach can gradually transform your relationship with food from one based on strict rules and judgments to a more flexible and nurturing one.
Sources
Jason M.Nagata et al. The social epidemiology of binge-eating disorder and behaviors in early adolescents. Journal of Eating Disorders.2023 Oct 11, 182.
Rynders et al. Sedentary behaviour is a key determinant of metabolic inflexibility. J Physiol. 2018 Apr 15;596(8):1319-1330.
Rath, E. and Haller, D. Intestinal epithelial cell metabolism at the interface of microbial dysbiosis and tissue injury. Mucosal Immunol 2022 Apr 15, 595–604
Yvonne MH Bruls et al. Carnitine supplementation improves metabolic flexibility and skeletal muscle acetylcarnitine formation in volunteers with impaired glucose tolerance: A randomised controlled trial. The Lancet 2019 Oct 49, 318-330.
Moon, I. and Han, J. Moderating Effects of Physical Activity on the Relationship between Adverse Childhood Experiences and Health-Related Quality of Life. Int. J. Environ. Res. Public Health 2022 Jan, 19, 6