| Family First Feature |

Smoke and Mirrors: What Now?

Five experts share practical steps toward a healthier life

 

HAES to Health

Rachel Tuchman, LMHC

 

Health at Every Size (HAES) — you’ve heard the term tossed around, your friend keeps quoting lines from the approach, but you’re still wondering: What is it?

HAES is a weight-neutral approach that shifts the focus from body size and weight to health, because no, weight and health are not the same thing. HAES supports improved healthy behaviors for people of all sizes, without using weight as a mediator.

Diet culture has made us believe that health is a body size and a way of eating but in reality, health is much more complex and multi-faceted; it can’t be defined by any one factor. Many factors that contribute to our overall health — genetics, socioeconomic status, and environment — have nothing to do with how we look, what we eat, and how much we exercise.

Health at every size does not mean that every size is healthy; it means that people can be healthy at any size. It challenges the value of dieting, or pursuing weight loss, for health. But for so many of us, health has been boiled down to weight. When you take away that focus, what’s left?

HAES encourages body acceptance instead of focusing on weight. It fosters self-compassion. True wellness includes social connections, meaningful work, fulfillment in our lives, and a sense of purpose.

And it works. The HAES approach is associated with improvements in physiological measures (like blood pressure and blood lipids), health behaviors (eating and activity habits, dietary quality) and psychosocial outcomes (such as mood, self-esteem, and body image). HAES achieves these health outcomes more successfully than dieting or weight loss interventions, and without the negative outcomes associated with a weight focus.

Research has shown that people with strong self-esteem are more likely to adopt positive health behaviors. When we learn to value our bodies, even if they don’t look exactly the way we want, we strengthen our ability to care for ourselves. Body respect, rather than body positivity, is a HAES concept. You don’t have to love the way your body looks, but it still deserves your care and respect.

HAES calls for weight inclusivity. This means accepting and respecting body diversity; bodies come in all shapes and sizes. We need to stop the idealizing and pathologizing certain sizes and weights. Thin isn’t necessarily healthy and fat isn’t automatically unhealthy. Using the BMI scale to measure health is flawed — it doesn’t take into account other factors such as body composition, distribution of fat, or muscle mass. Many thin people are being categorized as healthy based on their BMI when they could be engaging in more health-compromising behaviors than someone considered “obese.”

HAES also advocates for health enhancement, supporting health policies that improve and equalize access to information and services that improve well-being while taking into account individual physical, economic, social, spiritual, and other needs.

Respectful care is a fundamental tenet of HAES. As individuals and as society, we must work to acknowledge biases (fat phobia) and work to end discrimination, weight stigma, and weight bias. Doctors offices should feel safe for people of all sizes. Mental health providers and fitness professionals should be providing respectful and unbiased care to all people.

HAES is about eating well. It supports the concept of intuitive eating, an approach to wellness that tells us our bodies can be trusted to cue us for our nourishment needs as opposed to “diet rules” and restriction. Food is valued for nutritional, psychological, cultural, and other reasons beyond staying alive. A wonderful mantra I’ve seen for the HAES approach is “self-care, not self-control.”

Finally, HAES believes that life-supporting movement is crucial. People of all sizes, abilities, and interests should be supported in engaging in enjoyable movement to the degree they choose. Build activity into your daily routines and find enjoyable ways to be active, instead of restricting yourself to strict gym routines or narrow definitions of “exercise.” The goal is to promote wellbeing and self-care, not dictating set guidelines for frequency and intensity of exercise.

While weight is not a predictor of health, HAES research has found that behaviors are. Getting more sleep, drinking more water, eating more fruits and vegetables, cutting back on alcohol, reducing stress, and increasing physical activities have all been shown to improve health — regardless of weight. Renowned relationship researcher Dr. John Gottman found spending time with loved ones does more for your health and longevity than spending time exercising.

The HAES mindset may feel counterintuitive. It contradicts much of what we’ve always believed about health and wellness. But keep an open mind, learn more about diet culture, and continue to educate yourself — you might be surprised. And hopefully, you’ll move closer to a healthier, more fulfilling life.


Rachel Tuchman is a Licensed Mental Health Counselor based in Cedarhurst, NY, with over ten years of experience. Rachel is a HAES-aligned clinician who promotes the importance of body respect and behaviors that honor our health. She also treats kids and teens; adults; women experiencing infertility, pregnancy loss, and post-hysterectomy; and is available for speaking engagements.

