Dr. Kerri Fullerton ND

Intuitive Eating. Health At Every Size (HAES) Doctor

Respect Your Body

An Open Letter to All Health Professionals

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We all have our biases. That’s part of being human. But as a health care professional, we need to be held to a higher standard and we need to check our personal biases at the door. Far too many doctors, both in the traditional medical system and the integrative system, treat patients with obesity with distain[i]. They hold the belief that these patients are lazy[ii], undisciplined, and uninterested in their health. Regardless of a patient’s complaint, they are dismissed and told that they need to lose weight. Then, when these patients come back, at the same weight or heavier, they are tagged as ‘non-compliant’, “Clearly they don’t care enough about their health to make the necessary changes, so if they won’t take their health seriously, then why should I?” This way of thinking is leaving too many patients misdiagnosed[iii] and unheard; all the doctors see is the number on the scale. This has to change.
 

When I was in naturopathic medical school, the late Dr. Timothy said to me, “there is no such thing as a non-compliant patient, just poor treatment plans.” It stuck with me, and molded how I treat each person that comes into my office. As a doctor, it’s my responsibility to ensure my patient’s success. If I create a treatment plan that they can’t follow, it means that I didn’t listen to them well enough. If I didn’t account for something in their life, in their preference or in their budget then I didn’t meet them where they were. As their doctor, that’s my fault and not theirs. You see, not everybody is at the same place in this life. Not everybody has the same access as everybody else. Everybody has their own preferences on what they like to eat and how they like to move.
 

So how can your patients succeed when you’re only measuring the scale? When they come into your office and tell you that they are eating more vegetables, that they’ve cut back on the ‘junk’ food, and that they’re moving more than ever, but you weigh them and sigh, then they know they’ve lost. Again. And people will only rally so many times before they give up. And you know what they lose? Those healthy habits that they started to develop. They start to associate nutritious food and movement with failure. And that means that they lose out on the possibility of implementing these lifestyle changes with any long-term success. Because we are wired to avoid pain, they will begin to avoid exercise, they will avoid vegetables and they will eventually avoid YOU.
 

People with obesity, or even those who fall into the ‘overweight’ category, have been failing for a long time. And failing sucks. Just look at a team who can’t get ahead. Without amazing coaching, these teams stay down; the players don’t invest as much of themselves into the sport, blaming starts and their sense of worth drops. Ultimately, pride and respect slips away and the fun is gone. As humans, we like to play to win, so help your patients do just that. Give them real goals for where THEY are right NOW; in this body, in this life, and at this time.
 

If they show up to your office, congratulate them for making time for this appointment and making their health a priority[iv]. Ask them what you can do for them and find out what they need right now. Use the opportunity to create a safe environment where they don’t feel judged and looked down upon. Create treatment plans that allow them to win. Be kind to them, they face enough shame every time they look in the mirror. They need you to take a stand for them. Teach them how to accept and appreciate this body. That will allow their self-respect to emerge, and when you respect something, you’re far more likely to take care of it.
 

Until next time,

dr kerri

Live Life. Love Food. Be Free.

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[i] http://www.medscape.com/viewarticle/826246

[ii] http://www.webmd.com/diet/news/20030926/even-doctors-have-obesity-prejudice#1

[iii] http://www.prevention.com/health/healthy-living/weight-and-obesity-discrimination-doctors

[iv] https://www.fastcompany.com/3025080/why-positive-encouragement-works-better-than-criticism

No Way Am I Buying Bigger Pants!

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Fall is upon us and that means…wardrobe change!

But what if you pull out last year’s skirts, pants and dresses only to find that they shrunk? Or maybe it’s that you expanded? Either way, they won’t fit comfortably. So, what’s a girl to do? I’ll tell you what many will do – they’ll decide to diet and exercise themselves into those clothes. I’ve even heard ‘experts’ advise women to go and buy a piece of clothing one size too small ON PURPOSE so that they can work themselves into it. But there’s a problem with that philosophy; it’s not very kind, not very respectful and certainly not very body positive.

When you wear clothes that don’t fit, you’re more likely to feel self-conscious[i] and you’re more likely to develop negative mental chatter. Not to mention how exhausting those thoughts can be[ii]; it takes a lot of energy to feel crappy all day long! Then what happens when people start to feel badly about themselves? What happens when they feel ashamed and not good enough? They isolate and comfort themselves. For so many of us that means TV and food, alone at home. Numerous studies have consistently linked self-compassion to lower levels of eating pathology[iii]. Self-compassion was implicated as a protective factor against poor body image and eating pathology. Ultimately, the more you develop your self-compassion, the better your body image and eating habits become.

