Nutritionist Failure

Warning: discussion of food, fatness, and disordered eating. 

I blog so infrequently that I couldn't figure out how to get back into here to blog. Oops! 

Someday I will have to figure out why certain things drive me to write here, rather than other social media where it is more directly brought to people's attention, but today is not that day. 

A heck of a lot has happened since 2019, hey? And yet, I'm not here to touch on any of that. I am here for the one thing that seems to drive me to my blog - my body. 

I had an appointment this week with a nutritionist. This nutritionist works at a clinic that does medical weight management and has my least favourite 'o' word in the name, and so I assumed would have some background and experience in working with fat folks like me. I was optimistic it would be different from the other times I've met with nutritionists and other medical folks about my relationship with food. It sure as heck wasn't. And it was upsetting as all get out. But... it also made me realize some things. 

If you look back far enough on this blog, you will see that I am not new to trying to change how I eat. And I have made (temporary) significant changes before. Hell, this blog will show you a transformation from a fat me to a much less fat me via a commercial weight loss plan and a points system. I was placed on my first calorie restriction diet at the age of 17 (and the goal I was given was an amount that would be considered starvation in any other situation). I have tried again, and again, and again. 

This is the pattern that happens when I do restriction: 

1. I start restriction thinking this time it will be different because 'x'
2. I have some level of success with restriction, which makes it worth the fact that I spend all of my waking time thinking about food and said restriction itself. This period can last anywhere from a few days to two years. 
3. I reach a point where the only food I have told myself I am 'allowed' to eat is food that is unappetizing. Sometimes it's just easier to not eat than to eat stuff I don't want, so I start doing that at times. 
4. I eventually crack from thinking about food 24/7 but not eating (or eating in very restrictive ways) and eat pretty much everything in my house until I feel sick (aka binge)
5. I enter a cycle of trying to be 'good' but then having days where I binge until I feel sick. I tell myself it's fine, because I'm only throwing up because it hurts not because of shame. Note: I feel shame the whole time. 
6. I return to the same eating habits I had before all this, with a high sense of shame about it. 

I have done this pattern over and over again in my life. And I've told very few people very small pieces of it.

A couple of years ago I managed to step out of this cycle. I decided I was done, and I was done with the idea of weight loss. I started to just eat whatever I wanted to eat. And I will be honest that through this I gained a lot of weight (although this was also related to a significant decrease in physical activity for complex and varied reasons to be explored separately). With the guidance and support of the right people, I slowly began to separate food from shame. After about two years of actively working on this, I recently noticed some big changes. I started to be able to tell when I was full, and my portions decreased significantly for most meals. I now get 2-3 meals out of what used to be one. There are days where I crave foods that I used to rarely eat, generally food that is higher in nutrients and is more flavourful. I snack a lot less, because I'm more able to distinguish when my desire to eat is because I'm bored versus when I'm genuinely hungry. 

Have I lost weight? No. And that hasn't been the point. But I am really proud of the way my relationship with food has been changing because I am giving my body more of what it needs and listening to it better.

And then I talked to the nutritionist. She asked what I've done, and I stated I've been on multiple diets, including a commercial one, and have tried most methods of weight loss out there. She asked me some lifestyle questions and made one small recommendation that was fair enough. And then she started trying to tell me about changes to make, and chose a meal to highlight. In doing so, she stated that I should be eating 1200 - 1600 calories a day.

I responded with confusion, as from previous conversations with knowledgeable professionals I've been cautioned against eating significantly below my basal metabolic rate (i.e. the number of calories my body requires just to exist even if I was doing nothing at all all day), which I suspect at my current size is not 1600 calories per day. The response was basically 'well the doctor will talk to you about that'. 

And then I broke. I started crying, because I knew what was coming. I knew that I was being told to calorie count and return to a life of restriction, and I knew that this would lead me back into that cycle. I knew I was being asked to tie food and shame together again, to see my size as a moral failing, and to try to willpower my way into a smaller body. And I felt the years of shame, of self-loathing, of wondering why I can't do it crash into me. I spent most of the rest of the call crying, and pretty much agreed to whatever was said to get off the phone. The doctor had one good suggestion, that I've been considering for a while but he was able to reinforce. The doctor also seemed to be doing damage control by clarifying that they didn't mean I would *immediately* restrict to 1600 calories, but that that would be a long term goal of a calorie counting practice.

I am not returning to calorie counting. I am not starting a new, somehow magically different restriction diet that will end the same way and leave me wondering why I can't do it. I am not entering back into that cycle (although I have spent most of the last days having to actively resist the simultaneous urges to somehow both never eat again and eat everything in the house out of spite, so that's fun). I will find, and pay for out of pocket, a private nutritionist who can help me with the things I actually want: ways to introduce nutrients that I am currently missing into my diet sustainably through foods that I will actually enjoy and *want* to eat. Because I refused to spend another 20 years fighting my body and believing it makes me a failure as a human. 

I had a whole other realization throughout processing this this week, which is that the way that my brain fixates on food in certain circumstances is the exact same as what I have learned to identify as intrusive thoughts when not about food. It is all kinds of messed up that I have been convinced the ones about food are a moral failing rather than supported in understanding them as intrusive thoughts and encouraged to address them as such. But this blog post is too long already, so I won't get into all that. Instead, I present a script for the appointment I wanted but didn't get:

Nutritionist: You mentioned on your intake form that you've done multiple diets and a wide variety of attempts to lose weight. Is that right? 

Linden: Yes, that is. 

N: And is that what you are looking to do now? 
L: No, actually it isn't. I have found those attempts really damaging, and am instead hoping to take an approach of how I can add nutrition to my diet rather than focusing on taking away calories. 

N: Oh, can you expand on that? 
L: Of course. One of the reasons that a restrictive approach to food is really hard for me is that I find a lot of high nutrition and low calorie foods unappealing. Especially vegetables - I have to work hard to convince myself to eat most vegetables. I would like to focus on how to bring the nutrients I know I'm currently missing into my daily diet, and do so in a way that they are appealing and therefore is sustainable. My body is telling me it craves these things more often, so I could use help finding ways that my taste buds and brain will be on board easily.