Lindsay M. Adler- Certified Eating Disorder Specialist and Supervisor
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Let go of resolutions: Ring in the New Year with intentions

12/22/2017

 
Lindsay M. Adler, LMFT, CEDS, E-RYT 200
As the New Year approaches, you can’t get through an episode of your favorite TV show without being bombarded by commercials telling you that you need to look and feel better because you would be so much happier if you had 6-pack abs, could fit in size 4 jeans and ate like a rabbit.
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January rolls around and gyms get flooded with people, swearing they are going to lose the 10lbs they gained during the holiday (or whatever weight they might think is excessive). Also, people find new “cures” for their weight that promise them they will lose weight, and for good this time. 

Ugh…January…’tis the season of being told you aren’t good enough! 

These messages can lead to “New Year’s Resolutions”.  Today, I want to talk about how setting New Year’s resolutions can be unhelpful and sometimes unhealthy. I also want to share with you some alternatives to consider that can help you enter your New Year with health in mind. 

What is a Resolution?

First, let’s take a look at what resolution means in the terms of a New Year’s resolution. According to Dictionary.com, resolution in this context means, “[T]he act of resolving or determining upon an action, course of action, method, procedure, etc. A resolve; a decision or determination”. And, the Cambridge Dictionary defines resolutions as “a promise to yourself to do or to not do something”. Basically, resolution involves a determination to fix something. 

What is unhelpful about resolutions?

When we make a resolution, we are saying, “something is wrong and I need to fix it” and we also are saying, “I need to have enough determination and will power to change it”. Meaning, you have to be “strong enough” to fix the problem. What happens if someone isn’t as determined as another person might be, does that mean they fail? Or, are they considered a failure because they just don’t have the “willpower”? 
Resolutions come from a place of judgment and expectation. 
Often when people are making resolutions (as with most goals), they place a lot of their worth in what they are doing (and, inherently they would since it requires determination). When life gets stressful or busy, often it is difficult to stay on top of everything or remain completely determined to do something. We inevitably struggle; it is part of being human. When this happens, it is not uncommon for resolutions to fall under the radar. Let’s look at an example: 
Terri feels uncomfortable about her weight. She has been eating more than normal with all of the holiday parties and feels guilty about it. Terri sees all of her friends go to the gym and one friend told her about this new diet that helped her lose 10lbs fast. Terri says once the holiday is over she will “be good” and makes a New Year’s resolution to lose 30lbs. In January, she feels determined. She goes to the gym 6 days a week and has started this new diet. Terri is starting to feel “good” about herself. As February comes along, she notices she has less time to go to the gym. She also started to crave carbohydrates since the diet she is on tells her she can’t go over 15gms of carbohydrates a day. In March, Terri feels “a complete mess”.  She is not following her diet and barely attends the gym. Terri starts to feel worthless and ashamed that she can’t just “stick with it” when other people seem to. Terri thinks, “what is wrong with me?”. And, to top it off, Terri has gained weight. She feels like a “loser”.
This is a very common example of what many people face, so, if this story sounds familiar, you are not alone.
The fact is New Year’s resolutions often fail, and it doesn’t say anything about the person’s worth. Resolutions often do not work because the meaning behind a resolution is unhealthy in that it focuses on what is wrong.
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Set intentions!

What do you do if resolutions do not work or are unhealthy? Set intentions.

I like to view intentions as we do in the yoga world. In yoga, an intention is also called sankalpa, a Sanskrit word meaning a vow from the heart. An intention is an aim that guides one to action evoked from the heart. Thus, intentions are guided and formed in congruence with someone’s values.

Also, according to Buddhist teachings, an intention provides a path focused on how you are “being” or engaging in the present moment. Intentions are based on understanding your values and making a commitment to align your actions with these inner values.
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Actions rooted with intentionality will help you create wise goals. Creating goals linked to your intention can help you achieve goals without judgement because they are connected to your values rather than being contingent on an outcome. Being grounded in intention is what provides integrity and unity in your life. Ideally, intentions are created so we can be congruent with our goals. Often times, we create suffering or stress for ourselves by setting goals that are not rooted with intention and thus, are attached to specific outcomes- such as with the example above. 