Unfortunately, we’ve become so used to the negative self-talk that encourages us into unhealthy eating habits that we don’t realize how hurtful it truly is. Can you imagine saying something like that to your daughter, “No way fatty! You can’t have pants that fit. Work yourself into what you’ve got.” Absolutely not! Instead, you’d say something like, “No worries honey. Let’s go get you something cute and trendy that fits right and feels great.” You might be thinking “But Kerri – it’s motivation. If my pants don’t fit, I’m going to forgo that cookie and want to eat salads and hit the gym!” You might, for a while. But eventually you’ll get hungry. Your body will start to conserve energy making you feel unmotivated. Then you’ll end up hungry and exhausted with pants that still don’t fit.

So, instead of putting myself through all of the unkind thoughts, and instead of squeezing myself into clothes that make me feel uncomfortable, I make a point to clear out my clothes each season. Anything that doesn’t fit, or anything I just don’t feel great in anymore, I donate. Then I go and buy a few new pieces that fit my body, and that make me feel good. When I feel good in the clothes I wear, and when I look in my closet and get excited to get dressed, I take better care of myself. I’m more likely to eat foods that feel good in my body instead of the foods that comfort my mood and I’m far more likely to have a bounce in my step and take the stairs.

Think of it this way, the clothes that are in your closet and in your drawers need to fit your today body, not your yesterday body or an idea of your tomorrow body. Your today body is the body you get to live your life in right now, so why not put clothes on it that make you feel good? Even if you don’t have a lot of money to spend on clothing, you still have options. All you really need are a couple of bottoms in neutral colours and a few tops to compliment. You don’t have to go to the designer shops to find something that makes you feel confident!

 

Make sure that when you look in your closet, you’re excited to put those clothes on. There’s nothing worse than starting the day already feeling frumpy. I highly recommend that you go through all of your clothes (right down to your panties, bras and socks) and get rid of the things that don’t make you feel good. Take them out of your line of vision and then see what you’re left with; You’ll probably only need a couple of pieces to round out your wardrobe. Remember that purchasing those items is an investment in your happiness. This isn’t about deciding that you’re going to be fatter, or if your today body is okay, it’s about respecting that this is the body that you have. If you’re not wearing clothes that fit, it’s going to be very difficult to establish a respectful relationship with your body. I encourage all my Rebels to join in the closet cleanout this fall. See how it goes. Let’s get back to living life instead of loathing our bodies.

Until next time,

dr kerri

Live Life. Love Food. Be Free.

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[i] http://www.huffingtonpost.com/jenn-hand/if-youre-waiting-until-you-lose-weight-before-you-buy-clothes-read-this_b_8253792.html

[ii] http://www.successconsciousness.com/mental-noise.htm

[iii] https://www.ncbi.nlm.nih.gov/pubmed/27038782

All or Nothing is Killing Health

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Have you ever thought to yourself “If I can’t do it right, then I won’t do it at all”? My brother and I were sitting in the kitchen one day and we got to talking. What do all of the top selling diets have in common? Why are they always unsuccessful[i]? It’s not the food, it’s the rules. Almost all of the most popular diets have an all or nothing mentality that makes it impossible to live an enjoyable life. What happens when you break away from your diet for a meal or two? You’re made to feel like a failure. This mentality can be toxic in all parts of your life, especially when it comes to your happiness. Our eating habits, and our mental health are intimately connected[ii]. So instead of focussing on failure, we need to celebrate flexibility. The healthiest weight is the weight you maintain while living an enjoyable life.

A few years after that conversation, when I first got my dog, I truly understood this lesson on flexibility. Before Chief came into our lives, I had my morning routine perfectly crafted. I would wake up around 7am, and immediately spread out my yoga mat for a 15-minute meditation. Following that, I would brew myself a cup of coffee, sit down at the kitchen table, and browse the morning paper. This time before work allowed me to prepare myself for the day; It was my ‘me’ time. Then he arrived, as a puppy, and everything changed. I would wake up to a little tongue licking my fingertips sometime between 4-5am, and out we went for our first walk.