 

Our Body, Our Responsibility

Rorie Weisberg

In reading the ongoing discussion in Smoke and Mirrors, I’ve noticed that there seems to be an attitude of, “If you’re into eating healthy, you’ve fallen prey to diet culture and body shaming.”

I wholeheartedly agree that our society places far too much focus on externals and impossible standards. Our growing awareness and the movement to push against it are so important. I fully agree that it’s time to stop worshipping the scale.

But there’s a difference between dieting to get skinny versus maintaining healthy eating habits for the sake of overall health and well-being. True self-respect includes nourishing our bodies.

Our bodies are precious gifts entrusted to us by Hashem as the vehicles for the work our neshamos need to accomplish in This World. The attitude they deserve is one of gratitude and respect, not judgement, intolerance, or conditional love.

But eating healthy is not contradictory to loving your body! It can and should have nothing to do with what most of us think of as “dieting.” It’s just one of the healthy habits that keep our body running as smoothly as possible for as long as possible.

It’s important to embrace our bodies just as they are, but true self-respect doesn’t negate the responsibility we have toward our health. Part of respecting ourselves is feeding ourselves real fuel and real food. Sure, indulgence has a healthy place in a balanced life, when done mindfully and respectfully. But our right to love ourselves includes our right to make health-promoting choices.

It can be confusing to try to reclaim our health without subscribing to the prevalent culture of restrictive dieting and body manipulation. The Torah is our primary and most trustworthy resource. The Rambam in Hilchos Deos gives us the Torah perspective on our obligation to our health, which has nothing to do with what size skirt we wear.

Many of the habits he describes sound similar to ideas touted by the diet industry. But instead of being part of a dieting ritual, we can incorporate those Torah-true habits into our lifestyles as part of a lifetime demonstration of self-respect and self-love.

If you follow my columns in Family Table, you know that I use the acronym SHAPE to help people focus on the five core habits of a health-promoting lifestyle. Not to change your shape, but to get in shape.

S – Make Sleep a priority by shutting down electronics at least 30 minutes before bed (an hour is preferable). The Rambam says the eight hours before sunrise provide us with the most rejuvenating sleep.

H – Keep yourself well-Hydrated by drinking up to half your body weight in ounces of water. The Rambam advises drinking most of your water between meals. If you don’t like the taste of water, flavor it with fresh fruit rather than sugar and artificial sweeteners and colors.

A – Become Attuned to your body’s cues for hunger and satiation. This happens when you prove to yourself that you will lovingly feed your body whenever your body (not mind) gets hungry. Respecting your body means feeding it real food when it’s hungry, and stopping when you’ve had enough.

P – Our bodies are meant to be used for Physical activity. The Rambam advises us to warm the body daily. The key is moving them smarter, not harder. The Rambam tells us to pay attention to your body language and facial expressions. If you’re wincing, your body is telling you it’s too much. The best exercise is doing something you enjoy, like dancing or playing ball.

E — Last but not least is Eating real, whole, nutritious food, foods that offer our bodies the macronutrients they need. Most people need daily consumption of all the macronutrients, including protein, complex carbohydrates, healthy fats, and fiber. Eating a diet rich in plant-based ingredients fuels your body with the vitamins, minerals, antioxidants, and prebiotics needed for overall health and wellness.

Tap into true self-respect to deliver your body the care it needs — not for the sake of manipulating its shape, but for the sake of doing your part to ensure that it can function at its best. Our health is so important, and it’s our responsibility to maintain it. While we try to free ourselves from the pressures of the diet culture, let’s not confuse a healthy lifestyle with weight loss schemes.

As a health coach certified in integrative nutrition, Rorie Weisberg educates people on different platforms online, in print, and in person on how to make healthy habits doable and delicious. Rorie also developed a product line of better-for-you bread mixes and baking esssentials. Enabling everyone to make the foods they love with ingredients that love them back.

 

Keep Moving

Mimi Chait

When you exercise, you’re getting two-for-one; you’re improving your mental health and physical health at the same time. During my fitness classes, I don’t talk about burning calories or losing weight. Weight loss is obviously a great outcome that may happen with exercise, but it’s only one among so many potential benefits.