Intentions are more helpful

As stated above, intentions help you to be in alignment with your values. Also, as opposed to resolutions, intentions do not state there is something inherently wrong with you or something that needs to be solved. Thus, we can go into an intention without shame or guilt. Instead, we step into intentions with purpose and meaning—which often leads to a happier and healthier life

Intentions versus resolutions:

​Here is a list of common resolutions and their intention alternatives. 
Resolution
Intention
Lose weight
  • Be kind to my body and respond healthfully to my body
  • Let go of judgments about my body
  • Be gentle with my body and practice acceptance 
Go to the gym/ exercise more
  • Listen to my body and respond accordingly
  • Be open and receptive to joy when being active in my body
  • Be present with movements and body sensations while being active in my body
Eat healthy
  • Practice mindfulness while eating and listen to my body
  • Reduce judgments about food while nourishing my body 
Start a new hobby and stick with it
  • Be open and receptive to something new
Hopefully this list will help spark ideas for your own intentions. As you approach the New Year, don’t give into our society’s views of what someone should or should not do. An idea is to come up with two or three intentions you want to carry with you throughout the year. Write these out and place them in an area you might review regularly (e.g., calendar, refrigerator, car, etc.). By reviewing your intentions regularly, it will help you work towards being present with your values throughout the day, week, month and year. I encourage you to dive into a place of meaning and purpose aligned with your values which is a more fruitful experience.

Fat Shaming and Fatphobia: An Epidemic

10/10/2017

 
Lindsay M. Adler, LMFT, CEDS, E-RYT 200 
“How could she let herself go like that?”
“He’s so smart. How could he let himself get that large?”
“Should you really be eating that?”
“Can you believe that person is buying cake? They shouldn’t be eating those rich foods.”
“She added extra cream to her coffee. I think she should have skim milk instead.”
“Can you believe she is wearing leggings? I don’t think that is appropriate.”

“That kid’s mother should not be letting him eat all of those cookies. He is going to gain much more weight.”
Have you heard yourself or someone else say statements like these when referencing someone in a bigger body (aka a “fat” person)? Or maybe you haven’t shared these thoughts out loud, but you might have thought something similar in your head. 
If you have had thoughts like these or have noticed others making comments like these, it would not be out of the ordinary in our society. These statements are driven by a society dominated by diet culture, thin ideals and misconceptions about what health means.  
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We have been programmed in our society to believe that thinness is the only acceptable lifestyle and that if you are not thin, you must be unhealthy. Most importantly, if you are not thin, you are considered morally inferior to others.

Today, I will be explaining fat shaming and fatphobia. Along with these explanations, I will also be sharing with you how though at times you might be meaning well, you could actually be engaging in these two behaviors without even knowing it. Also, while reading this blog, pay attention to how you are feeling (emotionally and physically). Because fat shaming and fatphobia are so ingrained in our culture, it might bring up some uncomfortable feelings within yourself, especially if you come to realize you have been engaging in these shaming behaviors towards others or towards yourself. Try noticing how you feel without judgment. My intention is to help introduce ways of thinking about health that may be new to you.

Fat shaming

Shame is a feeling of “I am bad”. Shame is a deep internal experience of feeling not good enough or being a problem. Shame is very focused on the self and how the self relates to others. This means we can only feel shame as a member of a group, otherwise we would not compare ourselves with others. 

Shame is something we can experience within ourselves, through our own judgments based on our society’s standards and shame can also be something we experience through direct interaction with others. This means, even if I were never directly told I was “bad” or a “horrible person,” I could develop the belief I was bad or horrible based on my own perceptions from my interactions with others. On the other hand, I could experience shame as a normal response to someone making a hurtful comment about me. 
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Now that we have a simple understanding of shame, let’s talk about fat shaming.
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Fat shaming is when someone criticizes, ridicules, judges or mocks someone for being a certain weight, shape or body size.

Fat shaming is found in many covert (not openly acknowledged) and overt (openly acknowledged) ways in our society. Here is a small list of some ways people fat shame and ways fat shaming is threaded into our society.
Overt fat shaming 
  • Making negative statements about someone’s weight, shape and body size. For example, “She looks like a pig”, “He could stand to loose a few pounds”, “I can’t believe they are eating that piece of cake”, “Hey, fatty!”
  • Making prescriptions about someone based on weight, shape or body size. For instance, a doctor prescribes weight loss before understanding the full picture of why someone might be having health problems. 
  • Making specific judgments about someone based on their weight, shape and body size. For instance, making statements that a person must be unintelligent because they “let themselves go” or that the person “shouldn’t eat junk foods”. 
  • Weight loss advertisements telling people they need to lose weight to have more friends, a better sex life or feel confident.
Covert fat shaming
  • Having deeply threaded judgments about people of a specific weight, shape or body type that is not stated out loud. For instance, thinking a person must be unintelligent based on their weight, that the person is weak, immoral or wrong. 
  • Giving favoring treatment to those who are a size that society deems acceptable, i.e., thin. 
  • Not having multiple sizes of clothing for all shapes and needing separate stores for those of a specific size. 
  • Only focusing on someone’s weight as an important aspect of health and paying little to no attention on the person’s overall well-being or other markers of health (meaning how they feel, what they believe, what they have experienced in life, etc).  

