Moving Away From Disordered Eating - Using A Non-Diet Approach
Jannette Travali, MS, MPH, RD, LDN

In fitness settings, training strategies have moved away from guilting and intimidating to empowering for increased physical health and performance. This approach is increasing seen in team management in the workplace, as well. The idea is that by tuning individuals inward and helping them to become better focused on their own emotions, physical presence and outward goals, we can enhance physical, emotional and social well being. From a performance perspective, this translates into improved athletic achievement and/or increased job productivity.

Although we have successfully made the motivational switch at the gym and at work, we still have a major blind spot when it comes to issues of weight and food. Nowhere is this need more apparent than in the management of weight and some related eating disorders. A large part of the medical community and the popular press still focus on health risk, negative appearance, body weight and choosing the "right" set of foods. In reality, successful life changes involve the understanding that our behaviors are an interaction of emotions, genetics, finances, and access to family, work and social support systems. Successfully altering health-related a behavior requires that damaging behaviors be viewed as learned responses to life stress. Behaviors and stressors need to be altered, healed and resolved, not controlled.

Traditional programs tend to keep individuals externally focused on what to eat, what not to eat and how much to exercise. While focusing on the magical mix, participants often remain disconnected from their bodies and emotions as they follow a plan of diet and exercise. Long-term success rates for traditional weight management programs have been quite poor. Individuals involved in such approaches often feel as though they have failed. Guilt and embarrassment lead to loss of confidence and further stress - all the while taking the person further away from wellness.

From the widespread frustration with diets that do not work, pressures to be thin, the need to manage health risks and to deal with the growing eating disorder crisis in this country, a new treatment perspective has emerged: the use of a Non-Diet Approach. A Non-Diet Approach is a more wellness-oriented solution. The approach also draws on the strategies of other "life change" and motivational arenas. It incorporates self-actualization and body image issues. Most practitioners who use this approach focus on helping individuals feeling better about themselves, eating well in a more balanced, relaxed way and being comfortably physically active.

A Non-Diet Approach involves the following components:

• Acceptance
Developing unconditional self-acceptance - of body, physical limits, disease, emotional factors
• Awareness
Developing a gentle awareness of emotions, hunger, habits, etc. which may trigger a damaging behavior or keep someone from making a more positive behavior choice

• Trust
Developing a client/therapist link based on honesty and trust

• Information
Developing informed, self-determined food choices based on and understanding of food properties and the effect that a specific choice may or may not have on overall goals (this applies to exercise as well)

• Freedom
Developing freedom from feelings of deprivation through gradual exposure, availability and continual use of previously "forbidden" food choices

• Permission
Granting permission to make our own food choices, to make mistakes and remedy them in a safe, therapeutic atmosphere (without guilt and shame)

• Patience
Altering the timeline for "results" with the understanding that permanent lifestyle changes take longer to achieve and do not follow a simple cookbook remedy

A Non-Diet Approach challenges all the old rules for weight loss and following special diets. It encourages individuals to pay attention, focus inward and to evaluate individual situations in making choices (about food and activity). Although it may seem uncomfortable at first, this level of understanding and awareness is essential for long-term freedom from food obsession and disordered eating. Participants who use this approach ultimately become more relaxed in their food and activity choices, making a healthful lifestyle a more fun and natural way of life.

© 2003 Jannette Travali, MS, MPH, RD, LDN is a Registered Dietitian and Exercise Physiologist who is the Director of The Center for Mind & Body Wellness, a Private Nutrition Therapy Practice specializing in disordered eating; from weight management to anorexia, bulimia, PCOS, food aversions and compulsive overeating. Her counseling incorporates a Non-Diet Approach, focusing on cognitive and behavior modification - involving diet, lifestyle, body image and exercise. With offices in the Cranberry, Wexford and the East End, she may be reached at 724.933.1119 (North) or 412.422.9313 (Pittsburgh).


Nutrition Therapy for PCOS - Knowing What to Look For & Finding a Qualified Practitioner
Jannette Travali, MS, MPH, RD

There is so much confusion surrounding the idea of "low carb" diets to help manage Polycystic Ovarian Syndrome [PCOS]. To be a truly effective management tool, your "low carb" meal plan should be part of an Individualized Self-Care Plan developed by a qualified Nutrition Therapist. The following article is designed to help you understand what needs to be considered in development of an individualized self-care plan and how to find a qualified Nutrition Therapist to develop such a plan.

A thorough Medical History and Family Medical History should be included. Not all women with PCOS have the exact same combination of medical issues, but all of your medical issues (including Medications and Supplements) need to be factored into an individualized plan. A Nutrition, Exercise and Weight History (including a Dieting History) is needed to help understand your specific metabolic tendencies and potential disordered eating patterns. A Survey of Your Daily Life Responsibilities, Recreational Likes/Dislikes and Food Likes/Dislikes is helpful in assessing life stress and setting up the individual pieces of a plan. Your comfort level in your own skin (Body Comfort) is also considered in developing a safe and non-threatening plan of movement.

All of the gathered information is used to develop a plan of gradual, step-wise goals involving diet, movement and other lifestyle factors. Choices and placement of food is based on your body and your lifestyle, not given as a blanket solution. Your plan should begin with one or two areas and build on your progress. It is not the speed of change but the sustainability of change that is important. You are more likely to abandon a plan of radical changes and you may even be triggered to binge eat as a result. Your Nutrition Therapist should explain the physiology of PCOS and the reasons for each goal. The amount of support you will need will vary throughout the process of attaining your goals.

In order to find a qualified Nutrition Therapist in your area, contact the American Dietetic Association at www.eatright.org, ask other women with PCOS about positive (and negative) experiences they may have had, ask your Endocrinologist for a referral to someone with a significant amount of experience treating women with PCOS. Remember, this is not a weight loss referral! With PCOS the apparently simple energy-in/energy-out equations, do not easily apply. Look for someone with specific PCOS and disordered eating experience.

© 2002 Jannette Travali, MS, MPH, RD is a Registered Dietitian and Exercise Physiologist who is the Director of The Center for Mind & Body Wellness, in a Private Nutrition Therapy Practice specializing in disordered eating; from weight management to anorexia, bulimia, PCOS, food aversions and compulsive overeating. Her counseling incorporates a Non-Diet Approach, focusing on cognitive and behavior modification involving diet, lifestyle, body image and exercise. With offices in the North Hills and the East End, she may be reached at 724.933.1119 (North) or 412.422.9313 (Pittsburgh).