Exercise so that you feel strong and independent. Stretch to improve flexibility and increase your range of motion so you can move through your day with ease. Work out so that your heart and lungs are strong, so that you can walk up a flight of stairs without huffing and puffing, so that you’ll be able to run, dance, and play with your children and grandchildren. Incorporating aerobic activity, strength training, and flexibility into a regular exercise program makes all of that possible.

Exercise to improve your mental wellbeing. It gives you a chance to take a break from the hustle and bustle of daily life, and causes your body to release endorphins, feel-good hormones.

I’ve found that by understanding the full array of benefits that exercise can offer, people are able to remain motivated to keep moving even when the going almost inevitably gets tough along the way.

Mimi Chait is a fitness instructor based in Detroit. She gives classes in her studio and is the creator of Mimi’s Live Fitness, a website offering woman and girls recorded fitness classes with Jewish music.


Toward a Healthier Self

Dr. Marcy Forta

Eating disorders are serious and complicated illnesses. They’re among the deadliest mental illnesses, second only to drug overdoses. Nine percent of the population will be affected by an eating disorder at some point in their lifetime. And while there are wonderful treatment programs, unfortunately, many of those treated will continue to struggle.

Though there are fewer statistics out there for the frum community, there are studies indicating that over a third of frum women have body image issues, that we display higher disordered eating issues than our secular counterparts, and that we may be as much as twice as likely to develop an eating disorder. Those are scary numbers.

We don’t know why some people develop eating disorders while others with similar risk factors and propensities do not. What we do know is that there are numerous risk factors that contribute to eating disorder onset. General risk factors include genetics, family dynamics, societal expectations, personality, and psychological factors. As frum Jews, we have to contend with all of these, as well as some unique to our community.

Food is a wonderful brachah from Hashem that plays a critical role in our oneg Shabbos and Yom Tov, and in all our simchahs. The sheer abundance of food, and the time we spend planning and preparing it, leads to a paradox. On the one hand, we encourage cooking and baking — yet women and girls are often given the message not to enjoy it too much.

Pressure is another large category of risk. Perfectionistic pressure, the need to be and exemplify perfection, is particularly damaging. It leads to excessive pressure for us and can become crippling to those who feel as though they’re falling short.

Our overall mindset, that we should be able to push through any setback and get the job done no matter what, places huge pressure on women and girls of all ages, wreaks havoc on our self-esteem and self-image, and creates substantial risk for eating disorders.

Academic pressure is another area of considerable pressure. Girls are expected to be model students and get good grades. I’ve heard many stories of girls who are deeply distraught if they receive a B on their report card. This is particularly hard for girls who struggle scholastically. There’s also substantial academic pressure to get into the “right” seminary in order to ensure the proper shidduch, as well as an overarching subtle message that you have to do well in school in order to marry well.

This brings us to shidduch pressure, a multifaceted category of pressure. Girls as young as eight or nine are discussing the expectation to be thin and to be beautiful, warning that otherwise, you may not get a good shidduch. And sadly, their perceptions are based on reality.

Shadchanim have been known to tell girls that they have to lose weight in order to even get a date. Mothers, while screening prospects for their sons, will eliminate girls based on their or their mother’s dress size. These young impressionable girls watch the struggles of their siblings, cousins, and older friends and know what’s in store for them. There’s a constant pressure to be attractive, to ensure you have what you need on your résumé, and that you conform to the requisite physical expectations.

There are other pressures as well: Peer pressure, that need to be a part of and accepted by certain social groups; the constant pressure generated by the implication that thin equals happy; the pressure for our girls to grow up quickly, as they’re expected to marry at a young age.

All of these and more weigh heavily on our girls. Pressure is a substantial, documented risk for increased vulnerability regarding disordered eating as well as for lower self-esteem and reduced body-image. Our community, with its additional unique pressures, experiences real and measurable risk.

Where, then, do we go from here? How do we counteract these challenges?

Having these important conversations is the vital first step. Educating ourselves about our unique risk factors and struggles creates awareness, and all knowledge is power.

Here are some practical ideas that can help us move toward healthier mindsets, both for ourselves and for our children:

Shift the Focus. Very often we’re paralyzed by a number on the scale or the numbers or the tags in our clothing. We have to shift our focus and rethink our relationship with food. Food sustains us. We need food several times a day, each and every day. Food should not be used as a reward — not in school, not for losing weight, not for going to camp, not for anything. Likewise, food should also not be used as a punishment — you cannot eat this food or do this thing until you lose a certain number of pounds. Food needs to be used as a tool for our health and it should be recognized as such. The same is true of our children’s weight. Paying them or bribing them to lose a certain amount of weight is counterproductive and dangerous. We must be so careful in how we speak to our daughters about food, what they eat, how much they eat, and what they weigh.