A note on Fatphobia

Fatphobia is another form of fat shaming.  Fatphobia is a fear of fat or overweight  people. Someone who might struggle with Fatphobia might only want to socialize with thin or average weight people. They might also feel anxious or uncomfortable around someone in a larger body. 

Health professionals play a role

Health care professionals such as doctors, nurses, dietitians, trainers, coaches, et cetera can play a role in perpetuating the cycle of fat shaming. Health care providers often first look at weight before exploring any other aspects of a person’s struggles. This is shown in how we are immediately weighed at the doctor’s office even before seeing the doctor! Doctors might comment on how a person needs to lose weight when someone comes in for a medical concern and can miss important reasons why the individual is having medical problems in the first place. 
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Health care professionals are also failing to understand the whole person including their environmental stressors and psychological history. This bias can also adversely impact the treatment of a “thin” person, who may be immediately seen as healthy when they might have severe stressors causing conditions of pain or distress.

Fat shaming causes more problems

Fat shaming actually does the opposite of what people might intend it to do. People might think that fat shaming would help motivate people to lose more weight and get “healthy”. In reality, fat shaming increases body dissatisfaction, lowers self-esteem and worsens stress leading to further physical and psychological problems. This means fat shaming causes more harm than good.

Here is how to change

Body acceptance
Body acceptance means being welcoming and approving of any body, at any shape or any size. This isn’t just an internal process, meaning one learning to love or accept their body. Body acceptance also needs to happen on a societal level, meaning we need to change how society (including health care professionals) look at people’s bodies. There needs to be fewer expectations of what someone should do or look like. Instead there needs to be more focus on how people are feeling in their body (physically, mentally and spiritually). Health is not black or white. Health is a vast concept that each person defines for themselves, and hopefully without judgment. 

If you are someone who finds themselves fat shaming others or your own self, it is best to work towards challenging and changing these beliefs (and without shaming yourself in the process). Here are just a few ways you can work towards challenging these beliefs: read about body acceptance (see a few references I have provided), speak with a therapist or other professional trained on body acceptance, and join or create your own social support group focused on body acceptance (this can include social media groups committed to challenging society’s messages). Remember, judgment never leads to long lasting psychological and physical health, acceptance does.
A few Resources and Podcasts of interest:
  • Bacon, L. (2010). Health at every size: the surprising truth about your weight. Dallas, TX: BenBella Books.
  • Bacon, L., & Aphramor, L. (2014). Body respect: what conventional health books get wrong, leave out, and just plain fail to understand about weight. Dallas, TX: BenBella Books.
  • Food Psych Podcast with Christy Harrison, MPH, RD, CDN: Episode 42
            https://itunes.apple.com/us/podcast/42-health-at-every-size-with-linda-bacon/id700512884?i=1000351682871&mt=2
  • Reclaiming You Podcast with Sarah Vance: Episode 24
            https://itunes.apple.com/us/podcast/losehatenotweight-with-virgie-tovar/id1163270509?i=1000379823562&mt=2

Yoga: Are we missing the point?

7/6/2017

 
Lindsay M. Adler, LMFT, CEDS, E-RYT 200
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Picture this: 
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​You decide to take your first yoga class. You walk in, set your mat down, and take a look around. Almost all the students (mostly female) are wearing the newest Lululemon pants. Many students are practicing reaching their foot to the back of their head, even before class begins. 

The instructor arrives and keeps telling you to push yourself. Everyone around you is huffing and puffing trying to jump from one pose to the next. When the instructor asks everyone to try an arm balance, you freak out because somehow everyone just easily jumps from having their feet on the ground, to having their feet dangling in the air while they are balancing on their hands. 

And when you are finally done with all that bouncing around, you lie in savasana (AKA corpse pose) but feel that your mind can’t stop thinking about how awkward you feel and you start to judge yourself for not being able to balance on your hands. Worse still, you aren’t really sure how to let go of these thoughts and your instructor has left the room so you can lie in this pose for as long as you like. 

How do you imagine you might feel after taking a yoga class like this? Would you feel calm, relaxed, centered, and connected with your body? Most importantly, would you feel compassionate towards yourself and would your nervous system feel at peace? 

This kind of scenario has become all too common as yoga has become popularized in the United States.
Today, the problem is that yoga has turned from an emotional and often spiritual practice based on physical movements and conscious control of one’s breath to a practice based on image, commercialization, social class and physical eliteness.   

What is yoga? 