My first steps of the day were no longer towards the rolled yoga mat in the closet, they were now towards the leash at the front door. Although I loved the time spent with Chief, I would often feel “off” for the rest of the day. I thought that because I didn’t have a full 15 minutes for my meditation, why bother doing it at all? Since I didn’t meditate, would I even feel relaxed enough to sit and enjoy the paper with my coffee? Because I didn’t have time for my entire routine, I didn’t bother with any of it. But then it clicked. Was it true that I didn’t have as much time as I did before Chief? Yes. But was it also true that I did have SOME time available? Also yes. Instead of 15 minutes immediately when I woke up, my meditation became 5 minutes after the walk. Sometimes I even supplemented the meditation with a few minutes of stretching. I allowed myself to relax enough to enjoy my coffee, because even a small win is still a win.

This “all or nothing” mentality made me feel like a failure when life got in the way of my routine. I believed that if I couldn’t continue the routine fully, that there was no point even trying at all. This is the same thought process that fuels the yo-yo dieting cycle and many weight loss regimes. The lack of flexibility in those diets makes one taste of a ‘forbidden’ food feel like the failure of an entire diet. Following the ‘failure’ of one diet or another, the feelings of anxiety, disappointment and distress come sweeping in[iii]. Psychologically, chronic dieters are more likely to overeat while in distress than non-dieters[iv]. When we feel like we are failing, we let ourselves give up, and we allow ourselves to truly fail. Instead, we need to allow flexibility, and ditch this “all or nothing” attitude:

  1. Think Long Term – Will you really be eating meal replacement bars for the next 15 years? Are you vowing off carbs for the rest of your life? Probably not. When we jump on a diet that restricts too many everyday foods, we can find ourselves becoming frustrated with our temptations. But when you put that tasty treat into a long term perspective, you allow flexibility, and reduce the pressure to be ‘perfect’.

 

  1. Celebrate the Small Wins – Just because you didn’t have time for your spin class, doesn’t mean you’ve failed. Why not go for a walk with the dog instead? Don’t hold yourself to such strict rules, and allow yourself to acknowledge the little accomplishments (because they are still accomplishments).

 

  1. Let Life Get in the Way – You need a plan, and you need to be willing to work outside the plan. Let yourself enjoy a sweet icy treat with your kids on a hot day, and don’t be afraid to try the dessert at a birthday party. Allow flexibility, because you are your healthiest self when you live a life you enjoy.

Most weight loss plans don’t give us the flexibility to indulge once in a while, and they often prevent us from finding a sustainable balance in our lives. This “all or nothing” attitude that we’ve learned from dieting is killing our mental, physical and emotional health. Instead of enforcing such harsh rules, let’s celebrate flexibility. Remember that if it doesn’t fit into a lifestyle that you enjoy, then it’s probably not sustainable. Find activities that fit into your schedule and do the things that make you happy. Know that sometimes life gets in the way, so don’t be afraid to throw your routine (and your rulebook) out the window.

Until next time,

dr kerri

Live Life. Love Food. Be Free.

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[i] http://newsroom.ucla.edu/releases/Dieting-Does-Not-Work-UCLA-Researchers-7832

[ii] https://www.psychologytoday.com/blog/evolutionary-psychiatry/201103/dieting-can-make-you-lose-your-mind

[iii] http://scicurious.scientopia.org/2011/02/09/dieting-stress-and-the-changing-brain/

[iv]http://s3.amazonaws.com/academia.edu.documents/45427122/polivy_and_herman_1999_Distress.pdf?AWSAccessKeyId=AKIAIWOWYYGZ2Y53UL3A&Expires=1487885162&Signature=VNdRjlzKt4%2FStwZqY5MQzaO%2BxD4%3D&response-content-disposition=inline%3B%20filename%3DDistress_and_eating_Why_do_dieters_overe.pdf

Is it Possible to be Fit and Fat, and Have Fun?

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What does being ‘fit’ mean to you? Does it bring to mind images of tanned and toned bodies no larger than a size 4? Even with the #bodypositive movement, so many of us don’t associate different body types as being fit and healthy. Socially, we have formed such a strong connection between fitness and ‘skinny’ bodies that many of us don’t even consider that someone could, at the same time, be ‘fat’ and fit. This stigma is leaving many women and girls in a constant battle for the ‘perfect body’, and even worse, it’s readily being passed onto the next generation. Our children are being taught from a young age that your size is a reflection of your health. What can we do to stop the cycle? Change the conversation.

