Dr. Kerri Fullerton ND

Intuitive Eating. Health At Every Size Doctor

Blog

What Working on Your Health Can Look Like Without a Diet to Lose Weight

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Spring is here. That means that weight loss season is here again.

They know that dieting isn’t trendy anymore so they won’t be dieting or weight loss ads. No, they’ll be called health challenges or fitness challenges, maybe a Post Pandemic Reboot.

A diet by any other name is still a diet. What makes something a diet? Intentional weight loss. Restriction (even if that’s called moderation or sensible portions or just eating clean). It is intentional weight loss that has the dismal stats.

And I get it. You want to DO SOMETHING towards improving your health (that’s if health is something you value. It may not be and that doesn’t de-value your worth in any way). Lucky for you I have compiled a list of ways that you can work on your health without falling victim to yet another gain-lose-gain weight cycle.

10 ways to work in your health without intentional weight loss:

  1. Sleep: improve glucose regulation and mood regulation
  2. Mindfulness: improve mental health and reduce cortisol levels
  3. Movement: reduce your cardiovascular risk
  4. Debt counselling: reduce stress and improve relationships
  5. Counseling: develop emotional intelligence
  6. Self-compassion: increase motivation, self-worth and resilience
  7. Join a group of like minded people: develop a sense of belonging
  8. Social Media cleanse/Unfollow challenge: reduce your intake of not-enoughness
  9. Values work: spiritual health
  10. Laugh: improve sleep, improved stress response

Bottom line: If you’re feeling ‘meh’ there are so many things that you can be DOING to support your health that don’t involve restricting foods that you enjoy or trying to shrink your body.

Learn more about Living Life As A Rebel here. It’s how you can hold onto your anti-diet values AND work towards some specific health goals.

Join the Rebellion

Spring Detox Marketing: Don’t Get Duped!

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A patient sent me the website to a cleanse that was recommended to her. The longer I was on the site the more frustrated I got.

Like most cleanses or detoxes, there’s a specially formulated concoction that you drink in lieu of eating food. This is the only thing to be consumed for a few days to a week (although some ‘allow’ you a ‘sensible’ meal once a day in addition to these pouches).

The claims are remarkable. Promises of weight loss (no shit, you’re starving yourself), promises of healthy (the quick changes in your labs are not permanent – they’re temporary just like the cleanse and accompanying weight loss).

What really got my goat this time was when they said “Kick start healthy eating habits, gain control over portion sizes and improve energy”.

Let’s review the cycle of restriction:

  1. Starving your body will make you HYPERfocus on food. This is natural – it’s like if you weren’t able to breathe properly, it becomes difficult to focus on anything else. Or if you’re deprived of enough water your thirst will overcome you.
  2. Under-eating sets you up for OVER-eating. Just like when you can finally breath again you will take DEEP breaths and breathe more heavily until your body believes that you have free access to air; when you eat again, you will be DRIVEN to eat HUGE amounts until your body feels safe that food is longer restricted.
  3. That energy that they’re promising? It comes from your body having to produce cortisol to keep you going (cause you know, there’s no FOOD to do that). Our stress response will make us more alert because it’s getting us ready to escape danger. This is TEMPORARY access to the emergency fund. The trouble is, most of us are chronically OVER-stressed and need help reducing chronically high circulating cortisol. So yes, you may have some extra nervous energy but that’s not the same as being able to focus and be engaged positively in your life.

Look, I get the desire to shake off the winter blues and get back into something. In fact, I encourage it. But can we please find ways to re-engage with life and health promoting behaviours WITHOUT causing harm in the process?

The next Living Life As A Rebel group starts at the end of April. If you’re itching to ‘do’ something without getting caught in another diet cycle, then this may be just what you’re looking for. Register before April 12th to get Early Adopter bonuses!

Join the Rebellion

Health At Every Size™ approach to Polycystic Ovarian Syndrome (PCOS)

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“Just lose weight”

“Just stop eating carbs”

These are the first words of advice that most newly diagnosed PCOS sufferers hear. And most of them will try it. And most of them won’t be able to sustain it for long. And most of them will blame themselves.

This reason alone may explain why those with a PCOS diagnosis are also more likely to have unrecognized disordered eating behaviours or worse, a full blown eating disorder, than those without a PCOS diagnosis.

Birth control is another common first line therapy for PCOS. I don’t have any objection to birth control, especially if you’re trying to prevent pregnancy. But what if you do want to become pregnant? Or the contraceptives give you life interfering side effects?

I don’t mean to bum you out here. In fact, I hope to have the opposite effect. It’s just that most women who come to me with PCOS feel so defeated because they’ve done the low-carb/no-carb diet cycle so many times that they just can’t face it again but they also just can’t tolerate their symptoms anymore.