Yoga has had many different purposes in the thousands of years it has been in existence. Overall, yoga has always been intended to be a practice that unites the mind and body. Yoga actually means to “yoke”.

People often erroneously think that yoga is a religious practice or even just a “workout” when in fact it is neither. Yoga is a practice where one learns to integrate mind and body states, experiences and sensations through the use of movement and controlled breathing. Simplified, yoga is a type of moving meditation. 

People often associate yoga with individuals bending and twisting into pretzels; however the real emphasis of yoga is not about how far one bends, stretches or twists. Yoga is about connecting with one’s body and mind. When practicing yoga, one’s intention should then be about increasing internal awareness with the hope that less attention is paid to what one looks like and instead is focused on how one feels in one’s mind and body. Through this process, yoga can help someone let go of negative and competitive thoughts.  

There are various benefits to practicing yoga. Yoga poses or asanas stretch and strengthen the entire body, leaving you feeling relaxed, calm and at ease. Physically, it lowers blood pressure, can reduce risk of heart disease, increases blood and oxygen flow to your vital organs, and reduces chronic body pain. Psychologically, yoga is often encouraged for those struggling with mental health issues such as eating disorders, depression and anxiety. This is because yoga can reduces stress, help someone learn new ways to coping and increase heart rate variability. 

Yoga meets our society 

Have you seen the magazine Yoga Journal? Yoga Journal is a great example of how yoga has become popularized in our society. With that popularization, yoga has shifted away from a physical, emotional and often spiritual practice to a Westernized symbol of affluence and physical perfection. 

In our westernized society, yoga is a symbol of affluence. What do I mean by this? Take a look through Yoga Journal and you can see. Yoga has become the “in” thing to do. This means all of the celebrities do it and of course when you see these celebrities “practicing” yoga, they always have the newest most expensive yoga clothing, are stick thin and decked out with makeup—all of which are not related to what yoga philosophy teaches us. 

As the “in” thing, yoga is mostly accessible via private yoga studios and gyms. All of which require a student to buy a membership or purchase classes. Other options for practicing yoga include videos (via DVD, online streaming or Youtube), donation classes and city recreation programs that have classes at a reduced fee. Overall, in most cases someone has to pay to learn yoga, meaning someone has to have extra money lying around to pay for these classes. So, if you are struggling to put food on the table or pay your rent, you likely aren’t going to be able to afford to take yoga classes or simply have the time to practice because you might be working several jobs to make ends meet. 
Practicing yoga in our society can also mean students trying to meet physical perfection through being able to jump into a handstand or touch your foot to your head in a backbend. This is perpetuated by media, which emphasizes images of people doing advanced poses.
 For example, consider Instagram, where you see photoshopped images of people posing on the beach or type “yoga” into Google imagines and you will get a list of pictures of majestic men and women contorting themselves. Think about how this might affect someone who has a disability or injury. Will they see these images and think they can do yoga? ​​
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Changing the face of yoga in our society

We need to shift the way yoga is viewed in our society. Take a look at a few ways we could change the way we see yoga.

  • Allow yoga to be more available to everyone-despite socioeconomic status. For example, studios could provide more community classes, free classes and donation-based classes. 
  • Shift the focus away from materialism (i.e., clothing or other products) and promote the philosophy of yoga. This means teaching others about the philosophy of yoga. (I plan to discuss the philosophy of yoga in a later blog.) 
  • Media should show people of all shapes, sizes and ethnic backgrounds practicing yoga and, practicing more than the physical yoga practice.  
  • As much as someone focuses on teaching the physical practice, they should also be teaching the other aspects of yoga beyond the physical practice. This does not mean a teacher can’t teach the physical practice, a good teacher can integrate the emotional and psychological components of the practice with the physical practice. Go beyond teaching Power yoga, how much you sweat, strengthen or stretch the body. For example, when I teach a physical practice, I try to make sure I introduce to the student ways they can understand their nervous system through the movements they make. This way, they can understand how to have their practice be a part of coping with stressors. 
  • Teachers can create a culture in their classes of non-competition and non-materialism. This might mean slowing down the practice to help people understand the mind-body connection yoga brings and reduce the emphasis on jumping from pose to pose. 
  • Studios can offer classes of all types, not just Vinyasa or Power yoga but restorative yoga, therapeutic yoga, yin yoga and much more. This will give students the opportunity to see other sides of yoga beyond the “workout”. It can also provide people who have injuries or disabilities a place to practice. ​

Yoga is inherently good! 