Rethink Priorities. We teach our children from a young age to focus on middos, telling them that’s what matters — but our behavior sometimes says the opposite. Often, we model and reinforce externality as something we aspire to, feeling we must be thin and beautiful in order to have real value. We praise people who lose weight and who are attractive, highlighting how important these things are to us. But, as Yidden, this isn’t who we’re meant to be. We have to stop the excessive praise of people who lose weight or who we deem beautiful. Our focus must be redirected toward the middos and inner character traits of others.

Stop Modeling Perfectionism. Our children must see us acknowledge that we’re not perfect, and that that’s okay. We work so hard to be superwomen, caring for our children, cooking elaborate meals, taking care of the house, entertaining, learning, davening, and working. If our children cannot see us acknowledge that life isn’t perfect, and that we sometimes get overwhelmed, then they will not have the tools to cope when they feel they haven’t lived up to our standards and expectations.

Reduce the Stigma. Often there’s shame and guilt associated with asking questions or needing help. If girls don’t see the adults in their lives model acceptance of needing help, then they feel that something is wrong with them when they need to reach out, leading to feelings of shame and guilt. While there have been inroads in our community regarding removing the stigma of mental health intervention, there’s still a long way to go, even more so with eating disorders. We don’t judge those who need medical help for a physical ailment; mental and emotional health must be treated equally, without judgement or labels.

Educate and Increase Awareness. Attitudes and perceptions that may contribute to disordered eating can develop in children as young as six. We need to help our kids form a healthy relationship with food from a young age. Parents, educators, and health professionals need to understand that our community has unique risk factors for disordered eating and eating disorders, and learn to recognize the symptoms and signs that accompany them. Schools must institute eating disorder prevention programs to bolster healthy eating habits, increase nutrition knowledge, and offer body-image and self-esteem support. These have had measurable success in reducing overall risk as well as in supporting self-esteem and healthy body image.

Dr. Marcy Forta is a leading authority on eating disorders within the Frum Jewish Adolescent Community. She is a Body Project Facilitator and Certified Holistic Nutritionist, focusing her efforts on eating disorder education, awareness, and prevention programs within our community.

You’re Already Good Enough

Rachel Goodman

Intuitive eating has been growing in popularity, but many people misunderstand it, and then feel it doesn’t “work” for them. This usually happens when it’s approached as another way to diet.

Intuitive eating isn’t a diet. There’s no promise of weight loss; there’s a focus on health. A diet says: You need to ‘be good’ with food so that your body shrinks. With intuitive eating, you’re already good enough. Your job is to care for your body and trust it will settle at the weight it’s meant to be at. Food becomes natural and enjoyable, instead of something you’re at war with.

Intuitive eating isn’t based on opinions; it’s a module that’s been scientifically shown to be effective. There are over 100 published papers on IE, many of which show intuitive eaters have better health outcomes when compared to dieters including: lower triglyceride levels, increased body appreciation and self-esteem, better coping skills, lower rates of eating disorders, and increased general wellbeing.

So what is intuitive eating? Intuitive eating is becoming the expert of your body’s, trusting its cues of hunger and fullness, knowing what satisfies it, and learning to differentiate between your physical and emotional needs.

We’re all born intuitive eaters. Most children know how much they need to eat. Some days they’ll eat more, other days less. Most children grow appropriately and are perfectly healthy. We’re all born with that innate ability to listen to our bodies. Yet somewhere along the way, we lose it.

When it comes to our bodies, we recognize that physiological needs are natural. With breathing, you’d never say “Hey, I breathed too much yesterday! Ugh, I feel so guilty, let me breathe less now to make up for it.” You trust your body regulates your breathing exactly as it should. It does the same for eating, but dieting teaches us to distrust our cues.

Intuitive eating is living in alignment with your values. What’s more important — stressing about the cake you had, or enjoying a seudah with your family? Health is not just about nutrients, but about our life, relationships, and stress levels. When you learn to trust your body, you open up all that brain space previously fixated on food to living your life and feeling good.

Here are the ten principles of Intuitive Eating:

1. See diets for what they are and reject the diet mentality.

Think of all the diets you’ve tried, of the successes that were short-lived and ultimately failed. Not because you failed, but because diets fail!