Or it’s a mother coming in saying that they think their daughter has PCOS and they’re terrified that they’ll end up on the same cycle but they have no idea what to do.

That hope that I was mentioning? PCOS can be treated without giving up carbs or going on another diet.

Step 1: History and Testing

Firstly, we need to see all of what’s going on. PCOS is a condition that comes with all kinds of potential challenges. We need to know what’s happening for YOU. We need to screen you for other conditions that tend to show up alongside PCOS like Binge Eating, Anxiety, Depression, Insulin Resistance, Vitamin D insufficiency and Inflammation.

Only once we have YOUR PCOS picture can we customize the PCOS Process to YOU.

Step 2: Nutritional Therapy

You didn’t think that nutrition would be left out just because I said no dieting did you? There are many ways to experiment with different ways of eating to help address your PCOS. We only do this if it’s safe to do so. In my experience those fresh out of diet culture can turn any nutritional recommendations into a new diet. We’ll take a look at your current relationship with food first and then proceed with caution. Intuitive Eating support may be just the nutritional therapy that you need.

Step 3: Supplement Therapy

Supplements are used to adjust the biochemistry of your PCOS and lessen symptoms over the long term. Which supplements and in what does will depend on what we discovered in Step 1. Don’t worry – you won’t have to swallow buckets of pills each day. I’ve never practiced like that. Typically it takes a 3-6 months to see any significant changes on your labs so we’ll keep working on other therapies in the meantime.

Step 4: Movement Therapy

We know that exercise is good for us right? But most people who’ve been living in diet land for years only know exercise to be punishing – either earning their treat or burning it off. Not to mention, some of the biochemistry of PCOS makes exercise painful and exhausting. So, we’re going to talk about movement. In the same way that we’re working on healing your relationship with food, so too will we be healing your relationship with your body and movement.

 Step 5: Stress Reduction Therapy

This step is one that we all like to skip over isn’t it? I can hear you “Kerri, we all have stress, I just deal with it”. Yes AND we need to assess your sleep (HUGE influence on hormones, appetite and cravings), rest (your body is sick and needs to be cared for), and mindset (having PCOS puts more stress on you than you’re even aware of). Don’t worry, I’m all about small changes made over the long-term. I promise that I won’t turn your life upside it’s head.

If you’re ready to try a anti-diet approach to PCOS, or if you think that you may have PCOS and don’t want to start down the diet cycle, then I invite you to book a Connection Call. We can chat, free of charge. If we discover that I’m not the right fit for you, that’s cool. I’m sure that I can point you in the direction that is a good fit for you.

Until next time,
Dr Kerri

I blew it …

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I went for a walk on a beautiful sunny day and had the pleasure of seeing these deer. About two or three minutes later, I slipped on the ice and landed on my butt. I was not happy to say the least. I quickly got to my feet brushed myself off and carried on with my walk. From the outside it likely looked like no big deal. But what was going on inside my head was another story.

That slip could have ruined the walk – it could have ruined my day. Haven’t I said that eating a cookie ruined my day before? I mean, how many times have I eaten one cookie and then declared that it had ruined whatever day, week or month and particular plan I was following? How many times have I missed a work out and declared that I blew the training program?

The all or nothing mindset is some thing I have been actively challenging through my recovery from disordered eating and body image challenges. I heard an analogy once that went something like this: If someone stole $10 from you would you go to the bank and pull out $1430 and hand it over to them? Not likely. You see, there are 1440 minutes in every single day. When 10 minutes of day goes sideways and then we let it drag out into the rest of the day, it’s like we’re giving over the rest of our money. Or possibly seven times that much if we let that one moment ruin the week. How easily we give away our time because somebody said something unkind; because something went wrong; because I slipped on the ice; because I ate a cookie; because I skipped a work out…you get the point.

There’s a technique that I teach in my Living Life as a Rebel program called A.I.R. The A for a stands for Awareness, the I stands for Identification and the R stands for Reflection.

When I slipped on the ice I became Aware of how quickly I wanted to fall into the ‘the walk is ruined’ narrative. The awareness of that conversation in my head allowed me to reconnect with the sense of joy that I had just experienced standing there looking at those deer. I was able to reconnect
to the feeling of incredible gratitude that I had been experiencing enjoying a beautiful walk on a sunny snowy day and seeing deer right here in my neighbourhood.

If I let that go because of falling it would’ve been like handing over that additional thousand dollars because the fall took the 10 to begin with.

Now there’s a very good biological reason for this. We have something called negativity bias in our minds.

It’s a great survival strategy. It helps us remember the scary stuff to ensure that we don’t do those things again.

Knowing that that we have this natural tendency allows us to have another level of compassion and awareness for ourselves. The fall triggered my ‘reactive primitive’ brain. My awareness of that allowed my ‘thinking’ brain to take over and give a broader assessment of the situation and realize that walking the dog is not a dangerous act.

