health at every size and intuitive eating for eating disorders prevention and eating disorders treatment

Treating and preventing eating disorders with Intuitive Eating and Health at Every Size, an interview with Brandi Koch MA, RD

In my work with parents of kids who have been diagnosed with an eating disorder, I have met a range of parents, from parents who have eating disorders themselves to parents who have no food issues and are natural intuitive eaters.

Regardless of where parents fall on the spectrum, my goal is to educate them about Health at Every Size and Intuitive Eating, both of which I find essential to healing from and preventing eating disorders.

Health at Every Size (HAES)Β is the understanding that body weight is not the best indicator of physical health. It also recognizes that size diversity is natural and normal, and our society’s focus on a single lean body ideal is unnecessarily harmful to those living in larger bodies.

Intuitive Eating (IE) is learning to follow the body’s natural hunger and fullness cues and use them to guide eating. Instead of using rules and deprivation, Intuitive Eating is based on paying attention and reconnecting with our body’s innate wisdom about what we need.

We live in a society in which the lean body ideal and restrictive diet behaviors are marketed to us from every angle. We believe that low body weight is ideal and that the best way to achieve low body weight is through food restriction. However, what all parents need to learn is that bodies naturally occur in diverse sizes and shapes and that our bodies can guide our eating as long as we listen to them.

Stop trying to control weight

I understand this is a radical concept for many parents. It can take some time to accept these concepts because they run counter to almost everything we have been taught our whole lives. I know that parents worry about their children’s health and self-esteem. If a child is in a larger body, parents want to help them avoid bullying, and therefore believe that they need to help their kids reduce their food intake and thereby reduce their body size.

At times parents have brought their child in to meet with me and ask me to help the child with weight loss. I tell them that is not how this works and often times the child is going through puberty when the body naturally needs to gain weight to facilitate growth. I teach the family that bodies change, and that is most definitely OK.

The thin ideal is such a small portion of the population. Instead of focusing on losing weight, I help children reconnect with their natural hunger and fullness cues and reassure them that bodies come in all shapes and sizes. I teach these concepts to parents as well, and by extension, the whole family relearns how to eat intuitively, which is the healthiest eating pattern and ultimate goal.

Stop disordered eating behavior

Something I want parents to understand is no matter what name you give it if you are restricting and managing your food intake in any way, that is disordered eating behavior. This behavior needs to stop in order for our children to heal. For example, Weight Watchers is marketing their point system as a flexible “lifestyle,” but it is most definitely still a diet.

It is very hard for me as a professional treating a child who has an eating disorder when they tell me that their parent just joined Weight Watchers or started Whole 30. These diet programs reinforce the very messages that we are working to recalibrate during eating disorder treatment.

I cannot stop parents from pursuing diets, but I do wish all parents knew how damaging it is to our children when they see their parents dieting and not trusting their own bodies. Dieting is ubiquitous in our society, but that does not mean it is benign. It is extremely dangerous and has no positive long-term outcomes.

Look at weight bias

Parents need to look at their own biases around weight and food restriction. We all need to look closely at the diet industry and understand why it is so successful. Industries do not succeed when they solve a problem for life. They succeed when they have repeat customers who are convinced that they have a problem and that the solution to their “problem” comes from the industry. This isn’t “belief,” it’s science. The difference is not the validity of the data, but that HAES and IE are not being driven by the $70 billion diet industry.

In most cases, a higher body weight is not a problem. Even if it were, dieting is not a proven, safe and effective treatment. Diets simply don’t work. If all parents learned this, we would see a very different landscape.

I ask all parents to stop dieting. Our children need – and deserve – to see normalized eating. When you diet, you are modeling body hate. We need to model healthy food behavior and body acceptance for our kids. This is the key to eating disorder recovery and prevention.

However, the most important thing I need parents to know is that I am sure you have done the best you can with the knowledge you have had. I practice methods that will help you and your children find a healthier way forward. Let’s relearn how to eat intuitively. Let’s relearn to honor the bodies we have, not constantly wish for an unattainable ideal.Β I truly believe that all families benefit from these concepts.


Brandi Koch Nutrition RDBrandi Koch MA, RD, has dedicated her career to helping individuals who struggle with eating disorders. Brandi specializes in individual nutrition counseling with an emphasis on Intuitive Eating, Health at Every Size and Body Acceptance.Β Website

 

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