This week, I’d like to share a story. Recently, I was at a wedding where a belly dancer was brought in to perform for the guests. As she stepped onto the dance floor, many of us were in awe of her presence; she was beaming, dripping in brightly coloured silks and gold jewellery. For half an hour, she shook, shimmied and danced to song after song. No breaks. But, what seemed to strike many of us was her size. She was not what society would describe as small, and she carried more around the middle than most women would consider desirable.

I was not the only health professional at the wedding. During the performance, one of my fellow professionals turned to me with wide eyes and said, “I would have expected her to have a six pack.” I looked back at her inquisitively. She concluded that, “She just looks so strong” and I agreed. It was at this moment that I understood how prevalent this misconception is. So many of us don’t seem to believe that you can be ‘fat’ AND fit.

What struck me more than anything was the way in which my fellow healthcare professionals judged her. I was among very talented individuals, who are all amazing at what they do. They care deeply about their work and their patients. Even as I was surrounded by what should have been an incredibly accepting group, I was instead met with body prejudice; my colleagues were unable to disassociate the size of the woman from their assumption about her fitness. This beautiful, strong and inspiring woman was the embodiment of good health. She had us all beat on core strength and stamina, as she danced with grace and softness. Yet all we could focus on was her size.

Within the #bodypositive community, the belly dancer I saw perform wouldn’t be considered ‘fat’. Instead, she would be categorized as ‘full sized’ (and not ‘plus sized’). But by Hollywood’s standards, she was ‘fat’. She does not have the kind of body that we typically see in magazines, movies or commercials. Ultimately, she was far from what we consider the ‘ideal body.’[1]

Here lies the challenge. The stigma we hold to those people who carry extra weight is so deeply engrained in our own minds and perspectives that we accept it as true. Fat becomes synonymous with lazy, unhealthy and undesirable. As a society, we become so stuck with these thoughts that many individuals are becoming hypersensitive. They believe that they carry extra weight (even though they are very ‘normal’) and are opting to avoid everyday activities because of their distorted body image. For some people, that means not participating in fitness related activities for fear of being seen, judged or even shamed. The judgement of their own bodies prevents them from being free to live their life. Even more disappointing is that this scenario is far from rare. The Dove report revealed that 80% of women and girls had cancelled important life events (like birthday parties, trying out for a team, family dinners and holidays) due to low body esteem.[2]

Starting from a very young age, children look to their parents for love, guidance and support. They are in the process of forming their own perspective of the world, and along the way, they internalize the perspectives and ideals of the family.[3] This is why it’s so important for us to change the conversation of food and the body at the beginning of the parenting journey. When mom and dad repeatedly speak about their eating habits, their diet, or their weight loss journey, children are taught that those are priorities in life. Instead of inadvertently contributing to disordered eating and a bad body image, we can focus on a healthy outlook on life. Our kids need to know that skinny doesn’t mean healthy, and fat doesn’t mean unhealthy.[4]

The new conversation teaches us that parents who:

  • Discuss healthy eating with their kids without the conversation being about weight, raise teenagers that are less likely to develop eating disorders or obesity [i]
  • Don’t restrict foods, raise teenagers that are less likely to develop disordered eating [ii]
  • Model healthy eating behaviours and lifestyle choices themselves, for the sake of health and not weight loss, raise kids who are more likely to live a healthy lifestyle [iii]

Instead of being fearful of fat, we need to focus on fun. Rather than dieting before a special event, why not stay active with your kids or your husband? For the next generation, we need to create an environment where children are not afraid of being teased, and where teenagers aren’t constantly comparing themselves to the countless ‘skinny’ celebrities. Just as it does with women, the stigma around fat is stopping our children from participating in the very activities that lead to health. You can’t tell a person’s health from their weight, and you can’t tell a person’s fitness from their size. Just like the belly dancer, we can be incredibly fit, while living in a large body. I encourage my Rebels to not only change their perspective, but change the conversation.

Until next time,

dr kerri

Live Life. Love Food. Be Free.

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[1] https://www.psychologytoday.com/blog/media-spotlight/201311/media-exposure-and-the-perfect-body

[2] http://www.prnewswire.com/news-releases/new-dove-research-finds-beauty-pressures-up-and-women-and-girls-calling-for-change-583743391.html

[3] https://opentextbc.ca/introductiontosociology/chapter/chapter5-socialization/

[4] http://healthland.time.com/2012/09/05/can-you-be-fat-and-fit-or-thin-and-unhealthy/

[i] JAMA Pediatr. 2013 Aug 1;167(8):746-53. doi: 10.1001/jamapediatrics.2013.78

[ii] Int J Eat Disord. 2014 Apr;47(3):310-4. doi: 10.1002/eat.22189. Epub 2013 Sep 18.