This was the Identification part of the A.I.R. I was able to identify what was triggered in me.

I’ve already described some of the Reflection part – the reframing of my thoughts to realize that the fall didn’t wipe out the gratitude. I also reflected on the idea of putting some spikes on my boots.

To extend this idea back into eating and body image work, we can become aware of the “I blew it” moments and transform them into a more compassionate reflection.
We can remember that it was just a cookie; that eating the cookie doesn’t mean anything other than we ate the cookie.
We can use self-compassion to decide that we’re not going to give away the other 1430 minutes to the cookie.
We can just let cookies be cookies.

Is “Fat But Fit” really possible?

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I sat and read the New York Post article, Being Fat but Fit isn’t Really Possible, over the weekend and am compelled to share my thoughts about it today. I’m so disappointed by this headline and by the conclusion of the study itself.

It’s important to note that the study DID find that increased physical activity decreased the risk for cardiovascular disease and diabetes across all BMI categories. It would be easy to forget this important finding with the provocative headline used by the New York Post.  To reiterate: fitness, in terms of activity, DOES in fact provide cardiovascular and health protection at ANY weight. Moving on.

The article concluded that this protection isn’t as great as it would be if those active participants were in a smaller body. That physical activity didn’t COMPETELY negate the negative consequences of being in a larger body. I have to ask though, when did healthy come to mean ZERO risk?

Over and above that, I’m bothered by the topics that they didn’t talk about at all that have an impact. Some of what they didn’t discuss in their paper is:

  • The history of weight cycling
  • The impacts of weight stigma and size discrimination

And finally, and possibly the most important piece that they glossed over, is that we do not currently have an intervention that can reduce someone’s weight to a ‘normal’ BMI and keep them there. That’s right. No matter how intentional or functional your weight loss is, there is no 100% certain, guaranteed method that will prevent you from ever gaining the weight back. Not to mention that intentional weight loss is associated with many negative health consequences.

Behaviour Based Approach

The Health At Every Size™ approach is behaviours based as opposed to an outcome based approach. That means that we focus on actions that are within a person’s control instead of outcomes that are not.  When we spend our time and energy focused on things that we can actually control, we have the opportunity to be empowered and engaged. We are given the opportunity to measure something that will build our confidence and that will lead to a positive experience which means that we are far more likely to keep it up. For example, one patient of mine was wanting to do a certain hike on her holiday. She started training to increase her strength and endurance. Even though her weight didn’t change, she was able to not only participate in that hike, but she also started to see how her new fitness levels were showing up in her day-to-day life. This is the longest that she has ever stuck to a fitness plan and a big part of that is because she stopped measuring her success (or failure) on the scale.

Sustained long-term weight loss has dismal, defeating and disappointing statistics. Most people who embark on a weight-loss journey are not going to be successful and those who are deemed a success usually maintain a very small weight loss compared to their initial weight loss. In fact, almost 95% of those who lose weight will have gained back some, all or more weight within 2-5 years. Traci Mann expands on this in her book “Secrets from the eating lab”.

Nobody wants to play a game that they can’t win and the weight loss game has been played for centuries with very little success. Certainly not the kind of success that these authors are talking about. According to them, in order to be labelled as ‘healthy,’ you must reach the lower weight and stay there permanently. And I haven’t even touched upon the shortcomings of the BMI scale yet.

Why am I talking about this today? If you read the article this weekend, and it started to throw you off the track of following a Diet Rebel lifestyle, where you’re pursuing your health and fitness goals without the pursuit of weight loss, I wanted to take this opportunity to assure you that you are still on the right track.

How much you weigh IS NOT UP TO YOU and we have to consider your history:

  • At what age did you start having a dysfunctional relationship with food and your body?
  • How many times has your weight gone up and down and down and up?
  • How dissociated are you from your body’s natural hunger and fulness signals, likes and dislikes?
  • What does your self-esteem and confidence look like?
  • How able are youto fully participate in life right now?
  • And what is your Childhood Adverse Experience score?

Twice as likely to have high cholesterol

Let’s do a quick chat about what it actually means if I tell you that you are twice as likely to have high cholesterol. That sounds terrifying doesn’t it? Let me share my risks with you. I won’t share my actual numbers (weight, BMI, cholesterol, etc.) but will share my actual risk assessment numbers.

I used this risk calculator (QRISK 2-2014) and found that currently I have a less than 1% risk of having a cardiovascular event in the next 5 years.

If I double my cholesterol level, it bumps me up to 1.5% chance. If I lose 20kg, but keep the higher cholesterol level, my risk changes to 1.1 %.

Numbers can be used to scare the pants off of us, but they can also be looked at as a way to smooth the edges of urgency and keep us focused on what matters – taking care of ourselves.