While there’s a growing body of research showing the negative health implications of yo-yo dieting such as loss of muscle mass, binge eating, negative body image, and long-term weight regain, this isn’t what you need to be convinced that dieting doesn’t work.

Reflect on your own dieting history and ask: Has dieting given me the results I wanted in the long run? Do I have a positive body image as a result? Can I enjoy all foods without guilt or shame? What has dieting taken from my life?

Prepare to explore a new journey.

2. Honor your hunger. Adequately feed your body. Learn to recognize biological hunger signals and honor them. If you haven’t eaten for six hours, and then binge, that’s not a lack of willpower, it’s your body working exactly as it should because after hours of hunger, the body wants quick energy — it doesn’t care what it is at that point! Every time you appropriately feed your body when it initially signals hunger, you’re building trust with yourself and with food.

3. Give yourself unconditional permission to eat and enjoy food. Restricting foods leads to cravings and bingeing. Give yourself permission to eat. By allowing yourself all foods without judgement, you can approach food with a sense of empowerment and learn to listen to your body’s response and eat what you actually like in amounts that satisfy you.

4. Challenge the food police. You can’t make peace with food if you have a constant critic in your mind. Everywhere you turn you’ll find diet rules — convincing you that you need to follow them to reach optimal health and to feel good about yourself. That you’re being “good” if you eat a salad and “bad” if you eat a cookie. Learn to shout a resounding No! to the food police: You are not what you eat. You’re not a cookie. You’re not good or bad based on what you eat.

5. Feel your fullness. Learn to recognize what comfortable fullness feels like. So many people are disconnected — they know only super hungry or super full. Tune into your body. Pause in the middle of a snack or meal and assess how full you are. Know that you can always go back to it (or eat something else) when you’re hungry again. Allowing yourself to eat all foods will make it easier to stop eating when you are full.

6. Discover the satisfaction factor. Savoring and deriving pleasure from food is just as important as eating food for fuel and nourishment. This is a key element of being able to eat intuitively. When you eat foods you enjoy, without guilt, they leave you feeling satisfied and content. You’ll start to find that you may eat less because it doesn’t take as much to satisfy you, especially when you eat foods you love.

7. Honor your feelings. It’s normal to turn to food for soothing. It becomes problematic when you don’t have any other way to soothe or it triggers a binge. We all eat emotionally at some point, but when you eat to numb your feelings, it distracts you from your emotions and does little to improve the situation. The goal isn’t to demonize food, but to expand your toolbox and learn how to cope without food as well to better serve you.

8. Respect your body. We need to accept and respect body diversity. So many factors play into body size — genetics, stress, medical history, etc. Our culture places so much focus on body size. We say it’s about health, but is that true if the only acceptable outcome is a smaller body? As long as you believe “I need to shrink my body,” how can you give it what it wants? Even if you don’t love how your body looks, respect it and give it what it needs.

9. Exercise to feel the difference. Exercise has so many health benefits! When we filter it down to weight loss, we do ourselves a disservice. Move to feel good, not as punishment for what you ate.

10. Honor your health. Make choices that honor your health and that you enjoy. Intuitive eating isn’t about perfection. There isn’t one single food or meal that will cause you to be unhealthy. It’s what you eat consistently over time that matters. This is the last principle because it can feel challenging to authentically choose nutritious foods from a place of self-care if you haven’t worked through the other principles first. Your body wants to feel good, but you have to learn how to trust it and honor what it needs without fear.

Reclaiming the intuitive eater you were born as is a journey. There’s a lot of unlearning to do. Diets are attractive because they’re linear — lose ten pounds in ten days! — and intuitive eating can feel like a tango, two steps forward, one step back. The end goal is to authentically feel good and care for your body; to eat vegetables because you want to, not because you have to — and to enjoy cake, too, without guilt! It’s about progress, not perfection.

It can feel scary to let go of dieting. It can be hard to heal your relationship with your body. But it’s so much harder to live with constant guilt and shame. It’s okay to start slow, choose one food at a time to make peace with and see what you discover.

 

Rachel Goodman is a registered dietitian nutritionist, speaker, and mom who helps women have a healthy relationship with food and feel good in their bodies so they can live the healthy, happy, and fulfilled life that they deserve.

(Originally featured in Family First, Issue 731)

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