I’ve been a registered dietitian for a really long time—since 1999. And I've learned a lot about healthy eating over the years. I started in hospitals working with very sick patients, then moved to a clinic, working with every type of patient—from babies to the elderly—where I worked for 10 years. Finally, in 2012, I started my own practice, as well as a media and nutrition consulting business. Through all of these jobs, and all of these years, I’ve learned a hell of a lot about nutrition, but also about human nature. You don’t counsel people for years on end and not gain at least a little insight on the human condition (and a keen sense of when someone is putting just a bit of spin on things when they report back to you about what they’ve been eating).
I still have years of work ahead of me, but here are the most valuable lessons I’ve learned so far:
1. People’s “food issues” are rarely just about food.
I’ve counseled hundreds of people who want to have better relationships with food so they’ll be able to have more control over their eating habits, whether that means learning how to stop eating when they’re full, quitting chronic dieting, letting go of self-sabotaging thoughts and behaviors about food and weight, or learning how to eat more freely. The one thing I’ve consistently seen throughout those hours of sitting and speaking with people whose “food issues” run the gamut is that their behaviors, whatever they are, are rarely only about food or even eating. Sometimes their ideas about and relationships to food have developed in response to a trauma or a set of circumstances they didn’t have control over, which means their current struggle is rooted in something way deeper. This is why it’s not at all helpful (and is pretty mean) to say that people of size should “just stop eating so much” or that people who struggle with disordered eating should “just eat a sandwich.” Nothing could be more insulting than to oversimplify peoples’ situations in such a flippant way. (Not to mention how problematic it is to assume someone has "a problem" with food, eating, or their weight just because of the way their body looks.)
Many of the food issues I see with my clients have serious origins that go far beyond someone liking food too much or too little, and far beyond food at all. Someone who is a chronic dieter, for example, may have been put on a diet at a very young age, and made to feel as though they’re not good enough unless they’re “skinny,” thereby being primed for years of negotiating a tricky, and oftentimes troubling, relationship to eating. Food is just one way a particular struggle can manifest itself in someone’s life.
2. No one lays on their deathbed thinking “Glad I skipped [food-centered social thing] and avoided those excess calories.”
When I worked in the ICU, I saw lots of patients as they lay dying, who had no idea the very day before that they’d be in such a position. I was young and single when I worked in trauma and critical care, and watching people my age dying made an impression on me. It was a time in my life when I was hypercritical of myself and trying to watch my diet very carefully, and one day it dawned on me: What had I missed out on while trying to follow my unnecessarily rigid standards? How many of those people lying there hooked up to a ventilator would say, “Boy, am I ever glad that I skipped that round of margaritas with my friends so I could stay home and eat healthy?” Who would ever say, “I’m dying, but at least I’m thin!!” Of course I can’t know what is in people’s heads, but I’d be willing to bet not a single one. And with that realization, my outlook on life—and the way I made decisions about food—changed. We’re only here once, people. Make it good, because tomorrow might not happen for any of us. For me, that means having that round of margs.
3. The things we say to kids about their bodies matter—and keep mattering—for a long, long time.
I cringe with discomfort when I think about how many clients I’ve had who developed negative self-image and/or a fractured relationship with food after being told at a young age that they were “overweight” or otherwise made to feel inadequate because of their weight. I had a father call his daughter “fat” right in front of me when she was in for weight loss counseling. I wanted to disappear, and I’m sure she did, too.
I can’t caution you enough: If you are ever in contact with young people (or anyone, actually), to keep your observations about their weight or diet to yourself. If you must say something about what a person is eating, make it weight-neutral and kind, not critical, and only do it if necessary. No one really gives a shit about your unsolicited comments about their lunch, so just don’t.
I’ve spent hundreds of hours with clients, trying to help them undo the damage they’ve sustained from those sorts of remarks. I usually refer them to a therapist to work through these issues, because as I mentioned above, they’re often beyond my scope of practice.
4. Fad diets come and go, but balanced is forever.
I’ve seen high carb, low fat, Atkins, Ornish, paleo, keto, and many other elimination and/or weight loss diets out there. I’ve heard that eggs were bad, then they were good. I’ve seen Snackwell's and fat-free mayonnaise, baked chips, and “avocado is fattening, so limit it.” Through all of this though, my recommendations have never changed. Aim for balanced nutrition while enjoying food/your life will always be by advice.
It has always been obvious to me that something like an egg or an avocado would never be the downfall of someone’s diet, yet culturally we seem to be hung up on determining which food, or food type, is responsible for causing the “obesity epidemic” and making us sick. I refuse to play along, innately knowing that the best diet is mostly whole foods and not too much ultra-processed stuff; eating when you’re hungry and stopping when you’re full, along with a healthy relationship to food. Sure, it’s important to look at new recommendations and research that emerges. And some of us may do better on certain ratios of macronutrients—more or fewer carbs, more or fewer fats. But the overarching lesson here is that you can’t really go wrong with minimally processed, whole foods—with some treats thrown in there for good measure.
5. Related: The best diet is the one you personally will enjoy and that you’ll stick to.
When I was in nutrition school, there were some pretty firm guidelines about how healthy people should be eating: Some variation of 60 percent carbs, 15 percent protein, and 25 percent fat. Now, we understand that we aren’t all built the same, and that the best diet for someone is the one they’ll stick to for life. We used to dismiss low-carb diets as “dangerous.” Now now we know that that’s probably not the case, at least for certain populations. Just know this: We’re all different. You do you, and find what works. Don’t try to force yourself into eating in a way that’s unsustainable and not enjoyable.
Here’s to another 20 years of working. Stay tuned!