Yoga is essentially good. Yoga is not the problem. The food, diet, fitness and fashion industry is what has shifted the meaning of yoga to something more superficial, materialistic and commercialized. I have heard individuals tell me they were turned away from yoga because they felt intimidated by the practice, which is disheartening to hear. My intention of writing this blog is not to discourage people from trying yoga or practicing yoga.
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​​My intention is to bring us (including myself- I am not immune to society’s messages) back to what is really important and the reason for practicing yoga-AKA the intention of practicing. 

Finding a healthy intention for practicing yoga is important. Think about why you are practicing. What do you hope to achieve beyond physical benefits? Sometimes it takes finding the right teacher or class that will help you develop healthy intentions for practicing. I suggest trying all types of yoga and various teachers. And, while taking classes and thereafter, notice any thoughts and feelings which arise after the practice. Use this information to inform you about whether the class or teacher was a healthy fit for you and if it was healthy, what emotional or psychological components can you work on from the practice. Meaning, even if a teacher focuses on integrating physical and psychological benefits of yoga in the class and being non-competitive, it doesn’t mean you might not still struggle with competitive or negative thoughts about yourself. In that case, allow the practice to be a place to reduce these psychological states. And as one of my teachers always said, most importantly, enjoy the journey.

Gluten-Free: Disordered eating in disguise

5/11/2017

 
Lindsay M. Adler, LMFT, CEDS, E-RYT 200
Gluten: the scary monster that tears your intestines to shreds, leaving you with a leaking gut, a gassy and bloated stomach, and diarrhea or constipation. 
While gluten-free is essential for those formally diagnosed with celiac disease or a non-celiac gluten sensitivity, a gluten-free diet for the average person is extremely unhealthy despite all the information you might have received from the Internet, books or even your doctor. Yes, even your doctor can have faulty beliefs about gluten.

Gluten-free has become a diet of epidemic proportions, leading to a new gluten-free industry worth billions of dollars. Gluten-free is intimately connected to the “clean-eating” trend, both fueled by companies that are making money off of people’s fears.
Today, I will be examining this new dieting trend. So, let’s dive in. 

​Gluten defined

Gluten is a term for a protein found in wheat, rye, barley and triticale. This protein helps food maintain its shape. 

Celiac Disease and Non-celiac gluten sensitivity 

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Celiac disease is an autoimmune disease in which the immune system damages the lining of the small intestine, causing nutrients to be absorbed improperly. Celiac disease began to take notice after World War II and was found to be an autoimmune disease in the 1970s. Celiac disease is diagnosed from an exam, blood tests, genetic tests and most definitively, from a biopsy of the intestinal lining. Only 1% of the American population suffers from celiac disease. Medical professionals agree that if someone is diagnosed with celiac disease, they should be placed on a gluten-free diet.

Non-celiac gluten sensitivity is similar to celiac disease regarding its symptoms, however it is not an autoimmune disease. Meaning, the person does not have antibodies or damage to the intestinal lining. Someone with non-celiac gluten sensitivity is often encouraged to reduce gluten intake.

Non-celiac gluten sensitivity has been less researched and professionals are often in debate about it. This debate is due to some research indicating a nocebo effect related to gluten-sensitivity. A nocebo effect means that if someone thinks they will have negative reaction to something, they often will (similar to the placebo effect in which someone thinks something will help them and they get positive results.) In some studies researchers found individuals who thought gluten would be harmful for them actually showed symptoms related to celiac disease when they ate flour that they thought contained gluten but was actually gluten-free. Other studies show when people stopped eating gluten and then started eating it again, they showed symptoms of celiac disease which could be related to beliefs about gluten being harmful. 

Is gluten bad? No!

In the recent past, gluten-free has been ostracized by the food, fitness and health industries. Gluten has been equated to the devil and celebrities haven’t helped with spreading misconceptions about gluten by claiming clean eating and a gluten-free diet are superior lifestyle choices. Even worse, some medical professionals have endorsed a gluten-free diet as a way to cure all your aliments (which we will get to in a moment).

The truth is gluten is not bad for us to eat. Foods that contain gluten carry essential nutrients we need to grow and remain healthy. This is evident from some of the original discoveries from WWII. In WWII due to a lack of food resources, many children became severely malnourished (often from a lack of fruits, vegetables and wheat related products). Those with celiac disease seemed to have reduced symptoms, but all other children suffered.

Foods with gluten such as wheat, rye and barely contain healthy fiber, vitamin B-12, zinc and folate, all essential to a healthy diet. However, the food, diet and fitness industries want us to believe gluten is bad. 
Why?
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Because, they make a huge profit off of gluten-free products. According to the National Foundation of Celiac Awareness, gluten-free products are 242% more costly than regular products. Which might sound nice if you are a food manufacture. 

