But eating well isn’t simply a choice. If it were that easy, we’d all be doing it! Other circumstances and situations can make it hard. Many people “make the decision” only to find it hard to make it last more than a meal or two. What gives?
I often reference at Maslow’s Hierarchy of Needs in my work. Essentially, all humans have basic needs that must be met in order to function at a higher level. Namely these are food, water, rest, and warmth (aka shelter). When any of these areas are compromised, more complicated tasks such as nurturing relationships with yourself and others become difficult.
|
Adapting the models for counseling…
So here’s a work-in-progress model I’ve developed based upon what I’ve learned in my studies of health behavior theories, Intuitive Eating, eating disorder counseling, and in my studies as a certified diabetes educator.
It’s a blend of worlds that helps me recognize aspects that might be cracking someone’s foundation and ability to make lasting change.
Foundational: Physical, financial, and emotional security and safety
When I see a patient with a chronic health condition (eg, diabetes, high cholesterol) who is homeless, unemployed, in an abusive relationship, and/or has a chronic mental health condition like schizophrenia, my job is not to put them on a restrictive diet. Instead, I work to connect them to the resources they need to make it through today.
For example, I have patients who drink 1-3 liters of soda a day. However, that soda plays a vital role in their survival – they use it to quiet the voices in their head. Others need it to stay awake because they’re afraid to sleep at night on the street. If they don’t have a tool to replace soda, then what?
|
Physical: Eating every 3-4 hours ● Adequate protein, fat, carbohydrate
● Hydration
● Physical and emotional rest
e heightened; reactions are more extreme). If you doubt this, check out the work by Ansel Keys.
I cannot emphasize the importance of physical and emotional rest enough. Inadequate sleep and excessive physical / emotional stress similarly shift our food preferences and ability to properly recognize hunger / fullness cues as well as internally motivated food preferences.
It’s so common that someone comes to see me with excessive life stress and inadequate rest (working multiple jobs; caring for family members on top of work; high demand work schedule with long / irregular hours). We only have so much energy we can put into our day and lives and sleep / leisurely activities often take a back seat putting the body’s stress response on high alert.
Curious what stress does to the body? Click here to learn more about stress response and here to learn about the effects of chronic stress.
Emotional: Honor feelings ● Emotional connection ● Family history
Take for example family history. Most people in the United States and the world aren’t too far away from a state of starvation – wars, depressions, and famines aren’t far down the line in many families. When food / types of food are rationed, we are forced to stop eating before feeling satisfied. Then when food is available, we eat beyond the point of comfort because you never know when the next meal will be. Both circumstances make it hard to make “choices” about food. When our upbringing comes from a place of poor foundation, it’s helpful to recognize those circumstances don’t still exist. (side note: sounds a little like dieting, right?)
|
External triggers: Diet mentality ● Media ● Social circles / norms ●
Cultural influences
For example, if your social media feed is full of sweet potato and kale salads, you’re going to feel more pressure to eat those foods (even if you don’t really want them). The media and people we surround ourselves with often dictate what we perceive to be normal and acceptable. If all of your friends hate their body, you’re going to feel pressure to find something about yourself to dislike – even if it’s not rooted in truth. If you’re watching the Food Network all day, you’re probably going to feel pretty hungry.
|
Internal cues: Internal hunger and satiety cues
Function: Select foods for physical, cognitive, or spiritual needs
Moral of the story…
Life is not linear. Sometimes life happens and puts a crack in the foundation (eg, losing a family/friend; changes in money / work; health conditions). This can make higher levels more challenging than they were. I propose that instead of punishing yourself for “failing” at eating broccoli every day, recognize that deeper issues are making it challenging and give yourself some compassion and flexibility to change that goal as life allows. Food (and our relationship with food) is complicated and goes so much deeper than “eat this, not that.”
So next time I ask you “how are you?” I’m not judging the morality of your food choices or behavior. I’m genuinely asking, “how’s your life?” Because that’s the foundation I’m building on.
I just came across your post on The Mindful Dietitian facebook group. I appreciate this post. I love how you married Maslow and Ellyn Satter’s work. How is the model working for you almost 2 years later?
I too work with homeless, food-insecure population, most with some form of trauma history. I think that’s why especially connect with your content here. Thank you for sharing!