I knew that most dietitians were spending a lot of time helping people try to lose weight and were having very little long-term success. Oh no, I did not want to spend my days frustrated by being involved with work that had a 95% recidivism rate, even back in 1982. But like all good intentions, I soon found that it was impossible to be in private practice without getting referrals for weight loss. Whether doctors wanted me to help their patients control their cholesterol levels or blood pressure, or whether I was referred a young child with a developmental disability, the goal of weight loss or weight control seemed to always be a part of the process. This was quite a dilemma, but I had to surrender to it and counsel people with the skills I had learned in graduate school. Unfortunately, the training that was offered involved putting people on a food exchange system that was correlated with a specified number of calories based on their height, weight, and desired weight. I was taught to weigh them every week and have them keep detailed diaries of what they ate and how much they ate. I instructed them to bring these diaries into their sessions each week.
I found very quickly that my worst nightmare was being realized. Although I loved my patients, I was beginning to hate my work. I felt exhilarated when they lost weight and defeated and helpless when they couldn't keep their food diaries, or even worse, when the scale wouldn't budge or went back up. I remember a day when I was counseling a highly intelligent young woman who reported eating compulsively and not being able to stop the behavior. The feelings of helplessness that she expressed were, unfortunately, the exact same feelings that I was experiencing. I feel very embarrassed talking about those days. I'm afraid that I might have done more harm than good, but I can't blame myself; I can only blame the system I was taught to utilize.
Around this time, I started to hear some talk about the "non-diet" approach and became very curious about it. I discovered that this approach suggested letting people eat whatever they wanted to eat, without restriction! Horrors!! How could I, as a registered dietitian with a master's degree in nutrition tell people they could eat whatever they wanted? What if they only wanted cake and candy? Impossible approach, or so I thought, before I started thinking about the psychology of dieting and the psychology of external control. I realized very quickly that deprivation can only lead to over-glorifying what is not allowed, and that external control usually leads to rebellion. Maslow has said that we are driven by our unmet needs. If we're told we can't have chocolate, chocolate is all we will think and dream about. And just watch what happens in countries that are ruled by dictators--coups and rebellions become rampant! As I began to read about the eating habits of children who are offered a wide variety of food, both nutritious foods and play foods, I discovered that they seemed to develop a completely balanced approach to eating.
At this point, I felt ready to not only change my professional paradigm about weight control but to begin to put notes, chapter headings, and an outline on my computer that were the beginnings of what I hoped would become a very important book. At that time there were no published books by dietitians geared at helping people to change their relationship with food from the trappings of the diet mentality to the freedom of listening to one's body for the signals of how to eat in a satisfying way. At this same time, my co-author, Evelyn Tribole, was also in the early stages of writing a book with a psychologist. One day, Evelyn and I ran into each other in the hall in my office suite. (Although living in Irvine, CA, Evelyn saw patients one day a week in my offices in Beverly Hills.) I took one look at Evelyn that day and knew immediately that something was wrong. After asking her "what's up", she told me about her frustrations in working with her current co-author, as she felt that this woman's writing skills were not up to par. When Evelyn said that she was going to end the endeavor and look for someone with whom to write, I immediately got excited and said, "let's write this book together". And, thus, the roots of Intuitive Eating were planted! And what a glorious and gratifying adventure this has been.
ADDENDUM: In the years since Intuitive Eating was first written, my thinking about “weight control” has dramatically evolved. I have come to believe in the deepest part of my being that any focus on weight loss perpetuates the weight stigmatization that is rampant in our culture. I believe that we are all given a blueprint for every aspect of our beings, including our weight. Any attempt to alter that blueprint can only lead to misery, shame, and destructive behaviors. I am a strong proponent of HAES (Health at Every Size) http://www.haescommunity.org, which “acknowledges that good health can best be realized independent from considerations of size”.
HOW I DISCOVERED INTUITIVE EATING
In my training to become a registered dietitian I was offered a traineeship at a clinic affiliated with Children's Hospital in Los Angeles. This clinic offered a multi-disciplinary approach to treating children with developmental disabilities. In this program, I had the opportunity to work with many different professionals, including psychiatrists, psychologists, social workers, physical therapists, occupational therapists, speech therapists, nurses, etc.
It was a wonderful experience for me, and while finishing up my training and then working at this facility part-time after I became registered as a dietitian, I decided that I would begin a private practice in nutrition counseling. I planned to work with various health problems, including developmental disabilities, but vowed that I would not deal with weight control!
©2019 Elyse Resch