Problems with going Gluten-free without a medical diagnosis 

There are many problems with going on a gluten-free diet without being formally diagnosed with celiac disease or non-celiac gluten sensitivity. But first, lets look at what common claims are about gluten besides the symptoms of celiac disease.
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A simple Google search will show hundreds of claims. Some of the most popular are gut inflammation, gut permeability (that leaky gut I mentioned in the beginning of this blog), inflammation in the body, fatigue, confusion, ADHD and digestive problems.

One of the common reasons people stop eating gluten (and a common prescription from doctors) without having celiac disease is the claim related to inflammation in the body. I think it is important to address this claim. I have reviewed research on gluten and there is little to no evidence that it causes inflammation in the body. This has not been proven. When I spoke to Dr. Ralph Carson (a leading dietary expert) at our recent IAEDP conference, he shared the only evidence of causes of inflammation in the body are three factors: cortisol, excessive abdominal tissue and insulin resistance. He said research thus far shows gluten does not cause inflammation in the body.

Again, research only shows gluten as a problem for those with celiac disease or non-celiac gluten sensitivity.

Research also shows those who take on a gluten-free diet who do not have celiac disease end up causing more problems. These include:

  • Vitamin deficiencies.  B-12, zinc, and folate are especially affected.
  • Decreased fiber intake. Fiber is essential for a balanced diet.
  • Increased arsenic and mercury in the body. In a study conducted by several universities, researchers found those with a gluten-free diet had twice as much arsenic in their blood from eating gluten-free products and 70% more mercury than those eating a normal diet. This is because most gluten-free products replace wheat with rice. Since rice is grown in flooded fields in absorbs more arsenic and metals from the environment and fertilizers. Arsenic and mercury are toxic to the body. This is why it is important to eat a variety of grains (and yes, you can still eat some rice).
  • Weight changes. Often weight gain occurs due to eating gluten-free foods that add extra ingredients to help it taste better.
  • Decreased healthy bacteria in the gut. Healthy bacteria in our gut is fed by complex carbohydrates, like those in wheat, rye and barley. When someone eats gluten-free they starve this healthy bacteria and it can die. When this bacteria is diminished, it causes digestive problems. This is an important because often those who go on a gluten-free diet who have never had been diagnosed with celiac disease, end up killing this bacteria. Wand when they eat gluten again, they show signs similar to gluten-sensitivity or celiac disease., This lleadsing them to believe they do hadve a medical diagnosisproblem with gluten from the beginning w, when in fact, their gluten-free diet caused their problems.  when this healthy bacteria is diminished, the individual can have symptoms that mimic gluten sensitivity.
  • Higher risk of Type 2 Diabetes and Cardiovascular Disease  
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​Stop the non-sense healthcare professionals! 
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Have you heard of the book , The Grain Brain: The surprising truths about wheat, carbs and sugar by David Perlmutter? If you haven’t heard of this book, then you obviously haven’t been watching the newest Dr. Oz. (which is probably a good thing!)

This book is a leading example of how some health care professionals turn themselves into health gurus by establishing “cures” for illnesses and failing to use research to back their claims. Dr. David Perlmutter has actually made millions of dollars off of this book and other nutritional supplements, all through faulty research. Some researchers and physicians consider him a quack. Yet, primary care physicians, specialty doctors, dietitians and other healthcare providers are prescribing his book to help with ailments. 
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This is an example of how health care professionals can actually do more harm than good by not reviewing long standing research and evidence on health claims and instead giving in to views set by industries or individuals wanting to make a buck off of fears and insecurities of people. 

Gluten-free = disordered eating

With all this information, we can see how a gluten-free diet (for someone without celiac disease or non-celiac gluten-sensitivity) is simply another fad diet. This fad is harmful because the food, weight-loss and fitness industries have made false claims about it leading to a thinner “healthier” body. And, it is harmful because some people in the medical community have reinforced these false claims and have added more by stating gluten-free can cure illnesses. In reality, research shows a balanced diet and moderate physical activity leads to a healthier self.

Gluten-free has become another way for disordered eating to be acceptable in our society.  And, gluten-free diets – like the “clean-eating” trend – are often linked to eating disordered behaviors. 

What to do

​Here is what we need to do as individuals, professionals and as a society.
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  1. If you do not have celiac disease or non-celiac gluten-sensitivity than refrain from eating gluten-free. It’s actually harmful to you.
  2. If you think you might have celiac disease or non-celiac gluten-sensitivity, then get formalized testing rather than self-diagnosing.
  3. If a doctor or other healthcare professional suggests a gluten-free diet for reasons other than being diagnosed with celiac disease or non-celiac gluten-sensitivity, get a second opinion and challenge this view, rather than agreeing. Do your research.
  4. Healthcare professionals, do your research and think more broadly about the prescriptions you are providing. Is your recommendation based off of established clinical research or the best selling book?
  5. As a member of society, encourage others to do their research on these claims or similar dietary claims. Be an informed consumer.
  6. Gather with other wise-minded individuals and use support to challenge these misconceptions about food. It’s easier when we have support in the face of a disordered society.
 
