Dealing with a Chronic Illness but Can't Stick with Your Therapeutic Diet?? Read this.

Happy Thursday morning! I hope your week has been a good one:)
I've had one question pop up over and over again in the past few I've made myself a cup of tea, pulled on my Glerups and I'm ready to write it out.

The question has many iterations but here's the basic formula:
I have been living and struggling with (fill in the chronic illness) for (X number) of years. I know from my (fill in health practitioner/professional) that I should be avoiding (long list of foods) but every time I try I just get pulled back into (some form of food struggle, anywhere along the spectrum of mild to debilitating). How can I manage my health without getting pulled back in to diet culture?

Here is the a long-ish, roundabout way - as if you expected anything else for me?

When working with women I often talk about a "food pyramid" - not like the one in the United States that tells you which food groups to eat but more like Maslow's Hierarchy of Needs. Do you know it? It's a theory of human psychology that describes the fact that when we are struggling to meet our most basic survival needs we aren't exactly in a place to strive for higher levels of self-actualization (ie if you don't have a roof over your head, you likely aren't in a place to meditate yourself toward enlightenment). I would liken "my" pyramid of food needs to Maslow's hierarchy of needs - as in, when you are struggling to just "get food into yourself" in a reasonable way - it's pretty much impossible to attend to loftier food goals. I think (thought) it was genius!! Women could really understand WHY they were having trouble committing to super foods and anti-inflammatory diets when they were having trouble with the most basic aspects of feeding themselves.

{Side note for those who haven't been following my work - to our body, when we are on diets on in the restriction-binge cycle associated with dieting, it feels to our body that we do not have enough food or that food security is threatened. It doesn't matter that you COULD just eat anytime...when you are not attending to your body's hunger and appetite signals in the pursuit of weight-loss - your body feels deprived}

I planned to actually sketch out the pyramid and make it a THING!!! I was pretty sure I'd rule the world with this drawing...

And then, maybe a year ago, I was skimming through Pinterest, looking for an infographic that'd articulate some concept I was trying to explain and I found THIS - from Ellyn Satter:

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And at first, I was like OMG!!! I KNEW IT! There IS a pyramid of food needs...I was soooo excited. I danced around - stopping for only a few moments of rage-y jealousy that Satter had discovered and articulated the concept first. Ha! The sulking got a wee bit worse when I dug into her explanation of the pyramid - only to discover that she ALSO likens it to Maslow's Hierarchy of needs.....I mean. COME ON!!!!

Anyway, I'm over it and it's a concept that holds true. You don't need to understand all the levels of The Hierarchy of Food Needs except to understand that when you are struggling in your relationship with food (to get "enough food" and/or reliable, ongoing access to food - because diet culture keeps us in a state of constant deprivation on one level or another) you will struggle to reach the higher levels of instrumental food (that is, using food to alter or manage your health). I see women in a revolving door - basically spinning between the levels of reliable, ongoing access to food (again, this is AS PERCEIVED by your body - it doesn't necessarily mean that you don't actually have access to food) and trying to stick with instrumental food plans. It's dizzying.

Last week on Instagram I posted this:


And some people were like, "huh?".
I was trying to articulate the pyramid theory a different way - as in - before you take on the work of worrying about, learning about, and applying the specifics of foods - you FIRST need to have a solid, healthy, relationship with food.

Without the relationship as the foundation - you'll end up in that revolving door. And it'll feel bad. And you won't be able to figure out WHY you can't stick with anything -  even if it's for your HEALTH.

When you are in a place where your body is worried about getting enough food or having reliable access to food (dieting and manipulating your food feels like this to your body), ANY kind of food avoiding (even for really good reasons) will further trigger feelings of not enough and keep you stuck at the bottom of the pyramid.

So what does that mean? Does it mean that you CAN'T attend to your health via food?
NO! Of course not, but it does mean that the biggest, best thing you could possibly prioritize when it comes to your health IS healing your relationship with food. I also work with women to find ways of using food and movement therapeutically that DOES NOT trigger feelings of deprivation - these tend to be milder strategies that I call "ADDING IN" strategies - but they still work!

Health is not 0 or 100%. It's a continuum and we can work on sliding you up the scale in smaller, more incremental ways - working toward toward your therapeutic food goals WHILE healing that relationship with food. 

But the bottom line, if you can't do the thing that's truly best for your health, it's because SOMEWHERE your brain is still living in diet mentality. You need to start there.


This can be complicated work. If you want help, I suggest checking out my 6 month 1:1 program.....we can work you OUT of diet mentality and into a therapeutic diet that WORKS for you!!!!