Now, I am a healthcare professional and I do care about health. There is no moral obligation, however, for you to care or value your health. I also know, as a healthcare provider, that stress and self-flagellation are not health promoting.

When we continually tell people in larger sized bodies that they cannot access the label of healthy, we are not helping them get healthy. Some of these people have been told from the time they were little kids that they were fat. They were bullied. They were told they didn’t belong. They weren’t allowed to enjoy the food like the rest of the family. Studies like this promote the perpetuation of weight stigma. Even if their bigger body didn’t show up until later in life, the mental health effects of weight stigma and not belonging; being told that their efforts aren’t good enough; that THEY are not good enough; have terrible effects on their physical health. Including diabetes risk, inflammation levels and cortisol levels. 

Where do we go from here?

We focus on where we have control. We focus on healing our relationship with food and our bodies. We focus on healing our relationship with exercise so that we can reap the benefits (the health benefits that were documented in the study). This way, we can continue to focus on health-promoting behaviours, such as:

  • Joyful and respectful movement,
  • Adopting self-compassion,
  • Practicing Intuitive Eating; and
  • Developing a mindfulness practice.

And then we let our bodies land where they will.

I’m here to help.

Dedicated to helping you find peace and power with your body,

Tips for getting through change

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Even though we knew lockdown was coming, it’s still not easy. Change is hard, even when it’s expected, because it disrupts our routines. Things get uncomfortable. We have to think about things that were automatic only yesterday and our focus gets scattered. This is normal and expected.

a sprout grows out of a crack to represent change
A young plant growing out of concrete. Concept of break through

Now that we’re into week two of at home learning, we can revisit our routines, schedules and expectations, in order to make adjustments. Remember the 3 D’s: Delegate, Delay and Delete.

Some of the routines worthy of our attention include: sleep, meals, and socialization.

Sleep

When our schedules get out of whack, sleep is often neglected. This is unfortunate at sleep has such a tremendous effect on our mental well-being, our hormonal response, and our intellect, specifically our focus and memory.

 It’s also important to recognize that we may need more sleep during times of high stress so now is hardly the time to be skimping.

Do your best to keep a consistent bedtime. Set an alarm to GO to bed instead of (or as well as) an alarm to get up.

Meals

Mealtimes contribute to our circadian rhythm. They help our bodies find the flow to the day (especially helpful when it’s cloudy all day and dark so early).

Stress can interfere with our ability to hear our intuitive body signals of hunger. So while we’re juggling all of the things we may not notice that we’re hungry. Top that off with caffeine, another interference for body cues, and we may find ourselves tired, unfocused and grumpy instead of ‘hungry’. In that state we’re far more likely to make food choices that don’t feel aligned with our bodies.

Feeding our bodies at  regular times can help curb that vulnerability later in the day. It can help us use pleasure foods for comfort instead of trying to make a meal out them.

You may decide to set alarms so that you don’t forget to remember. And keep it simple. This is more about eating regularly than what you’re eating. Remember that any food is better than no food.  

One final thought on food: it’s okay that food is a comfort right now. Lean into that so that you can do it with intention and compassion.

Socialize

Humans are social creatures. We NEED to connect with others. Now more than ever we need to be creative and intentional with how we socialize. Plan get togethers with friends by taking an online fitness classes; talk on the phone while you walk; plan watch parties (where you watch a show together-but-apart online or even on the phone); have lunch over Zoom.

I know that it’s not the same. It will be different. It’s like when I eat dairy free cheese; it’s not the same and I don’t expect it to be.

A couple of other things to make sure go into your schedule:

Laugh

This can be with the socialization piece but it doesn’t have to be. Find some funny YouTube channels (lots of comedians have these) or a find a series on Netflix or Prime that makes you laugh.

**Pease share your favourites in the comments so that I can check them out!

Mental health check

It’s okay to need help to get through this. If medication isn’t your jam then rest assured that there are some great herbs and amino acids that can help with stress, anxiety and melancholy. Things like St. John’s Wort, gaba, theanine, and ashwagandha to name a few. Please check with a professional to see what’s right for you. Natural does not mean safe. This is especially true if you have medical conditions or take medication, even birth control.

A conversation with a professional or support group can go a long way. It’s important to know that you’re not alone in how you’re feeling.

You could also check out some Cognitive Behavioural Therapy (CBT) or Mindfulness Based Stress Reduction (MBSR) programs online. Many of these programs are covered by OHIP.

Everything that I’ve mentioned here isn’t a luxury. These are basic human needs. Sure your circumstances may require a modified version of implementation, that’s okay. Nuances are part of life. If I can help you tease that out, I’m happy to help.

I know that you’re tired. Be gentle with yourself. Beating yourself up will not lead to lasting change. After all, you can’t hate yourself healthy.

Until next time,

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