A few (of many) Resources:
Biesiekierski, J. R., Peters, S. L., Newnham, E. D., Rosella, O., Muir, J. G., & Gibson, P. R. (2013). No Effects of Gluten in Patients With Self-Reported Non-Celiac Gluten Sensitivity After Dietary Reduction of Fermentable, Poorly Absorbed, Short-Chain Carbohydrates. Gastroenterology, 145(2). doi:10.1053/j.gastro.2013.04.051
 
Bulka, C. M., Davis, M. A., Karagas, M. R., Ahsan, H., & Argos, M. (2017). The Unintended Consequences of a Gluten-free Diet. Epidemiology, 28(3). doi:10.1097/ede.0000000000000640
 
Carson, R., RD, Ph.D. (2017, March 26). Beyond the Basics: Nutritional Management of Eating Disorders . Lecture presented at IAEDP 2017 Symposium in Nevada, Henderson.
 
Guandalini, S., & Polanco, I. (2015). Nonceliac Gluten Sensitivity or Wheat Intolerance Syndrome? The Journal of Pediatrics, 166(4), 805-811. doi:10.1016/j.jpeds.2014.12.039
 
Hallert, C., Grant, C., Grehn, S., Granno, C., Hulten, S., Midhagen, G., . . . Valdimarsson, T. (2002). Evidence of poor vitamin status in coeliac patients on a gluten-free diet for 10 years. Alimentary Pharmacology and Therapeutics, 16(7), 1333-1339. doi:10.1046/j.1365-2036.2002.01283.x
 
Howard, J. (2017, March 10). Gluten-free diets: Where do we stand? Retrieved May 11, 2017, from
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Lebwohl, B., Cao, Y., Zong, G., Hu, F. B., Green, P. H., Neugut, A. I., . . . Chan, A. T. (2017). Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study. Bmj. doi:10.1136/bmj.j1892
 
Levinovitz, A. (n.d.). The Problem With David Perlmutter, the Grain Brain Doctor. Retrieved May 11, 2017, from
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Zanini, B., Baschè, R., Ferraresi, A., Ricci, C., Lanzarotto, F., Marullo, M., . . . Lanzini, A. (2015). Randomised clinical study: gluten challenge induces symptom recurrence in only a minority of patients who meet clinical criteria for non-coeliac gluten sensitivity. Alimentary Pharmacology & Therapeutics, 42(8), 968-976. doi:10.1111/apt.13372

Are you a Tiger, Gazelle or Opossum?Part two: Working with your nervous system

4/17/2017

 
Lindsay M. Adler, LMFT, CEDS, E-RYT 200

In my last blog, we discovered how our nervous system has the power to protect us when facing danger. We respond like a tiger (to fight), a gazelle (to run), or an opossum (to freeze). Now it’s time to look at how you can use the powers of your nervous system to protect you from real threats, while avoiding activating your nervous system when the perception of threat is actually coming from your own thoughts. In other words, let’s look at how you can work with your nervous system to help create healthier responses to stressful situations.

Understanding what is a threat
As we learned, evolutionarily, our nervous system is wired to help us survive, meaning respond accordingly to threats. However, our brain is wired in this way so intensely that we can respond to something as if it is a threat when it is not. 
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Take the classic example from your 8th grade science textbook. You are walking down the sidewalk and see a slender, brown object on the ground. You instantly jump back, your heart is racing and you start sweating. And now, that you are further back from this object you can calm down enough to take a closer glance. Then, you notice it is actually a stick, not a snake! Thank goodness!

This example explains how quickly our body responds to perceived threats. This fast acting survival mode not only works when we see a stick on the sidewalk, it also happens in other areas in our life such as work, school and relationships. ​
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For example, say you have a big project you are completing for your company. You know most of your superiors will be analyzing your work. You start to feel stressed out, because you wonder what sort of impressions your work might make on your superiors. You start to think that if they don’t like your work, they will consider you a complete idiot and fire you. So, when you walk into the conference room to start the presentation, your heart starts racing. You start to sweat. All of a sudden you find yourself staring at the door. You have the urgent desire to exit the room, because it just seems like you are going to ‘die’ if you have to be in that room one minute longer!