[iii] Br J Nutr. 2008 Feb;99 Suppl 1:S22-5. doi: 10.1017/S0007114508892471.

What’s Wrong With Wanting to Lose Weight?

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What’s wrong with wanting to lose a little bit of weight? What’s wrong with wanting to look better in a dress that you bought for an event. Nothing is wrong with it, I simply have not met anyone who would like to just temporarily lose weight. Nobody has ever said to me, “I just want to lose 50 pounds for like a year or two and then get it back.” People want to lose weight permanently and yet there’s no known way to make that happen right now.

Right now, long-term weight loss is an exception, not the rule. We make the problem about the person, not the practice, which is twisted because in medicine that doesn’t make any sense. We would never use a therapy that has a 95% failure rate. That would be unacceptable but somehow, dieting continues to be recommended and supported. Why does it feel like most of the people, and most of the studies and most of the articles say it’s because the person doesn’t keep following the program; that any program will work for someone if they just stick with it long-term.

Herein lies the problem. The strategies used to lose weight are too extreme for someone to fit into their daily life without making it the single most important thing. So even something that from the outside seems moderate at first, might not work so well in the long-term. This could be a particular gym routine that has to be adhered to by going to the gym. What if going to a gym no longer suits your lifestyle? You either need to make your life suit the plan or you need to make plans to suit your lifestyle. I’m a bigger fan of the latter.

Make a plan that fits your lifestyle! Find something that works into your life. It may require change and there will be a transition time. The same will be needed with food. Your eating habits must include living. They must include anything that your heart desires, otherwise life will get in the way of your plan and mess it up. We are here to live. You need to be able to go on holidays and enjoy the food from different cultures. You need to be able to have food with your family and friends. You need to be able to go out for dinner or to a barbecue without it being a big problem. When the rules get to be the single most important thing, that’s when it all falls apart.

Our children see that a diet, and that weight-loss and that maintenance is the most important thing; more important than sharing in the joy of your kid’s birthday cake; more important than sitting down to feast with family and friends; more important than anything. I cannot accept that weight-loss should be the most important thing in someone’s life. Too many great minds are being wasted in the pursuit of this. Too many women are missing out on living in the pursuit of weight-loss, and what’s worse is that it doesn’t work.

We do know that health benefits can happen without weight-loss. Chase health. Make a dietary change. Whether it leads to weight loss or not is irrelevant. Every diet out there has a couple of fundamental consistencies. We as humans need more vegetables than what the average North American eats. Does that mean that we need to stop other foods? Probably not. Like my friend Jen says, “It’s Rad to Add: It’s more important to pay attention to what you’re putting into your diet, and less to what you take out.” Find creative and fun ways to make food tasty and interesting. Find a way to move your body that makes you feel good and that makes you feel strong. But before any of that can happen, people who have been chasing weight-loss for so long need to change their mindset. The association with any kind of dietary change or exercise plan sends them into this weight-loss mode; into this way of being that is all consuming. The idea of adding vegetables immediately triggers thoughts of removing other foods, of restricting other things. The mere idea of starting an exercise program throws them into a mindset of all or nothing. Every day they must adhere to these insane plans that cannot be sustained in the long-term.

First and foremost is of course, the relationship that you create with your body. It’s about body gratitude, appreciation and, dare I say, the love that needs to be expressed to your own body. Every day, stepping into that place of appreciation and love. Most of the women that I know, or work with have spent the better part of their life hating their bodies.  And even if hate is too strong of a word for some of these women, they are very critical of their body. The research is there.1 We know that employees thrive in an environment of reinforcement and acknowledgment. Similarly, we know that children thrive and develop at an accelerated rate when they are encouraged and supported. A woman is going to do better in her life if she is encouraged and loved. Since I am with myself all day long, that love and support needs to start with me, and so it does with you too.

How can you start to love a body that you’ve been at war with for years? You can begin by building a foundation of appreciation. Do this by starting each day with looking in the mirror and thanking your body for keeping you alive all night long. Then you build from there.

Live Life. Love Food. Be Free.

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1 http://www.gallup.com/businessjournal/12157/power-praise-recognition.aspx