This example shows how our own mind can increase our stress response by making up a (scary) story about a situation, which then creates a threatening experience. 
Because our mind has this capability, it is important to start to work with our nervous system by learning how to decrease our arousal to perceived threats; otherwise we will be on edge all the time. Being in a stress response all the time is what often leads to health problems such as hypertension, chronic pain and immune system deficiencies. 

Trauma’s influence on the perception of threats

These perceived reactions to threats are seen more frequently if you have experienced trauma, because your body has been more wired to be vigilant for threats. Thus, your brain will be more wired to prevent these threats from happening again. 

Let’s consider the example above happening to someone who had experienced bullying as a child, which led to feeling inferior or worthless. For this individual, being in the room of superiors at work could feel even more threatening. Then imagine one of these superiors makes a critical comment. The experience of threat jumps up even more, as the individual is reminded of a time being bullied as a child. You can see how quickly things can escalate, leading to the activation of someone’s nervous system by moving into fight, flight or freeze.

One problem with not resolving trauma is that it can lead to experiences such as the one I have described above. For someone who has experienced trauma, their nervous system is wired for a quick response to threats. If the individual hasn’t resolved their trauma, then their nervous system might overact to situations that have some resemblance to the trauma. This can lead to heightened responses to normal everyday experiences (or everyday stressors).

For example, someone with an unresolved trauma from combat might have a heightened nervous system response to situations which remind that person of the event, such as having flashbacks when hearing firecrackers during the 4th of July. This soldier’s nervous system is responding to a perceived threat due to the person’s past experiences. This is why good treatment for trauma should be used so that someone’s nervous system doesn’t always take over their life when they are not actually being threatened. 

Listen to what your nervous system is saying

One important factor is to start to paying attend to what your body is saying about a certain experience. Notice when your nervous system moves into fight, flight or freeze reactions. For instance, do you notice your heart racing at the sight of your boss? Do you notice yourself feeling sleepy or “cloudy” when approaching a looming deadline that seems impossible to complete? Or, do you find yourself avoiding situations that you know evoke fear? Answering questions like these are important first steps in discovering what to do next. 

Acting accordingly as needed

Acting accordingly is difficult. This is because sometimes our nervous system just takes over (remember the reptilian portion of our brain) and we find ourselves being unable to think about how to react; we just react. If you are someone who often reacts in response to the nervous system, it is often helpful to find a skilled professional such as a psychotherapist to help you learn to calm your nervous system. Learning to calm your nervous system allows your pre-frontal cortex or your thinking brain to come into play. 

In a calmer state, you are more able to understand and respond in more helpful ways to stressors. This can help you can decide whether something is a perceived threat based off of past experiences or an actual threat in the moment. Once you have the ability to differentiate between then two, then you are more able to decide the healthiest response. 
Let’s use the example above to explore this concept. First, the person would begin to understand how their nervous system responds to stressors. Then, they might notice the physiological responses to their boss such as increased heart and breathing rate when their boss makes the critical remark. Since they have awareness of this response, they can begin to use breathing techniques to start to activate their parasympathetic nervous system (to calm them). Once engaging in slowed breathing, they feel a tiny bit less stressed and because of this, they can start to use their thinking brain to challenge negative beliefs about the situation. For example, they might be able to now think, “It’s okay. The boss isn’t bullying you. They are giving you critical feedback,” or “You are an adult now, and you have the power to leave this room at any time.”  These thoughts will help the person further calm their nervous system and decide how they want to respond to the situation, instead of responding like the gazelle and running out the room. ​
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However, it is important to remember that if you are seriously being threatened, you want your nervous system to respond immediately. We want our body to respond to actual threats. Meaning, if a bear is near you when hiking, you want to understand it’s dangerous and to get out (just walk away slowly with a bear). Without our nervous system alarming us that the bear is harmful, we could easily be injured. 
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Sometimes, when someone has had a trauma which evokes more of a freeze response, they can struggle with reacting when needed to threatening situations. For instance, they might immediately feel sleepy and immobile when it would be healthier for them to run. In these cases, the individual would want to work on learning how to activate their sympathetic nervous system rather than their parasympathetic nervous system. All which can be best learned in psychotherapy. 

Working with the nervous system 

As you can see, sometimes we need to work with our nervous system to create healthier responses. This means, we might need help from a guide to learn about our nervous system and know how to respond to it. Some great resources include a trained trauma psychotherapist, yoga therapist, meditation instructor, movement therapist and massage therapist trained in treating trauma. 

It is also important to know that even if you haven’t had a trauma, it’s still possible you might struggle with an overactive or under-active nervous system. So, gaining some guidance can improve your overall wellbeing and reduce any risk related to chronic stressors.
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